Science.gov

Sample records for address cancer health

  1. Designing a Community-Based Lay Health Advisor Training Curriculum to Address Cancer Health Disparities

    PubMed Central

    Gwede, Clement K.; Ashley, Atalie A.; McGinnis, Kara; Montiel-Ishino, F. Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B.; Wathington, Deanna; Dash-Pitts, Lolita; Green, B. Lee

    2012-01-01

    Introduction Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. Approach and Strategies Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic–community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Discussion and Conclusions Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research. PMID:22982709

  2. Oral Cancer in African Americans: Addressing Health Disparities

    ERIC Educational Resources Information Center

    Dodd, Virginia J.; Watson, Jennifer M.; Choi, Youjin; Tomar, Scott L.; Logan, Henrietta L.

    2008-01-01

    Objectives: To explore factors underlying African Americans' perceptions of oral cancer and the oral cancer exam. Study findings were used to guide development of oral cancer messages designed to increase oral cancer exams among African Americans. Methods: Focus groups were conducted to understand African Americans' attitudes and expectations…

  3. Addressing Environmental Health Inequalities

    PubMed Central

    Gouveia, Nelson

    2016-01-01

    Environmental health inequalities refer to health hazards disproportionately or unfairly distributed among the most vulnerable social groups, which are generally the most discriminated, poor populations and minorities affected by environmental risks. Although it has been known for a long time that health and disease are socially determined, only recently has this idea been incorporated into the conceptual and practical framework for the formulation of policies and strategies regarding health. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), “Addressing Environmental Health Inequalities—Proceedings from the ISEE Conference 2015”, we incorporate nine papers that were presented at the 27th Conference of the International Society for Environmental Epidemiology (ISEE), held in Sao Paulo, Brazil, in 2015. This small collection of articles provides a brief overview of the different aspects of this topic. Addressing environmental health inequalities is important for the transformation of our reality and for changing the actual development model towards more just, democratic, and sustainable societies driven by another form of relationship between nature, economy, science, and politics. PMID:27618906

  4. Native Women at Risk: Addressing Cancer Prevention.

    ERIC Educational Resources Information Center

    Thiemann, Kay M. B.

    1994-01-01

    Discusses outcomes of a conference that brought together representatives from Indian tribes, state health departments, the Indian Health Service, the Mayo Clinic, and the American Cancer Society, to address the high rate of cervical cancer among American Indian women. Describes barriers to health care and plans to promote cancer screening among…

  5. Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure

    PubMed Central

    Moan, Johan; Porojnicu, Alina Carmen; Dahlback, Arne; Setlow, Richard B.

    2008-01-01

    Solar radiation is the main cause of skin cancers. However, it also is a main source of vitamin D for humans. Because the optimal status of vitamin D protects against internal cancers and a number of other diseases, a controversy exists: Will increased sun exposure lead to net health benefits or risks? We calculated the relative yield of vitamin D photosynthesis as a function of latitude with a radiative transfer model and cylinder geometry for the human skin surface. The annual yield of vitamin D is 3.4 and 4.8 times larger below the equator than in the U.K. and Scandinavia, respectively. In populations with similar skin types, there are clear latitude gradients of all major forms of skin cancer, indicating a north–south gradient in real sun exposure. Surprisingly, the incidence rates of major internal cancers also increase from north to south. However, the survival prognosis also improves significantly from north to south. Reasons for these findings are discussed in view of the role of vitamin D. In Norway, melanoma rates increased by a factor of 6 from 1960 to 1990, while the prognosis improved in the same period. After 1990, melanoma rates have remained constant or even decreased in age groups <50 years, whereas the prognosis has not improved further. These data, together with those for internal cancers and the beneficial effects of an optimal vitamin D status, indicate that increased sun exposure may lead to improved cancer prognosis and, possibly, give more positive than adverse health effects. PMID:18180454

  6. Prevalence and framing of health disparities in local print news: Implications for multilevel interventions to address cancer inequalities

    PubMed Central

    Nagler, Rebekah H.; Bigman, Cabral A.; Ramanadhan, Shoba; Ramamurthi, Divya; Viswanath, K.

    2016-01-01

    Background Americans remain under-informed about cancer and other health disparities and the social determinants of health (SDH). The news media may be contributing to this knowledge deficit, whether by discussing these issues narrowly or ignoring them altogether. Because local media are particularly important in influencing public opinion and support for public policies, this study examines the prevalence and framing of disparities/SDH in local mainstream and ethnic print news. Methods We conducted a multi-method content analysis of local mainstream (English-language) and ethnic (Spanish-language) print news in two lower-income cities in New England with substantial racial/ethnic minority populations. After establishing inter-coder reliability (kappa=0.63–0.88), coders reviewed the primary English- and Spanish-language newspaper in each city, identifying both disparities and non-disparities health stories published between February 2010 and January 2011. Results Local print news coverage of cancer and other health disparities was rare. Of 650 health stories published across four newspapers during the one-year study period, only 21 (3.2%) discussed disparities/SDH. Although some stories identified causes of and solutions for disparities, these were often framed in individual (e.g., poor dietary habits) rather than social contextual terms (e.g., lack of food availability/affordability). Cancer and other health stories routinely missed opportunities to discuss disparities/SDH. Conclusion Local mainstream and ethnic media may be ideal targets for multilevel interventions designed to address cancer and other health inequalities. Impact By increasing media attention to and framing of health disparities, we may observe important downstream effects on public opinion and support for structural solutions to disparities, particularly at the local level. PMID:27196094

  7. Global epigenetic screening technologies: a novel tool to address cancer health disparities in high-risk population groups.

    PubMed

    Guerrero-Preston, Rafael

    2008-12-01

    Racial, ethnic and class disparities in cancer incidence and mortality have been well documented. Disparities in the utilization of preventive, curative and treatment services among ethnic minorities have been reported. Screening can be effective at detecting cancer at treatable stages, but a large proportion of people at risk have not been screened or are not regularly screened, as recommended by the American Cancer Society's national guidelines. Early detection technologies have the potential of both influencing mortality from cancer, as well as enhancing primary prevention through detection and removal of lesions that could potentially develop into cancer. Cancer is an epigenetic disease characterized by the breakdown of DNA methylation and histones modification patterns. Epigenetic approaches may contribute to a reduction in cancer health disparities impacting early detection and increasing cancer treatment options. Epigenetic events represent important mechanism(s) by which gene function is selectively activated or inactivated, through genetic and non-genetic manifestations. Emerging evidence indicates that various epigenetic alterations, such as global histones modifications and DNA hypomethylation, common to most types of cancer, are modified by environmental exposures throughout the life course. A simple, easily explained and easy to understand non-invasive test, such as the DNA methylation index, that may screen for several cancer sites at once, may remove some of the existing barriers to cancer screening utilization, and contribute to the reduction of cancer disparities. Epigenetic approaches may also prove to be useful in identifying environmental and lifestyle factors that contribute to the prevalence of other chronic conditions in high risk populations, such as Puerto Rican populations in the United States and Puerto Rico.

  8. Opportunities and challenges of using technology to address health disparities.

    PubMed

    Rivers, Brian M; Bernhardt, Jay M; Fleisher, Linda; Green, Bernard Lee

    2014-03-01

    During a panel presentation at the American Association for Cancer Research Cancer Health Disparities Conference titled 'Opportunities and challenges of using technology to address health disparities', the latest scientific advances in the application and utilization of mobile technology and/or mobile-health (mHealth) interventions to address cancer health disparities were discussed. The session included: an examination of overall population trends in the uptake of technology and the potential of addressing health disparities through such media; an exploration of the conceptual issues and challenges in the construction of mHealth interventions to address disparate and underserved populations; and a presentation of pilot study findings on the acceptability and feasibility of using mHealth interventions to address prostate cancer disparities among African-American men.

  9. Addressing Breast Cancer Health Disparities in the Mississippi Delta Through an Innovative Partnership for Education, Detection, and Screening.

    PubMed

    Mayfield-Johnson, Susan; Fastring, Danielle; Fortune, Melody; White-Johnson, Freddie

    2016-06-01

    Projects to reduce disparities in cancer treatment and research include collaborative partnerships and multiple strategies to promote community awareness, education, and engagement. This is especially needed in underserved areas such as the Mississippi Delta where more women are diagnosed at regional and distant stages of breast cancer. The purpose for this project was to increase the relatively low screening rate for African American women in the Mississippi Delta through a partnership between the Mississippi Network for Cancer Control and Prevention at The University of Southern Mississippi, The Fannie Lou Hamer Cancer Foundation and the Mississippi State Department of Health to decrease health disparities in breast cancer through increased awareness on self-early detection methods, leveraging resources to provide mammography screenings, and adequate follow-up with services and treatment for abnormal findings. Through this collaborative effort, over 500 women in three rural Mississippi Delta counties were identified, provided community education on early self-detection, and given appointments for mammography screenings within one fiscal year.

  10. Addressing Breast Cancer's Unequal Burden

    MedlinePlus

    ... be useful for all women. How will the study work? The initiative will gather data from 18 smaller studies. While some of these studies were able to ... future cancer research among minority populations. Dr. Martin's work seeks to ... women in breast cancer studies? Historically, trust has been a key issue in ...

  11. Photonovels: an innovative approach to address health disparities and sustainability.

    PubMed

    McGinnis, Kara; Montiel-Ishino, F Alejandro; Standifer, Maisha Kambon; Wathington, Deanna; Goldsmith, Johnetta; Baldwin, Julie A

    2014-09-01

    Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a University of South Florida/H. Lee Moffitt Cancer Center & Research Institute partnership, our group created a photonovel, an educational tool which explains topics using a graphic novel style. The photonovel was designed to educate community members about prostate cancer and was compared to standard cancer educational materials currently used for cancer outreach. We found that our photonovel served as an effective health education tool to address cancer health disparities in medically underserved and underrepresented populations in Tampa Bay.

  12. Addressing health literacy in patient decision aids

    PubMed Central

    2013-01-01

    Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations. Methods We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Results Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies

  13. Creating a cadre of junior investigators to address the challenges of cancer-related health disparities: lessons learned from the community networks program.

    PubMed

    Felder, Tisha M; Brandt, Heather M; Armstead, Cheryl A; Cavicchia, Philip P; Braun, Kathryn L; Adams, Swann A; Friedman, Daniela B; Tanjasiri, Sora; Steck, Susan E; Smith, Emily R; Daguisé, Virginie G; Hébert, James R

    2012-06-01

    Community-based participatory research (CBPR) initiatives such as the National Cancer Institute's Community Networks Program (CNP) (2005-2010) often emphasize training of junior investigators from underrepresented backgrounds to address health disparities. From July to October 2010, a convenience sample of 80 participants from the 25 CNP national sites completed our 45-item, web-based survey on the training and mentoring of junior investigators. This study assessed the academic productivity and CBPR-related experiences of the CNP junior investigators (n=37). Those from underrepresented backgrounds reported giving more presentations in non-academic settings (nine vs. four in the last 5 years, p=0.01), having more co-authored publications (eight vs. three in the last 5 years, p=0.01), and spending more time on CBPR-related activities than their non-underrepresented counterparts. Regardless of background, junior investigators shared similar levels of satisfaction with their mentors and CBPR experiences. This study provides support for the success of the CNP's training program, especially effort directed at underrepresented investigators.

  14. Creating a Cadre of Junior Investigators to Address the Challenges of Cancer-Related Health Disparities: Lessons Learned from the Community Networks Program

    PubMed Central

    Felder, Tisha M.; Brandt, Heather M.; Armstead, Cheryl; Cavicchia, Philip P.; Braun, Kathryn L.; Adams, Swann A.; Friedman, Daniela B.; Tanjasiri, Sora; Steck, Susan E.; Smith, Emily R.; Daguisé, Virginie G.; Hébert, James R.

    2012-01-01

    Community-based participatory research (CBPR) initiatives such as the National Cancer Institute’s Community Networks Program (CNP) (2005–2010) often emphasize training of junior investigators from underrepresented backgrounds to address health disparities. From July to October 2010, a convenience sample of 80 participants from the 25 CNP national sites completed our 45-item, web-based survey on the training and mentoring of junior investigators. This study assessed the academic productivity and CBPR-related experiences of the CNP junior investigators (n=37). Those from underrepresented backgrounds reported giving more presentations in non-academic settings (9 vs. 4 in last 5 years, p=0.01), having more co-authored publications (8 vs. 3 in last 5 years, p=0.01), and spending more time on CBPR-related activities than their non-underrepresented counterparts. Regardless of background, junior investigators shared similar levels of satisfaction with their mentors and CBPR experiences. This study provides support for the success of the CNP’s training program, especially effort directed at underrepresented investigators. PMID:22528636

  15. Addressing Asthma Health Disparities: A Multilevel Challenge

    PubMed Central

    Canino, Glorisa; McQuaid, Elizabeth L.; Rand, Cynthia S.

    2009-01-01

    Substantial research has documented pervasive disparities in the prevalence, severity, and morbidity of asthma among minority populations compared to non-Latino whites. The underlying causes of these disparities are not well understood, and as a result, the leverage points to address them remain unclear. A multilevel framework for integrating research in asthma health disparities is proposed in order to advance both future research and clinical practice. The components of the proposed model include health care policies and regulations, operation of the health care system, provider/clinician-level factors, social/environmental factors, and individual/family attitudes and behaviors. The body of research suggests that asthma disparities have multiple, complex and inter-related sources. Disparities occur when individual, environmental, health system, and provider factors interact with one another over time. Given that the causes of asthma disparities are complex and multilevel, clinical strategies to address these disparities must therefore be comparably multilevel and target many aspects of asthma care. Clinical Implications: Several strategies that could be applied in clinical settings to reduce asthma disparities are described including the need for routine assessment of the patient’s beliefs, financial barriers to disease management, and health literacy, and the provision of cultural competence training and communication skills to health care provider groups. PMID:19447484

  16. Aboriginal health promotion through addressing employment discrimination.

    PubMed

    Ferdinand, Angeline S; Paradies, Yin; Perry, Ryan; Kelaher, Margaret

    2014-01-01

    The Localities Embracing and Accepting Diversity (LEAD) program aimed to improve the mental health of Aboriginal Victorians by addressing racial discrimination and facilitating social and economic participation. As part of LEAD, Whittlesea Council adopted the Aboriginal Employment Pathways Strategy (AEPS) to increase Aboriginal employment and retention within the organisation. The Aboriginal Cultural Awareness Training Program was developed to build internal cultural competency and skills in recruiting and retaining Aboriginal staff. Analysis of surveys conducted before (pre; n=124) and after (post; n=107) the training program indicated a significant increase in participant understanding across all program objectives and in support of organisational policies to improve Aboriginal recruitment and retention. Participants ended the training with concrete ideas about intended changes, as well as how these changes could be supported by their supervisors and the wider organisation. Significant resources have since been allocated to implementing the AEPS over 5 years. In line with principles underpinning the National Aboriginal and Torres Strait Islander Health Plan 2013-23, particularly the focus on addressing racism as a determinant of health, this paper explores the AEPS and training program as promising approaches to health promotion through addressing barriers to Aboriginal employment. Possible implications for other large organisations are also considered.

  17. Addressing Risks to Advance Mental Health Research

    PubMed Central

    Iltis, Ana S.; Misra, Sahana; Dunn, Laura B.; Brown, Gregory K.; Campbell, Amy; Earll, Sarah A.; Glowinski, Anne; Hadley, Whitney B.; Pies, Ronald; DuBois, James M.

    2015-01-01

    Objective Risk communication and management are essential to the ethical conduct of research, yet addressing risks may be time consuming for investigators and institutional review boards (IRBs) may reject study designs that appear too risky. This can discourage needed research, particularly in higher risk protocols or those enrolling potentially vulnerable individuals, such as those with some level of suicidality. Improved mechanisms for addressing research risks may facilitate much needed psychiatric research. This article provides mental health researchers with practical approaches to: 1) identify and define various intrinsic research risks; 2) communicate these risks to others (e.g., potential participants, regulatory bodies, society); 3) manage these risks during the course of a study; and 4) justify the risks. Methods As part of a National Institute of Mental Health (NIMH)-funded scientific meeting series, a public conference and a closed-session expert panel meeting were held on managing and disclosing risks in mental health clinical trials. The expert panel reviewed the literature with a focus on empirical studies and developed recommendations for best practices and further research on managing and disclosing risks in mental health clinical trials. IRB review was not required because there were no human subjects. The NIMH played no role in developing or reviewing the manuscript. Results Challenges, current data, practical strategies, and topics for future research are addressed for each of four key areas pertaining to management and disclosure of risks in clinical trials: identifying and defining risks, communicating risks, managing risks during studies, and justifying research risks. Conclusions Empirical data on risk communication, managing risks, and the benefits of research can support the ethical conduct of mental health research and may help investigators better conceptualize and confront risks and to gain IRB approval. PMID:24173618

  18. Addressing health disparities: Brown University School of Public Health.

    PubMed

    Wetle, Terrie Fox; Scanlan, Karen

    2014-09-02

    Health disparities are a public health concern in Rhode Island and around the world. Faculty members and students in the Brown University School of Public Health are working to understand, address, and ultimately eliminate disparities in health and health care affecting diverse populations. Our educational offerings and research efforts are directed toward understanding and addressing the social, cultural, and environmental factors that contribute to these health disparities. Research methods to carry out this work include implementing interdisciplinary, community-based, quantitative and qualitative research with the goal of preventing, reducing, and eliminating health disparities. This article focuses on some of the School's work with vulnerable communities confronting issues around the following: HIV/AIDS, obesity, nutrition, physical activity and delivery of health services.

  19. Strengthening health information systems to address health equity challenges.

    PubMed Central

    Nolen, Lexi Bambas; Braveman, Paula; Dachs, J. Norberto W.; Delgado, Iris; Gakidou, Emmanuela; Moser, Kath; Rolfe, Liz; Vega, Jeanette; Zarowsky, Christina

    2005-01-01

    Special studies and isolated initiatives over the past several decades in low-, middle- and high-income countries have consistently shown inequalities in health among socioeconomic groups and by gender, race or ethnicity, geographical area and other measures associated with social advantage. Significant health inequalities linked to social (dis)advantage rather than to inherent biological differences are generally considered unfair or inequitable. Such health inequities are the main object of health development efforts, including global targets such as the Millennium Development Goals, which require monitoring to evaluate progress. However, most national health information systems (HIS) lack key information needed to assess and address health inequities, namely, reliable, longitudinal and representative data linking measures of health with measures of social status or advantage at the individual or small-area level. Without empirical documentation and monitoring of such inequities, as well as country-level capacity to use this information for effective planning and monitoring of progress in response to interventions, movement towards equity is unlikely to occur. This paper reviews core information requirements and potential databases and proposes short-term and longer term strategies for strengthening the capabilities of HIS for the analysis of health equity and discusses HIS-related entry points for supporting a culture of equity-oriented decision-making and policy development. PMID:16184279

  20. Addressing Health Care Disparities Among Sexual Minorities.

    PubMed

    Baptiste-Roberts, Kesha; Oranuba, Ebele; Werts, Niya; Edwards, Lorece V

    2017-03-01

    There is evidence of health disparities between sexual minority and heterosexual populations. Although the focus of lesbian, gay, bisexual, and transgender health research has been human immunodeficiency virus/acquired immunodeficiency syndrome and sexually transmitted infection among men who have sex with men, there are health disparities among sexual minority women. Using the minority stress framework, these disparities may in part be caused by individual prejudice, social stigma, and discrimination. To ensure equitable health for all, there is urgent need for targeted culturally sensitive health promotion, cultural sensitivity training for health care providers, and intervention-focused research.

  1. Strategies for addressing global environmental health concerns.

    PubMed

    Suk, William A; Davis, E Ann

    2008-10-01

    While each region of the world faces unique public health challenges, environmental threats to vulnerable populations in Asia constitute a significant global public health challenge. Environmental threats to health are widespread and are increasing as nations in the region undergo rapid industrial development. One of the major predictors of ill health is poverty. Regional poverty puts large populations at risk for ill health, which exacerbates poverty and increases the exposure risk to environmental factors, such as pollution and disease. Patterns of illness have changed dramatically in the last century, and will continue to change in this century. Chemical toxicants in the environment, poverty, and little or no access to health care are all factors contributing to life-threatening diseases. Therefore, it is vital that we develop a better understanding of the mechanisms and interactions between nutrition, infectious disease, environmental exposures, and genetic predisposition in order to develop better prevention methods.

  2. Addressing the social determinants of children's health: a cliff analogy.

    PubMed

    Jones, Camara Phyllis; Jones, Clara Yvonne; Perry, Geraldine S; Barclay, Gillian; Jones, Camille Arnel

    2009-01-01

    This paper presents a "Cliff Analogy" illustrating three dimensions of health intervention to help people who are falling off of the cliff of good health: providing health services, addressing the social determinants of health, and addressing the social determinants of equity. In the terms of the analogy, health services include an ambulance at the bottom of the cliff, a net or trampoline halfway down, and a fence at the top of the cliff. Addressing the social determinants of health involves the deliberate movement of the population away from the edge of the cliff. Addressing the social determinants of equity acknowledges that the cliff is three-dimensional and involves interventions on the structures, policies, practices, norms, and values that differentially distribute resources and risks along the cliff face. The authors affirm that we need to address both the social determinants of health, including poverty, and the social determinants of equity, including racism, if we are to improve health outcomes and eliminate health disparities.

  3. Sustaining CBPR partnerships to address health disparities in times of economic instability.

    PubMed

    Weiss, Elisa S; Stevenson, Alexis J; Erb-Downward, Jennifer; Combs, Sarah; Sabino, Eilleen E; Michel, Tamara A; Kemeny, M Margaret; Ackley-Kazdal, Tameron; O'Connor, Maureen; Rapkin, Bruce

    2012-11-01

    In unstable economic environments, CBPR partnerships in underserved communities may face unanticipated obstacles that threaten success and sustainability. This report describes challenges experienced by HealthLink, a CBPR partnership to address cancer disparities in Queens, N.Y., and how HealthLink adapted. Recommendations for designing CBPR partnerships to overcome unexpected challenges are provided.

  4. MO-FG-BRB-03: Addressing the Cancer Challenge: International Cancer Experts Corps

    SciTech Connect

    Coleman, N.

    2015-06-15

    The global burden of cancer is growing rapidly with an estimated 15 million new cases per year worldwide in 2015, growing to 19 million by 2025 and 24 million by 2035. The largest component of this growth will occur in low-to-middle income countries (LMICs). About half of these cases will require radiation treatment. The gap for available cancer treatment, including radiation therapy, between high-income countries (HICs) and LMICs is enormous. Accurate data and quantitative models to project the needs and the benefits of cancer treatment are a critical first step in closing the large cancer divide between LMICs and HICs. In this context, the Union for International Cancer Control (UICC) has developed a Global Task Force on Radiotherapy for Cancer Control (GTFRCC) with a charge to answer the question as to what it will take to close the gap between what exists today and reasonable access to radiation therapy globally by 2035 and what the potential clinical and economic benefits are for doing this. The Task Force has determined the projections of cancer incidence and the infrastructure required to provide access to radiation therapy globally. Furthermore it has shown that appropriate investment not only yields improved clinical outcomes for millions of patients but that it also provides an overall economic gain throughout all the income settings where this investment is made. This symposium will summarize the facets associated with this global cancer challenge by reviewing the cancer burden, looking at the requirements for radiation therapy, reviewing the benefits of providing such therapy both from a clinical and economic perspective and finally by looking at what approaches can be used to aid in the alleviation of this global cancer challenge. The speakers are world renowned experts in global public health issues (R. Atun), medical physics (D. Jaffray) and radiation oncology (N. Coleman). Learning Objectives: To describe the global cancer challenge and the

  5. NIH Research Addresses Aging Issues and Disparities in Oral Health

    MedlinePlus

    ... please turn JavaScript on. Feature: Oral Health and Aging NIH Research Addresses Aging Issues and Disparities in Oral Health Past Issues / ... What types of research is NIDCR conducting on aging and oral health? We’re currently funding basic ...

  6. Addressing Cancer Disparities Among American Indian and Alaska Native Populations

    Cancer.gov

    Cancer disparities and health equity research is a critical part of NCI’s research portfolio. The three researchers featured in this video receive funding from NCI to conduct research among American Indian and Alaska Native populations.

  7. Physical and Mental Health Among Cancer Survivors

    PubMed Central

    Naughton, Michelle J.; Weaver, Kathryn E.

    2015-01-01

    The physical and mental health of cancer patients needs to be addressed not only during active treatment but also throughout the continuum of survivorship care. This commentary provides an overview of issues pertinent to cancer survivors, with an emphasis on mental health issues and recommendations for annual clinical screening and monitoring using recently published guidelines from the American Society of Clinical Oncology. PMID:25046097

  8. Addressing future challenges for cancer services: part II.

    PubMed

    Maher, Jane; Radford, Gina

    2016-02-01

    Jane Maher & Gina Radford speak to Gemma Westcott, Commissioning Editor Jane Maher has been Macmillan's Chief Medical Officer since 1999 and now shares the role as Joint Chief Medical Officer with general practitioner Rosie Loftus, reflecting the growing need for specialists and generalists to work more effectively together. She has been an National Health Service (NHS) improvement clinical leader for over 10 years and is a Consultant Clinical Oncologist at Mount Vernon Cancer Centre and Hillingdon Hospital where she has worked for more than 20 years, during which she helped develop nonsurgical oncology services in five district general hospitals. She is a senior Clinical Lecturer at University College London and Visiting Professor in Cancer and Supportive Care at the Centre for Complexity Management at the University of Hertfordshire. Jane chaired the Maher Committee for the Department of Health in 1995, led the UK National Audit of Late Effects Pelvic Radiotherapy for the Royal College of Radiologists (RCR) in 2000 and, most recently, chaired the National Cancer Survivorship Initiative Consequences of Treatment work stream. She co-founded one of the first Cancer Support and Information services in the UK, winning the Nye Bevan award in 1992 and there are now more than 60 units based on this model. She is a member of the Older People and Cancer Clinical Advisory Group. She has written more than 100 published articles and is a UK representative for cancer survivorship in Europe and advises on cancer survivorship programs in Denmark and Canada. Gina Radford is Deputy Chief Medical Officer for England, a post she took up in January 2015. Prior to that, she has held a number of roles in public health, at local and regional level. Most recently she was Centre Director for Anglia and Essex for Public Health England, and as a part of that role helped lead nationally on the public health response to Ebola. She was until very recently Chair of one of the NICE public health

  9. The American Cancer Society's Approach to Addressing the Cancer Burden in the LGBT Community.

    PubMed

    Wender, Richard; Sharpe, Katherine B; Westmaas, J Lee; Patel, Alpa V

    2015-11-05

    The American Cancer Society (ACS) has embraced the achievement of equity in cancer-related health outcomes as a foundational principle. Lesbian, gay, bisexual, and transgender (LGBT) individuals experience health disparities related to certain risk factors for cancer and in certain cancer outcomes. Accordingly, the ACS is defining a new program of work in partnership with the LGBT community to help understand and reduce disparities in cancer risk factors and outcomes. This article describes the cancer control program of the ACS including specific public health and research programs targeted at reducing cancer related health disparities for the LGBT population.

  10. Cancer Core Europe: a consortium to address the cancer care-cancer research continuum challenge.

    PubMed

    Eggermont, Alexander M M; Caldas, Carlos; Ringborg, Ulrik; Medema, René; Tabernero, Josep; Wiestler, Otmar

    2014-11-01

    European cancer research for a transformative initiative by creating a consortium of six leading excellent comprehensive cancer centres that will work together to address the cancer care-cancer research continuum. Prerequisites for joint translational and clinical research programs are very demanding. These require the creation of a virtual single 'e-hospital' and a powerful translational platform, inter-compatible clinical molecular profiling laboratories with a robust underlying computational biology pipeline, standardised functional and molecular imaging, commonly agreed Standard Operating Procedures (SOPs) for liquid and tissue biopsy procurement, storage and processing, for molecular diagnostics, 'omics', functional genetics, immune-monitoring and other assessments. Importantly also it requires a culture of data collection and data storage that provides complete longitudinal data sets to allow for: effective data sharing and common database building, and to achieve a level of completeness of data that is required for conducting outcome research, taking into account our current understanding of cancers as communities of evolving clones. Cutting edge basic research and technology development serve as an important driving force for innovative translational and clinical studies. Given the excellent track records of the six participants in these areas, Cancer Core Europe will be able to support the full spectrum of research required to address the cancer research- cancer care continuum. Cancer Core Europe also constitutes a unique environment to train the next generation of talents in innovative translational and clinical oncology.

  11. Addressing Low Literacy and Health Literacy in Clinical Oncology Practice

    PubMed Central

    Garcia, Sofia F.; Hahn, Elizabeth A.; Jacobs, Elizabeth A.

    2011-01-01

    Low functional literacy and low health literacy continue to be under-recognized and are associated with poorer patient health outcomes. Health literacy is a dynamic state influenced by how well a healthcare system delivers information and services that match patients’ abilities, needs and preferences. Oncology care poses considerable health literacy demands on patients who are expected to process high stakes information about complex multidisciplinary treatment over lengths of time. Much of the information provided to patients in clinical care and research is beyond their literacy levels. In this paper, we provide an overview of currently available guidelines and resources to improve how the needs of patients with diverse literacy skills are met by cancer care providers and clinics. We present recommendations for health literacy assessment in clinical practice and ways to enhance the usability of health information and services by improving written materials and verbal communication, incorporating multimedia and culturally appropriate approaches, and promoting health literacy in cancer care settings. The paper also includes a list of additional resources that can be used to develop and implement health literacy initiatives in cancer care clinics. PMID:20464884

  12. Addressing psychosocial issues in cancer survivorship: past, present and future.

    PubMed

    Walsh, Katherine

    2016-12-01

    With a burgeoning population of cancer survivors, organizations in the USA and around the world are considering how to address the many long-term and late psychosocial effects of cancer and cancer treatment. This article reviews the changing landscape of survivorship care over the past 50 years, from the time when there were relatively few survivors to the future, when the number of cancer survivors in the USA alone is expected to reach close to 20 million. Institute of Medicine Reports, intra-organizational summits and accrediting standards that have influenced the development of survivorship care plans and programs and the roles of the Internet and smartphone applications along with oncology specialist and primary care providers are discussed.

  13. Designing Technology to Address Parent Uncertainty in Childhood Cancer.

    PubMed

    Morrison, Caroline F; Szulczewski, Lauren; Strahlendorf, Laura F; Lane, J Blake; Mullins, Larry L; Pai, Ahna L H

    2016-01-01

    The stress and uncertainty created by a child's cancer diagnosis and treatment can affect parent and child functioning. Health technology provides a potential avenue for intervention delivery. Interviews were conducted with parents of children diagnosed with cancer to discover their needs following diagnosis and design a relevant mobile application. Treatment experience was the overarching theme. Subthemes included the emotional response, use of information, and environmental factors. Technology was used primarily to seek out information and communicate with others. Health technologies are gaining popularity and have the potential to be beneficial for patients and families throughout the treatment experience.

  14. Challenges to using a business case for addressing health disparities.

    PubMed

    Lurie, Nicole; Somers, Stephen A; Fremont, Allen; Angeles, January; Murphy, Erin K; Hamblin, Allison

    2008-01-01

    The authors consider the challenges to quantifying both the business case and the social case for addressing disparities, which is central to achieving equity in the U.S. health care system. They describe the practical and methodological challenges faced by health plans exploring the business and social cases for undertaking disparity-reducing interventions. Despite these challenges, sound business and quality improvement principles can guide health care organizations seeking to reduce disparities. Place-based interventions may help focus resources and engage health care and community partners who can share in the costs of-and gains from-such efforts.

  15. Increasing the capacity of health sciences to address health disparities.

    PubMed

    Daley, Sandra P; Broyles, Shelia L; Rivera, Lourdes M; Reznik, Vivian M

    2009-09-01

    In order to create a cohort of investigators who are engaged in health disparities research, scholarship, and practice, and to increase the amount of funding in the university that is invested in research focused on reducing health disparities, the San Diego EXPORT Center implemented 2 major initiatives: (1) the support of underrepresented minority (URM) junior faculty development and (2) the funding for pilot research grants in health disparities. This paper describes the activities employed by the center and summarizes the outcomes of these two initiatives. Ninety-five percent (18 of 19) URM junior faculty completed the faculty development program, and 83.3% (15 of 18) of the completers are advancing in their academic careers at University of California San Diego (UCSD) and are teaching, working with populations at risk and/or conducting research in health disparities. EXPORT awarded 7 investigators a total of $429186 to conduct pilot research, and 71.4% (5/7) have now obtained $4.7 million in independent extramural funding. The San Diego EXPORT Center has increased the research capacity, strengthened the infrastructure for health disparities research, and created a cohort of successful URM junior faculty who are advancing in their academic careers. These investigators are already changing the climate at UCSD by their leadership activities, research focus, peer-networking, and mentoring of students.

  16. Redesigning Health Care Practices to Address Childhood Poverty.

    PubMed

    Fierman, Arthur H; Beck, Andrew F; Chung, Esther K; Tschudy, Megan M; Coker, Tumaini R; Mistry, Kamila B; Siegel, Benjamin; Chamberlain, Lisa J; Conroy, Kathleen; Federico, Steven G; Flanagan, Patricia J; Garg, Arvin; Gitterman, Benjamin A; Grace, Aimee M; Gross, Rachel S; Hole, Michael K; Klass, Perri; Kraft, Colleen; Kuo, Alice; Lewis, Gena; Lobach, Katherine S; Long, Dayna; Ma, Christine T; Messito, Mary; Navsaria, Dipesh; Northrip, Kimberley R; Osman, Cynthia; Sadof, Matthew D; Schickedanz, Adam B; Cox, Joanne

    2016-04-01

    Child poverty in the United States is widespread and has serious negative effects on the health and well-being of children throughout their life course. Child health providers are considering ways to redesign their practices in order to mitigate the negative effects of poverty on children and support the efforts of families to lift themselves out of poverty. To do so, practices need to adopt effective methods to identify poverty-related social determinants of health and provide effective interventions to address them. Identification of needs can be accomplished with a variety of established screening tools. Interventions may include resource directories, best maintained in collaboration with local/regional public health, community, and/or professional organizations; programs embedded in the practice (eg, Reach Out and Read, Healthy Steps for Young Children, Medical-Legal Partnership, Health Leads); and collaboration with home visiting programs. Changes to health care financing are needed to support the delivery of these enhanced services, and active advocacy by child health providers continues to be important in effecting change. We highlight the ongoing work of the Health Care Delivery Subcommittee of the Academic Pediatric Association Task Force on Child Poverty in defining the ways in which child health care practice can be adapted to improve the approach to addressing child poverty.

  17. Addressing the Mental Health Needs of Pregnant and Parenting Adolescents

    PubMed Central

    Beers, Lee; Southammakosane, Cathy; Lewin, Amy

    2014-01-01

    Adolescent parenthood is associated with a range of adverse outcomes for young mothers, including mental health problems such as depression, substance abuse, and posttraumatic stress disorder. Teen mothers are also more likely to be impoverished and reside in communities and families that are socially and economically disadvantaged. These circumstances can adversely affect maternal mental health, parenting, and behavior outcomes for their children. In this report, we provide an overview of the mental health challenges associated with teen parenthood, barriers that often prevent teen mothers from seeking mental health services, and interventions for this vulnerable population that can be integrated into primary care services. Pediatricians in the primary care setting are in a unique position to address the mental health needs of adolescent parents because teens often turn to them first for assistance with emotional and behavioral concerns. Consequently, pediatricians can play a pivotal role in facilitating and encouraging teen parents’ engagement in mental health treatment. PMID:24298010

  18. 75 FR 51831 - Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-23

    ...] [FR Doc No: 2010-20679] DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs... or items that measure how well health plans and health providers address health plan...

  19. Using Cost-Effectiveness Analysis to Address Health Equity Concerns.

    PubMed

    Cookson, Richard; Mirelman, Andrew J; Griffin, Susan; Asaria, Miqdad; Dawkins, Bryony; Norheim, Ole Frithjof; Verguet, Stéphane; J Culyer, Anthony

    2017-02-01

    This articles serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. We first introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who gains and who loses from a cost-increasing health program depends on differences among people in terms of health risks, uptake, quality, adherence, capacity to benefit, and-crucially-who bears the opportunity costs of diverting scarce resources from other uses. We describe two main ways of using CEA to address health equity concerns: 1) equity impact analysis, which quantifies the distribution of costs and effects by equity-relevant variables, such as socioeconomic status, location, ethnicity, sex, and severity of illness; and 2) equity trade-off analysis, which quantifies trade-offs between improving total health and other equity objectives. One way to analyze equity trade-offs is to count the cost of fairer but less cost-effective options in terms of health forgone. Another method is to explore how much concern for equity is required to choose fairer but less cost-effective options using equity weights or parameters. We hope this article will help the health technology assessment community navigate the practical options now available for conducting equity-informative CEA that gives policymakers a better understanding of equity impacts and trade-offs.

  20. Defining Health Across the Cancer Continuum

    PubMed Central

    Wallace, Audrey S; Everett, Ashlyn S; Dover, Laura; McDonald, Andrew; Kropp, Lauren

    2017-01-01

    Health is not defined by the absence of disease or suffering, but by response to a series of life events that can markedly alter the quality and quantity of life. Patients with cancer experience significant but dynamic physical, psychosocial, and financial challenges. With the increasing number of patients with early stage cancers transitioning to survivorship, there is a critical need to address health promotion and overall well-being. For those with advanced cancer, discussion about prognosis and early integration of palliative care can have a profound impact on the quality of life. Effective communication between healthcare providers and patients is important in aligning treatment recommendations with patient goals and preferences throughout cancer therapy. This review provides a dynamic definition of health and proposes actionable guidelines for health promotion at any point along the cancer continuum: survivorship after early cancer or when goals of care transition to improve quality at the end of life. PMID:28357161

  1. Promoting health by addressing living conditions in Norwegian municipalities.

    PubMed

    Hagen, Susanne; Torp, Steffen; Helgesen, Marit; Fosse, Elisabeth

    2016-07-10

    Worldwide, inequalities in health are increasing, even in well-developed welfare states such as Norway, which in 2012, saw a new public health act take effect that enshrined equity in health as national policy and devolved to municipalities' responsibility to act on the social determinants of health. The act deems governance structures and "Health in All Policies" approaches as important steering mechanisms for local health promotion. The aim of this study is to investigate whether Norway's municipalities address living conditions - economic circumstances, housing, employment and educational factors - in local health promotion, and what factors are associated with doing so. All Norway's municipalities (n= 428) were included in this cross-sectional study, and both register and survey data were used and were subjected to descriptive and bi- and multivariate regression analyses. Eighty-two percent of the municipalities reported that they were capable of reducing inequalities in health. Forty percent of the municipalities defined living conditions as a main challenge in their local public health promotion, while 48% cited it as a main health promotion priority. Our study shows that defining living conditions as a main challenge is positively associated with size of municipality, and also its assessment of its own capability in reducing inequalities in health. The latter factor was also associated with actually prioritizing living conditions in health promotion, as was having established cross-sectorial working groups or inter-municipal collaboration related to local health promotion. This study underlines the importance of inter-sectoral collaboration to promote health and well-being.

  2. Interventions addressing health inequalities in European regions: the AIR project.

    PubMed

    Salmi, Louis-Rachid; Barsanti, Sara; Bourgueil, Yann; Daponte, Antonio; Piznal, Ewelina; Ménival, Solange

    2015-10-26

    Disparities in health between social groups have been documented all over Europe. We summarize the methods and results of the Addressing Inequalities in Regions (AIR) project, which identified illustrative interventions and policies developed in European regions to reduce inequalities at the primary health care level. The first phase was a systematic review of the published literature. The second phase was a survey of European regions, collecting information on policies aiming at reducing health inequalities through primary health care and identifying regional, innovative and evaluated interventions. The third phase assessed interventions through methods defined by a formal consensus, and selected illustrative practices considered good practices for several of nine evaluation criteria. The review included 98 evaluations of interventions and 10 reviews; 80% of interventions were from North-America. Three main pathways to reduce health inequalities were identified: providing health promotion, improving financial access to care and modifying care provision. The first survey identified 90 interventions. Most national strategies included health inequalities issues. Education was the most frequently identified targeted determinant. Most interventions were health promotion general or targeted at specific health determinants, conditions or groups. The second survey assessed 46 interventions. Many involved the population in planning, implementation and evaluation. We also identified the multidisciplinary of interventions, and some who had an impact on empowerment of the targeted population. The AIR project documented that policies and actions can be implemented at the regional level through primary care providers. Policies and interventions are seldom evaluated.

  3. Visible and Invisible Trends in Black Men's Health: Pitfalls and Promises for Addressing Racial, Ethnic, and Gender Inequities in Health.

    PubMed

    Gilbert, Keon L; Ray, Rashawn; Siddiqi, Arjumand; Shetty, Shivan; Baker, Elizabeth A; Elder, Keith; Griffith, Derek M

    2016-01-01

    Over the past two decades, there has been growing interest in improving black men's health and the health disparities affecting them. Yet, the health of black men consistently ranks lowest across nearly all groups in the United States. Evidence on the health and social causes of morbidity and mortality among black men has been narrowly concentrated on public health problems (e.g., violence, prostate cancer, and HIV/AIDS) and determinants of health (e.g., education and male gender socialization). This limited focus omits age-specific leading causes of death and other social determinants of health, such as discrimination, segregation, access to health care, employment, and income. This review discusses the leading causes of death for black men and the associated risk factors, as well as identifies gaps in the literature and presents a racialized and gendered framework to guide efforts to address the persistent inequities in health affecting black men.

  4. Addressing the future burden of cancer and its impact on the oncology workforce: where is cancer prevention and control?

    PubMed

    Chang, Shine; Cameron, Carrie

    2012-05-01

    The need for cancer professionals has never been more urgent than it is today. Reports project serious shortages by 2020 of oncology health care providers. Although many plans have been proposed, no role for prevention has been described. In response, a 2-day symposium was held in 2009 at The University of Texas MD Anderson Cancer Center to capture the current status of the cancer prevention workforce and begin to identify gaps in the workforce. Five working groups were organized around the following topic areas: (a) health policy and advocacy; (b) translation to the community; (c) integrating cancer prevention into clinical practice; (d) health services infrastructure and economics; and (e) discovery, research, and technology. Along with specific recommendations on these topics, the working groups identified two additional major themes: the difficulty of defining areas within the field (including barriers to communication) and lack of sufficient funding. These interdependent issues synergistically impede progress in preventing cancer; they are explored in detail in this synthesis, and recommendations for actions to address them are presented. Progress in cancer prevention should be a major national and international goal. To achieve this goal, ensuring the health of the workforce in cancer prevention and control is imperative.

  5. The Mini Report: a Practical Tool to Address Lung Cancer Disparities in Rural Communities.

    PubMed

    Mueller-Luckey, Georgia S; Zahnd, Whitney E; Garner, Kyle; Heitkamp, Ruth; Jenkins, Wiley D; Boehler, Michael D; Steward, David E

    2015-10-06

    Community-based participatory research (CBPR) is an effective way to address cancer disparities in medically underserved populations. Our research demonstrates how CBPR principles were used to develop lung cancer and risk factor mini reports for a network of community coalitions in the Illinois Delta Region, a predominately rural region with high lung cancer disparities in southern Illinois. An academic-community partnership, including a community-based medical school, state public health department, and a healthcare system, used CBPR principles to translate epidemiological, behavioral, and demographic data into understandable, comprehensive, yet concise mini reports for each coalition. A cyclical and iterative process was used to draft, revise, and optimize these mini reports to raise awareness about lung cancer disparities in the community and to provide information to help guide the development of interventions that address these disparities. The use of CBPR principles was a successful way to create mini reports about local lung cancer disparities and risk factors that were usable in individual communities. Local coalitions used the mini reports to educate community members at local meetings, to guide strategic planning, and to disseminate information through their respective websites. Additionally, the process of creating these reports built trust among academic-community partners and provided additional avenues of engagement, such as the involvement of an academic partner in the strategic planning process of a local coalition. Using CBPR processes is an effective way to translate epidemiological data into a community-friendly format to address cancer disparities.

  6. Adaptation of a Counseling Intervention to Address Multiple Cancer Risk Factors among Overweight/Obese Latino Smokers

    ERIC Educational Resources Information Center

    Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Hernandez Robles, Eden; Heredia, Natalia; Spears, Claire A.; Correa-Fernández, Virmarie; Eakin, Elizabeth; Resnicow, Ken; Basen-Engquist, Karen; Wetter, David W.

    2015-01-01

    More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social…

  7. Health Literacy and Urbanicity Among Cancer Patients

    PubMed Central

    Halverson, Julie; Martinez-Donate, Ana; Trentham-Dietz, Amy; Walsh, Matthew C.; Strickland, Jeanne Schaaf; Palta, Mari; Smith, Paul D.; Cleary, James

    2014-01-01

    Purpose Low health literacy is associated with inadequate health care utilization and poor health outcomes, particularly among elderly persons. There is a dearth of research exploring the relationship between health literacy and place of residence (urbanicity). This study examined the association between urbanicity and health literacy, as well as factors related to low health literacy, among cancer patients. Methods A cross-sectional survey was conducted with a population-based sample of 1,841 cancer patients in Wisconsin. Data on sociodemographics, urbanicity, clinical characteristics, insurance status, and health literacy were obtained from the state’s cancer registry and participants’ answers to a mailed questionnaire. Partially and fully adjusted multivariate logistic regression models were fitted to examine: 1) the association between urbanicity and health literacy, and 2) the role of socioeconomic status as a possible mediator of this relationship. Findings Rural cancer patients had a 33% (95% CI: 1.06–1.67) higher odds of having lower levels of health literacy than their counterparts in more urbanized areas of Wisconsin. The association between urbanicity and health literacy attenuated after controlling for socioeconomic status. Conclusions Level of urbanicity was significantly related to health literacy. Socioeconomic status fully mediated the relationship between urbanicity and health literacy. These results call for policies and interventions to assess and address health literacy barriers among cancer patients in rural areas. PMID:24088213

  8. Evaluating complex community-based health promotion: addressing the challenges.

    PubMed

    Jolley, Gwyneth

    2014-08-01

    Community-based health promotion is poorly theorised and lacks an agreed evidence-base. This paper examines characteristics of community-based health promotion and the challenges they present to evaluation. A review of health promotion evaluation leads to an exploration of more recent approaches, drawing on ideas from complexity theory and developmental evaluation. A reflexive analysis of three program evaluations previously undertaken as an evaluation consultant is used to develop a conceptual model to help in the design and conduct of health promotion evaluation. The model is further explored by applying it retrospectively to one evaluation. Findings suggest that the context-contingent nature of health promotion programs; turbulence in the community context and players; multiple stakeholders, goals and strategies; and uncertainty of outcomes all contribute to the complexity of interventions. Bringing together insights from developmental evaluation and complexity theory can help to address some evaluation challenges. The proposed model emphasises recognising and responding to changing contexts and emerging outcomes, providing rapid feedback and facilitating reflexive practice. This will enable the evaluator to gain a better understanding of the influence of context and other implementation factors in a complex setting. Use of the model should contribute to building cumulative evidence and knowledge in order to identify the principles of health promotion effectiveness that may be transferable to new situations.

  9. Providing Palliative Care to Patients with Cancer: Addressing the Needs in Kenya

    PubMed Central

    Malloy, Pam; Boit, Juli; Tarus, Allison; Marete, Joyce; Ferrell, Betty; Ali, Zipporah

    2017-01-01

    Cancer is the third highest cause of death in Kenya, preceded by infectious and cardiovascular diseases, and in most cases, diagnosed in later stages. Nurses are the primary caregivers, assessing and managing these patients in the clinic, in inpatient settings, and in rural and remote communities. While cancer rates remain high, the burden to the patient, the caregiver, and society as a whole continues to rise. Kenya's poverty complicates cancer even further. Many Kenyans are unaware of cancer's signs and symptoms, and limited diagnostic and treatment centers are available. Despite these barriers, there is still hope and help for those in Kenya, who suffer from cancer. The World Health Organization has stated that palliative care is a basic human right and nurses providing this care in Kenya are making efforts to support cancer patients’ ongoing needs, in order to promote compassionate palliative care and prevent suffering. The purpose of this paper is to address the palliative care needs of patients with cancer in Kenya by providing education to nurses and influencing health-care policy and education at micro and macro levels. A case study weaved throughout will highlight these issues. PMID:28217729

  10. Trends in public health policies addressing violence against women

    PubMed Central

    Loría, Kattia Rojas; Rosado, Teresa Gutiérrez; Espinosa, Leonor María Cantera; Marrochi, Leda María Marenco; Sánchez, Anna Fernández

    2014-01-01

    OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia. PMID:25210820

  11. Addressing the Financial Consequences of Cancer: Qualitative Evaluation of a Welfare Rights Advice Service

    PubMed Central

    Moffatt, Suzanne; Noble, Emma; White, Martin

    2012-01-01

    Background The onset, treatment and trajectory of cancer is associated with financial stress among patients across a range of health and welfare systems and has been identified as a significant unmet need. Welfare rights advice can be delivered effectively in healthcare settings, has the potential to alleviate financial stress, but has not yet been evaluated. We present an evaluation of a welfare rights advice intervention designed to address the financial consequences of cancer. Methods Descriptive study of welfare outcomes among 533 male and 641 female cancer patients and carers aged 4–95 (mean 62) years, who accessed the welfare rights advice service in North East England between April 2009 and March 2010; and qualitative interview study of a maximum variation sample of 35 patients and 9 carers. Results Over two thirds of cancer patients and carers came from areas of high socio-economic deprivation. Welfare benefit claims were successful for 96% of claims made and resulted in a median increase in weekly income of £70.30 ($109.74, €84.44). Thirty-four different types of benefits or grants were awarded. Additional resources were perceived to lessen the impact of lost earnings, help offset costs associated with cancer, reduce stress and anxiety and increase ability to maintain independence and capacity to engage in daily activities, all of which were perceived to impact positively on well-being and quality of life. Key barriers to accessing benefit entitlements were knowledge, system complexity, eligibility concerns and assumptions that health professionals would alert patients to entitlements. Conclusions The intervention proved feasible, effectively increased income for cancer patients and was highly valued. Addressing the financial sequelae of cancer can have positive social and psychological consequences that could significantly enhance effective clinical management and suitable services should be routinely available. Further research is needed to evaluate

  12. Addressing Family Smoking in Child Health Care Settings.

    PubMed

    Hall, Nicole; Hipple, Bethany; Friebely, Joan; Ossip, Deborah J; Winickoff, Jonathan P

    2009-08-01

    OBJECTIVE: To discuss strategies for integrating evidence-based tobacco use screening, cessation assistance, and referral to outside services into visits with families in outpatient child health care settings. METHODS: Presentation of counseling scenarios used in the Clinical Effort Against Secondhand Smoke Exposure (CEASE) training video and commentary. RESULTS: Demonstrated strategies include: eliciting information about interest and readiness to quit smoking, respectfully setting an agenda to discuss smoking, tailoring advice and education to the specific circumstances, keeping the dialogue open, prescribing cessation medication, helping the smoker set an action plan for cessation, enrolling the smoker in free telephone counseling through the state quitline, and working with family members to establish a completely smoke-free home and car. Video demonstrations of these techniques are available at www.ceasetobacco.org. CONCLUSION: Child health care clinicians have a unique opportunity to address family smoking and can be most effective by adapting evidence-based tobacco cessation counseling strategies for visits in the pediatric setting.

  13. Interweaving Knowledge Resources to Address Complex Environmental Health Challenges

    PubMed Central

    Anderson, Beth Ellen; Suk, William A.

    2015-01-01

    Background Complex problems do not respect academic disciplinary boundaries. Environmental health research is complex and often moves beyond these boundaries, integrating diverse knowledge resources to solve such challenges. Here we describe an evolving paradigm for interweaving approaches that integrates widely diverse resources outside of traditional academic environments in full partnerships of mutual respect and understanding. We demonstrate that scientists, social scientists, and engineers can work with government agencies, industry, and communities to interweave their expertise into metaphorical knowledge fabrics to share understanding, resources, and enthusiasm. Objective Our goal is to acknowledge and validate how interweaving research approaches can contribute to research-driven, solution-oriented problem solving in environmental health, and to inspire more members of the environmental health community to consider this approach. Discussion The National Institutes of Health’s National Institute of Environmental Health Sciences Superfund Research Program (SRP), as mandated by Congress, has evolved to become a program that reaches across a wide range of knowledge resources. SRP fosters interweaving multiple knowledge resources to develop innovative multidirectional partnerships for research and training. Here we describe examples of how motivation, ideas, knowledge, and expertise from different people, institutions, and agencies can integrate to tackle challenges that can be as complex as the resources they bring to bear on it. Conclusions By providing structure for interweaving science with its stakeholders, we are better able to leverage resources, increase potential for innovation, and proactively ensure a more fully developed spectrum of beneficial outcomes of research investments. Citation Anderson BE, Naujokas MF, Suk WA. 2015. Interweaving knowledge resources to address complex environmental health challenges. Environ Health Perspect 123:1095–1099

  14. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening.

    PubMed

    Ka'opua, Lana Sue I; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2016-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai'i-based project on anal cancer screening tools. Krueger's focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being "on the radar" of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through "real talk" (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai'i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales.

  15. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

    PubMed Central

    Ka‘opua, Lana Sue I.; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L.; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2015-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai‘i-based project on anal cancer screening tools. Krueger’s focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being “on the radar” of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through “real talk” (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai‘i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. PMID:26630979

  16. MO-FG-BRB-01: Investing to Address the Global Cancer Challenge

    SciTech Connect

    Atun, R.

    2015-06-15

    The global burden of cancer is growing rapidly with an estimated 15 million new cases per year worldwide in 2015, growing to 19 million by 2025 and 24 million by 2035. The largest component of this growth will occur in low-to-middle income countries (LMICs). About half of these cases will require radiation treatment. The gap for available cancer treatment, including radiation therapy, between high-income countries (HICs) and LMICs is enormous. Accurate data and quantitative models to project the needs and the benefits of cancer treatment are a critical first step in closing the large cancer divide between LMICs and HICs. In this context, the Union for International Cancer Control (UICC) has developed a Global Task Force on Radiotherapy for Cancer Control (GTFRCC) with a charge to answer the question as to what it will take to close the gap between what exists today and reasonable access to radiation therapy globally by 2035 and what the potential clinical and economic benefits are for doing this. The Task Force has determined the projections of cancer incidence and the infrastructure required to provide access to radiation therapy globally. Furthermore it has shown that appropriate investment not only yields improved clinical outcomes for millions of patients but that it also provides an overall economic gain throughout all the income settings where this investment is made. This symposium will summarize the facets associated with this global cancer challenge by reviewing the cancer burden, looking at the requirements for radiation therapy, reviewing the benefits of providing such therapy both from a clinical and economic perspective and finally by looking at what approaches can be used to aid in the alleviation of this global cancer challenge. The speakers are world renowned experts in global public health issues (R. Atun), medical physics (D. Jaffray) and radiation oncology (N. Coleman). Learning Objectives: To describe the global cancer challenge and the

  17. Addressing Health Disparities through Multi-institutional, Multidisciplinary Collaboratories

    PubMed Central

    Fleming, Erik S.; Perkins, James; Easa, David; Conde, José G.; Baker, Richard S.; Southerland, William M.; Dottin, Robert; Benabe, Julio E.; Ofili, Elizabeth O.; Bond, Vincent C.; McClure, Shelia A.; Sayre, Michael H.; Beanan, Maureen J.; Norris, Keith C.

    2009-01-01

    The national research leadership has recently become aware of the tremendous potential of translational research as an approach to address health disparities. The Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) is a research network that supports multi-institutional, multidisciplinary collaboration with a focus on key diseases and conditions for which disproportionately adverse racial and ethnic health disparities exist. The RTRN is designed to facilitate the movement of scientific advances across the translational research spectrum by providing researchers at different institutions with the infrastructure and tools necessary to collaborate on interdisciplinary and transdisciplinary research projects relating to specific health outcomes for which major racial/ethnic disparities exist. In the past, the difficulty of overcoming the restrictions imposed by time and space have made it difficult to carry out this type of large-scale, multilevel collaboration efficiently. To address this formidable challenge, the RTRN will deploy a translational research cluster system that uses “cyber workspaces” to bring researchers with similar interests together by using online collaboratory technology. These virtual meeting environments will provide a number of tools, including videoconferences (seminars, works in progress, meetings); project management tools (WebCT, Microsoft Share Point); and posting areas for projects, concepts, and other research and educational activities. This technology will help enhance access to resources across institutions with a common mission, minimize many of the logistical hurdles that impede intellectual exchange, streamline the planning and implementation of innovative interdisciplinary research, and assess the use of protocols and practices to assist researchers in interacting across and within cyber workspaces. PMID:18646341

  18. Facilitators, Challenges, and Collaborative Activities in Faith and Health Partnerships to Address Health Disparities

    ERIC Educational Resources Information Center

    Kegler, Michelle C.; Hall, Sarah M.; Kiser, Mimi

    2010-01-01

    Interest in partnering with faith-based organizations (FBOs) to address health disparities has grown in recent years. Yet relatively little is known about these types of partnerships. As part of an evaluation of the Institute for Faith and Public Health Collaborations, representatives of 34 faith--health teams (n = 61) completed semi-structured…

  19. Health Journalism Internships: A Social Marketing Strategy to Address Health Disparities

    PubMed Central

    Nguyen, Duy H.; Shimasaki, Suzuho; Stafford, Helen Shi

    2010-01-01

    The USA seeks to eliminate health disparities by stimulating the rapid uptake of health-promoting behaviors within disadvantaged communities. A health journalism internship incorporates social marketing strategies to increase communities' access to cancer information, while helping the interns who are recruited from underrepresented communities gain admission to top graduate schools. Interns are taught basic health journalism skills that enable them to create immediate streams of cancer-related press releases for submission to community newspapers. Interns are charged with the social responsibility of continuing this dissemination process throughout their careers. Intermediate outcomes are measured as mediators of distal behavioral change goals. PMID:20186519

  20. Health journalism internships: a social marketing strategy to address health disparities.

    PubMed

    Nguyen, Duy H; Shimasaki, Suzuho; Stafford, Helen Shi; Sadler, Georgia Robins

    2010-09-01

    The USA seeks to eliminate health disparities by stimulating the rapid uptake of health-promoting behaviors within disadvantaged communities. A health journalism internship incorporates social marketing strategies to increase communities' access to cancer information, while helping the interns who are recruited from underrepresented communities gain admission to top graduate schools. Interns are taught basic health journalism skills that enable them to create immediate streams of cancer-related press releases for submission to community newspapers. Interns are charged with the social responsibility of continuing this dissemination process throughout their careers. Intermediate outcomes are measured as mediators of distal behavioral change goals.

  1. The case for addressing explosive weapons: conflict, violence and health.

    PubMed

    Rappert, Brian; Moyes, Richard; Lang, Iain

    2012-12-01

    In recent years, states and non-governmental organizations have expressed concern about the humanitarian consequences of the category of technologies labelled 'explosive weapons', particularly in relation to their use in populated areas. This article seeks to outline the magnitude of these consequences as well as what can be done to reduce harms. In particular, it makes a case for how health approaches could help prevent the harms associated with this category of weapons. Attention is given to the types of evidence and argument that might be required to characterize explosive weapons. An overarching aim is to consider how alternative ways of understanding weapons and violence can create new opportunities for addressing harms from conflict.

  2. Use of Evidence-Based Interventions to Address Disparities in Colorectal Cancer Screening.

    PubMed

    Joseph, Djenaba A; Redwood, Diana; DeGroff, Amy; Butler, Emily L

    2016-02-12

    Colorectal cancer (CRC) is the second leading cause of cancer death among cancers that affect both men and women. Despite strong evidence of their effectiveness, CRC screening tests are underused. Racial/ethnic minority groups, persons without insurance, those with lower educational attainment, and those with lower household income levels have lower rates of CRC screening. Since 2009, CDC's Colorectal Cancer Control Program (CRCCP) has supported state health departments and tribal organizations in implementing evidence-based interventions (EBIs) to increase use of CRC screening tests among their populations. This report highlights the successful implementation of EBIs to address disparities by two CRCCP grantees: the Alaska Native Tribal Health Consortium (ANTHC) and Washington State's Breast, Cervical, and Colon Health Program (BCCHP). ANTHC partnered with regional tribal health organizations in the Alaska Tribal Health System to implement provider and client reminders and use patient navigators to increase CRC screening rates among Alaska Native populations. BCCHP identified patient care coordinators in each clinic who coordinated staff training on CRC screening and integrated client and provider reminder systems. In both the Alaska and Washington programs, instituting provider reminder systems, client reminder systems, or both was facilitated by use of electronic health record systems. Using multicomponent interventions in a single clinical site or facility can support more organized screening programs and potentially result in greater increases in screening rates than relying on a single strategy. Organized screening systems have an explicit policy for screening, a defined target population, a team responsible for implementation of the screening program, and a quality assurance structure. Although CRC screening rates in the United States have increased steadily over the past decade, this increase has not been seen equally across all populations. Increasing the

  3. Teaching undergraduate nursing students about environmental health: addressing public health issues through simulation.

    PubMed

    Stanley, Mary Jo; Rojas, Deb

    2014-01-01

    Schools of nursing are challenged to find clinical placements in public health settings. Use of simulation can address situations unique to public health, with attention to specific concerns, such as environmental health. Environmental health is an integral part of public health nursing and is a standard of professional practice. Current simulations focus on acute care situations, offering limited scenarios with a public health perspective and excluding environmental health. This study's simulation scenario was created to enhance nursing students' understanding of public health concepts within an environmental health context. Outcomes from the simulation include the need for integration of environmental issues in public health teaching. Students stated that this scenario provided a broader understanding of the environmental influences that can affect the client's and family's health. This scenario fills a void in simulation content, while providing an interactive teaching and learning strategy to help students to apply knowledge to practice.

  4. National Institutes of Health addresses the science of diversity.

    PubMed

    Valantine, Hannah A; Collins, Francis S

    2015-10-06

    The US biomedical research workforce does not currently mirror the nation's population demographically, despite numerous attempts to increase diversity. This imbalance is limiting the promise of our biomedical enterprise for building knowledge and improving the nation's health. Beyond ensuring fairness in scientific workforce representation, recruiting and retaining a diverse set of minds and approaches is vital to harnessing the complete intellectual capital of the nation. The complexity inherent in diversifying the research workforce underscores the need for a rigorous scientific approach, consistent with the ways we address the challenges of science discovery and translation to human health. Herein, we identify four cross-cutting diversity challenges ripe for scientific exploration and opportunity: research evidence for diversity's impact on the quality and outputs of science; evidence-based approaches to recruitment and training; individual and institutional barriers to workforce diversity; and a national strategy for eliminating barriers to career transition, with scientifically based approaches for scaling and dissemination. Evidence-based data for each of these challenges should provide an integrated, stepwise approach to programs that enhance diversity rapidly within the biomedical research workforce.

  5. National Institutes of Health addresses the science of diversity

    PubMed Central

    Valantine, Hannah A.; Collins, Francis S.

    2015-01-01

    The US biomedical research workforce does not currently mirror the nation’s population demographically, despite numerous attempts to increase diversity. This imbalance is limiting the promise of our biomedical enterprise for building knowledge and improving the nation’s health. Beyond ensuring fairness in scientific workforce representation, recruiting and retaining a diverse set of minds and approaches is vital to harnessing the complete intellectual capital of the nation. The complexity inherent in diversifying the research workforce underscores the need for a rigorous scientific approach, consistent with the ways we address the challenges of science discovery and translation to human health. Herein, we identify four cross-cutting diversity challenges ripe for scientific exploration and opportunity: research evidence for diversity’s impact on the quality and outputs of science; evidence-based approaches to recruitment and training; individual and institutional barriers to workforce diversity; and a national strategy for eliminating barriers to career transition, with scientifically based approaches for scaling and dissemination. Evidence-based data for each of these challenges should provide an integrated, stepwise approach to programs that enhance diversity rapidly within the biomedical research workforce. PMID:26392553

  6. Addressing Family Smoking in Child Health Care Settings

    PubMed Central

    Hall, Nicole; Hipple, Bethany; Friebely, Joan; Ossip, Deborah J.; Winickoff, Jonathan P.

    2009-01-01

    Objective To discuss strategies for integrating evidence-based tobacco use screening, cessation assistance, and referral to outside services into visits with families in outpatient child health care settings. Methods Presentation of counseling scenarios used in the Clinical Effort Against Secondhand Smoke Exposure (CEASE) training video and commentary. Results Demonstrated strategies include: eliciting information about interest and readiness to quit smoking, respectfully setting an agenda to discuss smoking, tailoring advice and education to the specific circumstances, keeping the dialogue open, prescribing cessation medication, helping the smoker set an action plan for cessation, enrolling the smoker in free telephone counseling through the state quitline, and working with family members to establish a completely smoke-free home and car. Video demonstrations of these techniques are available at www.ceasetobacco.org. Conclusion Child health care clinicians have a unique opportunity to address family smoking and can be most effective by adapting evidence-based tobacco cessation counseling strategies for visits in the pediatric setting. PMID:20448841

  7. Older Hispanic women, health literacy, and cervical cancer screening.

    PubMed

    Flores, Bertha E; Acton, Gayle J

    2013-11-01

    Approximately 90 million people in the United States lack basic literacy skills, which affect health behaviors. Cervical cancer is preventable and treatable, yet few older Hispanic women seek screening and continue to be a high-risk group for cervical cancer. A literature review was conducted to address the relationship between cervical cancer screening, health literacy, and older Hispanic women. Eighty studies were reviewed, and nine addressed health literacy and Hispanic women. One study addressed the association between functional health literacy and Pap smear screening among older Hispanic women. Few studies have explored the association between preventive cervical cancer screening and health literacy among older Hispanic women. Nurses must assess health literacy and be prepared to provide care, which is culturally, and linguistically appropriate to improve health outcomes. Further research is needed to be inclusive of all populations including older Hispanic women.

  8. Hispanic Women's Expectations of Campus-Based Health Clinics Addressing Sexual Health Concerns

    ERIC Educational Resources Information Center

    Stephens, Dionne P.; Thomas, Tami L.

    2011-01-01

    Although the number of Hispanic women attending postsecondary institutions has significantly increased in the past decade, knowledge about their use of campus health services to address sexuality-related issues remains low. Increased information about this population is crucial given that sexual health indicators have shown Hispanic women in…

  9. The Yo me cuido® Program: Addressing Breast Cancer Screening and Prevention Among Hispanic Women.

    PubMed

    Davis, Jenna L; Ramos, Roberto; Rivera-Colón, Venessa; Escobar, Myriam; Palencia, Jeannette; Grant, Cathy G; Green, B Lee

    2015-09-01

    Breast cancer is less likely to be diagnosed at the earliest stage in Hispanic/Latino (Hispanic) women compared to non-Hispanic White women, even after accounting for differences in age, socioeconomic status, and method of detection. Moffitt Cancer Center created a comprehensive health education program called Yo me cuido (®) (YMC) to address and reduce breast cancer disparities among Spanish- and English-speaking Hispanic women by providing breast cancer and healthy lifestyles awareness and education, and promoting breast cancer screenings, reminders, and referrals for women 40 years and older. The purpose of this paper is to showcase the innovative approaches and methods to cancer prevention and early detection of the YMC program, and to promote it as an effective tool for improving outcomes in community health education, outreach, and engagement activities with Hispanic populations. Key components of the program include educational workshops, mammogram referrals, and a multimedia campaign. The YMC program is unique because of its approaches in reaching the Hispanic population, such as delivering the program with compassionate services to empower participants to live a healthier lifestyle. Additionally, direct follow-up for mammography screenings is provided by program staff. From 2011 to 2013, YMC has educated 2,226 women and 165 men through 93 workshops. About 684 (52 %) women ages 40 and older have had a screening mammogram within their first year of participating in the program. The YMC program is an innovative cancer education and outreach program that has demonstrated a positive impact on the lives of the Hispanic community in the Tampa Bay region.

  10. Maryland's Special Populations Cancer Network: cancer health disparities reduction model.

    PubMed

    Baquet, Claudia R; Mack, Kelly M; Bramble, Joy; DeShields, Mary; Datcher, Delores; Savoy, Mervin; Hummel, Kery; Mishra, Shiraz I; Brooks, Sandra E; Boykin-Brown, Stephanie

    2005-05-01

    Cancer in Maryland is a serious health concern for minority and underserved populations in rural and urban areas. This report describes the National Cancer Institute (NCI) supported Maryland Special Populations Cancer Network (MSPN), a community-academic partnership. The MSPN's priority populations include African Americans, Native Americans, and other medically underserved residents of rural and urban areas. The MSPN has established a community infrastructure through formal collaborations with several community partners located in Baltimore City, the rural Eastern Shore, and Southern and Western Maryland, and among the Piscataway Conoy Tribe and the other 27 Native American Tribes in Maryland. Key partners also include the University of Maryland Eastern Shore and the University of Maryland Statewide Health Network. The MSPN has implemented innovative and successful programs in cancer health disparities research, outreach, and training; clinical trials education, health disparities policy, and resource leveraging. The MSPN addresses the goal of the NCI and the Department of Health and Human Services (DHHS) to reduce and eventually eliminate cancer health disparities. Community-academic partnerships are the foundation of this successful network.

  11. Development of an Internet Intervention to Address Behaviors Associated with Skin Cancer Risk among Young Adults

    PubMed Central

    Heckman, Carolyn; Darlow, Susan; Munshi, Teja; Caruso, Carolyn; Ritterband, Lee; Raivitch, Stephanie; Fleisher, Linda; Manne, Sharon

    2015-01-01

    Purpose Skin cancer is the most common cancer in the US, and its incidence is increasing. The major risk factor for skin cancer is exposure to ultraviolet radiation (UV). Young adults tend to expose themselves to large amounts of UV and engage in minimal skin protection, which increases their skin cancer risk. Interventions are needed to address risk behaviors among young adults that may lead to skin cancer. The nternet offers a cost-effective way to widely disseminate efficacious interventions. The current paper describes the development of an online skin cancer risk reduction intervention (UV4.me) for young adults. Procedures The iterative development process for UV4.me followed best-practice guidelines and included the following activities: individual interviews, focus groups, content development by the expert team, acceptability testing, cognitive interviewing for questionnaires, quality control testing, usability testing, and a pilot randomized controlled trial. Participant acceptability and usability feedback was assessed. Principal Results The development process produced an evidence-informed intervention that is individually-tailored, interactive, and multimedia in nature based on the Integrative Model of Behavior Prediction, a model for internet interventions, and other best-practice recommendations, expert input, as well as user acceptability and usability feedback gathered before, during, and after development. Major Conclusions Development of an acceptable intervention intended to have a significant public health impact requires a relatively large investment in time, money, expertise, and ongoing user input. Lessons learned and recommendations are discussed. The comprehensive process used may help prepare others interested in creating similar behavioral health interventions. PMID:26640776

  12. Prevalence and correlates of local health department activities to address mental health in the United States.

    PubMed

    Purtle, Jonathan; Klassen, Ann C; Kolker, Jennifer; Buehler, James W

    2016-01-01

    Mental health has been recognized as a public health priority for nearly a century. Little is known, however, about what local health departments (LHDs) do to address the mental health needs of the populations they serve. Using data from the 2013 National Profile of Local Health Departments - a nationally representative survey of LHDs in the United States (N=505) - we characterized LHDs' engagement in eight mental health activities, factors associated with engagement, and estimated the proportion of the U.S. population residing in jurisdictions where these activities were performed. We used Handler's framework of the measurement of public health systems to select variables and examined associations between LHD characteristics and engagement in mental health activities using bivariate analyses and multilevel, multivariate logistic regression. Assessing gaps in access to mental healthcare services (39.3%) and implementing strategies to improve access to mental healthcare services (32.8%) were the most common mental health activities performed. LHDs that provided mental healthcare services were significantly more likely to perform population-based mental illness prevention activities (adjusted odds ratio: 7.1; 95% CI: 5.1, 10.0) and engage in policy/advocacy activities to address mental health (AOR: 3.9; 95% CI: 2.7, 5.6). Our study suggests that many LHDs are engaged in activities to address mental health, ranging from healthcare services to population-based interventions, and that LHDs that provide healthcare services are more likely than others to perform mental health activities. These findings have implications as LHDs reconsider their roles in the era of the Patient Protection and Affordable Care Act and LHD accreditation.

  13. The “Long Tail” and Public Health: New Thinking for Addressing Health Disparities

    PubMed Central

    Hovmand, Peter; Pfeiffer, Debbie J.; Fairchild, Maggie; Rath, Suchitra; Golla, Balaji; Casey, Chris

    2014-01-01

    The prevailing approach to improving population health focuses on shifting population means through a few targeted and universal interventions. The success of this approach for eliminating health disparities depends on an assumption about the distribution of demand for such interventions. We explored whether long tail thinking from business might yield greater progress in eliminating disparities. We examined 2011 to 2013 data from 513 state and local health agency representatives in 47 states who used an online system to create 4351 small media and client reminder products promoting colorectal cancer screening. Products in the long tail were more likely to target minority groups with higher rates of colorectal cancer and lower rates of screening than Whites. Long tail thinking could help improve the public's health and eliminate disparities. PMID:25322308

  14. Making the invisible visible: are health social workers addressing the social determinants of health?

    PubMed

    Craig, Shelley L; Bejan, Raluca; Muskat, Barbara

    2013-01-01

    This study explored the ways in which health social workers (HSW) address the social determinants of health (SDH) within their social work practice. Social workers (n = 54) employed at major hospitals across Toronto had many years of practice in health care (M = 11 years; SD = 10.32) and indicated that SDH were a top priority in their daily work; with 98% intentionally intervening with at least one and 91% attending to three or more. Health care services were most often addressed (92%), followed by housing (72%), disability (79%), income (72%), and employment security (70%). Few HSW were tackling racism, Aboriginal status, gender, or social exclusion in their daily practice.

  15. Public health's promise for the future: 1989 Presidential address

    SciTech Connect

    Shannon, I.S. )

    1990-08-01

    Public health's promise for the future is inextricably related to efforts which maximize human potential and which realize the world's interdependence. Public health challenges are not only constant and complex but frequently surrounded by political activities. In this environment, the public health enterprise has been enhanced by the Institute of Medicine, National Academy of Sciences' report on The Future of Public Health and the assessment framework it provides. Risk reduction through preventive and health promotion activities is the primary focus of public health, but facilitation is often dependent upon society's understanding and willingness-to-pay for such services. The effectiveness of public health is related to an ability to coordinate public and private efforts at national, state, and local levels. Also in this environment, public health is empowered through its multidisciplinary approach. However, epidemiology provides a unifying framework for the collective public health effort. Based on the use of epidemiology, public health is empowered to make the argument for a national health program and to support the concept of health as a determinant of life options. Public health's promise for the future can be fulfilled by continuing to increase its scientific base for decision-making, by self-examination and correction, by advocating and promoting self-examination and correction, by advocating and promoting social justice and by promoting firm partnerships with the public.

  16. Addressing overdiagnosis and overtreatment in cancer: a prescription for change

    PubMed Central

    Esserman, Laura J.; Thompson, Ian M.; Reid, Brian; Nelson, Peter; Ransohoff, David F.; Welch, H. Gilbert; Hwang, Shelley; Berry, Donald A.; Kinzler, Kenneth W.; Black, William C.; Bissell, Mina; Parnes, Howard; Srivastava, Sudhir

    2015-01-01

    A vast range of disorders—from indolent to fast-growing lesions—are labelled as cancer. Therefore, we believe that several changes should be made to the approach to cancer screening and care, such as use of new terminology for indolent and precancerous disorders. We propose the term indolent lesion of epithelial origin, or IDLE, for those lesions (currently labelled as cancers) and their precursors that are unlikely to cause harm if they are left untreated. Furthermore, precursors of cancer or high-risk disorders should not have the term cancer in them. The rationale for this change in approach is that indolent lesions with low malignant potential are common, and screening brings indolent lesions and their precursors to clinical attention, which leads to overdiagnosis and, if unrecognised, possible overtreatment. To minimise that potential, new strategies should be adopted to better define and manage IDLEs. Screening guidelines should be revised to lower the chance of detection of minimal-risk IDLEs and inconsequential cancers with the same energy traditionally used to increase the sensitivity of screening tests. Changing the terminology for some of the lesions currently referred to as cancer will allow physicians to shift medicolegal notions and perceived risk to reflect the evolving understanding of biology, be more judicious about when a biopsy should be done, and organise studies and registries that offer observation or less invasive approaches for indolent disease. Emphasis on avoidance of harm while assuring benefit will improve screening and treatment of patients and will be equally effective in the prevention of death from cancer. PMID:24807866

  17. Developing Social Marketing Capacity to Address Health Issues

    ERIC Educational Resources Information Center

    Whitelaw, S.; Smart, E.; Kopela, J.; Gibson, T.; King, V.

    2011-01-01

    Purpose: Social marketing is increasingly being seen as a potentially effective means of pursuing health education practice generally and within various specific areas such as mental health and wellbeing and more broadly in tackling health inequalities. This paper aims to report and reflect on the authors' experiences of undertaking a health…

  18. To Your Health: NLM update transcript - Addressing physician burnout

    MedlinePlus

    ... start here' section of MedlinePlus.gov's stress health topic page . The American Heart Association adds helpful information about ... start here' section of MedlinePlus.gov's stress health topic page. MedlinePlus.gov's stress health topic page additionally provides ...

  19. Anthropologists address health equity: recognizing barriers to care

    PubMed Central

    2015-01-01

    Systems change is necessary for improving health care in the United States, especially for populations suffering from health disparities. Theoretical and methodological contributions of anthropology to health care design and delivery can inform systems change by providing a window into provider and patient perceptions and practices. Our community-engaged research teams conduct in-depth investigations of provider perceptions of patients, often uncovering gaps between patient and provider perceptions resulting in the degradation of health equity. We present examples of projects where collaborations between anthropologists and health professionals resulted in actionable data on functioning and malfunctioning systemic momentum toward efforts to eliminate disparities and support wellness. PMID:27158189

  20. Metformin in obesity, cancer and aging: addressing controversies

    PubMed Central

    Berstein, Lev M.

    2012-01-01

    Metformin, an oral anti-diabetic drug, is being considered increasingly for treatment and prevention of cancer, obesity as well as for the extension of healthy lifespan. Gradually accumulating discrepancies about its effect on cancer and obesity can be explained by the shortage of randomized clinical trials, differences between control groups (reference points), gender- and age-associated effects and pharmacogenetic factors. Studies of the potential antiaging effects of antidiabetic biguanides, such as metformin, are still experimental for obvious reasons and their results are currently ambiguous. Here we discuss whether the discrepancies in different studies are merely methodological or inherently related to individual differences in responsiveness to the drug. PMID:22589237

  1. Oral health in Libya: addressing the future challenges.

    PubMed

    Peeran, Syed Wali; Altaher, Omar Basheer; Peeran, Syed Ali; Alsaid, Fatma Mojtaba; Mugrabi, Marei Hamed; Ahmed, Aisha Mojtaba; Grain, Abdulgader

    2014-01-01

    Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human resources with the present status of dental education are reviewed comprehensively. A bibliographic study of oral health research and publications has been carried out. The results point toward a common indicator that oral health-related research is low. Strategies have to be developed to educate the medical and dental professionals, to update the current curriculum and enable the system to be competent in all aspects of oral health care management.

  2. Narratives and Images Used by Public Communication Campaigns Addressing Social Determinants of Health and Health Disparities

    PubMed Central

    Clarke, Christopher E.; Niederdeppe, Jeff; Lundell, Helen C.

    2012-01-01

    Researchers have increasingly focused on how social determinants of health (SDH) influence health outcomes and disparities. They have also explored strategies for raising public awareness and mobilizing support for policies to address SDH, with particular attention to narrative and image-based information. These efforts will need to overcome low public awareness and concern about SDH; few organized campaigns; and limited descriptions of existing message content. To begin addressing these challenges, we analyzed characteristics of 58 narratives and 135 visual images disseminated by two national SDH awareness initiatives: The Robert Wood Johnson Foundation’s Commission to Build a Healthier America and the PBS-produced documentary film Unnatural Causes. Certain types of SDH, including income/wealth and one’s home and workplace environment, were emphasized more heavily than others. Solutions for addressing SDH often involved combinations of self-driven motivation (such as changes in personal health behaviors) along with externally-driven factors such as government policy related to urban revitilization. Images, especially graphs and charts, drew connections among SDH, health outcomes, and other variables, such as the relationship between mother’s education and infant mortality as well as the link between heart disease and education levels within communities. We discuss implications of these findings for raising awareness of SDH and health disparities in the US through narrative and visual means. PMID:23330220

  3. Narratives and images used by public communication campaigns addressing social determinants of health and health disparities.

    PubMed

    Clarke, Christopher E; Niederdeppe, Jeff; Lundell, Helen C

    2012-12-01

    Researchers have increasingly focused on how social determinants of health (SDH) influence health outcomes and disparities. They have also explored strategies for raising public awareness and mobilizing support for policies to address SDH, with particular attention to narrative and image-based information. These efforts will need to overcome low public awareness and concern about SDH; few organized campaigns; and limited descriptions of existing message content. To begin addressing these challenges, we analyzed characteristics of 58 narratives and 135 visual images disseminated by two national SDH awareness initiatives: The Robert Wood Johnson Foundation's Commission to Build a Healthier America and the PBS-produced documentary film Unnatural Causes. Certain types of SDH, including income/wealth and one's home and workplace environment, were emphasized more heavily than others. Solutions for addressing SDH often involved combinations of self-driven motivation (such as changes in personal health behaviors) along with externally-driven factors such as government policy related to urban revitilization. Images, especially graphs and charts, drew connections among SDH, health outcomes, and other variables, such as the relationship between mother's education and infant mortality as well as the link between heart disease and education levels within communities. We discuss implications of these findings for raising awareness of SDH and health disparities in the US through narrative and visual means.

  4. Information technology in health care: addressing promises and pitfalls.

    PubMed

    Stanyon, Robert

    2005-01-01

    Health information technology (HIT) and electronic medical records systems are receiving much attention in health care though only a relatively small number of health care organizations and providers have embraced the technology. This article introduces important concepts and definitions and provides the risk manager with key elements to consider when incorporating HIT principles into a proactive risk management program. A checklist is offered to assist in the assessment of electronic records systems.

  5. Infusing Oral Health Care into Nursing Curriculum: Addressing Preventive Health in Aging and Disability

    PubMed Central

    Hahn, Joan Earle; FitzGerald, Leah; Markham, Young Kee; Glassman, Paul; Guenther, Nancy

    2012-01-01

    Access to oral health care is essential for promoting and maintaining overall health and well-being, yet oral health disparities exist among vulnerable and underserved populations. While nurses make up the largest portion of the health care work force, educational preparation to address oral health needs of elders and persons with disabilities is limited across nursing curricula. This descriptive study reports on the interdisciplinary development, implementation, and testing of an oral health module that was included and infused into a graduate nursing curriculum in a three-phase plan. Phase 1 includes evaluation of a lecture presented to eight gerontological nurse practitioner (GNP) students. Phase 2 includes evaluation of GNP students' perceptions of learning, skills, and confidence following a one-time 8-hour practicum infused into 80 required practicum hours. The evaluation data show promise in preparing nurse practitioner students to assess and address preventive oral health needs of persons aging with disabilities such that further infusion and inclusion in a course for nurse practitioners across five specialties will implemented and tested in Phase 3. PMID:22619708

  6. Addressing Parental Mental Health Within Interventions for Children: A Review

    PubMed Central

    Acri, Mary C.; Hoagwood, Kimberly Eaton

    2015-01-01

    Purpose Untreated parent mental health problems have deleterious effects upon the family, yet caregivers are unlikely to receive services for their emotional health. We conducted a review of treatments and services for children and adolescents that also offered services to parents. Methods Child treatment and service studies were included in the present study if they analyzed parent symptoms or diagnoses over time, and the intervention contained a parent component. Results Of 200 studies reviewed, 20 contained a component for the parent and assessed the parent’s emotional health at multiple time points. Depression and anxiety were the most commonly studied parental mental health problem; most parent components consisted of behavioral strategies in service of the child’s psychological health. Conclusion Major shifts in health care policy affecting mental health services provide an opportunity to create integrated and coordinated health and behavioral health systems. Attention must be given to ensure that the workforce of providers, the administrative structures, and the reimbursement strategies are strengthened and connected to serve the needs of parents/caregivers and children in order to enhance family outcomes. PMID:26527857

  7. Addressing environmental health Implications of mold exposure after major flooding.

    PubMed

    Metts, Tricia A

    2008-03-01

    Extensive water damage resulting from major flooding is often associated with mold growth if materials are not quickly and thoroughly dried. Exposure to fungal contamination can lead to several infectious and noninfectious health effects impacting the respiratory system, skin, and eyes. Adverse health effects can be categorized as infections, allergic or hypersensitivity reactions, or toxic-irritant reactions. Workers and building occupants can minimize their exposure to mold by avoiding areas with excessive mold growth, using personal protective equipment, and implementing environmental controls. Occupational health professionals should encourage workers to seek health care if they experience any symptoms that may be linked to mold exposure.

  8. The Ethical Imperative of Addressing Oral Health Disparities

    PubMed Central

    Lee, J.Y.; Divaris, K.

    2014-01-01

    Health disparities are preventable differences in the burden of disease or opportunities to achieve optimal health that are experienced by socially disadvantaged population groups. Reducing health disparities has been identified as an ethical imperative by the World Health Organization’s Commission on Social Determinants of Health and numerous other national and international bodies. Significant progress has been made over the past years in identifying vulnerable groups, and ‘distal’ factors including political, economic, social, and community characteristics are now considered pivotal. It is thus unsurprising that the remarkable advances in the science and practice of dentistry have not led to notable reductions in oral health disparities. In this review, we summarize recent work and emphasize the need for a solid theoretical framing to guide oral health disparities research. We provide a theoretical framework outlining pathways that operate across the continuum of oral health determinants during the lifecourse and highlight potential areas for intervention. Because oral health disparities emanate from the unequal distribution of social, political, economic, and environmental resources, tangible progress is likely to be realized only by a global movement and concerted efforts by all stakeholders, including policymakers, the civil society, and academic, professional, and scientific bodies. PMID:24189268

  9. Policy challenges in addressing racial disparities and improving population health.

    PubMed

    Mechanic, David

    2005-01-01

    Socioeconomic status fundamentally affects most health and disease outcomes, but black Americans are doubly disadvantaged by low status, discrimination, and residential segregation. Improving health and removing disparities are essential goals, but some efforts that improve the health of blacks in important ways also increase black-white disparity ratios. People with more information, influence, resources, and social networks may be better able to take advantage of new technologies and scientific developments, initially increasing disparities. Better health and reduced mortality should be the key policy criteria, but these criteria should be linked with consideration of careful targeting to level the playing field and close disparities.

  10. Ideological and organizational components of differing public health strategies for addressing the social determinants of health.

    PubMed

    Raphael, Dennis; Brassolotto, Julia; Baldeo, Navindra

    2015-12-01

    Despite a history of conceptual contributions to reducing health inequalities by addressing the social determinants of health (SDH), Canadian governmental authorities have struggled to put these concepts into action. Ontario's-Canada's most populous province-public health scene shows a similar pattern. In statements and reports, governmental ministries, professional associations and local public health units (PHUs) recognize the importance of these issues, yet there has been varying implementation of these concepts into public health activity. The purpose of this study was to gain insight into the key features responsible for differences in SDH-related activities among local PHUs. We interviewed Medical Officers of Health (MOH) and key staff members from nine local PHUs in Ontario varying in SDH activity as to their understandings of the SDH, public health's role in addressing the SDH, and their units' SDH-related activities. We also reviewed their unit's documents and their organizational structures in relation to acting on the SDH. Three clusters of PHUs are identified based on their SDH-related activities: service-delivery-oriented; intersectoral and community-based; and public policy/public education-focused. The two key factors that differentiate PHUs are specific ideological commitments held by MOHs and staff and the organizational structures established to carry out SDH-related activities. The ideological commitments and the organizational structures of the most active PHUs showed congruence with frameworks adopted by national jurisdictions known for addressing health inequalities. These include a structural analysis of the SDH and a centralized organizational structure that coordinates SDH-related activities.

  11. Understanding and addressing health disparities in North Carolina.

    PubMed

    Bell, Ronny A

    2012-01-01

    Health disparities--differences in the provision and outcomes of health care in 2 distinct populations--are pervasive and long-standing in North Carolina. Although some strategies for closing these gaps have been effective, many disparities have resisted attempts to eliminate them. Future efforts should focus on policy implementation and the translation of research findings into effective interventions.

  12. Perspectives of "Health" in the Rural Context. Keynote Address.

    ERIC Educational Resources Information Center

    Alfero, Charles

    This paper explores the broad definition of health in the rural context and relates it to policy, practice, and pedagogical challenges in providing access to services in rural areas. Historically, policy, practice, and teaching institutions have supported a dependency model for health service delivery, forcing rural communities to rely on…

  13. Addressing Parental Mental Health within Interventions for Children: A Review

    ERIC Educational Resources Information Center

    Acri, Mary C.; Hoagwood, Kimberly Eaton

    2015-01-01

    Purpose: Untreated parent mental health problems have deleterious effects upon the family, yet caregivers are unlikely to receive services for their emotional health. We conducted a review of treatments and services for children and adolescents that also offered services to parents. Methods: Child treatment and service studies were included in the…

  14. How scholarly nursing literature addresses health disparities for racial/ethnic minority men.

    PubMed

    Dallas, Constance

    2004-01-01

    The purpose of this article is to review conceptual/theoretical and review/agenda setting nursing literature on the health care of racial/ethnic minority men [specifically African American/Black, Hispanic/Latino, American Indian/Alaskan Native and Asian/Pacific Islander men] in one of the four targeted areas of health disparities. CINAHL and MEDLINE computer databases were searched from 1983 to the present using a combination of manual and computer-based methods to identify the nursing literature that included any racial/ethnic men in the sample and addressed at least one of the four areas of health disparities targeted by Department of Health and Human Services (DHHS) that affect adults: heart disease, malignant neoplasms (cancer), diabetes mellitus and Human Immunodeficiency Virus (HIV)/AIDS. This review provides an overview of health disparities experienced by racial/ethnic minority men in the targeted areas and of the types of conceptual and agenda-setting articles published in scholarly nursing literature in those targeted areas.

  15. Oral health in Libya: addressing the future challenges

    PubMed Central

    Peeran, Syed Wali; Altaher, Omar Basheer; Peeran, Syed Ali; Alsaid, Fatma Mojtaba; Mugrabi, Marei Hamed; Ahmed, Aisha Mojtaba; Grain, Abdulgader

    2014-01-01

    Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human resources with the present status of dental education are reviewed comprehensively. A bibliographic study of oral health research and publications has been carried out. The results point toward a common indicator that oral health–related research is low. Strategies have to be developed to educate the medical and dental professionals, to update the current curriculum and enable the system to be competent in all aspects of oral health care management. PMID:24666627

  16. Addressing the Changing Sources of Health Information in Iran

    PubMed Central

    Alishahi-Tabriz, Amir; Sohrabi, Mohammad-Reza; Kiapour, Nazanin; Faramarzi, Nina

    2013-01-01

    Background: Following the entrance of new technologies in health information era, this study aimed to assess changes in health information sources of Iranian people during past decade. Methods: Totally 3000 people were asked about their main sources of health information. They were selected as two community-based samples of 1500 people of more than 18-years-old in two different periods of time in August 2002 and August 2010 from the same locations in Tehran, the capital of Iran. Data analyzed based on age group, sex, educational level and household income in two different periods of time using Chi-square. Odds ratios associated with each basic characteristic were calculated using logistic regression. Results: Most common sources of health information in 2002 were radio and television (17.7%), caregivers (14.9%) and internet (14.2%) and in 2010 were radio and television (19.3%), internet (19.3%) and caregivers (15.8%) (P < 0.001). In 2010, young adults female used television and radio and male used internet as the main source of health information (P = 0.003). In moderate educational level women got their health information from radio and television and caregivers; while men used radio and television and internet as main source of health information (P = 0.005). Highly educated women and men mainly got their health information from internet and radio and television (P > 0.05). Conclusion: Although during 8 years of study radio and television remained as main source of health information but there is an increasing tendency to use internet especially in men. Policymakers should revise their broadcasting strategies based on people demand. PMID:23412519

  17. Health innovation networks to help developing countries address neglected diseases.

    PubMed

    Morel, Carlos M; Acharya, Tara; Broun, Denis; Dangi, Ajit; Elias, Christopher; Ganguly, N K; Gardner, Charles A; Gupta, R K; Haycock, Jane; Heher, Anthony D; Hotez, Peter J; Kettler, Hannah E; Keusch, Gerald T; Krattiger, Anatole F; Kreutz, Fernando T; Lall, Sanjaya; Lee, Keun; Mahoney, Richard; Martinez-Palomo, Adolfo; Mashelkar, R A; Matlin, Stephen A; Mzimba, Mandi; Oehler, Joachim; Ridley, Robert G; Senanayake, Pramilla; Singer, Peter; Yun, Mikyung

    2005-07-15

    Gross inequities in disease burden between developed and developing countries are now the subject of intense global attention. Public and private donors have marshaled resources and created organizational structures to accelerate the development of new health products and to procure and distribute drugs and vaccines for the poor. Despite these encouraging efforts directed primarily from and funded by industrialized countries, sufficiency and sustainability remain enormous challenges because of the sheer magnitude of the problem. Here we highlight a complementary and increasingly important means to improve health equity: the growing ability of some developing countries to undertake health innovation.

  18. Social Entrepreneurship in Religious Congregations’ Efforts to Address Health Needs

    PubMed Central

    Werber, Laura; Mendel, Peter J.; Derose, Kathryn Pitkin

    2013-01-01

    Purpose Examine how religious congregations engage in social entrepreneurship as they strive to meet health-related needs in their communities. Design Multiple case studies. Setting Los Angeles County, California. Participants Purposive sample of 14 congregations representing diverse races-ethnicities (African American, Latino, and white) and faith traditions (Jewish and various Christian). Method Congregations were recruited based on screening data and consultation of a community advisory board. In each congregation, researchers conducted interviews with clergy and lay leaders (n=57); administered a congregational questionnaire; observed health activities, worship services, and neighborhood context; and reviewed archival information. Interviews were analyzed using a qualitative, code-based approach. Results Congregations’ health-related activities tended to be episodic, small in scale, and local in scope. Trust and social capital played important roles in congregations’ health initiatives, providing a safe, confidential environment and leveraging resources from – and for – faith-based and secular organizations in their community networks. Congregations also served as “incubators” for members to engage in social entrepreneurship. Conclusion Although the small scale of congregations’ health initiatives suggest they may not have the capacity to provide the main infrastructure for service provision, congregations can complement the efforts of health and social providers with their unique strengths. Specifically, congregations are distinctive in their ability to identify unmet local needs, and congregations’ position in their communities permit them to network in productive ways. PMID:23875986

  19. American health improvement depends upon addressing class disparities.

    PubMed

    Schroeder, Steven A

    2016-11-01

    The gap in health status between the United States and other (OECD) developed countries not only persists but has widened over the past decade. This has occurred despite major declines in smoking prevalence. But as with other health problems, such as obesity, gun violence, and teenage pregnancy, progress against smoking has disproportionately benefitted the better off segments of the American population. Thus smoking, as well as other problems, is now concentrated among the vulnerable members of our society: the poor and less educated, as well as disadvantaged groups such as those with mental illness and substance use disorders, the homeless, those who are incarcerated, and the LGBT community. Although this is a national issue, these problems, as well as overall poverty, are especially concentrated in the Southeastern part of the country. Compared with the other OECD countries, the U.S. has much greater inequality of income and wealth. Furthermore, we are unique in leaving substantial portions of our population not covered by health insurance, again most prominently in the southeastern region. This national health disparity is not simply a factor of the multicultural nature of American society, because it persists when the health of the whites only is compared with the more racially homogeneous OECD nations. The complexity of our poor health performance rules out a single intervention. But it is clear that without focusing on the less fortunate members of our society, especially those in the Southeast, our performance will continue to lag, and possibly deteriorate further.

  20. The role of academic research and teaching in addressing health in situations of conflict and instability.

    PubMed

    Collinson, Lucie

    2014-01-01

    The key roles of academic research and teaching in addressing health in situations of conflict and instability are to better inform and better equip actors with the knowledge and skills to address health problems. The four key contributions of research are: quantifying the health problem, examining the contextual circumstances, investigating the epidemiology of health problems and evaluation of health care and humanitarian interventions. The role of teaching can complement research by distributing its' findings in addition to teaching skill sets to apply this knowledge and conduct further research. Academic research and teaching both play imperative roles in enabling more successful approaches in addressing health in situations of conflict and instability.

  1. The case for the World Health Organization's Commission on Social Determinants of Health to address gender identity.

    PubMed

    Pega, Frank; Veale, Jaimie F

    2015-03-01

    We analyzed the case of the World Health Organization's Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments, as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH.

  2. Applied social and behavioral science to address complex health problems.

    PubMed

    Livingood, William C; Allegrante, John P; Airhihenbuwa, Collins O; Clark, Noreen M; Windsor, Richard C; Zimmerman, Marc A; Green, Lawrence W

    2011-11-01

    Complex and dynamic societal factors continue to challenge the capacity of the social and behavioral sciences in preventive medicine and public health to overcome the most seemingly intractable health problems. This paper proposes a fundamental shift from a research approach that presumes to identify (from highly controlled trials) universally applicable interventions expected to be implemented "with fidelity" by practitioners, to an applied social and behavioral science approach similar to that of engineering. Such a shift would build on and complement the recent recommendations of the NIH Office of Behavioral and Social Science Research and require reformulation of the research-practice dichotomy. It would also require disciplines now engaged in preventive medicine and public health practice to develop a better understanding of systems thinking and the science of application that is sensitive to the complexity, interactivity, and unique elements of community and practice settings. Also needed is a modification of health-related education to ensure that those entering the disciplines develop instincts and capacities as applied scientists.

  3. Keeping Current. Library Media Specialists: Addressing the Student Health Epidemic

    ERIC Educational Resources Information Center

    Buddy, Juanita

    2005-01-01

    Health and educational leaders are sounding the alarm about the unhealthy condition of many students in America's K-12 schools. Each day, new scientific studies confirm that "The majority of American youth are sedentary and do not eat well. Sixteen percent of school-aged children and adolescents--or nine million--are overweight, a figure that has…

  4. Health Education: Addressing the Asian-American Student.

    ERIC Educational Resources Information Center

    Hong, Annann; Hong, Luoluo

    This paper examines the health status of Asian Americans. In introductory sections, the paper looks at: patterns of Asian immigration, myths surrounding Asian Americans as a "model minority," such as the false notion that Asian Americans as a group are always academic and economic achievers despite their minority status; institutional,…

  5. Assessing Rural Coalitions That Address Safety and Health Issues

    ERIC Educational Resources Information Center

    Burgus, Shari; Schwab, Charles; Shelley, Mack

    2012-01-01

    Community coalitions can help national organizations meet their objectives. Farm Safety 4 Just Kids depends on coalitions of local people to deliver farm safety and health educational programs to children and their families. These coalitions are called chapters. An evaluation was developed to identify individual coalition's strengths and…

  6. Sex and gender matter in health research: addressing health inequities in health research reporting.

    PubMed

    Gahagan, Jacqueline; Gray, Kimberly; Whynacht, Ardath

    2015-01-31

    Attention to the concepts of 'sex' and 'gender' is increasingly being recognized as contributing to better science through an augmented understanding of how these factors impact on health inequities and related health outcomes. However, the ongoing lack of conceptual clarity in how sex and gender constructs are used in both the design and reporting of health research studies remains problematic. Conceptual clarity among members of the health research community is central to ensuring the appropriate use of these concepts in a manner that can advance our understanding of the sex- and gender-based health implications of our research findings. During the past twenty-five years much progress has been made in reducing both sex and gender disparities in clinical research and, to a significant albeit lesser extent, in basic science research. Why, then, does there remain a lack of uptake of sex- and gender-specific reporting of health research findings in many health research journals? This question, we argue, has significant health equity implications across all pillars of health research, from biomedical and clinical research, through to health systems and population health.

  7. Addressing health disparities in rural communities using telehealth.

    PubMed

    Marcin, James P; Shaikh, Ulfat; Steinhorn, Robin H

    2016-01-01

    The regionalization of pediatric services has resulted in differential access to care, sometimes creating barriers to those living in underserved, rural communities. These disparities in access contribute to inferior healthcare outcomes among infants and children. We review the medical literature on telemedicine and its use to improve access and the quality of care provided to pediatric patients with otherwise limited access to pediatric subspecialty care. We review the use of telemedicine for the provision of pediatric subspecialty consultations in the settings of ambulatory care, acute and inpatient care, and perinatal and newborn care. Studies demonstrate the feasibility and efficiencies gained with models of care that use telemedicine. By providing pediatric subspecialty care in more convenient settings such as local primary care offices and community hospitals, pediatric patients are more likely to receive care that adheres to evidence-based guidelines. In many cases, telemedicine can significantly improve provider, patient, and family satisfaction, increase measures of quality of care and patient safety, and reduce overall costs of care. Models of care that use telemedicine have the potential to address pediatric specialists' geographic misdistribution and address disparities in the quality of care delivered to children in underserved communities.

  8. Using community-based participatory research to address health disparities.

    PubMed

    Wallerstein, Nina B; Duran, Bonnie

    2006-07-01

    Community-based participatory research (CBPR) has emerged in the past decades as an alternative research paradigm, which integrates education and social action to improve health and reduce health disparities. More than a set of research methods, CBPR is an orientation to research that focuses on relationships between academic and community partners, with principles of colearning, mutual benefit, and long-term commitment and incorporates community theories, participation, and practices into the research efforts. As CBPR matures, tensions have become recognized that challenge the mutuality of the research relationship, including issues of power, privilege, participation, community consent, racial and/or ethnic discrimination, and the role of research in social change. This article focuses on these challenges as a dynamic and ever-changing context of the researcher-community relationship, provides examples of these paradoxes from work in tribal communities, discusses the evidence that CBPR reduces disparities, and recommends transforming the culture of academia to strengthen collaborative research relationships.

  9. Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

    SciTech Connect

    Simpson, Sarah . E-mail: sarah.simpson@unsw.edu.au; Mahoney, Mary; Harris, Elizabeth; Aldrich, Rosemary; Stewart-Williams, Jenny

    2005-10-15

    In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft framework in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA.

  10. Addressing environmental health concerns near Trecatti landfill site, United Kingdom.

    PubMed

    Fielder, H M; Palmer, S R; Poon-King, C; Moss, N; Coleman, G

    2001-01-01

    Residents near the Trecatti landfill site located in South Wales, United Kingdom, expressed concern about odors and health effects they attributed to site emissions. The authors compared routinely collected, population-based, health data from potentially exposed electoral wards (i.e., United Kingdom electoral tracts) with data from both wards nearby, matched for socioeconomic deprivation scores, and with wards where residents were likely to attend the same hospital. Mortality rates were higher for all causes and neoplastic diseases (but not respiratory disease) in the exposed wards, but there was no change in rates after the site opened. Hospital data revealed a transient increase in admissions for asthma during the 3 yr that preceded the peak in odor complaints. The birth prevalence of congenital malformations was raised in the exposed wards, but the authors could not exclude a possible artifact resulting from differences in reporting practices between hospitals. The absence of environmental monitoring in the community during the period of public concern was a significant weakness of this study.

  11. Medical mycology and fungal immunology: new research perspectives addressing a major world health challenge.

    PubMed

    Gow, Neil A R; Netea, Mihai G

    2016-12-05

    Fungi cause more than a billion skin infections, more than 100 million mucosal infections, 10 million serious allergies and more than a million deaths each year. Global mortality owing to fungal infections is greater than for malaria and breast cancer and is equivalent to that owing to tuberculosis (TB) and HIV. These statistics evidence fungal infections as a major threat to human health and a major burden to healthcare budgets worldwide. Those patients who are at greatest risk of life-threatening fungal infections include those who have weakened immunity or have suffered trauma or other predisposing infections such as HIV. To address these global threats to human health, more research is urgently needed to understand the immunopathology of fungal disease and human disease susceptibility in order to augment the advances being made in fungal diagnostics and drug development. Here, we highlight some recent advances in basic research in medical mycology and fungal immunology that are beginning to inform clinical decisions and options for personalized medicine, vaccine development and adjunct immunotherapies.This article is part of the themed issue 'Tackling emerging fungal threats to animal health, food security and ecosystem resilience'.

  12. Medical mycology and fungal immunology: new research perspectives addressing a major world health challenge

    PubMed Central

    Gow, Neil A. R.; Netea, Mihai G.

    2016-01-01

    Fungi cause more than a billion skin infections, more than 100 million mucosal infections, 10 million serious allergies and more than a million deaths each year. Global mortality owing to fungal infections is greater than for malaria and breast cancer and is equivalent to that owing to tuberculosis (TB) and HIV. These statistics evidence fungal infections as a major threat to human health and a major burden to healthcare budgets worldwide. Those patients who are at greatest risk of life-threatening fungal infections include those who have weakened immunity or have suffered trauma or other predisposing infections such as HIV. To address these global threats to human health, more research is urgently needed to understand the immunopathology of fungal disease and human disease susceptibility in order to augment the advances being made in fungal diagnostics and drug development. Here, we highlight some recent advances in basic research in medical mycology and fungal immunology that are beginning to inform clinical decisions and options for personalized medicine, vaccine development and adjunct immunotherapies. This article is part of the themed issue ‘Tackling emerging fungal threats to animal health, food security and ecosystem resilience’. PMID:28080988

  13. NASA's Systems Engineering Approaches for Addressing Public Health Surveillance Requirements

    NASA Technical Reports Server (NTRS)

    Vann, Timi

    2003-01-01

    NASA's systems engineering has its heritage in space mission analysis and design, including the end-to-end approach to managing every facet of the extreme engineering required for successful space missions. NASA sensor technology, understanding of remote sensing, and knowledge of Earth system science, can be powerful new tools for improved disease surveillance and environmental public health tracking. NASA's systems engineering framework facilitates the match between facilitates the match between partner needs and decision support requirements in the areas of 1) Science/Data; 2) Technology; 3) Integration. Partnerships between NASA and other Federal agencies are diagrammed in this viewgraph presentation. NASA's role in these partnerships is to provide systemic and sustainable solutions that contribute to the measurable enhancement of a partner agency's disease surveillance efforts.

  14. Addressing health disparities in middle school students' nutrition and exercise.

    PubMed

    Frenn, Marilyn; Malin, Shelly; Bansal, Naveen; Delgado, Mary; Greer, Yvonne; Havice, Michael; Ho, Mary; Schweizer, Heidi

    2003-01-01

    Those with low income, especially women of African American and Hispanic heritage have the greatest risk of inactivity and obesity. A 4-session (Internet and video) intervention with healthy snack and gym labs was tested in 2 (gym lab in 1) urban low-middle-income middle schools to improve low fat diet and moderate and vigorous physical activity.1 The gym lab was particularly beneficial (p =.002). Fat in diet decreased with each Internet session in which students participated. Percentage of fat in food was reduced significantly p =.018 for Black, White, and Black/Native American girls in the intervention group. Interventions delivered through Internet and video may enable reduction of health disparities in students by encouraging those most at risk to consume 30% or less calories from fat and to engage in moderate and vigorous physical activity.

  15. School Nurses' Perceived Prevalence and Competence to Address Student Mental Health Problems

    ERIC Educational Resources Information Center

    Stephan, Sharon H.; Connors, Elizabeth H.

    2013-01-01

    Due to under-identification of student mental health problems and limited specialty mental health providers in schools, school nurses are often faced with identifying and addressing student mental health needs. This exploratory study assessed prevalence and types of student mental health problems encountered by school nurses, as well as their…

  16. Disparities in human resources: addressing the lack of diversity in the health professions.

    PubMed

    Grumbach, Kevin; Mendoza, Rosalia

    2008-01-01

    African Americans, Latinos, and American Indians are severely underrepresented in the health professions. A strong case for diversity may be made on the grounds of civil rights, public health and educational benefit, and business gains. Improving the diversity of the health professions requires multiprong strategies addressing the educational pipeline, admissions policies and the institutional culture at health professions schools, and the broader policy environment.

  17. Recognizing and addressing the stigma associated with mental health nursing: a critical perspective.

    PubMed

    Gouthro, Trina Johnena

    2009-11-01

    Negative and stigmatizing beliefs regarding mental health nursing discredit the valuable contributions of mental health nurses, but more importantly, these beliefs discredit the needs of people who access mental health care. The stigma associated with mental health nursing, however, has received little attention in the literature. In this article, the author explores the stigma associated with mental health nursing from a critical lens. Recommendations are proposed to address the stigma associated with mental health nursing and mental illness, concurrently, within nursing education.

  18. The 2007 Leona Tyler Address: Mental Health Policy in Higher Education

    ERIC Educational Resources Information Center

    Stone, Gerald

    2008-01-01

    The 2007 Leona Tyler Address concerns mental health policy in higher education. In the aftermath of the Virginia Tech tragedy, mental health professionals have proffered several proposals. This address reviewed and critiqued these proposals. After critical review, I make several recommendations based on the following principles: developing…

  19. Towards a feminist global bioethics: addressing women's health concerns worldwide.

    PubMed

    Tong, R

    2001-01-01

    In this paper I argue that a global bioethics is possible. Specifically, I present the view that there are within feminist approaches to bioethics some conceptual and methodological tools necessary to forge a bioethics that embraces the health-related concerns of both developing and developed nations equally. To support my argument I discuss some of the challenges that have historically confronted feminists. If feminists accept the idea that women are entirely the same, then feminists present as fact the fiction of the essential "Woman." Not only does "Woman" not exist, -she" obscures important racial, ethnic, cultural, and class differences among women. However, if feminists stress women's differences too much, feminists lose the power to speak coherently and cogently about gender justice, women's rights, and sexual equality in general. Analyzing the ways in which the idea of difference as well as the idea of sameness have led feminists astray, I ask whether it is possible to avoid the Scylla of absolutism (imperialism, colonialism, hegemony) on the one hand and the Charybdis of relativism (postmodernism, fragmentation, Balkanization) on the other. Finally, after reflecting upon the work of Uma Narayan, Susan Muller Okin, and Martha Nussbaum, I conclude that there is a way out of this ethical bind. By focusing on women's, children's, and men's common human needs, it is possible to lay the foundation for a just and caring global bioethics.

  20. New smart materials to address issues of structural health monitoring.

    SciTech Connect

    Chaplya, Pavel Mikhail

    2004-12-01

    Nuclear weapons and their storage facilities may benefit from in-situ structural health monitoring systems. Appending health-monitoring functionality to conventional materials and structures has been only marginally successful. The purpose of this project was to evaluate feasibility of a new smart material that includes self-sensing health monitoring functions similar to that of a nervous system of a living organism. Reviews of current efforts in the fields of heath-monitoring, nanotechnology, micro-electromechanical systems (MEMS), and wireless sensor networks were conducted. Limitations of the current nanotechnology methods were identified and new approaches were proposed to accelerate the development of self-sensing materials. Wireless networks of MEMS sensors have been researched as possible prototypes of self-sensing materials. Sensor networks were also examined as enabling technologies for dense data collection techniques to be used for validation of numerical methods and material parameter identification. Each grain of the envisioned material contains sensors that are connected in a dendritic manner similar to networks of neurons in a nervous system. Each sensor/neuron can communicate with the neighboring grains. Both the state of the sensor (on/off) and the quality of communication signal (speed/amplitude) should indicate not only a presence of a structural defect but the nature of the defect as well. For example, a failed sensor may represent a through-grain crack, while a lost or degraded communication link may represent an inter-granular crack. A technology to create such material does not exist. While recent progress in the fields of MEMS and nanotechnology allows to envision these new smart materials, it is unrealistic to expect creation of self-sensing materials in the near future. The current state of MEMS, nanotechnology, communication, sensor networks, and data processing technologies indicates that it will take more than ten years for the

  1. Global ovarian cancer health disparities

    PubMed Central

    Chornokur, Ganna; Amankwah, Ernest K.; Schildkraut, Joellen M.; Phelan, Catherine M.

    2013-01-01

    Objective The objective of this article is to broadly review the scientific literature and summarize the most up-to-date findings on ovarian cancer health disparities worldwide and in the United States (U.S.). Methods The present literature on disparities in ovarian cancer was reviewed. Original research and relevant review articles were included. Results Ovarian cancer health disparities exist worldwide and in the U.S. Ovarian cancer disproportionately affect African American women at all stages of the disease, from presentation through treatment, and ultimately increased mortality and decreased survival, compared to non-Hispanic White women. Increased mortality is likely to be explained by unequal access to care and non-standard treatment regimens frequently administered to African American women, but may also be attributed to genetic susceptibility, acquired co-morbid conditions and increased frequency of modifiable risk factors, albeit to substantially lesser extent. Unequal access to care is, in turn, largely a consequence of lower socioeconomic status and lack of private health insurance coverage among the African American population. Conclusions Our findings suggest the need for policy changes aimed at facilitating equal access to quality medical care. At the same time, further research is necessary to fully resolve racial disparities in ovarian cancer. PMID:23266352

  2. The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

    PubMed Central

    Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

    2014-01-01

    Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

  3. Consumer Health Education. Breast Cancer.

    ERIC Educational Resources Information Center

    Arkansas Univ., Fayetteville, Cooperative Extension Service.

    This short booklet is designed to be used by health educators when teaching women about breast cancer and its early detection and the procedure for breast self-examination. It includes the following: (1) A one-page teaching plan consisting of objectives, subject matter, methods (including titles of films and printed materials), target audience,…

  4. The Role of Health Education in Addressing Uncertainty about Health and Cell Phone Use--A Commentary

    ERIC Educational Resources Information Center

    Ratnapradipa, Dhitinut; Dundulis, William P., Jr.; Ritzel, Dale O.; Haseeb, Abdul

    2012-01-01

    Although the fundamental principles of health education remain unchanged, the practice of health education continues to evolve in response to the rapidly changing lifestyles and technological advances. Emerging health risks are often associated with these lifestyle changes. The purpose of this article is to address the role of health educators…

  5. Local Health Departments’ Activities to Address Health Disparities and Inequities: Are We Moving in the Right Direction?

    PubMed Central

    Shah, Gulzar H.; Sheahan, John P.

    2015-01-01

    Context: Health disparities are among the critical public health challenges. Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with variation in such engagement. Methods: We used the 2013 National Profile of LHDs Survey to perform Logistic Regression of activities LHDs performed to address health disparities. Results: About 20 percent of LHDs did not perform any activity to address health disparities. Significant decreases occurred since 2005 in the proportion of LHDs that performed health disparity reduction/elimination activities for four activities. LHD characteristics significantly associated (p≤0.05) with the increased likelihood of performing activities to address health disparities were: recent completion of community health assessment, community health improvement plan and agency wide strategic plan. Other significant positive impacts on such activities included per capita expenditures, local governance, having one or more local boards of health, larger population size and metropolitan status of the LHD jurisdiction. Conclusions: Reduced infrastructural capacity of LHDs has resulted in fewer LHDs addressing health disparities in their jurisdictions. LHD characteristics associated with higher performance of activities for health disparity reduction identified by this research have important policy implications. PMID:26703693

  6. The Role of Nutrition-Related Initiatives in Addressing Community Health Needs Assessments

    ERIC Educational Resources Information Center

    George, Daniel R.; Rovniak, Liza S.; Dillon, Judy; Snyder, Gail

    2017-01-01

    Academic Health Centers and nonprofit hospitals are exploring strategies to meet Affordable Care Act mandates requiring tax-exempt institutions to address community health needs, which commonly include major chronic illnesses. We explore the implications of this regulatory landscape, describing methods that nonprofit health care institutions are…

  7. Leveraging Cloud Computing to Address Public Health Disparities: An Analysis of the SPHPS.

    PubMed

    Jalali, Arash; Olabode, Olusegun A; Bell, Christopher M

    2012-01-01

    As the use of certified electronic health record technology (CEHRT) has continued to gain prominence in hospitals and physician practices, public health agencies and health professionals have the ability to access health data through health information exchanges (HIE). With such knowledge health providers are well positioned to positively affect population health, and enhance health status or quality-of-life outcomes in at-risk populations. Through big data analytics, predictive analytics and cloud computing, public health agencies have the opportunity to observe emerging public health threats in real-time and provide more effective interventions addressing health disparities in our communities. The Smarter Public Health Prevention System (SPHPS) provides real-time reporting of potential public health threats to public health leaders through the use of a simple and efficient dashboard and links people with needed personal health services through mobile platforms for smartphones and tablets to promote and encourage healthy behaviors in our communities. The purpose of this working paper is to evaluate how a secure virtual private cloud (VPC) solution could facilitate the implementation of the SPHPS in order to address public health disparities.

  8. The evolving role of partnerships in addressing community public health issues: policy and ethical implications.

    PubMed

    Wendel, Monica L; Burdine, James N; McLeroy, Kenneth R

    2007-01-01

    The current state of health insurance coverage in the United States is deteriorating. Historically, efforts to address access at the federal level have met with insurmountable opposition. This article describes a model utilizing the Partnership Approach to Community Health Improvement to engage communities in developing creative ways of addressing local health issues, discusses the policy implications of such a model, and explores ethical issues inherent in the discussion of universal access. An argument is presented for a national dialogue seeking societal agreement to approach access and health from a perspective of solidarity.

  9. The Case for the World Health Organization’s Commission on Social Determinants of Health to Address Gender Identity

    PubMed Central

    Veale, Jaimie F.

    2015-01-01

    We analyzed the case of the World Health Organization’s Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments, as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH. PMID:25602894

  10. Addressing poverty, education, and gender equality to improve the health of women worldwide.

    PubMed

    Tyer-Viola, Lynda A; Cesario, Sandra K

    2010-01-01

    The Millennium Development Goals (MDG) that target alleviating poverty, improving primary education, and fostering gender equity are important as a foundation to promote world health. Achieving these goals will create an environment for healthy lives for women and children. Poverty, education, and gender equality, although undeniably linked, need to be addressed individually. Nurses have the capacity and political will to address MDGs and to contribute to the health and well-being of the world population.

  11. Implementing a Public Health Approach to Addressing Mental Health Needs in a University Setting: Lessons and Challenges

    ERIC Educational Resources Information Center

    Parcover, Jason; Mays, Sally; McCarthy, Amy

    2015-01-01

    The mental health needs of college students are placing increasing demands on counseling center resources, and traditional outreach efforts may be outdated or incomplete. The public health model provides an approach for reaching more students, decreasing stigma, and addressing mental health concerns before they reach crisis levels. Implementing a…

  12. Establishing the Infrastructure to Comprehensively Address Cancer Disparities: A Model for Transdisciplinary Approaches

    PubMed Central

    Green, B. Lee; Rivers, Desiree A.; Kumar, Nagi; Baldwin, Julie; Rivers, Brian M.; Sultan, Dawood; Jacobsen, Paul; Gordon, Leslene E.; Davis, Jenna; Roetzheim, Richard

    2014-01-01

    Summary The Center for Equal Health (CEH), a transdisciplinary Center of Excellence, was established to investigate cancer disparities comprehensively and achieve health equity through research, education, training, and community outreach. This paper discusses challenges faced by CEH, strategies employed to foster collaborations, lessons learned, and future considerations for establishing similar initiatives. PMID:24185157

  13. Getting to the root of the problem: health promotion strategies to address the social determinants of health.

    PubMed

    Gore, Dana M; Kothari, Anita R

    2013-01-08

    Although extensive research shows that the social determinants of health influence the distribution and course of chronic diseases, there is little programming in public health that addresses the social determinants as a disease prevention strategy. This paper discusses different types of health promotion initiatives and differentiates them based on whether they attempt to impact intermediate (environmental) determinants of health or structural determinants of health. We argue for the importance of programming targeted at the structural determinants as opposed to programming targeted solely at the immediate environment. Specifically, the former has more potential to create significant improvements in health, contribute to long-term social change and increase health equity. We urge public health leaders to take this distinction into consideration during public health program planning, and to build capacity in the public health workforce to tackle structural mechanisms that lead to poor health and health inequities.

  14. Program To Address Sociocultural Barriers to Health Care in Hispanic Communities. National Program Report.

    ERIC Educational Resources Information Center

    Jackson, Mike; Heroux, Janet

    Many members of the Hispanic community are separated from the larger community by language barriers and different cultures and belief systems. These factors can affect Hispanic Americans' ability to seek and gain access to the health care system. The Program To Address Sociocultural Barriers to Health Care in the Hispanic Community, known as…

  15. Everyone Swims: A Community Partnership and Policy Approach to Address Health Disparities in Drowning and Obesity

    ERIC Educational Resources Information Center

    Stempski, Sarah; Liu, Lenna; Grow, H. Mollie; Pomietto, Maureen; Chung, Celeste; Shumann, Amy; Bennett, Elizabeth

    2015-01-01

    Well-known disparities exist in rates of obesity and drowning, two public health priorities. Addressing these disparities by increasing access to safe swimming and water recreation may yield benefits for both obesity and injury prevention. "Everyone Swims," a community partnership, brought community health clinics and water recreation…

  16. 75 FR 20913 - Center for Devices and Radiological Health; New Address Information

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-22

    ...--MAMMOGRAPHY 0 24. The authority citation for 21 CFR part 900 continues to read as follows: Authority: 21 U.S.C... address: Food and Drug Administration, Center for Devices and Radiological Health, Division of Mammography... Radiological Health, Director, Division of Mammography Quality and Radiation Programs, 10903 New Hampshire...

  17. Strategies for Addressing Asthma within a Coordinated School Health Program, with Updated Resources. Revised

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2006

    2006-01-01

    This publication offers concrete suggestions for schools working to improve the health and school attendance of students with asthma. The Centers for Disease Control and Prevention (CDC) has identified six strategies for schools and districts to consider when addressing asthma within a coordinated school health program. The six strategies detailed…

  18. Addressing the shortage of health professionals in rural China: issues and progress

    PubMed Central

    Hou, Jianlin; Ke, Yang

    2015-01-01

    Maldistribution of health professionals between urban and rural areas has been a serious problem in China. Urban hospitals attract most of the health professionals with serious shortages in rural areas. To address this issue, a number of policies have been implemented by the government, such as free medical education in exchange for obligatory rural service. PMID:25905487

  19. Latinos and Cancer Information: Perspectives of Patients, Health Professionals and Telephone Cancer Information Specialists

    PubMed Central

    Kaplan, Celia P.; Nápoles, Anna; Davis, Sharon; Lopez, Monica; Pasick, Rena J.; Livaudais-Toman, Jennifer; Pérez-Stable, Eliseo J.

    2016-01-01

    Semi-structured interviews were conducted with 16 Latino cancer patients diagnosed in California; 10 health professionals from the San Francisco Bay Area and Fresno, California; and 10 Cancer Information Services (CIS) information specialists from the regional offices handling calls from Spanish-speakers. Interview guides were designed by the investigators to answer three main research questions: 1) How do Latinos obtain information about cancer and what types of information do they access?; 2) What sources of cancer information do they seek out and find credible?; and 3) What are the barriers and facilitators to Latinos obtaining cancer information? Stakeholders generally viewed health professionals as the most credible source of cancer information. All groups regarded family and friends as important sources of information. Patients and health professionals tended to differ on the value of print materials. Although patients found them generally useful, health professionals tended to view them as inadequate for meeting the informational needs of their Latino patients due to the challenge of low health literacy. Health professionals also tended to undervalue Internet resources compared to patients and CIS specialists. All stakeholders viewed language, ethnic discordance and the impact on patients of the initial diagnosis as barriers to effective communication of cancer information. Health professionals and CIS specialists, but not patients, mentioned low literacy as a barrier. Our findings underscore the importance of the physician-patient relationship as a point of intervention to address the unmet informational and psychosocial needs of Latino cancer patients. PMID:27642542

  20. Exploring the potential of Web 2.0 to address health disparities.

    PubMed

    Gibbons, M Chris; Fleisher, Linda; Slamon, Rachel E; Bass, Sarah; Kandadai, Venk; Beck, J Robert

    2011-01-01

    This article addresses use of the Internet and Web 2.0 technologies by racial and ethnic minorities and explores the potential opportunities and challenges in leveraging Web 2.0 approaches to impact health disparities. These opportunities and challenges include developing approaches and methods to (a) identify strategies for integrating social media into health promotion interventions focused on major health-related issues that affect members of medically underserved groups; (b) amalgamate techniques to leverage and connect social-media technologies to other evidence-informed online resources; (c) integrate health communication best practices, including addressing health literacy issues; (d) capitalize on social networking to enhance access and communication with health care providers; and (e) advance current efforts and ongoing expansion of research participation by individuals from underserved communities.

  1. Effectiveness of Primary Health Care Services in Addressing Mental Health Needs of Minority Refugee Population in New Zealand.

    PubMed

    Shrestha-Ranjit, Jagamaya; Patterson, Elizabeth; Manias, Elizabeth; Payne, Deborah; Koziol-McLain, Jane

    2017-04-01

    Many people are displaced from their country of origin and become refugees, mostly due to armed conflicts, political violence and human rights abuse. Refugees have complex mental, physical, and social health problems related to their traumatic background and the experiences they have endured during their refugee journey. The aim of this qualitative exploratory study was to examine the effectiveness of primary health care services in addressing mental health needs of Bhutanese refugee women resettled in New Zealand. This study included focus group discussion with Bhutanese women and men followed by interviews with health service providers. The findings of this study highlighted inadequacies and constraints in addressing Bhutanese refugee women's mental health needs in New Zealand and provided evidence for recommendations to address these inadequacies.

  2. Basic Information about Health Disparities in Cancer

    MedlinePlus

    ... Causes of Death Among American Indians and Alaska Natives African American Women and Mass Media Campaign Partners Related Links Stay Informed Cancer Home Basic Information About Health Disparities in Cancer Language: English Español (Spanish) Recommend ...

  3. Peer Navigators and Integrated Care to Address Ethnic Health Disparities of People with Serious Mental Illness

    PubMed Central

    Corrigan, Patrick W.; Pickett, Susan; Batia, Karen; Michaels, Patrick J.

    2017-01-01

    People of color with serious mental illnesses experience high rates of morbidity and mortality. Patient navigators, developed for cancer care, may help this group benefit from integrated care. This review examined patient navigators’ key ingredients for cancer care for relevance to patients of color for application of peer services to psychiatric goals. Among cancer patients, navigators lead to greater treatment engagement and improved health outcomes for ethnic minority groups. Research also suggests peers can improve integrated care by providing effective psychiatric services to individuals with mental illness. Ongoing research examines peer navigators’ impact on integrated care for patients of color. PMID:25144699

  4. Implementing the obesity care model at a community health center in Hawaii to address childhood obesity.

    PubMed

    Okihiro, May; Pillen, Michelle; Ancog, Cristeta; Inda, Christy; Sehgal, Vija

    2013-01-01

    Obesity, the most common chronic disease of childhood, is prevalent among economically disadvantaged children. The Chronic Care and Obesity Care Models are comprehensive health care strategies to improve outcomes by linking primary care best practices and community-based programs. Pediatric providers and community health centers are well positioned to design and implement coordinated and synergistic programs to address childhood health disparities. This article describes a comprehensive project based on the Obesity Care Model initiated at a rural community health center in Hawaii to address childhood obesity including: (1) the health care delivery changes constituting the quality improvement project; (2) capacity and team-building activities; (3) use of the project community level data to strengthen community engagement and investment; and (4) the academic-community partnership providing the project framework. We anticipate that these efforts will contribute to the long-term goal of reducing the prevalence of obesity and obesity associated morbidity in the community.

  5. The politics of knowledge: implications for understanding and addressing mental health and illness.

    PubMed

    Jenkins, Emily K

    2014-03-01

    While knowledge represents a valuable commodity, not all forms of knowledge are afforded equal status. The politics of knowledge, which entails the privileging of particular ways of knowing through linkages between the producers of knowledge and other bearers of authority or influence, represents a powerful force driving knowledge development. Within the health research and practice community, biomedical knowledge (i.e. knowledge pertaining to the biological factors influencing health) has been afforded a privileged position, shaping the health research and practice community's view of health, illness and appropriate intervention. The aim of this study is to spark critical reflection and dialogue surrounding the ways in which the politics of knowledge have constrained progress in addressing mental health and illness, one of today's leading public health issues. I argue that the hegemony of biological knowledge represents an ethical issue as it limits the breadth of knowledge available to support practitioners to 'do good' in terms of addressing mental illness. Given the power and influence inherent within the nursing community, I propose that nurses ought to engage in critical reflection and action in an effort to better situate the health research and practice community to effectively address the mental health of populations.

  6. CDC’s Health Equity Resource Toolkit: Disseminating Guidance for State Practitioners to Address Obesity Disparities

    PubMed Central

    Payne, Gayle Holmes; James, Stephen D.; Hawley, Lisa; Corrigan, Bethany; Kramer, Rachel E.; Overton, Samantha N.; Farris, Rosanne P.; Wasilewski, Yvonne

    2015-01-01

    Obesity has been on the rise in the United States over the past three decades, and is high. In addition to population-wide trends, it is clear that obesity affects some groups more than others and can be associated with age, income, education, gender, race and ethnicity, and geographic region. To reverse the obesity epidemic, the Centers for Disease Control and Prevention) promotes evidence-based and practice-informed strategies to address nutrition and physical activity environments and behaviors. These public health strategies require translation into actionable approaches that can be implemented by state and local entities to address disparities. The Centers for Disease Control and Prevention used findings from an expert panel meeting to guide the development and dissemination of the Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities (available at http://www.cdc.gov/obesity/health_equity/toolkit.html). The Toolkit helps public health practitioners take a systematic approach to program planning using a health equity lens. The Toolkit provides a six-step process for planning, implementing, and evaluating strategies to address obesity disparities. Each section contains (a) a basic description of the steps of the process and suggested evidence-informed actions to help address obesity disparities, (b) practical tools for carrying out activities to help reduce obesity disparities, and (c) a “real-world” case study of a successful state-level effort to address obesity with a focus on health equity that is particularly relevant to the content in that section. Hyperlinks to additional resources are included throughout. PMID:24962967

  7. CDC's Health Equity Resource Toolkit: disseminating guidance for state practitioners to address obesity disparities.

    PubMed

    Payne, Gayle Holmes; James, Stephen D; Hawley, Lisa; Corrigan, Bethany; Kramer, Rachel E; Overton, Samantha N; Farris, Rosanne P; Wasilewski, Yvonne

    2015-01-01

    Obesity has been on the rise in the United States over the past three decades, and is high. In addition to population-wide trends, it is clear that obesity affects some groups more than others and can be associated with age, income, education, gender, race and ethnicity, and geographic region. To reverse the obesity epidemic, the Centers for Disease Control and Prevention) promotes evidence-based and practice-informed strategies to address nutrition and physical activity environments and behaviors. These public health strategies require translation into actionable approaches that can be implemented by state and local entities to address disparities. The Centers for Disease Control and Prevention used findings from an expert panel meeting to guide the development and dissemination of the Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities (available at http://www.cdc.gov/obesity/health_equity/toolkit.html). The Toolkit helps public health practitioners take a systematic approach to program planning using a health equity lens. The Toolkit provides a six-step process for planning, implementing, and evaluating strategies to address obesity disparities. Each section contains (a) a basic description of the steps of the process and suggested evidence-informed actions to help address obesity disparities, (b) practical tools for carrying out activities to help reduce obesity disparities, and (c) a "real-world" case study of a successful state-level effort to address obesity with a focus on health equity that is particularly relevant to the content in that section. Hyperlinks to additional resources are included throughout.

  8. Addressing social determinants of health inequities: what can the state and civil society do?

    PubMed

    Blas, Erik; Gilson, Lucy; Kelly, Michael P; Labonté, Ronald; Lapitan, Jostacio; Muntaner, Carles; Ostlin, Piroska; Popay, Jennie; Sadana, Ritu; Sen, Gita; Schrecker, Ted; Vaghri, Ziba

    2008-11-08

    In this Health Policy article, we selected and reviewed evidence synthesised by nine knowledge networks established by WHO to support the Commission on the Social Determinants of Health. We have indicated the part that national governments and civil society can play in reducing health inequity. Government action can take three forms: (1) as provider or guarantor of human rights and essential services; (2) as facilitator of policy frameworks that provide the basis for equitable health improvement; and (3) as gatherer and monitor of data about their populations in ways that generate health information about mortality and morbidity and data about health equity. We use examples from the knowledge networks to illustrate some of the options governments have in fulfilling this role. Civil society takes many forms: here, we have used examples of community groups and social movements. Governments and civil society can have important positive roles in addressing health inequity if political will exists.

  9. Using role substitution to address the health workforce shortage and to facilitate integration?

    PubMed

    Leach, Matthew J

    2012-11-09

    The health workforce is perceived to be in short supply in most developed and developing countries. There are concerns that this could result in reduced coverage of health services and the delivery of suboptimal care. Strategies to address the health workforce shortage have focussed predominantly on recruitment and training, with relatively little regard to the equally important issue of retention. One approach that may improve job satisfaction, opportunities for specialisation and the workload of health workers, and thus, improve retention and more importantly, patient outcomes, is role substitution. Many complementary and alternative medicine (CAM) practitioners appear to be well placed in terms of educational preparation to substitute (either horizontally or vertically) a number of roles traditionally performed by conventional health disciplines. As well as the potential benefits to the health workforce and the quality of patient care, role substitution could provide an important first step toward integrating CAM practitioners into mainstream health care settings.

  10. The role of private foundations in addressing health care workforce needs.

    PubMed

    Thibault, George E

    2013-12-01

    There is an increased awareness among policy makers, providers, and educators that the size, composition, geographic distribution, and skill mix of the health care workforce is of great importance in determining the likelihood of success in achieving our societal goals for health care reform. As academic and governmental institutions work to address these pressing questions, private foundations can and should play an important role in supporting the design, execution, and evaluation of innovative educational programs that will address these needs. Foundations also can and should play a role in generating information that will better inform health care workforce policies and in convening thought leaders to make recommendations that will advance the field of workforce studies.The author details current efforts by the Josiah Macy Jr. Foundation and other private foundations to address health care workforce needs. Foundations can play important roles as catalysts for change in our educational processes, and they can serve as important links between education and health care delivery systems. Partnerships among foundations and between private foundations and federal agencies can be powerful forces in helping to better align the skills of future health professionals with changing patient demographics and a changing health care system.

  11. Addressing the Social Determinants of Suicidal Behaviors and Poor Mental Health in LGBTI Populations in Australia.

    PubMed

    Skerrett, Delaney Michael; Mars, Michelle

    2014-09-01

    The purpose of this article is to describe and assess-as well as identify and rectify gaps in-intervention and prevention initiatives that specifically address poor mental health outcomes and suicidal behaviors in lesbian, gay, bisexual, transgender, and intersex (LGBTI) populations in Australia. It begins with an overview of the evidence base for heightened vulnerability to suicidal behaviors among LGBTI people in Australia. It then provides a discussion on the public health implications for LGBTI-targeted mental health initiatives and the prevention of and timely intervention in LGBTI suicidal behaviors. We conclude that the literature supports an increased risk for poorer mental health outcomes and suicidal behaviors in LGBTI populations in the Australian context. Psychological distress and suicidal behaviors in LGBTI people in Australia have social determinants that can and have been addressed through the provision of interventions with a strong evidence base in reducing these outcomes, implemented at a nationwide level, including training of health professionals and gatekeepers to mental health services and the general public. We conclude that the current Australian focus appears to address many of the social determinants of suicidal behaviors and poor mental health in LGBTI people but requires sustained and uniform government support if it is to continue and to produce measurable results.

  12. Developing Survey Research Infrastructure At An Historically Black College/University To Address Health Disparities

    PubMed Central

    Howard, Daniel L.; Boyd, Carlton L.; Kalsbeek, Bill; Godley, Paul A.

    2011-01-01

    This article describes the development of the Center for Survey Research at Shaw University, a Historically Black College and University (HBCU), and its efforts to build a data collection infrastructure that addresses issues germane to health disparities research in the African American population. Academic institutions that are similar to Shaw in size, mission, and background can use the Project EXPORT collaboration and the Center for Survey Research as models for establishing their own research infrastructure and subsequent survey center in order to address health disparities through the use of survey methodology. PMID:22090795

  13. What does an e-mail address add? - Doing health and technology at home.

    PubMed

    Andreassen, Hege K

    2011-02-01

    There is increasing interest in using electronic mail and other electronic health technologies (e-health technologies) in patient follow-ups. This study sheds light on patients' reception of provider-initiated e-health in their everyday environments. In a research project carried out in Norway (2005-2007), an electronic address for a hospital dermatology ward was offered to 50 patient families for improved access to expert advice from the patients' homes. Drawing on semi-structured interviews with 12 families, this paper explores how the electronic address was integrated into everyday health practice. The research illuminates how the electronic address did not only represent changes related to treatment procedures and frequency or nature of expert contact; it was also important to other practices in the everyday lives of the families of patients with chronic illness. Once in place on the patients' computers, the electronic address was ascribed at least four different roles: it was used as the intended riverbed for a flow of information, but also as a safety alarm, as a shield to the medical gaze and as a token of competence in care and parenting. The multiplicity in use and reception of an electronic address in patient settings illustrates the need to include patients' everyday practices in current professional and political discussions of e-mail and other e-health technologies. Thus this paper argues that there is a need for research on electronic patient-provider communication that moves beyond frequency of use and questions on how technology will affect medical encounters. Social science equally needs to investigate how provider-initiated e-health technologies gets involved in patients' moral and social performance of health and illness in everyday life.

  14. Integrating oral health throughout cancer care.

    PubMed

    Hartnett, Erin

    2015-10-01

    Oral health is often not a priority during cancer treatment; however, patients with cancer are at increased risk for oral complications during and after treatment. This article focuses on the importance of oral health care before, during, and after cancer treatment using the head, eyes, ears, nose, oral cavity, and throat, or HEENOT, approach. AT A GLANCE: Oral health is linked to overall health, and healthcare providers must be cognizant of the oral-systemic connection with patients undergoing cancer treatment, which may cause acute and chronic oral health problems. 
Oral assessment, prevention, early recognition, and treatment of oral problems must be incorporated into cancer care, particularly with the aid of an interprofessional team to meet patients' oral care needs. 
The head, eyes, ears, nose, oral cavity, and throat, or HEENOT, approach integrates oral care into patients' history taking, physical examination, and plan of cancer care.
.

  15. Optimizing cancer care through mobile health.

    PubMed

    Odeh, Bassel; Kayyali, Reem; Nabhani-Gebara, Shereen; Philip, Nada

    2015-07-01

    The survival rates for patients living with cancer are increasing, due to recent advances in detection, prevention and treatment. It has been estimated that there were 28 million cancer survivors around the world in 2012. In the UK, for patients diagnosed in 2007, it is predicted that more than half of them will survive their cancer for 5 years or more. A large majority of cancer survivors report unmet supportive care needs and distressing symptoms and adverse long-term consequences related to their cancer. Cancer management could be optimized to better meet patients demand through technology, including mobile health (m-Health). m-Health is defined as the use of mobile communications and network technologies for health care. m-Health can help both patients and health-care professionals and play an important part in managing and delivering cancer care including managing side effects, supporting drug adherence, providing cancer information, planning and follow up and detecting and diagnosing cancer. Health authorities have already published guidelines regulating m-Health to insure patient safety and improve the accountability of its applications.

  16. Creating a Patient Navigation Model to Address Cervical Cancer Disparities in a Rural Hispanic Farmworker Community

    PubMed Central

    Wells, Kristen J.; Rivera, Maria I.; Proctor, Sara K.; Arroyo, Gloria; Bynum, Shalanda A.; Quinn, Gwendolyn P.; Luque, John S.; Rivera, Marlene; Martinez-Tyson, Dinorah; Meade, Cathy D.

    2013-01-01

    Summary This report describes the implementation of a pilot patient navigation (PN) program created to address cervical cancer disparities in a predominantly Hispanic agricultural community. Since November 2009, a patient navigator has provided services to patients of Catholic Mobile Medical Services (CMMS). The PN program has resulted in the need for additional clinic sessions to accommodate the demand for preventive care at CMMS. PMID:23698685

  17. Addressing health care disparities and increasing workforce diversity: the next step for the dental, medical, and public health professions.

    PubMed

    Mitchell, Dennis A; Lassiter, Shana L

    2006-12-01

    The racial/ethnic composition of our nation is projected to change drastically in the coming decades. It is therefore important that the health professions improve their efforts to provide culturally competent care to all patients. We reviewed literature concerning health care disparities and workforce diversity issues--particularly within the oral health field--and provide a synthesis of recommendations to address these issues. This review is highly relevant to both the medical and public health professions, because they are facing similar disparity and workforce issues. In addition, the recent establishment of relationships between oral health and certain systemic health conditions will elevate oral health promotion and disease prevention as important points of intervention in the quest to improve our nation's public health.

  18. Are health-based payments a feasible tool for addressing risk segmentation?

    PubMed

    Rogal, D L; Gauthier, A K

    1998-01-01

    As they attempt to increase health insurance coverage and improve the efficiency of the market, researchers, policymakers, and health plan representatives have been addressing the issue of risk segmentation. Many risk assessment tools and risk-adjusted payment methodologies have been developed and demonstrated for a variety of populations and payers experiencing various market constraints. The evidence shows that risk-adjusted payments are feasible for most populations receiving acute care, while technical obstacles, political issues, and some research gaps remain.

  19. Health Education: What Can It Look Like after Health Care Reform? 1993 SOPHE Presidential Address.

    ERIC Educational Resources Information Center

    Jorgensen, Cynthia M.

    1994-01-01

    In plans for health care reform, the role of health education in reducing risk behaviors associated with leading causes of death must be recognized. Reform offers new opportunities for prevention programs in schools, worksites, and communities. (SK)

  20. Addressing the social determinants of health of children and youth: a role for SOPHE members.

    PubMed

    Allensworth, Diane D

    2011-08-01

    The determinants of youth health disparities include poverty, unequal access to health care, poor environmental conditions, and educational inequities. Poor and minority children have more health problems and less access to health care than their higher socioeconomic status cohorts. Having more health problems leads to more absenteeism in school, which, in turn, can affect achievement. The educational level that one attains is a significant determinant of one's earning potential and health. Those who learn more earn more money and have a better health status. Those who do not attain a high school diploma on average live 6 to 9 years less than those who do graduate from high school. Furthermore, their children also experience poorer health and the cycle is repeated. Achieving a high school diploma and a college degree is an acknowledged route out of poverty. However, that route is blocked for many poor and minority students. SOPHE is in a prime position to be the organization linking the health care, public health and education sectors in addressing the reduction of both health disparities and educational inequities. This article describes what SOPHE members can do both individually and collectively to reduce the health and educational inequities facing our most vulnerable children.

  1. Teaching lesbian, gay, bisexual and transgender health in a South African health sciences faculty: addressing the gap

    PubMed Central

    2013-01-01

    Background People who identity as lesbian, gay, bisexual and transgender (LGBT) have specific health needs. Sexual orientation and gender identity are social determinants of health, as homophobia and heteronormativity persist as prejudices in society. LGBT patients often experience discrimination and prejudice in health care settings. While recent South African policies recognise the need for providing LGBT specific health care, no curricula for teaching about LGBT health related issues exist in South African health sciences faculties. This study aimed to determine the extent to which LGBT health related content is taught in the University of Cape Town’s medical curriculum. Methods A curriculum mapping exercise was conducted through an online survey of all academic staff at the UCT health sciences faculty, determining LGBT health related content, pedagogical methodology and assessment. Results 127 academics, across 31 divisions and research units in the Faculty of Health Sciences, responded to the survey, of which 93 completed the questionnaire. Ten taught some content related to LGBT health in the MBChB curriculum. No LGBT health related content was taught in the allied health sciences curricula. The MBChB curriculum provided no opportunity for students to challenge their own attitudes towards LGBT patients, and key LGBT health topics such as safer sex, mental health, substance abuse and adolescent health were not addressed. Conclusion At present, UCTs health sciences curricula do not adequately address LGBT specific health issues. Where LGBT health related content is taught in the MBChB curriculum, it is largely discretionary, unsystematic and not incorporated into the overarching structure. Coordinated initiatives to integrate LGBT health related content into all health sciences curricula should be supported, and follow an approach that challenges students to develop professional attitudes and behaviour concerning care for patients from LGBT backgrounds, as

  2. Tailored Educational Approaches for Consumer Health (TEACH): a model system for addressing health communication.

    PubMed

    Cohn, Wendy F; Pannone, Aaron; Schubart, Jane; Lyman, Jason; Kinzie, Mable; Broshek, Donna K; Guterbock, Thomas M; Hartman, David; Mick, David; Bolmey, Armando; Garson, Arthur T

    2006-01-01

    The Consumer Health Education Institute (CHEDI) has developed a model system to improve the quality and effectiveness of patient education and health communication. Through assessment of characteristics and preferences, segmentation into groups and matching with the appropriate materials, we have demonstrated that patients and health consumers have different health information needs and preferences which show promise as a basis for selecting or designing the most appropriate materials or programs.

  3. Developing Effective Interuniversity Partnerships and Community-Based Research to Address Health Disparities

    PubMed Central

    Carey, Timothy S.; Howard, Daniel L.; Goldmon, Moses; Roberson, James T.; Godley, Paul A.; Ammerman, Alice

    2009-01-01

    Health disparities are an enormous challenge to American society. Addressing these disparities is a priority for U.S. society and especially for institutions of higher learning, with their threefold mission of education, service, and research. Collaboration across multiple intellectual disciplines will be critical as universities address health disparities. In addition, universities must collaborate with communities, with state partners, and with each other. Development of these collaborations must be sensitive to the history and unique characteristics of each academic institution and population. The authors describe the challenges of all three types of collaboration, but primarily focus on collaboration between research-intensive universities and historically black colleges and universities. The authors describe a four-year collaboration between Shaw University and the University of North Carolina at Chapel Hill (UNC-CH). These universities strategically developed multiple research initiatives to address health disparities, building on modest early success and personal relationships. These activities included participation by Shaw faculty in faculty development activities, multiple collaborative pilot studies, and joint participation in securing grants from the Agency for Health care Research and Quality of the federal Department of Health and Human Services and the National Institutes of Health, including a P-60 Project EXPORT center grant. These multiple activities were sometimes led by UNC-CH, sometimes by Shaw University. Open discussion of problems as they arose, realistic expectations, and mutual recognition of the strengths of each institution and its faculty have been critical in achieving successful collaboration to date. PMID:16249303

  4. The health of women and girls: how can we address gender equality and gender equity?

    PubMed

    Payne, Sarah

    2015-01-01

    This article focuses on the health of women and girls, and the role of addressing gender inequalities experienced by women and girls. The health of both males and females is influenced by sex, or biological factors, and gender, or socially constructed influences, including gender differences in the distribution and impact of social determinants of health, access to health promoting resources, health behaviors and gender discourse, and the ways in which health systems are organized and financed, and how they deliver care. Various strategies to address the health of women and girls have been developed at intergovernmental, regional, and national level, and by international nongovernmental organizations. These include vertical programs which aim to target specific health risks and deliver services to meet women and girl's needs, and more cross-cutting approaches which aim at "gender" policy making. Much of this work has developed following the adoption of gender mainstreaming principles across different policy arenas and scales of policy making, and this article reviews some of these strategies and the evidence for their success, before concluding with a consideration of future directions in global policy.

  5. Addressing cancer disparities via community network mobilization and intersectoral partnerships: a social network analysis.

    PubMed

    Ramanadhan, Shoba; Salhi, Carmel; Achille, Erline; Baril, Nashira; D'Entremont, Kerrie; Grullon, Milagro; Judge, Christine; Oppenheimer, Sarah; Reeves, Chrasandra; Savage, Clara; Viswanath, Kasisomayajula

    2012-01-01

    Community mobilization and collaboration among diverse partners are vital components of the effort to reduce and eliminate cancer disparities in the United States. We studied the development and impact of intersectoral connections among the members of the Massachusetts Community Network for Cancer Education, Research, and Training (MassCONECT). As one of the Community Network Program sites funded by the National Cancer Institute, this infrastructure-building initiative utilized principles of Community-based Participatory Research (CBPR) to unite community coalitions, researchers, policymakers, and other important stakeholders to address cancer disparities in three Massachusetts communities: Boston, Lawrence, and Worcester. We conducted a cross-sectional, sociometric network analysis four years after the network was formed. A total of 38 of 55 members participated in the study (69% response rate). Over four years of collaboration, the number of intersectoral connections reported by members (intersectoral out-degree) increased, as did the extent to which such connections were reported reciprocally (intersectoral reciprocity). We assessed relationships between these markers of intersectoral collaboration and three intermediate outcomes in the effort to reduce and eliminate cancer disparities: delivery of community activities, policy engagement, and grants/publications. We found a positive and statistically significant relationship between intersectoral out-degree and community activities and policy engagement (the relationship was borderline significant for grants/publications). We found a positive and statistically significant relationship between intersectoral reciprocity and community activities and grants/publications (the relationship was borderline significant for policy engagement). The study suggests that intersectoral connections may be important drivers of diverse intermediate outcomes in the effort to reduce and eliminate cancer disparities. The findings

  6. Coordinated public health initiatives to address violence against women and adolescents.

    PubMed

    Dutton, Mary Ann; James, Lisa; Langhorne, Aleisha; Kelley, Marylouise

    2015-01-01

    Intimate partner violence (IPV) is a well-recognized public health problem. IPV affects women's physical and mental health through direct pathways, such as injury, and indirect pathways, such as a prolonged stress response that leads to chronic health problems. The influence of abuse can persist long after the violence has stopped and women of color are disproportionately impacted. Successfully addressing the complex issue of IPV requires multiple prevention efforts that target specific risk and protective factors across individual, interpersonal, institutional, community, and societal levels. This paper includes examples of community-based, state led and federally funded public health programs focused on IPV along this continuum. Two community-based efforts to increase access to mental health care for low income, women of color who had experienced IPV, Mindfulness-Based Stress Reduction, and a telehealth intervention are discussed. Core tenets of a patient-centered comprehensive approach to assessment and responses and strategies for supporting a statewide comprehensive response are described in Project Connect: A Coordinated Public Health Initiative to Prevent Violence Against Women. Project Connect provides technical assistance to grantees funded through the Violence Against Women Act's health title and involves developing, implementing, and evaluating new ways to identify, respond to, and prevent domestic and sexual violence and promote an improved public health response to abuse in states and Native health programs. Health care partnerships with domestic violence experts are critical in order to provide training, develop referral protocols, and to link IPV victims to advocacy services. Survivors need a comprehensive response that addresses their safety concerns and may require advocacy around housing or shelter, legal assistance, and safety planning. Gaps in research knowledge identified are health system readiness to respond to IPV victims in health care

  7. Coordinated Public Health Initiatives to Address Violence Against Women and Adolescents

    PubMed Central

    James, Lisa; Langhorne, Aleisha; Kelley, Marylouise

    2015-01-01

    Abstract Intimate partner violence (IPV) is a well-recognized public health problem. IPV affects women's physical and mental health through direct pathways, such as injury, and indirect pathways, such as a prolonged stress response that leads to chronic health problems. The influence of abuse can persist long after the violence has stopped and women of color are disproportionately impacted. Successfully addressing the complex issue of IPV requires multiple prevention efforts that target specific risk and protective factors across individual, interpersonal, institutional, community, and societal levels. This paper includes examples of community-based, state led and federally funded public health programs focused on IPV along this continuum. Two community-based efforts to increase access to mental health care for low income, women of color who had experienced IPV, Mindfulness-Based Stress Reduction, and a telehealth intervention are discussed. Core tenets of a patient-centered comprehensive approach to assessment and responses and strategies for supporting a statewide comprehensive response are described in Project Connect: A Coordinated Public Health Initiative to Prevent Violence Against Women. Project Connect provides technical assistance to grantees funded through the Violence Against Women Act's health title and involves developing, implementing, and evaluating new ways to identify, respond to, and prevent domestic and sexual violence and promote an improved public health response to abuse in states and Native health programs. Health care partnerships with domestic violence experts are critical in order to provide training, develop referral protocols, and to link IPV victims to advocacy services. Survivors need a comprehensive response that addresses their safety concerns and may require advocacy around housing or shelter, legal assistance, and safety planning. Gaps in research knowledge identified are health system readiness to respond to IPV victims in health

  8. Addressing Externalities From Swine Production to Reduce Public Health and Environmental Impacts

    PubMed Central

    Osterberg, David; Wallinga, David

    2004-01-01

    Animal agriculture in the United States for the most part has industrialized, with negative consequences for air and water quality and antibiotic use. We consider health and environmental impacts of current US swine production and give an overview of current federal, state, and local strategies being used to address them. PMID:15451736

  9. Addressing Mental Health Needs in Our Schools: Supporting the Role of School Counselors

    ERIC Educational Resources Information Center

    Collins, Traci P.

    2014-01-01

    School counselors are a well-positioned resource to reach the significant number of children and adolescents with mental health problems. In this special school counseling issue of "The Professional Counselor," some articles focus on systemic, top-down advocacy efforts as the point of intervention for addressing child and adolescent…

  10. Addressing Agricultural Issues in Health Care Education: An Occupational Therapy Curriculum Program Description

    ERIC Educational Resources Information Center

    Smallfield, Stacy; Anderson, Angela J.

    2008-01-01

    Context: Medical and allied health professionals who work in agricultural states frequently address the needs of clients who live and work in rural and frontier environments. The primary occupations of those living in rural areas include farming, ranching, or other agriculture-related work. Farming is consistently ranked as one of the most…

  11. [Research in social psychiatry - addressing future challenges of health- and social systems].

    PubMed

    Riedel-Heller, Steffi G

    2009-01-01

    Demographic change, limited financial resources and increasing social exclusion of individuals suffering chronic illness are major challenges for health and social systems in general and for psychiatry in particular. The paper analyses to what extent social psychiatric research currently addresses this challenges. Future perspectives are discussed, exploring the relationship of clinical neuroscience and social psychiatry.

  12. Faculty Attitudes toward Addressing Mental Health Conditions and Substance Abuse among College Students

    ERIC Educational Resources Information Center

    O'Connor-Merrigan, Mary L.

    2013-01-01

    The continued prevalence of mental health conditions and substance abuse among students enrolled in institutions of higher education is a significant and progressing concern, with marked impact on retention, academic success, graduation rate, and alarming personal consequences. Yet, many institutions struggle with successfully addressing these…

  13. A theoretical model to address organizational human conflict and disruptive behavior in health care organizations.

    PubMed

    Piper, Llewellyn E

    2006-01-01

    This article proposes a theoretical model for leaders to use to address organizational human conflict and disruptive behavior in health care organizations. Leadership is needed to improve interpersonal relationships within the workforce. A workforce with a culture of internal conflict will be unable to achieve its full potential to delivery quality patient care.

  14. Challenges of collaboration to address health disparities in the rapidly growing community of Las Vegas, Nevada.

    PubMed

    Woodson, Joyce M; Braxton-Calhoun, Millicent; Black, Jacqueline; Marinelli, Rosalie; O'Hair, Alyssa; Constantino, Nora L

    2009-08-01

    Collaboration was established between a university and the faith-based community in Clark County, Nevada to develop a coalition to address chronic disease in the African American population. The university faculty enlisted several churches and health related agencies to join the coalition. The challenges of collaborating with a community coalition to develop and implement a grant are discussed.

  15. Addressing Children's Oral Health in the New Millennium: Trends in the Dental Workforce

    PubMed Central

    Mertz, Elizabeth; Mouradian, Wendy

    2009-01-01

    The Surgeon General's Report on Oral Health (SGROH) and the Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist to population ratio is declining, while mal-distribution of dentists continues for rural and underserved communities. The diversity of the dental workforce has only improved slightly, while the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include: enhanced training in children's oral health for general dentists; expanded scope of practice for allied dental health professionals; new dental practitioners including the dental health aid therapist; and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts and strong partnerships with communities will be needed to effect substantive changes in children's oral health. PMID:19854121

  16. Structural Vulnerability: Operationalizing the Concept to Address Health Disparities in Clinical Care.

    PubMed

    Bourgois, Philippe; Holmes, Seth M; Sue, Kim; Quesada, James

    2017-03-01

    The authors propose reinvigorating and extending the traditional social history beyond its narrow range of risk behaviors to enable clinicians to address negative health outcomes imposed by social determinants of health. In this Perspective, they outline a novel, practical medical vulnerability assessment questionnaire that operationalizes for clinical practice the social science concept of "structural vulnerability." A structural vulnerability assessment tool designed to highlight the pathways through which specific local hierarchies and broader sets of power relationships exacerbate individual patients' health problems is presented to help clinicians identify patients likely to benefit from additional multidisciplinary health and social services. To illustrate how the tool could be implemented in time- and resource-limited settings (e.g., emergency department), the authors contrast two cases of structurally vulnerable patients with differing outcomes. Operationalizing structural vulnerability in clinical practice and introducing it in medical education can help health care practitioners think more clearly, critically, and practically about the ways social structures make people sick. Use of the assessment tool could promote "structural competency," a potential new medical education priority, to improve understanding of how social conditions and practical logistics undermine the capacities of patients to access health care, adhere to treatment, and modify lifestyles successfully. Adoption of a structural vulnerability framework in health care could also justify the mobilization of resources inside and outside clinical settings to improve a patient's immediate access to care and long-term health outcomes. Ultimately, the concept may orient health care providers toward policy leadership to reduce health disparities and foster health equity.

  17. Health systems challenges in cervical cancer prevention program in Malawi

    PubMed Central

    Maseko, Fresier C.; Chirwa, Maureen L.; Muula, Adamson S.

    2015-01-01

    treatment. Conclusion Numerous health system challenges are prevailing in the cervical cancer prevention program in Malawi. These challenges need to be addressed if the health system is to improve on the coverage of cervical cancer screening and treatment. PMID:25623612

  18. Disease patterns addressed by mobile health-enabling technologies--a literature review.

    PubMed

    Von Bargen, Tobias; Schwartze, Jonas; Haux, Reinhold

    2013-01-01

    Health-enabling technologies can contribute to a better living with diverse disease patterns, especially at home. Ambient Assisted Living (AAL) provides security and convenience at the main place of residence, but usually cannot be taken on the road. Mobile health-enabling technologies could overcome this barrier of immobility and enable its' users to take advantages of assistive technology with them. The presented literature review examines disease patterns, which can be addressed by mobile health-enabling technologies. Especially chronic diseases, like diabetes, are very responsive for continuous support by portable support technology.

  19. A community health worker intervention to address the social determinants of health through policy change.

    PubMed

    Ingram, Maia; Schachter, Ken A; Sabo, Samantha J; Reinschmidt, Kerstin M; Gomez, Sofia; De Zapien, Jill Guernsey; Carvajal, Scott C

    2014-04-01

    Public policy that seeks to achieve sustainable improvements in the social determinants of health, such as income, education, housing, food security and neighborhood conditions, can create positive and sustainable health effects. This paper describes preliminary results of Acción para la Salud, a public health intervention in which Community health workers (CHWs) from five health agencies engaged their community in the process of making positive systems and environmental changes. Academic-community partners trained Acción CHWs in community advocacy and provided ongoing technical assistance in developing strategic advocacy plans. The CHWs documented community advocacy activities through encounter forms in which they identified problems, formulated solutions, and described systems and policy change efforts. Strategy maps described the steps of the advocacy plans. Findings demonstrate that CHWs worked to initiate discussions about underlying social determinants and environment-related factors that impact health, and identified solutions to improve neighborhood conditions, create community opportunities, and increase access to services.

  20. Knowledge into action? understanding ideological barriers to addressing health inequalities at the local level.

    PubMed

    Collins, Patricia A; Abelson, Julia; Eyles, John D

    2007-01-01

    The objective of this study was to explore the presence of ideological barriers to addressing local health inequalities in Hamilton, Ontario, Canada. A survey of active citizens revealed low levels of awareness of the social determinants of health (SDOH) framework, and some incongruence between understanding and attitudes towards the SDOH. Support for addressing health inequalities was associated with awareness of the SDOH framework, liberal value-systems, and a cluster of socio-demographic characteristics. Liberal leaning participants were also more politically active than their conservative counterparts. Ideological barriers included lack of SDOH awareness, narrow understandings of the relative influences of the SDOH, resistance to de-prioritizing healthcare, and conservative values. Advancement of a SDOH policy agenda should incorporate wider dissemination efforts to citizens and local service providers to increase support for this framework, and utilization of existing support and political engagement from liberal-leaning demographics.

  1. Policy Options for Addressing Health System and Human Resources for Health Crisis in Liberia Post-Ebola Epidemic

    PubMed Central

    Budy, Fidel C.T.

    2015-01-01

    Qualified healthcare workers within an effective health system are critical in promoting and achieving greater health outcomes such as those espoused in the Millennium Development Goals. Liberia is currently struggling with the effects of a brutal 14-year long civil war that devastated health infrastructures and caused most qualified health workers to flee and settle in foreign countries. The current output of locally trained health workers is not adequate for the tasks at hand. The recent Ebola Virus Disease (EVD) exposed the failings of the Liberian healthcare system. There is limited evidence of policies that could be replicated in Liberia to encourage qualified diaspora Liberian health workers to return and contribute to managing the phenomenon. This paper reviews the historical context for the human resources for health crisis in Liberia; it critically examines two context-specific health policy options to address the crisis, and recommends reverse brain drain as a policy option to address the immediate and critical crisis facing the health care sector in Liberia. PMID:27622002

  2. Policy Options for Addressing Health System and Human Resources for Health Crisis in Liberia Post-Ebola Epidemic.

    PubMed

    Budy, Fidel C T

    2015-01-01

    Qualified healthcare workers within an effective health system are critical in promoting and achieving greater health outcomes such as those espoused in the Millennium Development Goals. Liberia is currently struggling with the effects of a brutal 14-year long civil war that devastated health infrastructures and caused most qualified health workers to flee and settle in foreign countries. The current output of locally trained health workers is not adequate for the tasks at hand. The recent Ebola Virus Disease (EVD) exposed the failings of the Liberian healthcare system. There is limited evidence of policies that could be replicated in Liberia to encourage qualified diaspora Liberian health workers to return and contribute to managing the phenomenon. This paper reviews the historical context for the human resources for health crisis in Liberia; it critically examines two context-specific health policy options to address the crisis, and recommends reverse brain drain as a policy option to address the immediate and critical crisis facing the health care sector in Liberia.

  3. A Strategic Framework for Utilizing Late-Stage (T4) Translation Research to Address Health Inequities

    PubMed Central

    Lopez-Class, Maria; Peprah, Emmanuel; Zhang, Xinzhi; Kaufmann, Peter G.; Engelgau, Michael M.

    2016-01-01

    Achieving health equity requires that every person has the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances. Inequity experienced by populations of lower socioeconomic status is reflected in differences in health status and mortality rates, as well as in the distribution of disease, disability and illness across these population groups. This article gives an overview of the health inequities literature associated with heart, lung, blood and sleep (HLBS) disorders. We present an ecological framework that provides a theoretical foundation to study late-stage T4 translation research that studies implementation strategies for proven effective interventions to address health inequities. PMID:27440979

  4. Advocacy to action: addressing coordinated school health program issues with school boards.

    PubMed

    Wiley, David C; Howard-Barr, Elissa M

    2005-01-01

    As the need for Coordinated School Health Programs (CSHP) increases, so does recognition of the importance for advocating with local school boards for their support. Identifying the diversified make up of school board members and implementing effective strategies to advocate for coordinated school health can help facilitate the successful inclusion of such a program. With increasing emphasis placed on standardized testing and the "basic" curriculum, school board members need to become aware of specific benefits a CSHP can provide their district. With the relationship between health status and academic achievement confirmed in scientific research, school boards may begin paying more attention to providing high-quality health services and health instruction for students. This article presents items to consider and steps to take before, during, and after addressing a local school board for their support in implementing a CSHP.

  5. Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals

    ERIC Educational Resources Information Center

    Thompson, Tess; Kreuter, Matthew W.; Boyum, Sonia

    2016-01-01

    Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g., housing). Callers to 2-1-1 in Missouri (N = 1,090) with at least one behavioral…

  6. A Framework for Educating Health Professionals to Address the Social Determinants of Health

    ERIC Educational Resources Information Center

    National Academies Press, 2016

    2016-01-01

    The World Health Organization defines the social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." These forces and systems include economic policies, development agendas, cultural and social norms, social policies,…

  7. CHILDREN'S ENVIRONMENTAL HEALTH RESEARCH - EPA AND DHHS COLLABORATE TO ADDRESS LONG-TERM HEALTH ISSUES

    EPA Science Inventory

    Children's environmental health is important to the mission of both the U.S. Department of Health and Human Services (DHHS) and the U.S. Environmental Protection Agency (EPA). Over the past seven years, federal experts from a variety of disciplines including survey sampling desi...

  8. An approach to addressing governance from a health system framework perspective.

    PubMed

    Mikkelsen-Lopez, Inez; Wyss, Kaspar; de Savigny, Don

    2011-12-02

    As countries strive to strengthen their health systems in resource constrained contexts, policy makers need to know how best to improve the performance of their health systems. To aid these decisions, health system stewards should have a good understanding of how health systems operate in order to govern them appropriately. While a number of frameworks for assessing governance in the health sector have been proposed, their application is often hindered by unrealistic indicators or they are overly complex resulting in limited empirical work on governance in health systems. This paper reviews contemporary health sector frameworks which have focused on defining and developing indicators to assess governance in the health sector. Based on these, we propose a simplified approach to look at governance within a common health system framework which encourages stewards to take a systematic perspective when assessing governance. Although systems thinking is not unique to health, examples of its application within health systems has been limited. We also provide an example of how this approach could be applied to illuminate areas of governance weaknesses which are potentially addressable by targeted interventions and policies. This approach is built largely on prior literature, but is original in that it is problem-driven and promotes an outward application taking into consideration the major health system building blocks at various levels in order to ensure a more complete assessment of a governance issue rather than a simple input-output approach. Based on an assessment of contemporary literature we propose a practical approach which we believe will facilitate a more comprehensive assessment of governance in health systems leading to the development of governance interventions to strengthen system performance and improve health as a basic human right.

  9. Addressing the community/public health nursing shortage through a multifaceted regional approach.

    PubMed

    Young, Staci; Acord, Lea; Schuler, Sue; Hansen, Judith M

    2014-01-01

    Despite increasing needs resulting from emerging societal and health care issues, the number of trained community/public health (C/PH) nurses in the United States is facing a precipitous decline. Numerous factors contribute to this shortage including an aging workforce, a poorly funded public health system, inconsistencies in C/PH nursing educational approaches and opportunities, and a shortage of sites for clinical training. Determined to address the C/PH nursing shortage in their region, a consortium of public health professionals, university deans and faculty, and state nursing leaders in southeastern Wisconsin came together to address these issues from three perspectives: (a) curricular analysis and redesign, (b) expansion of clinical placement opportunities, and (c) paid community/public health nursing internships for seniors in baccalaureate nursing programs. This article outlines briefly the activities undertaken related to curricular review and clinical placements, and then describes in detail the approach, challenges and results of the senior internship program. Together, these programs produced long-lasting results including an unprecedented level of collaboration between academic institutions and public health nursing professionals, the expansion of both traditional and nontraditional clinical sites in the region, and a transformative learning experience for seventeen senior nursing students from five participating universities.

  10. Identifying and Addressing the Unmet Health Care Needs of Drug Court Clients.

    PubMed

    Dugosh, Karen L; Festinger, David S; Lipkin, Jessica L

    2016-12-01

    Drug courts address issues such as employment and housing but largely miss the opportunity to address important health care issues. The current study examined the prevalence and correlates of chronic medical conditions among a sample of drug court clients who were participating in a clinical trial of an intervention to reduce HIV risk. A total of 256 clients completed a health survey at entry into the drug court program and 9 months post-entry. The baseline health survey included a comprehensive list of chronic medical conditions, and participants were asked to indicate which, if any, they had ever been diagnosed as having. They were also asked to indicate whether or not they were currently receiving treatment for each chronic condition that they endorsed. The follow-up survey was identical to the baseline survey, with the exception that it contained items reflecting (1) whether or not any member of the drug court team engaged in discussion with the client about each of the chronic conditions reported and (2) whether the client received a referral to medical care for endorsed conditions while in the drug court program. Results indicated that over 50% of clients reported at least one chronic condition and 21% reported more than one condition. Among those with chronic conditions, 71% reported having chronic conditions for which they were not currently receiving treatment. Unfortunately, drug court clients reported that the drug court team did little to address these unmet health needs. Findings from this study suggest that clients could benefit if drug court programs began to widen their focus to include addressing health-related issues.

  11. Don't blame patients, engage them: transforming health systems to address health literacy.

    PubMed

    Frosch, Dominick L; Elwyn, Glyn

    2014-01-01

    The passage of the Patient Protection and Affordable Care Act is affirming a new era for health care delivery in the United States, with an increased focus on patient engagement. The field of health literacy has important contributions to make, and there are opportunities to achieve much more synergy between these seemingly different perspectives. Systems need to be designed in a user-centered way that is responsive to patients at all levels of health literacy. Similarly, strategies are needed to ensure that patients are supported to become engaged, at the level they desire, instead of the status quo, in which patients are rarely actively empowered and encouraged to engage in health care decisions, where preferences are rarely elicited, and where there is a lack of interest in how their life circumstances shape their priorities.

  12. Addressing Health Inequalities in the Delivery of the Human Papillomavirus Vaccination Programme: Examining the Role of the School Nurse

    PubMed Central

    Boyce, Tammy; Holmes, Alison

    2012-01-01

    Background HPV immunisation of adolescent girls is expected to have a significant impact in the reduction of cervical cancer. UK The HPV immunisation programme is primarily delivered by school nurses. We examine the role of school nurses in delivering the HPV immunisation programme and their impact on minimising health inequalities in vaccine uptake. Methods and Findings A rapid evidence assessment (REA) and semi-structured interviews with health professionals were conducted and analysed using thematic analysis. 80 health professionals from across the UK are interviewed, primarily school nurses and HPV immunisation programme coordinators. The REA identified 2,795 articles and after analysis and hand searches, 34 relevant articles were identified and analysed. Interviews revealed that health inequalities in HPV vaccination uptake were mainly related to income and other social factors in contrast to published research which emphasises potential inequalities related to ethnicity and/or religion. Most school nurses interviewed understood local health inequalities and made particular efforts to target girls who did not attend or missed doses. Interviews also revealed maintaining accurate and consistent records influenced both school nurses' understanding and efforts to target inequalities in HPV vaccination uptake. Conclusions Despite high uptake in the UK, some girls remain at risk of not being vaccinated with all three doses. School nurses played a key role in reducing health inequalities in the delivery of the HPV programme. Other studies identified religious beliefs and ethnicity as potentially influencing HPV vaccination uptake but interviews for this research found this appeared not to have occurred. Instead school nurses stated girls who were more likely to be missed were those not in education. Improving understanding of the delivery processes of immunisation programmes and this impact on health inequalities can help to inform solutions to increase uptake and

  13. Residential address errors in public health surveillance data: a description and analysis of the impact on geocoding.

    PubMed

    Zinszer, Kate; Jauvin, Christian; Verma, Aman; Bedard, Lucie; Allard, Robert; Schwartzman, Kevin; de Montigny, Luc; Charland, Katia; Buckeridge, David L

    2010-07-01

    The residential addresses of persons with reportable communicable diseases are used increasingly for spatial monitoring and cluster detection, and public health may direct interventions based upon the results of routine spatial surveillance. There has been little assessment, however, of the quality of address data in reportable disease notifications and of the corresponding impact of these errors on geocoding and routine public health practices. The objectives of this study were to examine address errors for a selected reportable disease in a large urban center in Canada and to assess the impact of identified errors on geocoding and the estimated spatial distribution of the disease. We extracted data for all notifications of campylobacteriosis from the Montreal public health department from 1995 to 2008 and used an address verification algorithm to determine the validity of the residential address for each case and to suggest corrections for invalid addresses. We assessed the types of address errors as well as the resulting positional errors, calculating the distance between the original address and the correct address as well as changes in disease density. Address errors and missing addresses were prevalent in the public health records (10% and 5%, respectively) and they influenced the observed distribution of campylobacteriosis in Montreal, with address correction changing case location by a median of 1.1 km. Further examination of the extent of address errors in public health data is essential, as is the investigation of how these errors impact routine public health functions.

  14. Addressing London's modern urban health challenges: learning from other global cities.

    PubMed

    Doyle, Y G; Mills, A J; Korkodilos, M

    2017-03-18

    Around 150 cities have emerged as notable at a global scale. With a global population of fewer than 12%, they generate 46% of world gross domestic product. There is growing interest in how cities can accelerate health improvements through wider social and economic collaboration. A team led by Public Health England in London visited counterparts in New York City and Paris to examine how city health leaders addressed public health challenges. The three cities have similar health challenges but different legal, political and fiscal resources for promoting and protecting health. Consequently, there is no single model that every city could adopt. Organizational structures, interpersonal relationships and individual skills can play an important part in effective delivery of better city health. Lack of access to published evidence on how practice has been influenced by city health policies hampers learning between cities. There is little easily comparable data to guide those interested in such learning. Municipal governments are ideally situated to join researchers to fill this gap in the literature.

  15. Assessing opinions in community leadership networks to address health inequalities: a case study from Project IMPACT

    PubMed Central

    McCauley, M. P.; Ramanadhan, S.; Viswanath, K.

    2015-01-01

    This study demonstrates a novel approach that those engaged in promoting social change in health can use to analyze community power, mobilize it and enhance community capacity to reduce health inequalities. We used community reconnaissance methods to select and interview 33 participants from six leadership sectors in ‘Milltown’, the New England city where the study was conducted. We used UCINET network analysis software to assess the structure of local leadership and NVivo qualitative software to analyze leaders’ views on public health and health inequalities. Our main analyses showed that community power is distributed unequally in Milltown, with our network of 33 divided into an older, largely male and more powerful group, and a younger, largely female group with many ‘grassroots’ sector leaders who focus on reducing health inequalities. Ancillary network analyses showed that grassroots leaders comprise a self-referential cluster that could benefit from greater affiliation with leaders from other sectors and identified leaders who may serve as leverage points in our overall program of public agenda change to address health inequalities. Our innovative approach provides public health practitioners with a method for assessing community leaders’ views, understanding subgroup divides and mobilizing leaders who may be helpful in reducing health inequalities. PMID:26471919

  16. Toward Culturally Centered Integrative Care for Addressing Mental Health Disparities among Ethnic Minorities

    PubMed Central

    Holden, Kisha; McGregor, Brian; Thandi, Poonam; Fresh, Edith; Sheats, Kameron; Belton, Allyson; Mattox, Gail; Satcher, David

    2014-01-01

    Despite decades of research, recognition and treatment of mental illness and its co-morbidities still remain a significant public health problem in the United States. Ethnic minorities are identified as a population that is vulnerable to mental health disparities and face unique challenges pertaining to mental health care. Psychiatric illness is associated with great physical, emotional, functional, and societal burden. The primary health care setting may be a promising venue for screening, assessment, and treatment of mental illnesses for ethnic minority populations. We propose a comprehensive, innovative, culturally centered integrated care model to address the complexities within the health care system, from the individual level, that includes provider and patient factors, to the system level, which include practice culture and system functionality issues. Our multi-disciplinary investigative team acknowledges the importance of providing culturally tailored integrative healthcare to holistically concentrate on physical, mental, emotional, and behavioral problems among ethnic minorities in a primary care setting. It is our intention that the proposed model will be useful for health practitioners, contribute to the reduction of mental health disparities, and promote better mental health and well-being for ethnic minority individuals, families, and communities. PMID:25383991

  17. Addressing geriatric oral health concerns through national oral health policy in India

    PubMed Central

    Singh, Abhinav; Purohit, Bharathi M

    2015-01-01

    There is an escalating demand for geriatric oral healthcare in all developed and developing countries including India. Two-thirds of the world’s elderly live in developing countries. This is a huge population that must receive attention from policy-makers who will be challenged by the changing demands for social and health services including oral health services. Resources are limited thus rather than being aspirational in wanting to provide all treatment needed for everybody, this critique presents a road map of how we might answer the present and future geriatric oral health concerns in a most efficient manner in a developing country. Viewing the recent Indian demographic profile and the trends in oral health, pertinent policy subjects have been discussed concerning the oral health needs of the elderly and also the associated challenges which include strategies to improve quality of life, strategies to train and educate the dental workforce and above all the role of healthcare systems towards realization of better aged society in India and other developing countries. PMID:25584351

  18. Understanding health anxiety following breast cancer diagnosis.

    PubMed

    Jones, Shannon L; Hadjistavropoulos, Heather D; Gullickson, Kirsten

    2014-01-01

    Health anxiety is a persistent fear of illness or disease that often involves the misinterpretation of bodily symptoms as signs of serious illness. Evidence shows that health anxiety affects a proportion of women following a diagnosis of breast cancer, but there are some limitations to how health anxiety has been measured. The objectives of this study were to (1) provide an estimate of clinically elevated health anxiety in women after a diagnosis of breast cancer using a validated measure appropriate for medical populations and (2) understand patient, disease, and anxiety/vulnerability variables that predict health anxiety in this group. Canadian women (n = 137) diagnosed with breast cancer within the past five years completed an online survey measuring health anxiety, along with patient, disease, and anxiety/vulnerability variables. Clinically significant health anxiety was reported by 23.4% of the sample. The regression model revealed that younger age, more advanced stage of breast cancer, increased cognitive anxiety sensitivity, and greater body vigilance were significant unique predictors of health anxiety. These findings highlight that a proportion of women report substantial health anxiety following breast cancer diagnosis, with a combination of patient, disease, and anxiety/vulnerability variables associated with the experience. Further research is needed to better understand the impact of health anxiety in this population.

  19. Using community-based participatory research to address Chinese older women's health needs: Toward sustainability.

    PubMed

    Chang, E-Shien; Simon, Melissa A; Dong, XinQi

    2016-01-01

    Although community-based participatory research (CBPR) has been recognized as a useful approach for eliminating health disparities, less attention is given to how CBPR projects may address gender inequalities in health for immigrant older women. The goal of this article is to share culturally sensitive strategies and lessons learned from the PINE study-a population-based study of U.S. Chinese older adults that was strictly guided by the CBPR approach. Working with Chinese older women requires trust, respect, and understanding of their unique historical, social, and cultural positions. We also discuss implications for developing impact-driven research partnerships that meet the needs of this vulnerable population.

  20. Addressing the migration of health professionals: the role of working conditions and educational placements

    PubMed Central

    2009-01-01

    This article provides a brief overview of the global health-worker shortage, which could undermine the Millennium Development Goal to halt and begin to reverse the spread of HIV/AIDS. The current situation suggests that long-term solutions to shortages can only be found by addressing the problem from a global perspective; that is, to eliminate shortages through substantial investments in training and retaining health workers in developed and developing countries, and not through policies that do not work towards solving this underlying problem, such as ones that restrict migration. PMID:19922691

  1. New Perspectives in Mental Health: Addressing Cognitive Deficits in Remitted Depression.

    PubMed

    Chen, Jason I; Hergert, Danielle C

    2017-02-08

    The purpose of this essay is to explore the long-term impact of depression on cognitive functioning and to discuss possible treatment strategies that mental health and psychiatric nurses may employ in practice or pursue in research to improve patient outcomes. As psychiatric and mental health nurses play a valuable role in promoting recovery from depression, addressing cognitive difficulties associated with depression may be an important area for nursing practice. This essay will first introduce the rationale for evaluating cognitive deficits in remitted depression in regards to the impact on quality of life (QOL). This article is protected by copyright. All rights reserved.

  2. Everyone Swims: a community partnership and policy approach to address health disparities in drowning and obesity.

    PubMed

    Stempski, Sarah; Liu, Lenna; Grow, H Mollie; Pomietto, Maureen; Chung, Celeste; Shumann, Amy; Bennett, Elizabeth

    2015-04-01

    Well-known disparities exist in rates of obesity and drowning, two public health priorities. Addressing these disparities by increasing access to safe swimming and water recreation may yield benefits for both obesity and injury prevention. Everyone Swims, a community partnership, brought community health clinics and water recreation organizations together to improve policies and systems that facilitated learning to swim and access to swimming and water recreation for low-income, diverse communities. Based in King County, Washington, Everyone Swims launched with Centers for Disease Control and Prevention grant funding from 2010 to 2012. This partnership led to multiple improvements in policies and systems: higher numbers of clinics screening for swimming ability, referrals from clinics to pools, more scholarship accessibility, and expansion of special swim programs. In building partnerships between community health/public health and community recreation organizations to develop systems that address user needs in low-income and culturally diverse communities, Everyone Swims represents a promising model of a structured partnership for systems and policy change to promote health and physical activity.

  3. Mapping of Health Communication and Education Strategies Addressing the Public Health Dangers of Illicit Online Pharmacies.

    PubMed

    Anderson, Allison C; Mackey, Tim K; Attaran, Amir; Liang, Bryan A

    2016-01-01

    Illicit online pharmacies are a growing global public health concern. Stakeholders have started to engage in health promotion activities to educate the public, yet their scope and impact has not been examined. We wished to identify health promotion activities focused on consumer awareness regarding the risks of illicit online pharmacies. Organizations engaged on the issue were first identified using a set of engagement criteria. We then reviewed these organizations for health promotion programs, educational components, public service announcements, and social media engagement. Our review identified 13 organizations across a wide spectrum of stakeholders. Of these organizations, 69.2% (n = 9) had at least one type of health promotion activity targeting consumers. Although the vast majority of these organizations were active on Facebook or Twitter, many did not have dedicated content regarding online pharmacies (Facebook: 45.5%, Twitter: 58.3%). An online survey administered to 6 respondents employed by organizations identified in this study found that all organizations had dedicated programs on the issue, but only half had media planning strategies in place to measure the effectiveness of their programs. Overall, our results indicate that though some organizations are actively engaged on the issue, communication and education initiatives have had questionable effectiveness in reaching the public. We note that only a few organizations offered comprehensive and dedicated content to raise awareness on the issue and were effective in social media communications. In response, more robust collaborative efforts between stakeholders are needed to educate and protect the consumer about this public health and patient safety danger.

  4. Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context

    PubMed Central

    2014-01-01

    Background International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Discussion Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address

  5. Addressing the Health Needs of High-Risk Filipino Americans in the Greater Philadelphia Region.

    PubMed

    Bhimla, Aisha; Yap, Lauren; Lee, Minsun; Seals, Brenda; Aczon, Hermie; Ma, Grace X

    2017-04-01

    Filipino Americans represent one of the largest and most diverse immigrant populations in the United States. It has been established that chronic diseases are a significant public health issue affecting this population. We conducted a health needs assessment of 200 Filipino Americans aged 18 years or older residing in the greater Philadelphia region. Study participants were recruited from eight Filipino community-based organizations in the region. Information about demographic and acculturative characteristics, health behaviors, self-reported chronic health conditions, and chronic disease perception were collected. Participants were older and highly acculturated. With regards to health behaviors, several did not meet dietary fruit and vegetables intake and physical activity guidelines. The top five health conditions were high blood pressure (67.5 %), high blood cholesterol (57.1 %), arthritis (28.9 %), diabetes (21.8 %), and cancer (14.7 %). Majority of participants perceived high blood pressure, high blood cholesterol, and diabetes to be a concern in their community, and had high awareness of the risk factors associated with these diseases. Reported rates of hypertension, high cholesterol, and diabetes suggest that lifestyle interventions targeting diet and physical activity, in addition to health education, are needed in this population.

  6. Barriers to cancer screening in Hmong Americans: the influence of health care accessibility, culture, and cancer literacy.

    PubMed

    Lee, Hee Yun; Vang, Suzanne

    2010-06-01

    Hmong Americans face high cancer mortality rates even in comparison to their Asian American counterparts, and report low utilization of cancer screenings. To date, no study has been conducted on the cultural barriers this population faces in undergoing cancer screenings. A systematic review of the literature was conducted to examine the existing knowledge regarding the barriers to cancer screening for Hmong Americans. Potential barriers were identified from this examination to include: health access factors (type of health insurance, ethnicity of provider, low English proficiency, and years spent in the U.S.); cultural factors (belief in the spiritual etiology of diseases, patriarchal values, modesty, and mistrust of the western medical system); and cancer literacy factors (cancer and prevention illiteracy). Based on this review, potential cultural and ethnic group-specific prevention strategies and cancer health policies are discussed to address these barriers and enhance screening behavior among the Hmong.

  7. Examples of Cancer Health Disparities

    MedlinePlus

    ... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Events Cancer Currents Blog All Press Releases 2017 ... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Cancer Currents Blog About NCI NCI Overview History ...

  8. How I do it: managing bone health in patients with prostate cancer.

    PubMed

    Barkin, Jack

    2014-08-01

    Urologists have two scenarios where they have to address bone loss or increased risk of fractures in men with prostate cancer. In the first setting, a patient who has been started on androgen deprivation therapy may develop cancer-treatment-induced bone loss. In the second setting, a patient's prostate cancer may have metastasized to the bone. This article describes six steps to manage bone health in patients diagnosed with prostate cancer in a community practice.

  9. New dialogue for the way forward in maternal health: addressing market inefficiencies.

    PubMed

    McCarthy, Katharine; Ramarao, Saumya; Taboada, Hannah

    2015-06-01

    Despite notable progress in Millennium Development Goal (MDG) five, to reduce maternal deaths three-quarters by 2015, deaths due to treatable conditions during pregnancy and childbirth continue to concentrate in the developing world. Expanding access to three effective and low-cost maternal health drugs can reduce preventable maternal deaths, if available to all women. However, current failures in markets for maternal health drugs limit access to lifesaving medicines among those most in need. In effort to stimulate renewed action planning in the post-MDG era, we present three case examples from other global health initiatives to illustrate how market shaping strategies can scale-up access to essential maternal health drugs. Such strategies include: sharing intelligence among suppliers and users to better approximate and address unmet need for maternal health drugs, introducing innovative financial strategies to catalyze otherwise unattractive markets for drug manufacturers, and employing market segmentation to create a viable and sustainable market. By building on lessons learned from other market shaping interventions and capitalizing on opportunities for renewed action planning and partnership, the maternal health field can utilize market dynamics to better ensure sustainable and equitable distribution of essential maternal health drugs to all women, including the most marginalized.

  10. Strategies for expanding colorectal cancer screening at community health centers.

    PubMed

    Sarfaty, Mona; Doroshenk, Mary; Hotz, James; Brooks, Durado; Hayashi, Seiji; Davis, Terry C; Joseph, Djenaba; Stevens, David; Weaver, Donald L; Potter, Michael B; Wender, Richard

    2013-01-01

    Community health centers are uniquely positioned to address disparities in colorectal cancer (CRC) screening as they have addressed other disparities. In 2012, the federal Health Resources and Services Administration, which is the funding agency for the health center program, added a requirement that health centers report CRC screening rates as a standard performance measure. These annually reported, publically available data are a major strategic opportunity to improve screening rates for CRC. The Patient Protection and Affordable Care Act enacted provisions to expand the capacity of the federal health center program. The recent report of the Institute of Medicine on integrating public health and primary care included an entire section devoted to CRC screening as a target for joint work. These developments make this the ideal time to integrate lifesaving CRC screening into the preventive care already offered by health centers. This article offers 5 strategies that address the challenges health centers face in increasing CRC screening rates. The first 2 strategies focus on improving the processes of primary care. The third emphasizes working productively with other medical providers and institutions. The fourth strategy is about aligning leadership. The final strategy is focused on using tools that have been derived from models that work.

  11. CANCER INCIDENCE IN THE AGRICULTURAL HEALTH STUDY

    EPA Science Inventory

    The Agricultural Health Study (AHS) was undertaken to ascertain the etiology of cancers observed to be elevated in agricultural populations. Methods: The AHS is a large prospective, cohort study of private applicators and commercial applicators licensed to apply restricted use ...

  12. The role of law in addressing mental health-related aspects of disasters and promoting resilience.

    PubMed

    Rutkow, Lainie

    2012-01-01

    Law plays a critical role in emergency preparedness and disaster response by establishing an infrastructure for the response and facilitating coordination among the federal, state, and local governments. Once a disaster occurs, certain legal mechanisms are activated to ensure that individuals' needs for mental health care are met, both for pre-existing and emergent conditions. This includes the rapid deployment of mental health care personnel and the implementation of crisis counseling programs in affected regions. By facilitating an influx of resources, including personnel, supplies, and financial assistance, the law can help communities quickly rebound and return to a sense of normal. Drawing on examples from the United States, this article illustrates the diverse ways in which the law simultaneously addresses mental health-related aspects of disasters and promotes resilience within affected communities.

  13. Addressing the social determinants of health through the Alameda County, California, place matters policy initiative.

    PubMed

    Schaff, Katherine; Desautels, Alexandra; Flournoy, Rebecca; Carson, Keith; Drenick, Teresa; Fujii, Darlene; Lee, Anna; Luginbuhl, Jessica; Mena, Mona; Shrago, Amy; Siegel, Anita; Stahl, Robert; Watkins-Tartt, Kimi; Willow, Pam; Witt, Sandra; Woloshin, Diane; Yamashita, Brenda

    2013-11-01

    In Alameda County, California, significant health inequities by race/ethnicity, income, and place persist. Many of the county's low-income residents and residents of color live in communities that have faced historical and current disinvestment through public policies. This disinvestment affects community conditions such as access to economic opportunities, well-maintained and affordable housing, high-quality schools, healthy food, safe parks, and clean water and air. These community conditions greatly affect health. At the invitation of the Joint Center for Political and Economic Studies' national Place Matters initiative, Alameda County Supervisor Keith Carson's Office and the Alameda County Public Health Department launched Alameda County Place Matters, an initiative that addresses community conditions through local policy change. We describe the initiative's creation, activities, policy successes, and best practices.

  14. Addressing health and health-care disparities: the role of a diverse workforce and the social determinants of health.

    PubMed

    Jackson, Chazeman S; Gracia, J Nadine

    2014-01-01

    Despite major advances in medicine and public health during the past few decades, disparities in health and health care persist. Racial/ethnic minority groups in the United States are at disproportionate risk of being uninsured, lacking access to care, and experiencing worse health outcomes from preventable and treatable conditions. As reducing these disparities has become a national priority, insight into the social determinants of health has become increasingly important. This article offers a rationale for increasing the diversity and cultural competency of the health and health-care workforce, and describes key strategies led by the U.S. Department of Health and Human Services' Office of Minority Health to promote cultural competency in the health-care system and strengthen community-level approaches to improving health and health care for all.

  15. Addressing the Social Determinants of Health to Reduce Tobacco-Related Disparities

    PubMed Central

    Garrett, Bridgette E.; Dube, Shanta R.; Babb, Stephen; McAfee, Tim

    2016-01-01

    Introduction Comprehensive tobacco prevention and control efforts that include implementing smoke-free air laws, increasing tobacco prices, conducting hard-hitting mass media campaigns, and making evidence-based cessation treatments available are effective in reducing tobacco use in the general population. However, if these interventions are not implemented in an equitable manner, certain population groups may be left out causing or exacerbating disparities in tobacco use. Disparities in tobacco use have, in part, stemmed from inequities in the way tobacco control policies and programs have been adopted and implemented to reach and impact the most vulnerable segments of the population that have the highest rates of smokings (e.g., those with lower education and incomes). Methods Education and income are the 2 main social determinants of health that negatively impact health. However, there are other social determinants of health that must be considered for tobacco control policies to be effective in reducing tobacco-related disparities. This article will provide an overview of how tobacco control policies and programs can address key social determinants of health in order to achieve equity and eliminate disparities in tobacco prevention and control. Results Tobacco control policy interventions can be effective in addressing the social determinants of health in tobacco prevention and control to achieve equity and eliminate tobacco-related disparities when they are implemented consistently and equitably across all population groups. Conclusions Taking a social determinants of health approach in tobacco prevention and control will be necessary to achieve equity and eliminate tobacco-related disparities. PMID:25516538

  16. Addressing domestic violence through antenatal care in Sri Lanka's plantation estates: Contributions of public health midwives.

    PubMed

    Infanti, Jennifer J; Lund, Ragnhild; Muzrif, Munas M; Schei, Berit; Wijewardena, Kumudu

    2015-11-01

    Domestic violence in pregnancy is a significant health concern for women around the world. Globally, much has been written about how the health sector can respond effectively and comprehensively to domestic violence during pregnancy via antenatal services. The evidence from low-income settings is, however, limited. Sri Lanka is internationally acknowledged as a model amongst low-income countries for its maternal and child health statistics. Yet, very little research has considered the perspectives and experiences of the key front line health providers for pregnant women in Sri Lanka, public health midwives (PHMs). We address this gap by consulting PHMs about their experiences identifying and responding to pregnant women affected by domestic violence in an underserved area: the tea estate sector of Badulla district. Over two months in late 2014, our interdisciplinary team of social scientists and medical doctors met with 31 estate PHMs for group interviews and a participatory workshop at health clinics across Badulla district. In the paper, we propose a modified livelihoods model to conceptualise the physical, social and symbolic assets, strategies and constraints that simultaneously enable and limit the effectiveness of community-based health care responses to domestic violence. Our findings also highlight conceptual and practical strategies identified by PHMs to ensure improvements in this complex landscape of care. Such strategies include estate-based counselling services; basic training in family counselling and mediation for PHMs; greater surveillance of abusive men's behaviours by male community leaders; and performance evaluation and incentives for work undertaken to respond to domestic violence. The study contributes to international discussions on the meanings, frameworks, and identities constructed at the local levels of health care delivery in the global challenge to end domestic violence. In turn, such knowledge adds to international debates on the roles

  17. California Veterans Receive Inadequate Treatment to Address their Mental Health Needs

    PubMed Central

    Tran, Linda Diem; Grant, David; Aydin, May

    2016-01-01

    Data from the 2011 to 2013 California Health Interview Survey (CHIS) were pooled to estimate prevalence of mental health need (serious psychological distress and impairment in one or more life domains), minimally adequate treatment (having four or more visits with a health professional in the past 12 months and use of prescription medication for mental health problems in the past 12 months), and suicide ideation among veterans living in California. Numbers and percentages were weighted to the CA population using a large sample size (N=6,952), and for comparison purposes, veterans and nonveterans were standardized to the age and gender distribution of veterans in the sample. Although differences in mental health need were similar between veterans and nonveterans after adjustment, over three-quarters of veterans did not receive minimally adequate treatment needed to address their mental health needs. Suicide ideation was significantly higher among veterans than nonveterans. Male veterans at all ages were more vulnerable to thinking about suicide compared to their nonveteran counterparts. PMID:27570802

  18. Addressing gaps in abortion education: a sexual health elective created by medical students.

    PubMed

    Caro-Bruce, Emily; Schoenfeld, Elizabeth; Nothnagle, Melissa; Taylor, Julie

    2006-05-01

    Medical school curricula frequently contain gaps in the areas of abortion and sexual health. A group of first- and second-year medical students at the authors' institution organized a collaborative, multidisciplinary elective course to address such omissions in the preclinical curriculum. This paper describes the process of creating and implementing the elective. Medical students identified curricular gaps in the areas of abortion, sexual assault, lesbian/gay/bisexual/transgender health, and HIV counseling. Clinical faculty and community-based professionals were invited to address these topics in a weekly lecture series organized by students. The course also included a half-day experience shadowing at a local abortion clinic. Collaboration with several student groups helped broaden student interest in and increase financial support for the elective. Some 37% of all first- and second-year students enrolled in the elective and received institutional credit for the course. Written and verbal evaluations confirmed student satisfaction with the lectures and the clinical experience. Dynamic and well-prepared speakers who presented interesting medical content received the highest ratings from students. Student leaders identified several challenges in implementing the elective. Ultimately the elective proved to be a successful collaboration among students, faculty, and healthcare providers, and resulted in permanent changes in the standard medical school curriculum. Challenges for student-initiated electives include difficulty in finding administrative support, securing funding and ensuring sustainability. This paper aims to make this process accessible and applicable to other students and faculty interested in addressing curricular gaps at their respective medical schools.

  19. How sustainable agriculture can address the environmental and human health harms of industrial agriculture.

    PubMed Central

    Horrigan, Leo; Lawrence, Robert S; Walker, Polly

    2002-01-01

    The industrial agriculture system consumes fossil fuel, water, and topsoil at unsustainable rates. It contributes to numerous forms of environmental degradation, including air and water pollution, soil depletion, diminishing biodiversity, and fish die-offs. Meat production contributes disproportionately to these problems, in part because feeding grain to livestock to produce meat--instead of feeding it directly to humans--involves a large energy loss, making animal agriculture more resource intensive than other forms of food production. The proliferation of factory-style animal agriculture creates environmental and public health concerns, including pollution from the high concentration of animal wastes and the extensive use of antibiotics, which may compromise their effectiveness in medical use. At the consumption end, animal fat is implicated in many of the chronic degenerative diseases that afflict industrial and newly industrializing societies, particularly cardiovascular disease and some cancers. In terms of human health, both affluent and poor countries could benefit from policies that more equitably distribute high-protein foods. The pesticides used heavily in industrial agriculture are associated with elevated cancer risks for workers and consumers and are coming under greater scrutiny for their links to endocrine disruption and reproductive dysfunction. In this article we outline the environmental and human health problems associated with current food production practices and discuss how these systems could be made more sustainable. PMID:12003747

  20. How sustainable agriculture can address the environmental and human health harms of industrial agriculture.

    PubMed

    Horrigan, Leo; Lawrence, Robert S; Walker, Polly

    2002-05-01

    The industrial agriculture system consumes fossil fuel, water, and topsoil at unsustainable rates. It contributes to numerous forms of environmental degradation, including air and water pollution, soil depletion, diminishing biodiversity, and fish die-offs. Meat production contributes disproportionately to these problems, in part because feeding grain to livestock to produce meat--instead of feeding it directly to humans--involves a large energy loss, making animal agriculture more resource intensive than other forms of food production. The proliferation of factory-style animal agriculture creates environmental and public health concerns, including pollution from the high concentration of animal wastes and the extensive use of antibiotics, which may compromise their effectiveness in medical use. At the consumption end, animal fat is implicated in many of the chronic degenerative diseases that afflict industrial and newly industrializing societies, particularly cardiovascular disease and some cancers. In terms of human health, both affluent and poor countries could benefit from policies that more equitably distribute high-protein foods. The pesticides used heavily in industrial agriculture are associated with elevated cancer risks for workers and consumers and are coming under greater scrutiny for their links to endocrine disruption and reproductive dysfunction. In this article we outline the environmental and human health problems associated with current food production practices and discuss how these systems could be made more sustainable.

  1. Public Health Action Model for Cancer Survivorship

    PubMed Central

    Moore, Angela R.; Buchanan, Natasha D.; Fairley, Temeika L.; Smith, Judith Lee

    2016-01-01

    Long-term objectives associated with cancer survivors have been suggested by Healthy People 2020, including increasing the proportion of survivors living beyond 5 years after diagnosis and improving survivors’ mental and physical health-related quality of life. Prior to reaching these objectives, several intermediate steps must be taken to improve the physical, social, emotional, and financial well-being of cancer survivors. Public health has a role in developing strategic, actionable, and measurable approaches to facilitate change at multiple levels to improve the lives of survivors and their families. The social ecological model has been used by the public health community as the foundation of multilevel intervention design and implementation, encouraging researchers and practitioners to explore methods that promote internal and external changes at the individual, interpersonal, organizational, community, and policy levels. The survivorship community, including public health professionals, providers, policymakers, survivors, advocates, and caregivers, must work collaboratively to identify, develop, and implement interventions that benefit cancer survivors. The National Action Plan for Cancer Survivorship highlights public health domains and associated strategies that can be the impetus for collaboration between and among the levels in the social ecological model and are integral to improving survivor outcomes. This paper describes the Public Health Action Model for Cancer Survivorship, an integrative framework that combines the National Action Plan for Cancer Survivorship with the social ecological model to demonstrate how interaction among the various levels may promote better outcomes for survivors. PMID:26590641

  2. Prostate cancer: appraisal, coping, and health status.

    PubMed

    Ahmad, Muayyad M; Musil, Carol M; Zauszniewski, Jaclene A; Resnick, Martin I

    2005-10-01

    The purpose of this study was to identify how cognitive appraisal and types of coping affect the health status of men with prostate cancer. Lazarus and Folkman's model of stress and coping guided this correlational, cross-sectional study. The convenience sample was composed of 131 men with prostate cancer who completed the Cognitive Appraisal of Health Scale, the Ways of Coping Checklist, and the Short-Form Health Survey using mailed questionnaires. Participants who appraised more harm or loss experienced worse physical and mental health. When participants perceived their diagnosis as posing more harm or loss or a greater threat, they were more likely to use emotion-focused coping. When the diagnosis was perceived as a challenge, men were more likely to use more problem-focused coping. The findings of this study enable health care providers to be more attentive to the psychosocial needs of prostate cancer patients.

  3. Addressing the "other" health literacy competencies--knowledge, dispositions, and oral/aural communication: development of TALKDOC, an intervention assessment tool.

    PubMed

    Helitzer, Deborah; Hollis, Christine; Sanders, Margaret; Roybal, Suzanne

    2012-01-01

    Most health literacy assessments evaluate literacy skills including reading, writing; numeracy and interpretation of tables, graphs, diagrams and charts. Some assess understanding of health systems, and the ability to adequately apply one's skills to specific health-related tasks or demands in health situations. However, to achieve functional health literacy, the ability to "obtain, process, and understand basic health information and services needed to make appropriate health decisions," other health literacy dimensions should be assessed: a person's knowledge and attitudes about a health issue affects his or her ability to and interest in participating in his or her own care. In patient care settings, the abilities to listen, ask questions and check one's understanding are crucial to making appropriate decisions and carrying out instructions. Although literacy is a skill associated with educational attainment and therefore difficult to change in a short time, health education interventions can address health literacy domains such as knowledge, attitudes and oral communication skills. For this reason, an instrument that can assess these constructs is a valuable part of a health educator's toolbox. The authors describe the development and process and outcomes of testing a novel instrument targeted to assess HPV and cervical cancer health literacy competencies, TALKDOC, including its validation with the Health Activities Literacy Scale.

  4. Addressing Hearing Health Care Disparities among Older Adults in a US-Mexico Border Community

    PubMed Central

    Ingram, Maia; Marrone, Nicole; Sanchez, Daisey Thalia; Sander, Alicia; Navarro, Cecilia; de Zapien, Jill Guernsey; Colina, Sonia; Harris, Frances

    2016-01-01

    Hearing loss is associated with cognitive decline and impairment in daily living activities. Access to hearing health care has broad implications for healthy aging of the U.S. population. This qualitative study investigated factors related to the socio-ecological domains of hearing health in a U.S.–Mexico border community experiencing disparities in access to care. A multidisciplinary research team partnered with community health workers (CHWs) from a Federally Qualified Health Center (FQHC) in designing the study. CHWs conducted interviews with people with hearing loss (n = 20) and focus groups with their family/friends (n = 27) and with members of the community-at-large (n = 47). The research team conducted interviews with FQHC providers and staff (n = 12). Individuals experienced depression, sadness, and social isolation, as well as frustration and even anger regarding communication. Family members experienced negative impacts of deteriorating communication, but expressed few coping strategies. There was general agreement across data sources that hearing loss was not routinely addressed within primary care and assistive hearing technology was generally unaffordable. Community members described stigma related to hearing loss and a need for greater access to hearing health care and broader community education. Findings confirm the causal sequence of hearing impairment on quality of life aggravated by socioeconomic conditions and lack of access to hearing health care. Hearing loss requires a comprehensive and innovative public health response across the socio-ecological framework that includes both individual communication intervention and greater access to hearing health resources. CHWs can be effective in tailoring intervention strategies to community characteristics. PMID:27574602

  5. The Arkansas aging initiative: an innovative approach for addressing the health of older rural Arkansans.

    PubMed

    Beverly, Claudia J; McAtee, Robin E; Chernoff, Ronni; Davis, Gwynn V; Jones, Susan K; Lipschitz, David A

    2007-04-01

    The Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences in Little Rock is addressing one of the most pressing policy issues facing the United States: how to care for the burgeoning number of older adults. In 2001, the Institute created the Arkansas Aging Initiative, which established seven satellite centers on aging across the state using $1.3 to $2 million dollars annually from the state's portion of the Master Tobacco Settlement. These centers on aging assist the state's population of older adults, many of whom reside in rural areas, live in poverty, and suffer from poor health. The centers provide multiple avenues of education for the community, health care providers, families, and caregivers. The Arkansas Aging Initiative, in partnership with local hospitals, also makes geriatric primary and specialty care more accessible through senior health clinics established across rural Arkansas. In 2005, older adults made more than 36,000 visits to these clinics. All sites have attracted at least one physician who holds a Certificate of Added Qualifications in geriatrics and one advanced practice nurse. Other team members include geriatric medical social workers, pharmacists, nutritionists, and neuropsychologists. This initiative also addresses other policy issues, including engaging communities in building partnerships and programs crucial to maximizing their limited resources and identifying opportunities to change reimbursement mechanisms for care provided to the growing number of older adults. We believe this type of program has the potential to create a novel paradigm for nationwide implementation.

  6. Developing sustainable global health technologies: insight from an initiative to address neonatal hypothermia.

    PubMed

    Gupta, Rajesh; Patel, Rajan; Murty, Naganand; Panicker, Rahul; Chen, Jane

    2015-02-01

    Relative to drugs, diagnostics, and vaccines, efforts to develop other global health technologies, such as medical devices, are limited and often focus on the short-term goal of prototype development instead of the long-term goal of a sustainable business model. To develop a medical device to address neonatal hypothermia for use in resource-limited settings, we turned to principles of design theory: (1) define the problem with consideration of appropriate integration into relevant health policies, (2) identify the users of the technology and the scenarios in which the technology would be used, and (3) use a highly iterative product design and development process that incorporates the perspective of the user of the technology at the outset and addresses scalability. In contrast to our initial idea, to create a single device, the process guided us to create two separate devices, both strikingly different from current solutions. We offer insights from our initial experience that may be helpful to others engaging in global health technology development.

  7. The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health

    PubMed Central

    Valle, Adolfo Martinez

    2016-01-01

    Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH. PMID:26928215

  8. The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health.

    PubMed

    Valle, Adolfo Martinez

    2016-01-01

    Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH.

  9. Should Canadian health promoters support a food stamp-style program to address food insecurity?

    PubMed

    Power, Elaine M; Little, Margaret H; Collins, Patricia A

    2015-03-01

    Food insecurity is an urgent public health problem in Canada, affecting 4 million Canadians in 2012, including 1.15 million children, and associated with significant health concerns. With little political will to address this significant policy issue, it has been suggested that perhaps it is time for Canada to try a food stamp-style program. Such a program could reduce rates of food insecurity and improve the nutritional health of low-income Canadians. In this article, we explore the history of the US food stamp program; the key impetus of which was to support farmers and agricultural interests, not to look after the needs of people living in poverty. Though the US program has moved away from its roots, its history has had a lasting legacy, cementing an understanding of the problem as one of lack of food, not lack of income. While the contemporary food stamp program, now called Supplemental Nutrition Assistance Program (SNAP), reduces rates of poverty and food insecurity, food insecurity rates in the USA are significantly higher than those in Canada, suggesting a food stamp-style program per se will not eliminate the problem of food insecurity. Moreover, a food stamp-style program is inherently paternalistic and would create harm by reducing the autonomy of participants and generating stigma, which in itself has adverse health effects. Consequently, it is ethically problematic for health promoters to advocate for such a program, even if it could improve diet quality.

  10. Emerging Developments in Pharmacists' Scope of Practice to Address Unmet Health Care Needs.

    PubMed

    Burns, Anne L

    2016-09-01

    Pharmacists' comprehensive training is being leveraged in emerging patient care service opportunities that include prescriptive authority under collaborative practice agreements (CPAs) with prescribers or through state-based protocols. CPAs and state-based protocols expand pharmacists' scope of practice to allow the pharmacist to perform designated functions under the terms of the agreement or protocol. For patient-specific CPAs, this often includes initiating, modifying, or discontinuing therapy and ordering laboratory tests. For population-based CPAs and state-based protocols, pharmacists are often authorized to initiate medications to address a public health need. CPAs and state-based protocols are mechanisms to optimally use pharmacists' education and training.

  11. Addressing indigenous health workforce inequities: A literature review exploring 'best' practice for recruitment into tertiary health programmes

    PubMed Central

    2012-01-01

    Introduction Addressing the underrepresentation of indigenous health professionals is recognised internationally as being integral to overcoming indigenous health inequities. This literature review aims to identify 'best practice' for recruitment of indigenous secondary school students into tertiary health programmes with particular relevance to recruitment of Māori within a New Zealand context. Methodology/methods A Kaupapa Māori Research (KMR) methodological approach was utilised to review literature and categorise content via: country; population group; health profession ffocus; research methods; evidence of effectiveness; and discussion of barriers. Recruitment activities are described within five broad contexts associated with the recruitment pipeline: Early Exposure, Transitioning, Retention/Completion, Professional Workforce Development, and Across the total pipeline. Results A total of 70 articles were included. There is a lack of published literature specific to Māori recruitment and a limited, but growing, body of literature focused on other indigenous and underrepresented minority populations. The literature is primarily descriptive in nature with few articles providing evidence of effectiveness. However, the literature clearly frames recruitment activity as occurring across a pipeline that extends from secondary through to tertiary education contexts and in some instances vocational (post-graduate) training. Early exposure activities encourage students to achieve success in appropriate school subjects, address deficiencies in careers advice and offer tertiary enrichment opportunities. Support for students to transition into and within health professional programmes is required including bridging/foundation programmes, admission policies/quotas and institutional mission statements demonstrating a commitment to achieving equity. Retention/completion support includes academic and pastoral interventions and institutional changes to ensure safer

  12. Addressing the human resources crisis: a case study of the Namibian health service

    PubMed Central

    McCourt, Willy; Awases, Magda

    2007-01-01

    Background This paper addresses an important practical challenge to staff management. In 2000 the United Nations committed themselves to the ambitious targets embodied in the Millennium Development Goals (MDGs). Only five years later, it was clear that poor countries were not on track to achieve them. It was also clear that achieving the three out of the eight MDGs that concern health would only be possible if the appropriate human resources (HR) were in place. Methods We use a case study based on semi-structured interview data to explore the steps that Namibia, a country facing severe health problems that include an alarmingly high AIDS infection rate, has taken to manage its health workers. Results In the fifteen years since independence, Namibia has patiently built up a relatively good strategic framework for health policy in the context of government policy as a whole, including strong training arrangements at every level of health staffing, and it has brought HIV/AIDS under the strategic umbrella through its National Strategic Plan for HIV/AIDS. Its major weakness is that it has not kept pace with the rise in HIV/AIDS and TB infection: the community counselling service, still at the pilot stage at the time of this study, was the only specific response. That has created a tension between building long-term capacity in a strategic context and responding to the short-term demands of the AIDS and TB crisis, which in turn affects the ability of HR to contribute to improving health outcomes. Conclusion It is suggested that countries like Namibia need a new paradigm for staffing their health services. Building on the existing strategic framework, it should target the training of 'mid-level cadres'. Higher-level cadres should take on the role of supporting and monitoring the mid-level cadres. To do that, they will need management training and a performance management framework for staff support and monitoring. PMID:17224048

  13. What can Pakistan do to address maternal and child health over the next decade?

    PubMed

    Bhutta, Zulfiqar A; Hafeez, Assad

    2015-11-25

    Pakistan faces huge challenges in meeting its international obligations and agreed Millennium Development Goal targets for reducing maternal and child mortality. While there have been reductions in maternal and under-5 child mortality, overall rates are barely above secular trends and neonatal mortality has not reduced much. Progress in addressing basic determinants, such as poverty, undernutrition, safe water, and sound sanitary conditions as well as female education, is unsatisfactory and, not surprisingly, population growth hampers economic growth and development across the country. The devolution of health to the provinces has created challenges as well as opportunities for action. This paper presents a range of actions needed for change within the health and social sectors, including primary care, social determinants, strategies to reach the unreached, and accountability.

  14. Defining health by addressing individual, social, and environmental determinants: New opportunities for health care and public health

    PubMed Central

    Bircher, Johannes; Kuruvilla, Shyama

    2014-01-01

    The Millennium Development Goals (MDGs) mobilized global commitments to promote health, socioeconomic, and sustainable development. Trends indicate that the health MDGs may not be achieved by 2015, in part because of insufficient coordination across related health, socioeconomic, and environmental initiatives. Explicitly acknowledging the need for such collaboration, the Meikirch Model of Health posits that: Health is a state of wellbeing emergent from conducive interactions between individuals' potentials, life's demands, and social and environmental determinants. Health results throughout the life course when individuals' potentials – and social and environmental determinants – suffice to respond satisfactorily to the demands of life. Life's demands can be physiological, psychosocial, or environmental, and vary across contexts, but in every case unsatisfactory responses lead to disease. This conceptualization of the integrative nature of health could contribute to ongoing efforts to strengthen cooperation across actors and sectors to improve individual and population health – leading up to 2015 and beyond. PMID:24943659

  15. Transdisciplinary cardiovascular and cancer health disparities training: experiences of the centers for population health and health disparities.

    PubMed

    Golden, Sherita Hill; Ferketich, Amy; Boyington, Josephine; Dugan, Sheila; Garroutte, Eva; Kaufmann, Peter G; Krok, Jessica; Kuo, Alice; Ortega, Alexander N; Purnell, Tanjala; Srinivasan, Shobha

    2015-07-01

    The Centers for Population Health and Health Disparities program promotes multilevel and multifactorial health equity research and the building of research teams that are transdisciplinary. We summarized 5 areas of scientific training for empowering the next generation of health disparities investigators with research methods and skills that are needed to solve disparities and inequalities in cancer and cardiovascular disease. These areas include social epidemiology, multilevel modeling, health care systems or health care delivery, community-based participatory research, and implementation science. We reviewed the acquisition of the skill sets described in the training components; these skill sets will position trainees to become leaders capable of effecting significant change because they provide tools that can be used to address the complexities of issues that promote health disparities.

  16. Addressing Behavioral Health Disparities for Somali Immigrants Through Group Cognitive Behavioral Therapy Led by Community Health Workers.

    PubMed

    Pratt, Rebekah; Ahmed, Nimo; Noor, Sahra; Sharif, Hiba; Raymond, Nancy; Williams, Chris

    2017-02-01

    To test the feasibility and acceptability of implementing an evidence-based, peer-delivered mental health intervention for Somali women in Minnesota, and to assess the impact of the intervention on the mental health of those who received the training. In a feasibility study, 11 Somali female community health workers were trained to deliver an 8-session cognitive behavioral therapy intervention. Each of the trainers recruited 5 participants through community outreach, resulting in 55 participants in the intervention. Self-assessed measures of mood were collected from study participants throughout the intervention, and focus groups were conducted. The 55 Somali women who participated recorded significant improvements in mood, with self-reported decreases in anxiety and increases in happiness. Focus group data showed the intervention was well received, particularly because it was delivered by a fellow community member. Participants reported gaining skills in problem solving, stress reduction, and anger management. Participants also felt that the intervention helped to address some of the stigma around mental health in their community. Delivery of cognitive behavioral therapy by a community health workers offered an acceptable way to build positive mental health in the Somali community.

  17. Addressing inequalities in oral health in India: need for skill mix in the dental workforce.

    PubMed

    Mathur, Manu Raj; Singh, Ankur; Watt, Richard

    2015-01-01

    Dentistry has always been an under-resourced profession. There are three main issues that dentistry is facing in the modern era. Firstly, how to rectify the widely acknowledged geographical imbalance in the demand and supply of dental personnel, secondly, how to provide access to primary dental care to maximum number of people, and thirdly, how to achieve both of these aims within the financial restraints imposed by the central and state governments. The trends of oral diseases have changed significantly in the last 20 years. The two of the most common oral diseases that affect a majority of the population worldwide, namely dental caries and periodontitis, have been proved to be entirely preventable. Even for life-threatening oral diseases like oral cancer, the best possible available treatment is prevention. There is a growing consensus that appropriate skill mix can prove very beneficial in providing these preventive dental care services to the public and aid in achieving the goal of universal oral health coverage. Professions complementary to dentistry (PCD) have been found to be effective in reducing inequalities in oral health, improving access and spreading the messages of health promotion across entire spectrum of socio-economic hierarchy in various studies conducted globally. This commentary provides a review of the effectiveness of skill mix in dentistry and a reflection on how this can be beneficial in achieving universal oral health care in India.

  18. Oral health considerations in cancer survivors.

    PubMed

    Mawardi, Hani H; Al-Mohaya, Maha A; Treister, Nathaniel S

    2013-05-01

    Over the past decade, advances in cancer treatment have helped in prolonging the survival rate for cancer patients. However, the patients who undergo treatment for cancer are potentially at high-risk for developing a number of oral complications, including oral mucositis, infections, hyposalivation, dental caries, and jaw osteonecrosis. Cancer survivors may remain at life-long risk of developing oral complications, and therefore require long-term dental follow-up, well after completion of cancer therapy. Patients should typically undergo thorough oral examination prior to initiation of therapy, during and after therapy to identify any active infection. In addition, and in order to maintain adequate oral health throughout treatment, patients should continue normal oral hygiene with tooth brushing and interproximal cleaning. The aim of this review is to discuss potential oral complications as a result of cancer therapy, and the certain precautions we should be aware of these patients.

  19. Comparing the health impacts of different sources of energy. Keynote address

    SciTech Connect

    Hamilton, L.D.

    1981-01-01

    Assessing health impacts of different energy sources requires synthesis of research results from any different disciplines into a rational framework. Information is often scanty; qualitatively different risks, or energy systems with substantially different end uses, must be put on a common footing. Historically institutional constraints have inhibited agencies from making incisive comparisons necessary for formulating energy policy; this has exacerbated public controversy over appropriate energy sources. Risk assessment methods reviewed include examples drawn from work of the Biomedical and Environmental Assessment Division at Brookhaven National Laboratory and elsewhere. Uncertainty over the mechanism and size of air pollution health damage is addressed through a probabilistic health-damage function, using sulfate-particle exposure as an indicator. This facilitates intercomparison through analysis of each step in the whole fuel cycle between a typical coal and nuclear powerplant. Occupational health impacts, a significant fraction of overall damage, are illustrated by accident trends in coal mining. In broadening comparisons to include new technologies, one must include the impact of manufacturing the energy-producing device as part of an expanded fuel cycle, via input/output methods. Throughout the analysis, uncertainties must be made explicit in the results, including uncertainty of data and uncertainty in choice of appropriate models and methods. No single method of comparative risk assessment is fully satisfactory; each has its limitations. One needs to compare several methods if decision-making is to be realistic.

  20. Addressing racial inequities in health care: civil rights monitoring and report cards.

    PubMed

    Smith, D B

    1998-02-01

    Large racial inequities in health care use continue to be reported, raising concerns about discrimination. Historically, the health system, with its professionally dominated, autonomous, voluntary organizational structure, has presented special challenges to civil rights efforts. De jure racial segregation in the United States gave way to a period of aggressive litigation and enforcement from 1954 until 1968 and then to the current period of relative inactivity. A combination of factors--declining federal resources and organizational capacity to address more subtle forms of discriminatory practices in health care settings, increasingly restrictive interpretations by the courts, and the lack of any systematic mechanisms for the statistical monitoring of providers--offers little assurance that discrimination does not continue to play a role in accounting for discrepancies in use. The current rapid transformation of health care into integrated delivery systems driven by risk-based financing presents both new opportunities and new threats. Adequate regulation, markets, and management for such systems impose new requirements for comparative systematic statistical assessment of performance. My conclusion illustrates ways that current "report card" approaches to monitoring performance of such systems could be used to monitor, correct, and build trust in equitable treatment.

  1. Strategies and resources to address colorectal cancer screening rates and disparities in the United States and globally.

    PubMed

    Potter, Michael B

    2013-01-01

    Colorectal cancer is a significant cause of mortality in the United States and globally. In the United States, increased access to screening and effective treatment has contributed to a reduction in colorectal cancer incidence and mortality for the general population, though significant disparities persist. Worldwide, the disparities are even more pronounced, with vastly different colorectal cancer mortality rates and trends among nations. Newly organized colorectal cancer screening programs in economically developed countries with a high burden of colorectal cancer may provide pathways to reduce these disparities over time. This article provides an overview of colorectal cancer incidence, mortality, screening, and disparities in the United States and other world populations. Promising strategies and resources are identified to address colorectal cancer screening rates and disparities in the United States and worldwide.

  2. Current progress in public health models addressing the critical organ shortage.

    PubMed

    Shanmugarajah, Kumaran; Villani, Vincenzo; Madariaga, Maria Lucia L; Shalhoub, Joseph; Michel, Sebastian G

    2014-12-01

    Since its inauguration in 1954, the field of modern transplantation has made great strides in surgical technique, the prevention of acute and chronic rejection, the minimization of immunosuppression-related side-effects and transplant tolerance. As such, organ transplantation is used worldwide as a curative, life-saving treatment for people with end-stage organ failure. However, the successes of organ transplantation have resulted in the number of patients on transplant waiting lists far exceeding the number of organs available, with growing numbers of patients dying while awaiting transplants. In order to address this critical organ shortage, a number of legislative changes have been implemented worldwide to increase the number of individuals registering as organ donors. These have included presumed consent donation, incentivized organ donation, commercial organ transplantation and mandated choice models. This article will address these public health policies in turn. The implementation of these strategies and the evidence for their efficacy will be evaluated. Based on this, we have identified that well-supported transplant coordinators approaching next-of-kin, incentives and public health campaigns are key factors that increase organ donation. Finally we propose a modified mandated choice model that may be an alternative option to maximize the number of available organs for transplantation.

  3. To Your Health: NLM update transcript - Reassessing cervical cancer

    MedlinePlus

    ... here' section of MedlinePlus.gov's cervical cancer health topic page . The National Cancer Institute provides additional information about ... factors' section of MedlinePlus.gov's cervical cancer health topic page. MedlinePlus.gov's cervical cancer health topic page also ...

  4. Addressing the social determinants of health through health system strengthening and inter-sectoral convergence: the case of the Indian National Rural Health Mission

    PubMed Central

    Prasad, Amit Mohan; Chakraborty, Gautam; Yadav, Sajjan Singh; Bhatia, Salima

    2013-01-01

    Background At the turn of the 21st century, India was plagued by significant rural–urban, inter-state and inter-district inequities in health. For example, in 2004, the infant mortality rate (IMR) was 24 points higher in rural areas compared to urban areas. To address these inequities, to strengthen the rural health system (a major determinant of health in itself) and to facilitate action on other determinants of health, India launched the National Rural Health Mission (NRHM) in April 2005. Methods Under the NRHM, Rs. 666 billion (US$12.1 billion) was invested in rural areas from April 2005 to March 2012. There was also a substantially higher allocation for 18 high-focus states and 264 high-focus districts, identified on the basis of poor health and demographic indicators. Other determinants of health, especially nutrition and decentralized action, were addressed through mechanisms like State/District Health Missions, Village Health, Sanitation and Nutrition Committees, and Village Health and Nutrition Days. Results Consequently, in bigger high-focus states, rural IMR fell by 15.6 points between 2004 and 2011, as compared to 9 points in urban areas. Similarly, the maternal mortality rate in high-focus states declined by 17.9% between 2004–2006 and 2007–2009 compared to 14.6% in other states. Conclusion The article, on the basis of the above approaches employed under NRHM, proposes the NRHM model to ‘reduce health inequities and initiate action on SDH’. PMID:23458089

  5. Maintaining Sexual Health throughout Gynecologic Cancer Survivorship: A Comprehensive Review and Clinical Guide

    PubMed Central

    Huffman, Laura B.; Hartenbach, Ellen M.; Carter, Jeanne; Rash, Joanne K.; Kushner, David M.

    2016-01-01

    Objective The diagnosis and treatment of gynecologic cancer can cause short- and long-term negative effects on sexual health and quality of life (QoL). The aim of this article is to present a comprehensive overview of the sexual health concerns of gynecologic cancer survivors and discuss evidence-based treatment options for commonly encountered sexual health issues. Methods A comprehensive literature search of English language studies on sexual health in gynecologic cancer survivors and the treatment of sexual dysfunction was conducted in MEDLINE databases. Relevant data are presented in this review. Additionally, personal and institutional practices are incorporated where relevant. Results Sexual dysfunction is prevalent among gynecologic cancer survivors as a result of surgery, radiation, and chemotherapy--negatively impacting QoL. Many patients expect their healthcare providers to address sexual health concerns, but most have never discussed sex-related issues with their physician. Lubricants, moisturizers, and dilators are effective, simple, non-hormonal interventions that can alleviate the morbidity of vaginal atrophy, stenosis, and pain. Pelvic floor physical therapy can be an additional tool to address dyspareunia. Cognitive behavioral therapy has been shown to be beneficial to patients reporting problems with sexual interest, arousal, and orgasm. Conclusion Oncology providers can make a significant impact on the QoL of gynecologic cancer survivors by addressing sexual health concerns. Simple strategies can be implemented into clinical practice to discuss and treat many sexual issues. Referral to specialized sexual health providers may be needed to address more complex problems. PMID:26556768

  6. Creating Community–Academic Partnerships for Cancer Disparities Research and Health Promotion

    PubMed Central

    Meade, Cathy D.; Menard, Janelle M.; Luque, John S.; Martinez-Tyson, Dinorah; Gwede, Clement K.

    2010-01-01

    To effectively attenuate cancer disparities in multiethnic, medically underserved populations, interventions must be developed collaboratively through solid community–academic partnerships and driven by community-based participatory research (CBPR). The Tampa Bay Community Cancer Network (TBCCN) has been created to identify and implement interventions to address local cancer disparities in partnership with community-based nonprofit organizations, faith-based groups, community health centers, local media, and adult literacy and education organizations. TBCCN activities and research efforts are geared toward addressing critical information and access issues related to cancer control and prevention in diverse communities in the Tampa Bay area. Such efforts include cross-cultural health promotion, screening, and awareness activities in addition to applied research projects that are rooted in communities and guided by CBPR methods. This article describes these activities as examples of partnership building to positively affect cancer disparities, promote community health, and set the stage for community-based research partnerships. PMID:19822724

  7. Venous thromboembolism in cancer patients: an underestimated major health problem.

    PubMed

    Khalil, Jihane; Bensaid, Badr; Elkacemi, Hanan; Afif, Mohamed; Bensaid, Younes; Kebdani, Tayeb; Benjaafar, Noureddine

    2015-06-20

    Venous thromboembolism (VTE) is a major health problem among patients with cancer, its incidence in this particular population is widely increasing. Although VTE is associated with high rates of mortality and morbidity in cancer patients, its severity is still underestimated by many oncologists. Thromboprophylaxis of VTE now considered as a standard of care is still not prescribed in many institutions; the appropriate treatment of an established VTE is not yet well known by many physicians and nurses in the cancer field. Patients are also not well informed about VTE and its consequences. Many studies and meta-analyses have addressed this question so have many guidelines that dedicated a whole chapter to clarify and expose different treatment strategies adapted to this particular population. There is a general belief that the prevention and treatment of VTE cannot be optimized without a complete awareness by oncologists and patients. The aim of this article is to make VTE a more clear and understood subject.

  8. Health Disparity and Cancer Health Disparity in China

    PubMed Central

    Wang, Qi; Jiao, Jie

    2016-01-01

    China is one of the largest and most populated countries in the world. It has undergone rapid economic growth in recent years. However, the development is not equitable, and the distribution of wealth significantly varies among the regions in China. Geographical and socioeconomic inequalities, together with the lack of an equitable national social support system, cause the high variance of health outcomes among the regions. Furthermore, the fast growth of the economy has evoked many environmental challenges and puts much pressure on the population. The severe environmental deterioration, especially of the atmosphere and water bodies, has affected the health of the people living in China. As a result, cancer has become a major public health issue, and an alarming increase in incidence and mortality has been reported. However, cancer incidence and mortality vary in different areas in China. Cancer and cancer treatment disparities have existed for years. This article will discuss the existing health and cancer disparities associated with the risk factors and how these disparities are managed in China. PMID:28083550

  9. Two-stage residual inclusion estimation: addressing endogeneity in health econometric modeling.

    PubMed

    Terza, Joseph V; Basu, Anirban; Rathouz, Paul J

    2008-05-01

    The paper focuses on two estimation methods that have been widely used to address endogeneity in empirical research in health economics and health services research-two-stage predictor substitution (2SPS) and two-stage residual inclusion (2SRI). 2SPS is the rote extension (to nonlinear models) of the popular linear two-stage least squares estimator. The 2SRI estimator is similar except that in the second-stage regression, the endogenous variables are not replaced by first-stage predictors. Instead, first-stage residuals are included as additional regressors. In a generic parametric framework, we show that 2SRI is consistent and 2SPS is not. Results from a simulation study and an illustrative example also recommend against 2SPS and favor 2SRI. Our findings are important given that there are many prominent examples of the application of inconsistent 2SPS in the recent literature. This study can be used as a guide by future researchers in health economics who are confronted with endogeneity in their empirical work.

  10. Building Capacity to Address Women's Health Issues in the Mixtec and Zapotec Community

    PubMed Central

    Maxwell, Annette E.; Young, Sandra; Vega, Roena Rabelo; Cayetano, Reggie T.; Crespi, Catherine M.; Bastani, Roshan

    2015-01-01

    Introduction Mixtecs and Zapotecs are indigenous populations from Mexico. Many are unable to read and write and speak only their native non-written languages, Mixteco and Zapoteco. About half of California's indigenous farm worker population is estimated to be Mixteco-speaking (82,000-125,000), and about 20,000 Mixtecs and a smaller number of Zapotecs live in Ventura County. Objectives A community-academic partnership conducted mixed-methods research with the aims of (1) collecting preliminary data on women's health needs; (2) training promotoras to assist with this effort; and (3) engaging community members and obtaining their input through community dialogues. Methods Promotoras who were bilingual in Spanish and either Mixteco or Zapoteco were trained to conduct surveys that included questions on breast feeding and receipt of breast and cervical cancer screening exams. Barriers to and facilitators of women obtaining these cancer screening tests were discussed in small groups. Results In 2013, 813 Mixtec and Zapotec women completed surveys. Although most women reported breast feeding (94%), and receipt of a pelvic exam (85%) and a breast exam (72%), only 44% of women 40 years and older had ever heard of and 33% had ever had a mammogram. Community members recommended offering free mammograms on the weekend by female providers, having women accompanied by promotoras who can translate, conducting door-to-door outreach, advertising cancer screening on the radio and providing small incentives to women. Discussion Trained bi-lingual promotoras can assist in increasing the capacity of indigenous communities to conduct collaborative research by engaging community members and collecting local data. PMID:25986880

  11. A resolution recognizing that the occurrence of prostate cancer in African-American men has reached epidemic proportions and urging Federal agencies to address that health crisis by supporting education, awareness outreach, and research specifically focused on how prostate cancer affects African-American men.

    THOMAS, 112th Congress

    Sen. Kerry, John F. [D-MA

    2012-06-14

    06/14/2012 Referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S4206) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  12. A resolution recognizing that the occurrence of prostate cancer in African-American men has reached epidemic proportions and urging Federal agencies to address that health crisis by designating funds for education, awareness outreach, and research specifically focused on how prostate cancer affects African-American men.

    THOMAS, 111th Congress

    Sen. Kerry, John F. [D-MA

    2009-06-18

    06/18/2009 Referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S6819) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  13. Estimating the Health Effects of Greenhouse Gas Mitigation Strategies: Addressing Parametric, Model, and Valuation Challenges

    PubMed Central

    Hess, Jeremy J.; Ebi, Kristie L.; Markandya, Anil; Balbus, John M.; Wilkinson, Paul; Haines, Andy; Chalabi, Zaid

    2014-01-01

    simultaneously improving health. Citation: Remais JV, Hess JJ, Ebi KL, Markandya A, Balbus JM, Wilkinson P, Haines A, Chalabi Z. 2014. Estimating the health effects of greenhouse gas mitigation strategies: addressing parametric, model, and valuation challenges. Environ Health Perspect 122:447–455; http://dx.doi.org/10.1289/ehp.1306744 PMID:24583270

  14. Addressing the socioeconomic determinants of adolescent health: experiences from the WHO/HBSC Forum 2007.

    PubMed

    Koller, Theadora; Morgan, Antony; Guerreiro, Ana; Currie, Candace; Ziglio, Erio

    2009-09-01

    Over the past 25 years, the WHO collaborative cross-national Health Behaviour in School-aged Children (HBSC) study has been accumulating evidence that provides insights into how to promote the health and well-being of young people. HBSC has increased understanding of the determinants of young people's health, particularly in relation to the social contexts in which they live, learn and play. The study now spans 43 countries and regions in Europe and North America. HBSC provides intelligence for the development and evaluation of public health policy and practice at national, sub-national and international levels. However, the mere existence of evidence does not automatically change policy nor necessarily improve the lives of young people. Effective mechanisms to ensure use of evidence in policy-making and practice are needed. The WHO/HBSC Forum series is a platform designed to facilitate the translation of evidence into action. Forum processes convene researchers, policy-makers and practitioners from across Europe to analyse data, review policies and interventions, and identify lessons learned to improve the health of adolescents through actions that address the social contexts that influence their health. Each Forum process consists of case studies produced by interdisciplinary teams in countries and regions, cross-country evidence reviews, a European consultation, an outcomes statement within a final publication, and a Web-based knowledge platform. In addition to emphasizing the translation of research into action, the Forum series focuses on increasing know-how to scale up intersectoral policies and interventions; reduce health inequities; and involve young people in the design, implementation and evaluation of policies and interventions. Interviews with selected participants in the 2007 Forum process revealed that national-level impacts of involvement were: brokering new or strengthening existing working relationships among members of case study drafting teams

  15. Addressing Human Variability in Next-Generation Human Health Risk Assessments of Environmental Chemicals

    PubMed Central

    Bois, Frederic Y.; Chiu, Weihsueh A.; Hattis, Dale; Rusyn, Ivan; Guyton, Kathryn Z.

    2012-01-01

    Background: Characterizing variability in the extent and nature of responses to environmental exposures is a critical aspect of human health risk assessment. Objective: Our goal was to explore how next-generation human health risk assessments may better characterize variability in the context of the conceptual framework for the source-to-outcome continuum. Methods: This review was informed by a National Research Council workshop titled “Biological Factors that Underlie Individual Susceptibility to Environmental Stressors and Their Implications for Decision-Making.” We considered current experimental and in silico approaches, and emerging data streams (such as genetically defined human cells lines, genetically diverse rodent models, human omic profiling, and genome-wide association studies) that are providing new types of information and models relevant for assessing interindividual variability for application to human health risk assessments of environmental chemicals. Discussion: One challenge for characterizing variability is the wide range of sources of inherent biological variability (e.g., genetic and epigenetic variants) among individuals. A second challenge is that each particular pair of health outcomes and chemical exposures involves combinations of these sources, which may be further compounded by extrinsic factors (e.g., diet, psychosocial stressors, other exogenous chemical exposures). A third challenge is that different decision contexts present distinct needs regarding the identification—and extent of characterization—of interindividual variability in the human population. Conclusions: Despite these inherent challenges, opportunities exist to incorporate evidence from emerging data streams for addressing interindividual variability in a range of decision-making contexts. PMID:23086705

  16. Report: EPA Is Documenting How It Addresses Time-Critical Public Health Risks Under Its Superfund Authority

    EPA Pesticide Factsheets

    Report #16-P-0059, December 9, 2015. We found that the EPA can provide documentation that imminent and substantial endangerment threats to public health at Superfund time-critical removal sites have been addressed.

  17. Addressing students' social and emotional needs: the role of mental health teams in schools.

    PubMed

    Haynes, Norris M

    2002-01-01

    Children in today's society face many stresses from a variety of sources that have a major impact on thier psychosocial adjustment and academic performance in school. These stressful events and thier consequences on the quality of life and academic success are particularly significant among low-income and ethnic minority students in American society. Many schools have adopted strategies to help students who are impacted by stressful life events to deal affectively with their problems in an attempt to reduce school failure and school dropout rates among these students. Most notable among these strategies are school-based mental health programs including the establishment of school-based mental health teams which seek to proactively address individual student concerns while improving the general climate of schools. The evidence seems to support the claim that these school-based services have a positive impact on students' social and emotional well-being as well as on their academic achievements. However, with more careful monitoring and much more consistent support from administrators and policy makers, these school-based approaches can more fully realize their potential to enhance the quality of life and to positively impact the future of many poor and ethnic minority students.

  18. Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health.

    PubMed

    Miller, Eric; Sikes, Hadley D

    Immunochromatographic rapid diagnostic tests (RDTs) have demonstrated significant potential for use as point-of-care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs.

  19. Addressing the systems-based practice requirement with health policy content and educational technology.

    PubMed

    Nagler, Alisa; Andolsek, Kathryn; Dossary, Kristin; Schlueter, Joanne; Schulman, Kevin

    2010-01-01

    Duke University Hospital Office of Graduate Medical Education and Duke University's Fuqua School of Business collaborated to offer a Health Policy lecture series to residents and fellows across the institution, addressing the "Systems-based Practice" competency.During the first year, content was offered in two formats: live lecture and web/podcast. Participants could elect the modality which was most convenient for them. In Year Two, the format was changed so that all content was web/podcast and a quarterly live panel discussion was led by module presenters or content experts. Lecture evaluations, qualitative focus group feedback, and post-test data were analyzed.A total of 77 residents and fellows from 8 (of 12) Duke Graduate Medical Education departments participated. In the first year, post-test results were the same for those who attended the live lectures and those who participated via web/podcast. A greater number of individuals participated in Year Two. Participants from both years expressed the need for health policy content in their training programs. Participants in both years valued a hybrid format for content delivery, recognizing a desire for live interaction with the convenience of accessing web/podcasts at times and locations convenient for them. A positive unintended consequence of the project was participant networking with residents and fellows from other specialties.

  20. Developing a Gap Taxonomy to Address Crew Health Risks in NASA's Human Research Program

    NASA Technical Reports Server (NTRS)

    Kundrot, Craig E.; Edwards, J. Michelle

    2009-01-01

    The mission of NASA's Human Research Program (HRP) is to understand and reduce the risk to crew health and performance in exploration missions. The HRP addresses 27 specific risks by identifying and then filling gaps in understanding the risks and in the ability to disposition the risks. The primary bases for identifying gaps have been past experience and requirements definition. This approach has been very effective in identifying some important, relevant gaps, but may be inadequate for identifying gaps outside the past experience base. We are exploring the use of a gap taxonomy as a comprehensive, underlying conceptual framework that allows a more systematic identification of gaps. The taxonomy is based on these stages in medical care: prediction, prevention, detection/diagnosis, treatment, monitoring, rehabilitation, and lifetime surveillance. This gap taxonomy approach identifies new gaps in HRP health risks. Many of the new gaps suggest risk reduction approaches that are more cost effective than present approaches. A major benefit of the gap taxonomy approach is to identify new, economical approaches that reduce the likelihood and/or consequence of a risk.

  1. An addressable conducting network for autonomic structural health management of composite structures

    NASA Astrophysics Data System (ADS)

    Takahashi, Kosuke; Park, Jong Se; Hahn, H. Thomas

    2010-10-01

    The electrical resistance change method (ERCM) has long been an area of interest as an in-service health monitoring system. To apply the ERCM to existing structures, a new concept, the addressable conducting network (ACN), is proposed for autonomic structural health management of graphite/polymer composites. The ACN consists of two sets of conducting lines normal to each other, where one set resides on the top surface of the laminate and the other on the bottom surface. Damage can be detected by monitoring the resistance change 'through the laminate thickness' between two lines. By using a thermally mendable polymer as the matrix, the same conducting lines can be used to supply the electric current needed for resistive heating, thereby allowing the detected damage to be healed. As shown experimentally, the electrical resistance change method using an ACN distinguishes between laminates made of properly and improperly cured prepreg as well as revealing damage generated during three-point bending tests. Finite element analysis was performed to examine the feasibility of the ACN and indicated that the damage can be easily located from the spatial distribution of resistance changes and that the damaged area can be locally heated by supplying a large amount of current to selected conducting lines.

  2. Systems approach to address incivility and disruptive behaviors in health-care organizations.

    PubMed

    Holloway, Elizabeth; Kusy, Mitchell

    2011-01-01

    In response to the growing evidence that disruptive behaviors within health-care teams constitute a major threat to the quality of care, the Joint Commission on Accreditation of Healthcare Organization (JCAHO; Joint Commission Resources, 2008) has a new leadership standard that addresses disruptive and inappropriate behaviors effective January 1, 2009. For professionals who work in human resources and organization development, these standards represent a clarion call to design and implement evidence-based interventions to create health-care communities of respectful engagement that have zero tolerance for disruptive, uncivil, and intimidating behaviors by any professional. In this chapter, we will build an evidence-based argument that sustainable change must include organizational, team, and individual strategies across all professionals in the organization. We will then describe an intervention model--Toxic Organization Change System--that has emerged from our own research on toxic behaviors in the workplace (Kusy & Holloway, 2009) and provide examples of specific strategies that we have used to prevent and ameliorate toxic cultures.

  3. Using social marketing to address barriers and motivators to agricultural safety and health best practices.

    PubMed

    Yoder, Aaron M; Murphy, Dennis J

    2012-01-01

    Social marketing is an intervention development strategy that pays considerable attention to barriers to and motivators for behavioral change or adoption of recommended behaviors. Barriers are obstacles that prevent individuals from changing or adopting behaviors and are often referred to as the "cons" or "costs" of doing something. Motivators, on the other hand, are factors that encourage individuals to change or adopt behaviors and are often referred to as the "pros," "benefits," or "influencing factors" of doing something. Importantly, social marketing does not target education or knowledge change as an end point; rather, it targets behavior change. Studies across several types of desired behaviors (e.g., smoking cessation, weight control, more exercise, sunscreen use, radon testing) using the Stages of Change model have found systematic relationships between stages of change and pros and cons of changing behavior. A review of literature identifies numerous research and intervention studies that directly reference social marketing in agricultural safety and health, studies that identify reasons why parents allow their children to be exposed to hazardous situations on the farm, and reasons why youth engage in risky behaviors, but only two studies were found that show evidence of systematically researching specific behavioral change motivating factors. The authors offer several suggestions to help address issues relating to social marketing and agricultural safety and health.

  4. Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health

    PubMed Central

    Miller, Eric; Sikes, Hadley D.

    2015-01-01

    Immunochromatographic rapid diagnostic tests (RDTs) have demonstrated significant potential for use as point-of-care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs. PMID:26594252

  5. Paraprofessional Home Visitors' Perspectives on Addressing Poor Mental Health, Substance Abuse, and Domestic Violence: A Qualitative Study

    ERIC Educational Resources Information Center

    Tandon, S. Darius; Mercer, Constance D.; Saylor, Elizabeth L.; Duggan, Anne K.

    2008-01-01

    This research was conducted to understand paraprofessional home visitors' perceptions of their training in addressing poor mental health, substance abuse, and domestic violence, and their actions in working with families in addressing these issues. Five focus groups were conducted with a total of 28 paraprofessional home visitors. Three main…

  6. An analysis of content in comprehensive cancer control plans that address chronic hepatitis B and C virus infections as major risk factors for liver cancer.

    PubMed

    Momin, Behnoosh; Richardson, Lisa

    2012-08-01

    Chronic hepatitis B and hepatitis C virus (HBV and HCV) infections are among the leading causes of preventable death worldwide. Chronic viral hepatitis is the cause of most primary liver cancer, which is the third leading cause of cancer deaths globally and the ninth leading cause of cancer deaths in the United States. The extent to which comprehensive cancer control (CCC) programs in states, tribal governments and organizations, territories, and Pacific Island jurisdictions address chronic hepatitis B and/or hepatitis C infections as risk factors for liver cancer or recommend interventions for liver cancer prevention in their CCC plans remains unknown. We searched CCC plans for this information using the search tool at http://www.cdc.gov/cancer/ncccp/ to access the content of plans for this information. A combination of key search terms including "liver cancer", "hepatitis", "chronic alcohol", and "alcohol abuse" were used to identify potential content regarding liver cancer risk factors and prevention. Relevant content was abstracted for further review and classification. Of 66 (Although CDC funds 65 programs, one of the Pacific Island Jurisdiction grantees is the Federated States of Micronesia (FSM). This national program supports four FSM states, each of which submits a cancer plan to CDC for a total of 69 plans. During this time period, 66 plans were available on the website.) CCC plans, 27% (n = 18) addressed liver cancer using the above-mentioned search terms. In the 23 plans that addressed HBV and/or HCV, there were 25 goals, objectives, strategies, and outcomes aimed at reducing the incidence or prevalence of HBV and/or HCV infection. While nearly a third of CCC programs identify at least one goal, objective, strategy, outcome, or prevention program to reduce cancer burden in their CCC plans, few plans discuss specific actions needed to reduce the burden of liver cancer.

  7. Consensus Statement on Electronic Health Predictive Analytics: A Guiding Framework to Address Challenges

    PubMed Central

    Amarasingham, Ruben; Audet, Anne-Marie J.; Bates, David W.; Glenn Cohen, I.; Entwistle, Martin; Escobar, G. J.; Liu, Vincent; Etheredge, Lynn; Lo, Bernard; Ohno-Machado, Lucila; Ram, Sudha; Saria, Suchi; Schilling, Lisa M.; Shahi, Anand; Stewart, Walter F.; Steyerberg, Ewout W.; Xie, Bin

    2016-01-01

    Context: The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive analytic (e-HPA) applications, defined as the use of electronic algorithms that forecast clinical events in real time with the intent to improve patient outcomes and reduce costs. There is an urgent need for a systematic framework to guide the development and application of e-HPA to ensure that the field develops in a scientifically sound, ethical, and efficient manner. Objectives: Building upon earlier frameworks of model development and utilization, we identify the emerging opportunities and challenges of e-HPA, propose a framework that enables us to realize these opportunities, address these challenges, and motivate e-HPA stakeholders to both adopt and continuously refine the framework as the applications of e-HPA emerge. Methods: To achieve these objectives, 17 experts with diverse expertise including methodology, ethics, legal, regulation, and health care delivery systems were assembled to identify emerging opportunities and challenges of e-HPA and to propose a framework to guide the development and application of e-HPA. Findings: The framework proposed by the panel includes three key domains where e-HPA differs qualitatively from earlier generations of models and algorithms (Data Barriers, Transparency, and Ethics) and areas where current frameworks are insufficient to address the emerging opportunities and challenges of e-HPA (Regulation and Certification; and Education and Training). The following list of recommendations summarizes the key points of the framework: Data Barriers: Establish mechanisms within the scientific community to support data sharing for predictive model development and testing.Transparency: Set standards around e-HPA validation based on principles of scientific transparency and reproducibility.Ethics: Develop both individual-centered and society-centered risk-benefit approaches to evaluate

  8. Challenges faced by multidisplinary new investigators on addressing grand challenges in global health

    PubMed Central

    2014-01-01

    Background The grand challenges approach aims to spark innovative and transformative strategies to overcome barriers to significant global health issues. Grand Challenges Canada endorses an ‘Integrated Innovation™’ approach that focuses on the intersection of scientific/technological, social and business innovation. In this article we explore themes emerging from a dialogue between the authors, who are multidisciplinary recipients of the ‘Rising Stars in Global Health’ award from Grand Challenges Canada, regarding benefits of engaging in integrated innovation research, and recommendations for how this approach may develop in the future. Discussion Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections on applying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges 2012 meeting; and 3) authors’ visions of Grand Challenges Canada and the Grand Challenge movement towards 2020. The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and report themes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potential for scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges and opportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding Integrated Innovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; and c) potential for future commercialization. Conclusions Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories, methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international, interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge for new investigators

  9. Addressing gaps in physician knowledge regarding transgender health and healthcare through medical education

    PubMed Central

    McPhail, Deborah; Rountree-James, Marina; Whetter, Ian

    2016-01-01

    Background Transgender people (those people whose sex at birth does not “match” their felt gender identity) are a priority group for healthcare as they experience high rates of discrimination and related illnesses. Despite this, there is a trend of poor healthcare access for trans people due, in large part, to the denial of care on the part of physicians. A small body of literature is beginning to suggest that this denial of care may be due to a lack of physician knowledge as well as, in some cases, to transphobia. There is a dearth of research in Canada, however, exploring whether and/or how knowledge gaps create barriers to quality care, and whether medical education can attend to these gaps while and through addressing gender normativity. Methods To fill these gaps in the literature, we undertook a qualitative study with 30 trans identified people and 11 physicians (N=41) in Winnipeg, Manitoba. Methods included semi-structured individual interviews and focus groups. Data were transcribed and analyzed with NVivo qualitative data software using iterative methods. Results An overwhelming finding of this study was a lack of physician knowledge, as reported both by trans people and by physicians, that resulted in a denial of trans-specific care and also impacted general care. Transphobia was also identified as a barrier to quality care by both trans people and physicians. Physicians were open to learning more about trans health and healthcare. Conclusions The findings suggest a pressing need for better medical education that exposes students to basic skills in trans health so that they can become competent in providing care to trans people. This learning must take place alongside anti-transphobia education. Based on these findings, we suggest key recommendations at the close of the paper for providing quality trans health curriculum in medical education. PMID:28344694

  10. From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice

    PubMed Central

    Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee

    2014-01-01

    Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician’s ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs. PMID:24855416

  11. From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice.

    PubMed

    Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee

    2014-04-01

    Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician's ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs.

  12. Addressing Methodological Challenges in Large Communication Datasets: Collecting and Coding Longitudinal Interactions in Home Hospice Cancer Care

    PubMed Central

    Reblin, Maija; Clayton, Margaret F; John, Kevin K; Ellington, Lee

    2015-01-01

    In this paper, we present strategies for collecting and coding a large longitudinal communication dataset collected across multiple sites, consisting of over 2000 hours of digital audio recordings from approximately 300 families. We describe our methods within the context of implementing a large-scale study of communication during cancer home hospice nurse visits, but this procedure could be adapted to communication datasets across a wide variety of settings. This research is the first study designed to capture home hospice nurse-caregiver communication, a highly understudied location and type of communication event. We present a detailed example protocol encompassing data collection in the home environment, large-scale, multi-site secure data management, the development of theoretically-based communication coding, and strategies for preventing coder drift and ensuring reliability of analyses. Although each of these challenges have the potential to undermine the utility of the data, reliability between coders is often the only issue consistently reported and addressed in the literature. Overall, our approach demonstrates rigor and provides a “how-to” example for managing large, digitally-recorded data sets from collection through analysis. These strategies can inform other large-scale health communication research. PMID:26580414

  13. Investigation of Three Approaches to Address Fear of Recurrence Among Breast Cancer Survivors

    ClinicalTrials.gov

    2015-12-09

    Breast Neoplasms; Breast Cancer; Breast Carcinoma; Malignant Neoplasm of Breast; Cancer of Breast; Mammary Neoplasm, Human; Human Mammary Carcinoma; Malignant Tumor of Breast; Mammary Cancer; Mammary Carcinoma; Anxiety; Fear; Neoplasm Remission, Spontaneous; Spontaneous Neoplasm Regression; Regression, Spontaneous Neoplasm; Remission, Spontaneous Neoplasm; Spontaneous Neoplasm Remission

  14. Addressing Student Mental Health Needs by Providing Direct and Indirect Services and Building Alliances in the Community

    ERIC Educational Resources Information Center

    Kaffenberger, Carol J.; O'Rorke-Trigiani, Judith

    2013-01-01

    Given that 20% of students experience mental health issues that interfere with school performance and most of these students will turn first to their school for help, school counselors need to consider how they can best serve this population. This article describes how school counselors can address the mental health needs of students by providing…

  15. Community health clinical education in Canada: part 2--developing competencies to address social justice, equity, and the social determinants of health.

    PubMed

    Cohen, Benita E; Gregory, David

    2009-01-01

    Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.

  16. Health Behaviors of Minority Childhood Cancer Survivors

    PubMed Central

    Stolley, Melinda R.; Sharp, Lisa K.; Tangney, Christy; Schiffer, Linda; Arroyo, Claudia; Kim, Yoonsang; Campbell, Richard; Schmidt, Mary Lou; Breen, Kathleen; Kinahan, Karen E.; Dilley, Kim; Henderson, Tara; Korenblit, Allen D.; Seligman, Katya

    2015-01-01

    Background Available data suggest that childhood cancer survivors (CCSs) are comparable to the general population on many lifestyle parameters. However, little is known about minority CCSs. This cross-sectional study describes and compares the body mass index (BMI) and health behaviors of African-American, Hispanic and White survivors to each other and to non-cancer controls. Methods Participants included 452 adult CCS (150 African-American, 152 Hispanic, 150 white) recruited through four childhood cancer treating institutions and 375 ethnically-matched non-cancer controls (125 in each racial/ethnic group) recruited via targeted digit dial. All participants completed a 2-hour in-person interview. Results Survivors and non-cancer controls reported similar health behaviors. Within survivors, smoking and physical activity were similar across racial/ethnic groups. African-American and Hispanic survivors reported lower daily alcohol use than whites, but consumed unhealthy diets and were more likely to be obese. Conclusions This unique study highlights that many minority CCSs exhibit lifestyle profiles that contribute to increased risk for chronic diseases and late effects. Recommendations for behavior changes must consider the social and cultural context in which minority survivors may live. PMID:25564774

  17. Addressing healthcare.

    PubMed

    Daly, Rich

    2013-02-11

    Though President Barack Obama has rarely made healthcare references in his State of the Union addresses, health policy experts are hoping he changes that strategy this year. "The question is: Will he say anything? You would hope that he would, given that that was the major issue he started his presidency with," says Dr. James Weinstein, left, of the Dartmouth-Hitchcock health system.

  18. Building nursing research capacity to address health disparities: engaging minority baccalaureate and master's students.

    PubMed

    Goeppinger, Jean; Miles, Margaret Shandor; Weaver, Wanda; Campbell, Lenora; Roland, E Joyce

    2009-01-01

    In order to decrease health disparities, nursing needs to promote opportunities for minority nursing students to incorporate the conduct, as well as the utilization, of research into their professional careers. This article describes a model program to facilitate minority research career development, the Research Enrichment and Apprenticeship Program (REAP). REAP was developed and implemented by a federally funded partnership between 2 historically Black universities and a research-intensive university. Fifty-five (N = 55) baccalaureate and master's nursing students and 35 faculty members from the 3 schools participated in an intensive research mentorship program guided by learner-centered pedagogical approaches that culminated in the public presentation of students' research projects at a scientific poster session. Student, faculty, and institutional achievements, as well as challenges, were identified and addressed as the partnership evolved. Recognizing and building upon the strengths of both minority-serving and research-intensive institutions allowed the development of an exemplar program. While process measures provided many indicators of success, long-term evaluation of research career-related outcomes are needed.

  19. Corruption in health-care systems and its effect on cancer care in Africa.

    PubMed

    Mostert, Saskia; Njuguna, Festus; Olbara, Gilbert; Sindano, Solomon; Sitaresmi, Mei Neni; Supriyadi, Eddy; Kaspers, Gertjan

    2015-08-01

    At the government, hospital, and health-care provider level, corruption plays a major role in health-care systems in Africa. The returns on health investments of international financial institutions, health organisations, and donors might be very low when mismanagement and dysfunctional structures of health-care systems are not addressed. More funding might even aggravate corruption. We discuss corruption and its effects on cancer care within the African health-care system in a sociocultural context. The contribution of high-income countries in stimulating corruption is also described. Corrupt African governments cannot be expected to take the initiative to eradicate corruption. Therefore, international financial institutions, health organisations, and financial donors should use their power to demand policy reforms of health-care systems in Africa troubled by the issue of corruption. These modifications will ameliorate the access and quality of cancer care for patients across the continent, and ultimately improve the outcome of health care to all patients.

  20. Addressing the Social Determinants of Health of Children and Youth: A Role for SOPHE Members

    ERIC Educational Resources Information Center

    Allensworth, Diane D.

    2011-01-01

    The determinants of youth health disparities include poverty, unequal access to health care, poor environmental conditions, and educational inequities. Poor and minority children have more health problems and less access to health care than their higher socioeconomic status cohorts. Having more health problems leads to more absenteeism in school,…

  1. School-Based Health Centers and Childhood Obesity: "An Ideal Location to Address a Complex Issue"

    ERIC Educational Resources Information Center

    National Assembly on School-Based Health Care, 2010

    2010-01-01

    One of today's most pressing public health problems is the rise in childhood overweight and obesity. School-based health centers (SBHCs)--the convergence of public health, primary care, and mental health in schools--represent an important element in the public health toolbox for combating the challenging epidemic. When working side-by-side in a…

  2. Has the Rajiv Aarogyasri Community Health Insurance Scheme of Andhra Pradesh Addressed the Educational Divide in Accessing Health Care?

    PubMed Central

    Rao, Mala; Singh, Prabal Vikram; Katyal, Anuradha; Samarth, Amit; Bergkvist, Sofi; Renton, Adrian; Netuveli, Gopalakrishnan

    2016-01-01

    Background Equity of access to healthcare remains a major challenge with families continuing to face financial and non-financial barriers to services. Lack of education has been shown to be a key risk factor for 'catastrophic' health expenditure (CHE), in many countries including India. Consequently, ways to address the education divide need to be explored. We aimed to assess whether the innovative state-funded Rajiv Aarogyasri Community Health Insurance Scheme of Andhra Pradesh state launched in 2007, has achieved equity of access to hospital inpatient care among households with varying levels of education. Methods We used the National Sample Survey Organization 2004 survey as our baseline and the same survey design to collect post-intervention data from 8623 households in the state in 2012. Two outcomes, hospitalisation and CHE for inpatient care, were estimated using education as a measure of socio-economic status and transforming levels of education into ridit scores. We derived relative indices of inequality by regressing the outcome measures on education, transformed as a ridit score, using logistic regression models with appropriate weights and accounting for the complex survey design. Findings Between 2004 and 2012, there was a 39% reduction in the likelihood of the most educated person being hospitalised compared to the least educated, with reductions observed in all households as well as those that had used the Aarogyasri. For CHE the inequality disappeared in 2012 in both groups. Sub-group analyses by economic status, social groups and rural-urban residence showed a decrease in relative indices of inequality in most groups. Nevertheless, inequalities in hospitalisation and CHE persisted across most groups. Conclusion During the time of the Aarogyasri scheme implementation inequalities in access to hospital care were substantially reduced but not eliminated across the education divide. Universal access to education and schemes such as Aarogyasri have the

  3. Violent Behavior in Cancer Patients--A Rarely Addressed Phenomenon in Oncological Treatment

    ERIC Educational Resources Information Center

    Grube, Michael

    2012-01-01

    Dealing with violent cancer patients can be particularly challenging. The purpose of this study was to collect data on the frequency, quality, and underlying variables affecting violent behavior as well as to examine the role played by this behavior in the premature interruption of treatment. A total of 388 cancer inpatients were examined by…

  4. Addressing cancer control needs of African-born immigrants in the US: a systematic literature review.

    PubMed

    Hurtado-de-Mendoza, Alejandra; Song, Minna; Kigen, Ocla; Jennings, Yvonne; Nwabukwu, Ify; Sheppard, Vanessa B

    2014-10-01

    Compared to non-Hispanic Whites, African immigrants have worse cancer outcomes. However, there is little research about cancer behaviors and/or interventions in this growing population as they are generally grouped with populations from America or the Caribbean. This systematic review examines cancer-related studies that included African-born participants. We searched PsycINFO, Ovid Medline, Pubmed, CINHAL, and Web of Science for articles focusing on any type of cancer that included African-born immigrant participants. Twenty articles met study inclusion criteria; only two were interventions. Most articles focused on one type of cancer (n=11) (e.g., breast cancer) and were conducted in disease-free populations (n=15). Studies included African participants mostly from Nigeria (n=8) and Somalia (n=6). However, many papers (n=7) did not specify nationality or had small percentages (<5%) of African immigrants (n=5). Studies found lower screening rates in African immigrants compared to other subpopulations (e.g. US-born). Awareness of screening practices was limited. Higher acculturation levels were associated with higher screening rates. Barriers to screening included access (e.g. insurance), pragmatic (e.g. transportation), and psychosocial barriers (e.g. shame). Interventions to improve cancer outcomes in African immigrants are needed. Research that includes larger samples with diverse African subgroups including cancer survivors is necessary to inform future directions.

  5. School‐based brief psycho‐educational intervention to raise adolescent cancer awareness and address barriers to medical help‐seeking about cancer: a cluster randomised controlled trial

    PubMed Central

    Stoddart, Iona; Forbat, Liz; Neal, Richard D.; O'Carroll, Ronan E.; Haw, Sally; Rauchhaus, Petra; Kyle, Richard G.

    2015-01-01

    Abstract Objectives Raising cancer awareness and addressing barriers to help‐seeking may improve early diagnosis. The aim was to assess whether a psycho‐educational intervention increased adolescents' cancer awareness and addressed help‐seeking barriers. Methods This was a cluster randomised controlled trial involving 2173 adolescents in 20 schools. The intervention was a 50‐min presentation delivered by a member of Teenage Cancer Trust's (UK charity) education team. Schools were stratified by deprivation and roll size and randomly allocated to intervention/control conditions within these strata. Outcome measures were the number of cancer warning signs and cancer risk factors recognised, help‐seeking barriers endorsed and cancer communication. Communication self‐efficacy and intervention fidelity were also assessed. Results Regression models showed significant differences in the number of cancer warning signs and risk factors recognised between intervention and control groups. In intervention schools, the greatest increases in recognition of cancer warning signs at 6‐month follow‐up were for unexplained weight loss (from 44.2% to 62.0%) and change in the appearance of a mole (from 46.3% to 70.7%), up by 17.8% and 24.4%, respectively. Greatest increases in recognition of cancer risk factors were for getting sunburnt more than once as a child (from 41.0% to 57.6%) and being overweight (from 42.7% to 55.5%), up by 16.6% and 12.8%, respectively. Regression models showed that adolescents in intervention schools were 2.7 times more likely to discuss cancer at 2‐week follow‐up compared with the control group. No differences in endorsement of barriers to help‐seeking were observed. Conclusions School‐based brief psycho‐educational interventions are easy to deliver, require little resource and improve cancer awareness. © 2015 The Authors. Psycho‐Oncology published by John Wiley & Sons Ltd. PMID:26502987

  6. Environment and Health: Not Only Cancer

    PubMed Central

    Colao, Annamaria; Muscogiuri, Giovanna; Piscitelli, Prisco

    2016-01-01

    The Hippocratic tradition emphasized environmental causes of diseases and the need for harmony between the individual and the natural environment as the right philosophy to maintain a good health status. Public awareness and scientific attention concerning environmental pollution is usually focused on the consequent increased risk of developing cancer. Air pollution has been recognized by the World Health Organization (WHO) to cause cardiovascular and respiratroy diseases, as well as lung cancer, after acute/chronic exposure to fine particulates (PM2.5 and PM10) even at concentrations which are 50% lower than those accepted as legal limits in many developed countries. An increase of 10 µg/m3 of PM2.5 produces a +4%–6% of overall mortality, a +10% of cardiovascular disease prevalence (arithmyas, acute myocardial infarctions, and heart failure) and a +22% of lung cancer prevalence. In addition to these chronic effects, acute hospitalizations are also affected, especially among susceptible populations such as children and diabetic patients. Water and soil contamination also have an additional detrimental effect on people’s health. Other issues concerning environment contamination and human health include male/female fertility, metabolic and thyroid conditions, but also professional exposures resulting in occupational diseases. Moreover, in the perspective of “gender medicine”, different acute or chronic effects of environmental pollution should be specifically assessed both in men and in women. This special issue on “Environmental Diseases” is aimed at providing a global overview about different threats to human health possibily originating from environmental contamination. PMID:27447654

  7. Public-private partnerships in community health centers: addressing the needs of underserved populations.

    PubMed

    Shi, Leiyu; Collins, Patricia B

    2007-01-01

    Community health centers have provided high quality, cost-effective primary healthcare to underserved populations for over four decades. From the beginning, collaboration has been a central component of the community health center model of care. This article begins with an overview of community health center achievements and the drive for increased private-public partnerships in public health. The historic and current role of public-private partnerships within community health centers is described, with a particular focus on the Bureau of Primary Health Care initiatives (that is, the Health Disparities Collaborative and the Healthy Communities Access Program). Community health centers' establishment of partnerships in response to Hurricane Katrina and Medicare Part D is discussed. Finally, this article considers the continuing role of community health center public-private partnerships in the context of political and healthcare market shifts.

  8. Opportunities for nursing-dental collaboration: addressing oral health needs among the elderly.

    PubMed

    Coleman, Patricia

    2005-01-01

    Providing quality oral health care for the growing elderly population is a major challenge, particularly for those residing in long-term care institutions. The Surgeon General's report on oral health in America (2000) noted that elders are at particularly high risk for oral health problems, and poor oral health in seniors has been linked to general systemic health risks such as cardiovascular disease, stroke, poor nutrition, and respiratory infection. This article outlines the need for greater attention to oral health care for the elderly in both nursing education and practice, and describes opportunities for effective inter-professional collaboration between nursing and oral health professionals. It also provides specific recommendations for fostering such collaboration. Working together, nurses and dental professionals can raise awareness of this issue, promote higher standards for oral care, and improve oral health and quality of life for elderly Americans.

  9. Addressing Health Inequities: Coronary Heart Disease Training within Learning Disabilities Services

    ERIC Educational Resources Information Center

    Holly, Deirdre; Sharp, John

    2014-01-01

    People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed…

  10. Integrating Education on Addressing Health Disparities into the Graduate Social Work Curriculum

    ERIC Educational Resources Information Center

    Mitchell, Jamie Ann

    2012-01-01

    The purpose of this article is to propose an elective social work course as a means of better preparing social workers entering practice in healthcare to meet the challenges of promoting health and reducing health disparities in minority and underserved communities. Course offerings specifically targeting health or medical social work training…

  11. Presidential address 1996: “Dear ministers of health....”

    PubMed Central

    Taylor, Bryce R.

    1997-01-01

    The Canadian Association of General Surgeons, representing community and academic general surgeons throughout Canada, is concerned about the widespread effects of health care restructuring on clinical care, education and research. The general surgeon remains one of the critical members of the health care team and should have an adequate voice in ongoing discussions regarding health care reform. PMID:9126122

  12. A community approach to addressing excess breast and cervical cancer mortality among women of African descent in Boston.

    PubMed

    Bigby, JudyAnn; Ko, Linda K; Johnson, Natacha; David, Michele M A; Ferrer, Barbara

    2003-01-01

    In 2000, the REACH Boston 2010 Breast and Cervical Cancer Coalition conducted a community needs assessment and found several factors that may have contributed to disproportionately high breast and cervical cancer mortality among black women: (a) Focus group participants reported that many women in their communities had limited awareness about risk factors for cancer as well as about screening. (b) Black women experienced barriers to care related to the cultural competence of providers and of institutions. (c) Black women were not receiving adequate follow-up for abnormal mammograms and Pap smears. The Coalition's Community Action Plan to address disparities includes a model primary care service for black women; scholarships to increase the number of black mammogram technologists; primary care provider and radiology technologist training about disparities and cultural competence; and education to increase awareness among black women and to increase leadership and advocacy skills.

  13. Study Protocol: A randomized controlled trial of patient navigation-activation to reduce cancer health disparities

    PubMed Central

    2010-01-01

    Background Cancer health disparities affecting low-income and minority patients are well documented. Root-causes are multifactorial, including diagnostic and treatment delays, social and financial barriers, and poor communication. Patient navigation and communication coaching (activation) are potential interventions to address disparities in cancer treatment. The purpose of this clinical trial is to test the effectiveness of an intervention combining patient navigation and activation to improve cancer treatment. Methods/Design The Rochester Patient Navigation Research Program (PNRP) is a National Cancer Institute-sponsored, patient-level randomized trial (RCT) of patient navigation and activation, targeting newly-diagnosed breast and colorectal cancer patients in Rochester, NY. The goal of the program is to decrease cancer health disparities by addressing barriers to receipt of cancer care and promoting patient self-efficacy. The intervention uses trained, paraprofessional patient navigators recruited from the target community, and a detailed training and supervisory program. Recruited patients are randomly assigned to receive either usual care (except for baseline and follow-up questionnaires and interviews) or intervention. The intervention patients receive tailored assistance from their patient navigators, including phone calls, in-person meetings, and behind-the-scenes coordination of care. A total of 344 patients have been recruited. Outcomes measured at three month intervals include timeliness of care, patient adherence, patient satisfaction, quality of life, self-efficacy, health literacy, and cancer knowledge. Discussion This unique intervention combining patient navigation and patient activation is designed to address the multifactorial problem of cancer health disparities. If successful, this study will affect the design and implementation of patient navigation programs. Trials Registration clinicaltrials.gov identifier NCT00496678 PMID:20939928

  14. The Evidence Base for Mental Health Consultation in Early Childhood Settings: Research Synthesis Addressing Staff and Program Outcomes

    ERIC Educational Resources Information Center

    Brennan, Eileen M.; Bradley, Jennifer R.; Allen, Mary Dallas; Perry, Deborah F.

    2008-01-01

    Research Findings: One strategy to support early childhood providers' work with children exhibiting challenging behavior is offering mental health consultation services in order to build staff skills and confidence and reduce staff stress and turnover. Through systematic search procedures, 26 recent studies were identified that addressed the…

  15. To Your Health: NLM Update transcript - Geography of cancer deaths

    MedlinePlus

    ... Your Health: NLM Update Transcript Geography of cancer deaths : 03/27/2017 To use the sharing features ... on weekly topics. An overall decline in cancer deaths across the U.S. is not uniform, and research ...

  16. Disparities in Cancer Incidence, Stage, and Mortality at Boston Health Care for the Homeless Program

    PubMed Central

    Baggett, Travis P.; Chang, Yuchiao; Porneala, Bianca C.; Bharel, Monica; Singer, Daniel E.; Rigotti, Nancy A.

    2015-01-01

    Introduction Homeless people have a high burden of cancer risk factors and suboptimal rates of cancer screening, but the epidemiology of cancer has not been well described in this population. We assessed cancer incidence, stage, and mortality in homeless adults relative to general population standards. Methods We cross-linked a cohort of 28,033 adults seen at Boston Health Care for the Homeless Program in 2003–2008 to Massachusetts cancer registry and vital registry records. We calculated age-standardized cancer incidence and mortality ratios (SIRs and SMRs). We examined tobacco use among incident cases and estimated smoking-attributable fractions. Trend tests were used to compare cancer stage distributions with those in Massachusetts adults. Analyses were conducted in 2012–2015. Results During 90,450 person-years of observation, there were 361 incident cancers (SIR=1.13, 95% CI=1.02, 1.25) and 168 cancer deaths (SMR=1.88, 95% CI=1.61, 2.19) among men, and 98 incident cancers (SIR=0.93, 95% CI=0.76, 1.14) and 38 cancer deaths (SMR=1.61, 95% CI=1.14, 2.20) among women. For both sexes, bronchus and lung cancer was the leading type of incident cancer and cancer death, exceeding Massachusetts estimates more than twofold. Oropharyngeal and liver cancer cases and deaths occurred in excess among men, whereas cervical cancer cases and deaths occurred in excess among women. About one third of incident cancers were smoking-attributable. Colorectal, female breast, and oropharyngeal cancers were diagnosed at more-advanced stages than in Massachusetts adults. Conclusions Efforts to reduce cancer disparities in homeless people should include addressing tobacco use and enhancing participation in evidence-based screening. PMID:26143955

  17. Cancer Survivors Gain from Web-Based Health Care

    MedlinePlus

    ... 163535.html Cancer Survivors Gain From Web-Based Health Care But some patients reported missing face-to-face ... 10, 2017 (HealthDay News) -- Online- and phone-based health care offers a number of benefits for cancer survivors, ...

  18. Addressing oral health disparities in settings without a research-intensive dental school: collaborative strategies.

    PubMed

    Easa, David; Harrigan, Rosanne; Hammatt, Zoè; Greer, Mark; Kuba, Carolyn; Davis, James; Beck, James D; Offenbacher, Steven

    2005-01-01

    Research suggests that oral health is linked to systemic health, and those with poor oral health are potentially at greater risk for important diseases, including cardiovascular disease, stroke, diabetes mellitus, and adverse pregnancy outcomes. Asians and Pacific Islanders (APIs) in Hawaii have high rates of many such diseases. Studies in children in Hawaii have revealed disparities in dental health; for example, API children have significantly higher rates of cavities than other groups. Hence, conducting further study is vital in adults, particularly APIs, to assess oral health and its correlation to overall health outcomes. Given the lack of a dental school and the lack of fluoridated water in the state, the University of Hawaii's John A. Burns School of Medicine (ABSOM) has identified the need to assume a leadership role in creating effective community-based oral health research and treatment programs. With the support of the National Institute of Dental and Craniofacial Research, JABSOM fostered a collaborative relationship with the University of North Carolina at Chapel Hill School of Dentistry, a premiere research-intensive dental school, the Waimanalo Health Center, and the Hawaii State Department of Health. This partnership has worked together to implement a community-based approach to performing research designed to illuminate disparities and develop innovative strategies to promote oral health in Hawaii's diverse populations. We hope that this collaborative, culturally competent approach may serve as a model for use in other settings without a research-intensive dental school.

  19. Addressing health inequalities by using Structural Funds. A question of opportunities.

    PubMed

    Neagu, Oana Maria; Michelsen, Kai; Watson, Jonathan; Dowdeswell, Barrie; Brand, Helmut

    2017-03-01

    Making up a third of the EU budget, Structural and Investment Funds can provide important opportunities for investing in policies that tackle inequalities in health. This article looks back and forward at the 2007-2013 and 2014-2020 financial periods in an attempt to inform the development of health equity as a strand of policy intervention under regional development. It combines evidence from health projects funded through Structural Funds and a document analyses that locates interventions for health equity under the new regulations. The map of opportunities has changed considerably since the last programming period, creating more visibility for vulnerable groups, social determinants of health and health systems sustainability. As the current programming period is progressing, this paper contributes to maximizing this potential but also identifying challenges and implementation gaps for prospective health system engagement in pursuing health equity as part of Structural Funds projects. The austerity measures and their impact on public spending, building political support for investments as well as the difficulties around pursuing health gains as an objective of other policy areas are some of the challenges to overcome. European Structural and Investment Funds could be a window of opportunity that triggers engagement for health equity if sectors adopt a transformative approach and overcome barriers, cooperate for common goals and make better use of the availability of these resources.

  20. Non-cancer health effects of pesticides

    PubMed Central

    Sanborn, M.; Kerr, K.J.; Sanin, L.H.; Cole, D.C.; Bassil, K.L.; Vakil, C.

    2007-01-01

    OBJECTIVE To investigate whether there are associations between exposure to pesticides and 4 chronic non-cancer health effects: dermatologic, neurologic, reproductive, and genotoxic effects. DATA SOURCES We searched PreMedline, MEDLINE, and LILACS using the key word pesticide combined with the term for the specific health effect being searched. Reviewers scanned the references of all articles for additional relevant studies. STUDY SELECTION Studies since 1992 were assessed using structured inclusion and quality-of-methods criteria. Studies scoring <4 on a 7-point global methodologic quality scale were excluded. In total, 124 studies were included. These studies had a mean quality score of 4.88 out of 7. SYNTHESIS Strong evidence of association with pesticide exposure was found for all neurologic outcomes, genotoxicity, and 4 of 6 reproductive effects: birth defects, fetal death, altered growth, and other outcomes. Exposure to pesticides generally doubled the level of genetic damage as measured by chromosome aberrations in lymphocytes. Only a few high-quality studies focused on the dermatologic effects of pesticides. In some of these studies, rates of dermatitis were higher among those who had had high exposure to pesticides on the job. CONCLUSION Evidence from research on humans consistently points to positive associations between pesticide exposure and 3 of the 4 non-cancer health outcomes studied. Physicians have a dual role in educating individual patients about the risks of exposure and in reducing exposure in the community by advocating for restrictions on use of pesticides. PMID:17934035

  1. Are We Doing Enough to Address the Cancer Care Needs 
of the LGBT Community?

    PubMed

    Brown, Carlton; Mayer, Deborah K

    2015-06-01

    The 2011 film titled Gen Silent (http://gensilent.com) focuses on the needs and issues of six aging lesbian, gay, bisexual, and transgender (LGBT) people, at least two of whom had cancer. One of the issues made apparent in the film was the lack of trust in the healthcare system and the discrimination these individuals faced at a time when their needs were growing and they were increasingly vulnerable. It was sad and caused us to reflect on what we, as oncology nurses, are doing to meet the needs of LGBT individuals faced with a cancer diagnosis.
.

  2. Photovoice with vulnerable populations: addressing disparities in health promotion among people with intellectual disabilities.

    PubMed

    Jurkowski, Janine M; Paul-Ward, Amy

    2007-10-01

    Eliminating health disparities is a national priority. People with intellectual disabilities (PWID) are a vulnerable group that experiences health disparities. However, their health disparities have largely been overlooked. Photovoice is an effective method for engaging PWID in health promotion planning and research. This article discusses the importance of including PWID as a priority group, presents a Photovoice project among Latinos with ID, and concludes with recommendations for employing Photovoice with PWID. The Photovoice project was a part of a larger pilot study that aimed to enable the voices of Latinos with ID and guide the development of health promotion programs at a community agency. The findings were presented in reports and at a town hall meeting during which attendees responded and developed actions steps for improving health promotion for PWID. Each Photovoice participant received a scrapbook of their photographs as a keepsake of their experiences participating in the project [corrected

  3. The virtual network supporting the front lines: addressing emerging behavioral health problems following the tsunami of 2004.

    PubMed

    Reissman, Dori B; Schreiber, Merritt; Klomp, Richard W; Hoover, Michele; Kowalski-Trakofler, Kathleen; Perez, Jon

    2006-10-01

    The devastation wreaked by the 2004 tsunami in the Indian Ocean required extensive multinational and nongovernmental relief efforts to address the massive loss of infrastructure, people, and society. This article addresses approaches to behavioral incident management from a process perspective, through the lens of one official stateside channel of emergency operations. The process highlights the formation and connectivity of multidisciplinary teams that virtually supported the efforts of a seven-person, on-scene, behavioral health team aboard the USNS Mercy as part of Operation Unified Assistance in the Indian Ocean. Frontline health diplomacy and behavioral health relief efforts were greatly augmented by the virtual network of support from leading experts around the globe. Future disaster response and recovery efforts ought to build on the success of such virtual support networks, by planning for appropriate technology, expertise, and mutual aid partnerships.

  4. Estimation of health state utilities in breast cancer

    PubMed Central

    Kim, Seon-Ha; Jo, Min-Woo; Ock, Minsu; Lee, Hyeon-Jeong; Lee, Jong-Won

    2017-01-01

    Purpose The aim of this study is to determine the utility of breast cancer health states using the standard gamble (SG) and visual analog scale (VAS) methods in the Korean general population. Materials and methods Eight hypothetical breast cancer health states were developed based on patient education material and previous publications. Data from 509 individuals from the Korean general population were used to evaluate breast cancer health states using the VAS and the SG methods, which were obtained via computer-assisted personal interviews. Mean utility values were calculated for each human papillomavirus (HPV)-related health state. Results The rank of health states was identical between two valuation methods. SG values were higher than VAS values in all health states. The utility values derived from SG were 0.801 (noninvasive breast cancer with mastectomy and followed by reconstruction), 0.790 (noninvasive breast cancer with mastectomy only), 0.779 (noninvasive breast cancer with breast-conserving surgery and radiation therapy), 0.731 (invasive breast cancer with surgery, radiation therapy, and/or chemotherapy), 0.610 (locally advanced breast cancer with radical mastectomy with radiation therapy), 0.587 (inoperable locally advanced breast cancer), 0.496 (loco-regional recurrent breast cancer), and 0.352 (metastatic breast cancer). Conclusion Our findings might be useful for economic evaluation of breast cancer screening and interventions in general populations. PMID:28352159

  5. Investigating the Role of State Permitting and Agriculture Agencies in Addressing Public Health Concerns Related to Industrial Food Animal Production

    PubMed Central

    Fry, Jillian P.; Laestadius, Linnea I.; Grechis, Clare; Nachman, Keeve E.; Neff, Roni A.

    2014-01-01

    Objectives Industrial food animal production (IFAP) operations adversely impact environmental public health through air, water, and soil contamination. We sought to determine how state permitting and agriculture agencies respond to these public health concerns. Methods We conducted semi-structured qualitative interviews with staff at 12 state agencies in seven states, which were chosen based on high numbers or rapid increase of IFAP operations. The interviews served to gather information regarding agency involvement in regulating IFAP operations, the frequency and type of contacts received about public health concerns, how the agency responds to such contacts, and barriers to additional involvement. Results Permitting and agriculture agencies’ responses to health-based IFAP concerns are constrained by significant barriers including narrow regulations, a lack of public health expertise within the agencies, and limited resources. Conclusions State agencies with jurisdiction over IFAP operations are unable to adequately address relevant public health concerns due to multiple factors. Combining these results with previously published findings on barriers facing local and state health departments in the same states reveals significant gaps between these agencies regarding public health and IFAP. There is a clear need for regulations to protect public health and for public health professionals to provide complementary expertise to agencies responsible for regulating IFAP operations. PMID:24587087

  6. Time to address gender discrimination and inequality in the health workforce

    PubMed Central

    2014-01-01

    Gender is a key factor operating in the health workforce. Recent research evidence points to systemic gender discrimination and inequalities in health pre-service and in-service education and employment systems. Human resources for health (HRH) leaders’ and researchers’ lack of concerted attention to these inequalities is striking, given the recognition of other forms of discrimination in international labour rights and employment law discourse. If not acted upon, gender discrimination and inequalities result in systems inefficiencies that impede the development of the robust workforces needed to respond to today’s critical health care needs. This commentary makes the case that there is a clear need for sex- and age-disaggregated and qualitative data to more precisely illuminate gender-related trends and dynamics in the health workforce. Because of their importance for measurement, the paper also presents definitions and examples of sex or gender discrimination and offers specific case examples. At a broader level, the commentary argues that gender equality should be an HRH research, leadership, and governance priority, where the aim is to strengthen health pre-service and continuing professional education and employment systems to achieve better health systems outcomes, including better health coverage. Good HRH leadership, governance, and management involve recognizing the diversity of health workforces, acknowledging gender constraints and opportunities, eliminating gender discrimination and equalizing opportunity, making health systems responsive to life course events, and protecting health workers’ labour rights at all levels. A number of global, national and institution-level actions are proposed to move the gender equality and HRH agendas forward. PMID:24885565

  7. Colorectal cancer: consensus for CRC screening, but who addresses the controversies?

    PubMed

    Hoff, Geir

    2014-06-01

    In an update on recommendations for colorectal cancer screening, an Asia–Pacific consensus group has set a good standard for presenting level of agreement to recommendation levels. However, this update also exposes how consensus groups might concentrate on the less controversial issues—leaving the tricky questions in the dark.

  8. Community Wise: Development of a Model to Address Oppression in Order to Promote Individual and Community Health

    PubMed Central

    Windsor, Liliane; Pinto, Rogério M.; Benoit, Ellen; Jessell, Lauren; Jemal, Alexis

    2015-01-01

    Communities with histories of oppression have shown great resilience. Yet few health interventions focus on structural oppression as a contributor to health problems in these communities. This paper describes the development and active ingredients of Community Wise, a unique behavioral-health intervention designed to reduce substance use frequency, related health risk behaviors, and recidivism among individuals with a history of incarceration and substance abuse residing in distressed and predominantly African American communities. Community Wise, developed through the collaborative efforts of a board of service providers, researchers, consumers, and government officials, is a 12-week group intervention that aims to address behavioral-health problems by raising critical consciousness in distressed communities. PMID:26190947

  9. Assessing Opinions in Community Leadership Networks to Address Health Inequalities: A Case Study from Project IMPACT

    ERIC Educational Resources Information Center

    McCauley, M. P.; Ramanadhan, S.; Viswanath, K.

    2015-01-01

    This study demonstrates a novel approach that those engaged in promoting social change in health can use to analyze community power, mobilize it and enhance community capacity to reduce health inequalities. We used community reconnaissance methods to select and interview 33 participants from six leadership sectors in "Milltown", the New…

  10. "The L Pack": Addressing the Sexual Health Needs of Young Lesbians

    ERIC Educational Resources Information Center

    McAlister, Siobhan; Neill, Gail

    2009-01-01

    Concerns about the sexual health of women who identify as other than heterosexual have been highlighted in numerous research reports, yet access to information, advice and services remains limited within Northern Ireland. In response to this, a group of young women have produced a sexual health resource ("The L Pack") specifically for…

  11. Interns Addressing Mental Health Needs: Implementation of a Social and Emotional Education Program

    ERIC Educational Resources Information Center

    Fede, Jessica L.; Solomon, Benjamin G.; Whitcomb, Sara A.

    2011-01-01

    The estimated prevalence of one or more mental health disorders among children and adolescents between the ages of 9 and 17 is 21% (Satcher, 2001). Similarly, research by Greenberg et al., (2003) estimated that 20% of school-age youth experience mental health problems during the course of any school year. Despite these high prevalence rates, the…

  12. Commentary: Addressing the Gap Between Science and Practice in Children's Mental Health

    ERIC Educational Resources Information Center

    Walker, Hill M.

    2003-01-01

    The article by Fantuzzo, McWayne, and Bulotsky (2003), presenting their conceptualization of a paradigm for conducting applied research in children's mental health, is an intriguing fusion of key principles and recommendations. Their model comes close to meeting the profile of a new research paradigm in children's mental health. The author…

  13. Barriers to Addressing Adolescent Substance Use: Perceptions of New York School-Based Health Center Providers

    ERIC Educational Resources Information Center

    Harris, Brett; Shaw, Benjamin; Lawson, Hal; Sherman, Barry

    2016-01-01

    Background: Adolescent substance use is associated with chronic health conditions, accidents, injury, and school-related problems, including dropping out. Schools have the potential to provide students with substance use prevention and intervention services, albeit with confidentiality challenges. School-based health centers (SBHCs) provide…

  14. Effectively Addressing Mental Health Issues in Permanency-Focused Child Welfare Practice

    ERIC Educational Resources Information Center

    Ornelas, Laura A.; Silverstein, Deborah N.; Tan, Sherylle

    2007-01-01

    Children and families built by adoption or relative caregiving have specialized needs. This paper proposes a rubric for the central elements of permanency-focused mental health services in child welfare practice. Kinship Center provides an innovative mental health service delivery system, weaving foster and adoptive placement programs, adoption…

  15. Addressing a Threat to the Healthfulness of Tomorrow's Generation: The Case of Cigarette Smoking in Nigeria

    ERIC Educational Resources Information Center

    Egbe, Catherine O.; Petersen, Inge; Meyer-Weitz, Anna

    2014-01-01

    Cigarette smoking has widely received the attention of international and local health bodies. Efforts are being made towards curbing smoking prevalence globally with a view to reduce the health, economic and social effects of smoking in the society. While some developed countries are recording success in this effort mainly through stringent…

  16. On the road to a stronger public health workforce: visual tools to address complex challenges.

    PubMed

    Drehobl, Patricia; Stover, Beth H; Koo, Denise

    2014-11-01

    The public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges to the workforce that threaten the public's health. These challenges are complex, often involve multiple influencing or related causal factors, and demand comprehensive solutions. However, proposed solutions often focus on selected factors and might be fragmented rather than comprehensive. This paper describes approaches to characterizing the situation more comprehensively and includes two visual tools: (1) a fishbone, or Ishikawa, diagram that depicts multiple factors affecting the public health workforce; and (2) a roadmap that displays key elements-goals and strategies-to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward solutions. The visual tools aid thinking about ways to strengthen the public health workforce through collective solutions and to help leverage resources and build on each other's work. The strategic roadmap is intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC's commitment to working with partners on the highest priorities for strengthening the workforce to improve the public's health.

  17. Reference Genes for Addressing Gene Expression of Bladder Cancer Cell Models under Hypoxia: A Step Towards Transcriptomic Studies

    PubMed Central

    Soares, Janine; Neves, Manuel; Santos, Lúcio Lara; Ferreira, José Alexandre

    2016-01-01

    Highly aggressive, rapidly growing tumors contain significant areas of hypoxia or anoxia as a consequence of inadequate and/or irregular blood supply. During oxygen deprivation, tumor cells withstand a panoply of adaptive responses, including a shift towards anaerobic metabolism and the reprogramming of the transcriptome. One of the major mediators of the transcriptional hypoxic response is the hypoxia-inducible factor 1 (HIF-1), whose stabilization under hypoxia acts as an oncogenic stimulus contributing to chemotherapy resistance, invasion and metastasis. Gene expression analysis by qRT-PCR is a powerful tool for cancer cells phenotypic characterization. Nevertheless, as cells undergo a severe transcriptome remodeling.in response to oxygen deficit, the precise identification of reference genes poses a significant challenge for hypoxic studies. Herein, we aim to establish the best reference genes for studying the effects of hypoxia on bladder cancer cells. Accordingly, three bladder cancer cell lines (T24, 5637, and HT1376) representative of two distinct carcinogenesis pathways to invasive cancer (FGFR3/CCND1 and E2F3/RB1) were used. Additionally, we have explored the most suitable control gene when addressing the influence of Deferoxamine Mesilate salt (DFX), an iron chelator often used to avoid the proteasomal degradation of HIF-1α, acting as an hypoxia-mimetic agent. Using bioinformatics tools (GeNorm and NormFinder), we have elected B2M and HPRT as the most stable genes for all cell lines and experimental conditions out of a panel of seven putative candidates (HPRT, ACTB, 18S, GAPDH, TBP, B2M, and SDHA). These observations set the molecular basis for future studies addressing the effect of hypoxia and particularly HIF-1α in bladder cancer cells. PMID:27835695

  18. Reference Genes for Addressing Gene Expression of Bladder Cancer Cell Models under Hypoxia: A Step Towards Transcriptomic Studies.

    PubMed

    Lima, Luís; Gaiteiro, Cristiana; Peixoto, Andreia; Soares, Janine; Neves, Manuel; Santos, Lúcio Lara; Ferreira, José Alexandre

    2016-01-01

    Highly aggressive, rapidly growing tumors contain significant areas of hypoxia or anoxia as a consequence of inadequate and/or irregular blood supply. During oxygen deprivation, tumor cells withstand a panoply of adaptive responses, including a shift towards anaerobic metabolism and the reprogramming of the transcriptome. One of the major mediators of the transcriptional hypoxic response is the hypoxia-inducible factor 1 (HIF-1), whose stabilization under hypoxia acts as an oncogenic stimulus contributing to chemotherapy resistance, invasion and metastasis. Gene expression analysis by qRT-PCR is a powerful tool for cancer cells phenotypic characterization. Nevertheless, as cells undergo a severe transcriptome remodeling.in response to oxygen deficit, the precise identification of reference genes poses a significant challenge for hypoxic studies. Herein, we aim to establish the best reference genes for studying the effects of hypoxia on bladder cancer cells. Accordingly, three bladder cancer cell lines (T24, 5637, and HT1376) representative of two distinct carcinogenesis pathways to invasive cancer (FGFR3/CCND1 and E2F3/RB1) were used. Additionally, we have explored the most suitable control gene when addressing the influence of Deferoxamine Mesilate salt (DFX), an iron chelator often used to avoid the proteasomal degradation of HIF-1α, acting as an hypoxia-mimetic agent. Using bioinformatics tools (GeNorm and NormFinder), we have elected B2M and HPRT as the most stable genes for all cell lines and experimental conditions out of a panel of seven putative candidates (HPRT, ACTB, 18S, GAPDH, TBP, B2M, and SDHA). These observations set the molecular basis for future studies addressing the effect of hypoxia and particularly HIF-1α in bladder cancer cells.

  19. Community-based participatory research: its role in future cancer research and public health practice.

    PubMed

    Simonds, Vanessa W; Wallerstein, Nina; Duran, Bonnie; Villegas, Malia

    2013-05-16

    The call for community-based participatory research approaches to address cancer health disparities is increasing as concern grows for the limited effectiveness of existing public health practice and research in communities that experience a disparate burden of disease. A national study of participatory research projects, Research for Improved Health, funded by the National Institutes of Health (2009-2013), identified 64 of 333 projects focused on cancer and demonstrated the potential impact participatory approaches can have in reducing cancer disparities. Several projects highlight the success of participatory approaches to cancer prevention and intervention in addressing many of the challenges of traditional practice and research. Best practices include adapting interventions within local contexts, alleviating mistrust, supporting integration of local cultural knowledge, and training investigators from communities that experience cancer disparities. The national study has implications for expanding our understanding of the impact of participatory approaches on alleviating health disparities and aims to enhance our understanding of the barriers and facilitators to effective community-based participatory research.

  20. Connected Health and Progress against Cancer

    Cancer.gov

    An NCI Cancer Currents blog post about a new report from President’s Cancer Panel outlining how connective technologies can promote cancer prevention, enhance patients’ treatment experience, and accelerate progress in cancer research.

  1. The role of Violence Against Women Act in addressing intimate partner violence: a public health issue.

    PubMed

    Modi, Monica N; Palmer, Sheallah; Armstrong, Alicia

    2014-03-01

    Intimate partner violence (IPV) is defined as violence committed by a current or former boyfriend or girlfriend, spouse or ex-spouse. Each year, 1.3 to 5.3 million women in the United States experience IPV. The large number of individuals affected, the enormous healthcare costs, and the need for a multidisciplinary approach make IPV an important healthcare issue. The Violence Against Women Act (VAWA) addresses domestic violence, dating violence, sexual assault, and stalking. It emphasizes development of coordinated community care among law enforcement, prosecutors, victim services, and attorneys. VAWA was not reauthorized in 2012 because it lacked bipartisan support. VAWA 2013 contains much needed new provisions for Native Americans; lesbian, gay, bisexual, transgender, gay, and queer (LGBTQ) individuals; and victims of human trafficking but does not address the large amount of intimate partner violence in America's immigrant population. There are important remaining issues regarding intimate partner violence that need to be addressed by future legislation. This review examines the role of legislation and addresses proposals for helping victims of IPV.

  2. The Arkansas Aging Initiative: An Innovative Approach for Addressing the Health of Older Rural Arkansans

    ERIC Educational Resources Information Center

    Beverly, Claudia J.; McAtee, Robin E.; Chernoff, Ronni; Davis, Gwynn V.; Jones, Susan K.; Lipschitz, David A.

    2007-01-01

    The Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences in Little Rock is addressing one of the most pressing policy issues facing the United States: how to care for the burgeoning number of older adults. In 2001, the Institute created the Arkansas Aging Initiative, which established seven satellite centers on…

  3. Multi-Sectoral Action for Addressing Social Determinants of Noncommunicable Diseases and Mainstreaming Health Promotion in National Health Programmes in India

    PubMed Central

    Arora, Monika; Chauhan, Kavita; John, Shoba; Mukhopadhyay, Alok

    2011-01-01

    Major noncommunicable diseases (NCDs) share common behavioral risk factors and deep-rooted social determinants. India needs to address its growing NCD burden through health promoting partnerships, policies, and programs. High-level political commitment, inter-sectoral coordination, and community mobilization are important in developing a successful, national, multi-sectoral program for the prevention and control of NCDs. The World Health Organization's “Action Plan for a Global Strategy for Prevention and Control of NCDs” calls for a comprehensive plan involving a whole-of-Government approach. Inter-sectoral coordination will need to start at the planning stage and continue to the implementation, evaluation of interventions, and enactment of public policies. An efficient multi-sectoral mechanism is also crucial at the stage of monitoring, evaluating enforcement of policies, and analyzing impact of multi-sectoral initiatives on reducing NCD burden in the country. This paper presents a critical appraisal of social determinants influencing NCDs, in the Indian context, and how multi-sectoral action can effectively address such challenges through mainstreaming health promotion into national health and development programs. India, with its wide socio-cultural, economic, and geographical diversities, poses several unique challenges in addressing NCDs. On the other hand, the jurisdiction States have over health, presents multiple opportunities to address health from the local perspective, while working on the national framework around multi-sectoral aspects of NCDs. PMID:22628911

  4. Increasing the impact of health plan report cards by addressing consumers' concerns.

    PubMed

    Hibbard, J H; Harris-Kojetin, L; Mullin, P; Lubalin, J; Garfinkel, S

    2000-01-01

    Most plan report cards that compare the performance of health plans have framed the decision about plan choice as an opportunity to get better-quality care. This study uses a controlled experimental design to examine the effect of reframing the health plan choice decision to one that emphasizes protecting oneself from possible risk. The findings show that framing the health plan decision using a risk message has a consistent and significant positive impact on how consumers comprehend, value, and weight comparative performance information.

  5. Association of eHealth literacy with cancer information seeking and prior experience with cancer screening.

    PubMed

    Park, Hyejin; Moon, Mikyung; Baeg, Jung Hoon

    2014-09-01

    Cancer is a critical disease with a high mortality rate in the US. Although useful information exists on the Internet, many people experience difficulty finding information about cancer prevention because they have limited eHealth literacy. This study aimed to identify relationships between the level of eHealth literacy and cancer information seeking experience or prior experience with cancer screening tests. A total of 108 adults participated in this study through questionnaires. Data covering demographics, eHealth literacy, cancer information seeking experience, educational needs for cancer information searching, and previous cancer screening tests were obtained. Study findings show that the level of eHealth literacy influences cancer information seeking. Individuals with low eHealth literacy are likely to be less confident about finding cancer information. In addition, people who have a low level of eHealth literacy need more education about seeking information than do those with a higher level of eHealth literacy. However, there is no significant relationship between eHealth literacy and cancer screening tests. More people today are using the Internet for access to information to maintain good health. It is therefore critical to educate those with low eHealth literacy so they can better self-manage their health.

  6. Addressing the psychosocial wellbeing of teenage children of cancer patients and survivors.

    PubMed

    Annunziata, Maria Antonietta; Muzzatti, Barbara; Surbone, Antonella

    2016-02-01

    Thomas is 13 years old. His parents report a sharp decline in his school grades caused, according to his teachers' opinions, by listlessness and lack of concentration. The parents of Julia, 16 years old, describe her as restless, evasive, isolated, and withdrawn from others and from her usual activities. Linda, 18 years old, is described by her parents as indecisive, uncertain, and almost lethargic. Normally resolute and a high academic achiever, she appears locked in herself, unable to make choices. We first learned about them through the accounts of their concerned parents. Claire, 19 years old, lost weight and exercised hard enough to induce amenorrhea after her young mother underwent treatment for breast cancer, including antihormonal treatment. These four teenagers have in common a parent diagnosed with cancer, undergoing or having just completed treatment.

  7. An international review of the patterns and determinants of health service utilisation by adult cancer survivors

    PubMed Central

    2012-01-01

    Background There is a need to review factors related to health service utilisation by the increasing number of cancer survivors in order to inform care planning and the organisation and delivery of services. Methods Studies were identified via systematic searches of Medline, PsycINFO, CINAHL, Social Science Citation Index and the SEER-MEDICARE library. Methodological quality was assessed using STROBE; and the Andersen Behavioural Model was used as a framework to structure, organise and analyse the results of the review. Results Younger, white cancer survivors were most likely to receive follow-up screening, preventive care, visit their physician, utilise professional mental health services and least likely to be hospitalised. Utilisation rates of other health professionals such as physiotherapists were low. Only studies of health service use conducted in the USA investigated the role of type of health insurance and ethnicity. There appeared to be disparate service use among US samples in terms of ethnicity and socio-demographic status, regardless of type of health insurance provision s- this may be explained by underlying differences in health-seeking behaviours. Overall, use of follow-up care appeared to be lower than expected and barriers existed for particular groups of cancer survivors. Conclusions Studies focussed on the use of a specific type of service rather than adopting a whole-system approach and future health services research should address this shortcoming. Overall, there is a need to improve access to care for all cancer survivors. Studies were predominantly US-based focussing mainly on breast or colorectal cancer. Thus, the generalisability of findings to other health-care systems and cancer sites is unclear. The Andersen Behavioural Model provided an appropriate framework for studying and understanding health service use among cancer survivors. The active involvement of physicians and use of personalised care plans are required in order to ensure

  8. Girls in the juvenile justice system: leave no girl's health un-addressed.

    PubMed

    Guthrie, Barbara J; Hoey, Erin; Ravoira, LaWanda; Kintner, Eileen

    2002-12-01

    Despite an increase in middle to older aged adolescent females' early contact with the juvenile justice system, inadequate health care remains a concern. This descriptive study surveyed the physical and mental health needs of 130 self-selected, nonrandomized girls aged 12 to 18 years, with a mean age of 15.42 years (SD, 1.24), who were involved with a juvenile justice diversional program located in a southeastern region of the United States. Findings revealed early initiation of sexual-related activities (mean age, 13.9 years; SD, 1.49) and substance use (mean age, 12.9 years; SD, 1.53). The data suggest an increasing need for pediatric nurses, and in particular advanced practice nurses, to provide gender-responsive health care and health promotion services to early middle-childhood females in the juvenile justice system.

  9. Growing practice specialists in mental health: addressing stigma and recruitment with a nursing residency program.

    PubMed

    Ng, San; Kessler, Linda; Srivastava, Rani; Dusek, Janice; Duncan, Deborah; Tansey, Margaret; Jeffs, Lianne

    2010-05-01

    Despite the growing prevalence and healthcare needs of people living with mental illness, the stigma associated with mental health nursing continues to present challenges to recruiting new nurses to this sector. As a key recruitment strategy, five mental health hospitals and three educational institutions collaborated to develop and pilot an innovative nursing residency program. The purpose of the Mental Health Nursing Residency Program was to dispel myths associated with practising in the sector by promoting mental health as a vibrant specialty and offering a unique opportunity to gain specialized competencies. The program curriculum combines protected clinical time, collaborative learning and mentored clinical practice. Evaluation results show significant benefits to clinical practice and an improved ability to recruit and retain nurses. Nursing leadership was crucial at multiple levels for success. In this paper, we describe our journey in designing and implementing a nursing residency program for other nurse leaders interested in providing a similar program to build on our experience.

  10. Innovative Approaches Address Aging and Mental Health Needs in LGBTQ Communities

    PubMed Central

    Hoy-Ellis, Charles P.; Ator, Michael; Kerr, Christopher; Milford, Jessica

    2016-01-01

    LGBTQ older adults have higher levels of psychological distress as compared to older adults in general. They also experience multiple barriers to accessing equitable, culturally competent mental health and aging services because of their distinct histories and particular social contexts. This article discusses this lack of access to services, and highlights an innovative way mental health services are being delivered in LGBTQ communities. PMID:28366982

  11. A public-policy practicum to address current issues in human, animal, and ecosystem health.

    PubMed

    Herrmann, John A; Johnson, Yvette J; Troutt, H Fred; Prudhomme, Thomas

    2009-01-01

    There are recognized needs for cross-training health professionals in human, animal, and ecosystem health and for public health policy to be informed by experts from medical, science, and social science disciplines. Faculty members of the Community Health and Preventive Medicine Section at the University of Illinois at Urbana-Champaign, College of Veterinary Medicine, and the Institute of Government and Public Affairs, University of Illinois at Urbana-Champaign, have offered a public-policy course designed to meet those needs. The course was designed as a practicum to teach students the policy-making process through the development of policy proposals and to instruct students on how to effectively present accurate scientific, demographic, and statistical information to policy makers and to the public. All students substantially met the learning objectives of the course. This course represents another model that can be implemented to help students learn about complex, multifactorial issues that affect the health of humans, animals, and ecosystems, while promoting participation in public health policy development.

  12. Addressing the gap between public health emergency planning and incident response

    PubMed Central

    Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

    2013-01-01

    Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods: This study was conducted using critical case study methodology consisting of document review and 18 key-informant interviews with individuals who played key roles in planning and response. Thematic analysis was used to analyze data. Results: Several broad elements emerged as key to ensuring effective and efficient public health response: 1) developing a plan for emergency response; 2) establishing the framework for an ICS; 3) creating the infrastructure to support response; 4) supporting a workforce trained on emergency response roles, responsibilities, and equipment; and 5) conducting regular preparedness exercises. Conclusions: This research demonstrates the value of investments made and that effective emergency preparedness requires sustained efforts to maintain personnel and material resources. By having the infrastructure and experience based on ICS and EOC, the public health system had the capability to surge-up: to expand its day-to-day operation in a systematic and prolonged manner. None of these critical actions are possible without sustained funding for the public health infrastructure. Ultimately, this case study illustrates the importance of public health as a key leader in emergency response.

  13. Assembling GHERG: Could "academic crowd-sourcing" address gaps in global health estimates?

    PubMed

    Rudan, Igor; Campbell, Harry; Marušić, Ana; Sridhar, Devi; Nair, Harish; Adeloye, Davies; Theodoratou, Evropi; Chan, Kit Yee

    2015-06-01

    In recent months, the World Health Organization (WHO), independent academic researchers, the Lancet and PLoS Medicine journals worked together to improve reporting of population health estimates. The new guidelines for accurate and transparent health estimates reporting (likely to be named GATHER), which are eagerly awaited, represent a helpful move that should benefit the field of global health metrics. Building on this progress and drawing from a tradition of Child Health Epidemiology Reference Group (CHERG)'s successful work model, we would like to propose a new initiative - "Global Health Epidemiology Reference Group" (GHERG). We see GHERG as an informal and entirely voluntary international collaboration of academic groups who are willing to contribute to improving disease burden estimates and respect the principles of the new guidelines - a form of "academic crowd-sourcing". The main focus of GHERG will be to identify the "gap areas" where not much information is available and/or where there is a lot of uncertainty present about the accuracy of the existing estimates. This approach should serve to complement the existing WHO and IHME estimates and to represent added value to both efforts.

  14. To mitigate, resist, or undo: addressing structural influences on the health of urban populations.

    PubMed Central

    Geronimus, A T

    2000-01-01

    Young to middle-aged residents of impoverished urban areas suffer extra-ordinary rates of excess mortality, to which deaths from chronic disease contribute heavily. Understanding of urban health disadvantages and attempts to reverse them will be incomplete if the structural factors that produced modern minority ghettos in central cities are not taken into account. Dynamic conceptions of the role of race/ethnicity in producing health inequalities must encompass (1) social relationship between majority and minority populations that privilege the majority population and (2) the autonomous institutions within minority populations that members develop and sustain to mitigate, resist, or undo the adverse effects of discrimination. Broad social and economic policies that intensify poverty or undermine autonomous protections can reap dire consequences for health. Following from this structural analysis and previous research, guiding principles for action and suggestions for continued research are proposed. Without taking poverty and race/ethnicity into account, public health professionals who hope to redress the health problems of urban life risk exaggerating the returns that can be expected of public health campaigns or overlooking important approaches for mounting successful interventions. PMID:10846503

  15. Addressing the "Global Health Tax" and "Wild Cards": Practical Challenges to Building Academic Careers in Global Health.

    PubMed

    Palazuelos, Daniel; Dhillon, Ranu

    2016-01-01

    Among many possible benefits, global health efforts can expand the skills and experience of U.S. clinicians, improve health for communities in need, and generate innovations in care delivery with relevance everywhere. Yet, despite high rates of interest among students and medical trainees to include global health opportunities in their training, there is still no clear understanding of how this interest will translate into viable and sustained global health careers after graduation. Building on a growing conversation about how to support careers in academic global health, this Perspective describes the practical challenges faced by physicians pursuing these careers after they complete training. Writing from their perspective as junior faculty at one U.S. academic health center with a dedicated focus on global health training, the authors describe a number of practical issues they have found to be critical both for their own career development and for the advice they provide their mentees. With a particular emphasis on the financial, personal, professional, and logistical challenges that young "expat" global health physicians in academic institutions face, they underscore the importance of finding ways to support these career paths, and propose possible solutions. Such investments would not only respond to the rational and moral imperatives of global health work and advance the mission of improving human health but also help to fully leverage the potential of what is already an unprecedented movement within academic medicine.

  16. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review

    PubMed Central

    2011-01-01

    Background Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. Methods A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. Results A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries. The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes), lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury) more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Conclusion Research is needed to assess (i) the degree to which statutory plan appraisal processes (SA in the UK) incorporate health; (ii) whether

  17. Public health agendas addressing violence against rural women - an analysis of local level health services in the State of Rio Grande do Sul, Brazil.

    PubMed

    da Costa, Marta Cocco; Lopes, Marta Julia Marques; Soares, Joannie dos Santos Fachinelli

    2015-05-01

    This study analyses health managers' perceptions of local public health agendas addressing violence against rural women in municipalities in the southern part of the State Rio Grande do Sul in Brazil. It consists of an exploratory descriptive study utilizing a qualitative approach. Municipal health managers responsible for planning actions directed at women's health and primary health care were interviewed. The analysis sought to explore elements of programmatic vulnerability related to violence in the interviewees' narratives based on the following dimensions of programmatic vulnerability: expression of commitment, transformation of commitment into action, and planning and coordination. It was found that local health agendas directed at violence against rural women do not exist. Health managers are therefore faced with the challenge of defining lines of action in accordance with the guidelines and principles of the SUS. The repercussions of this situation are expressed in fragile comprehensive services for these women and programmatic vulnerability.

  18. Addressing the mental health nurse shortage: undergraduate nursing students working as assistants in nursing in inpatient mental health settings.

    PubMed

    Browne, Graeme; Cashin, Andrew; Graham, Iain; Shaw, Warren

    2013-10-01

    The population of mental health nurses is ageing and in the next few years we can expect many to retire. This paper makes an argument for the employment of undergraduate nursing students as Assistants in Nursing (AINs) in mental health settings as a strategy to encourage them to consider a career in mental health nursing. Skill mix in nursing has been debated since at least the 1980s. It appears that the use of AINs in general nursing is established and will continue. The research suggests that with the right skill mix, nursing outcomes and safety are not compromised. It seems inevitable that assistants in nursing will increasingly be part of the mental health nursing workforce; it is timely for mental health nurses to lead these changes so nursing care and the future mental health nursing workforce stay in control of nursing.

  19. Addressing the unique psychosocial barriers to breast cancer treatment experienced by African-American women through integrative navigation.

    PubMed

    Chatman, Michelle C; Green, Rodney D

    2011-12-01

    African-American women face a disproportionally high breast cancer mortality rate and a significantly low five-year survival rate after breast cancer treatment. This study investigated, through a series of focus groups, how 32 African-American women (N = 32) breast cancer patients and survivors managed their cancer-related health needs. Participants also reported important barriers to care including problematic interactions with medical professionals, challenges in intimate relations, difficulties in handling the stigma and myths about breast cancer, and the psychological challenges that they faced. A patient navigation model was implemented at an eastern urban hospital that emphasized integrative therapies such as meditation, nutritional instruction, and yoga. Follow-up telephone interviews with 37 additional African-American participants (N = 37) indicated the rating of effectiveness to be at 3.8 to 3.9 out of 4 for the integrative patient navigation program. Over half of the survivors reported using some complementary techniques after treatment was completed, thus suggesting a long-term improvement in their quality of life as a result of the integrative techniques.

  20. Addressing the health disadvantage of rural populations: how does epidemiological evidence inform rural health policies and research?

    PubMed

    Smith, Karly B; Humphreys, John S; Wilson, Murray G A

    2008-04-01

    We reviewed evidence of any apparently significant 'rural-urban' health status differentials in developed countries, to determine whether such differentials are generic or nation-specific, and to explore the nature and policy implications of determinants underpinning rural-urban health variations. A comprehensive literature review of rural-urban health status differentials within Australia, New Zealand, Canada, the USA, the UK, and a variety of other western European nations was undertaken to understand the differences in life expectancy and cause-specific morbidity and mortality. While rural location plays a major role in determining the nature and level of access to and provision of health services, it does not always translate into health disadvantage. When controlling for major risk determinants, rurality per se does not necessarily lead to rural-urban disparities, but may exacerbate the effects of socio-economic disadvantage, ethnicity, poorer service availability, higher levels of personal risk and more hazardous environmental, occupational and transportation conditions. Programs to improve rural health will be most effective when based on policies which target all risk determinants collectively contributing to poor rural health outcomes. Focusing solely on 'area-based' explanations and responses to rural health problems may divert attention from more fundamental social and structural processes operating in the broader context to the detriment of rural health policy formulation and remedial effort.

  1. "You Are Not Alone" Strategies for Addressing Mental Health and Health Promotion with a Refugee Women's Sewing Group.

    PubMed

    Salt, Rebekah J; Costantino, Margaret E; Dotson, Emma L; Paper, Bruce M

    2017-04-01

    Resettlement can be an uncertain time for refugees as they have often suffered life-threatening circumstances prior to flight from their countries, yet few resettlement programs screen for mental health. The purpose of this study was to pilot the Refugee Health Screener-15 (RHS-15) to assess mental health and the Pathways to Wellness intervention to identify internal and structural barriers affecting resettlement with a refugee women's sewing group. Community collaborations that create healthy social and physical environments through access to resources, economic opportunities, and social support promote a holistic approach to health and can improve quality of life for this vulnerable population.

  2. Discovery and Subtyping of Neo-Epitope Specific T-Cell Responses for Cancer Immunotherapy: Addressing the Mutanome.

    PubMed

    Diken, Mustafa; Vormehr, Mathias; Grunwitz, Christian; Kreiter, Sebastian; Türeci, Özlem; Sahin, Ugur

    2017-01-01

    Cancer accumulates 10s to 1000s of genomic mutations of which a fraction is immunogenic and may serve as an Achilles' heel of tumor cells. Mutation-specific T cells can recognize these antigens and destroy malignant cells. Strategies to immunotherapeutically address individual tumor mutations employing peptide or mRNA based vaccines are now actively investigated in mice and humans. An important step of determining the therapeutic potential of a mutanome vaccine is the detection of mutation reactive T-cell responses. In this chapter we provide protocols to identify and subtype mutation specific T cells in mice based on IFN-γ ELISpot and flow cytometry.

  3. Cancer registration, public health and the reform of the European data protection framework: Abandoning or improving European public health research?

    PubMed

    Andersen, Mette Rye; Storm, Hans H

    2015-06-01

    The importance of cancer- and other disease registries for planning, management and evaluation of healthcare systems has been shown repeatedly during the last 50 years. Complete and unbiased population-level analyses on routinely collected, individual data concerning health and personal characteristics can address significant concerns about risk factors for cancer and provide sound evidence about public health and the effectiveness of healthcare systems. The existence of quality controlled and comprehensive data in registries, allowed to be used for quality control, research and public health purposes are taken as granted by most health professionals and researchers. However, the current revision of the European Union (EU) data protection framework suggests a harmonisation of requirements for confidentiality and individual consent to data processing, likely at the expense of proper use of registry data in the health sector. Consequences of excessive confidentiality rules that may lead to missed data linkages have been simulated. The simulations provide one possible explanation for observed heterogeneity among some cancer incidence data. Further, public health, quality control and epidemiological research on large populations can no longer provide evidence for health interventions, if requirements for consent renders research impossible or where attempts to obtain consent from each data subject generates biased results. Health professionals should engage in the on-going debate on the Commission's proposal for a General Data Protection Regulation. The nature and use of registry data in public health research must be explained and known to policy-makers and the public. Use of cancer registry data and other epidemiological activity will terminate abruptly if an unnecessarily strict EU data protection regulation is adopted. Research based interventions, as well as the international recognised standing of cancer registries and register-based research institutions in

  4. Promoting Breast Cancer Screening in Rural, African American Communities: The "Science and Art" of Community Health Promotion.

    ERIC Educational Resources Information Center

    Altpeter, Mary; Earp, Jo Anne L.; Shopler, Janice H.

    1998-01-01

    Social ecological theory, social-work community organization models, and health-promotion models are brought together to address ways to generate change at the individual and policy levels, and to provide guidance for community health-promotion programs. An eight-year cancer-prevention project is presented as a case study. (EMK)

  5. Setting priorities to address cardiovascular diseases through universal health coverage in low- and middle-income countries

    PubMed Central

    Nugent, Rachel A

    2017-01-01

    Over the past decade, universal health coverage (UHC) has emerged as a major policy goal for many low- and middle-income country governments. Yet, despite the high burden of cardiovascular diseases (CVD), relatively little is known about how to address CVD through UHC. This review covers three major topics. First, we define UHC and provide some context for its importance, and then we illustrate its relevance to CVD prevention and treatment. Second, we discuss how countries might select high-priority CVD interventions for a UHC health benefits package drawing on economic evaluation methods. Third, we explore some implementation challenges and identify research gaps that, if addressed, could improve the inclusion of CVD into UHC. PMID:28321266

  6. Addressing the mental health needs of looked after children in foster care: the experiences of foster carers.

    PubMed

    York, W; Jones, J

    2017-03-01

    WHAT IS KNOWN ON THE SUBJECT?: In the UK and internationally, the number of looked after children is increasing year on year. Mental health problems among looked after children are significantly higher than in the general population, and the uptake of mental health services for these children is low. There is a poor prognosis for children with untreated mental health problems; this is further compounded if the child is within the care system. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This study adds to our understanding of foster carers' experiences of the mental health needs of looked after children and demonstrates some of the challenges associated with accessing appropriate and timely mental health services. New knowledge derived from this research is that the barriers to accessing Child and Adolescent Mental Health Services (CAMHS) are not at the time of initial referral as previously reported, but later, once within the mental health system with long waiting times experienced particularly for specialist services. This study provides new insights into the experience of being a foster carer and the levels of support and resources needed that directly relate to the viability of the placement. The majority of the foster carers interviewed were from a Black and Minority Ethnic (BME) background, previously under-represented in this research area. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: A number of areas in current CAMHS provision need addressing with a focus on accessibility, consultation and support for foster carers. Waiting times need to be addressed, and improved communication with other agencies is also highlighted. CAMHS nurses are well placed to develop and deliver a comprehensive care package to foster carers, offering more tailored support to them whilst enabling the children and young people in their care to access and engage more effectively with mental health services.

  7. Is It More Important to Address the Issue of Patient Mobility or to Guarantee Universal Health Coverage in Europe?

    PubMed Central

    Legido-Quigley, Helena

    2016-01-01

    This paper discusses whether European institutions should devote so much attention and funding to cross-border healthcare or they should instead prioritise guaranteeing universal health coverage (UHC), “addressing inequalities” and tackling the effects of austerity measures. The paper argues through providing the evidence in both areas of research, that the priority at European level from a public health and social justice perspective should be to guarantee UHC for all the population living in Europe and prioritise protective action for those who are most in need. PMID:26673649

  8. Looking within and beyond the community: lessons learned by researching, theorising and acting to address urban poverty and health.

    PubMed

    Hodgetts, Darrin; Chamberlain, Kerry; Tankel, Yadena; Groot, Shiloh

    2014-01-01

    Urban poverty and health inequalities are inextricably intertwined. By working in partnership with service providers and communities to address urban poverty, we can enhance the wellness of people in need. This article reflects on lessons learned from the Family100 project that explores the everyday lives, frustrations and dilemmas faced by 100 families living in poverty in Auckland. Lessons learned support the need to bring the experiences and lived realities of families to the fore in public deliberations about community and societal responses to urban poverty and health inequality.

  9. A responsive evaluation of mental health treatment in Cambodia: Intentionally addressing poverty to increase cultural responsiveness in therapy.

    PubMed

    Seponski, Desiree M; Lewis, Denise C; Megginson, Maegan C

    2014-01-01

    Mental health issues are significant contributors to the global burden of disease with the highest incidence in resource poor countries; 90% of those in need of mental health treatment reside in low resource countries but receive only 10% of the world's resources. Cambodia, the eighth least developed country in the world, serves as one example of the need to address mental health concerns in low-income, resource poor countries. The current study utilises responsive evaluation methodology to explore how poverty-stricken Cambodian clients, therapists and supervisors experience Western models of therapy as culturally responsive to their unique needs. Quantitative and qualitative data were triangulated across multiple stakeholders using numerous methods including a focus group, interviews, surveys, case illustrations and live supervision observation and analysed using constant comparative analysis. Emerging findings suggest that poverty, material needs, therapy location and financial situations greatly impact the daily lives and mental health conditions of Cambodians and hinder clients' therapeutic progress. The local community needs and context of poverty greatly hinder clients' therapeutic progress in therapy treatment and when therapy does not directly address the culture of poverty, clients did not experience therapy as valuable despite some temporary decreases in mental health symptoms.

  10. Addressing barriers to health: Experiences of breastfeeding mothers after returning to work.

    PubMed

    Valizadeh, Sousan; Hosseinzadeh, Mina; Mohammadi, Eesa; Hassankhani, Hadi; M Fooladi, Marjaneh; Schmied, Virginia

    2017-03-01

    Breastfeeding mothers returning to work often feel exhausted as they must feed on demand and attend to family and employment responsibilities, leading to concerns for their personal health. This study was prompted by a desire to understand and identify barriers to mothers' health. We describe the experiences of 12 Iranian breastfeeding and employed mothers through in-depth and semi-structured interviews and thematic analysis. Two main themes emerged: (i) working and mothering alone and (ii) facing concerns about health. The findings highlight the need for a support system for breastfeeding mothers within the family and in the workplace. Family-friendly policies targeting mothers' and employers' views are needed to support working mothers and promote breastfeeding.

  11. Addressing the Genetics of Human Mental Health Disorders in Model Organisms.

    PubMed

    McCammon, Jasmine M; Sive, Hazel

    2015-01-01

    Mental health disorders are notoriously difficult to diagnose and treat for a variety of reasons, including genetic heterogeneity, comorbidities, and qualitative diagnostic criteria. Discovery of the molecular pathology underlying these disorders is crucial to the development of quantitative biomarkers and novel therapeutics. In this review, we discuss contributions to the mental health field of different cellular and whole-animal approaches in characterizing psychiatric genetics and molecular pathology. These approaches include mammalian cell and neuronal culture, cerebral organoids, induced pluripotent stem cells, and the whole-animal models of nematodes, flies, mollusks, frogs, mice, and zebrafish, on the last of which we place extra emphasis. Integrative use of these cellular and animal systems in a complementary and informative fashion maximizes the potential contributions to the mental health field as a whole.

  12. Injustice, suffering, difference: how can community health nursing address the suffering of others?

    PubMed

    Drevdahl, Denise J

    2013-01-01

    Social justice brings to life the purpose of public health-improving a population's overall health and well-being. Critiques of the concept demonstrate that social justice is inconsistently defined and rarely is acted upon, and continuation of these injustices constitutes a form of suffering. Seeing one's self as disconnected from others makes their suffering normal. Viewing others from an ethical, moral, and human rights perspective helps one understand that the well-being of the self and the individual rests on the well-being of the collective other; this obligates each person to ameliorate and, if possible, prevent the suffering of others.

  13. The FDI African Strategy for Oral Health: addressing the specific needs of the continent.

    PubMed

    Hescot, Patrick; China, Emile; Bourgeois, Denis; Maina, Susan; Monteiro da Silva, Orlando; Luc Eiselé, Jean; Simpson, Christopher; Horn, Virginie

    2013-06-01

    The FDI World Dental Federation has defined a strategy for the development of oral health in Africa during the "African Summit" held in Cape Town, South Africa. The summit gathered presidents from 16 African National Dental Associations, FDI stakeholders, the World Health Organisation and government delegates. The outcomes of this summit were stated in a Declaration, defining the functional principles of the African strategy as three priorities: To establish and reinforce the credibility of NDAs To acquire and develop leadership and management skills Effective peer-to-peer exchange of information.

  14. Human Capital: Additional Actions Needed to Enhance DOD’s Efforts to Address Mental Health Care Stigma

    DTIC Science & Technology

    2016-04-01

    stress disorder or traumatic brain injury. Additionally, the Defense Suicide Prevention Office reports through the Executive Director of the Office of...Efforts to Address Mental Health Care Stigma Why GAO Did This Study A 2010 DOD task force on suicide prevention concluded that stigma—the negative...Representatives A 2010 Department of Defense (DOD) Task Force on the Prevention of Suicide by Members of the Armed Forces concluded that

  15. Determinants of Cancer Screening Disparities Among Asian Americans: A Systematic Review of Public Health Surveys.

    PubMed

    Jun, Jungmi; Nan, Xiaoli

    2017-04-05

    We conducted a systematic analysis of 24 peer-reviewed literary works that examined Asian Americans' breast, cervical, and colon cancer screening, focusing on empirical findings from large-scale public health surveys (i.e., NHIS, CHIS, HINTS, BRFSS). We provide an overview of relevant research in terms of study characteristics, samples, predictor/covariate of cancer screenings, and key findings. Our analysis indicates that Asian Americans' cancer screening rates are lower than for non-Hispanic Whites for all cancer types in four large-scale public health surveys throughout 17 study years. Acculturation and healthcare access were two significant factors in explaining Asian Americans' cancer screening rates. Cancer fatalism and family cancer history emerged as potential factors that may account for more variances. However, the screening disparities between Asian Americans and whites persist even after adjusting all covariates, including SES, acculturation, healthcare access, health status, and health perception/literacy. More individual and cultural factors should be identified to address these disparities.

  16. Procedures for addressing uncertainty and variability in exposure to characterize potential health risk from trichloroethylene contaminated ground water at Beale Air Force Base in California

    SciTech Connect

    Daniels, J I; Bogen, K T; Hall, L C

    1999-10-05

    Conservative deterministic, screening-level calculations of exposure and risk commonly are used in quantitative assessments of potential human-health consequences from contaminants in environmental media. However, these calculations generally are based on multiple upper-bound point estimates of input parameters, particularly for exposure attributes, and can therefore produce results for decision makers that actually overstate the need for costly remediation. Alternatively, a more informative and quantitative characterization of health risk can be obtained by quantifying uncertainty and variability in exposure. This process is illustrated in this report for a hypothetical population at a specific site at Beale Air Force Base in California, where there is trichloroethylene (TCE) contaminated ground water and a potential for future residential use. When uncertainty and variability in exposure were addressed jointly for this case, the 95th-percentile upper-bound value of individual excess lifetime cancer risk was a factor approaching 10 lower than the most conservative deterministic estimate. Additionally, the probability of more than zero additional cases of cancer can be estimated, and in this case it is less than 0.5 for a hypothetical future residential population of up to 26,900 individuals present for any 7.6-y interval of a 70-y time period. Clearly, the results from application of this probabilistic approach can provide reasonable and equitable risk-acceptability criteria for a contaminated site.

  17. The Role of School Health Services in Addressing the Needs of Students with Chronic Health Conditions: A Systematic Review

    ERIC Educational Resources Information Center

    Leroy, Zanie C.; Wallin, Robin; Lee, Sarah

    2017-01-01

    Children and adolescents in the United States spend many hours in school. Students with chronic health conditions (CHCs) may face lower academic achievement, increased disability, fewer job opportunities, and limited community interactions as they enter adulthood. School health services provide safe and effective management of CHCs, often for…

  18. Addressing the Sexual and Reproductive Health Needs of Young People in Ethiopia: An Analysis of the Current Situation.

    PubMed

    Muntean, Nigina; Kereta, Worknesh; Mitchell, Kirstin R

    2015-09-01

    Young people in Ethiopia face a number of risks to their sexual and reproductive health, including adolescent pregnancy, sexual violence, and unmet need for family planning. This study explores the extent to which current service provision addresses the SRH needs of young Ethiopians . Methods included a comprehensive review of the academic and policy literature on young people's SRH and service provision in Ethiopia; and 14 semi-structured Key Informant Interviews. Factors affecting utilization of sexual and reproductive services by young people include: limited SRH knowledge, lack of open discussion of sexual matters, low status of women, cultural and logistical barriers, competing priorities among community health professionals, limited resources for health facilities, and negative attitudes of providers towards unmarried youth. While the antenatal needs of young married women are somewhat addressed, gaps exist in terms of services for unmarried youth, young men, rural youth and vulnerable groups. The national policy platform has created an enabling environment for addressing youth SRH needs but challenges to implementing these policies still persist. The way forward requires a focus on reducing barriers to utilization of services, and attention to underserved groups. It also requires resource mobilization, strong leadership and effective coordination between stakeholders and donors.

  19. Designing e-Health Interventions for Low-Health-Literate Culturally Diverse Parents: Addressing the Obesity Epidemic

    PubMed Central

    Kahlor, LeeAnn; Tyler, Diane; Gustafson, Jamie

    2009-01-01

    Abstract Child and adolescent obesity is a significant problem contributing to long-term trends in adult obesity. Educating parents about strategies for raising healthy children is complicated by the problem of low health literacy. E-health provides new opportunities to educate low-health-literate audiences, and this project was intended as formative research to guide design of interventions for low-health-literate parents. Focus groups were conducted with African American, Hispanic, and white parents (n = 43), 18 years of age or older, and at or below median income for the region. Each focus group included the following: a discussion of parents' general use of the Internet for health information, the demonstration of a Web site designed specifically for low-health-literate users, and asking participants about ideas under consideration for future interventions. Participants use search engines to look for health information and use heuristics, such as position in search results, to evaluate Web site quality. Some participants avoid information from .edu and .gov domains due to perceived complexity, and there was an almost-universal lack of trust in the government for health information. University researchers, by contrast, were trusted sources as information providers. Content and usability that meet the needs of extremely low-literate audiences may be perceived as slow and lacking depth by more literate and Internet-savvy users. E-health can be used to educate low-health-literate audiences, but interventions designed for these users must be layered in terms of content and usability to meet varying levels of functional and media literacy. PMID:19694596

  20. Can TESOL Teachers Address the Mental Health Concerns of the Indochinese Refugees? Draft.

    ERIC Educational Resources Information Center

    Cohon, J. Donald, Jr.

    This paper examines research in the fields of psychology, anthropology, and the Teaching of English to Speakers of Other Languages (TESOL) as it relates to the mental health needs of the Indochinese refugees. It is argued that TESOL instructors are in a key position to influence the adaptation process of refugees in their classes. Cultural values…

  1. Introduction: Addressing Air Pollution and Health Science Questions to Inform Science and Policy

    EPA Science Inventory

    This special issue of Air Quality, Atmosphere and Health (AQAH) is the sixth and final in a series of special journal issues (Solomon 2010, 2011a, b; Solomon et al. 2011; Solomon 2012) associated with the 2010 Air Pollution and Heath Conference: Bridging the Gap between Sources ...

  2. Addressing Diversity in Health Science Students by Enhancing Flexibility through e-Learning

    ERIC Educational Resources Information Center

    Penman, Joy; Thalluri, Jyothi

    2014-01-01

    The technological advancements for teaching and learning sciences for health science students are embedded in the Thalluri-Penman Good Practice Model, which aims to improve the learning experiences of science students and increase student retention and success rates. The model also links students from urban and rural areas, studying both on-and…

  3. Women Veterans and Their Families: Preparing School and Agency Counselors to Address Their Mental Health Needs

    ERIC Educational Resources Information Center

    Stickel, Sue A.; Callaway, Yvonne L.; Compton, Emily A.

    2011-01-01

    Women have historically served as members of the armed forces and today the numbers of women are increasing and their roles are expanding. Increasingly women are experiencing combat related mental health concerns as well as issues unique to serving within a military culture. Licensed Professional Counselors (LPCs) will be eligible for jobs as…

  4. Life Before Tests: A District's Coordinated Health Approach for Addressing Children's Full Range of Needs

    ERIC Educational Resources Information Center

    Cooper, Patrick

    2005-01-01

    Chronic illnesses, depression, abuse of drugs, alcohol and tobacco. Sugary snacks and drinks, vending machines, obesity and bullying. Guns, gang violence, school shootings and test scores. Teen-age birth rates, one-parent households, lack of health or dental care, and, dropouts. All of these issues are interconnected and intertwined with education…

  5. Addressing Younger Workers’ Needs: The Promoting U through Safety and Health (PUSH) Trial Outcomes

    PubMed Central

    Rohlman, Diane S.; Parish, Megan; Elliot, Diane L.; Hanson, Ginger; Perrin, Nancy

    2016-01-01

    Most younger workers, less than 25 years old, receive no training in worker safety. We report the feasibility and outcomes of a randomized controlled trial of an electronically delivered safety and health curriculum for younger workers entitled, PUSH (Promoting U through Safety and Health). All younger workers (14–24 years old) hired for summer work at a large parks and recreation organization were invited to participate in an evaluation of an online training and randomized into an intervention or control condition. Baseline and end-of-summer online instruments assessed acceptability, knowledge, and self-reported attitudes and behaviors. One-hundred and forty participants (mean age 17.9 years) completed the study. The innovative training was feasible and acceptable to participants and the organization. Durable increases in safety and health knowledge were achieved by intervention workers (p < 0.001, effect size (Cohen’s d) 0.4). However, self-reported safety and health attitudes did not improve with this one-time training. These results indicate the potential utility of online training for younger workers and underscore the limitations of a single training interaction to change behaviors. Interventions may need to be delivered over a longer period of time and/or include environmental components to effectively alter behavior. PMID:27517968

  6. Addressing Health Disparities in the Undergraduate Curriculum: An Approach to Develop a Knowledgeable Biomedical Workforce

    ERIC Educational Resources Information Center

    Benabentos, Rocio; Ray, Payal; Kumar, Deepak

    2014-01-01

    Disparities in health and healthcare are a major concern in the United States and worldwide. Approaches to alleviate these disparities must be multifaceted and should include initiatives that touch upon the diverse areas that influence the healthcare system. Developing a strong biomedical workforce with an awareness of the issues concerning health…

  7. Mobile farm clinic outreach to address health conditions among Latino migrant farmworkers in Georgia.

    PubMed

    Luque, John S; Reyes-Ortiz, Carlos; Marella, Prasen; Bowers, Angelica; Panchal, Viral; Anderson, Lisa; Charles, Simone

    2012-01-01

    Agricultural labor involves exposure to many occupational hazards, some of which can lead to chronic health conditions. The purpose of this study was to conduct an occupational health needs assessment of illnesses and work-related injuries among a Latino migrant farmworker population (recruited to harvest Vidalia onions) in South Georgia. Study data included survey responses from 100 farmworkers attending mobile farm clinics in 2010 at their worker housing residences, supplemented by medical diagnoses data from the same clinics collected over 3 years (2009-2011) for 1161 farmworkers at six different farms. From the survey, the main health problems reported were hypertension (25%), eye problems (12%), musculoskeletal problems (11%), diabetes (10%), and depression (7%). In multivariate analyses, depression scores were associated with having a history of musculoskeletal problems (p = .002). According to the mobile farm clinic data, the most common medical diagnoses included back pain (11.8%), hypertension (11.4%), musculoskeletal problems (11.3%), gastrointestinal disorders (8.6%), eye problems (7.2%), dermatitis or rash (7.0%), and tinea or fungal skin infections (5.6%). The study identified eye and musculoskeletal problems as the major occupational health conditions for this population of farmworkers.

  8. Emotional Congruence in Learning and Health Encounters in Medicine: Addressing an Aspect of the Hidden Curriculum

    ERIC Educational Resources Information Center

    O'Callaghan, Anne

    2013-01-01

    This paper aims to draw attention to and provide insights into an area that is of educational significance for clinical teachers, namely the need to acknowledge and respond appropriately to the emotional context of both learning and health encounters in order to improve the outcomes of both. This need has been highlighted by recent calls for more…

  9. Keep Calm and Contracept! Addressing Young Women's Pleasure in Sexual Health and Contraception Consultations

    ERIC Educational Resources Information Center

    Hanbury, Ali; Eastham, Rachael

    2016-01-01

    Clinical sexual health consultations with young women often focus on avoiding "risks;" namely pregnancy and sexually transmitted infection transmission. They also typically fail to explore how contraception use can impact on the capacity to enjoy sexual relationships. In contrast, this paper argues that sexual pleasure should be a…

  10. Evaluating Health Risks from Inhaled Polychlorinated Biphenyls: Research Needs for Addressing Uncertainty

    EPA Science Inventory

    Indoor air polychlorinated biphenyl (PCB) concentrations in some U.S. schools are one or more orders of magnitude higher than background levels. In response to this, efforts have been made to assess the potential health risk posed by inhaled PCBs. These efforts are hindered by un...

  11. Global Health and Visa Policy Reform to Address Dangers of Hajj during Summer Seasons

    PubMed Central

    Aleeban, Mohanad; Mackey, Tim K.

    2016-01-01

    Every year on the 12th month of the Islamic calendar, 2–3 million Muslims from over 160 countries migrate to Holy sites in Saudi Arabia to perform the Hajj, representing one of the largest mass gathering events worldwide. Yet, the Hajj poses several challenges to global health and public safety, including the unique health risks posed by seasonal variability when Hajj occurs during summer months. Specifically, pilgrims taking the journey to Mecca are at higher risk for heat illnesses, heat-related injuries and exhaustion, and stampedes, when summer temperatures can reach up to 48.7°C. In response, we propose that the Saudi government, in coordination with the Organization of Islamic Cooperation and the World Health Organization, explore the establishment of an expert committee, create and use a predictive risk modeling tool, and establish a dynamic quota on Hajj visas to limit potential heat exposure for high-risk populations when the Hajj falls on seasons associated with extreme weather exposure. As climate change is projected to lead to future increases in temperatures in the region, this form of dynamic and evidence-based policymaking is needed to ensure human health and safety for generations of Hajj pilgrims to come. PMID:28066758

  12. A Tailored Approach to Identifying and Addressing College Students' Online Health Information Literacy

    ERIC Educational Resources Information Center

    Banas, Jennifer

    2008-01-01

    Background: College students may fail to practice information literacy skills because they are unaware of their skill level or are not concerned with the risks. Purpose: In order to develop an effective message that motivates college students to learn online health information literacy skills, a better understanding of perceptions about such…

  13. Addressing Younger Workers' Needs: The Promoting U through Safety and Health (PUSH) Trial Outcomes.

    PubMed

    Rohlman, Diane S; Parish, Megan; Elliot, Diane L; Hanson, Ginger; Perrin, Nancy

    2016-08-10

    Most younger workers, less than 25 years old, receive no training in worker safety. We report the feasibility and outcomes of a randomized controlled trial of an electronically delivered safety and health curriculum for younger workers entitled, PUSH (Promoting U through Safety and Health). All younger workers (14-24 years old) hired for summer work at a large parks and recreation organization were invited to participate in an evaluation of an online training and randomized into an intervention or control condition. Baseline and end-of-summer online instruments assessed acceptability, knowledge, and self-reported attitudes and behaviors. One-hundred and forty participants (mean age 17.9 years) completed the study. The innovative training was feasible and acceptable to participants and the organization. Durable increases in safety and health knowledge were achieved by intervention workers (p < 0.001, effect size (Cohen's d) 0.4). However, self-reported safety and health attitudes did not improve with this one-time training. These results indicate the potential utility of online training for younger workers and underscore the limitations of a single training interaction to change behaviors. Interventions may need to be delivered over a longer period of time and/or include environmental components to effectively alter behavior.

  14. Sexual and reproductive health and rights of older men and women: addressing a policy blind spot.

    PubMed

    Aboderin, Isabella

    2014-11-01

    Global debate on required policy responses to issues of older persons has intensified over the past 15 years, fuelled by a growing awareness of the rapid ageing of populations. Health has been a central focus, but scrutiny of global policies, human rights instruments and reports reveals that just as older people are excluded from sexual and reproductive health and rights agendas, so are issues of sexual and reproductive health and rights wholly marginal to current agendas focused on older people. A critical question is whether the policy lacuna reflects a dearth of research evidence or a faulty translation of existing knowledge. A reading of the current research landscape and literature, summarised in this paper, strongly suggests it is the former. To be sure, sexuality in old age is a burgeoning field of scientific inquiry. What the existing knowledge and discourse fail to provide is an engagement with, and elucidation of, the broader sexual and reproductive health and rights agenda as it relates to older persons. A concerted research effort is needed to provide a basis for developing policy guidance and for pinpointing essential indicators and establishing necessary data systems to enable a routine tracking of progress.

  15. Identifying and Addressing the Mental Health Needs of Online Students in Higher Education

    ERIC Educational Resources Information Center

    Barr, Bonny

    2014-01-01

    89% of colleges and universities in the United States offer online courses and of those institutions 58% offer degree programs that are completely online (Parker, Lenhart & Moore, 2011).Providing online student services is an important component of these distance programs and is often required by accrediting bodies. Health and wellness…

  16. Perspectives on the strategic uses of concept mapping to address public health challenges.

    PubMed

    Anderson, Lynda A; Slonim, Amy

    2017-02-01

    We examine the adaptation of approaches used to plan and implement the steps of concept mapping to meet specialized needs and requirements in several public health projects. Seven published concept mapping projects are detailed to document how each of the phases were modified to meet the specific aims of each project. Concept mapping was found to be a useful tool to complement public health roles such as assessment, program development, and priority setting. The phases of concept mapping allow for a blending of diverse perspectives, which is critical to public health efforts. The adaptability of concept mapping permits the use of multiple modalities such as the addition of face-to-face brainstorming; use of qualitative methods, including structured interviews; and review and use of published literature and guidelines. Another positive aspect of concept mapping for public health practice is its ability to identify program elements, provide a visual map of generated ideas and their relationships to one another, and assist in identifying priorities. Our reflections on the adaptability should help inform another generation in designing concept mapping projects and related products that may benefit from unique adaptations and the rapidly expanding social media technology and platforms.

  17. The Good Food Junction: a Community-Based Food Store Intervention to Address Nutritional Health Inequities

    PubMed Central

    Muhajarine, Nazeem; Ridalls, Tracy; Abonyi, Sylvia; Vatanparast, Hassan; Whiting, Susan; Walker, Ryan

    2016-01-01

    Background This is a 2-year study to assess the early impacts of a new grocery store intervention in a former food desert. Objective The purpose of the study is to understand the early health effects of the introduction of a large-scale food and nutrition-focused community-based population health intervention, the Good Food Junction (GFJ) Cooperative Store, in a geographically bounded group of socially disadvantaged neighborhoods (the “core neighborhoods”) in a midsized Canadian city. The GFJ grocery store was tasked with improving the access of residents to healthy, affordable food. The 5 research questions are: (1) What is the awareness and perception of the GFJ store among residents of the core neighborhoods? (2) Are there differences in awareness and perception among those who do and do not shop at the GFJ? (3) Will healthy food purchasing at the GFJ by residents of the core neighborhoods change over time, and what purchases are these individuals making at this store? (4) What early impact(s) will the GFJ have on key health-related outcomes (such as household food security status, vegetable and fruit intake, key aspects of self-reported mental health, self-reported health)? and (5) Are the effects of the intervention seen for specific vulnerable population groups, such as Aboriginal people, seniors (65 years old or older) and new immigrants (settled in Saskatoon for less than 5 years)? Methods The research project examined initial impacts of the GFJ on the health of the residents in surrounding neighborhoods through a door-to-door cross-sectional survey of food access and household demographics; an examination of GFJ sales data by location of shoppers' residences; and a 1-year, 3-time-point longitudinal study of self-reported health of GFJ shoppers. Results Analyses are on-going, but preliminary results show that shoppers are using the store for its intended purpose, which is to improve access to healthy food in a former food desert. Conclusions To our

  18. Prostate cancer health and cultural beliefs of black men: The Florida Prostate Cancer Disparity Project

    PubMed Central

    2011-01-01

    Background Since behavioral factors are significant determinants of population health, addressing prostate cancer (CaP)-related health beliefs and cultural beliefs are key weapons to fight this deadly disease. This study investigated the health beliefs and cultural beliefs of black men relative to CaP, and the key socio-demographic correlates of these beliefs. Methods The study design was a cross-sectional survey of 2,864 Florida black men, age 40 to 70, on their perceived susceptibility, perceived severity, attitude, outcomes beliefs, perceived behavioral control, CaP fatalism, religiosity, temporal orientation, and acculturation relative to CaP screening and prevention. Results The men reported favorable attitude and positive outcome beliefs, but moderate perceived behavioral control, CaP susceptibility and CaP severity. They also had low level of acculturation, did not hold fatalistic beliefs about CaP, had high religious coping skills and had high future time perspective. Several demographic variables were found to be associated with health beliefs and cultural beliefs. Discussion Our study provides rich data with regard to the health and cultural beliefs that might serve to inform the development of CaP control initiative for US-born and foreign-born black men. PMID:21992652

  19. Models of cancer survivorship health care: moving forward.

    PubMed

    Oeffinger, Kevin C; Argenbright, Keith E; Levitt, Gill A; McCabe, Mary S; Anderson, Paula R; Berry, Emily; Maher, Jane; Merrill, Janette; Wollins, Dana S

    2014-01-01

    The population of cancer survivors in the United States and worldwide is rapidly increasing. Many survivors will develop health conditions as a direct or indirect consequence of their cancer therapy. Thus, models to deliver high-quality care for cancer survivors are evolving. We provide examples of three different models of survivorship care from a cancer center, a community setting, and a country-wide health care system, followed by a description of the ASCO Cancer Survivorship Compendium, a tool to help providers understand the various models of survivorship care available and integrate survivorship care into their practices in a way that fits their unique needs.

  20. Health Promotion Among Older Cancer Survivors With Prior Disabling Conditions

    PubMed Central

    Becker, Heather; Kang, Sook Jung

    2013-01-01

    Older cancer survivors, who often cope with multiple disabling conditions, can find health promotion challenging. This study's purpose was to explore predictors of health promotion for older cancer survivors with a disabling condition that existed prior to their cancer diagnosis. The 92 cancer survivors were predominantly women with preexisting neuromuscular impairments and an average age of 69 years. Half were breast cancer survivors, and 58% were 6 or more years since their cancer diagnosis. In hierarchical regression analyses, self-efficacy for health promotion and social support were the strongest predictors of the total HPLPII and its subscales. The findings suggest that nursing interventions to assist older cancer survivors with multiple chronic conditions in building their social support and perceived self-efficacy may help them lead more healthy lives. PMID:22765516

  1. Cancer and Cancer Prevention and Control Programs in the Aberdeen Area Indian Health Service.

    ERIC Educational Resources Information Center

    Welty, Thomas K.

    1992-01-01

    Describes cancer control activities by the Indian Health Service in North Dakota, South Dakota, Iowa, and Nebraska, including risk factor assessment and cancer screening using a modified Health Risk Appraisal; interventions to reduce smoking; community empowerment; development of health education materials; and clinical preventive services. (SV)

  2. Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks

    PubMed Central

    Petkova, Elisaveta P.; Ebi, Kristie L.; Culp, Derrin; Redlener, Irwin

    2015-01-01

    The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region’s coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region’s unique vulnerabilities, and outlines recommendations for improving the region’s ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades. PMID:26270669

  3. Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks.

    PubMed

    Petkova, Elisaveta P; Ebi, Kristie L; Culp, Derrin; Redlener, Irwin

    2015-08-11

    The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region's coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region's unique vulnerabilities, and outlines recommendations for improving the region's ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades.

  4. The Health Sciences and Technology Academy: an educational pipeline to address health care disparities in West Virginia.

    PubMed

    McKendall, Sherron Benson; Kasten, Kasandra; Hanks, Sara; Chester, Ann

    2014-01-01

    Health and educational disparities are national issues in the United States. Research has shown that health care professionals from underserved backgrounds are more likely than others to work in underserved areas. The Association of American Medical Colleges' Project 3000 by 2000, to increase the number of underrepresented minorities in medical schools, spurred the West Virginia School of Medicine to start the Health Sciences and Technology Academy (HSTA) in 1994 with the goal of supporting interested underrepresented high school students in pursuing college and health professions careers. The program was based on three beliefs: (1) if underrepresented high school students have potential and the desire to pursue a health professions career and are given the support, they can reach their goals, including obtaining a health professions degree; (2) underserved high school students are able to predict their own success if given the right resources; and (3) community engagement would be key to the program's success.In this Perspective, the authors describe the HSTA and its framework and philosophy, including the underlying theories and pedagogy from research in the fields of education and the behavioral/social sciences. They then offer evidence of the program's success, specifically for African American students, including graduates' high college-going rate and overwhelming intention to choose a health professions major. Finally, the authors describe the benefits of the HSTA's community partnerships, including providing mentors to students, adding legislative language providing tuition waivers and a budgetary line item devoted to the program, and securing program funding from outside sources.

  5. Tools for address georeferencing - limitations and opportunities every public health professional should be aware of.

    PubMed

    Ribeiro, Ana Isabel; Olhero, Andreia; Teixeira, Hugo; Magalhães, Alexandre; Pina, Maria Fátima

    2014-01-01

    Various address georeferencing (AG) tools are currently available. But little is known about the quality of each tool. Using data from the EPIPorto cohort we compared the most commonly used AG tools in terms of positional error (PE) and subjects' misclassification according to census tract socioeconomic status (SES), a widely used variable in epidemiologic studies. Participants of the EPIPorto cohort (n = 2427) were georeferenced using Geographical Information Systems (GIS) and Google Earth (GE). One hundred were randomly selected and georeferenced using three additional tools: 1) cadastral maps (gold-standard); 2) Global Positioning Systems (GPS) and 3) Google Earth, single and in a batch. Mean PE and the proportion of misclassified individuals were compared. Google Earth showed lower PE than GIS, but 10% of the addresses were imprecisely positioned. Thirty-eight, 27, 16 and 14% of the participants were located in the wrong census tract by GIS, GPS, GE (batch) and GE (single), respectively (p<0.001). Misclassification according to SES was less frequent but still non-negligible -14.4, 8.1, 4.2 and 2% (p<0.001). The quality of georeferencing differed substantially between AG tools. GE seems to be the best tool, but only if prudently used. Epidemiologic studies using spatial data should start including information on the quality and accuracy of their georeferencing tools and spatial datasets.

  6. The crossroads of GIS and health information: a workshop on developing a research agenda to improve cancer control

    PubMed Central

    Pickle, Linda Williams; Szczur, Martha; Lewis, Denise Riedel; Stinchcomb, David G

    2006-01-01

    Cancer control researchers seek to reduce the burden of cancer by studying interventions, their impact in defined populations, and the means by which they can be better used. The first step in cancer control is identifying where the cancer burden is elevated, which suggests locations where interventions are needed. Geographic information systems (GIS) and other spatial analytic methods provide such a solution and thus can play a major role in cancer control. This report presents findings from a workshop held June 16–17, 2005, to bring together experts and stakeholders to address current issues in GIScience and cancer control. A broad range of areas of expertise and interest was represented, including epidemiology, geography, statistics, environmental health, social science, cancer control, cancer registry operations, and cancer advocacy. The goals of this workshop were to build consensus on important policy and research questions, identify roadblocks to future progress in this field, and provide recommendations to overcome these roadblocks. PMID:17118204

  7. Addressing the sexual problems of Iranian women in a primary health care setting: A quasi-experimental study

    PubMed Central

    Rostamkhani, Fatemeh; Jafari, Fatemeh; Ozgoli, Giti; Shakeri, Masomeh

    2015-01-01

    Background: The World Health Organization emphasizes on integration of sexual health into primary health care services, educating people and health care workers about sexuality, and promoting optimal sexual health. Despite the high prevalence of sexual problems, these problems are poorly managed in primary health care services. This study was conducted to evaluate the efficacy and feasibility of the first two steps of PLISSIT (Permission, Limited Information, Specific Suggestions, Intensive Treatment) model for handling of women sexual problems in a primary health care setting. Materials and Methods: This was a quasi-experimental study that was carried out in Zanjan, northwest of Iran. Eighty women who had got married in the past 5 years and had sexual problem were randomly assigned to control and intervention groups. The intervention group received consultation based on PLISSIT model by a trained midwife and the control group received routine services. Female Sexual Function Index (FSFI) questionnaire was used for assessing and tracking any changes in sexual function. Data were collected at three points: Before consultation and 2 and 4 weeks after consultation. Paired t-test and repeated measures analysis of variance (ANOVA) test were used for comparison of scores within groups. Results: Significant improvement was found in FSFI sub-domain scores, including sexual desire (P < 0.0001), arousal (P < 0.0001), lubrication (P < 0.0001), orgasm (P = 0.005), satisfaction (P = 0.005), pain (P < 0.0001), and FSFI total score (P < 0.0001) in the intervention group compared to the control group. Conclusions: This study showed that PLISSIT model can meet the sexual health needs of clients in a primary health care setting and it can be used easily by health workers in this setting for addressing sexual complaints and dysfunctions. PMID:25709703

  8. Responding to rural health needs through community participation: addressing the concerns of children and young adults.

    PubMed

    Jeffery, Vivienne; Ervin, Kaye

    2011-01-01

    A small rural health service undertook a major needs analysis in 2008 to identify gaps in service delivery and duplication of services. This exercise was intended to inform strategic direction but the result was consumer and community consultation and outcomes that far exceeded everyone's expectations. Organisations often pay lip service to the concept of community participation and consultation and the importance of consumer involvement. Turning this rhetoric into action is challenging and requires dedicated staff, organisational support and momentum for it to occur. The project described resulted in targeted, purposeful action regarding community engagement, and the findings and outcomes are reflective of this. The unexpected findings required an organisational shift, which was embraced by the health service and resulted in collaborative partnerships with consumers and organisations that are proving beneficial to the entire community and outlying areas. Few organisations would demonstrate the willingness to accommodate such change, or undertake a needs analysis that is chiefly community driven.

  9. Does addressing gender inequalities and empowering women and girls improve health and development programme outcomes?

    PubMed

    Taukobong, Hannah F G; Kincaid, Mary M; Levy, Jessica K; Bloom, Shelah S; Platt, Jennifer L; Henry, Sarah K; Darmstadt, Gary L

    2016-12-01

    This article presents evidence supporting the hypothesis that promoting gender equality and women's and girls' empowerment (GEWE) leads to better health and development outcomes. We reviewed the literature across six sectors-family planning (FP); maternal, newborn and child health (MNCH); nutrition; agriculture; water, sanitation and hygiene; and financial services for the poor-and found 76 studies from low and middle-income countries that met our inclusion criteria. Across these studies, we identified common GEWE variables that emerged repeatedly as significant predictors of sector outcomes. We grouped these variables into 10 thematic categories, which we termed 'gender-related levers'. These levers were then classified by the strength of evidence into Wedges, Foundations and Facilitators. Wedges are gender-related levers that had strong associations with improved outcomes across multiple sectors. They include: 'control over income/assets/resources', 'decision-making power' and 'education'. Elements of these levers overlap, but combined, they encapsulate agency. Increasing female agency promotes equality and broadly improves health and development for women, their families and their communities. The second classification, Foundations, displayed strong, positive associations across FP, MNCH and nutrition. Foundations have a more proximal relationship with sector outcomes and include: 'equitable interpersonal relationships', 'mobility' and 'personal safety'. Finally, the third group of levers, Facilitators, was associated with improved outcomes in two to three sectors and include: 'access to information', 'community groups', 'paid labour' and 'rights'. These levers make it easier for women and girls to achieve their goals and are more traditional elements of development programmes. Overall, gender-related levers were associated with improvements in a variety of health and development outcomes. Furthermore, these associations were cross-sectoral, suggesting that to

  10. A Framework to Address Challenges in Communicating the Developmental Origins of Health and Disease.

    PubMed

    Winett, Liana; Wallack, Lawrence; Richardson, Dawn; Boone-Heinonen, Janne; Messer, Lynne

    2016-09-01

    Findings from the field of Developmental Origins of Health and Disease (DOHaD) suggest that some of the most pressing public health problems facing communities today may begin much earlier than previously understood. In particular, this body of work provides evidence that social, physical, chemical, environmental, and behavioral influences in early life play a significant role in establishing vulnerabilities for chronic disease later in life. Further, because this work points to the importance of adverse environmental exposures that cluster in population groups, it suggests that existing opportunities to intervene at a population level may need to refocus their efforts "upstream" to sufficiently combat the fundamental causes of disease. To translate these findings into improved public health, however, the distance between scientific discovery and population application will need to be bridged by conversations across a breadth of disciplines and social roles. And importantly, those involved will likely begin without a shared vocabulary or conceptual starting point. The purpose of this paper is to support and inform the translation of DOHaD findings from the bench to population-level health promotion and disease prevention, by: (1) discussing the unique communication challenges inherent to translation of DOHaD for broad audiences, (2) introducing the First-hit/Second-hit Framework with an epidemiologic planning matrix as a model for conceptualizing and structuring communication around DOHaD, and (3) discussing the ways in which patterns of communicating DOHaD findings can expand the range of solutions considered and encourage discussion of population-level solutions in relation to one another, rather than in isolation.

  11. Cross-sectoral cancer care: views from patients and health care professionals regarding a personal electronic health record.

    PubMed

    Baudendistel, I; Winkler, E C; Kamradt, M; Brophy, S; Längst, G; Eckrich, F; Heinze, O; Bergh, B; Szecsenyi, J; Ose, D

    2017-03-01

    Cross-sectoral cancer care is complex and involves collaboration from health care professionals (HCPs) across multiple sectors. However, when health information exchange (HIE) is not adequate, it results in impeded coordination and continuity of care. A web-based personal electronic health record (PEPA) under patients' control, providing access to personal health data across sectors, is being developed. Aim of this study was to explore perceived benefits and concerns. Using a qualitative approach, 10 focus groups were performed collecting views of three prospective user groups: patients with colorectal cancer (n = 12), physicians (n = 17) and other HCPs (n = 16). Representatives from different health sectors across the Rhine-Neckar region (Germany) participated. Data were audio- and videotaped, transcribed verbatim and thematically analysed. Our study shows that patients and HCPs expected a PEPA to enhance cross-sectoral availability of information, cross-sectoral cooperation and facilitate data management. Quality of cancer care was expected to be improved. Concerns were expressed in terms of data protection and data security. Concepts like a PEPA offer the chance to support HIE and avoid gaps of information in cross-sectoral cancer care. This may lead to improvements in coordination and continuity of care. Issues concerning data security and protection have to be addressed.

  12. Addressing Health Disparities by Building Organizational Capacity in the Community: A Case Study of the Wai‘anae Coast Comprehensive Health Center

    PubMed Central

    Sehgal, Vija; Wilkinson, Tiana; Voloch, Kelli-Ann; Enos, Rachelle; O'Brien, Joyce

    2014-01-01

    Native Hawaiians and other residents living in economically disadvantaged communities suffer disproportionately from many health conditions, especially chronic diseases. Reversing this trend requires a comprehensive approach encompassing more than just improvement in healthcare delivery. Indeed, societal changes at multiple levels must occur, including environmental, systems, and policy change, in order to bring about sustainable improvements in community health and wellness. A key strategy to accomplish these upstream changes is an increase in the capacity of community-based organizations to provide leadership in health advocacy, support community health promotion, prioritize resource allocation, and participate in community health research. In disadvantaged communities where health disparities are the most severe, community health centers (CHC) are well positioned to take a pivotal role in these efforts. This report is a case study to describe processes taking place at Hawai‘i's largest CHC to build organizational capacity and bring about upstream changes that improve community health and wellness. Ongoing processes at the CHC include (1) Institutional: commitment to address health disparities, expand the CHC research infrastructure, and develop a comprehensive worksite wellness program (2) Collaborative: development of a network of community partners committed to the common goal of improving the health and wellness of community residents, and (3) Systems and Policy: activities to strengthen the CHC's and community's ability to influence systems changes and policies that reduce health disparities. Preliminary results are encouraging although the processes and timelines involved require a long-term commitment in order to affect tangible results that can be measured. PMID:25535600

  13. Addressing underutilization of consumer health information resource centers: a formative study*

    PubMed Central

    Kennedy, May G.; Kiken, Laura; Shipman, Jean P.

    2008-01-01

    Problem: Four consumer health information centers in Richmond, Virginia, provide one-on-one assistance in accessing health information. Because they may not be fully utilized at present, an exploratory marketing study of factors affecting usage of the centers was conducted. Method: Observers counted center passers-by and tracked their paths. Also, brief intercept interviews were conducted with people who had just used a center, people nearby who could have used one but did not, and people on the street. Finally, in-depth individual interviews were conducted with key informants. Results: There was a high degree of satisfaction with the centers among users. Nonusers universally endorsed the center concept. However, most passers-by did not even glance at the centers, and intercept interviewees suggested better signage and promoting the resource centers through various media channels. Key informants added suggestions about interpersonal strategies (e.g., physician referrals) for center usage promotion but cautioned that a large increase in traffic could not be accommodated without increasing staff size or shifting from a model of individualized service. Conclusions: Triangulating findings from multiple data collection methods can provide useful guidance for efforts to promote center utilization. At minimum, steps should be taken to make the largest centers more noticeable. Because center utilization is not only associated with consumer satisfaction with hospitals, but may also foster health literacy, both hospital-based and community-based usage promotion strategies may be warranted. All such promotional strategies should be audience-tested before they are adopted. PMID:18219380

  14. Addressing health system barriers to access to and use of skilled delivery services: perspectives from Ghana.

    PubMed

    Ganle, John Kuumuori; Fitzpatrick, Raymond; Otupiri, Easmon; Parker, Michael

    2016-10-01

    Poor access to and use of skilled delivery services have been identified as a major contributory factor to poor maternal and newborn health in sub-Saharan African countries, including Ghana. However, many previous studies that examine norms of childbirth and care-seeking behaviours have focused on identifying the norms of non-use of services, rather than factors, that can promote service use. Based on primary qualitative research with a total of 185 expectant and lactating mothers, and 20 healthcare providers in six communities in Ghana, this paper reports on strategies that can be used to overcome health system barriers to the use of skilled delivery services. The strategies identified include expansion and redistribution of existing maternal health resources and infrastructure, training of more skilled maternity caregivers, instituting special programmes to target women most in need, improving the quality of maternity care services provided, improving doctor-patient relationships in maternity wards, promotion of choice, protecting privacy and patient dignity in maternity wards and building partnerships with traditional birth attendants and other non-state actors. The findings suggest the need for structural changes to maternity clinics and routine nursing practices, including an emphasis on those doctor-patient relational practices that positively influence women's healthcare-seeking behaviours. Copyright © 2015 John Wiley & Sons, Ltd.

  15. Addressing sexual health in congenital heart disease: when being the same isn't the same.

    PubMed

    Loomba, Rohit S; Aggarwal, Saurabh; Pelech, Andrew N

    2015-01-01

    A larger number of individuals born with congenital heart disease is living into adolescence and young adulthood. With this comes the responsibility to counsel these patients regarding their sexual and reproductive health. This study utilizes representative data from the National Health and Nutrition Examination Survey to compare sexual measures including percentage of that sexually active, age of first sexual activity, number of sexual partners, condom use, and history of sexually transmitted diseases in those with and without congenital heart disease. A total of 1086 patients (1057 without congenital heart disease and 29 with congenital heart disease) were included in this study. Likelihood of being sexually active, age of first sexual intercourse, and condom use did not differ significantly between the two groups after multivariate analysis. Incidence of sexually transmitted disease did not differ between the two groups after multivariate analysis except for genital warts. There are no major differences in sexual measures between those with and without congenital heart disease. The absence of significant differences in sexual measures in those with congenital heart disease compared with the general population places this group of individuals at increased health risk known to occur with pregnancy.

  16. Cystic fibrosis: addressing the transition from pediatric to adult-oriented health care.

    PubMed

    Kreindler, James L; Miller, Victoria A

    2013-12-11

    Survival for patients with cystic fibrosis (CF) increased to nearly 40 years in 2012 from the early childhood years in the 1940s. Therefore, patients are living long enough to require transition from pediatric CF centers to adult CF centers. The goal of transition is for the young adult to be engaged in the adult health care system in ways that optimize health, maximize potential, and increase quality of life. A successful transition promotes autonomy and responsibility with respect to one's own health. Currently, there is an information gap in the literature with respect to psychological models that can help guide informed transition processes. In this review, we establish the framework in which transition exists in CF; we review some of the published literature from the last 20 years of experience with transition in CF centers around the world; and we discuss psychological models of pediatric illness that can help to explain the current state of transition to adult-oriented care from pediatric-oriented care and help to formulate new models of ascertaining readiness for transition. Finally, we look at our current knowledge gaps and opportunities for future research endeavors.

  17. Relative and absolute addressability of global disease burden in maternal and perinatal health by investment in R&D.

    PubMed

    Fisk, Nicholas M; McKee, Martin; Atun, Rifat

    2011-06-01

    Maternal and perinatal disease accounts for nearly 10% of the global burden of disease, with only modest progress towards achievement of the Millennium Development Goals. Despite a favourable new global health landscape in research and development (R&D) to produce new drugs for neglected diseases, R&D investment in maternal/perinatal health remains small and non-strategic. Investment in obstetric R&D by industry or the not-for-profit sector has lagged behind other specialties, with the number of registered pipeline drugs only 1-5% that for other major disease areas. Using a Delphi exercise with maternal/perinatal experts in global and translational research, we estimate that equitable pharmaceutical R&D and public sector research funding over the next 10-20 years could avert 1.1% and 1.9% of the global disease burden, respectively. In contrast, optimal uptake of existing research would prevent 3.0%, justifying the current focus on health service provision. Although R&D predominantly occurs in high-income countries, more than 98% of the estimated reduction in disease burden in this field would be in developing countries. We conclude that better pharmaceutical and public sector R&D would prevent around 1/3 and 2/3, respectively, of the disease burden addressable by optimal uptake of existing research. Strengthening R&D may be an important complementary strategy to health service provision to address global maternal and perinatal disease burden.

  18. Global Perspectives on Cancer Health Disparities: Impact, Utility, and Implications for Cancer Nursing

    PubMed Central

    So, Winnie K. W.; Chan, Raymond Javan; Truant, Tracy; Trevatt, Paul; Bialous, Stella Aguinaga; Barton-Burke, Margaret

    2016-01-01

    This paper examines cancer health disparities and contributing factors at national, regional, and international levels. The authors all live in different countries and regions with different health-care systems and practices. Despite the shared cancer nursing perspective, each country or global region approaches cancer disparities differently. With globalization the world is becoming smaller, and in turn becoming interconnected and interdependent. This article focuses on cancer health disparities and global cancer nursing, exemplifying these concepts about the impact and implications of person-centered care. PMID:28083548

  19. The Health Sciences and Technology Academy: An Educational Pipeline to Address Health Care Disparities in West Virginia

    PubMed Central

    McKendall, Sherron Benson; Kasten, Kasandra; Hanks, Sara; Chester, Ann

    2014-01-01

    Health and educational disparities are national issues in the United States. Research has shown that health care professionals from underserved backgrounds are more likely than others to work in underserved areas. The Association of American Medical Colleges’ Project 3000 by 2000, to increase the number of underrepresented minorities in medical schools, spurred the West Virginia School of Medicine to start the Health Sciences and Technology Academy (HSTA) in 1994 with the goal of supporting interested underrepresented high school students in pursuing college and health professions careers. The program was based on three beliefs: (1) if underrepresented high school students have potential and the desire to pursue a health professions career and are given the support, they can reach their goals, including obtaining a health professions degree; (2) underserved high school students are able to predict their own success if given the right resources; and (3) community engagement would be key to the program’s success. In this perspective, the authors describe the HSTA and its framework and philosophy, including the underlying theories and pedagogy from research in the fields of education and the behavioral/social sciences. They then offer evidence of the program’s success, specifically for African American students, including graduates’ high college-going rate and overwhelming intention to choose a health professions major. Finally, the authors describe the benefits of the HSTA’s community partnerships, including providing mentors to students, adding legislative language providing tuition waivers and a budgetary line item devoted to the program, and securing program funding from outside sources. PMID:24280836

  20. Collaboration, collegiality, and cooperation: consumer health library services and the American Cancer Society navigator role.

    PubMed

    Attwood, Carol Ann; Wellik, Kay E

    2012-10-01

    Patients and family members are overwhelmed by the diagnosis of cancer and often do not know where to look for answers, information on the treatment options, or community resources for support during the cancer journey. A unique relationship was forged with a patient and health education librarian at the Mayo Clinic in Arizona and an American Cancer Society navigator, which encouraged collaboration to better meet the informational and supportive healthcare needs of patients. This article addresses the background of the project, the steps taken to establish the relationship, space allocation, and need for confidentiality. The innovations produced by this partnership also are discussed, including development of cancer pathfinders and cancer communication blogs for patients, as well as comarketing of services.

  1. Keynote address at the Fifth Congress of the International Association for Adolescent Health.

    PubMed

    Ransome-Kuti, O

    1992-07-01

    This Nigerian Ministry of Health speech reiterates the importance of focusing on the problems of youth and adolescents which was 1st identified in 1989 at a World Health Assembly. Every stage of the life cycle is important because mental, physical, psychological, and social scars are carried into the future. It is important to make the transition to adulthood as smooth as possible. Of the 30% (1.5 billion) of the World's population that are adolescents 10-24 years old, 80% live in developing countries. 50% of the world population is 25 years. In the preparation for adulthood, age-old customs, culture, and tradition have ensured the stability and survival of societies, but great changes have taken place due to colonialism, modern education, urban migration, rapid travel an communication, tourism, and trade. There is weakening of traditional marriage. Foreign cultural influence has armed youths to challenge community cultural norms and parental authority to direct their development. There is social tension, disruption, an instability. Adults as role models have sometimes failed to represent integrity and honesty. There is a need for sensitive support and guidance from adults. Peer pressure operates for both good or ill. Some will react to this stress to conform in unhealthy ways. The health care system may not fill adolescent needs because they are too old for the pediatrician and too young for the physician. Girls are particularly vulnerable to the problems of premarital pregnancy, induced abortion, out-of-wedlock births, and sexually transmitted diseases. The pressure is to grow up fast, particularly in polygamous societies where the woman has security only in her children. Opportunities for dialogue degenerate into sessions of being "talked at" and forced compliance. Unemployment is very high which can lead to loss of self-esteem, psychological stress, and hopelessness and sometimes street fighting, thuggery, drug pushing, and armed robbery. Attempts worldwide are

  2. Addressing epidermal growth factor receptor tyrosine kinase inhibitor resistance in non-small cell lung cancer.

    PubMed

    Noda, Shoko; Kanda, Shintaro

    2016-01-01

    Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have significantly improved the survival of patients with advanced non-small cell lung cancer (NSCLC) harboring EGFR activating mutations. However, nearly all EGFR-mutant NSCLC tumors eventually acquire resistance to the currently used EGFR-TKIs and subsequently progress clinically. Acquired resistance to EGFR-TKIs is thus a huge issue in the treatment of EGFR-mutant NSCLC at present. On one hand, T790M second-site mutation has been recognized as a key mechanism of EGFR-TKI resistance, and third generation EGFR-TKIs such as osimertinib and rociletinib have been developed to overcome tumor cells harboring the T790M mutation. On the other hand, combination with cytotoxic chemotherapy is also expected as another strategy for preventing the acquired resistance to current EGFR-TKIs and prolonging the survival benefits by EGFR-TKIs. Here, we review updated strategies for preventing or overcoming acquired resistance to EGFR-TKIs.

  3. Policy Directions Addressing the Public Health Impact of Climate Change in South Korea: The Climate-change Health Adaptation and Mitigation Program.

    PubMed

    Shin, Yong Seung; Ha, Jongsik

    2012-01-01

    Climate change, caused by global warming, is increasingly recognized as a major threat to mankind's survival. Climate change concurrently has both direct and modifying influences on environmental, social, and public health systems undermining human health as a whole. Environmental health policy-makers need to make use of political and technological alternatives to address these ramifying effects. The objective of this paper is to review public health policy in Korea, as well as internationally, particularly as it relates to climate change health adaptation and mitigation programs (such as C-CHAMP of Korea), in order to assess and elicit directions for a robust environmental health policy that is adaptive to the health impacts of climate change. In Korea, comprehensive measures to prevent or mitigate overall health effects are limited, and the diffusion of responsibility among various government departments makes consistency in policy execution very difficult. This paper proposes integration, synergy, and utilization as the three core principles of policy direction for the assessment and adaptation to the health impacts of climate change. For specific action plans, we suggest policy making based on scientifically integrated health impact assessments and the prioritization of environmental factors in climate change; the development of practical and technological tools that support policy decisions by making their political implementation more efficient; and customized policy development that deals with the vulnerability of local communities.

  4. Uncovering Clinical Principles and Techniques to Address Minority Stress, Mental Health, and Related Health Risks Among Gay and Bisexual Men

    PubMed Central

    Pachankis, John E.

    2014-01-01

    Gay and bisexual men disproportionately experience depression, anxiety, and related health risks at least partially because of their exposure to sexual minority stress. This paper describes the adaptation of an evidence-based intervention capable of targeting the psychosocial pathways through which minority stress operates. Interviews with key stakeholders, including gay and bisexual men with depression and anxiety and expert providers, suggested intervention principles and techniques for improving minority stress coping. These principles and techniques are consistent with general cognitive behavioral therapy approaches, the empirical tenets of minority stress theory, and professional guidelines for LGB-affirmative mental health practice. If found to be efficacious, the psychosocial intervention described here would be one of the first to improve the mental health of gay and bisexual men by targeting minority stress. PMID:25554721

  5. Migrant women's perceptions of healthcare during pregnancy and early motherhood: addressing the social determinants of health.

    PubMed

    Almeida, Lígia Moreira; Casanova, Catarina; Caldas, José; Ayres-de-Campos, Diogo; Dias, Sónia

    2014-08-01

    Recent guidelines from the World Health Organization emphasize the need to monitor the social determinants of health, with particular focus on the most vulnerable groups. With this in mind, we evaluated the access, use and perceived quality of care received by migrant women during pregnancy and early motherhood, in a large urban area in northern Portugal. We performed semi-structured interviews in 25 recent mothers, contacted through welfare institutions, who had immigrated from Eastern European countries, Brazil, or Portuguese-speaking African countries. Six native-Portuguese women of equal economic status were also interviewed for comparison. Misinformation about legal rights and inadequate clarification during medical appointments frequently interacted with social determinants, such as low social-economic status, unemployment, and poor living conditions, to result in lower perceived quality of healthcare. Special attention needs to be given to the most vulnerable populations in order to improve healthcare. Challenges reside not only in assuring access, but also in promoting equity in the quality of care.

  6. NCCN Task Force Report: Bone Health In Cancer Care.

    PubMed

    Gralow, Julie R; Biermann, J Sybil; Farooki, Azeez; Fornier, Monica N; Gagel, Robert F; Kumar, Rashmi; Litsas, Georgia; McKay, Rana; Podoloff, Donald A; Srinivas, Sandy; Van Poznak, Catherine H

    2013-08-01

    Bone health and maintenance of bone integrity are important components of comprehensive cancer care. Many patients with cancer are at risk for therapy-induced bone loss, with resultant osteoporotic fractures, or skeletal metastases, which may result in pathologic fractures, hypercalcemia, bone pain, and decline in motility and performance status. Effective screening and timely interventions are essential for reducing bone-related morbidity. Management of long-term bone health requires a broad knowledge base. A multidisciplinary health care team may be needed for optimal assessment and treatment of bone-related issues in patients with cancer. Since publication of the previous NCCN Task Force Report: Bone Health in Cancer Care in 2009, new data have emerged on bone health and treatment, prompting NCCN to convene this multidisciplinary task force to discuss the progress made in optimizing bone health in patients with cancer. In December 2012, the panel members provided didactic presentations on various topics, integrating expert judgment with a review of the key literature. This report summarizes issues surrounding bone health in cancer care presented and discussed during this NCCN Bone Health in Cancer Care Task Force meeting.

  7. “My cancer is not my deepest concern”: life course disruption influencing patient pathways and health care needs among persons living with colorectal cancer

    PubMed Central

    Salamonsen, Anita; Kiil, Mona A; Kristoffersen, Agnete Egilsdatter; Stub, Trine; Berntsen, Gro R

    2016-01-01

    Background The concept of “patient pathways” in cancer care is most commonly understood as clinical pathways, operationalized as standardized packages of health care based on guidelines for the condition in question. In this understanding, patient pathways do not address multimorbidity or patient experiences and preferences. This study explored patient pathways understood as the individual and cultural life course, which includes both life and health events. The overall aim was to contribute to supportive and targeted cancer care. Materials and methods Nine Norwegian patients recently diagnosed with rectal cancer Tumor-Node-Metastasis stage I–III participated in qualitative interviews, five times over 1 year. Five patients later participated in a workshop where they made illustrations of and discussed patient pathways. Results Patient pathways including both health and life events were illustrated and described as complex and circular. Stress, anxiety, and depression caused by life events had significant disruptive effects and influenced patient-defined health care needs. The participants experienced the Norwegian public health service as focused on hospital-based standardized cancer care. They expressed unmet health care needs in terms of emotional and practical support in their everyday life with cancer, and some turned to complementary and alternative medicine. Conclusion This study suggests that acknowledging life course disruption before cancer diagnosis may have significant relevance for understanding complex patient pathways and individual health care needs. Approaching patient pathways as individual and socially constructed may contribute important knowledge to support targeted cancer care. PMID:27574408

  8. Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 Health Policy Meeting.

    PubMed

    Bloomrosen, Meryl; Starren, Justin; Lorenzi, Nancy M; Ash, Joan S; Patel, Vimla L; Shortliffe, Edward H

    2011-01-01

    Federal legislation (Health Information Technology for Economic and Clinical Health (HITECH) Act) has provided funds to support an unprecedented increase in health information technology (HIT) adoption for healthcare provider organizations and professionals throughout the U.S. While recognizing the promise that widespread HIT adoption and meaningful use can bring to efforts to improve the quality, safety, and efficiency of healthcare, the American Medical Informatics Association devoted its 2009 Annual Health Policy Meeting to consideration of unanticipated consequences that could result with the increased implementation of HIT. Conference participants focused on possible unintended and unanticipated, as well as undesirable, consequences of HIT implementation. They employed an input-output model to guide discussion on occurrence of these consequences in four domains: technical, human/cognitive, organizational, and fiscal/policy and regulation. The authors outline the conference's recommendations: (1) an enhanced research agenda to guide study into the causes, manifestations, and mitigation of unintended consequences resulting from HIT implementations; (2) creation of a framework to promote sharing of HIT implementation experiences and the development of best practices that minimize unintended consequences; and (3) recognition of the key role of the Federal Government in providing leadership and oversight in analyzing the effects of HIT-related implementations and policies.

  9. Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 Health Policy Meeting

    PubMed Central

    Starren, Justin; Lorenzi, Nancy M; Ash, Joan S; Patel, Vimla L; Shortliffe, Edward H

    2010-01-01

    Federal legislation (Health Information Technology for Economic and Clinical Health (HITECH) Act) has provided funds to support an unprecedented increase in health information technology (HIT) adoption for healthcare provider organizations and professionals throughout the U.S. While recognizing the promise that widespread HIT adoption and meaningful use can bring to efforts to improve the quality, safety, and efficiency of healthcare, the American Medical Informatics Association devoted its 2009 Annual Health Policy Meeting to consideration of unanticipated consequences that could result with the increased implementation of HIT. Conference participants focused on possible unintended and unanticipated, as well as undesirable, consequences of HIT implementation. They employed an input–output model to guide discussion on occurrence of these consequences in four domains: technical, human/cognitive, organizational, and fiscal/policy and regulation. The authors outline the conference's recommendations: (1) an enhanced research agenda to guide study into the causes, manifestations, and mitigation of unintended consequences resulting from HIT implementations; (2) creation of a framework to promote sharing of HIT implementation experiences and the development of best practices that minimize unintended consequences; and (3) recognition of the key role of the Federal Government in providing leadership and oversight in analyzing the effects of HIT-related implementations and policies. PMID:21169620

  10. Process Improvement: Addressing Attrition from the Uniformed Services University of the Health Sciences Nurse Anesthesia Program.

    PubMed

    Wilson, John Tyler; Gibbons, Susanne W; Wofford, Kenneth

    2015-10-01

    This retrospective cohort study examined the Uniformed Services University of the Health Sciences Registered Nurse Anesthesia program to identify reasons for high attrition rates. Relevant data were examined for 180 students enrolled in classes from 2005 through 2011. During that period, 40 students were dismissed or disenrolled, with the highest attrition rate (35%) occurring in the class of 2010. Evidence from this investigation indicates students who completed the program were younger, earned higher grade point averages while completing their undergraduate bachelor of science in nursing, and achieved higher analytic and total Graduate Record Examination scores than did students who withdrew or were dismissed. Gender differences were noted, as a greater proportion of women completed the program compared with men. Personal, family, and other issues frequently overlapped, with academic performance problems leading to attrition. Based on these findings, a number of important changes were made in the admission process to the USUHS RNA program and in the nonacademic mentoring and assistance offered to students.

  11. Leveraging the biology of adversity to address the roots of disparities in health and development.

    PubMed

    Shonkoff, Jack P

    2012-10-16

    Extensive evidence that personal experiences and environmental exposures are embedded biologically (for better or for worse) and the cumulative knowledge of more than four decades of intervention research provide a promising opportunity to mobilize evolving scientific insights to catalyze a new era of more effective early childhood policy and practice. Drawing on emerging hypotheses about causal mechanisms that link early adversity with lifelong impairments in learning, behavior, and health, this paper proposes an enhanced theory of change to promote better outcomes for vulnerable, young children by strengthening caregiver and community capacities to reduce or mitigate the impacts of toxic stress, rather than simply providing developmental enrichment for the children and parenting education for their mothers.

  12. Leveraging the biology of adversity to address the roots of disparities in health and development

    PubMed Central

    Shonkoff, Jack P.

    2012-01-01

    Extensive evidence that personal experiences and environmental exposures are embedded biologically (for better or for worse) and the cumulative knowledge of more than four decades of intervention research provide a promising opportunity to mobilize evolving scientific insights to catalyze a new era of more effective early childhood policy and practice. Drawing on emerging hypotheses about causal mechanisms that link early adversity with lifelong impairments in learning, behavior, and health, this paper proposes an enhanced theory of change to promote better outcomes for vulnerable, young children by strengthening caregiver and community capacities to reduce or mitigate the impacts of toxic stress, rather than simply providing developmental enrichment for the children and parenting education for their mothers. PMID:23045654

  13. Iron deficiency anemia among children: Addressing a global public health problem within a Canadian context.

    PubMed

    Christofides, Anna; Schauer, Claudia; Zlotkin, Stanley H

    2005-12-01

    Despite current Canadian pre- and perinatal nutrition programs, the prevalence of both iron deficiency and iron deficiency anemia (IDA) is very high among young Aboriginal children from Canada's remote north. The major risk factors for IDA include prolonged consumption of evaporated cow's milk, chronic infection and prolonged exclusive breastfeeding. In the present article, the authors discuss IDA as a significant public health problem in Canadian Aboriginal communities. Whereas the prevalence of IDA in Canadian children is between 3.5% and 10.5% in the general population, in two Northern Ontario First Nations communities and one Inuit community, the anemia rate was 36%, with 56% having depleted iron stores. Traditional methods of preventing IDA, including targeted fortification, dietary diversification and supplementation, have not solved the problem. The authors' research group at The Hospital for Sick Children in Toronto, Ontario, conceived of the strategy of 'home fortification' with 'Sprinkles' - single-dose sachets containing micronutrients in a powder form, which are easily sprinkled onto any foods prepared in the household. In Sprinkles, the iron (ferrous fumarate) is encapsulated within a thin lipid layer to prevent the iron from interacting with food. Sprinkles have been shown to be efficacious in the treatment of anemia in many developing countries. Their use in Aboriginal communities to treat and prevent anemia is described in the present paper. The authors believe that children in Aboriginal communities across Canada would potentially benefit if Sprinkles were incorporated into Health Canada's current distribution system, in combination with a social marketing strategy to encourage their use.

  14. The influence of health disparities on targeting cancer prevention efforts.

    PubMed

    Zonderman, Alan B; Ejiogu, Ngozi; Norbeck, Jennifer; Evans, Michele K

    2014-03-01

    Despite the advances in cancer medicine and the resultant 20% decline in cancer death rates for Americans since 1991, there remain distinct cancer health disparities among African Americans, Hispanics, Native Americans, and the those living in poverty. Minorities and the poor continue to bear the disproportionate burden of cancer, especially in terms of stage at diagnosis, incidence, and mortality. Cancer health disparities are persistent reminders that state-of-the-art cancer prevention, diagnosis, and treatment are not equally effective for and accessible to all Americans. The cancer prevention model must take into account the phenotype of accelerated aging associated with health disparities as well as the important interplay of biological and sociocultural factors that lead to disparate health outcomes. The building blocks of this prevention model will include interdisciplinary prevention modalities that encourage partnerships across medical and nonmedical entities, community-based participatory research, development of ethnically and racially diverse research cohorts, and full actualization of the prevention benefits outlined in the 2010 Patient Protection and Affordable Care Act. However, the most essential facet should be a thoughtful integration of cancer prevention and screening into prevention, screening, and disease management activities for hypertension and diabetes mellitus because these chronic medical illnesses have a substantial prevalence in populations at risk for cancer disparities and cause considerable comorbidity and likely complicate effective treatment and contribute to disproportionate cancer death rates.

  15. YOUR Blessed Health: a faith-based CBPR approach to addressing HIV/AIDS among African Americans.

    PubMed

    Griffith, Derek M; Pichon, Latrice C; Campbell, Bettina; Allen, Julie Ober

    2010-06-01

    Despite substantial federal, state, and local efforts to reduce the transmission of HIV/AIDS, African Americans experience higher rates of infection than any other ethnic or racial group in the United States. It is imperative to develop culturally and ecologically sensitive interventions to meet the sexual health needs of this population. Capitalizing on the assets, resources, and strengths of faith-based organizations, YOUR Blessed Health (YBH) is a community-based participatory research project developed to increase HIV/AIDS awareness and reduce HIV-related stigma among the African American faith community in Flint, Michigan. This article describes the historical context and development of YBH, discusses the results of the pilot study, and illustrates how YBH grew into a community mobilization effort led by faith leaders and their congregations to address HIV/AIDS. YBH highlights the importance of developing and testing intervention models that originate from community-based organizations to address complex and sensitive health issues among marginalized populations.

  16. Vaginal Dryness and Beyond: The Sexual Health Needs of Women Diagnosed With Metastatic Breast Cancer.

    PubMed

    McClelland, Sara I; Holland, Kathryn J; Griggs, Jennifer J

    2015-01-01

    While research on the sexual health of women with early stage cancer has grown extensively over the past decade, markedly less information is available to support the sexual health needs of women diagnosed with advanced breast cancer. Semistructured interviews were conducted with 32 women diagnosed with metastatic breast cancer (ages 35 to 77) about questions they had concerning their sexual health and intimate relationships. All participants were recruited from a comprehensive cancer center at a large Midwestern university. Three themes were examined: the role of sexual activity and intimate touch in participants' lives, unmet information needs about sexual health, and communication with medical providers about sexual concerns. Findings indicated that sexual activities with partners were important; however, participants worried about their own physical limitations and reported frequent physical (e.g., bone pains) and vaginal pain associated with intercourse. When women raised concerns about these issues in clinical settings, medical providers often focused exclusively on vaginal lubricants, which did not address the entirety of women's problems or concerns. In addition, women diagnosed with metastatic breast cancer reported needing additional resources about specialized vaginal lubricants, nonpenetrative and nongenitally focused sex, and sexual positions that did not compromise their physical health yet still provided pleasure.

  17. Addressing the NASM health and safety standard through curricular changes in a brass methods course: an outcome study.

    PubMed

    Laursen, Amy; Chesky, Kris

    2014-09-01

    The National Association of Schools of Music (NASM) recently ratified a new health and safety standard requiring schools of music to inform students about health concerns related to music. While organizations such as the Performing Arts Medicine Association have developed advisories, the exact implementation is the prerogative of the institution. One possible approach is to embed health education activities into existing methods courses that are routinely offered to music education majors. This may influence student awareness, knowledge, and the perception of competency and responsibility for addressing health risks associated with learning and performing musical instruments. Unfortunately, there are no known lesson plans or curriculum guides for supporting such activities. Therefore, the purpose of this study is to (1) develop course objectives and content that can be applied to a preexisting brass methods course, (2) implement course objectives into a semester-long brass methods course, and (3) test the effectiveness of this intervention on students' awareness, knowledge, perception of competency, and responsibly of health risks that are related to learning and performing brass instruments. Results showcase the potential for modifying methods courses without compromising the other objectives of the course. Additionally, students' awareness, knowledge, perception of competency, and responsibility were positively influenced as measured by changes in pre to post responses to survey group questions.

  18. The development and implementation of theory-driven programs capable of addressing poverty-impacted children's health, mental health, and prevention needs: CHAMP and CHAMP+, evidence-informed, family-based interventions to address HIV risk and care.

    PubMed

    McKernan McKay, Mary; Alicea, Stacey; Elwyn, Laura; McClain, Zachary R B; Parker, Gary; Small, Latoya A; Mellins, Claude Ann

    2014-01-01

    This article describes a program of prevention and intervention research conducted by the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project; McKay & Paikoff, 2007 ) investigative team. CHAMP refers to a set of theory-driven, evidence-informed, collaboratively designed, family-based approaches meant to address the prevention, health, and mental health needs of poverty-impacted African American and Latino urban youth who are either at risk for HIV exposure or perinatally infected and at high risk for reinfection and possible transmission. CHAMP approaches are informed by theoretical frameworks that incorporate an understanding of the critical influences of multilevel contextual factors on youth risk taking and engagement in protective health behaviors. Highly influential theories include the triadic theory of influence, social action theory, and ecological developmental perspectives. CHAMP program delivery strategies were developed via a highly collaborative process drawing upon community-based participatory research methods in order to enhance cultural and contextual sensitivity of program content and format. The development and preliminary outcomes associated with a family-based intervention for a new population, perinatally HIV-infected youth and their adult caregivers, referred to as CHAMP+, is described to illustrate the integration of theory, existing evidence, and intensive input from consumers and healthcare providers.

  19. Interventions to Address Medical Conditions and Health-Risk Behaviors Among Persons With Serious Mental Illness: A Comprehensive Review

    PubMed Central

    McGinty, Emma E.; Baller, Julia; Azrin, Susan T.; Juliano-Bult, Denise; Daumit, Gail L.

    2016-01-01

    People with serious mental illness (SMI) have mortality rates 2 to 3 times higher than the overall US population, largely due to cardiovascular disease. The prevalence of cardiovascular risk factors such as obesity and diabetes mellitus and other conditions, such as HIV/AIDS, is heightened in this group. Based on the recommendations of a National Institute of Mental Health stakeholder meeting, we conducted a comprehensive review examining the strength of the evidence surrounding interventions to address major medical conditions and health-risk behaviors among persons with SMI. Peer-reviewed studies were identified using 4 major research databases. Randomized controlled trials and observational studies testing interventions to address medical conditions and risk behaviors among persons with schizophrenia and bipolar disorder between January 2000 and June 2014 were included. Information was abstracted from each study by 2 trained reviewers, who also rated study quality using a standard tool. Following individual study review, the quality of the evidence (high, medium, low) and the effectiveness of various interventions were synthesized. 108 studies were included. The majority of studies examined interventions to address overweight/obesity (n = 80). The strength of the evidence was high for 4 interventions: metformin and behavioral interventions had beneficial effects on weight loss; and bupropion and varenicline reduced tobacco smoking. The strength of the evidence was low for most other interventions reviewed. Future studies should test long-term interventions to cardiovascular risk factors and health-risk behaviors. In addition, future research should study implementation strategies to effectively translate efficacious interventions into real-world settings. PMID:26221050

  20. Appealing to altruism: an alternative strategy to address the health workforce crisis in developing countries?

    PubMed Central

    Smith, Richard; Lagarde, Mylene; Blaauw, Duane; Goodman, Catherine; English, Mike; Mullei, Kethi; Pagaiya, Nonglak; Tangcharoensathien, Viroj; Erasmus, Ermin; Hanson, Kara

    2013-01-01

    Background Recruitment and retention of health workers is a major concern. Policy initiatives emphasize financial incentives, despite mixed evidence of their effectiveness. Qualitative studies suggest that nurses especially may be more driven by altruistic motivations, but quantitative research has overlooked such values. This paper adds to the literature through characterizing the nature and determinants of nurses’ altruism, based on a cross-country quantitative study. Methods An experimental ‘dictator game’ was undertaken with 1064 final year nursing students in Kenya, South Africa and Thailand between April 2007 and July 2008. This presents participants with a real financial endowment to split between themselves and another student, a patient or a poor person. Giving a greater share of this financial endowment to the other person is interpreted as reflecting greater altruism. Results Nursing students gave over 30% of their initial endowment to others (compared with 10% in similar experiments undertaken in other samples). Respondents in all three countries showed greater generosity to patients and the poor than to fellow students. Conclusions Consideration needs to be given to how to appeal to altruistic values as an alternative strategy to encourage nurses to enter the profession and remain, such as designing recruitment strategies to increase recruitment of altruistic individuals who are more likely to remain in the profession. PMID:22915772

  1. Can addressing death anxiety reduce health care workers' burnout and improve patient care?

    PubMed

    Melo, Carol Gouveia; Oliver, David

    2011-01-01

    Death anxiety may interfere with health care workers' (HCWs) relationships with patients and patients' families and increase HCWs' levels of burnout. This study shows the impact of a six-day course for HCWs that provided training in communication, in offering emotional and spiritual support to patients, and in personal introspection on death anxiety. The HCWs were given questionnaires to evaluate their level of burnout, personal well-being, and death anxiety as well as the quality of their relationships with patients before the course and four months after it. There were 150 study participants, all HCWs involved in caring for dying patients (85 in palliative care units and 65 in other settings). There was a control group of 26 HCWs who cared for the dying in settings other than palliative care units. The results show that the course appeared to lead to a significant reduction in levels of burnout and death anxiety; they also indicated an increase in personal well-being and professional fulfillment, and participants perceived an improvement in the quality of their relationships with patients and patients' families.

  2. Effectiveness of a parenting program in Bangladesh to address early childhood health, growth and development.

    PubMed

    Aboud, Frances E; Singla, Daisy R; Nahil, Md Imam; Borisova, Ivelina

    2013-11-01

    A stratified cluster design was used to evaluate a 10-month parenting program delivered to mothers of children in rural Bangladesh. Intervention mothers through a combination of group meetings and home visits received messages along with an illustrative card concerning hygiene, responsive feeding, play, communication, gentle discipline, and nutritious foods. Control mothers received the standard government care. Three months prior, 463 children between 4 and 14 months in a subdistrict of western Bangladesh were administered the cognitive, receptive language and expressive language Bayley III subtests, their length was taken and past week illness recorded. Gross motor milestones were reported by the mother and verified through observation. Mothers were interviewed concerning their practices: preventive health practices, dietary diversity, home stimulation, and knowledge about development milestones. Maternal depressive symptoms were assessed as a measure of emotional availability. Family sociodemographic variables included maternal education, family assets, decision-making and mobility autonomy. One month after the end of the program, mothers and their children were again assessed. Comparisons were made between intervention and control children who were under-12 months vs. 12 months and older at the start of the program. This may be a critical age, when children begin to be upright and mobile enough to explore on their own and be less dependent on parenting stimulation. Analyses yielded strong intervention effects on the three Bayley subtests and on parenting practices related to stimulation and knowledge of development milestones. Age effects were found only for dietary diversity in that younger children in the program benefited more than older ones. However, all children became more stunted. Findings are discussed in terms of theories of behaviour change and parenting, critical ages for parenting programs, and implications for program delivery.

  3. Using community-based participatory research to address Chinese older women’s health needs: Toward sustainability

    PubMed Central

    Chang, E-Shien; Simon, Melissa A.; Dong, XinQi

    2016-01-01

    ABSTRACT Although community-based participatory research (CBPR) has been recognized as a useful approach for eliminating health disparities, less attention is given to how CBPR projects may address gender inequalities in health for immigrant older women. The goal of this article is to share culturally sensitive strategies and lessons learned from the PINE study—a population-based study of U.S. Chinese older adults that was strictly guided by the CBPR approach. Working with Chinese older women requires trust, respect, and understanding of their unique historical, social, and cultural positions. We also discuss implications for developing impact-driven research partnerships that meet the needs of this vulnerable population. PMID:27310870

  4. Integrated Strategies to Address Maternal and Child Health and Survival in Low-Income Settings: Implications for Haiti.

    PubMed

    Bhutta, Zulfiqar A

    2016-01-01

    The Millennium Development Goals for improving maternal and child health globally were agreed on in 2000, and several monitoring and evaluation strategies were put in place, including "Countdown to 2015" for monitoring progress and intervention coverage to reach the goals. However, progress in achieving the goals has been slow, with only 13 of the 75 participating Countdown countries on track to reach the targets for reducing child mortality.An overview of child mortality rates in low-income countries is presented, followed by a discussion of evidenced-based interventions that can bridge the equity gaps in global health. Finally, comments are included on the companion article in this issue, "Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care" (page 59), and what is needed for that new project to succeed.

  5. Addressing the social determinants of health: a case study from the Mitanin (community health worker) programme in India.

    PubMed

    Nandi, Sulakshana; Schneider, Helen

    2014-09-01

    The Mitanin Programme, a government community health worker (CHW) programme, was started in Chhattisgarh State of India in 2002. The CHWs (Mitanins) have consistently adopted roles that go beyond health programme-specific interventions to embrace community mobilization and action on local priorities. The aim of this research was to document how and why the Mitanins have been able to act on the social determinants of health, describing the catalysts and processes involved and the enabling programmatic and organizational factors. A qualitative comparative case study of successful action by Mitanin was conducted in two 'blocks', purposefully selected as positive exemplars in two districts of Chhattisgarh. One case focused on malnutrition and the other on gender-based violence. Data collection involved 17 in-depth interviews and 10 group interviews with the full range of stakeholders in both blocks, including community members and programme team. Thematic analysis was done using a broad conceptual framework that was further refined. Action on social determinants involved raising awareness on rights, mobilizing women's collectives, revitalizing local political structures and social action targeting both the community and government service providers. Through these processes, the Mitanins developed identities as agents of change and advocates for the community, both with respect to local cultural and gender norms and in ensuring accountability of service providers. The factors underpinning successful action on social determinants were identified as the significance of the original intent and vision of the programme, and how this was carried through into all aspects of programme design, the role of the Mitanins and their identification with village women, ongoing training and support, and the relative autonomy of the programme. Although the results are not narrowly generalizable and do not necessarily represent the situation of the Mitanin Programme as a whole, the

  6. Addressing the social determinants of health: a case study from the Mitanin (community health worker) programme in India

    PubMed Central

    Schneider, Helen

    2014-01-01

    The Mitanin Programme, a government community health worker (CHW) programme, was started in Chhattisgarh State of India in 2002. The CHWs (Mitanins) have consistently adopted roles that go beyond health programme-specific interventions to embrace community mobilization and action on local priorities. The aim of this research was to document how and why the Mitanins have been able to act on the social determinants of health, describing the catalysts and processes involved and the enabling programmatic and organizational factors. A qualitative comparative case study of successful action by Mitanin was conducted in two ‘blocks’, purposefully selected as positive exemplars in two districts of Chhattisgarh. One case focused on malnutrition and the other on gender-based violence. Data collection involved 17 in-depth interviews and 10 group interviews with the full range of stakeholders in both blocks, including community members and programme team. Thematic analysis was done using a broad conceptual framework that was further refined. Action on social determinants involved raising awareness on rights, mobilizing women’s collectives, revitalizing local political structures and social action targeting both the community and government service providers. Through these processes, the Mitanins developed identities as agents of change and advocates for the community, both with respect to local cultural and gender norms and in ensuring accountability of service providers. The factors underpinning successful action on social determinants were identified as the significance of the original intent and vision of the programme, and how this was carried through into all aspects of programme design, the role of the Mitanins and their identification with village women, ongoing training and support, and the relative autonomy of the programme. Although the results are not narrowly generalizable and do not necessarily represent the situation of the Mitanin Programme as a whole, the

  7. Utilizing Chair Massage to Address One Woman’s Health in Rural Ghana West Africa: a Case Report

    PubMed Central

    Meryanos, Cathy J.

    2016-01-01

    Background and Objectives There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women’s health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. Case Presentation The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30–50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. Results The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45–65 degrees in the right arm, as well as 10–15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. Discussion This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries. PMID:27974948

  8. Cognitive representations of breast cancer, emotional distress and preventive health behaviour: a theoretical perspective.

    PubMed

    Decruyenaere, M; Evers-Kiebooms, G; Welkenhuysen, M; Denayer, L; Claes, E

    2000-01-01

    Individuals at high risk for developing breast and/or ovarian cancer are faced with difficult decisions regarding genetic testing, cancer prevention and/or intensive surveillance. Large interindividual differences exist in the uptake of these health-related services. This paper is aimed at understanding and predicting how people emotionally and behaviourally react to information concerning genetic predisposition to breast/ovarian cancer. For this purpose, the self-regulation model of illness representations is elaborated. This model suggests that health-related behaviour is influenced by a person's cognitive and emotional representation of the health threat. These representations generate coping behaviour aimed at resolving the objective health problems (problem-focussed coping) and at reducing the emotional distress induced by the health threat (emotion-focussed coping). Based on theoretical considerations and empirical studies, four interrelated attributes of the cognitive illness representation of hereditary breast/ovarian cancer are described: causal beliefs concerning the disease, perceived severity, perceived susceptibility to the disease and perceived controllability. The paper also addresses the complex interactions between these cognitive attributes, emotional distress and preventive health behaviour.

  9. Addressing Burnout in Oncology: Why Cancer Care Clinicians Are At Risk, What Individuals Can Do, and How Organizations Can Respond.

    PubMed

    Hlubocky, Fay J; Back, Anthony L; Shanafelt, Tait D

    2016-01-01

    Despite their benevolent care of others, today, more than ever, the cancer care professional who experiences overwhelming feelings of exhaustion, cynicism, and inefficacy is in grave jeopardy of developing burnout. Clinicians are repeatedly physically and emotionally exposed to exceedingly long hours in direct care with seriously ill patients/families, limited autonomy over daily responsibilities, endless electronic documentation, and a shifting medical landscape. The physical and emotional well-being of the cancer care clinician is critical to the impact on quality care, patient satisfaction, and overall success of their organizations. The prevention of burnout as well as targeting established burnout need to be proactively addressed at the individual level and organizational level. In fact, confronting burnout and promoting wellness are the shared responsibility of both oncology clinicians and their organizations. From an individual perspective, oncology clinicians must be empowered to play a crucial role in enhancing their own wellness by identification of burnout symptoms in both themselves and their colleagues, learning resilience strategies (e.g., mindful self-compassion), and cultivating positive relationships with fellow clinician colleagues. At the organizational level, leadership must recognize the importance of oncology clinician well-being; engage leaders and physicians in collaborative action planning, improve overall practice environment, and provide institutional wellness resources to physicians. These effective individual and organizational interventions are crucial for the prevention and improvement of overall clinician wellness and must be widely and systematically integrated into oncology care.

  10. Roundtable discussion at the UICC World Cancer Congress: looking toward the realization of universal health coverage for cancer in Asia.

    PubMed

    Akaza, Hideyuki; Kawahara, Norie; Nozaki, Shinjiro; Sonoda, Shigeto; Fukuda, Takashi; Cazap, Eduardo; Trimble, Edward L; Roh, Jae Kyung; Hao, Xishan

    2015-01-01

    The Japan National Committee for the Union for International Cancer Control (UICC) and UICC-Asia Regional Office (ARO) organized a Roundtable Discussion as part of the official program of the UICC World Cancer Congress 2014 in Melbourne, Australia. The theme for the Roundtable Discussion was - Looking Toward the Realization of Universal Health Care (UHC) for Cancer in Asia - and it was held on December 5, 2014. The meeting was held based on the recognition that although each country may take a different path towards the realization of UHC, one point that is common to all is that cancer is projected to be the most difficult disease to address under the goals of UHC and that there is, therefore, an urgent and pressing need to come to a common understanding and awareness with regard to UHC concepts that are a priority component of a post-MDG development agenda. The presenters and participants addressed the issue of UHC for cancer in Asia from their various perspectives in academia and international organizations. Discussions covered the challenges to UHC in Asia, collaborative approaches by international organizations, the need for uniform and relevant data, ways to create an Asia Cancer Barometer that could be applied to all countries in Asia. The session concluded with the recognition that research on UHC in Asia should continue to be used as a tool for cancer cooperation in Asia and that the achievement of UHC would require research and input not only from the medical community, but from a broad sector of society in a multidisciplinary approach. Discussions on this issue will continue towards the Asia-Pacific Cancer Conference in Indonesia in August 2015.

  11. CANCER INCIDENCE IN THE AGRICULTURAL HEALTH STUDY

    EPA Science Inventory

    Despite low mortality and cancer incidence rates overall, farmers may experience excess risk of several cancers. These excesses have been observed in some, but not all, retrospective epidemiological studies of agricultural workers in several countries. Excess risk has been ob...

  12. Vitamin D, Breast Cancer, and Bone Health

    DTIC Science & Technology

    2011-05-01

    breast cancer subjects and those at high risk of breast cancer . Currently recommended vitamin D supplemental doses are only appropriate for patients...for those at high risk for breast cancer . Currently recommended doses of vitamin D are appropriate for subjects with normal vitamin D levels and for...sunscreen use, clothing , and increasing amount of time spent indoors or on transportation). Vitamin D and breast cancer prevention Vitamin D

  13. DEFINING THE “COMMUNITY” FOR A COMMUNITY-BASED PUBLIC HEALTH INTERVENTION ADDRESSING LATINO IMMIGRANT HEALTH DISPARITIES: AN APPLICATION OF ETHNOGRAPHIC METHODS

    PubMed Central

    Edberg, Mark; Cleary, Sean; Simmons, Lauren B.; Cubilla-Batista, Idalina; Andrade, Elizabeth L.; Gudger, Glencora

    2015-01-01

    Although Latino and other immigrant populations are the driving force behind population increases in the U.S., there are significant gaps in knowledge and practice on addressing health disparities in these populations. The Avance Center for the Advancement of Immigrant/Refugee Health, a health disparities research center in the Washington, DC area, includes as part of its mission a multi-level, participatory community intervention (called Adelante) to address the co-occurrence of substance abuse, violence and sex risk among Latino immigrant youth and young adults. Research staff and community partners knew that the intervention community had grown beyond its Census-designated place (CDP) boundaries, and that connection and attachment to community were relevant to an intervention. Thus, in order to understand current geographic and social boundaries of the community for sampling, data collection, intervention design and implementation, the research team conducted an ethnographic study to identify self-defined community boundaries, both geographic and social. Beginning with preliminary data from a pilot intervention and the original CDP map, the research included: geo-mapping de-identified addresses of service clients from a major community organization; key informant interviews; and observation and intercept interviews in the community. The results provided an expanded community boundary profile and important information about community identity. PMID:25892743

  14. Education and Training for Health Professionals

    Cancer.gov

    The Cancer Classroom Series is a collection of webinars that highlights topics that provide the educational content, tools, and resources necessary for health professionals, especially those working in public health, to address cancer as a public health problem.

  15. The impact of electronic health record usage on cancer registry systems in Alabama.

    PubMed

    Houser, Shannon H; Colquitt, Shannon; Clements, Kay; Hart-Hester, Susan

    2012-01-01

    As the use of information technology within the healthcare setting increases, the impact of bridging registry data with electronic health records (EHRs) must be addressed. Current EHR implementation may create benefits as well as challenges to cancer registries in areas such as policies and regulations, data quality, reporting, management, staffing, and training. The purpose of this study was to assess 1) the status of EHR usage in cancer registries, 2) the impact of EHR usage on cancer registries, and 3) the benefits and challenges of EHR usage for cancer registries in Alabama. The study method consisted of a voluntary survey provided to participants at the Alabama Cancer Registry Association 2009 annual conference. Forty-three respondents completed the survey. Data indicated that the major benefits of EHR use for the cancer registry included more complete treatment information available to clinicians and researchers, more time for retrieving and analyzing data for clinicians and researchers, and better tracking of patient follow-up. The major challenges included lack of adequate resources, lack of medical staff support, and changing data standards. The conclusion of the study indicates that understanding the impacts and challenges of EHR usage within cancer registries has implications for public health data management, data reporting, and policy issues.

  16. Gastric cancer research in Mexico: A public health priority

    PubMed Central

    Sampieri, Clara Luz; Mora, Mauricio

    2014-01-01

    This study aimed review studies conducted on Mexican patients diagnosed with gastric cancer and/or diseases associated with its development, in which at least one Mexican institute has participated, and to assess their contributions to the primary and secondary prevention of this disease. A search of the Medline database was conducted using the following keywords: gastric/stomach cancer, Mexico. Studies of the Mexican population were selected in which at least one Mexican Institute had participated and where the findings could support public policy proposals directed towards the primary or secondary prevention of gastric cancer. Of the 148 studies found in the Medline database, 100 were discarded and 48 were reviewed. According to the analysis presented, these studies were classified as: epidemiology of gastric cancer (5/48); risk factors and protectors relating to gastric cancer (9/48); relationship between Helicobacter pylori and pathologies associated with gastric cancer and the development of the disease (16/48); relationship between the Epstein-Barr virus and pathologies associated with gastric cancer and the development of the disease (3/48); molecular markers for the development of diseases associated with gastric cancer and gastric cancer (15/48). Mexico requires a program for the prevention and control of gastric cancer based on national health indicators. This should be produced by a multidisciplinary committee of experts who can propose actions that are relevant in the current national context. The few studies of gastric cancer conducted on the Mexican population in national institutes highlight the poor connection that currently exists between the scientific community and the health sector in terms of resolving this health issue. Public policies for health research should support projects with findings that can be translated into benefits for the population. This review serves to identify national research groups studying gastric cancer in the Mexican

  17. Gastric cancer research in Mexico: a public health priority.

    PubMed

    Sampieri, Clara Luz; Mora, Mauricio

    2014-04-28

    This study aimed review studies conducted on Mexican patients diagnosed with gastric cancer and/or diseases associated with its development, in which at least one Mexican institute has participated, and to assess their contributions to the primary and secondary prevention of this disease. A search of the Medline database was conducted using the following keywords: gastric/stomach cancer, Mexico. Studies of the Mexican population were selected in which at least one Mexican Institute had participated and where the findings could support public policy proposals directed towards the primary or secondary prevention of gastric cancer. Of the 148 studies found in the Medline database, 100 were discarded and 48 were reviewed. According to the analysis presented, these studies were classified as: epidemiology of gastric cancer (5/48); risk factors and protectors relating to gastric cancer (9/48); relationship between Helicobacter pylori and pathologies associated with gastric cancer and the development of the disease (16/48); relationship between the Epstein-Barr virus and pathologies associated with gastric cancer and the development of the disease (3/48); molecular markers for the development of diseases associated with gastric cancer and gastric cancer (15/48). Mexico requires a program for the prevention and control of gastric cancer based on national health indicators. This should be produced by a multidisciplinary committee of experts who can propose actions that are relevant in the current national context. The few studies of gastric cancer conducted on the Mexican population in national institutes highlight the poor connection that currently exists between the scientific community and the health sector in terms of resolving this health issue. Public policies for health research should support projects with findings that can be translated into benefits for the population. This review serves to identify national research groups studying gastric cancer in the Mexican

  18. Public Health Opportunities for Promoting Health Equity in Cancer Prevention and Control in LGBT Populations.

    PubMed

    Massetti, Greta M; Ragan, Kathleen R; Thomas, Cheryll C; Ryerson, A Blythe

    Advances in cancer prevention, detection, and treatment have led to reductions in morbidity and premature mortality and improvements in quality of life. However, not all Americans have benefitted equally from these advances, and certain populations experience continued disparities in cancer care. Although research and public health efforts have highlighted the experiences of some groups, other populations have been relatively understudied, such as lesbian, gay, bisexual, and transgender (LGBT) individuals. Public health efforts in surveillance, research, programs, and partnerships can provide opportunities to advance health equity for LGBT at the population level and lead to better health outcomes for LGBT individuals with cancer.

  19. Public Health Opportunities for Promoting Health Equity in Cancer Prevention and Control in LGBT Populations.

    PubMed

    Massetti, Greta M; Ragan, Kathleen R; Thomas, Cheryll C; Ryerson, A Blythe

    2015-10-20

    Advances in cancer prevention, detection, and treatment have led to reductions in morbidity and premature mortality and improvements in quality of life. However, not all Americans have benefitted equally from these advances, and certain populations experience continued disparities in cancer care. Although research and public health efforts have highlighted the experiences of some groups, other populations have been relatively understudied, such as lesbian, gay, bisexual, and transgender (LGBT) individuals. Public health efforts in surveillance, research, programs, and partnerships can provide opportunities to advance health equity for LGBT at the population level and lead to better health outcomes for LGBT individuals with cancer.

  20. Public Health Opportunities for Promoting Health Equity in Cancer Prevention and Control in LGBT Populations

    PubMed Central

    Massetti, Greta M.; Ragan, Kathleen R.; Thomas, Cheryll C.; Ryerson, A. Blythe

    2015-01-01

    Advances in cancer prevention, detection, and treatment have led to reductions in morbidity and premature mortality and improvements in quality of life. However, not all Americans have benefitted equally from these advances, and certain populations experience continued disparities in cancer care. Although research and public health efforts have highlighted the experiences of some groups, other populations have been relatively understudied, such as lesbian, gay, bisexual, and transgender (LGBT) individuals. Public health efforts in surveillance, research, programs, and partnerships can provide opportunities to advance health equity for LGBT at the population level and lead to better health outcomes for LGBT individuals with cancer. PMID:26566532

  1. Health promotion interventions and policies addressing excessive alcohol use: A systematic review of national and global evidence as a guide to health-care reform in China

    PubMed Central

    Li, Qing; Babor, Thomas F.; Zeigler, Donald; Xuan, Ziming; Morisky, Donald; Hovell, Melbourne F.; Nelson, Toben F.; Shen, Weixing; Li, Bing

    2014-01-01

    Aims Steady increases in alcohol consumption and related problems are likely to accompany China's rapid epidemiologic transition and profit-based marketing activities. We reviewed research on health promotion interventions and policies to address excessive drinking and to guide health-care reform. Methods We searched in Chinese and English language databases and included 21 studies in China published between 1980 and 2013 that covered each policy area from the WHO Global Strategy to Reduce the Harmful Use of Alcohol. We evaluated and compared preventive interventions to the global alcohol literature for cross-national applicability. Results In contrast with hundreds of studies in the global literature, 11 of 12 studies from mainland China were published in Chinese; six of ten in English were on taxation from Taiwan or Hong Kong. Most studies demonstrated effectiveness in reducing excessive drinking, and some reported the reduction of health problems. Seven were randomized controlled trials. Studies targeted schools, drink-driving, workplaces, the health sector, and taxation. Conclusions China is the world's largest alcohol market, yet there has been little growth in alcohol policy research related to health promotion interventions over the past decade. Guided by a public health approach, the WHO Global Strategy, and health reform experience in Russia, Australia, Mexico, and the USA, China could improve its public health response through better coordination and implementation of surveillance and evidence-based research, and through programmatic and legal responses such as public health law research, screening and early intervention within health systems, and the implementation of effective alcohol control strategies. PMID:25533866

  2. Addressing gender inequalities to improve the sexual and reproductive health and wellbeing of women living with HIV

    PubMed Central

    Amin, Avni

    2015-01-01

    Introduction Globally, women constitute 50% of all persons living with HIV. Gender inequalities are a key driver of women's vulnerabilities to HIV. This paper looks at how these structural factors shape specific behaviours and outcomes related to the sexual and reproductive health of women living with HIV. Discussion There are several pathways by which gender inequalities shape the sexual and reproductive health and wellbeing of women living with HIV. First, gender norms that privilege men's control over women and violence against women inhibit women's ability to practice safer sex, make reproductive decisions based on their own fertility preferences and disclose their HIV status. Second, women's lack of property and inheritance rights and limited access to formal employment makes them disproportionately vulnerable to food insecurity and its consequences. This includes compromising their adherence to antiretroviral therapy and increasing their vulnerability to transactional sex. Third, with respect to stigma and discrimination, women are more likely to be blamed for bringing HIV into the family, as they are often tested before men. In several settings, healthcare providers violate the reproductive rights of women living with HIV in relation to family planning and in denying them care. Lastly, a number of countries have laws that criminalize HIV transmission, which specifically impact women living with HIV who may be reluctant to disclose because of fears of violence and other negative consequences. Conclusions Addressing gender inequalities is central to improving the sexual and reproductive health outcomes and more broadly the wellbeing of women living with HIV. Programmes that go beyond a narrow biomedical/clinical approach and address the social and structural context of women's lives can also maximize the benefits of HIV prevention, treatment, care and support. PMID:26643464

  3. PESTICIDES AND LUNG CANCER RISK IN THE AGRICULTURAL HEALTH STUDY

    EPA Science Inventory

    We examined the relationship between 50 widely used agricultural pesticides and lung cancer incidence in the Agricultural Health Study, a prospective cohort study of 57,284 pesticide applicators, and 32,333 spouses of farmer applicators with no prior history of lung cancer. Self...

  4. Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial

    PubMed Central

    Wall, Martin; Hayes, Richard; Moore, Derek; Petticrew, Mark; Clow, Angela; Schmidt, Elena; Draper, Alizon; Lock, Karen; Lynch, Rebecca; Renton, Adrian

    2009-01-01

    organisational levels targeted by the intervention, and secondly, a degree of flexibility or tailoring of the intervention, makes this trial potentially very useful in providing evidence of the types of activities that can be used to address chronic health problems in communities suffering from multiple deprivation. Trial Registration Current Controlled Trials ISRCTN68175121 PMID:19558712

  5. Association between School District Policies That Address Chronic Health Conditions of Students and Professional Development for School Nurses on Such Policies

    ERIC Educational Resources Information Center

    Jones, S. Everett; Brener, Nancy D.; Bergren, Martha Dewey

    2015-01-01

    Supportive school policies and well-prepared school nurses can best address the needs of students with chronic health conditions. We analyzed nationally representative data from the 2012 School Health Policies and Practices Study to examine whether districts with policies requiring that schools provide health services to students with chronic…

  6. Working with Local, State and Federal Partners to Address Health Education Needs of Hurricane Katrina Evacuees in Houston: A CDC Case Study

    ERIC Educational Resources Information Center

    Hoover, D. Michele; Dopson, Stephanie; Drehobl, Patricia

    2010-01-01

    For health educators to successfully meet the challenges of responding to public health emergencies, it is important to establish and understand the role of collaborations with local, state and federal partners in identifying potential public health issues and to develop theory-based models or strategies to address these issues before, during and…

  7. Network of communities in the fight against AIDS: local actions to address health inequities and promote health in Rio de Janeiro, Brazil.

    PubMed

    Edmundo, Kátia; Guimarães, Wanda; Vasconcelos, Maria do Socorro; Baptista, Ana Paula; Becker, Daniel

    2005-01-01

    When combined with major social inequities, the AIDS epidemic in Brazil becomes much more complex and requires effective and participatory community-based interventions. This article describes the experience of a civil society organisation, the Centre for Health Promotion (CEDAPS), in the slum communities (favelas) of Rio de Janeiro, Brazil. Using a community-based participatory approach, 55 community organisations were mobilised to develop local actions to address the increasing social vulnerability to HIV/AIDS of people living in squatter communities. This was done through on-going prevention initiatives based on the local culture and developed by a Network of Communities. The community movement has created a sense of "ownership" of social actions. The fight against AIDS has been a mobilising factor in engaging and organising communities and has contributed to raising awareness of health rights. Local actions included targeting the determinants of local vulnerability, as suggested by health promotion workers.

  8. Improving women's health during internatal periods: developing an evidenced-based approach to addressing maternal depression in pediatric settings.

    PubMed

    Feinberg, Emily; Smith, Megan V; Morales, Melody Johnson; Claussen, Angelika H; Smith, D Camille; Perou, Ruth

    2006-01-01

    The internatal period, the time between births of successive children, has become a focal point for risk assessment and health promotion in women's healthcare. This period represents a time when women are at high risk for a depressive disorder. The pediatric venue offers a unique opportunity for the identification and management of depression in the internatal period, as mothers who do not attend their own medical appointments are likely to accompany their child to pediatric visits. This paper discusses the role pediatric providers can undertake to improve women's health in the internatal period through the detection and management of maternal depression at well-child visits. Successful models of the management of depression in other primary care settings are explored for their potential for implementation in the pediatric venue. A specific model developed and implemented as part of a 3-year project is presented to highlight the feasibility of an evidenced-based approach to the management of maternal depression in the pediatric setting. We present evidence demonstrating that pediatric providers can successfully identify postpartum women with depression, monitor symptoms and treatment adherence, and communicate results to a woman's healthcare provider. Yet more investigation is needed to create preventive interventions for maternal depression that integrate evidenced-based practice standards for the treatment of depression in primary care venues into pediatric settings. Future programs and policies targeting maternal depression in the pediatric environment should address patient mental health literacy and stigma, the training and education of pediatric providers, and issues of privacy and reimbursement.

  9. Improving the implementation of an early literacy program by child health nurses through addressing local training and cultural needs.

    PubMed

    Hewer, Lee-anne; Whyatt, David

    2006-10-01

    This study evaluates the implementation of an early literacy program by child health nurses (CHNs) in Geraldton and the Midwest regions of Western Australia. Children's early preschool exposure to reading is an important step in developing literacy skills in later schooling. The program aims to improve early literacy development by supplying parents with an appropriate book and information on reading to children at the child's seven-to-nine months of age health check. This study highlights the potential role of CHNs in encouraging early literacy in regional communities. However, a barrier to the successful implementation of the program was found to be its dependence on attendance at a predetermined health check. This was especially so for the Aboriginal population, which had a significantly lower attendance rate. Dependence on personal and professional experience amongst CHNs also resulted in sub-optimal implementation of the program. Recommendations to broaden the scope of the intervention, in timing and location, and to develop appropriate training for CHNs are discussed. It is shown that the implementation of such evidence-based programs must address local community and service provider issues to reach their full potential.

  10. The National Breast and Cervical Cancer Early Detection Program in the era of health reform: a vision forward.

    PubMed

    Plescia, Marcus; Wong, Faye; Pieters, Jennifer; Joseph, Djenaba

    2014-08-15

    For the last 22 years, the Centers for Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) has provided high quality breast and cervical cancer screening to women who do not have health insurance or who have inadequate insurance. As the health care landscape changes, it is time for CDC to address new identified needs and opportunities to increase cancer screening and to further explore new or expanded roles for the program looking to the future. The NBCCEDP is well positioned to build upon its experience, established clinical and community partnerships, and success in serving disadvantaged and diverse populations to address important barriers to cancer screening that will persist as health reform is implemented. Additionally, the program can adapt its extensive experience with establishing and managing an organized system of delivering cancer screening and apply it to promote a more organized approach to screening through health care systems on a population level. Emphasis is placed on the implementation of evidenced-based interventions proven effective in increasing cancer screening rates, promising practices and other organizational policy and health systems interventions.

  11. Health reforms as examples of multilevel interventions in cancer care.

    PubMed

    Flood, Ann B; Fennell, Mary L; Devers, Kelly J

    2012-05-01

    To increase access and improve system quality and efficiency, President Obama signed the Patient Protection and Affordable Care Act with sweeping changes to the nation's health-care system. Although not intended to be specific to cancer, the act's implementation will profoundly impact cancer care. Its components will influence multiple levels of the health-care environment including states, communities, health-care organizations, and individuals seeking care. To illustrate these influences, two reforms are considered: 1) accountable care organizations and 2) insurance-based reforms to gather evidence about effectiveness. We discuss these reforms using three facets of multilevel interventions: 1) their intended and unintended consequences, 2) the importance of timing, and 3) their implications for cancer. The success of complex health reforms requires understanding the scientific basis and evidence for carrying out such multilevel interventions. Conversely and equally important, successful implementation of multilevel interventions depends on understanding the political setting and goals of health-care reform.

  12. Health Reforms as Examples of Multilevel Interventions in Cancer Care

    PubMed Central

    Fennell, Mary L.; Devers, Kelly J.

    2012-01-01

    To increase access and improve system quality and efficiency, President Obama signed the Patient Protection and Affordable Care Act with sweeping changes to the nation’s health-care system. Although not intended to be specific to cancer, the act's implementation will profoundly impact cancer care. Its components will influence multiple levels of the health-care environment including states, communities, health-care organizations, and individuals seeking care. To illustrate these influences, two reforms are considered: 1) accountable care organizations and 2) insurance-based reforms to gather evidence about effectiveness. We discuss these reforms using three facets of multilevel interventions: 1) their intended and unintended consequences, 2) the importance of timing, and 3) their implications for cancer. The success of complex health reforms requires understanding the scientific basis and evidence for carrying out such multilevel interventions. Conversely and equally important, successful implementation of multilevel interventions depends on understanding the political setting and goals of health-care reform. PMID:22623600

  13. Cancer Outcomes in Hispanics/Latinos in the United States: An Integrative Review and Conceptual Model of Determinants of Health

    PubMed Central

    Yanez, Betina; McGinty, Heather L.; Buitrago, Diana; Ramirez, Amelie G.; Penedo, Frank J.

    2015-01-01

    Cancer is the leading cause of death among Hispanics. Compared to non-Hispanic Whites, Hispanics are more likely to be diagnosed with advanced stages of disease and experience poor quality of life following a cancer diagnosis. Cancer outcomes are influenced by a confluence of social, cultural, behavioral and biological factors. Yet, much of the behavioral and psychosocial research in oncology has focused on non-Hispanic Whites, thus limiting our understanding of the potential web of factors that can influence cancer-related outcomes among Hispanics. Furthermore, features of Hispanic ethnicity and culture may influence and interact with, social, psychosocial, health care, disease-specific, and medical factors known to influence cancer-related outcomes, yet very few studies have integrated Hispanic cultural processes when addressing cancer-related outcomes for this ethnic group. Guided by the extant literature in oncology, Hispanic culture and health, and previously established models of determinants of minority health, we present a conceptual model that highlights the interplay of social, cultural, psychosocial, disease-specific, health care, and medical factors as determinants of cancer outcomes (morbidity, mortality, quality of life) and review key evidence of how features of Hispanic culture may influence cancer outcomes and contribute to the disparate outcomes observed in Hispanic cancer samples relative to non-Hispanic Whites. Finally, we conclude with a discussion of future research opportunities and existing challenges to researching oncology outcomes among Hispanics. PMID:27429867

  14. Cancer perceptions of South African mothers and daughters: implications for health promotion programs.

    PubMed

    Mosavel, Maghboeba; Simon, Christian; Ahmed, Rashid

    2010-09-01

    Cancer is one of the leading causes of death worldwide. A major reason why women do not obtain cancer screening procedures relates to the high levels of fear associated with cancer. In this study, we explored South African mothers' and daughters' reaction to the word "cancer" specifically. The study sample included 157 randomly selected mother and adolescent daughter pairs from an urban community in Cape Town, South Africa. Mothers and their adolescent daughters had very similar responses to the term "cancer." We found that most South African mothers and daughters had a fear-based attitude toward the illness. When we asked mothers what they immediately thought of upon hearing "cancer," a majority of women (69%) thought of death, and another 43% thought of suffering and the detrimental consequences of the illness. Similarly, 50% of the daughters also thought of death, and 42% thought of the detrimental aspects of cancer. Fatalistic attitudes and negative emotional reactions have important implications in cancer prevention and need to be addressed within a public health context.

  15. Close to community health providers post 2015: Realising their role in responsive health systems and addressing gendered social determinants of health

    PubMed Central

    2015-01-01

    Universal health coverage is gaining momentum and is likely to form a core part of the post Millennium Development Goal (MDG) agenda and be linked to social determinants of health, including gender; Close to community health providers are arguably key players in meeting the goal of universal health coverage through extending and delivering health services to poor and marginalised groups; Close to community health providers are embedded in communities and may therefore be strategically placed to understand intra household gender and power dynamics and how social determinants shape health and well-being. However, the opportunities to develop critical awareness and to translate this knowledge into health system and multi-sectoral action are poorly understood; Enabling close to community health providers to realise their potential requires health systems support and human resource management at multiple levels. PMID:28281706

  16. Increasing value: a research agenda for addressing the managerial and organizational challenges facing health care delivery in the United States.

    PubMed

    Shortell, Stephen M

    2004-09-01

    There is growing consensus that the U.S. health care system is not producing value relative to the resources invested. Unwarranted variation exists in quality and outcomes of care and underutilization of both evidence-based medicine and evidence-management practices. To address these issues, this article calls for a broad-based social science approach focused on obtaining a greater understanding of change at the individual, group, organizational, and environmental levels as they influence each other. Specific examples and questions for research are suggested with regard to the redesign of care systems, enhancing learning and transferring knowledge, and creating effective financial incentives. The specific measurement, analysis, and study design issues involved in under-taking such a research agenda are discussed.

  17. Primary Health Care and Cervical Cancer Mortality Rates in Brazil

    PubMed Central

    Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Thomaz, Erika Bárbara Abreu Fonseca; Queiroz, Rejane Christine de Sousa; de Souza, Marta Rovery; Lein, Adriana; Alvares, Viviane; de Almeida, Dante Grapiuna; Barbosa, Allan Claudius Queiroz; Thumé, Elaine; Staton, Catherine; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

    2017-01-01

    Cervical cancer is a common neoplasm that is responsible for nearly 230 000 deaths annually in Brazil. Despite this burden, cervical cancer is considered preventable with appropriate care. We conducted a longitudinal ecological study from 2002 to 2012 to examine the relationship between the delivery of preventive primary care and cervical cancer mortality rates in Brazil. Brazilian states and the federal district were the unit of analysis (N = 27). Results suggest that primary health care has contributed to reducing cervical cancer mortality rates in Brazil; however, the full potential of preventive care has yet to be realized. PMID:28252500

  18. Reducing Refugee Mental Health Disparities: A Community-Based Intervention to Address Post-Migration Stressors With African Adults

    PubMed Central

    Goodkind, Jessica R.; Hess, Julia M.; Isakson, Brian; LaNoue, Marianna; Githinji, Ann; Roche, Natalie; Vadnais, Kathryn; Parker, Danielle P.

    2014-01-01

    Refugees resettled in the United States have disproportionately high rates of psychological distress. Research has demonstrated the roles of post-migration stressors, including lack of meaningful social roles, poverty, unemployment, lack of environmental mastery, discrimination, limited English proficiency, and social isolation. We report a multi-method, within-group longitudinal pilot study involving the adaptation for African refugees of a community-based advocacy and learning intervention to address post-migration stressors. We found the intervention to be feasible, acceptable and appropriate for African refugees. Growth trajectory analysis revealed significant decreases in participants’ psychological distress and increases in quality of life, and also provided preliminary evidence of intervention mechanisms of change through the detection of mediating relationships whereby increased quality of life was mediated by increases in enculturation, English proficiency, and social support. Qualitative data helped to support and explain the quantitative data. Results demonstrate the importance of addressing the sociopolitical context of resettlement to promote the mental health of refugees and suggest a culturally-appropriate, and replicable model for doing so. PMID:24364594

  19. Reducing refugee mental health disparities: a community-based intervention to address postmigration stressors with African adults.

    PubMed

    Goodkind, Jessica R; Hess, Julia M; Isakson, Brian; LaNoue, Marianna; Githinji, Ann; Roche, Natalie; Vadnais, Kathryn; Parker, Danielle P

    2014-08-01

    Refugees resettled in the United States have disproportionately high rates of psychological distress. Research has demonstrated the roles of postmigration stressors, including lack of meaningful social roles, poverty, unemployment, lack of environmental mastery, discrimination, limited English proficiency, and social isolation. We report a multimethod, within-group longitudinal pilot study involving the adaptation for African refugees of a community-based advocacy and learning intervention to address postmigration stressors. We found the intervention to be feasible, acceptable, and appropriate for African refugees. Growth trajectory analysis revealed significant decreases in participants' psychological distress and increases in quality of life, and also provided preliminary evidence of intervention mechanisms of change through the detection of mediating relationships whereby increased quality of life was mediated by increases in enculturation, English proficiency, and social support. Qualitative data helped to support and explain the quantitative data. Results demonstrate the importance of addressing the sociopolitical context of resettlement to promote the mental health of refugees and suggest a culturally appropriate, and replicable model for doing so.

  20. DETERMINING THE "MARGIN OF INCREMENTAL EXPOSURE": AN APPROACH TO ASSESSING NON-CANCER HEALTH EFFECTS OF DIOXINS

    EPA Science Inventory

    U.S. Environmental Protection Agency (EPA) guidance issued in April 1994 for performing screening level risk analyses of emissions from facilities that burn hazardous waste does not address the evaluation of non-cancer health effects from dioxin emissions. Historically, EPA has ...

  1. Health Insurance for Cancer Care in Asia: Thailand

    PubMed Central

    Pittayapan, Pongpak

    2016-01-01

    Thailand has a universal multi-payer system with two main types of health insurance: National Health Security Office or public health insurance and private insurance. National health insurance is designed for people who are not eligible to be members of any employment-based health insurance program. Although private health insurance is also available, all Thai citizens are required to be enrolled in either national health insurance or employees’ health insurance. There are many differences between the public health insurance and private insurance. Public health insurance, therefore, initiates programs that offer many sets of benefit packages for high-cost care. For cancer care, cover screening, curative treatment such as surgery, chemotherapy, radiation together with supportive and palliative care. PMID:27981139

  2. Employing the church as a marketer of cancer prevention: a look at a health promotion project aimed to reduce colorectal cancer among African Americans in the Midwest.

    PubMed

    Lumpkins, Crystal Y; Coffey, Candice R; Daley, Christine M; Greiner, K Allen

    2013-01-01

    Health promotion programs designed to address colorectal cancer disparities among African Americans are increasing. Unfortunately, this group still shoulders a disproportionate mortality burden in the United States; these numbers are also reflective of colorectal cancer (CRC) disparities in the Midwest. The purpose of this study was to extrapolate results from in-depth interviews and brief surveys on the effectiveness of the church as a social marketer of CRC-prevention messages. Results show that pastors believe the congregation has limited knowledge about CRC risk and prevention; they also believe the church can improve cancer-prevention communication among members and those affiliated with the church.

  3. Using the World Health Organization's 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings

    PubMed Central

    2011-01-01

    Background Most adolescents live in resource-constrained countries and their mental health has been less well recognised than other aspects of their health. The World Health Organization's 4-S Framework provides a structure for national initiatives to improve adolescent health through: gathering and using strategic information; developing evidence-informed policies; scaling up provision and use of health services; and strengthening linkages with other government sectors. The aim of this paper is to discuss how the findings of a recent systematic review of mental health problems in adolescents in resource-constrained settings might be applied using the 4-S Framework. Method Analysis of the implications of the findings of a systematic search of the English-language literature for national strategies, policies, services and cross-sectoral linkages to improve the mental health of adolescents in resource-constrained settings. Results Data are available for only 33/112 [29%] resource-constrained countries, but in all where data are available, non-psychotic mental health problems in adolescents are identifiable, prevalent and associated with reduced quality of life, impaired participation and compromised development. In the absence of evidence about effective interventions in these settings expert opinion is that a broad public policy response which addresses direct strategies for prevention, early intervention and treatment; health service and health workforce requirements; social inclusion of marginalised groups of adolescents; and specific education is required. Specific endorsed strategies include public education, parent education, training for teachers and primary healthcare workers, psycho-educational curricula, identification through periodic screening of the most vulnerable and referral for care, and the availability of counsellors or other identified trained staff members in schools from whom adolescents can seek assistance for personal, peer and family

  4. Global health from a cancer care perspective.

    PubMed

    Pesec, Madeline; Sherertz, Tracy

    2015-01-01

    Cancer is now recognized as one of the four leading causes of morbidity and mortality worldwide, and incidence is expected to rise significantly in the next two decades. Unfortunately, low- and middle-income countries (LMIC) suffer disproportionately from the world's cancer cases. The growing burden of cancer and maldistribution of cancer care resources in LMIC warrant a massive re-evaluation of the structural inequalities that produce global oncological disparities and a worldwide commitment to improve both prevention and treatment strategies. Efforts to improve cancer care capacity should focus on horizontal strengthening of healthcare systems that provide safe, affordable, effective and sustainable care. In response to current deficiencies, many international organizations have started to partner with LMIC to create solutions. Telemedicine and international collaboration are also promising ways to effect change and improve global oncological care.

  5. Innovative patient-centered skills training addressing challenging issues in cancer communications: Using patient's stories that teach.

    PubMed

    Bishop, Thomas W; Gorniewicz, James; Floyd, Michael; Tudiver, Fred; Odom, Amy; Zoppi, Kathy

    2016-05-01

    This workshop demonstrated the utility of a patient-centered web-based/digital Breaking Bad News communication training module designed to educate learners of various levels and disciplines. This training module is designed for independent, self-directed learning as well as group instruction. These interactive educational interventions are based upon video-recorded patient stories. Curriculum development was the result of an interdisciplinary, collaborative effort involving faculty from the East Tennessee State University (ETSU) Graduate Storytelling Program and the departments of Family and Internal Medicine at the James H. Quillen College of Medicine. The specific goals of the BBN training module are to assist learners in: (1) understanding a five-step patient-centered model that is based upon needs, preferences, and expectations of patients with cancer and (2) individualizing communication that is consistent with patient preferences in discussing emotions, informational detail, prognosis and timeline, and whether or not to discuss end-of-life issues. The pedagogical approach to the training module is to cycle through Emotional Engagement, Data, Modeled Practices, Adaptation Opportunities, and Feedback. The communication skills addressed are rooted in concepts found within the Reaching Common Ground communication training. A randomized control study investigating the effectiveness of the Breaking Bad News module found that medical students as well as resident physicians improved their communication skills as measured by an Objective Structured Clinical Examination. Four other similarly designed modules were also created: Living Through Treatment, Transitions: From Curable to Treatable/From Treatable to End-of-Life, Spirituality, and Family.

  6. Impact of breast cancer recurrence and cancer-specific stress on spouse health and immune function.

    PubMed

    Gregorio, Sharla Wells-Di; Carpenter, Kristen M; Dorfman, Caroline S; Yang, Hae-Chung; Simonelli, Laura E; Carson, William E

    2012-02-01

    Spouses of cancer patients are at-risk for poor psychological and physical health as they cope with the complex nature of the disease and fears of losing their partner. Moreover, spouses often serve as patients' primary informal caregivers, a group that evidences poor outcomes across a variety of domains. The present study examines the relative contributions of cancer recurrence - a cancer-specific stressful event - and the subjective experience of cancer-specific stress (IES) in a sample of male spouses of breast cancer survivors. We hypothesized that stress would contribute to poorer physical health and compromised immune function. Spouses (recurrence; n=16) of patients who were coping with their first recurrence were matched to spouses of patients with no evidence of disease (disease-free; n=16). Self-reported physical health (physical symptoms and fatigue) and immune function [T-cell blastogenic response to the mitogens Concanavalin A (ConA) and phytohemagglutanin (PHA) and T3 monoclonal antibody (T3 Mab)] were included as outcomes. Results indicated that patient recurrence status was not a significant unique predictor of physical health or immune function; rather, among all spouses, cancer-specific stress symptoms were associated with increased physical symptoms and altered T-cell blastogenesis. These data suggest that the health implications of caregiving for spouses of cancer survivors is more strongly linked to their subjective experience of cancer as stressful, rather than simply the patients' disease status.

  7. The American Cancer Society and the American Health Care System.

    PubMed

    Brawley, Otis W

    2011-01-01

    The U.S. health care system is in critical condition. Costs are rising to the point that the high price of health care is a threat to the U.S. economy. In 2010, health care was more than 17% of the gross domestic product, and if it continues to rise at current rates, health care will become more than 25% of the overall U.S. economy. This growth rate is not sustainable. While U.S. per capita costs are the highest of any country worldwide, quality is varied. Indeed, American health care outcomes for cancer and other diseases are inferior to several European countries with far lower per capita costs. The truth is many Americans cannot afford adequate health care, and health care is rationed in the U.S. While many do not get the health care they need, some are actually harmed by overconsumption of unnecessary health care. These Americans are treated outside of established guidelines and get unnecessary procedures and take unnecessary medications. A substantial number of Americans are supportive of health care reform with the goal of getting needed, high-quality health care to those Americans who currently do not get it. The American Cancer Society is committed to using the established scientific methods of epidemiology to define the problems and identify possible solutions. We are committed proponents of the rational, evidence-based use of health care to avoid the wasteful and inefficient rationing of health care.

  8. Is food allergen analysis flawed? Health and supply chain risks and a proposed framework to address urgent analytical needs.

    PubMed

    Walker, M J; Burns, D T; Elliott, C T; Gowland, M H; Mills, E N Clare

    2016-01-07

    above recommendations from food authorities, business organisations and National Measurement Institutes is important; however transparent international coordination is essential. Thus our recommendations are primarily addressed to the European Commission, the Health and Food Safety Directorate, DG Santé. A global multidisciplinary consortium is required to provide a curated suite of data including genomic and proteomic data on key allergenic food sources, made publically available on line.

  9. Salud Para Su Corazon (health for your heart) community health worker model: community and clinical approaches for addressing cardiovascular disease risk reduction in Hispanics/Latinos.

    PubMed

    Balcazar, H; Alvarado, M; Ortiz, G

    2011-01-01

    This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy.

  10. mHealth Education Applications Along the Cancer Continuum.

    PubMed

    Davis, Sharon Watkins; Oakley-Girvan, Ingrid

    2015-06-01

    The majority of adults worldwide own a mobile phone, including those in under-resourced communities. Mobile health (mhealth) education technologies present a promising mechanism for improving cancer prevention, treatment, and follow-up. The purpose of this study was to summarize the literature related to mobile phone (mhealth) applications for patient education specific to cancer and identify current recommendations from randomized studies. In particular, we were interested in identifying mobile phone applications along the cancer continuum, from cancer prevention to survivorship. The authors identified 28 articles reporting on mobile applications for patients related to cancer. Articles were identified in all categories along the cancer continuum, including health professional involvement in application development. Of these, six involved direct patient education, and eight focused on improving patient/professional communication and patient self-management. However, only six of the studies were randomized interventions. The potential for mobile applications to help overcome the "health care gap" has not yet been realized in the studies from the USA that were reviewed for this paper. However, early recommendations are emerging that support the use of mHealth communications to change behaviors for cancer prevention, early detection, and symptom management and improved patient-provider communication. Recommendations include short messages, use of multiple modalities as patient characteristics dictate comfort with mHealth communication, and the inclusion of patients and health professionals to develop and test applications. Tailoring mHealth to particular cultures, languages, and ethnic groups may also represent a unique possibility to provide accessible information and education at minimal cost for under-resourced communities and individuals.

  11. Developing cognitive behaviour therapy training in India: Using the Kolb learning cycle to address challenges in applying transcultural models of mental health and mental health training.

    PubMed

    Beck, Andrew; Virudhagirinathan, B S; Santosham, Sangita; Begum, Faiz Jahan

    2014-10-01

    Although mental health workers in India across all major professional groups have identified an unmet need for training in cognitive behaviour therapy (CBT), the uncritical export of models of mental health, therapy provision and training to low- and middle-income countries is a problematic process. This paper describes the context for the first stand-alone CBT training programme in India, based in Chennai. This paper includes an evaluation of the first phase of the training and information from trainees regarding the quality and applicability of the training to their working context. The paper provides an overview of some of the critiques that are pertinent to this process and considers the way that the Kolb learning cycle can be used as a framework within training to go some way to addressing these difficulties.

  12. Cancer among circumpolar populations: an emerging public health concern

    PubMed Central

    Young, T. Kue; Kelly, Janet J.; Friborg, Jeppe; Soininen, Leena; Wong, Kai O.

    2016-01-01

    Objectives To determine and compare the incidence of cancer among the 8 Arctic States and their northern regions, with special focus on 3 cross-national indigenous groups – Inuit, Athabaskan Indians and Sami. Methods Data were extracted from national and regional statistical agencies and cancer registries, with direct age-standardization of rates to the world standard population. For comparison, the “world average” rates as reported in the GLOBOCAN database were used. Findings Age-standardized incidence rates by cancer sites were computed for the 8 Arctic States and 20 of their northern regions, averaged over the decade 2000–2009. Cancer of the lung and colon/rectum in both sexes are the commonest in most populations. We combined the Inuit from Alaska, Northwest Territories, Nunavut and Greenland into a “Circumpolar Inuit” group and tracked cancer trends over four 5-year periods from 1989 to 2008. There has been marked increase in lung, colorectal and female breast cancers, while cervical cancer has declined. Compared to the GLOBOCAN world average, Inuit are at extreme high risk for lung and colorectal cancer, and also certain rare cancers such as nasopharyngeal cancer. Athabaskans (from Alaska and Northwest Territories) share some similarities with the Inuit but they are at higher risk for prostate and breast cancer relative to the world average. Among the Sami, published data from 3 cohorts in Norway, Sweden and Finland show generally lower risk of cancer than non-Sami. Conclusions Cancer among certain indigenous people in the Arctic is an increasing public health concern, especially lung and colorectal cancer. PMID:26765259

  13. Cancer among circumpolar populations: an emerging public health concern.

    PubMed

    Young, T Kue; Kelly, Janet J; Friborg, Jeppe; Soininen, Leena; Wong, Kai O

    2016-01-01

    Objectives To determine and compare the incidence of cancer among the 8 Arctic States and their northern regions, with special focus on 3 cross-national indigenous groups - Inuit, Athabaskan Indians and Sami. Methods Data were extracted from national and regional statistical agencies and cancer registries, with direct age-standardization of rates to the world standard population. For comparison, the "world average" rates as reported in the GLOBOCAN database were used. Findings Age-standardized incidence rates by cancer sites were computed for the 8 Arctic States and 20 of their northern regions, averaged over the decade 2000-2009. Cancer of the lung and colon/rectum in both sexes are the commonest in most populations. We combined the Inuit from Alaska, Northwest Territories, Nunavut and Greenland into a "Circumpolar Inuit" group and tracked cancer trends over four 5-year periods from 1989 to 2008. There has been marked increase in lung, colorectal and female breast cancers, while cervical cancer has declined. Compared to the GLOBOCAN world average, Inuit are at extreme high risk for lung and colorectal cancer, and also certain rare cancers such as nasopharyngeal cancer. Athabaskans (from Alaska and Northwest Territories) share some similarities with the Inuit but they are at higher risk for prostate and breast cancer relative to the world average. Among the Sami, published data from 3 cohorts in Norway, Sweden and Finland show generally lower risk of cancer than non-Sami. Conclusions Cancer among certain indigenous people in the Arctic is an increasing public health concern, especially lung and colorectal cancer.

  14. Strengthening the Paediatricians Project 2: The effectiveness of a workshop to address the Priority Mental Health Disorders of adolescence in low-health related human resource countries

    PubMed Central

    2010-01-01

    Background Paediatricians can be empowered to address the Priority Mental Health Disorders at primary care level. To evaluate the effectiveness of a collaborative workshop in enhancing the adolescent psychiatry knowledge among paediatricians. Methods A 3-day, 27-hours workshop was held for paediatricians from different regions of India under the auspices of the National Adolescent Paediatric Task Force of the Indian Academy of Paediatrics. A 5-item pretest-posttest questionnaire was developed and administered at the beginning and end of the workshop to evaluate the participants' knowledge acquisition in adolescent psychiatry. Bivariate and multivariate analyses were performed on an intention-to-participate basis. Results Forty-eight paediatricians completed the questionnaire. There was significant enhancement of the knowledge in understanding the phenomenology, identifying the psychopathology, diagnosing common mental disorder and selecting the psychotropic medication in the bivariate analysis. When the possible confounders of level of training in paediatrics and number of years spent as paediatrician were controlled, in addition to the above areas of adolescent psychiatry, the diagnostic ability involving multiple psychological concepts also gained significance. However, both in the bivariate and multivariate analyses, the ability to refer to appropriate psychotherapy remained unchanged after the workshop. Conclusions This workshop was effective in enhancing the adolescent psychiatry knowledge of paediatricians. Such workshops could strengthen paediatricians in addressing the priority mental health disorders at the primary-care level in countries with low-human resource for health as advocated by the World Health Organization. However, it remains to be seen if this acquisition of adolescent psychiatry knowledge results in enhancing their adolescent psychiatry practice. PMID:20167069

  15. Development of a conceptual model of cancer caregiver health literacy.

    PubMed

    Yuen, E Y N; Dodson, S; Batterham, R W; Knight, T; Chirgwin, J; Livingston, P M

    2016-03-01

    Caregivers play a vital role in caring for people diagnosed with cancer. However, little is understood about caregivers' capacity to find, understand, appraise and use information to improve health outcomes. The study aimed to develop a conceptual model that describes the elements of cancer caregiver health literacy. Six concept mapping workshops were conducted with 13 caregivers, 13 people with cancer and 11 healthcare providers/policymakers. An iterative, mixed methods approach was used to analyse and synthesise workshop data and to generate the conceptual model. Six major themes and 17 subthemes were identified from 279 statements generated by participants during concept mapping workshops. Major themes included: access to information, understanding of information, relationship with healthcare providers, relationship with the care recipient, managing challenges of caregiving and support systems. The study extends conceptualisations of health literacy by identifying factors specific to caregiving within the cancer context. The findings demonstrate that caregiver health literacy is multidimensional, includes a broad range of individual and interpersonal elements, and is influenced by broader healthcare system and community factors. These results provide guidance for the development of: caregiver health literacy measurement tools; strategies for improving health service delivery, and; interventions to improve caregiver health literacy.

  16. Vitamin D, Breast Cancer and Bone Health

    DTIC Science & Technology

    2009-10-14

    The epidemiology component focuses on the role of vitamin D in breast cancer and aromatase inhibitor-induced osteoporosis , using methods of...multidisciplinary postdoctoral award investigating the role of vitamin D in aromatase inhibitor-induced osteoporosis in breast cancer, supporting studies in basic...science, clinical research and epidemiology . During the reporting period, the recipient made significant progress in opening the clinical trial and

  17. Academic Institutions and One Health: Building Capacity for Transdisciplinary Research Approaches to Address Complex Health Issues at the Animal–Human–Ecosystem Interface

    PubMed Central

    Allen-Scott, Lisa K.; Buntain, Bonnie; Hatfield, Jennifer M.; Meisser, Andrea

    2015-01-01

    To improve health at the human, animal, and ecosystem interface, defined as One Health, training of researchers must transcend individual disciplines to develop a new process of collaboration. The transdisciplinary research approach integrates frameworks and methodologies beyond academic disciplines and includes involvement of and input from policy makers and members of the community. The authors argue that there should be a significant shift in academic institutions’ research capacity to achieve the added value of a transdisciplinary approach for addressing One Health problems. This Perspective is a call to action for academic institutions to provide the foundations for this salient shift. The authors begin by describing the transdisciplinary approach, propose methods for building transdisciplinary research capacity, and highlight three value propositions that support the case. Examples are provided to illustrate how the transdisciplinary approach to research adds value through improved sustainability of impact, increased cost-effectiveness, and enhanced abilities to mitigate potentially harmful unintended consequences. The authors conclude with three key recommendations for academic institutions: (1) a focus on creating enabling environments for One Health and transdisciplinary research, (2) the development of novel funding structures for transdisciplinary research, and (3) training of “transmitters” using real-world-oriented educational programs that break down research silos through collaboration across disciplines. PMID:25650827

  18. Academic Institutions and One Health: Building Capacity for Transdisciplinary Research Approaches to Address Complex Health Issues at the Animal-Human-Ecosystem Interface.

    PubMed

    Allen-Scott, Lisa K; Buntain, Bonnie; Hatfield, Jennifer M; Meisser, Andrea; Thomas, Christopher James

    2015-07-01

    To improve health at the human, animal, and ecosystem interface, defined as One Health, training of researchers must transcend individual disciplines to develop a new process of collaboration. The transdisciplinary research approach integrates frameworks and methodologies beyond academic disciplines and includes involvement of and input from policy makers and members of the community. The authors argue that there should be a significant shift in academic institutions' research capacity to achieve the added value of a transdisciplinary approach for addressing One Health problems. This Perspective is a call to action for academic institutions to provide the foundations for this salient shift. The authors begin by describing the transdisciplinary approach, propose methods for building transdisciplinary research capacity, and highlight three value propositions that support the case. Examples are provided to illustrate how the transdisciplinary approach to research adds value through improved sustainability of impact, increased cost-effectiveness, and enhanced abilities to mitigate potentially harmful unintended consequences. The authors conclude with three key recommendations for academic institutions: (1) a focus on creating enabling environments for One Health and transdisciplinary research, (2) the development of novel funding structures for transdisciplinary research, and (3) training of "transmitters" using real-world-oriented educational programs that break down research silos through collaboration across disciplines.

  19. Talking about cancer with confidence: evaluation of cancer awareness training for community-based health workers

    PubMed Central

    Grimmett, Chloe; Macherianakis, Alexis; Rendell, Helen; George, Helen; Kaplan, Gwen; Kilgour, Gillian

    2014-01-01

    Aims: To examine the impact of cancer awareness training for community-based health workers on confidence to talk about cancer, and knowledge of cancer risk factors and signs and symptoms. Methods: Community-based health workers from Sandwell, Birmingham and Solihull were invited to take part in one of 14 one-day training workshops. Trainees completed questionnaires at the beginning of the workshop and were followed up one month later. Confidence in talking about cancer was examined. Knowledge of cancer risk factors and signs and symptoms was assessed. Trainees were asked to rate the usefulness of the workshop, whether they would recommend it to others and whether they had put what they had learnt into practice. Results: A total of 187 community-based health workers took part in the workshops, and 167 (89%) completed the one-month follow-up. Considerable improvements were observed in confidence to discuss cancer. For example, the proportion of participants reporting feeling ‘very confident’/‘fairly confident’ in discussing signs and symptoms of cancer increased from 32% to 96% (p < .001). Substantial improvements in trainees’ knowledge were also observed, with 79% of participants correctly identifying 10 out of 11 known risk factors for cancer at one month compared with 21% before training (p < .001). Average (unprompted) recall of cancer signs and symptoms also increased from 2.3 (±1.6) to 2.7 (±1.5), (p = .02). Most trainees (83%) rated the workshop as ‘very useful’, and 89% said they would ‘definitely’ recommend the workshop. Conclusion: The cancer awareness training was reviewed positively by community-based health workers and led to improvements in confidence to talk about cancer, and knowledge of risk factors and warning signs of cancer. It is hoped that raising awareness among this group will help them to communicate and drive behaviour change in the at-risk populations with whom they work. PMID:25169613

  20. Public social monitoring reports and their effect on a policy programme aimed at addressing the social determinants of health to improve health equity in New Zealand.

    PubMed

    Pega, Frank; Valentine, Nicole B; Matheson, Don; Rasanathan, Kumanan

    2014-01-01

    The important role that monitoring plays in advancing global health is well established. However, the role of social monitoring as a tool for addressing social determinants of health (SDH) and health equity-focused policies remains under-researched. This paper assesses the extent and ways in which New Zealand's (NZ) Social Reports (SRs) supported a SDH- and health equity-oriented policy programme nationally over the 2000-2008 period by documenting the SRs' history and assessing its impact on policies across sectors in government and civil society. We conducted key-informant interviews with five senior policy-makers and an e-mail survey with 24 government and civil society representatives on SRs' history and policy impact. We identified common themes across these data and classified them accordingly to assess the intensity of the reports' use and their impact on SDH- and health equity-focused policies. Bibliometric analyses of government publications and media items were undertaken to empirically assess SRs' impact on government and civil society. SRs in NZ arose out of the role played by government as the "benevolent social welfare planner" and an understanding of the necessity of economic and social security for "progress". The SRs were linked to establishing a government-wide programme aimed at reducing inequalities. They have been used moderately to highly in central and local government and in civil society, both within and outside the health sector, but have neither entered public treasury and economic development departments nor the commercial sector. The SRs have not reached the more universal status of economic indicators. However, they have had some success at raising awareness of, and have stimulated isolated action on, SDH. The NZ case suggests that national-level social monitoring provides a valuable tool for raising awareness of SDH across government and civil society. A number of strategies could improve social reports' effectiveness in stimulating

  1. SUPPORT Tools for evidence-informed health Policymaking (STP) 5: Using research evidence to frame options to address a problem.

    PubMed

    Lavis, John N; Wilson, Michael G; Oxman, Andrew D; Grimshaw, Jeremy; Lewin, Simon; Fretheim, Atle

    2009-12-16

    This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers and those supporting them may find themselves in one or more of the following three situations that will require them to characterise the costs and consequences of options to address a problem. These are: 1. A decision has already been taken and their role is to maximise the benefits of an option, minimise its harms, optimise the impacts achieved for the money spent, and (if there is substantial uncertainty about the likely costs and consequences of the option) to design a monitoring and evaluation plan, 2. A policymaking process is already underway and their role is to assess the options presented to them, or 3. A policymaking process has not yet begun and their role is therefore to identify options, characterise the costs and consequences of these options, and look for windows of opportunity in which to act. In situations like these, research evidence, particularly about benefits, harms, and costs, can help to inform whether an option can be considered viable. In this article, we suggest six questions that can be used to guide those involved in identifying policy and programme options to address a high-priority problem, and to characterise the costs and consequences of these options. These are: 1. Has an appropriate set of options been identified to address a problem? 2. What benefits are important to those who will be affected and which benefits are likely to be achieved with each option? 3. What harms are important to those who will be affected and which harms are likely to arise with each option? 4. What are the local costs of each option and is there local evidence about their cost-effectiveness? 5. What adaptations might be made to any given option and could they alter its benefits, harms and costs? 6. Which stakeholder views and experiences might influence an option

  2. A history of the working group to address Los Alamos community health concerns - A case study of community involvement and risk communication

    SciTech Connect

    Harry Otway; Jon Johnson

    2000-01-01

    In May 1991, at a Department of Energy (DOE) public hearing at Los Alamos, New Mexico, a local artist claimed there had been a recent brain tumor cluster in a small Los Alamos neighborhood. He suggested the cause was radiation from past operations of Los Alamos National Laboratory. Data from the Laboratory's extensive environmental monitoring program gave no reason to believe this charge to be true but also could not prove it false. These allegations, reported in the local and regional media, alarmed the community and revealed an unsuspected lack of trust in the Laboratory. Having no immediate and definitive response, the Laboratory offered to collaborate with the community to address this concern. The Los Alamos community accepted this offer and a joint Community-Laboratory Working Group met for the first time 29 days later. The working group set as its primary goal the search for possible carcinogens in the local environment. Meanwhile, the DOE announced its intention to fund the New Mexico Department of Health to perform a separate and independent epidemiological study of all Los Alamos cancer rates. In early 1994, after commissioning 17 environmental studies and meeting 34 times, the working group decided that the public health concerns had been resolved to the satisfaction of the community and voted to disband. This paper tells the story of the artist and the working group, and how the media covered their story. It summarizes the environmental studies directed by the working group and briefly reviews the main findings of the epidemiology study. An epilogue records the present-day recollections of some of the key players in this environmental drama.

  3. Improving Cancer-Related Outcomes with Connected Health - Acknowledgements

    Cancer.gov

    The President’s Cancer Panel is grateful to all participants who invested their time to take part in the series of workshops on connected health and cancer. A complete list of participants is in Series Information. The Panel is especially appreciative to the series co-chairs who graciously contributed their time and knowledge on this topic, providing valuable guidance during workshop planning and extensive input on this report.

  4. Parental cancer: Health-related quality of life and current psychosocial support needs of cancer survivors and their children.

    PubMed

    Bultmann, Johanna Christine; Beierlein, Volker; Romer, Georg; Möller, Birgit; Koch, Uwe; Bergelt, Corinna

    2014-12-01

    The presence of cancer and additional parental responsibilities can increase strain for individual patients as well as for their children. The construct of health-related quality of life (HRQL) is appropriate to measure a combination of physical, mental and social consequences as a result of disease. However, previous research has merely focused on symptom checklists. This study addresses the following questions: (i) does HRQL in children and their parents with cancer differ compared to the general population? (ii) Are there any variables that are associated with HRQL in children? (iii) What are current psychosocial support needs? A population-based survey of 976 survivors (<6 years post diagnosis) with minor children between 6 and 18 years (n = 1,449) was conducted with two German cancer registries. HRQL was assessed using SF-8 (survivors) and Kidscreen (children). The results were compared to normative populations, and predictors associated with HRQL in children were evaluated within a multilevel model. We found that the HRQL in children was better compared to the norm. Only children with support needs had worse HRQL. Older age, having a mother with cancer, having a parent not living together with a partner, and worse parental physical and mental health influenced HRQL in children. Illness characteristics were irrelevant. Even with a mean of 3.5 years after diagnosis, survivors had lower physical and mental health compared to the norm. Our findings reinforce the need for health professionals to pay attention to younger patients and their children. Even years after diagnosis, life might not have returned to normal.

  5. Building Capacity of Occupational Therapy Practitioners to Address the Mental Health Needs of Children and Youth: A Mixed-Methods Study of Knowledge Translation

    PubMed Central

    Demirjian, Louise; LaGuardia, Teri; Thompson-Repas, Karen; Conway, Carol; Michaud, Paula

    2015-01-01

    PURPOSE. We explored the meaning and outcomes of a 6-mo building capacity process designed to promote knowledge translation of a public health approach to mental health among pediatric occupational therapy practitioners participating in a Community of Practice. METHOD. A one-group (N = 117) mixed-methods design using a pretest–posttest survey and qualitative analysis of written reflections was used to explore the meaning and outcomes of the building capacity process. RESULTS. Statistically significant improvements (p < .02) in pretest–posttest scores of knowledge, beliefs, and actions related to a public health approach to mental health were found. Qualitative findings suggest that participation resulted in a renewed commitment to addressing children’s mental health. CONCLUSION. The building capacity process expanded practitioner knowledge, renewed energy, and promoted confidence, resulting in change leaders empowered to articulate, advocate for, and implement practice changes reflecting occupational therapy’s role in addressing children’s mental health. PMID:26565099

  6. Using the PACE EH model to mobilize communities to address local environmental health issues--a case study in Island County, Washington.

    PubMed

    Higman, Keith; Servatius, Celine; Webber, Whitney L; McDonald, Tim

    2007-01-01

    The Island County Environmental Health Initiative (ICEHI) is a demonstration project in the use of the Protocol for Assessing Community Excellence in Environmental Health (PACE EH) to build capacity in the 10 essential services of environmental health. The PACE EH methodology systematically applies the 10 essential services of environmental health through the completion of 13 tasks derived from a community-based environmental health assessment process. The ICEHI has successfully engaged community members, identified environmental health issues important to the community, and led to the implementation of action plans aimed at reducing environmental health risks through use of community resources. This paper describes the methodology utilized by the ICEHI to address locally important environmental health issues so that other local and state environmental health agencies may replicate the process in their communities.

  7. Initial clinical validation of Health Heritage, a patient-facing tool for personal and family history collection and cancer risk assessment.

    PubMed

    Baumgart, Leigh A; Postula, Kristen J Vogel; Knaus, William A

    2016-04-01

    Personal and family health histories remain important independent risk factors for cancer; however they are currently not being well collected or used effectively. Health Heritage was designed to address this need. The purpose of this study was to validate the ability of Health Heritage to identify patients appropriate for further genetic evaluation and to accurately stratify cancer risk. A retrospective chart review was conducted on 100 random patients seen at an adult genetics clinic presenting with concern for an inherited predisposition to cancer. Relevant personal and family history obtained from the patients' medical records was entered into Health Heritage. Recommendations by Health Heritage were compared to national guidelines of eligibility for genetic evaluation. Agreement between Health Heritage referral for genetic evaluation and guideline eligibility for genetic evaluation was 97% (sensitivity 98% and specificity 88%). Risk stratification for cancer was also compared between Health Heritage and those documented by a geneticist. For patients at increased risk for breast, ovarian, or colorectal cancer as determined by the geneticist, risk stratification by Health Heritage agreed 90, 93, and 75%, respectively. Discordances in risk stratification were attributed to both complex situations better handled by the geneticist and Health Heritage's adherence to incorporating all information into its algorithms. Health Heritage is a clinically valid tool to identify patients appropriate for further genetic evaluation and to encourage them to confirm the assessment and management recommendations with cancer genetic experts. Health Heritage also provides an estimate of cancer risk that is complementary to a genetics team.

  8. A Social Media mHealth Solution to Address the Needs of Dengue Prevention and Management in Sri Lanka

    PubMed Central

    Rathnayake, Vajira Sampath; Lim, Gentatsu; Panchapakesan, Chitra; Foo, Schubert; Wijayamuni, Ruwan; Wimalaratne, Prasad; Fernando, Owen Noel Newton

    2016-01-01

    Background Sri Lanka has witnessed a series of dengue epidemics over the past five years, with the western province, home to the political capital of Colombo, bearing more than half of the dengue burden. Existing dengue monitoring prevention programs are exhausted as public health inspectors (PHIs) cope with increasing workloads and paper-based modes of surveillance and education, characterizing a reactive system unable to cope with the enormity of the problem. On the other hand, the unprecedented proliferation and affordability of mobile phones since 2009 and a supportive political climate have thus far remained unexploited for the use of mobile-based interventions for dengue management. Objective To conduct a needs assessment of PHIs in Colombo with respect to their dengue-related tasks and develop a new mobile-based system to address these needs while strengthening existing systems. Methods One-on-one in-depth interviews were conducted with 29 PHIs to a) gain a nuanced, in-depth understanding of the current state of surveillance practices, b) understand the logistical, technological and social challenges they confront, and c) identify opportunities for mobile-based interventions. Quantitative analysis included simple descriptive statistics while qualitative analysis comprised textual analysis of 209 pages of transcripts (or nearly 600 minutes of conversations) using grounded theory approaches. Results Current paper-based data collection practices for dengue surveillance involved a circuitous, time consuming process that could take between 7-10 days to officially report and record a single case. PHIs confronted challenges in terms of unreliable, standalone GIS devices, delays in registering mosquito breeding sites and lack of engagement from communities while delivering dengue education. These findings, in concert with a high motivation to use mobile-based systems, informed the development of Mo-Buzz, a mobile-based system that integrates three components

  9. Working to Eliminate Cancer Health Disparities from Tobacco: A Review of the National Cancer Institute’s Community Networks Program

    PubMed Central

    Fagan, Pebbles; Cooper, Leslie; Canto, Maria; Carroll, William; Foster-Bey, John; Hébert, James R.; Lopez-Class, Maria; Ma, Grace X.; Nez Henderson, Patricia; Pérez-Stable, Eliseo J.; Santos, LorrieAnn; Smith, Justin H.; Tan, Yin; Tsoh, Janice; Chu, Kenneth

    2015-01-01

    Introduction: In 2005, the National Cancer Institute funded the Community Networks Program (CNP), which aimed to reduce cancer health disparities in minority racial/ethnic and underserved groups through community-based participatory research, education, and training. The purpose of this study was to describe the CNP model and their tobacco-related work in community-based research, education, and training using a tobacco disparities research framework. Methods: We conducted a comprehensive review of the CNP tobacco-related activities including publications, published abstracts, research activities, trainee pilot studies, policy-related activities, educational outreach, and reports produced from 2005–2009. Two authors categorized the tobacco-related activities and publications within the framework. Results: Although there was no mandate to address tobacco, the CNPs produced 103 tobacco-related peer-reviewed publications, which reflects the largest proportion (12%) of all CNP cancer-related publications. Selected publications and research activities were most numerous under the framework areas “Psychosocial Research,” “Surveillance,” “Epidemiology,” and “Treatment of Nicotine Addiction.” Thirteen CNPs participated in tobacco control policymaking in mainstream efforts that affected their local community and populations, and 24 CNPs conducted 1147 tobacco-related educational outreach activities. CNP activities that aimed to build research and infrastructure capacity included nine tobacco-related pilot projects representing 16% of all CNP cancer-related pilot projects, and 17 publications acknowledging leveraged partnerships with other organizations, a strategy encouraged by the CNP. Conclusions: The CNP is a promising academic-community model for working to eliminate tobacco-related health disparities. Future efforts may address scientific gaps, consider collaboration across groups, assess the extent of operationalizing community-based participatory

  10. Cross-sector partnerships and public health: challenges and opportunities for addressing obesity and noncommunicable diseases through engagement with the private sector.

    PubMed

    Johnston, Lee M; Finegood, Diane T

    2015-03-18

    Over the past few decades, cross-sector partnerships with the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious diseases in low- and middle-income countries. Now these partnerships are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of noncommunicable diseases. Partnering with businesses presents a means to acquire resources, as well as opportunities to influence the private sector toward more healthful practices. Yet even though collaboration is a core principle of public health practice, public-private or nonprofit-private partnerships present risks and challenges that warrant specific consideration. In this article, we review the role of public health partnerships with the private sector, with a focus on efforts to address obesity and noncommunicable diseases in high-income settings. We identify key challenges-including goal alignment and conflict of interest-and consider how changes to partnership practice might address these.

  11. Assessing needs and assets for building a regional network infrastructure to reduce cancer related health disparities.

    PubMed

    Wells, Kristen J; Lima, Diana S; Meade, Cathy D; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K; Pledger, W Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E; Fouad, Mona; Moreno, Carlos S; Lacey, Michelle; Christie, Debra W; Price-Haywood, Eboni G; Quinn, Gwendolyn P; Coppola, Domenico; Sodeke, Stephen O; Green, B Lee; Lichtveld, Maureen Y

    2014-06-01

    Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nation-wide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals.

  12. Cancer and ethnic minorities--the Department of Health's perspective.

    PubMed Central

    Bahl, V.

    1996-01-01

    With more than 160,000 deaths annually cancer is the second commonest cause of death in the UK. The little evidence available shows that black and minority ethnic people are experiencing an increase in cancer-related mortality. The Government's Health of the Nation report produced in 1993 by the Department of Health identifies key areas, in