Experiences in conducting multiple community-based HIV prevention trials among women in KwaZulu-Natal, South Africa

PubMed Central

2010-01-01

Background South Africa, with its scientific capacity, good infrastructure and high HIV incidence rates, is ideally positioned to conduct large-scale HIV prevention trials. The HIV Prevention Research Unit of the South African Medical Research Council conducted four phase III and one phase IIb trials of women-initiated HIV prevention options in KwaZulu-Natal between 2003 and 2009. A total of 7046 women participated, with HIV prevalence between 25% and 45% and HIV incidence ranging from 4.5-9.1% per year. Unfortunately none of the interventions tested had any impact on reducing the risk of HIV acquisition; however, extremely valuable experience was gained, lessons learned and capacity built, while the communities gained associated benefits. Experience Our experience in conducting these trials ranged from setting up community partnerships to developing clinical research sites and dissemination of trial results. Community engagement included setting up community-based research sites with approval from both political and traditional leaders, and developing community advisory groups to assist with the research process. Community-wide education on HIV/sexually transmitted infection prevention, treatment and care was provided to over 90 000 individuals. Myths and misconceptions were addressed through methods such as anonymous suggestion boxes in clinic waiting areas and intensive education and counselling. Attempts were made to involve male partners to foster support and facilitate recruitment of women. Peer educator programmes were initiated to provide ongoing education and also to facilitate recruitment of women to the trials. Recruitment strategies such as door-to-door recruitment and community group meetings were initiated. Over 90% of women enrolled were retained. Community benefits from the trial included education on HIV prevention, treatment and care and provision of ancillary care (such as Pap smears, reproductive health care and referral for chronic illnesses). Social benefits included training of home-based caregivers and sustainable ongoing HIV prevention education through peer educator programmes. Challenges Several challenges were encountered, including manipulation by participants of their eligibility criteria in order to enroll in the trial. Women attempted to co-enroll in multiple trials to benefit from financial reimbursements and individualised care. The trials became ethically challenging when participants refused to take up referrals for care due to stigma, denial of their HIV status and inadequate health infrastructure. Lack of disclosure of HIV status to partners and family members was particularly challenging. Some of the ethical dilemmas put to the test our responsibility as researchers and our obligation to provide health care to research participants. Conclusion Conducting these five trials in a period of six years provided us with invaluable insights into trial implementation, community participation, recruitment and retention, provision of care and dissemination of trial results. The critical mass of scientists trained as clinical trialists will continue to address the relentless HIV epidemic in our setting and ensure our commitment to finding a biomedical HIV prevention option for women in the future. PMID:20416063

A Community Based Systems Diagram of Obesity Causes.

PubMed

Allender, Steven; Owen, Brynle; Kuhlberg, Jill; Lowe, Janette; Nagorcka-Smith, Phoebe; Whelan, Jill; Bell, Colin

2015-01-01

Application of system thinking to the development, implementation and evaluation of childhood obesity prevention efforts represents the cutting edge of community-based prevention. We report on an approach to developing a system oriented community perspective on the causes of obesity. Group model building sessions were conducted in a rural Australian community to address increasing childhood obesity. Stakeholders (n = 12) built a community model that progressed from connection circles to causal loop diagrams using scripts from the system dynamics literature. Participants began this work in identifying change over time in causes and effects of childhood obesity within their community. The initial causal loop diagram was then reviewed and elaborated by 50 community leaders over a full day session. The process created a causal loop diagram representing community perceptions of determinants and causes of obesity. The causal loop diagram can be broken down into four separate domains; social influences; fast food and junk food; participation in sport; and general physical activity. This causal loop diagram can provide the basis for community led planning of a prevention response that engages with multiple levels of existing settings and systems.

A population-based study on health-related quality of life among urban community residents in Shenyang, Northeast of China.

PubMed

Song, Tian; Ding, Yan-wei; Sun, Yan; He, Yi-Ni; Qi, Dian-Jun; Wu, Ying; Wu, Bin; Lang, Lang; Yu, Kai; Zhao, Xin; Zhu, Liang-liang; Wang, Shuang; Yu, Xiao-Song

2015-09-19

Due to the rising standard of living environment and advances in public health and medical care in China, it has been a tendency in recent years that health-related quality of life (HRQoL) has been increasingly acknowledged in community health management. However, large-scale population-based study on evaluating HQRoL in northeast of China was not conducted. This article aims to investigate the HRQoL in community residents in Northeast China and explore the associated factors. Stratified multiple-stage sampling method was used in the cross-sectional survey to investigate HRQoL of community residents in northeast of China. Univariate analysis and multiple linear regressions were used to analyze the factors associated to HRQoL of the community residents. The results were confirmed that HRQoL in general population was well performed for the first time in northeast of China in a large scale population. Community residents had better mental health than physical health. The factors influencing HRQoL included gender, age, educational level, marital status, ethnic group, chronic disease status, having breakfast frequency weekly and sleep quality. However, drinking and smoking habits did not affect residents' HRQoL. In this study, the result of the large-scale survey was satisfactory in northeast of China, providing HRQoL status of community residents. Policies on specific health management in community public health would emphasize on lifestyle behaviors especially eating habits in order to improving HRQoL.

Community-based participatory research (CBPR) in South Africa: engaging multiple constituents to shape the research question.

PubMed

Mosavel, Maghboeba; Simon, Christian; van Stade, Debbie; Buchbinder, Mara

2005-12-01

Community engagement is an on-going, arduous, and necessary process for developing effective health promotion programs. The challenges are amplified when the particular health issue or research question is not prominent in the consciousness of the targeted community. In this paper, we explore the community-based participatory research (CBPR) model as a means to negotiate a mutual agenda between communities and researchers. The paper is focused on the (perceived) need for cervical cancer screening in an under-resourced community in Cape Town, South Africa. Cervical cancer is a significant health problem in this community and elsewhere in South Africa. Unlike HIV-AIDS, however, many Black South Africans have not been educated about cervical cancer and the importance of obtaining screening. Many may not consider screening a priority in their lives. Our research included extensive consultations and informal interviews with diverse community and regional stakeholders. Following these, we conducted 27 focus groups and 106 demographic surveys with randomly selected youth, parents, local health care personnel, educators and school staff. Focus group data were summarized and analyzed cross-sectionally. Community stakeholders were involved throughout this research. Our consultations, interviews, and focus group data were key in identifying the concerns and priorities of the community. By engaging community stakeholders, we developed a research framework that incorporated the community's concerns and priorities, and stressed the intersecting roles of poverty, violence, and other cultural forces in shaping community members' health and wellbeing. Community members helped to refocus our research from cervical cancer to 'cervical health,' a concept that acknowledged the impact on women's bodies and lives of HIV-AIDS and STDs, sexual violence, poverty, and multiple social problems. We conclude that the research agenda and questions in community-based health research should not be considered immutable. They need to be open to negotiation, creativity, and constant reinvention.

Comparison of outpatient medically attended and community-level influenza-like illness-New York City, 2013-2015.

PubMed

Russell, Kate E; Fowlkes, Ashley; Stockwell, Melissa S; Vargas, Celibell Y; Saiman, Lisa; Larson, Elaine L; LaRussa, Philip; Di Lonardo, Steve; Popowich, Michael; St George, Kirsten; Steffens, Andrea; Reed, Carrie

2018-05-01

Surveillance of influenza-like illness (ILI) in the United States is primarily conducted through medical settings despite a significant burden of non-medically attended ILI. To assess consistency between surveillance for respiratory viruses in outpatient and community settings using ILI surveillance from the Centers for Disease Control and Prevention Influenza Incidence Surveillance Project (IISP) and the Mobile Surveillance for Acute Respiratory Infections (ARI) and Influenza-Like Illness in the Community (MoSAIC) Study. The Influenza Incidence Surveillance Project conducts ILI surveillance in 3 primary care clinics in New York City, and MoSAIC conducts community-based ILI/ARI surveillance through text messaging among a cohort of New York City residents. Both systems obtain respiratory specimens from participants with ILI/ARI and test for multiple pathogens. We conducted a retrospective review of ILI cases in IISP and MoSAIC from January 2013 to May 2015 with descriptive analyses of clinical and laboratory data. Five-hundred twelve MoSAIC and 669 IISP participants met an ILI criteria (fever with cough or sore throat) and were included. Forty percent of MoSAIC participants sought care; the majority primary care. Pathogens were detected in 63% of MoSAIC and 70% of IISP cases. The relative distribution of influenza and other respiratory viruses detected was similar; however, there were statistically significant differences in the frequency that were not explained by care seeking. Outpatient and community-based surveillance in the one found similar timing and relative distribution of respiratory viruses, but community surveillance in a single neighborhood may not fully capture the variations in ILI etiology that occur more broadly. Published 2018. This article is a U.S. Government work and is in the public domain in the USA. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.

Community-based participatory research (CBPR) in South Africa: Engaging multiple constituents to shape the research question

PubMed Central

Mosavel, Maghboeba; Simon, Christian; van Stade, Debbie; Buchbinder, Mara

2011-01-01

Community engagement is an on-going, arduous, and necessary process for developing effective health promotion programs. The challenges are amplified when the particular health issue or research question is not prominent in the consciousness of the targeted community. In this paper, we explore the community-based participatory research (CBPR) model as a means to negotiate a mutual agenda between communities and researchers. The paper is focused on the (perceived) need for cervical cancer screening in an under-resourced community in Cape Town, South Africa. Cervical cancer is a significant health problem in this community and elsewhere in South Africa. Unlike HIV-AIDS, however, many Black South Africans have not been educated about cervical cancer and the importance of obtaining screening. Many may not consider screening a priority in their lives. Our research included extensive consultations and informal interviews with diverse community and regional stakeholders. Following these, we conducted 27 focus groups and 106 demographic surveys with randomly selected youth, parents, local health care personnel, educators and school staff. Focus group data were summarized and analyzed cross-sectionally. Community stakeholders were involved throughout this research. Our consultations, interviews, and focus group data were key in identifying the concerns and priorities of the community. By engaging community stakeholders, we developed a research framework that incorporated the community’s concerns and priorities, and stressed the intersecting roles of poverty, violence, and other cultural forces in shaping community members’ health and wellbeing. Community members helped to refocus our research from cervical cancer to ‘cervical health,’ a concept that acknowledged the impact on women’s bodies and lives of HIV-AIDS and STDs, sexual violence, poverty, and multiple social problems. We conclude that the research agenda and questions in community-based health research should not be considered immutable. They need to be open to negotiation, creativity, and constant reinvention. PMID:15955605

"We make the path by walking it": building an academic community partnership with Boston Chinatown.

PubMed

Rubin, Carolyn Leung; Allukian, Nathan; Wang, Xingyue; Ghosh, Sujata; Huang, Chien-Chi; Wang, Jacy; Brugge, Doug; Wong, John B; Mark, Shirley; Dong, Sherry; Koch-Weser, Susan; Parsons, Susan K; Leslie, Laurel K; Freund, Karen M

2014-01-01

The potential for academic community partnerships are challenged in places where there is a history of conflict and mistrust. Addressing Disparities in Asian Populations through Translational Research (ADAPT) represents an academic community partnership between researchers and clinicians from Tufts Medical Center and Tufts University and community partners from Boston Chinatown. Based in principles of community-based participatory research and partnership research, this partnership is seeking to build a trusting relationship between Tufts and Boston Chinatown. This case study aims to provides a narrative story of the development and formation of ADAPT as well as discuss challenges to its future viability. Using case study research tools, this study draws upon a variety of data sources including interviews, program evaluation data and documents. Several contextual factors laid the foundation for ADAPT. Weaving these factors together helped to create synergy and led to ADAPT's formation. In its first year, ADAPT has conducted formative research, piloted an educational program for community partners and held stakeholder forums to build a broad base of support. ADAPT recognizes that long term sustainability requires bringing multiple stakeholders to the table even before a funding opportunity is released and attempting to build a diversified funding base.

Resource-Based Capability on Development Knowledge Management Capabilities of Coastal Community

NASA Astrophysics Data System (ADS)

Teniwut, Roberto M. K.; Hasyim, Cawalinya L.; Teniwut, Wellem A.

2017-10-01

Building sustainable knowledge management capabilities in the coastal area might face a whole new challenge since there are many intangible factors involved from openness on new knowledge, access and ability to use the latest technology to the various local wisdom that still in place. The aimed of this study was to identify and analyze the resource-based condition of coastal community in this area to have an empirical condition of tangible and intangible infrastructure on developing knowledge management capability coastal community in Southeast Maluku, Indonesia. We used qualitative and quantitative analysis by depth interview and questionnaire for collecting the data with multiple linear regression as our analysis method. The result provided the information on current state of resource-based capability of a coastal community in this Southeast Maluku to build a sustainability model of knowledge management capabilities especially on utilization marine and fisheries resources. The implication of this study can provide an empirical information for government, NGO and research institution to dictate on how they conducted their policy and program on developing coastal community region.

Community-based group aquatic programme for individuals with multiple sclerosis: a pilot study.

PubMed

Salem, Yasser; Scott, Anne Hiller; Karpatkin, Herbert; Concert, George; Haller, Leah; Kaminsky, Eva; Weisbrot, Rivky; Spatz, Eugene

2011-01-01

The purpose of this study was to determine the feasibility of providing a community-based aquatic exercise programme and to examine the effects of a group aquatic exercise programme in individuals with multiple sclerosis. This study illustrates the implementation of a multidisciplinary community-based programme in a university community wellness centre coordinated with a local advocacy group. Eleven subjects with multiple sclerosis participated in a 5-week community-based aquatic exercise programme. Aquatic exercises were held twice weekly for 60 minutes and included aerobic exercises, strength training, flexibility exercises, balance training and walking activities. The 10-Metre Walk test, the Berg Balance Scale (BBS), the 'Timed Up and Go' (TUG) test, grip strength and the Modified Fatigue Impact Scale were used to assess motor function. Analysis of the scores demonstrated improved gait speed, BBS, TUG test and grip strength. The average attendance of the training sessions was good (88%), and no incidence of injuries, no incidence of falls and no adverse effects related to the exercise programme were reported. All participants reported that they enjoyed the programme, and they had improved after the training. A community-based aquatic exercise programme is feasible and resulted in improvement in motor functions of individuals with multiple sclerosis. These findings indicate that an aquatic training programme is appropriate and beneficial for individuals with multiple sclerosis and should be considered to augment the rehabilitation of those individuals. This programme may provide a viable model for a community-based wellness programme for people with disability including individuals with multiple sclerosis.

Concept Mapping for Planning and Evaluation of a Community-Based Initiative

ERIC Educational Resources Information Center

Chiu, Korinne

2012-01-01

Community-based initiatives address community issues by providing a multi-agency approach to prevention and intervention services (Connell et al.,1995). When incorporating multiple agencies, it can be challenging to obtain multiple perspectives and gaining consensus on the priorities and direction for these initiatives. This study employed a…

OPREVENT2: Design of a multi-institutional intervention for obesity control and prevention for American Indian adults.

PubMed

Gittelsohn, Joel; Jock, Brittany; Redmond, Leslie; Fleischhacker, Sheila; Eckmann, Thomas; Bleich, Sara N; Loh, Hong; Ogburn, Elizabeth; Gadhoke, Preety; Swartz, Jacqueline; Pardilla, Marla; Caballero, Benjamin

2017-01-23

Obesity and other nutrition-related chronic disease rates are high in American Indian (AI) populations, and an urgent need exists to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component (MLMC) interventions are needed, but there are significant knowledge gaps on how to deliver these types of interventions in low-income rural AI communities. OPREVENT2 is a MLMC intervention targeting AI adults living in six rural reservations in New Mexico and Wisconsin. Aiming to prevent and reduce obesity in adults by working at multiple levels of the food and physical activity (PA) environments, OPREVENT2 focuses on evidence-based strategies known to increase access to, demand for, and consumption of healthier foods and beverages, and increase worksite and home-based opportunities for PA. OPREVENT2 works to create systems-level change by partnering with tribal stakeholders, multiple levels of the food and PA environment (food stores, worksites, schools), and the social environment (children as change agents, families, social media). Extensive evaluation will be conducted at each level of the intervention to assess effectiveness via process and impact measures. Novel aspects of OPREVENT2 include: active engagement with stakeholders at many levels (policy, institutional, and at multiple levels of the food and PA system); use of community-based strategies to engage policymakers and other key stakeholders (community workshops, action committees); emphasis on both the built environment (intervening with retail food sources) and the social environment. This paper describes the design of the intervention and the evaluation plan of the OPREVENT2. Clinical Trial Registration: NCT02803853 (June 10, 2016).

Reflexive Research Ethics for Environmental Health and Justice: Academics and Movement-Building

PubMed Central

Cordner, Alissa; Ciplet, David; Brown, Phil; Morello-Frosch, Rachel

2012-01-01

Community-engaged research on environmental problems has reshaped researcher-participant relationships, academic-community interaction, and the role of community partners in human subjects protection and ethical oversight. We draw on our own and others’ research collaborations with environmental health and justice social movement organizations to discuss the ethical concerns that emerge in community-engaged research. In this paper we introduce the concept of reflexive research ethics: ethical guidelines and decision-making principles that depend on continual reflexivity concerning the relationships between researchers and participants. Seeing ethics in this way can help scientists conduct research that simultaneously achieves a high level of professional conduct and protects the rights, well-being, and autonomy of both researchers and the multiple publics affected by research. We highlight our research with community-based organizations in Massachusetts, California, and Alaska, and discuss the potential impacts of the community or social movement on the research process and the potential impacts of research on community or social movement goals. We conclude by discussing ways in which the ethical concerns that surface in community-engaged research have led to advances in ethical research practices. This type of work raises ethical questions whose answers are broadly relevant for social movement, environmental, and public health scholars. PMID:22690133

Social determinants of health among African Americans in a rural community in the Deep South: an ecological exploration.

PubMed

Scott, A J; Wilson, R F

2011-01-01

African Americans living in rural USA experience multiple health disparities as a result of both race and rural geography. An increasing literature suggests that social determinants of health, the social contexts in which people live their lives, are key contributors to these health disparities. Ecological theory provides a valuable conceptual framework for exploring social determinants of health in communities, but few US rural health community-based studies have utilized this approach, or engaged ecological theory to explore rural contexts. This exploratory study blended a community-based, qualitative approach with ecological theory with the objective of identifying potential social determinants of health among African Americans in a rural community in the Deep South, from the perspectives of participants. In-depth interviews were conducted with rural, Deep South African Americans participants who were purposefully sampled to incorporate a range of perspectives. Interview guides structured around five ecological levels (individual, relational, environmental, structural, and superstructural) were used to frame interviews. Iterative content analysis of interview transcripts and field notes identified potential social determinants of health. An 'editing' approach to content analysis was used. Data and analysis quality was tested by triangulation at the level of the researcher, and by member checking with community members. Potential determinants of health were identified at all five levels of the ecological framework. At the individual level, lack of engagement with personal health and health promotion was a recurring theme. Participation in preventive health activities and education was minimal, even when offered in community settings. At the relational level, lack of social capital emerged as another potential social determinant of health, with estrangement between the younger and elder generations as one source, and fractiousness among churches (key institutions in the community) representing another. At the environmental level, the community built environment was an area of concern as it lacked opportunities for physical activity and access to healthy foods. The local job environment was identified as a potential social determinant of health, given the strong ties between income and health. At the structural level, participants complained of cronyism and nepotism favoring Whites in access to jobs, including those where local policies and funding allocations were made (eg funding for the local health department). In education, school system tracking policies were perceived to discourage African Americans from university education. At the superstructural level, high rates of poverty and racism emerged as potential social determinants. Poverty directly limited many African Americans' access to quality health care, and subtle racism was perceived in some delivery of care. Persistent stress from poverty and racism was reported, which creates health risks through physiologic pathways. This study identified potential social determinants of health, at multiple ecological levels, among African Americans in a rural community in the Deep South. The social determinants identified had the ability to impact a variety of health behaviors and health outcomes. The results demonstrate the value of this approach to conducting rural, community-based research. This descriptive and exploratory study highlights the need for quantitative exploration of these issues, as well as the development of context-appropriate, community-based health interventions that address multiple ecological levels.

School-based participatory health education for malaria control in Ghana: engaging children as health messengers.

PubMed

Ayi, Irene; Nonaka, Daisuke; Adjovu, Josiah K; Hanafusa, Shigeki; Jimba, Masamine; Bosompem, Kwabena M; Mizoue, Tetsuya; Takeuchi, Tsutomu; Boakye, Daniel A; Kobayashi, Jun

2010-04-18

School children have been increasingly recognized as health messengers for malaria control. However, little evidence is available. The objective of this study was to determine the impact of school-based malaria education intervention on school children and community adults. This study was conducted in the Dangme-East district of the Greater Accra Region, Ghana, between 2007 and 2008. Trained schoolteachers designed participatory health education activities and led school children to disseminate messages related to malaria control to their communities. Three schools and their respective communities were chosen for the study and assigned to an intervention group (one school) and a control group (two schools). Questionnaire-based interviews and parasitological surveys were conducted before and after the intervention, with the intervention group (105 children, 250 community adults) and the control group (81 children, 133 community adults). Chi-square and Fisher's Exact tests were used to analyse differences in knowledge, practices, and parasite prevalence between pre- and post-intervention. After the intervention, the misperception that malaria has multiple causes was significantly improved, both among children and community adults. Moreover, the community adults who treated a bed net with insecticide in the past six months, increased from 21.5% to 50.0% (p < 0.001). Parasite prevalence in school children decreased from 30.9% to 10.3% (p = 0.003). These positive changes were observed only in the intervention group. This study suggests that the participatory health education intervention contributed to the decreased malaria prevalence among children. It had a positive impact not only on school children, but also on community adults, through the improvement of knowledge and practices. This strategy can be applied as a complementary approach to existing malaria control strategies in West African countries where school health management systems have been strengthened.

Exploring the Life Course Perspective in Maternal and Child Health through Community-Based Participatory Focus Groups: Social Risks Assessment.

PubMed

Salinas-Miranda, Abraham A; King, Lindsey M; Salihu, Hamisu M; Berry, Estrellita; Austin, Deborah; Nash, Susan; Scarborough, Kenneth; Best, Evangeline; Cox, Lillian; King, Georgette; Hepburn, Carrie; Burpee, Conchita; Richardson, Eugene; Ducket, Marlo; Briscoe, Richard; Baldwin, Julie

2017-01-01

Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas. Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain the experiences reported by the interviewees. A total of 78 residents participated in the focus groups. Children and adolescents' health risks were childhood obesity, lack of physical activity, and low self-esteem. Women's health risks were low self-esteem, low educational level, low health literacy, inadequate parenting skills, and financial problems. Risks during pregnancy included stress, low self-esteem, inadequate eating patterns, lack of physical activity, healthcare issues, lack of social support, and lack of father involvement during pregnancy. Multiple risk factors contribute to maternal and child health in low income communities in Tampa Bay. The intersection of risk factors in different life periods suggest possible pathways, cumulative, and latent effects, which must be considered in future longitudinal studies and when developing effective maternal and child health programs and policies.

Overlapping community detection based on link graph using distance dynamics

NASA Astrophysics Data System (ADS)

Chen, Lei; Zhang, Jing; Cai, Li-Jun

2018-01-01

The distance dynamics model was recently proposed to detect the disjoint community of a complex network. To identify the overlapping structure of a network using the distance dynamics model, an overlapping community detection algorithm, called L-Attractor, is proposed in this paper. The process of L-Attractor mainly consists of three phases. In the first phase, L-Attractor transforms the original graph to a link graph (a new edge graph) to assure that one node has multiple distances. In the second phase, using the improved distance dynamics model, a dynamic interaction process is introduced to simulate the distance dynamics (shrink or stretch). Through the dynamic interaction process, all distances converge, and the disjoint community structure of the link graph naturally manifests itself. In the third phase, a recovery method is designed to convert the disjoint community structure of the link graph to the overlapping community structure of the original graph. Extensive experiments are conducted on the LFR benchmark networks as well as real-world networks. Based on the results, our algorithm demonstrates higher accuracy and quality than other state-of-the-art algorithms.

Lessons Learned in Evaluating a Multisite, Comprehensive Teen Dating Violence Prevention Strategy: Design and Challenges of the Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships.

PubMed

Niolon, Phyllis Holditch; Taylor, Bruce G; Latzman, Natasha E; Vivolo-Kantor, Alana M; Valle, Linda Anne; Tharp, Andra T

2016-03-01

This paper describes the multisite, longitudinal cluster randomized controlled trial (RCT) design of the evaluation of the Dating Matters: Strategies to Promote Healthy Relationships initiative, and discusses challenges faced in conducting this evaluation. Health departments in 4 communities are partnering with middle schools in high-risk, urban communities to implement 2 models of teen dating violence (TDV) prevention over 4 years. Schools were randomized to receive either the Dating Matters comprehensive strategy or the "standard of care" strategy (an existing, evidence-based TDV prevention curriculum). Our design permits comparison of the relative effectiveness of the comprehensive and standard of care strategies. Multiple cohorts of students from 46 middle schools are surveyed in middle school and high school, and parents and educators from participating schools are also surveyed. Challenges discussed in conducting a multisite RCT include site variability, separation of implementation and evaluation responsibilities, school retention, parent engagement in research activities, and working within the context of high-risk urban schools and communities. We discuss the strengths and weaknesses of our approaches to these challenges in the hopes of informing future research. Despite multiple challenges, the design of the Dating Matters evaluation remains strong. We hope this paper provides researchers who are conducting complex evaluations of behavioral interventions with thoughtful discussion of the challenges we have faced and potential solutions to such challenges.

Lessons Learned in Evaluating a Multisite, Comprehensive Teen Dating Violence Prevention Strategy: Design and Challenges of the Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships

PubMed Central

Niolon, Phyllis Holditch; Taylor, Bruce G.; Latzman, Natasha E.; Vivolo-Kantor, Alana M.; Valle, Linda Anne; Tharp, Andra T.

2018-01-01

Objective This paper describes the multisite, longitudinal cluster randomized controlled trial (RCT) design of the evaluation of the Dating Matters: Strategies to Promote Healthy Relationships initiative, and discusses challenges faced in conducting this evaluation. Method Health departments in 4 communities are partnering with middle schools in high-risk, urban communities to implement 2 models of teen dating violence (TDV) prevention over 4 years. Schools were randomized to receive either the Dating Matters comprehensive strategy or the “standard of care” strategy (an existing, evidence-based TDV prevention curriculum). Our design permits comparison of the relative effectiveness of the comprehensive and standard of care strategies. Multiple cohorts of students from 46 middle schools are surveyed in middle school and high school, and parents and educators from participating schools are also surveyed. Results Challenges discussed in conducting a multisite RCT include site variability, separation of implementation and evaluation responsibilities, school retention, parent engagement in research activities, and working within the context of high-risk urban schools and communities. We discuss the strengths and weaknesses of our approaches to these challenges in the hopes of informing future research. Conclusions Despite multiple challenges, the design of the Dating Matters evaluation remains strong. We hope this paper provides researchers who are conducting complex evaluations of behavioral interventions with thoughtful discussion of the challenges we have faced and potential solutions to such challenges. PMID:29607239

“We Make the Path by Walking It”: Building an Academic Community Partnership With Boston Chinatown

PubMed Central

Rubin, Carolyn Leung; Allukian, Nathan; Wang, Xingyue; Ghosh, Sujata; Huang, Chien-Chi; Wang, Jacy; Brugge, Doug; Wong, John B.; Mark, Shirley; Dong, Sherry; Koch-Weser, Susan; Parsons, Susan K.; Leslie, Laurel K.; Freund, Karen M.

2015-01-01

Background The potential for academic community partnerships are challenged in places where there is a history of conflict and mistrust. Addressing Disparities in Asian Populations through Translational Research (ADAPT) represents an academic community partnership between researchers and clinicians from Tufts Medical Center and Tufts University and community partners from Boston Chinatown. Based in principles of community-based participatory research and partnership research, this partnership is seeking to build a trusting relationship between Tufts and Boston Chinatown. Objectives This case study aims to provides a narrative story of the development and formation of ADAPT as well as discuss challenges to its future viability. Methods Using case study research tools, this study draws upon a variety of data sources including interviews, program evaluation data and documents. Results Several contextual factors laid the foundation for ADAPT. Weaving these factors together helped to create synergy and led to ADAPT’s formation. In its first year, ADAPT has conducted formative research, piloted an educational program for community partners and held stakeholder forums to build a broad base of support. Conclusions ADAPT recognizes that long term sustainability requires bringing multiple stakeholders to the table even before a funding opportunity is released and attempting to build a diversified funding base. PMID:25435562

Developing a Community-Wide Initiative to Address Childhood Adversity and Toxic Stress: A Case Study of The Philadelphia ACE Task Force.

PubMed

Pachter, Lee M; Lieberman, Leslie; Bloom, Sandra L; Fein, Joel A

The Philadelphia ACE Task Force is a community based collaborative of health care providers, researchers, community-based organizations, funders, and public sector representatives. The mission of the task force is to provide a venue to address childhood adversity and its consequences in the Philadelphia metropolitan region. In this article we describe the origins and metamorphosis of the Philadelphia ACE Task Force, which initially was narrowly focused on screening for adverse childhood experiences (ACEs) in health care settings but expanded its focus to better represent a true community-based approach to sharing experiences with addressing childhood adversity in multiple sectors of the city and region. The task force has been successful in developing a research agenda and conducting research on ACEs in the urban context, and has identified foci of local activity in the areas of professional training and workforce development, community education, and local practical interventions around adversity, trauma, and resiliency. In this article we also address the lessons learned over the first 5 years of the task force's existence and offers recommendations for future efforts to build a local community-based ACEs collaborative. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The role of community context in planning and implementing community-based health promotion projects.

PubMed

Kegler, Michelle C; Rigler, Jessica; Honeycutt, Sally

2011-08-01

The current study examines how community context affected collaborative planning and implementation in eight sites participating in a healthy cities and communities initiative in California. Data are from 23 focus groups conducted with coalition members, and 76 semi-structured interviews with local coordinators and community leaders. Multiple case study methods were used to identify major themes related to how five contextual domains influenced collaborative planning and implementation. Results showed that history of collaboration can influence resources and interpersonal and organizational connections available for planning and implementation, as well as priorities selected for action. Community politics and history can affect which segments of the community participate in a planning process and what issues are prioritized, as well as the pool of partners willing to aid in implementation. Some community norms and values bring people together and others appear to limit involvement from certain groups. Community demographics and economic conditions may shape outreach strategies for planning and implementation, and may also shape priorities. Geography can play a role in assessment methods, priority selection, partners available to aid in implementation, and participation in activities and events. Results suggest that community context plays a substantive role in shaping how community-based health promotion projects unfold. Copyright © 2011 Elsevier Ltd. All rights reserved.

Community-based participatory research in complex settings: clean mind–dirty hands

PubMed Central

Makhoul, Jihad; Nakkash, Rima; Harpham, Trudy; Qutteina, Yara

2014-01-01

Despite the abundance of the literature which discusses factors supporting or inhibiting effective participation of community members in community-based research, there is a paucity of publications analysing challenges to participation in complex settings. This manuscript describes an intervention built on researcher–community partnership amid complex social conditions which challenged participation of community members at different stages of the research process. The research took place in a Palestinian refugee camp in Beirut, Lebanon and 1 of 12 in Lebanon which suffer from deteriorating social, economic and physical conditions perpetuated by state-imposed restrictions. The research team developed a community coalition which was involved in all stages of planning, designing, implementation and dissemination. In all those stages the aim was to maintain rigorous research, to follow a ‘clean mind’ approach to research, but maintain principles of community participation which necessitate ‘a dirty hand’. Despite commitment to the principles of community-based participatory research, participation of community members (including youth, parents and teachers) was affected to a great extent by the social, physical and structural conditions of the community context. Characteristics of the context where research is conducted and how it affects community members should not be overlooked since multiple factors beyond the researchers' control could interfere with the rigour of scientific research. Researchers need to develop a plan for participation with the community from the beginning with an understanding of the community forces that affect meaningful participation and address possible deterrence. PMID:23872385

Ethical Considerations for Conducting Health Disparities Research in Community Health Centers: A Social-Ecological Perspective

PubMed Central

Scott, Ebony; Melendez, Jennifer; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid

2013-01-01

Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings. PMID:24134347

Ethical considerations for conducting health disparities research in community health centers: a social-ecological perspective.

PubMed

Boutin-Foster, Carla; Scott, Ebony; Melendez, Jennifer; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid

2013-12-01

Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings.

Support for recreational trail development and community attachment: a case of the Soucook River Watershed

Treesearch

Jodi L. Michaud; Robert A. Robertson

2001-01-01

This study was conducted as part of a larger multi-community needs assessment. Data from this study allows for the determination of support for a multiple-use trail system linking communities within the Soucook River Watershed Region in New Hampshire. This study also examines the relationship between support for trail development and community attachment. The results...

Dose as a Tool for Planning and Implementing Community-Based Health Strategies.

PubMed

Kuo, Elena S; Harner, Lisa T; Frost, Madeline C; Cheadle, Allen; Schwartz, Pamela M

2018-05-01

A major challenge in community-based health promotion is implementing strategies that could realistically improve health at the population level. Population dose methodology was developed to help understand the combined impact of multiple strategies on population-level health behaviors. This paper describes one potential use of dose: as a tool for working collaboratively with communities to increase impact when planning and implementing community-level initiatives. Findings are presented from interviews conducted with 11 coordinators who used dose for planning and implementing local efforts with community coalitions. During early-stage planning, dose was used as a tool for strategic planning, and as a framework to build consensus among coalition partners. During implementation, a dose lens was used to revise strategies to increase their reach (the number of people exposed to the intervention) or strength (the relative change in behavior for each exposed person) to create population-level impact. A case study is presented, illustrating how some community coalitions and evaluators currently integrate dose into the planning and implementation of place-based healthy eating and active living strategies. Finally, a planning checklist was developed for program coordinators and evaluators. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Changing Communities, Community Satisfaction, and Quality of Life: A View of Multiple Perceived Indicators

ERIC Educational Resources Information Center

Matarrita-Cascante, David

2010-01-01

The relationship between a community's services and conditions, satisfaction, and overall quality of life were examined in this study. As these relationships respond to specific contextual and cultural settings, qualitative methods were used to account for their complexity and depth. Key informant interviews were conducted in two rural communities…

Theory and Metrics of Community Resilience: A Systematic Literature Review Based on Public Health Guidelines.

PubMed

Zamboni, Lucila M

2017-12-01

A systematic literature review on quantitative methods to assess community resilience was conducted following Institute of Medicine and Patient-Centered Outcomes Research Institute standards. Community resilience is the ability of a community to bounce back or return to normal after a disaster strikes, yet there is no agreement on what this actually means. All studies reviewed addressed natural disasters, but the methodological approaches can be applied to technological disasters, epidemics, and terrorist attacks. Theoretical frameworks consider the association between vulnerability, resilience, and preparedness, yet these associations vary across frameworks. Because of this complexity, indexes based on composite indicators are the predominant methodological tool used to assess community resilience. Indexes identify similar dimensions but observe resilience at both the individual and geographical levels, reflecting a lack of agreement on what constitutes a community. A consistent, cross-disciplinary metric for community resilience would allow for identifying areas to apply short-term versus long-term interventions. A comparable metric for assessing geographic units in multiple levels and dimensions is an opportunity to identify regional strengths and weaknesses, develop timely targeted policy interventions, improve policy evaluation instruments, and grant allocation formulas design. (Disaster Med Public Health Preparedness. 2017;11:756-763).

Lessons Learned From Community-Based Approaches to Sodium Reduction

PubMed Central

Kane, Heather; Strazza, Karen; Losby PhD, Jan L.; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S.; Frost, Corey; Margolis, Marjorie; Hersey, James

2017-01-01

Purpose This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. Design A multiple case study design was used. Setting This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Subjects Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. Analysis The project team conducted a document review of program materials and semi structured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Results Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. Conclusion The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption. PMID:24575726

Using community-based participatory research to develop the PARTNERS youth violence prevention program.

PubMed

Leff, Stephen S; Thomas, Duane E; Vaughn, Nicole A; Thomas, Nicole A; MacEvoy, Julie Paquette; Freedman, Melanie A; Abdul-Kabir, Saburah; Woodlock, Joseph; Guerra, Terry; Bradshaw, Ayana S; Woodburn, Elizabeth M; Myers, Rachel K; Fein, Joel A

2010-01-01

School-based violence prevention programs have shown promise for reducing aggression and increasing children's prosocial behaviors. Prevention interventions within the context of urban after-school programs provide a unique opportunity for academic researchers and community stakeholders to collaborate in the creation of meaningful and sustainable violence prevention initiatives. This paper describes the development of a collaborative between academic researchers and community leaders to design a youth violence prevention/leadership promotion program (PARTNERS Program) for urban adolescents. Employing a community-based participatory research (CBPR) model, this project addresses the needs of urban youth, their families, and their community. Multiple strategies were used to engage community members in the development and implementation of the PARTNERS Program. These included focus groups, pilot testing the program in an after-school venue, and conducting organizational assessments of after-school sites as potential locations for the intervention. Community members and academic researchers successfully worked together in all stages of the project development. Community feedback helped the PARTNERS team redesign the proposed implementation and evaluation of the PARTNERS Program such that the revised study design allows for all sites to obtain the intervention over time and increases the possibility of building community capacity and sustainability of programs. Despite several challenges inherent to CBPR, the current study provides a number of lessons learned for the continued development of relationships and trust among researchers and community members, with particular attention to balancing the demand for systematic implementation of community-based interventions while being responsive to the immediate needs of the community.

Concurrent adversities among adolescents with conduct problems: the NAAHS study.

PubMed

Reigstad, Bjørn; Kvernmo, Siv

2016-10-01

Several studies have confirmed that maltreatment and abuse in childhood are related to conduct problems. Less is known about such relationships with concurrent adversities in adolescence and, also, when compared with other severe adversities and possible multiple additive effects. The study encompassed a community population of 4881 adolescents 15-16 years of age 50.1 % boys and 49.9 % girls. Youth with and without conduct problem scores within the deviant range on the Strength and Difficulties Questionnaire (SDQ) was compared on 12 concurrent adversities. Based on self-reports, 4.4 % of the adolescents had conduct problem scores within the deviant range and more girls (5.1 %) than boys (3.7 %). In the deviant conduct problem group, 65.1 % had experienced two or more concurrent adversities compared with 26.3 % of youths in the non-deviant group (OR 5.23, 95 % CI 3.91-7.01). Likewise, the deviant conduct problem group was from 1.71 to 8.43 times more at the risk of experiencing the different adversities. Parental mental health problems and experiences of violence were multivariately strongest associated with conduct problem scores within the deviant range on the SDQ. A strong multiple additive relationship with adversities was found. Two-thirds of youth with SDQ conduct problem scores within the deviant range reported two or more concurrent adversities. Clinicians should seek information about kinds and amount of possible traumatic adversities in youth with conduct problems and offer evidence based treatment.

Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS.

PubMed

Santiago, Catherine Decarlo; Pears, Gillian; Baweja, Shilpa; Vona, Pamela; Tang, Jennifer; Kataoka, Sheryl H

2013-12-01

This study explored parent engagement in an evidence-based treatment, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), which was delivered in a school setting. To examine the successes and challenges in engaging parents in this school-based program, we conducted qualitative interviews by phone to obtain data from clinicians, parents, and other school personnel across eleven schools from 3 different regions of the United States. Almost all of these schools served low-income and ethnically diverse communities. We describe general impressions of parent engagement, parent reactions and preferences with regard to CBITS, barriers to parent engagement, and how to overcome barriers from multiple perspectives. Parent engagement across schools varied, with extensive outreach and relatively good parent engagement in CBITS described in some schools, while in other schools, efforts to engage parents were not as consistent. Implications for future efforts to engage parents in school-based treatments are discussed.

Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS

PubMed Central

Santiago, Catherine DeCarlo; Pears, Gillian; Baweja, Shilpa; Vona, Pamela; Tang, Jennifer; Kataoka, Sheryl H.

2013-01-01

This study explored parent engagement in an evidence-based treatment, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), which was delivered in a school setting. To examine the successes and challenges in engaging parents in this school-based program, we conducted qualitative interviews by phone to obtain data from clinicians, parents, and other school personnel across eleven schools from 3 different regions of the United States. Almost all of these schools served low-income and ethnically diverse communities. We describe general impressions of parent engagement, parent reactions and preferences with regard to CBITS, barriers to parent engagement, and how to overcome barriers from multiple perspectives. Parent engagement across schools varied, with extensive outreach and relatively good parent engagement in CBITS described in some schools, while in other schools, efforts to engage parents were not as consistent. Implications for future efforts to engage parents in school-based treatments are discussed. PMID:24273613

Managing Annual Flood Risk and Reducing Socioeconomic Flood Impacts in Rural Arctic through Science-Community Collaborations

NASA Astrophysics Data System (ADS)

Kontar, Y. Y.

2016-12-01

Multiple Arctic riverine communities face flood risk every spring. Within hours floodwater and ice debris destroy entire communities, displacing hundreds of people. In FY 2015-2016 an international project entitled Reducing Spring Flood Impacts for Wellbeing of Communities of the North was successfully conducted with the goal to identify best practices in managing the risk and reducing the socioeconomic impacts of floods associated with spring river ice breakup. In this presentation, we will elaborate on socioeconomic impacts of breakup floods, including long-term evacuation of population, loss of means of livelihoods, and ecosystem resource loss. We will also compare and contrast spring flood risk management and reduction strategies and their effectiveness in Alaska and Sakha Republic (Siberia), Russia. The findings are based on surveys completed by the representatives of adverse populations in two flood-prone communities in Alaska and Sakha Republic, as well as a series of roundtable discussions and interviews between social and geoscientists, emergency managers, and community leaders.

HIV Partner Notification Values and Preferences Among Sex Workers, Fishermen, and Mainland Community Members in Rakai, Uganda: A Qualitative Study.

PubMed

Quinn, Caitlin; Nakyanjo, Neema; Ddaaki, William; Burke, Virginia M; Hutchinson, Naadiya; Kagaayi, Joseph; Wawer, Maria J; Nalugoda, Fred; Kennedy, Caitlin E

2018-01-25

HIV partner notification involves contacting sexual partners of people who test HIV positive and referring them to HIV testing, treatment, and prevention services. To understand values and preferences of key and general populations in Rakai, Uganda, we conducted 6 focus group discussions and 63 in-depth interviews in high prevalence fishing communities and low prevalence mainland communities. Participants included fishermen and sex workers in fishing communities, male and female mainland community members, and healthcare providers. Questions explored three approaches: passive referral, provider referral, and contract referral. Qualitative data were coded and analyzed using a team-based matrix approach. Participants agreed that passive referral was most suitable for primary partners. Provider referral was acceptable in fishing communities for notifying multiple, casual partners. Healthcare providers voiced concerns about limited time, resources, and training for provider-assisted approaches. Options for partner notification may help people overcome barriers to HIV serostatus disclosure and help reach key populations.

Improvement in maternal health literacy among pregnant women who did not complete compulsory education: policy implications for community care services.

PubMed

Ohnishi, Mayumi; Nakamura, Keiko; Takano, Takehito

2005-05-01

This paper examined factors that influence the improvement in maternal health literacy among pregnant women in Paraguay, including those who did not complete compulsory education but participated in a community-based antenatal care program. Structured interviews were conducted to evaluate the pregnant women's maternal health literacy during their first, second, and third visits to the program in the Caazapa Region. The associations between individual maternal health knowledge scores and its gains, healthcare personnel capabilities, available health facility equipment, community social network, and living environment were analyzed by multiple regression analysis. The mean maternal health knowledge score from 124 women who completed three-consecutive assessments increased between the first and third interviews. Higher capabilities of healthcare personnel and better living environment were significantly related to gains in the maternal health knowledge score (p<0.01). Wider application of a community-based antenatal care program to meet the needs of those who are functionally illiterate in the standard language of the country, training for community healthcare personnel to improve capabilities, and resources for social network in the community would contribute to the improvement in maternal health literacy.

Mindfulness-based stress reduction (MBSR) and distress in a community-based sample.

PubMed

Evans, Susan; Ferrando, Stephen; Carr, Corey; Haglin, Dean

2011-01-01

Numerous studies have found Mindfulness-based stress reduction (MBSR) to be useful for a wide range of problems including anxiety, pain and coping with a medical illness. The primary goal of this study was to evaluate the effectiveness of an 8-week MBSR programme in relieving distress in a community based sample. Subjects (n = 14) were participants in the MBSR programme at a major academic medical center and completed the Profile of Mood States (POMS) and the Mindful Attention Awareness Scale (MAAS) prior to starting the class and at the end of the 8-week course. Means and standard deviations were computed for the pre-and post-POMS total and subscale measures and the MAAS. Wilcoxon Signed Ranks Test was conducted. There were significant reductions on multiple dimensions of distress on the POMS as well as a significant increase in mindful awareness as measured by the MAAS. These results suggest that MBSR appears to be associated with a reduction of distress and increased awareness of everyday life experiences in a sample of residents living in a large urban community.  Copyright © 2010 John Wiley & Sons, Ltd.

"Sitting in different chairs:" roles of the community health workers in the Poder es Salud/Power for Health Project.

PubMed

Farquhar, S A; Wiggins, N; Michael, Y L; Luhr, G; Jordan, J; Lopez, A

2008-07-01

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs' perspective. This article presents the CHWs' points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. Authors draw from an analysis of transcript data from in-depth interviews conducted with CHWs to present a description of the strategies employed by the CHWs to build leadership skills and knowledge among community members. CHWs also discuss their own personal and professional development. The analysis of the interviews suggests that CHWs valued their multiple roles with Poder es Salud/Power for Health and their participation on the project's Steering Committee. Based on CHWs' descriptions of their work, this type of involvement appears to build the CHWs' leadership skills and sense of efficacy to create change in their communities. By serving as community organizers and participating as producers of research, rather than acting merely as a deliverer of the intervention activities, the CHWs were able to build skills that make them more successful as CHWs.

Leveraging a Community Participatory Framework to Move Climate Survey Data into Action at a Small College

ERIC Educational Resources Information Center

Peters, C. Ellen; Benitez, Michael, Jr.

2017-01-01

A participatory framework in conducting research and implementing decisions can engage multiple constituents throughout a college community. At a small college, it is especially relevant, because nonmajority groups are especially vulnerable because of a smaller critical mass.

Exploring the barriers to and facilitators of implementing research into practice.

PubMed

Johnston, Bridget; Coole, Carol; Narayanasamy, Melanie; Feakes, Ruth; Whitworth, Gillian; Tyrell, Tracy; Hardy, Beth

2016-08-02

District and community nursing roles have changed rapidly in recent years. Community nurses are increasingly being tasked with carrying out multiple roles, which require them to put research into practice and use evidence-based tools and interventions. The implementation of interventions and tools needs to be developed from empirical research, requiring evidence, to be translated into practice. However, this process may be compromised or enhanced by a number of factors. This exploratory, descriptive qualitative study sought to identify barriers and facilitators to community nurses implementing research into practice. Four focus groups were conducted with registered community nurses and district nurses (n=22). Analysis identified four main themes: keeping up to date with evidence; using a clinical tool; education/training and implementation. Findings suggest that there are barriers at a personal, professional and organisational level. Strategies are suggested to overcome these obstacles.

Community-centered responses to Ebola in urban Liberia: the view from below.

PubMed

Abramowitz, Sharon Alane; McLean, Kristen E; McKune, Sarah Lindley; Bardosh, Kevin Louis; Fallah, Mosoka; Monger, Josephine; Tehoungue, Kodjo; Omidian, Patricia A

2015-04-01

The West African Ebola epidemic has demonstrated that the existing range of medical and epidemiological responses to emerging disease outbreaks is insufficient, especially in post-conflict contexts with exceedingly poor healthcare infrastructures. In this context, community-based responses have proven vital for containing Ebola virus disease (EVD) and shifting the epidemic curve. Despite a surge in interest in local innovations that effectively contained the epidemic, the mechanisms for community-based response remain unclear. This study provides baseline information on community-based epidemic control priorities and identifies innovative local strategies for containing EVD in Liberia. This study was conducted in September 2014 in 15 communities in Monrovia and Montserrado County, Liberia--one of the epicenters of the Ebola outbreak. Findings from 15 focus group discussions with 386 community leaders identified strategies being undertaken and recommendations for what a community-based response to Ebola should look like under then-existing conditions. Data were collected on the following topics: prevention, surveillance, care-giving, community-based treatment and support, networks and hotlines, response teams, Ebola treatment units (ETUs) and hospitals, the management of corpses, quarantine and isolation, orphans, memorialization, and the need for community-based training and education. Findings have been presented as community-based strategies and recommendations for (1) prevention, (2) treatment and response, and (3) community sequelae and recovery. Several models for community-based management of the current Ebola outbreak were proposed. Additional findings indicate positive attitudes towards early Ebola survivors, and the need for community-based psychosocial support. Local communities' strategies and recommendations give insight into how urban Liberian communities contained the EVD outbreak while navigating the systemic failures of the initial state and international response. Communities in urban Liberia adapted to the epidemic using multiple coping strategies. In the absence of health, infrastructural and material supports, local people engaged in self-reliance in order to contain the epidemic at the micro-social level. These innovations were regarded as necessary, but as less desirable than a well-supported health-systems based response; and were seen as involving considerable individual, social, and public health costs, including heightened vulnerability to infection.

Integrating Systems-Based Practice, Community Psychiatry, and Recovery into Residency Training

ERIC Educational Resources Information Center

LeMelle, Stephanie; Arbuckle, Melissa R.; Ranz, Jules M.

2013-01-01

Background: Behavioral health services involving multiple systems of care are increasingly being provided in community as well as hospital settings. Residents therefore should be familiar with multiple systems and the role of the psychiatrist in these systems. The authors describe a curriculum incorporating principles of systems-based practice…

LESSONS LEARNED FROM THE NATIONAL HUMAN EXPOSURE ASSESSMENT SURVEY (NHEXAS)

EPA Science Inventory

Three NHEXAS Studies were conducted from 1995-1997 to evaluate total human exposure to multiple chemicals on community and regional scales. EPA established cooperative agreements with three Consortia to conduct three interrelated NHEXAS field studies. The University of Arizona...

Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study.

PubMed

Echazú, Adriana; Juarez, Marisa; Vargas, Paola A; Cajal, Silvana P; Cimino, Ruben O; Heredia, Viviana; Caropresi, Silvia; Paredes, Gladys; Arias, Luis M; Abril, Marcelo; Gold, Silvia; Lammie, Patrick; Krolewiecki, Alejandro J

2017-10-01

Recommendations for soil-transmitted helminth (STH) control give a key role to deworming of school and pre-school age children with albendazole or mebendazole; which might be insufficient to achieve adequate control, particularly against Strongyloides stercoralis. The impact of preventive chemotherapy (PC) against STH morbidity is still incompletely understood. The aim of this study was to assess the effectiveness of a community-based program with albendazole and ivermectin in a high transmission setting for S. stercoralis and hookworm. Community-based pragmatic trial conducted in Tartagal, Argentina; from 2012 to 2015. Six communities (5070 people) were enrolled for community-based PC with albendazole and ivermectin. Two communities (2721 people) were re-treated for second and third rounds. STH prevalence, anemia and malnutrition were explored through consecutive surveys. Anthropometric assessment of children, stool analysis, complete blood count and NIE-ELISA serology for S. stercoralis were performed. STH infection was associated with anemia and stunting in the baseline survey that included all communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). Among communities with multiple interventions, STH prevalence decreased from 62% to 23% (p<0.001) after the first PC; anemia also diminished from 52% to 12% (p<0.001). After two interventions S. stercoralis seroprevalence declined, from 51% to 14% (p<0.001) and stunting prevalence decreased, from 19% to 12% (p = 0.009). Hookworm' infections are associated with anemia in the general population and nutritional impairment in children. S. stercoralis is also associated with anemia. Community-based deworming with albendazole and ivermectin is effective for the reduction of STH prevalence and morbidity in communities with high prevalence of hookworm and S. stercoralis.

The population approach to falls injury prevention in older people: findings of a two community trial

PubMed Central

2010-01-01

Background There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury. The aim of the study was to quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age. Methods Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States. Results The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest. Conclusions The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those that are intensively implemented. PMID:20167124

Community-Centered Responses to Ebola in Urban Liberia: The View from Below

PubMed Central

Abramowitz, Sharon Alane; McLean, Kristen E.; McKune, Sarah Lindley; Bardosh, Kevin Louis; Fallah, Mosoka; Monger, Josephine; Tehoungue, Kodjo; Omidian, Patricia A.

2015-01-01

Background The West African Ebola epidemic has demonstrated that the existing range of medical and epidemiological responses to emerging disease outbreaks is insufficient, especially in post-conflict contexts with exceedingly poor healthcare infrastructures. In this context, community-based responses have proven vital for containing Ebola virus disease (EVD) and shifting the epidemic curve. Despite a surge in interest in local innovations that effectively contained the epidemic, the mechanisms for community-based response remain unclear. This study provides baseline information on community-based epidemic control priorities and identifies innovative local strategies for containing EVD in Liberia. Methodology/Principal Findings This study was conducted in September 2014 in 15 communities in Monrovia and Montserrado County, Liberia – one of the epicenters of the Ebola outbreak. Findings from 15 focus group discussions with 386 community leaders identified strategies being undertaken and recommendations for what a community-based response to Ebola should look like under then-existing conditions. Data were collected on the following topics: prevention, surveillance, care-giving, community-based treatment and support, networks and hotlines, response teams, Ebola treatment units (ETUs) and hospitals, the management of corpses, quarantine and isolation, orphans, memorialization, and the need for community-based training and education. Findings have been presented as community-based strategies and recommendations for (1) prevention, (2) treatment and response, and (3) community sequelae and recovery. Several models for community-based management of the current Ebola outbreak were proposed. Additional findings indicate positive attitudes towards early Ebola survivors, and the need for community-based psychosocial support. Conclusions/Significance Local communities’ strategies and recommendations give insight into how urban Liberian communities contained the EVD outbreak while navigating the systemic failures of the initial state and international response. Communities in urban Liberia adapted to the epidemic using multiple coping strategies. In the absence of health, infrastructural and material supports, local people engaged in self-reliance in order to contain the epidemic at the micro-social level. These innovations were regarded as necessary, but as less desirable than a well-supported health-systems based response; and were seen as involving considerable individual, social, and public health costs, including heightened vulnerability to infection. PMID:25856072

Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

PubMed

Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

2015-12-01

To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

Formulation of an Integrated Community Based Disaster Management for Hydroelectric facilities: The Malaysia Case

NASA Astrophysics Data System (ADS)

Hijazzi, Norshamirra; Thiruchelvam, Sivadass; Sabri Muda, Rahsidi; Nasharuddin Mustapha, Kamal; Che Muda, Zakaria; Ghazali, Azrul; Kamal Kadir, Ahmad; Hakimie, Hazlinda; Sahari, Khairul Salleh Mohamed; Hasini, Hasril; Mohd Sidek, Lariyah; Itam, Zarina; Fadhli Mohamad, Mohd; Razad, Azwin Zailti Abdul

2016-03-01

Dams, however significant their contributions are to the society, are not immune to failures and diminishing lifespan not unlike other structural elements in our infrastructure. Despite continuing efforts on design, construction, operation, and maintenance of dams to improve the safety of the dams, the possibility of unforeseen events of dam failures is still possible. Seeing that dams are usually integrated into close approximities with the community, dam failures may consequent in tremendous loss of lives and properties. The aims of formulation of Integrated Community Based Disaster Management (ICBDM) is to simulate evacuation modelling and emergency planning in order to minimize loss of life and property damages in the event of a dam-related disaster. To achieve the aim above, five main pillars have been identified for the formulation of ICBDM. A series of well-defined program inclusive of hydrological 2-D modelling, life safety modelling, community based EWS and CBTAP will be conducted. Finally, multiple parties’ engagement is to be carried out in the form of table top exercise to measure the readiness of emergency plans and response capabilities of key players during the state of a crisis.

"We are all there for the same purpose": Support for an integrated community exercise program for older adults with HF and COPD.

PubMed

Desveaux, Laura; Harrison, Samantha; Lee, Annemarie; Mathur, Sunita; Goldstein, Roger; Brooks, Dina

Despite well-established improvements following rehabilitation, functional gains often diminish following discharge. To explore the attitudes of older adults with HF and COPD, who have completed rehabilitation, toward community-based exercise maintenance. Semi-structured interviews were conducted with 11 individuals with HF or COPD. Deductive thematic analysis uncovered three themes: 1) transitioning to community exercise is challenging, highlighting participants' struggle with unstructured maintenance and a lack of appropriate programs; 2) a structured, group-based program tailored to functional ability facilitates adherence, describing participants views on the importance of routine, and accountability; and 3) "We are all there for the same purpose" - participant support for integrated exercise, including the benefit of multiple perspectives and sustainability. A motivating program leader and access to appropriate facilities are key features to support adherence to prescribed activity. Tailored programs can be delivered consecutively to older adults with HF and COPD. Copyright © 2017 Elsevier Inc. All rights reserved.

Perceptions of tuberculosis among immigrants and refugees at an adult education center: a community-based participatory research approach.

PubMed

Wieland, Mark L; Weis, Jennifer A; Yawn, Barbara P; Sullivan, Susan M; Millington, Kendra L; Smith, Christina M; Bertram, Susan; Nigon, Julie A; Sia, Irene G

2012-02-01

English as a Second Language programs serve large foreign-born populations in the US with elevated risks of tuberculosis (TB), yet little is known about TB perceptions in these settings. Using a community-based participatory research approach, we elicited perceptions about TB among immigrant and refugee learners and staff at a diverse adult education center. Community partners were trained in focus groups moderation. Ten focus groups were conducted with 83 learners and staff. Multi-level, team-based qualitative analysis was conducted to develop themes that informed a model of TB perceptions among participants. Multiple challenges with TB control and prevention were identified. There were a variety of misperceptions about transmission of TB, and a lack of knowledge about latent TB. Feelings and perceptions related to TB included secrecy, shame, fear, and isolation. Barriers to TB testing include low awareness, lack of knowledge about latent TB, and the practical considerations of transportation, cost, and work schedule conflicts. Barriers to medication use include suspicion of generic medications and perceived side effects. We posit adult education centers with large immigrant and refugee populations as excellent venues for TB prevention, and propose several recommendations for conducting these programs. Content should dispel the most compelling misperceptions about TB transmission while clarifying the difference between active and latent disease. Learners should be educated about TB in the US and that it is curable. Finally, TB programs that include learners and staff in their design and implementation provide greater opportunity for overcoming previously unrecognized barriers.

A trait-based framework for stream algal communities.

PubMed

Lange, Katharina; Townsend, Colin Richard; Matthaei, Christoph David

2016-01-01

The use of trait-based approaches to detect effects of land use and climate change on terrestrial plant and aquatic phytoplankton communities is increasing, but such a framework is still needed for benthic stream algae. Here we present a conceptual framework of morphological, physiological, behavioural and life-history traits relating to resource acquisition and resistance to disturbance. We tested this approach by assessing the relationships between multiple anthropogenic stressors and algal traits at 43 stream sites. Our "natural experiment" was conducted along gradients of agricultural land-use intensity (0-95% of the catchment in high-producing pasture) and hydrological alteration (0-92% streamflow reduction resulting from water abstraction for irrigation) as well as related physicochemical variables (total nitrogen concentration and deposited fine sediment). Strategic choice of study sites meant that agricultural intensity and hydrological alteration were uncorrelated. We studied the relationships of seven traits (with 23 trait categories) to our environmental predictor variables using general linear models and an information-theoretic model-selection approach. Life form, nitrogen fixation and spore formation were key traits that showed the strongest relationships with environmental stressors. Overall, FI (farming intensity) exerted stronger effects on algal communities than hydrological alteration. The large-bodied, non-attached, filamentous algae that dominated under high farming intensities have limited dispersal abilities but may cope with unfavourable conditions through the formation of spores. Antagonistic interactions between FI and flow reduction were observed for some trait variables, whereas no interactions occurred for nitrogen concentration and fine sediment. Our conceptual framework was well supported by tests of ten specific hypotheses predicting effects of resource supply and disturbance on algal traits. Our study also shows that investigating a fairly comprehensive set of traits can help shed light on the drivers of algal community composition in situations where multiple stressors are operating. Further, to understand non-linear and non-additive effects of such drivers, communities need to be studied along multiple gradients of natural variation or anthropogenic stressors.

Understanding community-based processes for research ethics review: a national study.

PubMed

Shore, Nancy; Brazauskas, Ruta; Drew, Elaine; Wong, Kristine A; Moy, Lisa; Baden, Andrea Corage; Cyr, Kirsten; Ulevicus, Jocelyn; Seifer, Sarena D

2011-12-01

Institutional review boards (IRBs), designed to protect individual study participants, do not routinely assess community consent, risks, and benefits. Community groups are establishing ethics review processes to determine whether and how research is conducted in their communities. To strengthen the ethics review of community-engaged research, we sought to identify and describe these processes. In 2008 we conducted an online survey of US-based community groups and community-institutional partnerships involved in human-participants research. We identified 109 respondents who met participation criteria and had ethics review processes in place. The respondents' processes mainly functioned through community-institutional partnerships, community-based organizations, community health centers, and tribal organizations. These processes had been created primarily to ensure that the involved communities were engaged in and directly benefited from research and were protected from research harms. The primary process benefits included giving communities a voice in determining which studies were conducted and ensuring that studies were relevant and feasible, and that they built community capacity. The primary process challenges were the time and resources needed to support the process. Community-based processes for ethics review consider community-level ethical issues that institution-based IRBs often do not.

Predictors of the physical impact of Multiple Sclerosis following community-based, exercise trial.

PubMed

Kehoe, M; Saunders, J; Jakeman, P; Coote, S

2015-04-01

Studies evaluating exercise interventions in people with multiple sclerosis (PwMS) demonstrate small to medium positive effects and large variability on a number of outcome measures. No study to date has tried to explain this variability. This paper presents a novel exploration of data examining the predictors of outcome for PwMS with minimal gait impairment following a randomised, controlled trial evaluating community-based exercise interventions (N = 242). The primary variable was the physical component of the Multiple Sclerosis Impact Scale-29, version 2 (MSIS-29, v2) after a 10-week, controlled intervention period. Predictors were identified a priori and were measured at baseline. Multiple linear regression was conducted. Four models are presented lower MSIS-29, v2 scores after the intervention period were best predicted by a lower baseline MSIS-29,v2, a lower baseline Modified Fatigue Impact Score (physical subscale), randomisation to an exercise intervention, a longer baseline walking distance measured by the Six Minute Walk Test and female gender. This model explained 57.4% of the variance (F (5, 211) = 59.24, p < 0.01). These results suggest that fatigue and walking distance at baseline contribute significantly to predicting MSIS-29, v29 (physical component) after intervention, and thus should be the focus of intervention and assessment. Exercise is an important contributor to minimising the physical impact of MS, and gender-specific interventions may be warranted. © The Author(s), 2014.

Collaborative leadership and the implementation of community-based fall prevention initiatives: a multiple case study of public health practice within community groups.

PubMed

Markle-Reid, Maureen; Dykeman, Cathy; Ploeg, Jenny; Kelly Stradiotto, Caralyn; Andrews, Angela; Bonomo, Susan; Orr-Shaw, Sarah; Salker, Niyati

2017-02-16

Falls among community-dwelling older adults are a serious public health concern. While evidence-based fall prevention strategies are available, their effective implementation requires broad cross-sector coordination that is beyond the capacity of any single institution or organization. Community groups comprised of diverse stakeholders that include public health, care providers from the public and private sectors and citizen volunteers are working to deliver locally-based fall prevention. These groups are examples of collective impact and are important venues for public health professionals (PHPs) to deliver their mandate to work collaboratively towards achieving improved health outcomes. This study explores the process of community-based group work directed towards fall prevention, and it focuses particular attention on the collaborative leadership practices of PHPs, in order to advance understanding of the competencies required for collective impact. Four community groups, located in Ontario, Canada, were studied using an exploratory, retrospective, multiple case study design. The criteria for inclusion were presence of a PHP, a diverse membership and the completion of an initiative that fit within the scope of the World Health Organization Fall Prevention Model. Data were collected using interviews (n = 26), focus groups (n = 4), and documents. Cross-case synthesis was conducted by a collaborative team of researchers. The community groups differed by membership, the role of the PHP and the type of fall prevention initiatives. Seven practice themes emerged: (1) tailoring to address context; (2) making connections; (3) enabling communication; (4) shaping a vision; (5) skill-building to mobilize and take action; (6) orchestrating people and projects; and (7) contributing information and experience. The value of recognized leadership competencies was underscored and the vital role of institutional supports was highlighted. To align stakeholders working towards fall prevention for community-dwelling older adults and establish a foundation for collective impact, public health professionals employed practices that reflected a collaborative leadership style. Looking ahead, public health professionals will want to shift their focus to evaluating the effectiveness of their group work within communities. They will also need to assess outcomes and evaluate whether the anticipated reductions in fall rates among community-dwelling older adults is being achieved.

A multi-level examination of how the organizational context relates to readiness to implement prevention and evidence-based programming in community settings.

PubMed

Chilenski, Sarah M; Olson, Jonathan R; Schulte, Jill A; Perkins, Daniel F; Spoth, Richard

2015-02-01

Prior theoretical and empirical research suggests that multiple aspects of an organization's context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization's readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization's readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization's morale was also found to be a strong predictor of an organization's readiness. The findings of the current study are discussed in terms of implications for prevention and intervention.

A Multi-level Examination of how the Organizational Context Relates to Readiness to Implement Prevention and Evidence-Based Programming in Community Settings

PubMed Central

Chilenski, Sarah M.; Olson, Jonathan R.; Schulte, Jill A.; Perkins, Daniel F.; Spoth, Richard

2015-01-01

Prior theoretical and empirical research suggests that multiple aspects of an organization’s context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization’s readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization’s readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization’s morale was also found to be a strong predictor of an organization’s readiness. The findings of the current study are discussed in terms of implications for prevention and intervention. PMID:25463014

Community Involvement among Behaviourally Bisexual Men in the Midwestern USA: Experiences and Perceptions across Communities

PubMed Central

Dodge, Brian; Schnarrs, Phillip W.; Reece, Michael; Goncalves, Gabriel; Martinez, Omar; Nix, Ryan; Malebranche, David; Van Der Pol, Barbara; Murray, Maresa; Fortenberry, J. Dennis

2012-01-01

Limited research exists regarding community involvement and social support among behaviourally bisexual men. Previous studies suggest that bisexual men experience high levels of social stigma in both heterosexual and homosexual community settings. Research focusing on social support has demonstrated that individuals with limited access to similar individuals experience greater risk for negative health outcomes. Using a community-based research design, participants were recruited using multiple methods in Indianapolis, Indiana, USA. Researchers conducted in-depth, semi-structured interviews with 75 men who reported having engaged in bisexual behaviour within the past six months. Interviews elucidated the experiences of behaviourally bisexual men in heterosexual and homosexual settings, as well as their perceptions of the existence of a bisexual community or bisexual spaces. All participants perceived a lack of a visible bisexual community and expressed difficulty with being comfortable, or feeling belonging, within a variety of heterosexual and homosexual community spaces. Findings suggest the need for interventions focused on community building among, as well as creating spaces specifically designed for, bisexual men in order to increase perceived social support and decrease isolation and possible negative health outcomes. PMID:22978551

Tools to Assess Community-Based Cumulative Risk and Exposures

EPA Science Inventory

Multiple agents and stressors can interact in a given community to adversely affect human and ecological conditions. A cumulative risk assessment (CRA) analyzes, characterizes, and potentially quantifies the effects from multiple stressors, which include chemical agents (for exam...

Application of mixed-methods design in community-engaged research: Lessons learned from an evidence-based intervention for Latinos with chronic illness and minor depression.

PubMed

Aguado Loi, Claudia X; Alfonso, Moya L; Chan, Isabella; Anderson, Kelsey; Tyson, Dinorah Dina Martinez; Gonzales, Junius; Corvin, Jaime

2017-08-01

The purpose of this paper is to share lessons learned from a collaborative, community-informed mixed-methods approach to adapting an evidence-based intervention to meet the needs of Latinos with chronic disease and minor depression and their family members. Mixed-methods informed by community-based participatory research (CBPR) were employed to triangulate multiple stakeholders' perceptions of facilitators and barriers of implementing the adapted intervention in community settings. Community partners provided an insider perspective to overcome methodological challenges. The study's community informed mixed-methods: research approach offered advantages to a single research methodology by expanding or confirming research findings and engaging multiple stakeholders in data collection. This approach also allowed community partners to collaborate with academic partners in key research decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Social Anxiety Disorder and Victimization in a Community Sample of Adolescents

ERIC Educational Resources Information Center

Gren-Landell, Malin; Aho, Nikolas; Andersson, Gerhard; Svedin, Carl Goran

2011-01-01

Despite high prevalence rates of social anxiety disorder (SAD) and high rates of victimization in adolescents, studies on the relationship between these phenomena are missing. In the present study we report associations between SAD and multiple victimization experiences in a community sample of adolescents. A cross-sectional study was conducted on…

Process evaluation of a community-based adolescent obesity prevention project in Tonga

PubMed Central

2011-01-01

Background The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma'alahi Youth Project (MYP) conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents) to promote healthy eating and regular physical activity and to reduce the prevalence of overweight and obesity amongst youth and their families. This paper reflects on the process evaluation for MYP, against a set of Best Practice Principles for community-based obesity prevention. Methods MYP was managed by the Fiji School of Medicine. A team of five staff in Tonga were committed to planning, implementation and evaluation of a strategic plan, the key planks of which were developed during a two day community workshop. Intervention activities were delivered in villages, churches and schools, on the main island of Tongatapu. Process evaluation data covering the resource utilisation associated with all intervention activities were collected, and analysed by dose, frequency and reach for specific strategies. The action plan included three standard objectives around capacity building, social marketing and evaluation; four nutrition; two physical activity objectives; and one around championing key people as role models. Results While the interventions included a wide mix of activities straddling across all of these objectives and in both school and village settings, there was a major focus on the social marketing and physical activity objectives. The intervention reach, frequency and dose varied widely across all activities, and showed no consistent patterns. Conclusions The adolescent obesity interventions implemented as part of the MYP program comprised a wide range of activities conducted in multiple settings, touched a broad spectrum of the population (wider than the target group), but the dose and frequency of activities were generally insufficient and not sustained. Also the project confirmed that, while the MYP resulted in increased community awareness of healthy behaviours, Tonga is still in its infancy in terms of conducting public health research and lacks research infrastructure and capacity. PMID:21549018

Process evaluation of a community-based adolescent obesity prevention project in Tonga.

PubMed

Fotu, Kalesita F; Moodie, Marj M; Mavoa, Helen M; Pomana, Siosifa; Schultz, Jimaima T; Swinburn, Boyd A

2011-05-09

The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma'alahi Youth Project (MYP) conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents) to promote healthy eating and regular physical activity and to reduce the prevalence of overweight and obesity amongst youth and their families. This paper reflects on the process evaluation for MYP, against a set of Best Practice Principles for community-based obesity prevention. MYP was managed by the Fiji School of Medicine. A team of five staff in Tonga were committed to planning, implementation and evaluation of a strategic plan, the key planks of which were developed during a two day community workshop. Intervention activities were delivered in villages, churches and schools, on the main island of Tongatapu. Process evaluation data covering the resource utilisation associated with all intervention activities were collected, and analysed by dose, frequency and reach for specific strategies. The action plan included three standard objectives around capacity building, social marketing and evaluation; four nutrition; two physical activity objectives; and one around championing key people as role models. While the interventions included a wide mix of activities straddling across all of these objectives and in both school and village settings, there was a major focus on the social marketing and physical activity objectives. The intervention reach, frequency and dose varied widely across all activities, and showed no consistent patterns. The adolescent obesity interventions implemented as part of the MYP program comprised a wide range of activities conducted in multiple settings, touched a broad spectrum of the population (wider than the target group), but the dose and frequency of activities were generally insufficient and not sustained. Also the project confirmed that, while the MYP resulted in increased community awareness of healthy behaviours, Tonga is still in its infancy in terms of conducting public health research and lacks research infrastructure and capacity.

Practice-based research networks (PBRNs) are promising laboratories for conducting dissemination and implementation research.

PubMed

Heintzman, John; Gold, Rachel; Krist, Alexander; Crosson, Jay; Likumahuwa, Sonja; DeVoe, Jennifer E

2014-01-01

Dissemination and implementation science addresses the application of research findings in varied health care settings. Despite the potential benefit of dissemination and implementation work to primary care, ideal laboratories for this science have been elusive. Practice-based research networks (PBRNs) have a long history of conducting research in community clinical settings, demonstrating an approach that could be used to execute multiple research projects over time in broad and varied settings. PBRNs also are uniquely structured and increasingly involved in pragmatic trials, a research design central to dissemination and implementation science. We argue that PBRNs and dissemination and implementation scientists are ideally suited to work together and that the collaboration of these 2 groups will yield great value for the future of primary care and the delivery of evidence-based health care. © Copyright 2014 by the American Board of Family Medicine.

Jigsaw Research Communities: Coordinating Research and Service across Multiple Courses to Serve a Single Community Partner

ERIC Educational Resources Information Center

Cross, Anne; Eckberg, Deborah A.

2015-01-01

This article describes a public scholarship project in which two faculty members worked together to integrate service-learning and research into multiple courses to benefit a single community partner. The project linked undergraduate students, graduate students, and faculty in a broad-based research endeavor that contributed to the survival and…

An improved null model for assessing the net effects of multiple stressors on communities.

PubMed

Thompson, Patrick L; MacLennan, Megan M; Vinebrooke, Rolf D

2018-01-01

Ecological stressors (i.e., environmental factors outside their normal range of variation) can mediate each other through their interactions, leading to unexpected combined effects on communities. Determining whether the net effect of stressors is ecologically surprising requires comparing their cumulative impact to a null model that represents the linear combination of their individual effects (i.e., an additive expectation). However, we show that standard additive and multiplicative null models that base their predictions on the effects of single stressors on community properties (e.g., species richness or biomass) do not provide this linear expectation, leading to incorrect interpretations of antagonistic and synergistic responses by communities. We present an alternative, the compositional null model, which instead bases its predictions on the effects of stressors on individual species, and then aggregates them to the community level. Simulations demonstrate the improved ability of the compositional null model to accurately provide a linear expectation of the net effect of stressors. We simulate the response of communities to paired stressors that affect species in a purely additive fashion and compare the relative abilities of the compositional null model and two standard community property null models (additive and multiplicative) to predict these linear changes in species richness and community biomass across different combinations (both positive, negative, or opposite) and intensities of stressors. The compositional model predicts the linear effects of multiple stressors under almost all scenarios, allowing for proper classification of net effects, whereas the standard null models do not. Our findings suggest that current estimates of the prevalence of ecological surprises on communities based on community property null models are unreliable, and should be improved by integrating the responses of individual species to the community level as does our compositional null model. © 2017 John Wiley & Sons Ltd.

Community-based tobacco cessation program among women in Mumbai, India.

PubMed

Mishra, G A; Kulkarni, S V; Majmudar, P V; Gupta, S D; Shastri, S S

2014-12-01

Globally tobacco epidemic kills nearly six million people annually. Consumption of tobacco products is on the rise in low- and middle-income countries. Tobacco is addictive; hence, tobacco users need support in quitting. Providing tobacco cessation services to women in community enabling them to quit tobacco, identifying factors associated with quitting and documenting the processes involved to establish a replicable "model tobacco cessation program." This is a community based tobacco cessation program of one year duration conducted among women in a low socioeconomic area of Mumbai, India. It involved three interventions conducted at three months interval, comprised of health education, games and counseling sessions and a post intervention follow-up. Uni and multivariate analysis was performed to find out association of various factors with quitting tobacco. The average compliance in three intervention rounds was 95.2%. The mean age at initiation of tobacco was 17.3 years. Tobacco use among family members and in the community was primary reasons for initiation and addiction to tobacco was an important factor for continuation, whereas health education and counseling seemed to be largely responsible for quitting. The quit rate at the end of the programme was 33.5%. Multivariate logistic regression analysis found that women in higher age groups and women consuming tobacco at multiple locations are less likely to quit tobacco. Changing cultural norms associated with smokeless tobacco, strict implementation of antitobacco laws in the community and work places and providing cessation support are important measures in preventing initiation and continuation of tobacco use among women in India.

The Community Perinatal Care Study: Home Visiting and Nursing Support for Pregnant Women

ERIC Educational Resources Information Center

Johnston, David; Tough, Suzanne; Siever, Jodi

2006-01-01

This article describes The Community Perinatal Care Study, a community-based study of pregnancy support that was conducted in Calgary, Alberta, Canada, between 2001 and 2004. The study was conducted to learn how to improve community-based pregnancy care and to improve prenatal care and healthy births, particularly for women with increased…

The influence of hazard models on GIS-based regional risk assessments and mitigation policies

USGS Publications Warehouse

Bernknopf, R.L.; Rabinovici, S.J.M.; Wood, N.J.; Dinitz, L.B.

2006-01-01

Geographic information systems (GIS) are important tools for understanding and communicating the spatial distribution of risks associated with natural hazards in regional economies. We present a GIS-based decision support system (DSS) for assessing community vulnerability to natural hazards and evaluating potential mitigation policy outcomes. The Land Use Portfolio Modeler (LUPM) integrates earth science and socioeconomic information to predict the economic impacts of loss-reduction strategies. However, the potential use of such systems in decision making may be limited when multiple but conflicting interpretations of the hazard are available. To explore this problem, we conduct a policy comparison using the LUPM to test the sensitivity of three available assessments of earthquake-induced lateral-spread ground failure susceptibility in a coastal California community. We find that the uncertainty regarding the interpretation of the science inputs can influence the development and implementation of natural hazard management policies. Copyright ?? 2006 Inderscience Enterprises Ltd.

PERMANOVA-S: association test for microbial community composition that accommodates confounders and multiple distances.

PubMed

Tang, Zheng-Zheng; Chen, Guanhua; Alekseyenko, Alexander V

2016-09-01

Recent advances in sequencing technology have made it possible to obtain high-throughput data on the composition of microbial communities and to study the effects of dysbiosis on the human host. Analysis of pairwise intersample distances quantifies the association between the microbiome diversity and covariates of interest (e.g. environmental factors, clinical outcomes, treatment groups). In the design of these analyses, multiple choices for distance metrics are available. Most distance-based methods, however, use a single distance and are underpowered if the distance is poorly chosen. In addition, distance-based tests cannot flexibly handle confounding variables, which can result in excessive false-positive findings. We derive presence-weighted UniFrac to complement the existing UniFrac distances for more powerful detection of the variation in species richness. We develop PERMANOVA-S, a new distance-based method that tests the association of microbiome composition with any covariates of interest. PERMANOVA-S improves the commonly-used Permutation Multivariate Analysis of Variance (PERMANOVA) test by allowing flexible confounder adjustments and ensembling multiple distances. We conducted extensive simulation studies to evaluate the performance of different distances under various patterns of association. Our simulation studies demonstrate that the power of the test relies on how well the selected distance captures the nature of the association. The PERMANOVA-S unified test combines multiple distances and achieves good power regardless of the patterns of the underlying association. We demonstrate the usefulness of our approach by reanalyzing several real microbiome datasets. miProfile software is freely available at https://medschool.vanderbilt.edu/tang-lab/software/miProfile z.tang@vanderbilt.edu or g.chen@vanderbilt.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

PERMANOVA-S: association test for microbial community composition that accommodates confounders and multiple distances

PubMed Central

Tang, Zheng-Zheng; Chen, Guanhua; Alekseyenko, Alexander V.

2016-01-01

Motivation: Recent advances in sequencing technology have made it possible to obtain high-throughput data on the composition of microbial communities and to study the effects of dysbiosis on the human host. Analysis of pairwise intersample distances quantifies the association between the microbiome diversity and covariates of interest (e.g. environmental factors, clinical outcomes, treatment groups). In the design of these analyses, multiple choices for distance metrics are available. Most distance-based methods, however, use a single distance and are underpowered if the distance is poorly chosen. In addition, distance-based tests cannot flexibly handle confounding variables, which can result in excessive false-positive findings. Results: We derive presence-weighted UniFrac to complement the existing UniFrac distances for more powerful detection of the variation in species richness. We develop PERMANOVA-S, a new distance-based method that tests the association of microbiome composition with any covariates of interest. PERMANOVA-S improves the commonly-used Permutation Multivariate Analysis of Variance (PERMANOVA) test by allowing flexible confounder adjustments and ensembling multiple distances. We conducted extensive simulation studies to evaluate the performance of different distances under various patterns of association. Our simulation studies demonstrate that the power of the test relies on how well the selected distance captures the nature of the association. The PERMANOVA-S unified test combines multiple distances and achieves good power regardless of the patterns of the underlying association. We demonstrate the usefulness of our approach by reanalyzing several real microbiome datasets. Availability and Implementation: miProfile software is freely available at https://medschool.vanderbilt.edu/tang-lab/software/miProfile. Contact: z.tang@vanderbilt.edu or g.chen@vanderbilt.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:27197815

Implementing rapid HIV testing in outreach and community settings: results from an advancing HIV prevention demonstration project conducted in seven U.S. cities.

PubMed

Bowles, Kristina E; Clark, Hollie A; Tai, Eric; Sullivan, Patrick S; Song, Binwei; Tsang, Jenny; Dietz, Craig A; Mir, Julita; Mares-DelGrasso, Azul; Calhoun, Cindy; Aguirre, Daisy; Emerson, Cicily; Heffelfinger, James D

2008-01-01

The goals of this project were to assess the feasibility of conducting rapid human immunodeficiency virus (HIV) testing in outreach and community settings to increase knowledge of HIV serostatus among groups disproportionately affected by HIV and to identify effective nonclinical venues for recruiting people in the targeted populations. Community-based organizations (CBOs) in seven U.S. cities conducted rapid HIV testing in outreach and community settings, including public parks, homeless shelters, and bars. People with reactive preliminary positive test results received confirmatory testing, and people confirmed to be HIV-positive were referred to health-care and prevention services. A total of 23,900 people received rapid HIV testing. Of the 267 people (1.1%) with newly diagnosed HIV infection, 75% received their confirmatory test results and 64% were referred to care. Seventy-six percent were from racial/ethnic minority groups, and 58% identified themselves as men who have sex with men, 72% of whom reported having multiple sex partners in the past year. Venues with the highest proportion of new HIV diagnoses were bathhouses, social service organizations, and needle-exchange programs. The acceptance rate for testing was 60% among sites collecting this information. Findings from this demonstration project indicate that offering rapid HIV testing in outreach and community settings is a feasible approach for reaching members of minority groups and people at high risk for HIV infection. The project identified venues that would be important to target and offered lessons that could be used by other CBOs to design and implement similar programs in the future.

Assessing the Impact of Twenty-First Century Rural School Consolidation

ERIC Educational Resources Information Center

Surface, Jeanne

2011-01-01

The purpose of the study was to make a qualitative assessment of the impact of school consolidation on several rural Nebraska communities that have recently lost their schools. This research uses a multiple-case study design with interviews conducted in three Nebraska communities. The data from this research fell into four broad themes: social…

Real Time Analysis: Does Navy Have a Plan?

DTIC Science & Technology

2015-06-12

Information Dominance (ID) continues to rely on the collection of as much information as possible from the electromagnetic and cyber domains to conduct operations. However, with the increase in organic sensor data along with access to information that was currently outside Navy channels, data overload threatens the ability of the Navy to perform real time analysis. In the past three years the Navy ID community has chartered multiple roadmaps and vision documents nested within national policy to lead the way for decision superiority based on the information collected in the

Social entrepreneurship in religious congregations' efforts to address health needs.

PubMed

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

2014-01-01

Examine how religious congregations engage in social entrepreneurship as they strive to meet health-related needs in their communities. Multiple case studies. Los Angeles County, California. Purposive sample of 14 congregations representing diverse races/ethnicities (African-American, Latino, and white) and faith traditions (Jewish and various Christian). 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 by using a qualitative, code-based approach. 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. 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.

Sustainability and factors affecting the success of community-based reproductive health programs in rural northwest Ethiopia.

PubMed

Argaw, Daniel; Fanthahun, Mesganaw; Berhane, Yemane

2007-08-01

arious Community-Based Reproductive Health interventions were initiated in many developing countries but their effectiveness has not been evaluated as much as needed. A comparative cross sectional study was carried out in February 2002 among women who participated in community based reproductive health interventions in South Gondar zone, Ethiopia. The study was conducted in eight kebeles taking successful and weak program areas for comparison. Both quantitative and qualitative methods were used for data collection. The qualitative method included key informants interview, and Focus Group Discussions with Community-based reproductive health agents (CBRHAs). A multistage sampling technique was employed to select 792 study subjects for the quantitative part of the study. Awareness of the presence of the CBRHA in the locality, participation in selection of the agents, acceptance of the agent, and evertalking to CBRHA about reproductive health issues were significantly higher in successful than in weak program areas [OR(95% CI) = 2.32 (1.74, 3.08), 3.28 (1.22, 9.27), 6.65 (3.59, 12.43), and 5.05 (3.22, 7.96), respectively]. In multiple logistic regression analysis awareness of presence of CBRHA in the village, acceptance of the CBRHA, and having had discussion with CBRHA maintained significant associations with type of community-based reproductive health program (successful/weak). Focus Group Discussions and Key Informant Interviews revealed better involvement of community leaders and health workers in the process of selecting and supervising CBRHA in successful areas compared to weak areas. The sustainability score of the Community-Based Reproductive Health Program (CBRHP) graded by the program coordinators was 2.92 out of 5. Acceptance of the CBRHAs, communication of the agents with community members, level of Support to the agents, better involvement of community representatives in the selection process were found to be the major factors affecting CBRHP. Overall sustainability of the CBRHP was low which calls for an urgent action.

Assessing Health Promotion Interventions: Limitations of Traditional Research Methods in Community-Based Studies.

PubMed

Dressel, Anne; Schneider, Robert; DeNomie, Melissa; Kusch, Jennifer; Welch, Whitney; Sosa, Mirtha; Yeldell, Sally; Maida, Tatiana; Wineberg, Jessica; Holt, Keith; Bernstein, Rebecca

2017-09-01

Most low-income Americans fail to meet physical activity recommendations. Inactivity and poor diet contribute to obesity, a risk factor for multiple chronic diseases. Health promotion activities have the potential to improve health outcomes for low-income populations. Measuring the effectiveness of these activities, however, can be challenging in community settings. A "Biking for Health" study tested the impact of a bicycling intervention on overweight or obese low-income Latino and African American adults to reduce barriers to cycling and increase physical activity and fitness. A randomized controlled trial was conducted in Milwaukee, Wisconsin, in summer 2015. A 12-week bicycling intervention was implemented at two sites with low-income, overweight, or obese Latino and African American adults. We found that randomized controlled trial methodology was suboptimal for use in this small pilot study and that it negatively affected participation. More discussion is needed about the effectiveness of using traditional research methods in community settings to assess the effectiveness of health promotion interventions. Modifications or alternative methods may yield better results. The aim of this article is to discuss the effectiveness and feasibility of using traditional research methods to assess health promotion interventions in community-based settings.

A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties

ERIC Educational Resources Information Center

McKay, Mary M.; Gopalan, Geetha; Franco, Lydia; Dean-Assael, Kara; Chacko, Anil; Jackson, Jerrold M.; Fuss, Ashley

2011-01-01

This article presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within 13 urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this article focuses on parent…

Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study

PubMed Central

Juarez, Marisa; Vargas, Paola A.; Cajal, Silvana P.; Cimino, Ruben O.; Heredia, Viviana; Caropresi, Silvia; Paredes, Gladys; Arias, Luis M.; Abril, Marcelo; Gold, Silvia; Lammie, Patrick; Krolewiecki, Alejandro J.

2017-01-01

Background Recommendations for soil-transmitted helminth (STH) control give a key role to deworming of school and pre-school age children with albendazole or mebendazole; which might be insufficient to achieve adequate control, particularly against Strongyloides stercoralis. The impact of preventive chemotherapy (PC) against STH morbidity is still incompletely understood. The aim of this study was to assess the effectiveness of a community-based program with albendazole and ivermectin in a high transmission setting for S. stercoralis and hookworm. Methodology Community-based pragmatic trial conducted in Tartagal, Argentina; from 2012 to 2015. Six communities (5070 people) were enrolled for community-based PC with albendazole and ivermectin. Two communities (2721 people) were re-treated for second and third rounds. STH prevalence, anemia and malnutrition were explored through consecutive surveys. Anthropometric assessment of children, stool analysis, complete blood count and NIE-ELISA serology for S. stercoralis were performed. Principal findings STH infection was associated with anemia and stunting in the baseline survey that included all communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). Among communities with multiple interventions, STH prevalence decreased from 62% to 23% (p<0.001) after the first PC; anemia also diminished from 52% to 12% (p<0.001). After two interventions S. stercoralis seroprevalence declined, from 51% to 14% (p<0.001) and stunting prevalence decreased, from 19% to 12% (p = 0.009). Conclusions Hookworm’ infections are associated with anemia in the general population and nutritional impairment in children. S. stercoralis is also associated with anemia. Community-based deworming with albendazole and ivermectin is effective for the reduction of STH prevalence and morbidity in communities with high prevalence of hookworm and S. stercoralis. PMID:28991899

Informing comprehensive HIV prevention: a situational analysis of the HIV prevention and care context, North West Province South Africa.

PubMed

Lippman, Sheri A; Treves-Kagan, Sarah; Gilvydis, Jennifer M; Naidoo, Evasen; Khumalo-Sakutukwa, Gertrude; Darbes, Lynae; Raphela, Elsie; Ntswane, Lebogang; Barnhart, Scott

2014-01-01

Building a successful combination prevention program requires understanding the community's local epidemiological profile, the social community norms that shape vulnerability to HIV and access to care, and the available community resources. We carried out a situational analysis in order to shape a comprehensive HIV prevention program that address local barriers to care at multiple contextual levels in the North West Province of South Africa. The situational analysis was conducted in two sub-districts in 2012 and guided by an adaptation of WHO's Strategic Approach, a predominantly qualitative method, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. Analysis began during fieldwork with nightly discussions of findings and continued with coding original textual data from the fieldwork notebooks and a select number of recorded interviews. We conducted over 200 individual and group interviews and gleaned four principal social barriers to HIV prevention and care, including: HIV fatalism, traditional gender norms, HIV-related stigma, and challenges with communication around HIV, all of which fuel the HIV epidemic. At the different levels of response needed to stem the epidemic, we found evidence of national policies and programs that are mitigating the social risk factors but little community-based responses that address social risk factors to HIV. Understanding social and structural barriers to care helped shape our comprehensive HIV prevention program, which address the four 'themes' identified into each component of the program. Activities are underway to engage communities, offer community-based testing in high transmission areas, community stigma reduction, and a positive health, dignity and prevention program for stigma reduction and improve communication skills. The situational analysis process successfully shaped key programmatic decisions and cultivated a deeper collaboration with local stakeholders to support program implementation.

Web-based versus in-person methods for training lay community health advisors to implement health promotion workshops: participant outcomes from a cluster-randomized trial.

PubMed

Holt, Cheryl L; Tagai, Erin K; Santos, Sherie Lou Zara; Scheirer, Mary Ann; Bowie, Janice; Haider, Muhiuddin; Slade, Jimmie

2018-06-28

Project HEAL (Health through Early Awareness and Learning) is an implementation trial that compared two methods of training lay peer community health advisors (CHAs)-in-person ("Traditional") versus web-based ("Technology")-to conduct a series of three evidence-based cancer educational workshops in African American churches. This analysis reports on participant outcomes from Project HEAL. Fifteen churches were randomized to the two CHA training methods and the intervention impact was examined over 24 months. This study was conducted in Prince George's County, MD, and enrolled 375 church members age 40-75. Participants reported on knowledge and screening behaviors for breast, prostate, and colorectal cancer. Overall, cancer knowledge in all areas increased during the study period (p < .001). There were significant increases in digital rectal exam (p < .05), fecal occult blood test (p < .001), and colonoscopy (p < .01) at 24 months; however, this did not differ by study group. Mammography maintenance (56% overall) was evidenced by women reporting multiple mammograms within the study period. Participants attending all three workshops were more likely to report a fecal occult blood test or colonoscopy at 24 months (p < .05) than those who attended only one. These findings suggest that lay individuals can receive web-based training to successfully implement an evidence-based health promotion intervention that results in participant-level outcomes comparable with (a) people trained using the traditional classroom method and (b) previous efficacy trials. Findings have implications for resources and use of technology to increase widespread dissemination of evidence-based health promotion interventions through training lay persons in community settings.

Measuring Coverage in MNCH: Evaluation of Community-Based Treatment of Childhood Illnesses through Household Surveys

PubMed Central

Hazel, Elizabeth; Requejo, Jennifer; David, Julia; Bryce, Jennifer

2013-01-01

Community case management (CCM) is a strategy for training and supporting workers at the community level to provide treatment for the three major childhood diseases—diarrhea, fever (indicative of malaria), and pneumonia—as a complement to facility-based care. Many low- and middle-income countries are now implementing CCM and need to evaluate whether adoption of the strategy is associated with increases in treatment coverage. In this review, we assess the extent to which large-scale, national household surveys can serve as sources of baseline data for evaluating trends in community-based treatment coverage for childhood illnesses. Our examination of the questionnaires used in Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 2005 and 2010 in five sub-Saharan African countries shows that questions on care seeking that included a locally adapted option for a community-based provider were present in all the DHS surveys and in some MICS surveys. Most of the surveys also assessed whether appropriate treatments were available, but only one survey collected information on the place of treatment for all three illnesses. This absence of baseline data on treatment source in household surveys will limit efforts to evaluate the effects of the introduction of CCM strategies in the study countries. We recommend alternative analysis plans for assessing CCM programs using household survey data that depend on baseline data availability and on the timing of CCM policy implementation. PMID:23667329

Participatory development of incentives to coexist with jaguars and pumas.

PubMed

Amit, Ronit; Jacobson, Susan K

2018-01-22

Reducing costs and increasing benefits for rural communities coexisting with large carnivores is necessary for conservation of jaguar (Panthera onca) and puma (Puma concolor). To design acceptable incentives, stakeholders must be involved in the process. We conducted an innovative, structured, group communication process based on a Delphi technique as a template for identifying potential incentives. Community workshops with 133 members of 7 communities and surveys with 25 multidisciplinary experts from government, nongovernmental organizations, and academia provided iterative data to design a plan of incentives through 4 rounds of discussion. The final product integrated 862 ideas into 6 types of incentives: organization of communities, mechanisms for improved dialogue, citizen technical assistance, green labeling for community products, payment for the ecosystem service of biodiversity, and an assessment of financial alternatives. We used quantitative and qualitative techniques to indicate support for decisions about the design of incentives, which reduced researcher subjectivity. The diverse incentives developed and the cooperation from multiple stakeholders resulted in an incentive plan that integrated issues of governance, equity, and social norms. © 2018 Society for Conservation Biology.

Can a web-based community of practice be established and operated to lead falls prevention activity in residential care?

PubMed

Francis-Coad, Jacqueline; Etherton-Beer, Christopher; Bulsara, Caroline; Nobre, Debbie; Hill, Anne-Marie

The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training. Copyright © 2016 Elsevier Inc. All rights reserved.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

PubMed

Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making.

Evidence-based health promotion: applying it in practice.

PubMed

Wong, M L

2002-09-01

In health promotion, we should use interventions established by evidence to be effective in improving the health of the community. This paper reviews the concepts, evaluation and use of evidence in health promotion. A literature search of evidence-based health promotion and evaluation of health promotion was conducted using Medline, Social Science Citation Index (SSCI), PsycLIT and evidence-based web sites on health promotion, health education and community preventive services. Recent issues of key journals on health promotion, health education and public health were also hand-searched. The concept of evidence in health promotion interventions is complex due to its multidimensional nature. Evidence of effectiveness in health promotion is assessed by combining quantitative data on effect change in outcome measures and qualitative data on process evaluation of health promotion activities. Limitations to the use of randomised trials in community-based health promotion interventions include ethical and logistic problems in maintaining randomisation of subjects over long periods, absence of experimental conditions in the real-world setting, contamination of control subjects and the multidimensional nature of health promotion interventions. Randomised controlled trials should be used to evaluate the effectiveness of most health education and behavioural interventions in clinical settings. When such trials are not feasible as in community-based health promotion interventions, quasi-experimental designs provide strong evidence. Multiple methods are needed to assess evidence of effectiveness of health promotion programmes. Appropriate practice of evidence-based health promotion requires consideration of quality of available evidence, local values and prevailing resources.

Motivations for participating in a non-interventional gender-based violence survey in a low-income setting in South Africa.

PubMed

Sikweyiya, Yandisa; Nduna, Mzikazi; Shai, Nwabisa; Jewkes, Rachel

2017-06-29

Qualitative study of motivations to participate in research into violence and other sensitive issues can help interpretation of findings from community based quantitative surveys. It is equally important to conduct research that may enable a deeper understanding on what motivates people to participate in GBV studies. To date, not much research has been conducted to investigate the factors that influence non-enrolment and enrolment in GBV studies from the viewpoint of the real participants. The present study sought to explore people's reasons for participating in a non-intervention GBV community-based survey in Gauteng province, South Africa. Twenty-two qualitative in-depth interviews were conducted with adult black African men and women who had participated in a gender-based violence survey conducted in a low-income setting in South Africa. Some participants reported motives for survey participation which could be interpreted as altruistic. Their motives included a desire to contribute to advancement of knowledge and to share life experiences so that unknown others could learn from these experiences. Yet, some participants hoped their participation will result in personal benefit or that they may be helped with their socio-economic challenges. The analysis further revealed a complex relationship between altruism and self-interest motives for participating in the survey amongst some of the participants. We conclude that it is difficult to discern which motive was primary or preceded the other. This is because such motives are not fixed, probably multiple and owing to their fluidity, may shift in people's minds at different times and depending on the nature of the conversation. Moreover, there may be a shift in the weight given to different motives over time.

Faith communities and their assets for health promotion: the views from health professionals and faith leaders in Dundee, in Scotland.

PubMed

Fagan, Donna M; Kiger, Alice; van Teijlingen, Edwin

2012-06-01

Within the European Union, as well as in Canada and the United States (US), health promoters employ a number of strategies to encourage community-based health improvements. This involves the creation of innovative health promotion partnerships to support and enable people to choose and engage in healthy living practices. Compared to the US, in other Western countries, such as the United Kingdom, faith communities have largely been ignored in health promotion partnerships. This study established existing evidence about health promotion in faith communities in Scotland by examining the perceptions and attitudes concerning health promotion among faith leaders and health promotion professionals. We conducted 33 semi-structured interviews with health promotion professionals (n = 9) and representatives of Christian and non-Christian faith communities (n = 24). The majority of participants expressed an interest in the concept of health promotion in a faith community and could readily envision its application in their area of work. Both groups identified multiple physical assets, as well as social supports within faith communities that could be directed towards healthy living activities. Faith groups and church organisations may constitute potential partners and new settings to increase community capacity for health promotion. Further research and funding for demonstration projects may be particularly helpful to provide evidence of the strengths and limitations of faith-based health promotion in Scotland, which in turn could inform health promotion practice and policy.

Sustainable childhood obesity prevention through community engagement (SCOPE) program: evaluation of the implementation phase.

PubMed

McIntosh, Bonnie; Daly, Amelia; Mâsse, Louise C; Collet, Jean-Paul; Higgins, Joan Wharf; Naylor, Patti-Jean; Amed, Shazhan

2015-10-01

Childhood obesity rates are steadily rising. Sustainable Childhood Obesity Prevention Through Community Engagement (SCOPE) is a community-based participatory action research (PAR) program aimed at preventing childhood obesity. This study aimed to describe community perspectives on, and elicit feedback about, SCOPE's first phase of implementation in two pilot cities in British Columbia, Canada. A case study was implemented using interviews and questionnaires to obtain feedback about SCOPE from two groups: SCOPE coordinators and stakeholders (i.e., individuals and organizations that were a member of the community and engaged with SCOPE coordinators). Participants were recruited via email and (or) by telephone. Coordinators completed a telephone interview. Stakeholders completed a questionnaire and (or) a telephone interview. Thematic analysis was conducted. Participants included 2 coordinators and 15 stakeholders. Participants similarly interpreted SCOPE as a program focused on raising awareness about childhood obesity prevention, while engaging multiple community sectors. Overall, participants valued the program's role in facilitating networking and partnership development, providing evidence-based resources, technical expertise, and contributing funding. Participants felt that SCOPE is sustainable. However, participants felt that barriers to achieving healthy weights among children included those related to the built environment, and social, behavioral, and economic obstacles. Perspectives on factors that facilitated and acted as barriers to SCOPE's first phase of implementation were obtained from the SCOPE communities and may be used to enhance the sustainability of SCOPE and its applicability to other BC communities.

Children’s Healthy Living (CHL) Program for remote underserved minority populations in the Pacific region: rationale and design of a community randomized trial to prevent early childhood obesity

PubMed Central

2013-01-01

Background Although surveillance data are limited in the US Affiliated Pacific, Alaska, and Hawaii, existing data suggest that the prevalence of childhood obesity is similar to or in excess of other minority groups in the contiguous US. Strategies for addressing the childhood obesity epidemic in the region support the use of community-based, environmentally targeted interventions. The Children’s Healthy Living Program is a partnership formed across institutions in the US Affiliated Pacific, Alaska, and Hawaii to design a community randomized environmental intervention trial and a prevalence survey to address childhood obesity in the region through affecting the food and physical activity environment. Methods/Design The Children’s Healthy Living Program community randomized trial is an environmental intervention trial in four matched-pair communities in American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, and Hawaii and two matched-pair communities in Alaska. A cross-sectional sample of children (goal n = 180) in each of the intervention trial communities is being assessed for outcomes at baseline and at 24 months (18 months post-intervention). In addition to the collection of the participant-based measures of anthropometry, diet, physical activity, sleep and acanthosis nigricans, community assessments are also being conducted in intervention trial communities. The Freely Associated States of Micronesia (Federated States of Micronesia, and Republics of Marshall Islands and Palau) is only conducting elements of the Children’s Healthy Living Program sampling framework and similar measurements to provide prevalence data. In addition, anthropometry information will be collected for two additional communities in each of the 5 intervention jurisdictions to be included in the prevalence survey. The effectiveness of the environmental intervention trial is being assessed based on the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. Discussion The Children’s Healthy Living Program environmental trial is designed to focus on capacity building and to maximize the likelihood of sustainable impact on childhood obesity-related behaviors and outcomes. The multiple measures at the individual, community, and environment levels are designed to maximize the likelihood of detecting change. This approach enhances the likelihood for identifying and promoting the best methods to promote health and well-being of the children in the underserved US Affiliated Pacific Region. Trial registration NIH clinical trial # NCT01881373 PMID:24107083

Children's Healthy Living (CHL) Program for remote underserved minority populations in the Pacific region: rationale and design of a community randomized trial to prevent early childhood obesity.

PubMed

Wilken, Lynne R; Novotny, Rachel; Fialkowski, Marie K; Boushey, Carol J; Nigg, Claudio; Paulino, Yvette; Leon Guerrero, Rachael; Bersamin, Andrea; Vargo, Don; Kim, Jang; Deenik, Jonathan

2013-10-09

Although surveillance data are limited in the US Affiliated Pacific, Alaska, and Hawaii, existing data suggest that the prevalence of childhood obesity is similar to or in excess of other minority groups in the contiguous US. Strategies for addressing the childhood obesity epidemic in the region support the use of community-based, environmentally targeted interventions. The Children's Healthy Living Program is a partnership formed across institutions in the US Affiliated Pacific, Alaska, and Hawaii to design a community randomized environmental intervention trial and a prevalence survey to address childhood obesity in the region through affecting the food and physical activity environment. The Children's Healthy Living Program community randomized trial is an environmental intervention trial in four matched-pair communities in American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, and Hawaii and two matched-pair communities in Alaska. A cross-sectional sample of children (goal n = 180) in each of the intervention trial communities is being assessed for outcomes at baseline and at 24 months (18 months post-intervention). In addition to the collection of the participant-based measures of anthropometry, diet, physical activity, sleep and acanthosis nigricans, community assessments are also being conducted in intervention trial communities. The Freely Associated States of Micronesia (Federated States of Micronesia, and Republics of Marshall Islands and Palau) is only conducting elements of the Children's Healthy Living Program sampling framework and similar measurements to provide prevalence data. In addition, anthropometry information will be collected for two additional communities in each of the 5 intervention jurisdictions to be included in the prevalence survey. The effectiveness of the environmental intervention trial is being assessed based on the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. The Children's Healthy Living Program environmental trial is designed to focus on capacity building and to maximize the likelihood of sustainable impact on childhood obesity-related behaviors and outcomes. The multiple measures at the individual, community, and environment levels are designed to maximize the likelihood of detecting change. This approach enhances the likelihood for identifying and promoting the best methods to promote health and well-being of the children in the underserved US Affiliated Pacific Region. NIH clinical trial # NCT01881373.

Calmer Life: A Hybrid Effectiveness-implementation Trial for Late-life Anxiety Conducted in Low-income, Mental Health-Underserved Communities.

PubMed

Shrestha, Srijana; Wilson, Nancy; Kunik, Mark E; Wagener, Paula; Amspoker, Amber B; Barrera, Terri; Freshour, Jessica; Kraus-Schuman, Cynthia; Bavineau, Jane; Turner, Maria; Stanley, Melinda A

2017-05-01

Anxiety is common among older adults and is associated with multiple negative outcomes. Late-life anxiety is usually unrecognized by providers and undertreated, although evidence supports the effectiveness of psychosocial treatment. Access to mental health care is especially poor among African American seniors. New treatment models are needed to expand the reach of mental health care to minority elders. Our article outlines a study designed to test the effectiveness and implementation potential of Calmer Life (CL), a community-based, person-centered, flexible and culturally tailored intervention for late-life anxiety and worry, offered in low-income, mental health-underserved and predominantly African American communities. CL is skills-based, but also includes resource counseling and an option to integrate religion/spirituality. The study population includes individuals 50 years of age and older who are experiencing high levels of worry. The program was developed in the context of a community-academic partnership with organizations that provide services for seniors in underserved communities, and it trains nontraditional community providers to deliver the intervention. Study progress to date, challenges, and lessons learned are discussed. Data collection is ongoing, and study findings will be available in late 2017. CL will offer valuable information to help expand the reach of anxiety treatment among minority seniors living in underserved neighborhoods.

Integrated health messaging for multiple neglected zoonoses: Approaches, challenges and opportunities in Morocco.

PubMed

Ducrotoy, M J; Yahyaoui Azami, H; El Berbri, I; Bouslikhane, M; Fassi Fihri, O; Boué, F; Petavy, A F; Dakkak, A; Welburn, S; Bardosh, K L

2015-12-01

Integrating the control of multiple neglected zoonoses at the community-level holds great potential, but critical data is missing to inform the design and implementation of different interventions. In this paper we present an evaluation of an integrated health messaging intervention, using powerpoint presentations, for five bacterial (brucellosis and bovine tuberculosis) and dog-associated (rabies, cystic echinococcosis and leishmaniasis) zoonotic diseases in Sidi Kacem Province, northwest Morocco. Conducted by veterinary and epidemiology students between 2013 and 2014, this followed a process-based approach that encouraged sequential adaptation of images, key messages, and delivery strategies using auto-evaluation and end-user feedback. We describe the challenges and opportunities of this approach, reflecting on who was targeted, how education was conducted, and what tools and approaches were used. Our results showed that: (1) replacing words with local pictures and using "hands-on" activities improved receptivity; (2) information "overload" easily occurred when disease transmission pathways did not overlap; (3) access and receptivity at schools was greater than at the community-level; and (4) piggy-backing on high-priority diseases like rabies offered an important avenue to increase knowledge of other zoonoses. We conclude by discussing the merits of incorporating our validated education approach into the school curriculum in order to influence long-term behaviour change. Copyright © 2015 Elsevier B.V. All rights reserved.

Informing Comprehensive HIV Prevention: A Situational Analysis of the HIV Prevention and Care Context, North West Province South Africa

PubMed Central

Lippman, Sheri A.; Treves-Kagan, Sarah; Gilvydis, Jennifer M.; Naidoo, Evasen; Khumalo-Sakutukwa, Gertrude; Darbes, Lynae; Raphela, Elsie; Ntswane, Lebogang; Barnhart, Scott

2014-01-01

Objective Building a successful combination prevention program requires understanding the community’s local epidemiological profile, the social community norms that shape vulnerability to HIV and access to care, and the available community resources. We carried out a situational analysis in order to shape a comprehensive HIV prevention program that address local barriers to care at multiple contextual levels in the North West Province of South Africa. Method The situational analysis was conducted in two sub-districts in 2012 and guided by an adaptation of WHO’s Strategic Approach, a predominantly qualitative method, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. Analysis began during fieldwork with nightly discussions of findings and continued with coding original textual data from the fieldwork notebooks and a select number of recorded interviews. Results We conducted over 200 individual and group interviews and gleaned four principal social barriers to HIV prevention and care, including: HIV fatalism, traditional gender norms, HIV-related stigma, and challenges with communication around HIV, all of which fuel the HIV epidemic. At the different levels of response needed to stem the epidemic, we found evidence of national policies and programs that are mitigating the social risk factors but little community-based responses that address social risk factors to HIV. Conclusions Understanding social and structural barriers to care helped shape our comprehensive HIV prevention program, which address the four ‘themes’ identified into each component of the program. Activities are underway to engage communities, offer community-based testing in high transmission areas, community stigma reduction, and a positive health, dignity and prevention program for stigma reduction and improve communication skills. The situational analysis process successfully shaped key programmatic decisions and cultivated a deeper collaboration with local stakeholders to support program implementation. PMID:25028976

Ethics of Health Research in Communities: Perspectives From the Southwestern United States

PubMed Central

Williams, Robert L.; Willging, Cathleen E.; Quintero, Gilbert; Kalishman, Summers; Sussman, Andrew L.; Freeman, William L.

2010-01-01

PURPOSE The increasing attention paid to community-based research highlights the question of whether human research protections focused on the individual are adequate to safeguard communities. We conducted a study to explore how community members perceive low-risk health research, the adequacy of human research protection processes, and the ethical conduct of community-based research. METHODS Eighteen focus groups were conducted among rural and urban Hispanic and Native American communities in New Mexico using a semistructured guide. Group transcriptions were analyzed using iterative readings and coding, with review of the analytic summary by group members. RESULTS Although participants recognized the value of health research, many also identified several adverse effects of research in their communities, including social (community and individual labeling, stigmatization, and discrimination) and economic (community job losses, increased insurance rates, and loss of community income). A lack of community beneficence was emphasized by participants who spoke of researchers who fail to communicate results adequately or assist with follow-through. Many group members did not believe current human research and data privacy processes were adequate to protect or assist communities. CONCLUSIONS Ethical review of community-based health research should apply the Belmont principles to communities. Researchers should adopt additional approaches to community-based research by engaging communities as active partners throughout the research process, focusing on community priorities, and taking extra precautions to assure individual and community privacy. Plans for meaningful dissemination of results to communities should be part of the research design. PMID:20843885

Learning With E-books and Project-based Strategy in a Community Health Nursing Course.

PubMed

Sung, Tien-Wen; Wu, Ting-Ting

2018-03-01

With advances in information technology, "information-assisted instruction" has been gradually introduced to nursing education curricula. Specifically, the integration of an e-book system can effectively enhance nursing students' attention and interest. Most studies on nursing education that incorporated e-books have focused on the advantages of convenience and assistance provided by e-books. Few studies have addressed community health nursing and off-campus practice activities in relation to suitable teaching strategies for learning activities. This study involved designing and planning a multimedia e-book learning system with a project-based learning activity that conforms to the curriculum and practical requirements of a community health nursing course. The purpose was to reduce the gap between theory and practice and realize an effective learning process. For learning evaluations, a final examination analysis with an independent sample t test; a scoring scheme with intrateam, interteam, and expert ratings; and Bloom's taxonomy-based analysis were conducted. The evaluation results indicated that the comprehension and learning abilities of the experimental group using the e-book system with a mobile device were effectively improved. In addition, the exploratory process involved in project-based learning can develop multiple cognitive skills and problem-solving ability, thereby realizing effective learning.

Community governance of the Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Mohawk Nation, Canada.

PubMed

Cargo, Margaret; Lévesque, Lucie; Macaulay, Ann C; McComber, Alex; Desrosiers, Serge; Delormier, Treena; Potvin, Louise

2003-09-01

Health promotion emphasizes the importance of community ownership in the governance of community-based programmes, yet little research has been conducted in this area. This study examined perceptions of community ownership among project partners taking responsibility for decision-making related to the Kahnawake Schools Diabetes Prevention Project (KSDPP). Project partners were surveyed cross-sectionally at 18 months (T1) and 60 months (T2) into the project. The perceived influence of each project partner was assessed at T1 and T2 for three domains: (i) KSDPP activities; (ii) KSDPP operations; and (iii) Community Advisory Board (CAB) activities. Project staff were perceived to have the greatest influence on KSDPP activities, KSDPP operations and CAB activities at both T1 and T2. High mean scores of perceived influence for CAB members and community researchers, however, suggests that project decision-making was a shared responsibility among multiple community partners. Although academic researcher influence was consistently low, they were satisfied with their level of influence. This was unlike community affiliates, who were less satisfied with their lower level of influence. In keeping with Kanien'kehaka (Mohawk) culture, the findings suggest a participatory democracy or shared decision-making as the primary mode of governance of KSDPP.

The role of Indigenous knowledge in environmental health risk management in Yukon, Canada

PubMed Central

Friendship, Katelyn A.; Furgal, Chris M.

2012-01-01

Objectives This project aimed to gain better understandings of northern Indigenous risk perception related to food safety and to identify the role that Indigenous knowledge (IK) plays in risk management processes to support more effective and culturally relevant benefit-risk (B-R) management strategies. Study design The project used an exploratory qualitative case study design to investigate the role and place of IK in the management of environmental contaminants exposure via consumption of traditional foods in Yukon First Nations (YFNs). Methods Forty-one semi-directive interviews with Traditional Food Knowledge Holders and Health and Environment Decision-makers were conducted. A review and analysis of organizational documents related to past risk management events for the issue was conducted. Thematic content analysis was used to analyze transcripts and documents for key themes related to the research question. Results There was a recognized need by all participants for better collaboration between scientists and YFN communities. YFNs have been involved in identifying and defining community concerns about past risk issues, setting a local context, and participating in communications strategies. Interviewees stressed the need to commit adequate time for building relationships, physically being in the community, and facilitating open communication. Conducting community-based projects was identified as critical for collaboration and for cooperative learning and management of these issues. Conclusions The perception of “effective” benefit-risk management is significantly influenced by the efforts made to include local communities in the process. A set of common guiding principles within a process that brings together people and knowledge systems may provide a more effective way forward in cross-cultural, multiple knowledge system contexts for complex benefit-risk issues than a prescriptive rigid framework. PMID:22868192

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study

PubMed Central

Newman, Peter A.; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Objectives Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. Methods From 2008–2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Results Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. Conclusions This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making. PMID:26295159

Using a two-phase evolutionary framework to select multiple network spreaders based on community structure

NASA Astrophysics Data System (ADS)

Fu, Yu-Hsiang; Huang, Chung-Yuan; Sun, Chuen-Tsai

2016-11-01

Using network community structures to identify multiple influential spreaders is an appropriate method for analyzing the dissemination of information, ideas and infectious diseases. For example, data on spreaders selected from groups of customers who make similar purchases may be used to advertise products and to optimize limited resource allocation. Other examples include community detection approaches aimed at identifying structures and groups in social or complex networks. However, determining the number of communities in a network remains a challenge. In this paper we describe our proposal for a two-phase evolutionary framework (TPEF) for determining community numbers and maximizing community modularity. Lancichinetti-Fortunato-Radicchi benchmark networks were used to test our proposed method and to analyze execution time, community structure quality, convergence, and the network spreading effect. Results indicate that our proposed TPEF generates satisfactory levels of community quality and convergence. They also suggest a need for an index, mechanism or sampling technique to determine whether a community detection approach should be used for selecting multiple network spreaders.

"Bringing It All Back Home": An Interdisciplinary Model for Community-Based Learning

ERIC Educational Resources Information Center

Schwartz, Earl

2015-01-01

Leaders of community-based learning programs must prove the worth of their programs to community hosts, while engaging students at appropriate levels of learning. Pitfalls multiply when programs are interdisciplinary, involve multiple sites, and/or deal with questions of social equity. Such programs must effectively match and prepare students and…

How national context, project design, and local community characteristics influence success in community-based conservation projects.

PubMed

Brooks, Jeremy S; Waylen, Kerry A; Borgerhoff Mulder, Monique

2012-12-26

Community-based conservation (CBC) promotes the idea that conservation success requires engaging with, and providing benefits for, local communities. However, CBC projects are neither consistently successful nor free of controversy. Innovative recent studies evaluating the factors associated with success and failure typically examine only a single resource domain, have limited geographic scope, consider only one outcome, or ignore the nested nature of socioecological systems. To remedy these issues, we use a global comparative database of CBC projects identified by systematic review to evaluate success in four outcome domains (attitudes, behaviors, ecological, economic) and explore synergies and trade-offs among these outcomes. We test hypotheses about how features of the national context, project design, and local community characteristics affect these measures of success. Using bivariate analyses and multivariate proportional odds logistic regressions within a multilevel analysis and model-fitting framework, we show that project design, particularly capacity-building in local communities, is associated with success across all outcomes. In addition, some characteristics of the local community in which projects are conducted, such as tenure regimes and supportive cultural beliefs and institutions, are important for project success. Surprisingly, there is little evidence that national context systematically influences project outcomes. We also find evidence of synergies between pairs of outcomes, particularly between ecological and economic success. We suggest that well-designed and implemented projects can overcome many of the obstacles imposed by local and national conditions to succeed in multiple domains.

Community Interventions to Improve Glycemic Control in African Americans With Type 2 Diabetes: A Systemic Review

PubMed Central

Smalls, Brittany L.; Walker, Rebekah J.; Bonilha, Heather S.; Campbell, Jennifer A.; Egede, Leonard E.

2015-01-01

Purpose: The purpose of this study was to conduct a systematic review of published community interventions to evaluate different components of community interventions and their ability to positively impact glycemic control in African Americans with T2DM. Methods: Medline, PsychInfo, and CINAHL were searched for potentially eligible studies published from January 2000 through January 2012. The following inclusion criteria were established for publications: (1) describe a community intervention, not prevention; (2) specifically indicate, in data analysis and results, the impact of the community intervention on African American adults, 18 years and older; (3) measure glycemic control (HbA1C) as an outcome measure; and (4) involve patients in a community setting, which excludes hospitals and hospital clinics. Results: Thirteen studies out of 9,233 articles identified in the search met the predetermined inclusion criteria. There were 5 randomized control trials and 3 reported improved glycemic control in the intervention group compared to the control group at the completion of the study. Of the 8 studies that were not randomized control trials, 6 showed a statistically significant change in HbA1C. Conclusion: In general, the community interventions assessed led to significant reductions in HbA1C in African Americans with type 2 diabetes. Community health workers did not have a greater impact on glycemic control in this sample. The findings of this study provides insight for designing community-based interventions in the future, such as including use of multiple delivery methods, consideration of mobile device software, nutritionist educator, and curriculum-based approaches. PMID:26156923

INCORPORATING NONCHEMICAL STRESSORS INTO CUMMULATIVE RISK ASSESSMENTS

EPA Science Inventory

The risk assessment paradigm has begun to shift from assessing single chemicals using "reasonable worst case" assumptions for individuals to considering multiple chemicals and community-based models. Inherent in community-based risk assessment is examination of all stressors a...

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

Systematic Review of Community-Based Childhood Obesity Prevention Studies

PubMed Central

Segal, Jodi; Wu, Yang; Wilson, Renee; Wang, Youfa

2013-01-01

OBJECTIVE: This study systematically reviewed community-based childhood obesity prevention programs in the United States and high-income countries. METHODS: We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library for relevant English-language studies. Studies were eligible if the intervention was primarily implemented in the community setting; had at least 1 year of follow-up after baseline; and compared results from an intervention to a comparison group. Two independent reviewers conducted title scans and abstract reviews and reviewed the full articles to assess eligibility. Each article received a double review for data abstraction. The second reviewer confirmed the first reviewer’s data abstraction for completeness and accuracy. RESULTS: Nine community-based studies were included; 5 randomized controlled trials and 4 non–randomized controlled trials. One study was conducted only in the community setting, 3 were conducted in the community and school setting, and 5 were conducted in the community setting in combination with at least 1 other setting such as the home. Desirable changes in BMI or BMI z-score were found in 4 of the 9 studies. Two studies reported significant improvements in behavioral outcomes (1 in physical activity and 1 in vegetable intake). CONCLUSIONS: The strength of evidence is moderate that a combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. More research and consistent methods are needed to understand the comparative effectiveness of childhood obesity prevention programs in the community setting. PMID:23753099

A community responds to collective trauma: an ecological analysis of the James Byrd murder in Jasper, Texas.

PubMed

Wicke, Thomas; Silver, Roxane Cohen

2009-12-01

The brutal murder of James Byrd Jr. in June 1998 unleashed a storm of media, interest groups, high profile individuals and criticism on the Southeast Texas community of Jasper. The crime and subsequent response-from within the community as well as across the world-engulfed the entire town in a collective trauma. Using natural disaster literature/theory and employing an ecological approach, Jasper, Texas was investigated via an interrupted time series analysis to identify how the community changed as compared to a control community (Center, Texas) on crime, economic, health, educational, and social capital measures collected at multiple pre- and post-crime time points between 1995 and 2003. Differences-in-differences (DD) analysis revealed significant post-event changes in Jasper, as well as a surprising degree of resilience and lack of negative consequences. Interviews with residents conducted between March 2005 and 2007 identified how the community responded to the crisis and augmented quantitative findings with qualitative, field-informed interpretation. Interviews suggest the intervention of external organizations exacerbated the severity of the events. However, using strengths of specific local social institutions-including faith based, law enforcement, media, business sector and civic government organizations-the community effectively responded to the initial threat and to the potential negative ramifications of external entities.

Application of Citizen Science Risk Communication Tools in a Vulnerable Urban Community

PubMed Central

Jiao, Yuqin; Bower, Julie K.; Im, Wansoo; Basta, Nicholas; Obrycki, John; Al-Hamdan, Mohammad Z.; Wilder, Allison; Bollinger, Claire E.; Zhang, Tongwen; Hatten, Luddie Sr.; Hatten, Jerrie; Hood, Darryl B.

2015-01-01

A public participatory geographical information systems (PPGIS) demographic, environmental, socioeconomic, health status portal was developed for the Stambaugh-Elwood (SE) community in Columbus, OH. We hypothesized that soil at SE residences would have metal concentrations above natural background levels. Three aims were developed that allowed testing of this hypothesis. Aim 1 focused on establishing partnerships between academia, state agencies and communities to assist in the development of a community voice. Aim 2 was to design and conduct soil sampling for residents of the SE community. Aim 3 was to utilize our interactive, customized portal as a risk communication tool by allowing residents to educate themselves as to the potential risks from industrial sources in close proximity to their community. Multiple comparisons of means were used to determine differences in soil element concentration by sampling location at p < 0.05. The results demonstrated that eight metals (As, Cd, Cu, Pb, Mo, Se, Tl, Zn) occurred at statistically-significantly greater levels than natural background levels, but most were below risk-based residential soil screening levels. Results were conveyed to residents via an educational, risk-communication informational card. This study demonstrates that community-led coalitions in collaboration with academic teams and state agencies can effectively address environmental concerns. PMID:26703664

The conduct of practice-based research in community clinics compared to private practices: similarities, differences, and challenges

PubMed Central

Gillette, Jane; Cunha-Cruz, Joana; Gilbert, Ann; Speed-McIntyre, Pollene; Zhou, Lingmei; DeRouen, Timothy

2013-01-01

Practice-based research should be performed in all practice settings if the results are to be applied to all settings. However, some practice settings, such as community clinics, have unique features that may make the conduct of such research more challenging. The purpose of this article is to describe and compare the similarities and unique challenges related to conducting research in community clinics compared to private practices within the Northwest Practice-Based REsearch Collaborative in Evidence-Based DENTistry (PRECEDENT) network. Information was obtained from meetings with general dentists, a survey of general dentists (N = 253), and a clinical examination and record review of a systemic random sample of patients visiting community clinics and private practices. (N = 1903)—all part of a dental practice-based research network. The processes of conducting research, the dentist and patient sociodemographic characteristics, the prevalence of oral diseases, and the dental treatments received in community clinics and private practices were compared. Both community clinics and private practices have the clinical treatment of the patients as their priority and have time constraints on research. The processes of research training, obtaining informed consent, and collecting, transmitting, and securely maintaining research data are also similar. The patient populations and treatment needs differ substantially between community clinics and private practices, with a higher prevalence of dental caries and higher restorative treatment needs in the community clinic patients. The process of study participant selection and follow-up for research and the dentist and staff work arrangements also vary between the two practice settings. Although community clinic patients and their dental healthcare providers have different research needs and challenges than their counterparts in private practice, practice-based research can be successfully PMID:25429251

AMIGAS: Building a Cervical Cancer Screening Intervention for Public Health Practice

PubMed Central

Smith, Judith Lee; Wilson, Katherine M.; Orians, Carlyn E.; Byrd, Theresa L.

2015-01-01

Background Many barriers to cervical cancer screening for Hispanic women have been documented, but few effective interventions exist. The Community Preventive Services Task Force recommends increasing cervical cancer screening through various methods. Building on this evidence, the Centers for Disease Control and Prevention funded the research and testing phases for an evidence-based and theoretically grounded intervention designed to increase cervical cancer screening among never and rarely screened Hispanic women of Mexican descent. In this article, we describe the development process of the AMIGAS (Ayudando a las Mujeres con Información, Guía, y Amor para su Salud) intervention, highlight the integration of scientific evidence and community-based participatory research principles, and identify opportunities for dissemination, adaptation, and implementation of this intervention. Methods The AMIGAS team was a collaboration among researchers, promotoras (community health workers), and program administrators. The multiyear, multiphase project was conducted in Houston, Texas; El Paso, Texas; and Yakima, Washington. The team completed several rounds of formative research, designed intervention materials and methodology, conducted a randomized controlled trial, created a guide for program administrators, and developed an intervention dissemination plan. Results Trial results demonstrated that AMIGAS was successful in increasing cervical cancer screening among Hispanic women. Adaptation of AMIGAS showed minimal reduction of outcomes. Dissemination efforts are underway to make AMIGAS available in a downloadable format via the Internet. Conclusions Developing a community-based intervention that is evidence-based and theoretically grounded is challenging, time-intensive, and requires collaboration among multiple disciplines. Inclusion of key stakeholders—in particular program deliverers and administrators—and planning for dissemination and translation to practice are integral components of successful intervention design. By providing explicit directions for adaptation for program deliverers, relevant information for program administrators, and access to the intervention via the Internet, AMIGAS is available to help increase cervical cancer screening among Hispanic women and other women disproportionately affected by cervical cancer. PMID:23930983

“The One Who Chases You Away Does Not Tell You Go”: Silent Refusals and Complex Power Relations in Research Consent Processes in Coastal Kenya

PubMed Central

Kamuya, Dorcas M.; Theobald, Sally J.; Marsh, Vicki; Parker, Michael; Geissler, Wenzel P.; Molyneux, Sassy C.

2015-01-01

Consent processes have attracted significant research attention over the last decade, including in the global south. Although relevant studies suggest consent is a complex negotiated process involving multiple actors, most guidelines assume consent is a one-off encounter with a clear ‘yes’ or ‘no’ decision. In this paper we explore the concept of ‘silent refusals’, a situation where it is not clear whether potential participants want to join studies or those in studies want to withdraw from research, as they were not actively saying no. We draw on participant observation, in-depth interviews and group discussions conducted with a range of stakeholders in two large community based studies conducted by the KEMRI Wellcome Trust programme in coastal Kenya. We identified three broad inter-related rationales for silent refusals: 1) a strategy to avoid conflicts and safeguard relations within households, - for young women in particular—to appear to conform to the wishes of elders; 2) an approach to maintain friendly, appreciative and reciprocal relationships with fieldworkers, and the broader research programme; and 3) an effort to retain study benefits, either for individuals, whole households or wider communities. That refusals and underlying rationales were silent posed multiple dilemmas for fieldworkers, who are increasingly recognised to play a key interface role between researchers and communities in many settings. Silent refusals reflect and reinforce complex power relations embedded in decisions about research participation, with important implications for consent processes and broader research ethics practice. Fieldworkers need support to reflect upon and respond to the ethically charged environment they work in. PMID:25978465

Water quality of a coastal lagoon (ES, Brazil): abiotic aspects, cytogenetic damage, and phytoplankton dynamics.

PubMed

Duarte, Ian Drumond; Silva, Nayara Heloisa Vieira Fraga; da Costa Souza, Iara; de Oliveira, Larissa Bassani; Rocha, Lívia Dorsch; Morozesk, Mariana; Bonomo, Marina Marques; de Almeida Pereira, Thaís; Dias, Mauro Cesar; de Oliveira Fernandes, Valéria; Matsumoto, Silvia Tamie

2017-04-01

Assessment of water resources requires interdisciplinary studies that include multiple ecosystem aspects. This study evaluated the water quality of Juara Lagoon (ES, Brazil) based on physical and chemical variables, cytogenetic responses in Allium cepa and phytoplankton dynamics. Three sampling sites were defined and water samples were collected during two sampling periods. Analyses such as determination of photic zone, conductivity, and concentrations of nutrients and metals were conducted as well as cytotoxic, mutagenic, and genotoxic potentials using A. cepa test. The main attributes of phytoplankton community, such as total richness, total density, density by class, dominance, and diversity, were also evaluated. Results have revealed that Juara Lagoon has signs of artificial eutrophication at two sampling sites due to high levels of total phosphorus and ammonia nitrogen. Cytotoxic, genotoxic, and mutagenic potentials were detected as well as high concentrations of Fe and Mn. Furthermore, 165 phytoplankton taxa were recorded, with highest richness in Chlorophyceae and Cyanophyceae classes. In addition, Cyanophyceae presented as the highest density class. A. cepa test and phytoplankton community evaluation indicated that the ecological quality of Juara Lagoon is compromised.

The Los Angeles County Community Disaster Resilience Project - a community-level, public health initiative to build community disaster resilience.

PubMed

Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo

2014-08-19

Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest-posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

PubMed Central

Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo

2014-01-01

Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports. PMID:25153472

Considering Culturally Relevant Practices and Knowledge-Sharing When Creating an Activity-Promoting Community Research Agenda

ERIC Educational Resources Information Center

Coppola, Angela M.; McHugh, Tara-Leigh F.

2018-01-01

The purpose of the article is to discuss and reflect upon a process of building relationships and conducting community consultations to co-create a relevant community-based participatory research agenda exploring Indigenous youth activity-promoting programming. Four consultations were conducted with approximately 30 community members in Edmonton,…

Using the critical incident technique in community-based participatory research: a case study.

PubMed

Belkora, Jeffrey; Stupar, Lauren; O'Donnell, Sara

2011-01-01

Successful community-based participatory research involves the community partner in every step of the research process. The primary study for this paper took place in rural, Northern California. Collaborative partners included an academic researcher and two community based resource centers that provide supportive services to people diagnosed with cancer. This paper describes our use of the Critical Incident Technique (CIT) to conduct Community-based Participatory Research. We ask: Did the CIT facilitate or impede the active engagement of the community in all steps of the study process? We identified factors about the Critical Incident Technique that were either barriers or facilitators to involving the community partner in every step of the research process. Facilitators included the CIT's ability to accommodate involvement from a large spectrum of the community, its flexible design, and its personal approach. Barriers to community engagement included training required to conduct interviews, depth of interview probes, and time required. Overall, our academic-community partners felt that our use of the CIT facilitated community involvement in our Community-Based Participatory Research Project, where we used it to formally document the forces promoting and inhibiting successful achievement of community aims.

Advancing Professional Development Through a Community of Practice: the New England Network for Faculty Affairs.

PubMed

Power, Christine M; Thorndyke, Luanne E; Milner, Robert J; Lowney, Kathleen; Irvin, Charles G; Fonseca-Kelly, Zoe; Benjamin, Emelia J; Bhasin, Robina M; Connelly, Maureen T

2018-01-01

In an era of competing priorities, funding is increasingly restricted for offices of faculty affairs and development. Opportunities for professional staff to grow and network through attendance at national meetings and to share best practices are limited. We sought to describe a community of practice established to enhance the professional development of faculty affairs professionals and to document its impact. We outlined the process of formation of the New England Network for Faculty Affairs (NENFA), reviewed the pedagogical approaches to professional development, and surveyed members to evaluate the impact of NENFA on their activities, professional network and their institutions. After a successful 2011 initial meeting, NENFA created an organizing committee and conducted a needs assessment among potential members. NENFA's charter, mission, goals, and structure were based on survey results. NENFA's regional community of practice grew to 31 institutions and held 10 meetings over 5 years. Meetings have examined a faculty development topic in depth using multiple learning formats to engage participants from academic medical centers and allied professions. Results from a 2015 member survey confirmed the value of NENFA. Multiple members documented changes in practice as a result of participating. NENFA has been sustained by volunteer leadership, collaboration, and the value that the group has brought to its members. We propose that a "community of practice" offers an effective model for collaborative learning among individuals at different institutions within a competitive health care environment. We recommend that the approach be replicated in other regions.

What do evaluations tell us about implementing new models in rural and remote primary health care? Findings from a narrative analysis of seven service evaluations conducted by an Australian Centre of Research Excellence.

PubMed

Lyle, David; Saurman, Emily; Kirby, Sue; Jones, Debra; Humphreys, John; Wakerman, John

2017-01-01

A Centre of Research Excellence (CRE) in Rural and Remote Primary Healthcare was established in 2012 with the goal of providing evidence to inform policy development to increase equity of access to quality health care and the identification of services that should be available to the diverse communities characterising Australia. This article reports on the key findings from seven CRE service evaluations to better understand what made these primary health care (PHC) models work where they worked, and why. We conducted a narrative synthesis of 15 articles reporting on seven CRE service evaluations of different PHC models published between 2012 and 2015. Three different contexts for PHC reform were evaluated: community, regional and clinic based. Themes identified were factors that enabled changes to PHC delivery, processes that supported services to improve access to PHC and requirements for service adaptation to promote sustainability. In both Indigenous and mainstream community settings, the active engagement with local communities, and their participation in, or leadership of, shared decision-making was reported across the three themes. In addition, local governance processes, informed by service activity and impact data, enabled these service changes to be sustained over time. The considerations were different for the outreach, regional and clinic services that relied on internal processes to drive change because they did not require the cooperation of multiple organisations to succeed. The review highlighted that shared decision-making, negotiation and consultation with communities is important and should be used to promote feasible strategies that improve access to community-based PHC services. There is a growing need for service evaluations to report on the feasibility, acceptability and fit of successful service models within context, in addition to reach and effectiveness in order to provide evidence for local dissemination, adaption and implementation strategies.

Math Placement Validation Study: A Summary of the Criterion-Related Validity Evidence and Multiple Measures Data for the San Diego Community College District.

ERIC Educational Resources Information Center

Armstrong, William B.

In Fall 1994, the San Diego Community College District (SDCCD), in California, conducted a study to determine the validity of the Mathematics Diagnostic Testing Project (MDTP) placement test. The MDTP provides tests at four levels (i.e., algebra readiness, elementary algebra, intermediate algebra, and pre-calculus) and is used in the District for…

[Effects of different multiple cropping systems on paddy field weed community under long term paddy-upland rotation].

PubMed

Yang, Bin-Juan; Huang, Guo-Qin; Xu, Ning; Wang, Shu-Bin

2013-09-01

Based on a long term field experiment, this paper studied the effects of different multiple cropping systems on the weed community composition and species diversity under paddy-upland rotation. The multiple cropping rotation systems could significantly decrease weed density and inhibited weed growth. Among the rotation systems, the milk vetch-early rice-late maize --> milk vetchearly maize intercropped with early soybean-late rice (CCSR) had the lowest weed species dominance, which inhibited the dominant weeds and decreased their damage. Under different multiple cropping systems, the main weed community was all composed of Monochoia vaginalis, Echinochloa crusgalli, and Sagittaria pygmae, and the similarity of weed community was higher, with the highest similarity appeared in milk vetch-early rice-late maize intercropped with late soybean --> milk vetch-early maize-late rice (CSCR) and in CCSR. In sum, the multiple cropping rotations in paddy field could inhibit weeds to a certain extent, but attentions should be paid to the damage of some less important weeds.

The Mobile story: data-driven community efforts to raise graduation rates.

PubMed

Newell, Jeremiah; Akers, Carolyn

2010-01-01

Through sustained community organizing and strategic partnerships, the Mobile (Alabama) County Public School System is improving achievement and creating beat-the-odds schools that set and achieve high academic expectations despite the challenges of poverty and racial disparity. The authors chart how Mobile's Research Alliance for Multiple Pathways, funded through the U.S. Department of Labor's Multiple Pathways Blueprint Initiative, is identifying gaps in services throughout the community, analyzing the data about dropouts, benchmarking other communities, studying best practices, and mobilizing the community to expect and demand higher graduation rates. These activities are resulting in early identification of off-track students and coordination of school- and community-based reforms.

Health impact assessment in the UK planning system: the possibilities and limits of community engagement.

PubMed

Chadderton, Chloe; Elliott, Eva; Hacking, Nick; Shepherd, Michael; Williams, Gareth

2013-12-01

This paper explores the use of health impact assessment (HIA) as a means of facilitating community engagement in spatial planning. The paper discusses the background to the development of HIA as a tool for assessing the likely impact of policies and wider changes on health with a view to building those into planning and decision-making, and describes the evolution of HIA into more participatory forms. It then goes on to describe a case-study of plans for a waste incinerator in an inner-city area in the UK, where HIA was used in response to community concerns about the development as a means of building in the views of local people to the decision-making around the plan. We describe in detail how the HIA was conducted and additional research undertaken within a timescale set by the planning processes. We discuss the difficulties involved in conducting any kind of research-based HIA so rapidly and in a situation of multiple, competing stakeholder interests. We argue that although the HIA failed to influence the final decisions in this particular instance it does, nonetheless, provide a model for how to create 'knowledge spaces' in which different perspectives and information can be brought around the table to create more democratic approaches to planning for waste.

Reflections on Native Ethnography by a Nurse Researcher.

PubMed

Abdulrehman, Munib Said

2017-03-01

There are benefits and challenges associated with conducting research in a familiar setting, especially when the researcher is more an insider than an outsider. The aim of this article is to explore the author's experience as a native scholar conducting ethnographic research among the Swahili peoples of Lamu, Kenya. This article focuses on methodological issues related to conducting ethnographic research among the author's own people, including examining the issues of anthropological reflexivity as a native ethnographer and highlighting the author's experiences embodying multiple identities. Native ethnographers must consider the challenges associated with negotiating multiple roles in the research setting, especially in the presence of sociocultural factors such as gender stratification, complex kinship networks, socioeconomic hierarchies, illiteracy, and poverty. Embracing rather than being confused by the multiple levels of understanding native researchers bring to studies of their communities opens up new avenues of research and possibilities.

Occupational burnout and work factors in community and hospital midwives: a survey analysis.

PubMed

Yoshida, Yukiko; Sandall, Jane

2013-08-01

community-based midwifery practice has been promoted in the UK maternity policy over the last decade as a means of increasing continuity of care. However, there have been growing concerns to suggest that the community-based continuity model may not be sustainable due to the high levels of occupational burnout in midwives resulted by increased on-call work. this paper attempted to identify work factors associated with the levels of burnout in community midwives as compared to hospital midwives, aiming at contributing to the debate of organising sustainable midwifery care. a statistical analysis was conducted drawing on data from a survey of all midwives working at one Hospital Trust in England (n=238). Occupational burnout was measured using the Maslach Burnout Inventory (MBI). the sample midwives (n=128, 54%) had significantly higher levels of burnout compared to the reference groups. Multiple regression analysis identified as follows: (1) high levels of occupational autonomy were a key protective factor of burnout, and more prevalent in the community, (2) working hours were positively associated with burnout, and community midwives were more likely to have higher levels of stress recognition, and (3) support for work-life-balance from the Trust had a significant protective effect on the levels of burnout. the results should be taken into account in the maternity policy in order to incorporate continuity of care and sustainable organisation of midwifery care. Copyright © 2012 Elsevier Ltd. All rights reserved.

Emotional insecurity in the family and community and youth delinquency in Northern Ireland: a person-oriented analysis across five waves

PubMed Central

Cummings, E. Mark; Taylor, Laura K.; Merrilees, Christine E.; Goeke-Morey, Marcie C.; Shirlow, Peter

2015-01-01

Background Over one billion children are exposed worldwide to political violence and armed conflict. Currently, conclusions about bases for adjustment problems are qualified by limited longitudinal research from a process-oriented, social-ecological perspective. In this study, we examined a theoretically-based model for the impact of multiple levels of the social ecology (family, community) on adolescent delinquency. Specifically, this study explored the impact of children's emotional insecurity about both the family and community on youth delinquency in Northern Ireland. Methods In the context of a five-wave longitudinal research design, participants included 999 mother–child dyads in Belfast (482 boys, 517 girls), drawn from socially-deprived, ethnically-homogenous areas that had experienced political violence. Youth ranged in age from 10 to 20 and were 12.18 (SD = 1.82) years old on average at Time 1. Findings The longitudinal analyses were conducted in hierarchical linear modeling (HLM), allowing for the modeling of interindividual differences in intraindividual change. Intraindividual trajectories of emotional insecurity about the family related to children's delinquency. Greater insecurity about the community worsened the impact of family conflict on youth's insecurity about the family, consistent with the notion that youth's insecurity about the community sensitizes them to exposure to family conflict in the home. Conclusions The results suggest that ameliorating children's insecurity about family and community in contexts of political violence is an important goal toward improving adolescents' well-being, including reduced risk for delinquency. PMID:25981614

Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities.

PubMed

Lengerich, Eugene J; Kluhsman, Brenda C; Bencivenga, Marcyann; Allen, Regina; Miele, Mary Beth; Farace, Elana

2007-09-01

In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE-PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar's test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure the impact of such initiatives on the long term health and well being of cancer survivors in rural locations.

Factors associated with women's autonomy regarding maternal and child health care utilization in Bale Zone: a community based cross-sectional study.

PubMed

Nigatu, Dabere; Gebremariam, Abebe; Abera, Muluemebet; Setegn, Tesfaye; Deribe, Kebede

2014-07-03

Women's autonomy in health-care decision is a prerequisite for improvements in maternal and child health. Little is known about women's autonomy and its influencing factors on maternal and child health care in Ethiopia. Therefore, this study was conducted to assess women's autonomy and identify associated factors in Southeast Ethiopia. A community based cross-sectional study was conducted from March 19th until March 28th, 2011. A total of 706 women were selected using stratified sampling technique from rural and urban kebeles. The quantitative data were collected by interviewer administered questionnaire and analyzed using SPSS for window version 16.0. Descriptive statistics, bivariate and multiple logistic regression analyses were carried out to identify factors associated with women's autonomy for health care utilization. Out of 706 women less than half (41.4%) had higher autonomy regarding their own and their children's health. In the multiple logistic regression model monthly household income >1000 ETB [adjusted odds ratio(AOR):3.32(95% C.I: 1.62-6.78)], having employed husband [AOR: 3.75 (95% C.I:1.24-11.32)], being in a nuclear family structure [AOR: 0.53(95% C.I: 0.33-0.87)], being in monogamous marriage [AOR: 3.18(95% C.I: 1.35-7.50)], being knowledgeable and having favorable attitude toward maternal and child health care services were independently associated with an increased odds of women's autonomy. Socio-demographic and maternal factors (knowledge and attitude) were found to influence women's autonomy. Interventions targeting women's autonomy with regards to maternal and child health care should focus on addressing increasing awareness and priority should be given to women with a lower socioeconomic status.

Factors associated with women’s autonomy regarding maternal and child health care utilization in Bale Zone: a community based cross-sectional study

PubMed Central

2014-01-01

Background Women's autonomy in health-care decision is a prerequisite for improvements in maternal and child health. Little is known about women’s autonomy and its influencing factors on maternal and child health care in Ethiopia. Therefore, this study was conducted to assess women’s autonomy and identify associated factors in Southeast Ethiopia. Method A community based cross-sectional study was conducted from March 19th until March 28th, 2011. A total of 706 women were selected using stratified sampling technique from rural and urban kebeles. The quantitative data were collected by interviewer administered questionnaire and analyzed using SPSS for window version 16.0. Descriptive statistics, bivariate and multiple logistic regression analyses were carried out to identify factors associated with women’s autonomy for health care utilization. Result Out of 706 women less than half (41.4%) had higher autonomy regarding their own and their children’s health. In the multiple logistic regression model monthly household income >1000 ETB [adjusted odds ratio(AOR):3.32(95% C.I: 1.62-6.78)], having employed husband [AOR: 3.75 (95% C.I:1.24-11.32)], being in a nuclear family structure [AOR: 0.53(95% C.I: 0.33-0.87)], being in monogamous marriage [AOR: 3.18(95% C.I: 1.35-7.50)], being knowledgeable and having favorable attitude toward maternal and child health care services were independently associated with an increased odds of women’s autonomy. Conclusion Socio-demographic and maternal factors (knowledge and attitude) were found to influence women’s autonomy. Interventions targeting women’s autonomy with regards to maternal and child health care should focus on addressing increasing awareness and priority should be given to women with a lower socioeconomic status. PMID:24990689

Evaluation of a community-based training to promote responsible self-medication in East Java, Indonesia.

PubMed

Setiadi, Adji P; Wibowo, Yosi; Setiawan, Eko; Presley, Bobby; Mulyono, Ika; Wardhani, Ari S; Sunderland, Bruce

2018-05-24

To explore pharmacist/pharmacy staff trainers' perspectives on conducting community-based training to promote responsible self-medication, and to evaluate knowledge gained among community representatives participating in the training. Training was conducted in four districts/cities in East Java, Indonesia in 2016. A pre-test/post-test study was used to evaluate the knowledge of 129 community representatives (participants) before/after the training; pre-test and post-test scores as well as absolute gain were determined. Four focus group discussions with 20 pharmacist/pharmacy staff (trainers) were conducted after the training, and the data were thematically analysed. Overall mean test scores for community representatives significantly improved from 14.11 to 15.70 after the training (P < 0.001). The average total absolute gain was 1.85 (95% CI 1.29 to 2.39). To reach local communities, trainers suggested improvements to the content and structure of the module, training aids, trainer competency, approach and time allocation. Community-based training provides a potential strategy to improve community knowledge of medications. Findings from this study should inform strategies for a broader uptake amongst local communities in Indonesia. © 2018 Royal Pharmaceutical Society.

The Perceptions of Community College Students to Foreign Language Acquisition Grounded in Multiple Intelligence Theory

ERIC Educational Resources Information Center

Wallace, Richard Le Roy Wayne

2010-01-01

The purpose of this qualitative study was to examine and gain a clearer understanding of the perceptions of foreign language learning of adult foreign language learners attending a South-West Missouri community college. This study was based on the Multiple Intelligence (MI) theory of Howard Gardner. It examined the perceptions of adult language…

Integration of community structure data reveals observable effects below sediment guideline thresholds in a large estuary.

PubMed

Tremblay, Louis A; Clark, Dana; Sinner, Jim; Ellis, Joanne I

2017-09-20

The sustainable management of estuarine and coastal ecosystems requires robust frameworks due to the presence of multiple physical and chemical stressors. In this study, we assessed whether ecological health decline, based on community structure composition changes along a pollution gradient, occurred at levels below guideline threshold values for copper, zinc and lead. Canonical analysis of principal coordinates (CAP) was used to characterise benthic communities along a metal contamination gradient. The analysis revealed changes in benthic community distribution at levels below the individual guideline values for the three metals. These results suggest that field-based measures of ecological health analysed with multivariate tools can provide additional information to single metal guideline threshold values to monitor large systems exposed to multiple stressors.

Multi-Objective Community Detection Based on Memetic Algorithm

PubMed Central

2015-01-01

Community detection has drawn a lot of attention as it can provide invaluable help in understanding the function and visualizing the structure of networks. Since single objective optimization methods have intrinsic drawbacks to identifying multiple significant community structures, some methods formulate the community detection as multi-objective problems and adopt population-based evolutionary algorithms to obtain multiple community structures. Evolutionary algorithms have strong global search ability, but have difficulty in locating local optima efficiently. In this study, in order to identify multiple significant community structures more effectively, a multi-objective memetic algorithm for community detection is proposed by combining multi-objective evolutionary algorithm with a local search procedure. The local search procedure is designed by addressing three issues. Firstly, nondominated solutions generated by evolutionary operations and solutions in dominant population are set as initial individuals for local search procedure. Then, a new direction vector named as pseudonormal vector is proposed to integrate two objective functions together to form a fitness function. Finally, a network specific local search strategy based on label propagation rule is expanded to search the local optimal solutions efficiently. The extensive experiments on both artificial and real-world networks evaluate the proposed method from three aspects. Firstly, experiments on influence of local search procedure demonstrate that the local search procedure can speed up the convergence to better partitions and make the algorithm more stable. Secondly, comparisons with a set of classic community detection methods illustrate the proposed method can find single partitions effectively. Finally, the method is applied to identify hierarchical structures of networks which are beneficial for analyzing networks in multi-resolution levels. PMID:25932646

Multi-objective community detection based on memetic algorithm.

PubMed

Wu, Peng; Pan, Li

2015-01-01

Community detection has drawn a lot of attention as it can provide invaluable help in understanding the function and visualizing the structure of networks. Since single objective optimization methods have intrinsic drawbacks to identifying multiple significant community structures, some methods formulate the community detection as multi-objective problems and adopt population-based evolutionary algorithms to obtain multiple community structures. Evolutionary algorithms have strong global search ability, but have difficulty in locating local optima efficiently. In this study, in order to identify multiple significant community structures more effectively, a multi-objective memetic algorithm for community detection is proposed by combining multi-objective evolutionary algorithm with a local search procedure. The local search procedure is designed by addressing three issues. Firstly, nondominated solutions generated by evolutionary operations and solutions in dominant population are set as initial individuals for local search procedure. Then, a new direction vector named as pseudonormal vector is proposed to integrate two objective functions together to form a fitness function. Finally, a network specific local search strategy based on label propagation rule is expanded to search the local optimal solutions efficiently. The extensive experiments on both artificial and real-world networks evaluate the proposed method from three aspects. Firstly, experiments on influence of local search procedure demonstrate that the local search procedure can speed up the convergence to better partitions and make the algorithm more stable. Secondly, comparisons with a set of classic community detection methods illustrate the proposed method can find single partitions effectively. Finally, the method is applied to identify hierarchical structures of networks which are beneficial for analyzing networks in multi-resolution levels.

Trialing the Community-Based Collaborative Action Research Framework: Supporting Rural Health Through a Community Health Needs Assessment.

PubMed

Van Gelderen, Stacey A; Krumwiede, Kelly A; Krumwiede, Norma K; Fenske, Candace

2018-01-01

To describe the application of the Community-Based Collaborative Action Research (CBCAR) framework to uplift rural community voices while conducting a community health needs assessment (CHNA) by formulating a partnership between a critical access hospital, public health agency, school of nursing, and community members to improve societal health of this rural community. This prospective explorative study used the CBCAR framework in the design, collection, and analysis of the data. The framework phases include: Partnership, dialogue, pattern recognition, dialogue on meaning of pattern, insight into action, and reflecting on evolving pattern. Hospital and public health agency leaders learned how to use the CBCAR framework when conducting a CHNA to meet Affordable Care Act federal requirements. Closing the community engagement gap helped ensure all voices were heard, maximized intellectual capital, synergized efforts, improved communication by establishing trust, aligned resources with initiatives, and diminished power struggles regarding rural health. The CBCAR framework facilitated community engagement and promoted critical dialogue where community voices were heard. A sustainable community-based collaborative was formed. The project increased the critical access hospital's capacity to conduct a CHNA. The collaborative's decision-making capacity was challenged and ultimately strengthened as efforts continue to be made to address rural health.

Collaborative environments for capability-based planning

NASA Astrophysics Data System (ADS)

McQuay, William K.

2005-05-01

Distributed collaboration is an emerging technology for the 21st century that will significantly change how business is conducted in the defense and commercial sectors. Collaboration involves two or more geographically dispersed entities working together to create a "product" by sharing and exchanging data, information, and knowledge. A product is defined broadly to include, for example, writing a report, creating software, designing hardware, or implementing robust systems engineering and capability planning processes in an organization. Collaborative environments provide the framework and integrate models, simulations, domain specific tools, and virtual test beds to facilitate collaboration between the multiple disciplines needed in the enterprise. The Air Force Research Laboratory (AFRL) is conducting a leading edge program in developing distributed collaborative technologies targeted to the Air Force's implementation of systems engineering for a simulation-aided acquisition and capability-based planning. The research is focusing on the open systems agent-based framework, product and process modeling, structural architecture, and the integration technologies - the glue to integrate the software components. In past four years, two live assessment events have been conducted to demonstrate the technology in support of research for the Air Force Agile Acquisition initiatives. The AFRL Collaborative Environment concept will foster a major cultural change in how the acquisition, training, and operational communities conduct business.

Osteo-cise: Strong Bones for Life: Protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures

PubMed Central

2012-01-01

Background Osteoporosis affects over 220 million people worldwide, and currently there is no ‘cure’ for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition. Methods/design The Osteo-cise: Strong Bones for Life study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged ≥60 years will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month ‘research to practise’ translational phase. Participants will be randomly assigned to either the Osteo-cise intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test). Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand), falls incidence and health-related quality of life. Cost-effectiveness will also be assessed. Discussion The findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture. Trial registration Australian New Zealand Clinical Trials Registry reference ACTRN12609000100291 PMID:22640372

Community-centred eco-bio-social approach to control dengue vectors: an intervention study from Myanmar

PubMed Central

Wai, Khin Thet; Htun, Pe Than; Oo, Tin; Myint, Hla; Lin, Zaw; Kroeger, Axel; Sommerfeld, Johannes; Petzold, Max

2012-01-01

Objectives To build up and analyse the feasibility, process, and effectiveness of a partnership-driven ecosystem management intervention in reducing dengue vector breeding and constructing sustainable partnerships among multiple stakeholders. Methods A community-based intervention study was conducted from May 2009 to January 2010 in Yangon city. Six high-risk and six low-risk clusters were randomized and allocated as intervention and routine service areas, respectively. For each cluster, 100 households were covered. Bi-monthly entomological evaluations (i.e. larval and pupal surveys) and household acceptability surveys at the end of 6-month intervention period were conducted, supplemented by qualitative evaluations. Intervention description The strategies included eco-friendly multi-stakeholder partner groups (Thingaha) and ward-based volunteers, informed decision-making of householders, followed by integrated vector management approach. Findings Pupae per person index (PPI) decreased at the last evaluation by 5.7% (0.35–0.33) in high-risk clusters. But in low-risk clusters, PPI remarkably decreased by 63.6% (0.33–0.12). In routine service area, PPI also decreased due to availability of Temephos after Cyclone Nargis. As for total number of pupae in all containers, when compared to evaluation 1, there was a reduction of 18.6% in evaluation 2 and 44.1% in evaluation 3 in intervention area. However, in routine service area, more reduction was observed. All intervention tools were found as acceptable, being feasible to implement by multi-stakeholder partner groups. Conclusions The efficacy of community-controlled partnership-driven interventions was found to be superior to the vertical approach in terms of sustainability and community empowerment. PMID:23318238

Community-centred eco-bio-social approach to control dengue vectors: an intervention study from Myanmar.

PubMed

Wai, Khin Thet; Htun, Pe Than; Oo, Tin; Myint, Hla; Lin, Zaw; Kroeger, Axel; Sommerfeld, Johannes; Petzold, Max

2012-12-01

To build up and analyse the feasibility, process, and effectiveness of a partnership-driven ecosystem management intervention in reducing dengue vector breeding and constructing sustainable partnerships among multiple stakeholders. A community-based intervention study was conducted from May 2009 to January 2010 in Yangon city. Six high-risk and six low-risk clusters were randomized and allocated as intervention and routine service areas, respectively. For each cluster, 100 households were covered. Bi-monthly entomological evaluations (i.e. larval and pupal surveys) and household acceptability surveys at the end of 6-month intervention period were conducted, supplemented by qualitative evaluations. Intervention description: The strategies included eco-friendly multi-stakeholder partner groups (Thingaha) and ward-based volunteers, informed decision-making of householders, followed by integrated vector management approach. Pupae per person index (PPI) decreased at the last evaluation by 5·7% (0·35-0·33) in high-risk clusters. But in low-risk clusters, PPI remarkably decreased by 63·6% (0·33-0·12). In routine service area, PPI also decreased due to availability of Temephos after Cyclone Nargis. As for total number of pupae in all containers, when compared to evaluation 1, there was a reduction of 18·6% in evaluation 2 and 44·1% in evaluation 3 in intervention area. However, in routine service area, more reduction was observed. All intervention tools were found as acceptable, being feasible to implement by multi-stakeholder partner groups. The efficacy of community-controlled partnership-driven interventions was found to be superior to the vertical approach in terms of sustainability and community empowerment.

Assessing Adult Exposure to Community Violence: A Review of Definitions and Measures.

PubMed

DeCou, Christopher R; Lynch, Shannon M

2017-01-01

Although experiences of community violence are linked with negative outcomes for adults and children, few standardized measures assessing community violence exist, and available measures lack consistency concerning the definition of community violence. Further, most measures currently utilized to assess adult exposure to community violence were designed for use with children and adolescents. To address these identified concerns and make recommendations for future research, this article reviews contemporary definitions of community violence, identifies the outcomes of exposure to community violence for adults, and evaluates measures of exposure to community violence with published psychometric data employing adult samples. A systematic review of the literature was conducted to identify studies that (1) included a self-report of community violence exposure, (2) included primarily adult respondents, and (3) reported psychometric data. Seventeen studies met the inclusion criteria. Measures employed in these studies were reviewed and basic psychometric properties discussed. Notably, the Survey of Exposure to Community Violence was the most commonly used measure among these studies. Although multiple measures demonstrated limited but acceptable psychometric performance in select studies, few in-depth psychometric analyses exist for measures of adult exposure to community violence. Also, it is difficult to compare studies due to variations in definitions of community violence and multiple versions of each measure. Recommendations for future research include provision of explicit definitions of community violence and reporting psychometric data for measures. © The Author(s) 2015.

The effects of prolonged wear of textured shoe insoles on gait, foot sensation and proprioception in people with multiple sclerosis: study protocol for a randomised controlled trial.

PubMed

Hatton, Anna L; Dixon, John; Rome, Keith; Brauer, Sandra G; Williams, Katrina; Kerr, Graham

2016-04-21

Many people with multiple sclerosis experience problems with walking, which can make daily activities difficult and often leads to falls. Foot sensation plays an important role in keeping the body balanced whilst walking; however, people with multiple sclerosis often have poor sensation on the soles of their feet. Wearing a specially designed shoe insole, which enhances plantar sensory information, could help people with multiple sclerosis to walk better. This study will explore whether long-term wear of a textured insole can improve walking in people with multiple sclerosis. A prospective randomised controlled trial with two parallel groups will be conducted aiming to recruit 176 people with multiple sclerosis living in the community (Brisbane, Australia). Adults with a clinical diagnosis of multiple sclerosis, Disease Steps score 1-4, who are ambulant over 100 m and who meet specific inclusion criteria will be recruited. Participants will be randomised to a smooth control insole (n = 88) or textured insole (n = 88) group. The allocated insole will be worn for 12-weeks within participants' own footwear, with self-report wear diaries and falls calendars being completed over this period. Blinded assessors will conduct two baseline assessments and one post-intervention assessment. Gait tasks will be completed barefoot, wearing standardised footwear only, and wearing standardised footwear with smooth and textured insoles. The primary outcome measure will be mediolateral base of support when walking over even and uneven surfaces. Secondary measures include spatiotemporal gait parameters (stride length, stride time variability, double-limb support time, velocity), gait kinematics (hip, knee, and ankle joint angles, toe clearance, trunk inclination, arm swing, mediolateral pelvis/head displacement), foot sensation (light touch-pressure, vibration, two-point discrimination) and proprioception (ankle joint position sense). Group allocation will be concealed and all analyses will be based on an intention-to-treat principle. This study will explore the effects of wearing textured insoles over 12-weeks on gait, foot sensation and proprioception in people with multiple sclerosis. The study has the potential to identify a new, evidence-based footwear intervention which has the capacity to enhance mobility and independent living in people with multiple sclerosis. Australian New Zealand Clinical Trials Registry ACTRN12615000421538 . Registered 4 May 2015.

Engaging Community-Based Organizations in Fall Prevention Education

ERIC Educational Resources Information Center

Kramer, B. Josea; Vivrette, Rebecca L.; Rubenstein, Laurence Z.

2011-01-01

Falls are a major public health problem for older adults, and community-based organizations play a key role in educating seniors about falls prevention (FP). We conducted a qualitative process evaluation at six sites to report community-based centers' perspectives on adoption, adaptation, and sustainability of an evidence-based multifactorial FP…

Improving Participants' Retention in a Smoking Cessation Intervention Using a Community-based Participatory Research Approach.

PubMed

Estreet, Anthony; Apata, Jummai; Kamangar, Farin; Schutzman, Christine; Buccheri, Jane; O'Keefe, Anne-Marie; Wagner, Fernando; Sheikhattari, Payam

2017-01-01

This study compares participant' sretention in three phases of smoking cessation interventions, one provided in a health clinic and the subsequent two in community-based settings. Smoking cessation interventions were conducted in three phases from 2008 to 2015 in two underserved urban communities with low socioeconomic profiles and high rates of smoking ( n = 951). Phase I was conducted in a clinic; Phases II and III were conducted in community venues. In Phases II and III, incremental changes were made based on lessons learned from the previous phases. Retention (attending six or more sessions) was the primary predictor of cessation and was analyzed while controlling for associated factors including age, gender, race, employment, education, and nicotine dependence. Retention increased substantially over the three phases, with rates for attending six or more sessions of 13.8%, 51.9%, and 67.9% in Phases I, II, and III, respectively. Retention was significantly higher in community settings than in the clinic setting (adjusted odds ratio [OR] = 6.7; 95% confidence intervals [CI] = 4.6, 9.8). In addition to the intervention in community venues, predictors of retention included age and unemployment. Higher retention was significantly associated with higher quit rates (adjusted OR = 2.4; 95% CI = 1.5, 3.8). Conducting the intervention in community settings using trained peer motivators rather than health-care providers resulted in significantly higher retention and smoking cessation rates. This was due in part to the ability to tailor cessation classes in the community for specific populations and improving the quality of the intervention based on feedback from participants and community partners.

Asthma in the community: Designing instruction to help students explore scientific dilemmas that impact their lives

NASA Astrophysics Data System (ADS)

Tate, Erika Dawn

School science instruction that connects to students' diverse home, cultural, or linguistic experiences can encourage lifelong participation in the scientific dilemmas that impact students' lives. This dissertation seeks effective ways to support high school students as they learn complex science topics and use their knowledge to transform their personal and community environments. Applying the knowledge integration perspective, I collaborated with education, science, and community partners to design a technology enhanced science module, Improving Your Community's Asthma Problem. This exemplar community science curriculum afforded students the opportunity to (a) investigate a local community health issue, (b) interact with relevant evidence related to physiology, clinical management, and environmental risks, and (c) construct an integrated understanding of the asthma problem in their community. To identify effective instructional scaffolds that engage students in the knowledge integration process and prepare them to participate in community science, I conducted 2 years of research that included 5 schools, 10 teachers, and over 500 students. This dissertation reports on four studies that analyzed student responses on pre-, post-, and embedded assessments. Researching across four design stages, the iterative design study investigated how to best embed the visualizations of the physiological processes breathing, asthma attack, and the allergic immune response in an inquiry activity and informed evidence-based revisions to the module. The evaluation study investigated the impact of this revised Asthma module across multiple classrooms and differences in students' prior knowledge. Combining evidence of student learning from the iterative and evaluation studies with classroom observations and teacher interviews, the longitudinal study explored the impact of teacher practices on student learning in years 1 and 2. In the final chapter, I studied how the Asthma module and students' local community influenced students as they integrated their ideas related to perspectives, evidence use, the consideration of tradeoffs, and localization to construct explanations and decision justifications regarding their community's asthma problem. In the end, this dissertation offers evidence that informs the future design of community science instruction that successfully engages students in the knowledge integration process and has implications for creating multiple opportunities for students to meaningfully participate in community science.

Development of a Novel Method for Temporal Analysis of Airborne Microbial Communities

NASA Astrophysics Data System (ADS)

Spring, A.; Domingue, K. D.; Mooney, M. M.; Kerber, T. V.; Lemmer, K. M.; Docherty, K. M.

2017-12-01

Microorganisms are ubiquitous in the atmosphere, which serves as an important vector for microbial dispersal to all terrestrial habitats. Very little is known about the mechanisms that control microbial dispersal, because sampling of airborne microbial communities beyond 2 m above the ground is limited. The goal of this study was to construct and test an airborne microbial sampling system to collect sufficient DNA for conducting next generation sequencing and microbial community analyses. The system we designed employs helium-filled helikites as a mechanism for launching samplers to various altitudes. The samplers use a passive collection dish system, weigh under 6 lbs and are operated by remote control from the ground. We conducted several troubleshooting experiments to test sampler functionality. We extracted DNA from sterile collection dish surfaces and examined communities using amplicons of the V4 region of 16S rRNA in bacteria using Illumina Mi-Seq. The results of these experiments demonstrate that the samplers we designed 1) remain decontaminated when closed and collect sufficient microbial biomass for DNA-based analyses when open for 6 hours; 2) are optimally decontaminated with 15 minutes of UV exposure; 3) require 8 collection dish surfaces to collect sufficient biomass. We also determined that DNA extraction conducted within 24 hours of collection has less of an impact on community composition than extraction after frozen storage. Using this sampling system, we collected samples from multiple altitudes in December 2016 and May 2017 at 3 sites in Kalamazoo and Pellston, Michigan. In Kalamazoo, areas sampled were primarily developed or agricultural, while in Pellston they were primarily forested. We observed significant differences between airborne bacterial communities collected at each location and time point. Additionally, bacterial communities did not differ with altitude, suggesting that terrestrial land use has an important influence on the upward distribution of bacteria. Proteobacteria were predominant in air samples from Kalamazoo, while Firmicutes were more prevalent in Pellston. Our results demonstrate that the sampling platform we designed is a useful tool for exploring ecological questions related to distribution of airborne microbial communities across a vertical transect.

Geothermal Gases--Community Experiences, Perceptions, and Exposures in Northern California.

PubMed

Chiu, Cindy H; Lozier, Matthew J; Bayleyegn, Tesfaye; Tait, Karen; Barreau, Tracy; Copan, Lori; Roisman, Rachel; Jackson, Rebecca; Smorodinsky, Svetlana; Kreutzer, Richard A; Yip, Fuyuen; Wolkin, Amy

2015-12-01

Lake County, California, is in a high geothermal-activity area. Over the past 30 years, the city of Clearlake has reported health effects and building evacuations related to geothermal venting. Previous investigations in Clearlake revealed hydrogen sulfide at levels known to cause health effects and methane at levels that can cause explosion risks. The authors conducted an investigation in multiple cities and towns in Lake County to understand better the risk of geothermal venting to the community. They conducted household surveys and outdoor air sampling of hydrogen sulfide and methane and found community members were aware of geothermal venting and some expressed concerns. The authors did not, however, find hydrogen sulfide above the California Environmental Protection Agency air quality standard of 30 parts per billion over one hour or methane above explosive thresholds. The authors recommend improving risk communication, continuing to monitor geothermal gas effects on the community, and using community reports and complaints to monitor and document geothermal venting incidents.

Harmful Algal Blooms and Drinking Water Treatment Research

EPA Science Inventory

EPA has been conducting algal bloom research at multiple facilities around Lake Erie over the past few years to help communities confront the challenge of keeping cyanobacterial toxins from reaching consumers’ taps, while minimizing the financial burden. The first goal of this re...

Long-term impact of community-based information, education and communication activities on food hygiene and food safety behaviors in Vietnam: a longitudinal study.

PubMed

Takanashi, Kumiko; Quyen, Dao To; Le Hoa, Nguyen Thi; Khan, Nguyen Cong; Yasuoka, Junko; Jimba, Masamine

2013-01-01

Ingestion of contaminated water or food is a major contributor to childhood diarrhea in developing countries. In Vietnam, the use of community-based information, education and communication (IEC) activities could be a sustainable strategy to improve food hygiene and food safety behaviors. This study thus examined the long-term impact of community-based IEC activities on food hygiene and food safety behaviors. In this longitudinal study, we interviewed caregivers of children aged between six months and four years in suburban Hanoi. Baseline data were collected in January 2006 (n = 125). After conducting IEC interventions, we collected a 1(st) set of evaluation data in January 2007 (n = 132). To examine the long-term impact of the interventions, we then collected a 2(nd) set of evaluation data in January 2008 (n = 185). Changes in childhood diarrhea prevalence, IEC coverage, and food hygiene and food safety behaviors were assessed over a two-year period using bivariate and logistic regression analyses. Effective IEC channels were determined through multiple linear regression analysis. Childhood diarrhea was significantly reduced from 21.6% at baseline to 7.6% at the 1(st) post-intervention evaluation (P = 0.002), and to 5.9% at the 2(nd) evaluation. Among 17 food hygiene and food safety behaviors measured, a total of 11 behaviors were improved or maintained by the 2(nd) evaluation. Handwashing after toilet use was significantly improved at both evaluation points. Overall, 3 food safety behaviors and 7 food hygiene behaviors were found to have significantly improved at the 1(st) and at the 2(nd) evaluations, respectively. Flip chart communication administered by community groups was identified to be the most effective IEC channel for effecting behavior change (P = 0.018). Flip chart communication administered by community groups is effective for improving multiple food hygiene and food safety behaviors in sustainable ways, and should be included in water and health promotion programs.

Participation levels in 25 Community-based participatory research projects

PubMed Central

Spears Johnson, C. R.; Kraemer Diaz, A. E.; Arcury, T. A.

2016-01-01

This analysis describes the nature of community participation in National Institutes of Health and Centers for Disease Control and Prevention funded community-based participatory research (CBPR) projects, and explores the scientific and social implications of variation in community participation. We conducted in-depth interviews in 2012 with professional and community researchers from 25 CBPR projects in the Southeast US. Interview topics focused on participants’ experiences with the nature and conduct of their CBPR project. Projects were rated on community participation in 13 components of research. Projects varied substantially in community participation. Some projects had community participation in only two to three components; others had participation in every component. Some professional researchers were deliberate in their inclusion of community participation in all aspects of research, others had community participation in some aspects, and others were mainly concerned that community members had the opportunity to participate in the study. Findings suggest a need for a standardized rubric for community-based research that facilitates delineation of approaches and procedures that are effective and efficient. Little actual community participation may also result in negative social impacts for communities. PMID:27422896

The Children’s Attention-deficit Hyperactivity Disorder (ADHD) Telemental Health Treatment Study: Methodology for Conducting a Trial of Telemental Health in Multiple Underserved Communities

PubMed Central

Stoep, Ann Vander; Myers, Kathleen

2013-01-01

Background Children who live in non-metropolitan communities are underserved by evidence-based mental health care and underrepresented in clinical trials of mental health services. Telemental Health (TMH), the use of videoteleconferencing (VTC) to provide care that is usually delivered in person, shows promise for helping to rectify these service disparities. Purpose The Children’s ADHD Telemental Health Treatment Study (CATTS) is a randomized controlled trial designed to test the effectiveness of TMH in providing treatment to children diagnosed with attention-deficit hyperactivity disorder (ADHD) who are living in underserved communities. In this paper we describe the methodologies we developed for the trial and lessons learned. Methods Children ages 5.5-12 years of age with ADHD were referred to CATTS by their primary care physicians (PCP’s). The test intervention group (Group A) received six telepsychiatry sessions followed by in-person caregiver behavioral training delivered by a local therapist who was trained and supervised remotely. A secure website was used to support decision-making by the telepsychiatrists, to facilitate real-time collaboration between the telepsychiatrists and community therapists, and communication with the PCP’s. The control group (Group B) received a single telepsychiatry consultation followed by treatment with their PCP’s who implemented the telepsychiatrists’ recommendations at their discretion. Caregivers completed five sets of questionnaires about children’s symptoms and functioning and their own levels of distress. Older children (aged 10-12 years) completed questionnaires about their symptoms and functioning. Teachers completed ADHD rating scales. Questionnaires were completed online through a secure portal from personal computers. Results Eighty-eight PCP’s in seven communities referred the 223 children who participated in the trial. Attrition was low (3%). Children in Group A completed an average of 5.3 of 6 scheduled sessions; 96% of children in Group B completed their telepsychiatry consultation. Parents in both groups completed an average of 4.8 of 5 assessments. Telepsychiatrists and therapists showed high adherence to treatment protocols. Lessons Learned TMH proved to be a viable means of providing evidence-based pharmacological services to children and of training local therapists in evidence-based caregiver behavioral management. Recruitment was enhanced by offering the control group a telepsychiatry consultation. To meet recruitment targets across multiple dispersed sites, we developed community-specific strategies. A dedicated scheduler was a critical staff role to coordinate the multiple sites, sessions, and clinicians. Trial implementation was easier with sites that shared an electronic medical record system with our research hub. Conclusions The CATTS study used methods and procedures to optimize inclusion of children living in multiple dispersed and underserved areas. These experiences should advance the development of technologies needed to recruit underserved populations into research projects with the goal of reducing disparities in access to quality mental health care. PMID:23897950

Multiple stress response of lowland stream benthic macroinvertebrates depends on habitat type.

PubMed

Graeber, Daniel; Jensen, Tinna M; Rasmussen, Jes J; Riis, Tenna; Wiberg-Larsen, Peter; Baattrup-Pedersen, Annette

2017-12-01

Worldwide, lowland stream ecosystems are exposed to multiple anthropogenic stress due to the combination of water scarcity, eutrophication, and fine sedimentation. The understanding of the effects of such multiple stress on stream benthic macroinvertebrates has been growing in recent years. However, the interdependence of multiple stress and stream habitat characteristics has received little attention, although single stressor studies indicate that habitat characteristics may be decisive in shaping the macroinvertebrate response. We conducted an experiment in large outdoor flumes to assess the effects of low flow, fine sedimentation, and nutrient enrichment on the structure of the benthic macroinvertebrate community in riffle and run habitats of lowland streams. For most taxa, we found a negative effect of low flow on macroinvertebrate abundance in the riffle habitat, an effect which was mitigated by fine sedimentation for overall community composition and the dominant shredder species (Gammarus pulex) and by nutrient enrichment for the dominant grazer species (Baetis rhodani). In contrast, fine sediment in combination with low flow rapidly affected macroinvertebrate composition in the run habitat, with decreasing abundances of many species. We conclude that the effects of typical multiple stressor scenarios on lowland stream benthic macroinvertebrates are highly dependent on habitat conditions and that high habitat diversity needs to be given priority by stream managers to maximize the resilience of stream macroinvertebrate communities to multiple stress. Copyright © 2017 Elsevier B.V. All rights reserved.

COMMUNITY STRESSORS AND SUSCEPTIBILITY TO AIR POLLUTION IN URBAN ASTHMA

EPA Science Inventory

Given our large sample size within and across communities, our unique data on year-round fine-scale variability in multiple air pollutants, and our strong experience in community –based environmental health education and outreach, we believe that our study will provid...

Unifying Inference of Meso-Scale Structures in Networks.

PubMed

Tunç, Birkan; Verma, Ragini

2015-01-01

Networks are among the most prevalent formal representations in scientific studies, employed to depict interactions between objects such as molecules, neuronal clusters, or social groups. Studies performed at meso-scale that involve grouping of objects based on their distinctive interaction patterns form one of the main lines of investigation in network science. In a social network, for instance, meso-scale structures can correspond to isolated social groupings or groups of individuals that serve as a communication core. Currently, the research on different meso-scale structures such as community and core-periphery structures has been conducted via independent approaches, which precludes the possibility of an algorithmic design that can handle multiple meso-scale structures and deciding which structure explains the observed data better. In this study, we propose a unified formulation for the algorithmic detection and analysis of different meso-scale structures. This facilitates the investigation of hybrid structures that capture the interplay between multiple meso-scale structures and statistical comparison of competing structures, all of which have been hitherto unavailable. We demonstrate the applicability of the methodology in analyzing the human brain network, by determining the dominant organizational structure (communities) of the brain, as well as its auxiliary characteristics (core-periphery).

Community Engagement in Liberia: Routine Immunization Post-Ebola.

PubMed

Bedford, Juliet; Chitnis, Ketan; Webber, Nance; Dixon, Phil; Limwame, Ken; Elessawi, Rania; Obregon, Rafael

2017-01-01

A national integrated polio, measles, and deworming campaign was implemented across Liberia May 8-14, 2015. The community engagement and social mobilization component of the campaign was based on structures that had been invested in during the Ebola response. This article provides an overview of the community engagement and social mobilization activities that were conducted and reports the key findings of a rapid qualitative assessment conducted immediately after the campaign that focused on community perceptions of routine immunization in the post-Ebola context. Focus group discussions and interviews were conducted across four counties in Liberia (Montserrado, Nimba, Bong, and Margibi). Thematic analysis identified the barriers preventing and drivers leading to the utilization of routine immunization. Community members also made recommendations and forwarded community-based solutions to encourage engagement with future health interventions, including uptake in vaccination campaigns. These should be incorporated in the development and implementation of future interventions and programs.

Community Social Capital, Built Environment, and Income-Based Inequality in Depressive Symptoms Among Older People in Japan: An Ecological Study From the JAGES Project.

PubMed

Haseda, Maho; Kondo, Naoki; Ashida, Toyo; Tani, Yukako; Takagi, Daisuke; Kondo, Katsunori

2018-03-05

Although reducing socioeconomic inequalities in depression is necessary, their associated factors have rarely been studied. This study aimed to screen the potential contextual factors associated with income-based inequality in older adults' depression. Using data from the Japan Gerontological Evaluation Study (JAGES) of 2013, we conducted an ecological study covering 77 communities in Japan. Our measures of socioeconomic inequalities in depression were the slope index of inequalities (SII) and the relative index of inequalities (RII) of the prevalence of depressive symptoms across three income levels. We categorized available community-level factors, including socio-demographic factors, social participation, social relationships, subjective changes in the residential area, and the built environment. These indicators were aggregated from individual responses of 51,962 and 52,958 physically independent men and women, respectively, aged 65 years or more. We performed multiple linear regression analyses to explore factors with statistical significance of a two-tailed P-value less than 0.05. Factors associated with shallower gradients in depression for men included higher participation in local activities and reception or provision of social support, which did not show significant association among women. Perceived increases in unemployment and economic inequalities were positively associated with larger inequalities in both genders (P < 0.05). The built environment did not indicate any significant association. A community environment fostering social activities and relationships might be associated with smaller income-based inequalities in depression. There is a need for more deterministic studies for planning of effective community interventions to address socioeconomic inequalities in depression.

A Critical Reflection on the Multiple Roles Required to Facilitate Mutual Learning during Service-Learning in Creative Arts Education

ERIC Educational Resources Information Center

Meyer, Merna; Wood, Lesley

2017-01-01

In this article, I critically reflect on my own learning during a community-based, service-learning pilot project, highlighting the multiple roles that were required of me as facilitator. I provided opportunity for student teachers in a Creative Arts module to engage with youth from a local township community. The purpose of the participatory…

Exemplary Practice in Manitoba. Models of Quality in Literacy Programming.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg. Literacy and Continuing Education Branch.

This document profiles seven exemplary literacy programs in Manitoba, Canada: the Open Doors program in Winnipeg (a community-based program conducted in a school setting); the Brandon Friendship Centre literacy program (a community-based program conducted in a friendship center in rural Manitoba); the Flin Flon Friendship Centre literacy program…

Effects of multiple spreaders in community networks

NASA Astrophysics Data System (ADS)

Hu, Zhao-Long; Ren, Zhuo-Ming; Yang, Guang-Yong; Liu, Jian-Guo

2014-12-01

Human contact networks exhibit the community structure. Understanding how such community structure affects the epidemic spreading could provide insights for preventing the spreading of epidemics between communities. In this paper, we explore the spreading of multiple spreaders in community networks. A network based on the clustering preferential mechanism is evolved, whose communities are detected by the Girvan-Newman (GN) algorithm. We investigate the spreading effectiveness by selecting the nodes as spreaders in the following ways: nodes with the largest degree in each community (community hubs), the same number of nodes with the largest degree from the global network (global large-degree) and randomly selected one node within each community (community random). The experimental results on the SIR model show that the spreading effectiveness based on the global large-degree and community hubs methods is the same in the early stage of the infection and the method of community random is the worst. However, when the infection rate exceeds the critical value, the global large-degree method embodies the worst spreading effectiveness. Furthermore, the discrepancy of effectiveness for the three methods will decrease as the infection rate increases. Therefore, we should immunize the hubs in each community rather than those hubs in the global network to prevent the outbreak of epidemics.

a System Dynamics Approach for Looking at the Human and Environmental Interactions of Community-Based Irrigation Systems in New Mexico

NASA Astrophysics Data System (ADS)

Ochoa, C. G.; Tidwell, V. C.

2012-12-01

In the arid southwestern United States community water management systems have adapted to cope with climate variability and with socio-cultural and economic changes that have occurred since the establishment of these systems more than 300 years ago. In New Mexico, the community-based irrigation systems were established by Spanish settlers and have endured climate variability in the form of low levels of precipitation and have prevailed over important socio-political changes including the transfer of territory between Spain and Mexico, and between Mexico and the United States. Because of their inherent nature of integrating land and water use with society involvement these community-based systems have multiple and complex economic, ecological, and cultural interactions. Current urban population growth and more variable climate conditions are adding pressure to the survival of these systems. We are conducting a multi-disciplinary research project that focuses on characterizing these intrinsically complex human and natural interactions in three community-based irrigation systems in northern New Mexico. We are using a system dynamics approach to integrate different hydrological, ecological, socio-cultural and economic aspects of these three irrigation systems. Coupled with intensive field data collection, we are building a system dynamics model that will enable us to simulate important linkages and interactions between environmental and human elements occurring in each of these water management systems. We will test different climate variability and population growth scenarios and the expectation is that we will be able to identify critical tipping points of these systems. Results from this model can be used to inform policy recommendations relevant to the environment and to urban and agricultural land use planning in the arid southwestern United States.

Developing a community based service model for disability: Listening to the needs of all beneficiaries and providers.

PubMed

Collins, Katrina

2017-12-11

To inform the strategic and operational development of a community based service model at the Crann Centre, Cork, Ireland for SB children, adults, their families and providers. A needs assessment was conducted by gathering the views of multiple stakeholder perspectives within the SB community in the geographical region the Centre will serve. The intention is to create project deliverables that are responsive to the needs highlighted through this research. The study used a multi method design with a participatory research approach to explore the needs of SB individuals, families and providers. This involved in depth interviews, focus groups and online surveys. One hundred and fifty-nine respondents contributed to this qualitative needs assessment. The research established a range of psychosocial, clinical, vocational and educational issues causing ongoing difficulties for SB individuals and families. Providers highlighted supports that would benefit the social and clinical wellbeing of persons with SB. Collectively participants in the study reported that there was an absence of coordinated, continuous and comprehensive service delivery for the SB community in the region. This was amplified by geographical location of services and access to relevant supports. Consensus across stakeholders in this research pointed to the necessity for an innovative model of community based provision at the Crann Centre. This was described as offering a service with family at the core of an assets based model of practice. A key finding was the lack of importance placed on the social and emotional development of SB individuals. Traditionally participants described a singular focus on physical health through clinically defined treatment models. The desire for a social model of disability that informed health and wellbeing of SB individuals and families emerged as a prominent recommendation from the research.

School Dropout Prevention: What Arts-Based Community and Out-of-School-Time Programs Can Contribute

ERIC Educational Resources Information Center

Charmaraman, Linda; Hall, Georgia

2011-01-01

Out-of-school-time programs, especially arts-based programs, can be critical players in a community's efforts to prevent school dropout. This research review suggests the following approaches for arts-based programs: (1) recruitment and retention of target populations with multiple risk factors; (2) long-term skill development that engages youth…

Warming and Elevated CO2 Interact to Drive Rapid Shifts in Marine Community Production.

PubMed

Sorte, Cascade J B; Bracken, Matthew E S

2015-01-01

Predicting the outcome of future climate change requires an understanding of how alterations in multiple environmental factors manifest in natural communities and affect ecosystem functioning. We conducted an in situ, fully factorial field manipulation of CO2 and temperature on a rocky shoreline in southeastern Alaska, USA. Warming strongly impacted functioning of tide pool systems within one month, with the rate of net community production (NCP) more than doubling in warmed pools under ambient CO2 levels relative to initial NCP values. However, in pools with added CO2, NCP was unaffected by warming. Productivity responses paralleled changes in the carbon-to-nitrogen ratio of a red alga, the most abundant primary producer species in the system, highlighting the direct link between physiology and ecosystem functioning. These observed changes in algal physiology and community productivity in response to our manipulations indicate the potential for natural systems to shift rapidly in response to changing climatic conditions and for multiple environmental factors to act antagonistically.

Warming and Elevated CO2 Interact to Drive Rapid Shifts in Marine Community Production

PubMed Central

Sorte, Cascade J. B.; Bracken, Matthew E. S.

2015-01-01

Predicting the outcome of future climate change requires an understanding of how alterations in multiple environmental factors manifest in natural communities and affect ecosystem functioning. We conducted an in situ, fully factorial field manipulation of CO2 and temperature on a rocky shoreline in southeastern Alaska, USA. Warming strongly impacted functioning of tide pool systems within one month, with the rate of net community production (NCP) more than doubling in warmed pools under ambient CO2 levels relative to initial NCP values. However, in pools with added CO2, NCP was unaffected by warming. Productivity responses paralleled changes in the carbon-to-nitrogen ratio of a red alga, the most abundant primary producer species in the system, highlighting the direct link between physiology and ecosystem functioning. These observed changes in algal physiology and community productivity in response to our manipulations indicate the potential for natural systems to shift rapidly in response to changing climatic conditions and for multiple environmental factors to act antagonistically. PMID:26714167

Multiple Methodologies: Using Community-Based Participatory Research and Decolonizing Methodologies in Kenya

ERIC Educational Resources Information Center

Elder, Brent C.; Odoyo, Kenneth O.

2018-01-01

In this project, we examined the development of a sustainable inclusive education system in western Kenya by combining community-based participatory research (CBPR) and decolonizing methodologies. Through three cycles of qualitative interviews with stakeholders in inclusive education, participants explained what they saw as foundational components…

Study Protocol for a Home-based Obesity Prevention Program in Latino Preschool Children.

PubMed

Taverno Ross, Sharon E; Documet, Patricia I; Pate, Russell R; Smith-Tapia, Ivonne; Wisniewski, Lisa M; Gibbs, Bethany B

2017-07-15

This paper describes the study design for ANDALE Pittsburgh, a culturally-appropriate, family-based intervention to promote a healthy weight in Latino preschool children. The study was organized into two major phases: Phase I: Conduct focus groups with 30 Latino parents of preschool children to inform the development of a culturally-appropriate intervention; Phase II: Test the feasibility and effectiveness of the intervention with 50 families. Participants were recruited from an emerging Latino community through community gatherings, flyers, and word of mouth. Six promotoras (females >18 years, active in community) received 25 hours of training using the intervention curriculum finalized after Phase I. Promotoras delivered the home-based intervention to families over 10, 90-minute weekly sessions that included education, practice, and action (i.e., goal setting). Behavior modification constructs and strategies (e.g., goal setting, problem solving, social support), and building of self-efficacy through healthy recipe preparation and physical activity breaks, were also included. Outcomes (e.g., child BMI) were assessed pre- and post-intervention. Process evaluation assessed fidelity, dose, reach, recruitment, and contextual factors using multiple data sources and mixed methods. The ANDALE Pittsburgh study will expand the body of knowledge on interventions to promote a healthy weight in Latino preschool children living in an emerging Latino community. If successful, this approach will be evaluated in a future, larger-scale intervention and provide a potential model to help to address and prevent obesity in this population.

Erecting Closets and Outing Ourselves: Uncomfortable Reflexivity and Community-Based Research

ERIC Educational Resources Information Center

Reed, Sarah J.; Miller, Robin Lin; Nnawulezi, Nkiru; Valenti, Maria T.

2012-01-01

Feminist scholars and community psychologists have argued that reflexivity is a necessary component to conducting socially conscious research. Reflexivity, however, is rarely evident in community psychology. In this article, we share the uncomfortable realities that surfaced during a community-based research project in which we adapted and…

Participation Levels in 25 Community-Based Participatory Research Projects

ERIC Educational Resources Information Center

Spears Johnson, C. R.; Kraemer Diaz, A. E.; Arcury, T. A.

2016-01-01

This analysis describes the nature of community participation in National Institutes of Health and Centers for Disease Control and Prevention funded community-based participatory research (CBPR) projects, and explores the scientific and social implications of variation in community participation. We conducted in-depth interviews in 2012 with…

Participatory public health systems research: value of community involvement in a study series in mental health emergency preparedness.

PubMed

McCabe, O Lee; Marum, Felicity; Semon, Natalie; Mosley, Adrian; Gwon, Howard; Perry, Charlene; Moore, Suzanne Straub; Links, Jonathan M

2012-01-01

Concerns have arisen over recent years about the absence of empirically derived evidence on which to base policy and practice in the public health system, in general, and to meet the challenge of public health emergency preparedness, in particular. Related issues include the challenge of disaster-caused, behavioral health surge, and the frequent exclusion of populations from studies that the research is meant to aid. To characterize the contributions of nonacademic collaborators to a series of projects validating a set of interventions to enhance capacity and competency of public mental health preparedness planning and response. Urban, suburban, and rural communities of the state of Maryland and rural communities of the state of Iowa. Study partners and participants (both of this project and the studies examined) were representatives of academic health centers (AHCs), local health departments (LHDs), and faith-based organizations (FBOs) and their communities. A multiple-project, case study analysis was conducted, that is, four research projects implemented by the authors from 2005 through 2011 to determine the types and impact of contributions made by nonacademic collaborators to those projects. The analysis involved reviewing research records, conceptualizing contributions (and providing examples) for government, faith, and (nonacademic) institutional collaborators. Ten areas were identified where partners made valuable contributions to the study series; these "value-areas" were as follows: 1) leadership and management of the projects; 2) formulation and refinement of research topics, aims, etc; 3) recruitment and retention of participants; 4) design and enhancement of interventions; 5) delivery of interventions; 6) collection, analysis, and interpretation of data; 7) dissemination of findings; 8) ensuring sustainability of faith/government preparedness planning relationships; 9) optimizing scalability and portability of the model; and 10) facilitating translational impact of study findings. Systems-based partnerships among academic, faith, and government entities offer an especially promising infrastructure for conducting participatory public health systems research in domestic emergency preparedness and response.

Ethics and community-based participatory research: perspectives from the field.

PubMed

Bastida, Elena M; Tseng, Tung-Sung; McKeever, Corliss; Jack, Leonard

2010-01-01

Exploring the importance of ethical issues in the conduct of community-based participatory research (CBPR) continues to be an important topic for researchers and practitioners. This article uses the Beyond Sabor Project, a CBPR project implemented in the Lower Rio Grande Valley, as a case example to discuss ethical issues such as the importance of increasing community involvement in research, ensuring that communities benefit from the research, sharing leadership roles, and sensitive issues regarding data collection and sharing. Thereafter, this article concludes with a brief discussion of six principles that can inform the practice of ethical conduct when implementing CBPR studies. This article also lists additional reading resources on the importance of ethics in the conduct of CBPR.

Engaging Adolescents through Participatory and Qualitative Research Methods to Develop a Digital Communication Intervention to Reduce Adolescent Obesity

ERIC Educational Resources Information Center

Livingood, William C.; Monticalvo, David; Bernhardt, Jay M.; Wells, Kelli T.; Harris, Todd; Kee, Kadra; Hayes, Johnathan; George, Donald; Woodhouse, Lynn D.

2017-01-01

Background: The complexity of the childhood obesity epidemic requires the application of community-based participatory research (CBPR) in a manner that can transcend multiple communities of stakeholders, including youth, the broader community, and the community of health care providers. Aim: To (a) describe participatory processes for engaging…

Improving Participants’ Retention in a Smoking Cessation Intervention Using a Community-based Participatory Research Approach

PubMed Central

Estreet, Anthony; Apata, Jummai; Kamangar, Farin; Schutzman, Christine; Buccheri, Jane; O’Keefe, Anne-Marie; Wagner, Fernando; Sheikhattari, Payam

2017-01-01

Background: This study compares participant’ sretention in three phases of smoking cessation interventions, one provided in a health clinic and the subsequent two in community-based settings. Methods: Smoking cessation interventions were conducted in three phases from 2008 to 2015 in two underserved urban communities with low socioeconomic profiles and high rates of smoking (n = 951). Phase I was conducted in a clinic; Phases II and III were conducted in community venues. In Phases II and III, incremental changes were made based on lessons learned from the previous phases. Retention (attending six or more sessions) was the primary predictor of cessation and was analyzed while controlling for associated factors including age, gender, race, employment, education, and nicotine dependence. Results: Retention increased substantially over the three phases, with rates for attending six or more sessions of 13.8%, 51.9%, and 67.9% in Phases I, II, and III, respectively. Retention was significantly higher in community settings than in the clinic setting (adjusted odds ratio [OR] = 6.7; 95% confidence intervals [CI] = 4.6, 9.8). In addition to the intervention in community venues, predictors of retention included age and unemployment. Higher retention was significantly associated with higher quit rates (adjusted OR = 2.4; 95% CI = 1.5, 3.8). Conclusions: Conducting the intervention in community settings using trained peer motivators rather than health-care providers resulted in significantly higher retention and smoking cessation rates. This was due in part to the ability to tailor cessation classes in the community for specific populations and improving the quality of the intervention based on feedback from participants and community partners. PMID:29416835

Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya

PubMed Central

Watson-Jones, Deborah; Mugo, Nelly; Lees, Shelley; Mathai, Muthoni; Vusha, Sophie; Ndirangu, Gathari; Ross, David A.

2015-01-01

Background Sub-Saharan Africa bears the greatest burden of cervical cancer. Human papillomavirus (HPV) vaccination programmes to prevent the disease will need to reach vulnerable girls who may not be able access health and screening services in the future. We conducted formative research on facilitators and barriers to HPV vaccination and potential acceptability of a future HPV vaccination programme amongst girls living in hard-to-reach populations in Kenya. Methods Stakeholder interviews with Ministry of Health staff explored barriers to and support for the uptake of HPV vaccination. A situation assessment was conducted to assess community services in Maasai nomadic pastoralist communities in Kajiado County and in Korogocho informal settlement in Nairobi city, followed by focus group discussions (n=14) and semi-structured interviews (n=28) with health workers, parents, youth, and community and religious leaders. These covered marriage, knowledge of cervical cancer and HPV, factors that might inhibit or support HPV vaccine uptake and intention to accept HPV vaccine if a programme was in place. Results Reported challenges to an HPV vaccination programme included school absenteeism and drop-out, early age of sex and marriage, lack of parental support, population mobility and distance from services. Despite little prior knowledge of cervical cancer and HPV, communities were interested in receiving HPV vaccination. Adequate social mobilisation and school-based vaccination, supplemented by out-reach activities, were considered important facilitating factors to achieve high coverage. There was some support for a campaign approach to vaccine delivery. Conclusions Given the high level of support for a vaccine against cervical cancer and the experience of reaching pastoralist and slum-dwellers for other immunizations, implementing an HPV vaccine programme should be feasible in such hard-to-reach communities. This may require additional delivery strategies in addition to the standard school-based delivery, with vaccine offered at multiple venues, potentially through a campaign approach. PMID:26115523

Detection of core-periphery structure in networks based on 3-tuple motifs

NASA Astrophysics Data System (ADS)

Ma, Chuang; Xiang, Bing-Bing; Chen, Han-Shuang; Small, Michael; Zhang, Hai-Feng

2018-05-01

Detecting mesoscale structure, such as community structure, is of vital importance for analyzing complex networks. Recently, a new mesoscale structure, core-periphery (CP) structure, has been identified in many real-world systems. In this paper, we propose an effective algorithm for detecting CP structure based on a 3-tuple motif. In this algorithm, we first define a 3-tuple motif in terms of the patterns of edges as well as the property of nodes, and then a motif adjacency matrix is constructed based on the 3-tuple motif. Finally, the problem is converted to find a cluster that minimizes the smallest motif conductance. Our algorithm works well in different CP structures: including single or multiple CP structure, and local or global CP structures. Results on the synthetic and the empirical networks validate the high performance of our method.

"Cuz They Care about the People Who Goes There": The Multiple Roles of a Community-Based Youth Center in Providing "Youth (Comm)Unity" for Low-Income Chinese American Youth

ERIC Educational Resources Information Center

Wong, Nga-Wing Anjela

2010-01-01

This article will explore the role of "CYC," a community-based youth center, in providing a sense of what I call "Youth (Comm)Unity" for Chinese American youth from low-income immigrant families. While CYC combines the youths' home and school worlds, it is also distinct from these worlds by forming a new and hybrid culture/space. In doing so, I…

Uncontrolled diabetes mellitus: prevalence and risk factors among people with type 2 diabetes mellitus in an Urban District of Karachi, Pakistan.

PubMed

Siddiqui, Fahad Javaid; Avan, Bilal Iqbal; Mahmud, Sadia; Nanan, Debra J; Jabbar, Abdul; Assam, Pryseley Nkouibert

2015-01-01

This study aimed to explore the prevalence of, and factors associated with, uncontrolled diabetes mellitus (UDM) in a community setting in Pakistan. A single-center, cross-sectional study, conducted in a community-based specialized care center (SCC) for diabetes in District Central Karachi, in 2003, registered 452 type 2 DM participants, tested for HbA1c and interviewed face-to-face for other information. Logistic regression analysis was conducted to identify factors associated with UDM. Prevalence of UDM among diabetes patients was found to be 38.9% (95% CI: 34.4-43.4%). Multivariable logistic regression model analysis indicated that age <50 years (OR: 1.9; 95% CI: 1.2-2.9), being diagnosed in a hospital (vs. a clinic) (OR: 1.8; 95% CI: 1.1-2.8), diabetes information from a doctor or nurse only (vs. multiple sources) (OR: 1.8; 95% CI: 1.2-2.9), higher monthly treatment cost (OR: 1.3; 95% CI: 1.1-1.6; for every extra 500 PKR), and higher consumption of tea (OR: 1.5; 95% CI: 1.0-2.2; for every 2 extra cups) were independently associated with UDM. The prevalence of UDM was approximately 39% among persons with type 2 diabetes visiting a community based SCC for diabetes. Modifiable risk factors such as sources of diabetes information and black tea consumption can be considered as potential targets of interventions in Karachi. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A Community Intervention to Decrease Antibiotics Used for Self-Medication Among Latino Adults

PubMed Central

Mainous, Arch G.; Diaz, Vanessa A.; Carnemolla, Mark

2009-01-01

PURPOSE Recent evidence in Latino communities indicates substantial self-medication with antibiotics obtained without a prescription (WORx). We implemented and evaluated a culturally sensitive educational intervention to decrease antibiotic self-medication. METHODS We conducted a community-based intervention with preintervention and postintervention measures in the intervention community (Charleston, South Carolina) as well as a postintervention measure in a control community (Greenville, South Carolina) 200 miles away. The 9-month culturally sensitive intervention included multiple media sources (pamphlets, radio, newspapers). We evaluated the use of antibiotics WORx in the United States, as well as the likelihood of importing antibiotics, by surveying Latino adults in the intervention (n = 250) and in the control community (n = 250). RESULTS Most adults in the intervention community (69%) and the control community (60%) reported some exposure to messages about the inappropriate use of antibiotics, and 25.9% in the intervention community and 8.6% in the control community reported seeing our patient education pamphlets. A substantial proportion of Latino adults in both the intervention (31%) and control communities (20%) have obtained antibiotics WORx in the United States. In multivariate analyses, exposure to an educational message was not a significant predictor of having acquired antibiotics WORx in the United States in past 12 months. The primary predictor of respondents’ having acquired antibiotics WORx in the United States was whether they had bought antibiotics WORx outside the United States. CONCLUSIONS Novel approaches are needed to decrease the use of antibiotics WORx in Latino communities, as focusing only on education may not be sufficient to change behaviors common in their home countries. PMID:19901311

The Application of Learning Theories in Community College Classrooms. UCLA Community College Bibliography

ERIC Educational Resources Information Center

Carducci, Rozana

2006-01-01

The references in this document provide an overview of empirical and conceptual scholarship on the application of learning theories in community college classrooms. Specific theories discussed in the citations include: active learning, cooperative learning, multiple intelligences, problem-based learning, and self-regulated learning. In addition to…

Life-history strategies constrain invertebrate community tolerance to multiple stressors: A case study in the Ebro basin.

PubMed

Mondy, Cédric P; Muñoz, Isabel; Dolédec, Sylvain

2016-12-01

Multiple stressors constitute a serious threat to aquatic ecosystems, particularly in the Mediterranean region where water scarcity is likely to interact with other anthropogenic stressors. Biological traits potentially allow the unravelling of the effects of multiple stressors. However, thus far, trait-based approaches have failed to fully deliver on their promise and still lack strong predictive power when multiple stressors are present. We aimed to quantify specific community tolerances against six anthropogenic stressors and investigate the responses of the underlying macroinvertebrate biological traits and their combinations. We built and calibrated boosted regression tree models to predict community tolerances using multiple biological traits with a priori hypotheses regarding their individual responses to specific stressors. We analysed the combinations of traits underlying community tolerance and the effect of trait association on this tolerance. Our results validated the following three hypotheses: (i) the community tolerance models efficiently and robustly related trait combinations to stressor intensities and, to a lesser extent, to stressors related to the presence of dams and insecticides; (ii) the effects of traits on community tolerance not only depended on trait identity but also on the trait associations emerging at the community level from the co-occurrence of different traits in species; and (iii) the community tolerances and the underlying trait combinations were specific to the different stressors. This study takes a further step towards predictive tools in community ecology that consider combinations and associations of traits as the basis of stressor tolerance. Additionally, the community tolerance concept has potential application to help stream managers in the decision process regarding management options. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Partnership readiness for community-based participatory research

PubMed Central

Andrews, Jeannette O.; Newman, Susan D.; Meadows, Otha; Cox, Melissa J.; Bunting, Shelia

2012-01-01

The use of a dyadic lens to assess and leverage academic and community partners’ readiness to conduct community-based participatory research (CBPR) has not been systematically investigated. With a lack of readiness to conduct CBPR, the partnership and its products are vulnerable. The purpose of this qualitative study was to explore the dimensions and key indicators necessary for academic and community partnership readiness to conduct CBPR. Key informant interviews and focus groups (n = 36 participants) were conducted with academic and community participants who had experiences with CBPR partnerships. A ‘framework analysis' approach was used to analyze the data and generate a new model, CBPR Partnership Readiness Model. Antecedents of CBPR partnership readiness are a catalyst and mutual interest. The major dimensions of the CBPR Partnership Readiness Model are (i) goodness of fit, (ii) capacity, and (iii) operations. Preferred outcomes are sustainable partnership and product, mutual growth, policy and social and health impact on the community. CBPR partnership readiness is an iterative and dynamic process, partnership and issue specific, influenced by a range of environmental and contextual factors, amenable to change and essential for sustainability and promotion of health and social change in the community. PMID:20837654

A Qualitative Study of Interference with Communicative Participation across Communication Disorders in Adults

ERIC Educational Resources Information Center

Baylor, Carolyn; Burns, Michael; Eadie, Tanya; Britton, Deanna; Yorkston, Kathryn

2011-01-01

Purpose: To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults. Method: Interviews were conducted with 44 adults representing 7 different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering,…

Comparison of a theory-based (AIDS Risk Reduction Model) cognitive behavioral intervention versus enhanced counseling for abused ethnic minority adolescent women on infection with sexually transmitted infection: results of a randomized controlled trial.

PubMed

Champion, Jane Dimmitt; Collins, Jennifer L

2012-02-01

Ethnic minority adolescent women with a history of sexual or physical abuse and sexually transmitted infections represent a vulnerable population at risk for HIV. Community-based interventions for behavior modification and subsequent risk reduction have not been effective among these women. To evaluate the effects of a theory-based (AIDS Risk Reduction Model) cognitive behavioral intervention model versus enhanced counseling for abused ethnic minority adolescent women on infection with sexually transmitted infection at 6 and 12 months follow-up. Controlled randomized trial with longitudinal follow-up. Southwestern United States, Metropolitan community-based clinic. Mexican-and-African American adolescent women aged 14-18 years with a history of abuse or sexually transmitted infection seeking sexual health care. Extensive preliminary study for intervention development was conducted including individual interviews, focus groups, secondary data analysis, pre-testing and feasibility testing for modification of an evidence-based intervention prior to testing in the randomized controlled trial. Following informed consents for participation in the trial, detailed interviews concerning demographics, abuse history, sexual risk behavior, sexual health and physical exams were obtained. Randomization into either control or intervention groups was conducted. Intervention participants received workshop, support group and individual counseling sessions. Control participants received abuse and enhanced clinical counseling. Follow-up including detailed interview and physical exam was conducted at 6 and 12 months following study entry to assess for infection. Intention to treat analysis was conducted to assess intervention effects using chi-square and multiple regression models. 409 Mexican-(n=342) and African-(n=67) American adolescent women with abuse and sexually transmitted infection histories were enrolled; 90% intervention group attendance; longitudinal follow-up at 6 (93%) and 12 (94%) months. Intervention (n=199) versus control (n=210) group participants experienced fewer infections at 0-6 (0% versus 6.6%, p=.001), 6-12 (3.6% versus 7.8%, p=.005, CI 95% lower-upper .001-.386) and 0-12 (4.8% versus 13.2%, p=.002, CI 95% lower-upper, .002-.531) month intervals. A cognitive behavioral intervention specifically designed for ethnic minority adolescent women with a history of abuse and sexually transmitted infection was effective for prevention of infection. These results provide evidence for development of evidence-based interventions for sexually transmitted infection/HIV. Implications include translation to community-clinic-based settings for prevention of adverse outcomes regarding sexual health of adolescent women. Copyright © 2011 Elsevier Ltd. All rights reserved.

Emotional insecurity in the family and community and youth delinquency in Northern Ireland: a person-oriented analysis across five waves.

PubMed

Cummings, E Mark; Taylor, Laura K; Merrilees, Christine E; Goeke-Morey, Marcie C; Shirlow, Peter

2016-01-01

Over one billion children are exposed worldwide to political violence and armed conflict. Currently, conclusions about bases for adjustment problems are qualified by limited longitudinal research from a process-oriented, social-ecological perspective. In this study, we examined a theoretically-based model for the impact of multiple levels of the social ecology (family, community) on adolescent delinquency. Specifically, this study explored the impact of children's emotional insecurity about both the family and community on youth delinquency in Northern Ireland. In the context of a five-wave longitudinal research design, participants included 999 mother-child dyads in Belfast (482 boys, 517 girls), drawn from socially-deprived, ethnically-homogenous areas that had experienced political violence. Youth ranged in age from 10 to 20 and were 12.18 (SD = 1.82) years old on average at Time 1. The longitudinal analyses were conducted in hierarchical linear modeling (HLM), allowing for the modeling of interindividual differences in intraindividual change. Intraindividual trajectories of emotional insecurity about the family related to children's delinquency. Greater insecurity about the community worsened the impact of family conflict on youth's insecurity about the family, consistent with the notion that youth's insecurity about the community sensitizes them to exposure to family conflict in the home. The results suggest that ameliorating children's insecurity about family and community in contexts of political violence is an important goal toward improving adolescents' well-being, including reduced risk for delinquency. © 2015 Association for Child and Adolescent Mental Health.

Our Environment, Our Health: A Community-Based Participatory Environmental Health Survey in Richmond, California

ERIC Educational Resources Information Center

Cohen, Alison; Lopez, Andrea; Malloy, Nile; Morello-Frosch, Rachel

2012-01-01

This study presents a health survey conducted by a community-based participatory research partnership between academic researchers and community organizers to consider environmental health and environmental justice issues in four neighborhoods of Richmond, California, a low-income community of color living along the fence line of a major oil…

Participation levels in 25 Community-based participatory research projects.

PubMed

Spears Johnson, C R; Kraemer Diaz, A E; Arcury, T A

2016-10-01

This analysis describes the nature of community participation in National Institutes of Health and Centers for Disease Control and Prevention funded community-based participatory research (CBPR) projects, and explores the scientific and social implications of variation in community participation. We conducted in-depth interviews in 2012 with professional and community researchers from 25 CBPR projects in the Southeast US. Interview topics focused on participants' experiences with the nature and conduct of their CBPR project. Projects were rated on community participation in 13 components of research. Projects varied substantially in community participation. Some projects had community participation in only two to three components; others had participation in every component. Some professional researchers were deliberate in their inclusion of community participation in all aspects of research, others had community participation in some aspects, and others were mainly concerned that community members had the opportunity to participate in the study. Findings suggest a need for a standardized rubric for community-based research that facilitates delineation of approaches and procedures that are effective and efficient. Little actual community participation may also result in negative social impacts for communities. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Fluid Physical and Transport Phenomena Studies aboard the International Space Station: Planned Experiments

NASA Technical Reports Server (NTRS)

Singh, Bhim S.

1999-01-01

This paper provides an overview of the microgravity fluid physics and transport phenomena experiments planned for the International Spare Station. NASA's Office of Life and Microgravity Science and Applications has established a world-class research program in fluid physics and transport phenomena. This program combines the vast expertise of the world research community with NASA's unique microgravity facilities with the objectives of gaining new insight into fluid phenomena by removing the confounding effect of gravity. Due to its criticality to many terrestrial and space-based processes and phenomena, fluid physics and transport phenomena play a central role in the NASA's Microgravity Program. Through widely publicized research announcement and well established peer-reviews, the program has been able to attract a number of world-class researchers and acquired a critical mass of investigations that is now adding rapidly to this field. Currently there arc a total of 106 ground-based and 20 candidate flight principal investigators conducting research in four major thrust areas in the program: complex flows, multiphase flow and phase change, interfacial phenomena, and dynamics and instabilities. The International Space Station (ISS) to be launched in 1998, provides the microgravity research community with a unprecedented opportunity to conduct long-duration microgravity experiments which can be controlled and operated from the Principal Investigators' own laboratory. Frequent planned shuttle flights to the Station will provide opportunities to conduct many more experiments than were previously possible. NASA Lewis Research Center is in the process of designing a Fluids and Combustion Facility (FCF) to be located in the Laboratory Module of the ISS that will not only accommodate multiple users but, allow a broad range of fluid physics and transport phenomena experiments to be conducted in a cost effective manner.

Community Based Learning with Adults: Bridging Efforts in Multiple Sectors

ERIC Educational Resources Information Center

Holland, Barbara; Robinson, Gail

2008-01-01

In this article, the authors explore the diverse ways in which community based learning strategies are used to enhance further development of adults, raising their levels of educational attainment and increasing their involvement in public and civic activities. There are two social and demographic dynamics at the heart of this topic: the aging…

A Community-Based Early Intervention Program for Toddlers with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Rollins, Pamela Rosenthal; Campbell, Michelle; Hoffman, Renee Thibodeau; Self, Kayli

2016-01-01

This study examined Pathways Early Autism Intervention, a community-based, parent-mediated, intensive behavioral and developmental intervention program for children with autism spectrum disorders that could be used as a model for state-funded early intervention programs. A single-subject, multiple-baseline, across-participants design was used.…

Operation and challenges of home-based medical practices in the US: findings from six aggregated case studies.

PubMed

Norman, Gregory J; Orton, Kristann; Wade, Amy; Morris, Andrea M; Slaboda, Jill C

2018-01-27

Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U.S. geographic regions, we conducted a six-site HBPC practice assessment to better understand different operation structures, common challenges, and approaches to delivering HBPC. Six practices varying in size, care team composition and location agreed to participate. At each site we conducted unstructured interviews with key informants and directly observed practices and procedures in the field and back office. The aggregated case studies revealed important issues focused on team composition, patient characteristics, use of technology and urgent care delivery. Common challenges across the practices included provider retention and unmet community demand for home-based care services. Most practices, regardless of size, faced challenges around using electronic medical records (EMRs) and scheduling systems not designed for use in a mobile practice. Although many practices offered urgent care, practices varied in the methods used to provide care including the use of community paramedics and telehealth technology. Learnings compiled from these observations can inform other HBPC practices as to potential best practices that can be implemented in an effort to improve efficiency and scalability of HBPC so that seniors with multiple chronic conditions can receive comprehensive primary care services in their homes.

Using Community-Based Participatory Research to Assess Health Needs among Migrant and Seasonal Farmworkers

ERIC Educational Resources Information Center

Doyle, Eva; Rager, Robin; Bates, Denise; Cooper, Cheryl

2006-01-01

Principles of community-based participatory research (CBPR) were applied among migrant and seasonal farmworkers (MSFWs) in a seven-county region of east Texas. The study purpose was to establish community-based partnerships for CBPR and conduct a preliminary qualitative assessment of perceived health needs and capacities. Key informant interviews…

Community-Based Prevention Using Simple, Low-Cost, Evidence-Based Kernels and Behavior Vaccines

ERIC Educational Resources Information Center

Embry, Dennis D.

2004-01-01

A paradox exists in community prevention of violence and drugs. Good research now exists on evidence-based programs, yet extensive expenditures on prevention have not produced community-level results. Various multiproblems are quite prevalent in the United States, such as violence, Attention Deficit Hyperactivity Disorder (ADHD), conduct problems,…

Understanding the Context of Health for Persons With Multiple Chronic Conditions: Moving From What Is the Matter to What Matters

PubMed Central

Bayliss, Elizabeth A.; Bonds, Denise E.; Boyd, Cynthia M.; Davis, Melinda M.; Finke, Bruce; Fox, Michael H.; Glasgow, Russell E.; Goodman, Richard A.; Heurtin-Roberts, Suzanne; Lachenmayr, Sue; Lind, Cristin; Madigan, Elizabeth A.; Meyers, David S.; Mintz, Suzanne; Nilsen, Wendy J.; Okun, Sally; Ruiz, Sarah; Salive, Marcel E.; Stange, Kurt C.

2014-01-01

PURPOSE An isolated focus on 1 disease at a time is insufficient to generate the scientific evidence needed to improve the health of persons living with more than 1 chronic condition. This article explores how to bring context into research efforts to improve the health of persons living with multiple chronic conditions (MCC). METHODS Forty-five experts, including persons with MCC, family and friend caregivers, researchers, policy makers, funders, and clinicians met to critically consider 4 aspects of incorporating context into research on MCC: key contextual factors, needed research, essential research methods for understanding important contextual factors, and necessary partnerships for catalyzing collaborative action in conducting and applying research. RESULTS Key contextual factors involve complementary perspectives across multiple levels: public policy, community, health care systems, family, and person, as well as the cellular and molecular levels where most research currently is focused. Needed research involves moving from a disease focus toward a person-driven, goal-directed research agenda. Relevant research methods are participatory, flexible, multilevel, quantitative and qualitative, conducive to longitudinal dynamic measurement from diverse data sources, sufficiently detailed to consider what works for whom in which situation, and generative of ongoing communities of learning, living and practice. Important partnerships for collaborative action include cooperation among members of the research enterprise, health care providers, community-based support, persons with MCC and their family and friend caregivers, policy makers, and payers, including government, public health, philanthropic organizations, and the business community. CONCLUSION Consistent attention to contextual factors is needed to enhance health research for persons with MCC. Rigorous, integrated, participatory, multimethod approaches to generate new knowledge and diverse partnerships can be used to increase the relevance of research to make health care more sustainable, safe, equitable and effective, to reduce suffering, and to improve quality of life. PMID:24821898

Intimate partner violence prevention program in an Asian immigrant community: integrating theories, data, and community.

PubMed

Yoshihama, Mieko; Ramakrishnan, Aparna; Hammock, Amy C; Khaliq, Mahmooda

2012-07-01

To fill an existing gap in research and practice on intimate partner violence (IPV) in immigrant communities, the authors developed an IPV prevention program, called the Shanti Project, in an Asian Indian community in the Midwest. Building on the notion of shanti (harmony/peace), a cherished value and strength of the community, we created a communications campaign that combined social marketing and community-based participatory approaches. Recognizing the interactive influences of multiple levels of social ecology, campaign activities were designed to bring about changes at the individual, relationship/family, organization, and community levels. This article presents the development of this theoretically, empirically, and community-based IPV prevention program.

Into the Community and Not on the Shelf: Learning to Develop a Meaningful HIV/AIDS Curriculum for Multiple Communities

ERIC Educational Resources Information Center

Riley, Tasha

2014-01-01

This paper describes the process involved in creating a community-based training curriculum designed to build capacity and foster new knowledge in support of HIV/AIDS education. Highlighted are the challenges and triumphs incurred while working with community and academic partners to ensure the production of an adaptable curriculum designed to…

Overlapping communities from dense disjoint and high total degree clusters

NASA Astrophysics Data System (ADS)

Zhang, Hongli; Gao, Yang; Zhang, Yue

2018-04-01

Community plays an important role in the field of sociology, biology and especially in domains of computer science, where systems are often represented as networks. And community detection is of great importance in the domains. A community is a dense subgraph of the whole graph with more links between its members than between its members to the outside nodes, and nodes in the same community probably share common properties or play similar roles in the graph. Communities overlap when nodes in a graph belong to multiple communities. A vast variety of overlapping community detection methods have been proposed in the literature, and the local expansion method is one of the most successful techniques dealing with large networks. The paper presents a density-based seeding method, in which dense disjoint local clusters are searched and selected as seeds. The proposed method selects a seed by the total degree and density of local clusters utilizing merely local structures of the network. Furthermore, this paper proposes a novel community refining phase via minimizing the conductance of each community, through which the quality of identified communities is largely improved in linear time. Experimental results in synthetic networks show that the proposed seeding method outperforms other seeding methods in the state of the art and the proposed refining method largely enhances the quality of the identified communities. Experimental results in real graphs with ground-truth communities show that the proposed approach outperforms other state of the art overlapping community detection algorithms, in particular, it is more than two orders of magnitude faster than the existing global algorithms with higher quality, and it obtains much more accurate community structure than the current local algorithms without any priori information.

An innovative Oklahoma program to coordinate interdisciplinary and interagency services for children with special healthcare needs at a county level.

PubMed

Wolraich, Mark; Lockhart, Jennifer; Worley, Louis

2013-03-01

Children and youth with special health care needs (CYSHCN) and their families often require multiple services from multiple providers in order to meet their needs. The Sooner SUCCESS (State Unified Children's Comprehensive Exemplary Services for Special Needs), was developed based on a complex adaptive systems approach allowing local coalitions to address their unique needs. Sooner SUCCESS provides support to families and service providers at the community level including a broad range of supports from simply helping a family identify and access a service that already exists to innovatively marshaling generic resources to meet a unique need. The program uses these family support activities coupled with the Community Needs Assessment to identify local service needs encouraging community capacity building by coordinating the efforts of the health, mental health, social and education systems to identify service gaps and develop community-based strategies to fill those gaps.

A primary care-public health partnership addressing homelessness, serious mental illness, and health disparities.

PubMed

Weinstein, Lara Carson; Lanoue, Marianna D; Plumb, James D; King, Hannah; Stein, Brianna; Tsemberis, Sam

2013-01-01

People with histories of homelessness and serious mental illness experience profound health disparities. Housing First is an evidenced-based practice that is working to end homelessness for these individuals through a combination of permanent housing and community-based supports. The Jefferson Department of Family and Community Medicine and a Housing First agency, Pathways to Housing-PA, has formed a partnership to address multiple levels of health care needs for this group. We present a preliminary program evaluation of this partnership using the framework of the patient-centered medical home and the "10 Essential Public Health Services." Preliminary program evaluation results suggest that this partnership is evolving to function as an integrated person-centered health home and an effective local public health monitoring system. The Pathways to Housing-PA/Jefferson Department of Family and Community Medicine partnership represents a community of solution, and multiple measures provide preliminary evidence that this model is feasible and can address the "grand challenges" of integrated community health services.

Considering the needs of indigenous and local populations in conservation programs.

PubMed

Kohler, Florent; Brondizio, Eduardo S

2017-04-01

Local rural and indigenous communities have assumed increasing responsibility for conservation within and between areas buffering the impacts of agricultural or resource-extraction zones and protected areas. Empowering local communities as central partners in conservation and climate-change mitigation has allowed many people to gain access to land and citizenship rights but has provided limited improvements in access to social services and economic opportunities even as expectation about their role as environmental stewards grows. These expectations, however, are inconsistent with reality. We conducted multiple field studies in Brazil since the mid-1980s to illustrate the discrepancies between conservation programs and local conditions and expectations. We suggest that public policies and conservation programs should not delegate responsibility for managing protected areas to local and indigenous communities without considering local needs and expectations and locals' attitudes toward conservation. In other words, behavior that maintains or improves the environment should not be treated as traditional based on the expectations of outsiders. Framing local populations as traditional environmentalists creates contradictions and frustrations for local populations and for conservation professionals and policy makers. © 2016 Society for Conservation Biology.

Connecting Hispanic Women in Baltimore to the Mercy Medical Center Sexual Assault Forensic Examiners/Forensic Nurse Examiners Program: A Preliminary Assessment of Service Utilization and Community Awareness.

PubMed

Adams, Margaret; Fitzgerald, Sheila; Holbrook, Debra

2016-01-01

Sexual violence and gender-based violence represent a major public health problem causing significant negative mental, physical, and social outcomes for victims. The rapidly growing population of Hispanic women in Baltimore are both more vulnerable to sexual assault and less able to access postassault services. In an effort to assess service utilization and community awareness of the Mercy Medical Center Sexual Assault Forensic Examiners/Forensic Nurse Examiners Program, we conducted a retrospective chart review of 2,322 women who were seen by the program between 2010 and 2013 and found that only 2.5% of the women were identified as Hispanic, about half of what Baltimore City demographic data would predict. This exploratory pilot project, augmented by key informant interviews, reveals that Hispanic women are underutilizing sexual assault services. Multiple barriers exist for Hispanic women in obtaining victim services, including lack of awareness within the community that the services exist, cultural factors, language barriers, lack of awareness of legal rights, and a fear of deportation.

Factors Affecting Nutrition and Physical Activity Behaviors of Hispanic Families With Young Children: Implications for Obesity Policies and Programs.

PubMed

Stang, Jamie; Bonilla, Zobeida

2017-09-29

To determine preferred policies and programs to prevent obesity and diabetes as identified by parents and caregivers of 3- to 5-year-old Latino children. Constructs from the Social Ecological Model were used to develop 10 focus group and key informant interview questions. Community venues and schools in St Paul, MN. A total of 64 parents and caregivers and 20 key informants provided comments. Community-based participatory research methods were used to gather opinions regarding appropriate and preferred methods to prevent obesity and diabetes among Latino youth. Native Spanish-speaking investigators who were members of the community conducted 7 focus groups (60-90 minutes each) and 20 key informant interviews. Themes and subthemes of preferences based on participant comments. Transcript-based, long-table qualitative analysis. Five themes were identified: (1) cultural beliefs and practices are inconsistent with obesity prevention; (2) cost and convenience; (3) positive parenting practices; (4) we want to learn more about being healthy; and (5) gardens, parks, gyms, and school meals. At least 1 theme fell within each of the social ecological model domains. Our results suggest that parents of young Hispanic children prefer that obesity and diabetes prevention programs address multiple levels of influence. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Filling the gap in functional trait databases: use of ecological hypotheses to replace missing data.

PubMed

Taugourdeau, Simon; Villerd, Jean; Plantureux, Sylvain; Huguenin-Elie, Olivier; Amiaud, Bernard

2014-04-01

Functional trait databases are powerful tools in ecology, though most of them contain large amounts of missing values. The goal of this study was to test the effect of imputation methods on the evaluation of trait values at species level and on the subsequent calculation of functional diversity indices at community level using functional trait databases. Two simple imputation methods (average and median), two methods based on ecological hypotheses, and one multiple imputation method were tested using a large plant trait database, together with the influence of the percentage of missing data and differences between functional traits. At community level, the complete-case approach and three functional diversity indices calculated from grassland plant communities were included. At the species level, one of the methods based on ecological hypothesis was for all traits more accurate than imputation with average or median values, but the multiple imputation method was superior for most of the traits. The method based on functional proximity between species was the best method for traits with an unbalanced distribution, while the method based on the existence of relationships between traits was the best for traits with a balanced distribution. The ranking of the grassland communities for their functional diversity indices was not robust with the complete-case approach, even for low percentages of missing data. With the imputation methods based on ecological hypotheses, functional diversity indices could be computed with a maximum of 30% of missing data, without affecting the ranking between grassland communities. The multiple imputation method performed well, but not better than single imputation based on ecological hypothesis and adapted to the distribution of the trait values for the functional identity and range of the communities. Ecological studies using functional trait databases have to deal with missing data using imputation methods corresponding to their specific needs and making the most out of the information available in the databases. Within this framework, this study indicates the possibilities and limits of single imputation methods based on ecological hypothesis and concludes that they could be useful when studying the ranking of communities for their functional diversity indices.

Filling the gap in functional trait databases: use of ecological hypotheses to replace missing data

PubMed Central

Taugourdeau, Simon; Villerd, Jean; Plantureux, Sylvain; Huguenin-Elie, Olivier; Amiaud, Bernard

2014-01-01

Functional trait databases are powerful tools in ecology, though most of them contain large amounts of missing values. The goal of this study was to test the effect of imputation methods on the evaluation of trait values at species level and on the subsequent calculation of functional diversity indices at community level using functional trait databases. Two simple imputation methods (average and median), two methods based on ecological hypotheses, and one multiple imputation method were tested using a large plant trait database, together with the influence of the percentage of missing data and differences between functional traits. At community level, the complete-case approach and three functional diversity indices calculated from grassland plant communities were included. At the species level, one of the methods based on ecological hypothesis was for all traits more accurate than imputation with average or median values, but the multiple imputation method was superior for most of the traits. The method based on functional proximity between species was the best method for traits with an unbalanced distribution, while the method based on the existence of relationships between traits was the best for traits with a balanced distribution. The ranking of the grassland communities for their functional diversity indices was not robust with the complete-case approach, even for low percentages of missing data. With the imputation methods based on ecological hypotheses, functional diversity indices could be computed with a maximum of 30% of missing data, without affecting the ranking between grassland communities. The multiple imputation method performed well, but not better than single imputation based on ecological hypothesis and adapted to the distribution of the trait values for the functional identity and range of the communities. Ecological studies using functional trait databases have to deal with missing data using imputation methods corresponding to their specific needs and making the most out of the information available in the databases. Within this framework, this study indicates the possibilities and limits of single imputation methods based on ecological hypothesis and concludes that they could be useful when studying the ranking of communities for their functional diversity indices. PMID:24772273

How Nonclinical Are Community Samples?

ERIC Educational Resources Information Center

Thurston, Idia B.; Curley, Jessica; Fields, Sherecce; Kamboukos, Dimitra; Rojas, Ariz; Phares, Vicky

2008-01-01

Mental health services are underutilized in our society by both adults and children. This finding presents a potential problem for researchers conducting community-based research. Previous studies have demonstrated that community-based researchers frequently do not screen participants for the presence of psychopathology nor do they ascertain…

Subjective social status and readiness to quit among homeless smokers.

PubMed

Garey, Lorra; Reitzel, Lorraine R; Bakhshaie, Jafar; Kendzor, Darla E; Zvolensky, Michael J; Businelle, Michael S

2015-03-01

To explore the predictive value of subjective social status (SSS-US and SSS-Community) on readiness to quit among 245 homeless smokers. Hierarchical multiple regression analyses were conducted (stratified by sex). Higher SSS-US (p = .02) and SSS-Community (p < .001) predicted greater readiness to quit in the total sample. These relationships upheld for men (p's <. 01), but only SSS-Community predicted readiness to quit for women (p = .02). Higher SSS is associated with greater readiness to quit among homeless smokers. SSS-Community may be a more relevant index of SSS for women relative to SSS-US. Results suggest SSS may be a factor that contributes to smoking, disease, and health disparities.

The Health Impact Assessment (HIA) Resource and Tool ...

EPA Pesticide Factsheets

Health Impact Assessment (HIA) is a relatively new and rapidly emerging field in the U.S. An inventory of available HIA resources and tools was conducted, with a primary focus on resources developed in the U.S. The resources and tools available to HIA practitioners in the conduct of their work were identified through multiple methods and compiled into a comprehensive list. The compilation includes tools and resources related to the HIA process itself and those that can be used to collect and analyze data, establish a baseline profile, assess potential health impacts, and establish benchmarks and indicators for monitoring and evaluation. These resources include literature and evidence bases, data and statistics, guidelines, benchmarks, decision and economic analysis tools, scientific models, methods, frameworks, indices, mapping, and various data collection tools. Understanding the data, tools, models, methods, and other resources available to perform HIAs will help to advance the HIA community of practice in the U.S., improve the quality and rigor of assessments upon which stakeholder and policy decisions are based, and potentially improve the overall effectiveness of HIA to promote healthy and sustainable communities. The Health Impact Assessment (HIA) Resource and Tool Compilation is a comprehensive list of resources and tools that can be utilized by HIA practitioners with all levels of HIA experience to guide them throughout the HIA process. The HIA Resource

Water insecurity in Canadian Indigenous communities: some inconvenient truths.

PubMed

Sarkar, Atanu; Hanrahan, Maura; Hudson, Amy

2015-01-01

Canada has the second highest per capita water consumption in the world. However, little is known about complex socio-economic and cultural dynamics of water insecurities in Indigenous communities and the multiple health consequences. Most studies have concentrated on a simplified interpretation of accessibility, availability and quality issues, including some common water-borne infections as the only health outcomes. Thus, several government initiatives on potable water supply, particularly for remotely located communities, have failed to sustain and promote a healthy lifestyle. The objective was to explore the water insecurity, coping strategies and associated health risks in a small and isolated sub-Arctic Indigenous (Inuit) community in Canada. The study was based on a community-based survey (2013) in one of the most remote Inuit communities of Labrador. In-depth, open-ended key informant (KI) interviews (community leader (1), woman (1), nurse (1), teacher (1), and elder (1)) and focus group discussions (FGDs) were conducted with community leaders (5), community members (25), women (5), and high school students (8). Convenience sampling was followed in selection of the subjects for FGDs and approached some KIs. All the water sources (five in April and seven in October) were visited and tested for their physical, chemical and microbiological parameters. The FGDs and KI interviews were audio recorded and transcribed. In the analysis, the data (qualitative and quantitative) were broadly categorized into (a) water sources, access and quality, (b) coping, (c) health risks and (d) challenges to run a public water system. The community did not have any piped water supply. Their regular sources of water consisted of several unmonitored local streams, brooks, and ponds. The public water system was not affordable to the majority of community members who solely depended on government aid. Animal fecal contamination (in natural sources such as streams, brooks, and ponds) and the presence of disinfection by-products (in the public water system) were the major quality issues. Gastro-intestinal infections were the most common disease in the community. Per capita water consumption was less than one-third of the Canadian national average (274 L/day/person), severely compromising personal hygiene and water intake. High-sugar-content beverages were the most common alternative to lack of accessible and affordable potable water, particularly for children. Mental stress due to water insecurity and chronic back and shoulder injuries due to carrying heavy water buckets every day were the commonly encountered adverse health outcomes. Water insecurity has put the community at risk of multiple serious adverse health outcomes. The scenario is not unique in Canada. There are many remote Indigenous communities facing similar kinds of water insecurity.

Extending the Concept and Practice of Classroom Based Research to California Community Colleges. Final Report.

ERIC Educational Resources Information Center

Sacramento City Coll., CA. Learning Resources Div.

With support from the California Community College Fund for Instructional Improvement, 14 classroom-based research studies were conducted in fall 1991 at American River College (ARC), Consumnes River College (CRC), Sacramento City College (SCC), San Joaquin Delta College (SJDC), Solano Community College (SoCC), and Yuba Community College (YCC).…

Elucidating empowerment in El Proyecto Bienestar (the Well-Being Project).

PubMed

Postma, Julie

2008-05-01

This paper describes differences in how socioculturally diverse participants in one community-based participatory research project negotiated 'empowerment', and the implications of those differences for nurses involved in farmworker health and safety efforts. Internationally, empowerment and community participation are increasingly being used as strategies to reduce health disparities. Theories of empowerment vary in the academic literature and their connotations vary across cultures. Study participants were part of El Proyecto Bienestar, a community-based participatory research (CBPR) project whose aim was to identify and respond to occupational and environmental health threats in one Mexican-American farmworker community in the United States of America. Participant observation was used to audiorecord 18 participants in the third year (2006) of this 4-year project discussing future project activities. Discourse analysis was used to analyse the transcripts. While participants agreed that 'empowerment' was central to the project, they had different perspectives on what the term meant and the role that the project should play in empowering the farmworker community. Empowerment discourses positioned the project in three ways: (1) as an instrument used to strengthen farmworkers' collective political voice, (2) as an instrument used to represent multiple community interests and (3) as an instrument used to advocate on behalf of farmworkers. Individuals used multiple discourses signifying the complexity in participants' roles and obligations. Balancing power and developing knowledge collaboratively requires understanding multiple approaches to empowerment. Community empowerment as an outcome should not come at the expense of individual empowerment as part of the CBPR process.

Design and Testing of Novel Lethal Ovitrap to Reduce Populations of Aedes Mosquitoes: Community-Based Participatory Research between Industry, Academia and Communities in Peru and Thailand.

PubMed

Paz-Soldan, Valerie A; Yukich, Josh; Soonthorndhada, Amara; Giron, Maziel; Apperson, Charles S; Ponnusamy, Loganathan; Schal, Coby; Morrison, Amy C; Keating, Joseph; Wesson, Dawn M

2016-01-01

Dengue virus (and Chikungunya and Zika viruses) is transmitted by Aedes aegypti and Aedes albopictus mosquitoes and causes considerable human morbidity and mortality. As there is currently no vaccine or chemoprophylaxis to protect people from dengue virus infection, vector control is the only viable option for disease prevention. The purpose of this paper is to illustrate the design and placement process for an attractive lethal ovitrap to reduce vector populations and to describe lessons learned in the development of the trap. This study was conducted in 2010 in Iquitos, Peru and Lopburi Province, Thailand and used an iterative community-based participatory approach to adjust design specifications of the trap, based on community members' perceptions and feedback, entomological findings in the lab, and design and research team observations. Multiple focus group discussions (FGD) were held over a 6 month period, stratified by age, sex and motherhood status, to inform the design process. Trap testing transitioned from the lab to within households. Through an iterative process of working with specifications from the research team, findings from the laboratory testing, and feedback from FGD, the design team narrowed trap design options from 22 to 6. Comments from the FGD centered on safety for children and pets interacting with traps, durability, maintenance issues, and aesthetics. Testing in the laboratory involved releasing groups of 50 gravid Ae. aegypti in walk-in rooms and assessing what percentage were caught in traps of different colors, with different trap cover sizes, and placed under lighter or darker locations. Two final trap models were mocked up and tested in homes for a week; one model was the top choice in both Iquitos and Lopburi. The community-based participatory process was essential for the development of novel traps that provided effective vector control, but also met the needs and concerns of community members.

Design and Testing of Novel Lethal Ovitrap to Reduce Populations of Aedes Mosquitoes: Community-Based Participatory Research between Industry, Academia and Communities in Peru and Thailand

PubMed Central

Yukich, Josh; Soonthorndhada, Amara; Giron, Maziel; Apperson, Charles S.; Ponnusamy, Loganathan; Schal, Coby; Morrison, Amy C.; Keating, Joseph; Wesson, Dawn M.

2016-01-01

Background Dengue virus (and Chikungunya and Zika viruses) is transmitted by Aedes aegypti and Aedes albopictus mosquitoes and causes considerable human morbidity and mortality. As there is currently no vaccine or chemoprophylaxis to protect people from dengue virus infection, vector control is the only viable option for disease prevention. The purpose of this paper is to illustrate the design and placement process for an attractive lethal ovitrap to reduce vector populations and to describe lessons learned in the development of the trap. Methods This study was conducted in 2010 in Iquitos, Peru and Lopburi Province, Thailand and used an iterative community-based participatory approach to adjust design specifications of the trap, based on community members’ perceptions and feedback, entomological findings in the lab, and design and research team observations. Multiple focus group discussions (FGD) were held over a 6 month period, stratified by age, sex and motherhood status, to inform the design process. Trap testing transitioned from the lab to within households. Results Through an iterative process of working with specifications from the research team, findings from the laboratory testing, and feedback from FGD, the design team narrowed trap design options from 22 to 6. Comments from the FGD centered on safety for children and pets interacting with traps, durability, maintenance issues, and aesthetics. Testing in the laboratory involved releasing groups of 50 gravid Ae. aegypti in walk-in rooms and assessing what percentage were caught in traps of different colors, with different trap cover sizes, and placed under lighter or darker locations. Two final trap models were mocked up and tested in homes for a week; one model was the top choice in both Iquitos and Lopburi. Discussion The community-based participatory process was essential for the development of novel traps that provided effective vector control, but also met the needs and concerns of community members. PMID:27532497

Academic-Hospital Partnership: Conducting a Community Health Needs Assessment as a Service Learning Project.

PubMed

Krumwiede, Kelly A; Van Gelderen, Stacey A; Krumwiede, Norma K

2015-01-01

The purposes of this service learning project were to trial nursing student application of the Community-Based Collaborative Action Research (CBCAR) framework while conducting a community health needs assessment and to assess the effectiveness of the CBCAR framework in providing real-world learning opportunities for enhancing baccalaureate nursing students' public health knowledge. In this case study analysis, the CBCAR framework linked service learning and community health needs assessment with public health nursing core competencies. Fifteen nursing students partnered with collaborative members. Student observational field notes and narrative reflections were analyzed qualitatively for fidelity to the CBCAR framework and to evaluate student public health knowledge. Students successfully employed the CBCAR framework in collaboration with the critical access hospital and community stakeholders to design and conduct the community health needs assessment. Service learning themes were real-world solutions, professional development, community collaboration, and making a difference. Students developed skills in six of the eight domains of the Quad Council's core competencies for public health nurses. Community-Based Collaborative Action Research facilitates collaborative partnerships and relationships throughout the research process. Students benefited by applying what they have learned from their education to a real community who lacks resources. © 2014 Wiley Periodicals, Inc.

Signs of the Land: Reaching Arctic Communities Facing Climate Change

NASA Astrophysics Data System (ADS)

Sparrow, E. B.; Chase, M. J.; Demientieff, S.; Pfirman, S. L.; Brunacini, J.

2014-12-01

In July 2014, a diverse and intergenerational group of Alaskan Natives came together on Howard Luke's Galee'ya Camp by the Tanana River in Fairbanks, Alaska to talk about climate change and it's impacts on local communities. Over a period of four days, the Signs of the Land Climate Change Camp wove together traditional knowledge, local observations, Native language, and climate science through a mix of storytelling, presentations, dialogue, and hands-on, community-building activities. This camp adapted the model developed several years ago under the Association for Interior Native Educators (AINE)'s Elder Academy. Part of the Polar Learning and Responding Climate Change Education Partnership, the Signs of the Land Climate Change Camp was developed and conducted collaboratively with multiple partners to test a model for engaging indigenous communities in the co-production of climate change knowledge, communication tools, and solutions-building. Native Alaskans have strong subsistence and cultural connections to the land and its resources, and, in addition to being keen observers of their environment, have a long history of adapting to changing conditions. Participants in the camp included Elders, classroom teachers, local resource managers and planners, community members, and climate scientists. Based on their experiences during the camp, participants designed individualized outreach plans for bringing culturally-responsive climate learning to their communities and classrooms throughout the upcoming year. Plans included small group discussions, student projects, teacher training, and conference presentations.

Exploring the Position of Community-Based Nursing in Iran: A Qualitative Study.

PubMed

Heydari, Heshmatolah; Rahnavard, Zahra; Ghaffari, Fatemeh

2017-10-01

Community-based nursing focuses on providing health services to families and communities in the second and third levels of prevention and this can improve the individuals, families and communities' quality of life, and reduce the healthcare costs. The aim of this study was to explore the status of community-based nursing in Iran. This qualitative study was conducted from March to November 2015, in Tehran, Iran, using the content analysis approach. The study setting consisted of Iran and Tehran Faculties of Nursing and Midwifery, Tehran, Iran. The purposive sampling method was used. Twenty faculty members and Master's and PhD students were interviewed by using the face-to-face semi-structured interview method. Moreover, two focus groups were conducted for complementing and enriching the study data. The data were analyzed using the Graneheim and Lundman's approach to content analysis. The trustworthiness of the study findings was maintained by employing the Lincoln and Guba's criteria of credibility, dependability, and confirmability. In total, 580 codes were generated and categorized into three main categories of conventional services, the necessity for creating infrastructures, and multidimensional outcomes of community-based nursing. Introducing community-based nursing into nursing education curricula and creating ample job opportunities for community-based nurses seem clearly essential.

Determinants of Utilization and Community Experiences with Community Health Volunteers for Treatment of Childhood Illnesses in Rural Sierra Leone.

PubMed

Yansaneh, Aisha I; George, Asha S; Sharkey, Alyssa; Brieger, William R; Moulton, Lawrence H; Yumkella, Fatu; Bangura, Peter; Kabano, Augustin; Diaz, Theresa

2016-04-01

In 2010, at the same time as the national roll out of the Free Health Care Initiative (FHCI), which removed user fees for facility based health care, trained community health volunteers (CHVs) were deployed to provide integrated community case management of diarrhea, malaria and pneumonia to children under 5 years of age (U5) in Kambia and Pujehun districts, Sierra Leone. After 2 years of implementation and in the context of FHCI, CHV utilization rate was 14.0 %. In this study, we examine the factors associated with this level of CHV utilization. A cross-sectional household-cluster survey of 1590 caregivers of 2279 children U5 was conducted in 2012; with CHV utilization assessed using a multiple logistic regression model. Focus groups and in-depth interviews were also conducted to understand communities' experiences with CHVs. Children with diarrhea (OR = 3.17, 95 % CI: 1.17-8.60), from female-headed households (OR = 4.55, 95 % CI: 1.88-11.00), and whose caregivers reported poor quality of care as a barrier to facility care-seeking (OR = 8.53, 95 % CI: 3.13-23.16) were more likely to receive treatment from a CHV. Despite low utilization, caregivers were highly familiar and appreciative of CHVs, but were concerned about the lack of financial remuneration for CHVs. CHVs remained an important source of care for children from female-headed households and whose caregivers reported poor quality of care at health facilities. CHVs are an important strategy for certain populations even when facility utilization is high or when facility services are compromised, as has happened with the recent Ebola epidemic in Sierra Leone.

Is social exclusion pushing the Pakistani Hijras (Transgenders) towards commercial sex work? a qualitative study

PubMed Central

2012-01-01

Background The Hijra is a distinct type of gender role in South Asia where men act like women. This group of people is socially excluded by the general community, in terms of attainment of an opportunity for a socially productive life. Often this sort of deprivation forces these individuals towards professions like sex trade, in pursuit of sustenance, which as a consequence places them as a key block in the puzzle of an impending generalized HIV epidemic in Pakistan. Methods This study is a qualitative study, which involved 8 in-depth interviews and four focus group discussions, conducted in Rawalpindi and Islamabad (Pakistan) from February to April 2012. The data was audio taped and transcribed. Key themes were identified and built upon. The respondents were contacted through a gate keeper Hijra who was a member of the hijra community. Multiple interview sessions were conducted with each respondent. Results Two key categories of the Hijras were identified as Khusrapan and Zananapan, during the in-depth interview sessions. This initial information paved way for the four focus group discussions. The data was presented using key themes which were identified. The study participants explained their life histories to us which made it obvious that they had been socially excluded at many stages of their lives from performing normal social functions. This lack of occupational and educational opportunities pushed them towards entering the risky business of selling sex. Conclusion The transgender community is socially excluded by the Pakistani society which is leading them to indulge in commercial sex and putting their lives at risk. Prudent measures are needed to form community based organizations managed and led by hijra community and addressing their social exclusion and risky behaviors. PMID:23163979

Evidence-Based Assessment of Conduct Problems in Children and Adolescents

ERIC Educational Resources Information Center

McMahon, Robert J.; Frick, Paul J.

2005-01-01

This article provides a summary of research in 4 areas that have direct and important implications for evidence-based assessment of children and adolescents with conduct problems (CP): (a) the heterogeneity in types and severity of CP, (b) common comorbid conditions, (c) multiple risk factors associated with CP, and (d) multiple developmental…

A qualitative exploration of care-seeking pathways for sick children in the rural Oromia region of Ethiopia.

PubMed

Shaw, Bryan; Amouzou, Agbessi; Miller, Nathan P; Bryce, Jennifer; Surkan, Pamela J

2017-03-09

Ethiopia has experienced rapid improvements in its healthcare infrastructure, such as through the recent scale up of integrated community case management (iCCM) delivered by community-based health extension workers (HEWs) targeting children under the age of five. Despite notable improvements in child outcomes, the use of HEWs delivering iCCM remains very low. The aim of our study was to explain this phenomenon by examining care-seeking practices and treatment for sick children in two rural districts in the Oromia Region of Ethiopia. Using qualitative methods, we explored perceptions of child illness, influences on decision-making processes occurring over the course of a child's illness and caregiver perceptions of available community-based sources of child illness care. Sixteen focus group discussions (FGDs) and 40 in-depth interviews (IDIs) were held with mothers of children under age five. For additional perspective, 16 IDIs were conducted fathers and 22 IDIs with health extension workers and community health volunteers. Caregivers often described the act of care-seeking for a sick child as a time of considerable uncertainty. In particular, mothers of sick children described the cultural, social and community-based resources available to minimize this uncertainty as well as constraints and strategies for accessing these resources in order to receive treatment for a sick child. The level of trust and familiarity were the most common dynamics noted as influencing care-seeking strategies; trust in biomedical and government providers was often low. Overall, our research highlights the multiple and dynamic influences on care-seeking for sick children in rural Ethiopia. An understanding of these influences is critical for the success of existing and future health interventions and continued improvement of child health in Ethiopia.

Community Social Capital, Built Environment, and Income-Based Inequality in Depressive Symptoms Among Older People in Japan: An Ecological Study From the JAGES Project

PubMed Central

Takagi, Daisuke; Kondo, Katsunori

2018-01-01

Background Although reducing socioeconomic inequalities in depression is necessary, their associated factors have rarely been studied. This study aimed to screen the potential contextual factors associated with income-based inequality in older adults’ depression. Methods Using data from the Japan Gerontological Evaluation Study (JAGES) of 2013, we conducted an ecological study covering 77 communities in Japan. Our measures of socioeconomic inequalities in depression were the slope index of inequalities (SII) and the relative index of inequalities (RII) of the prevalence of depressive symptoms across three income levels. We categorized available community-level factors, including socio-demographic factors, social participation, social relationships, subjective changes in the residential area, and the built environment. These indicators were aggregated from individual responses of 51,962 and 52,958 physically independent men and women, respectively, aged 65 years or more. We performed multiple linear regression analyses to explore factors with statistical significance of a two-tailed P-value less than 0.05. Results Factors associated with shallower gradients in depression for men included higher participation in local activities and reception or provision of social support, which did not show significant association among women. Perceived increases in unemployment and economic inequalities were positively associated with larger inequalities in both genders (P < 0.05). The built environment did not indicate any significant association. Conclusions A community environment fostering social activities and relationships might be associated with smaller income-based inequalities in depression. There is a need for more deterministic studies for planning of effective community interventions to address socioeconomic inequalities in depression. PMID:29093358

Community Engagement in Youth Violence Prevention: Crafting Methods to Context.

PubMed

Morrel-Samuels, Susan; Bacallao, Martica; Brown, Shelli; Bower, Meredith; Zimmerman, Marc

2016-04-01

The purpose of the Youth Violence Prevention Centers (YVPC) Program at the Centers for Disease Control and Prevention is to reduce youth violence in defined high-risk communities through the implementation and evaluation of comprehensive, evidence based prevention strategies. Within this common framework, each YVPC varies in its structure and methods, however all engage communities in multiple ways. We explore aspects of community engagement employed by three centers that operate in very different contexts: a rural county in North Carolina; a suburban area of Denver, Colorado; and an urban setting in Flint, Michigan. While previous research has addressed theories supporting community involvement in youth violence prevention, there has been less attention to the implementation challenges of achieving and sustaining participation. In three case examples, we describe the foci and methods for community engagement in diverse YVPC sites and detail the barriers and facilitating factors that have influenced implementation. Just as intervention programs may need to be adapted in order to meet the needs of specific populations, methods of community engagement must be tailored to the context in which they occur. We discuss case examples of community engagement in areas with varying geographies, histories, and racial and ethnic compositions. Each setting presents distinct challenges and opportunities for conducting collaborative violence prevention initiatives and for adapting engagement methods to diverse communities. Although approaches may vary depending upon local contexts, there are certain principles that appear to be common across cultures and geography: trust, transparency, communication, commitment. We also discuss the importance of flexibility in community engagement efforts.

Newspaper Content Analysis in Evaluation of a Community-Based Participatory Project to Increase Physical Activity

ERIC Educational Resources Information Center

Granner, Michelle L.; Sharpe, Patricia A.; Burroughs, Ericka L.; Fields, Regina; Hallenbeck, Joyce

2010-01-01

This study conducted a newspaper content analysis as part of an evaluation of a community-based participatory research project focused on increasing physical activity through policy and environmental changes, which included activities related to media advocacy and media-based community education. Daily papers (May 2003 to December 2005) from both…

The Project P.A.T.H.S. in Hong Kong: Work Done and Lessons Learned in a Decade.

PubMed

Shek, Daniel T L; Wu, Florence K Y

2016-02-01

The Project Positive Adolescent Training through Holistic Social Programs is a positive youth development program initiated and financially supported by The Hong Kong Jockey Club Charities Trust. Since 2005, the project has gone through several phases, including the initial phase (2005-2012), school-based extension phase (2009-2016), and community-based extension phase (2013-2017). In the initial phase, with the involvement of academics from 5 universities in Hong Kong, the research team developed youth enhancement programs for junior secondary school students (20 hours per grade), trained the program implementers (20 hours per grade), assisted in the implementation in more than 250 schools, and evaluated the program using multiple evaluation strategies, including a 5-year longitudinal experimental study. In the school-based extension phase, the project was implemented for another cycle (2009-2010 and 2011-2012 school years) and a 6-year longitudinal study was conducted to understand the psychosocial development of Chinese adolescents in Hong Kong. In the community-based extension phase, the programs were administered by social workers in the community settings. Generally speaking, different evaluation findings showed that the programs in Project Positive Adolescent Training through Holistic Social Programs promoted positive development and reduced risk behavior in Chinese adolescents in Hong Kong. Positive youth development attributes and family functioning also have positive contributions to adolescent developmental outcomes over time. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Interventions in the commercial sex industry during the rise in syphilis rates among men who have sex with men (MSM).

PubMed

Taylor, Melanie; Montoya, Jorge A; Cantrell, Russell; Mitchell, Samuel J; Williams, Mark; Jordahl, Lori; Freeman, Millicent; Brown, James; Broussard, Dawn; Roland, Eric

2005-10-01

Describe sexually transmitted disease/human immunodeficiency virus prevention interventions targeting men who have sex with men (MSM) in commercial sex venues (CSV). Compilation of descriptive and evaluation data from the CDC 8-city MSM Syphilis Response on interventions conducted in bathhouses/sex clubs, circuit parties, the Internet, male sex workers, and the adult film industry. Interventions in the commercial sex industry (CSI) often involved multiple collaborative efforts between public health departments (PHD), community-based organizations (CBO), and CSV owners and managers. Education and condoms were provided at multiple venues, including circuit parties, bathhouses, and sex clubs. CBO staff reported one-on-one street and CSV outreach to engage MSM at risk. Evaluation data demonstrate that MSM exposed to media campaigns were more aware of syphilis and more likely to have been tested for syphilis than MSM who did not see the campaigns. PHD and CBO are using multiple means of reaching MSM in the CSI. Evaluations are needed to determine which of these efforts decreases syphilis transmission.

Leveraging the U.S. Criminal Justice System to Access Women for HIV Interventions.

PubMed

Meyer, Jaimie P; Muthulingam, Dharushana; El-Bassel, Nabila; Altice, Frederick L

2017-12-01

The criminal justice (CJ) system can be leveraged to access women for HIV prevention and treatment programs. Research is lacking on effective implementation strategies tailored to the specific needs of CJ-involved women. We conducted a scoping review of published studies in English from the United States that described HIV interventions, involved women or girls, and used the CJ system as an access point for sampling or intervention delivery. We identified 350 studies and synthesized data from 42 unique interventions, based in closed (n = 26), community (n = 7), or multiple/other CJ settings (n = 9). A minority of reviewed programs incorporated women-specific content or conducted gender-stratified analyses. CJ systems are comprised of diverse access points, each with unique strengths and challenges for implementing HIV treatment and prevention programs for women. Further study is warranted to develop women-specific and trauma-informed content and evaluate program effectiveness.

The quality of feeding assistance care practices for long-term care veterans: implications for quality improvement efforts.

PubMed

Simmons, Sandra F; Sims, Nichole; Durkin, Daniel W; Shotwell, Matthew S; Erwin, Scott; Schnelle, John F

2013-09-01

The primary purpose of this study was to determine the quality of feeding assistance care and identify areas in need of improvement for a sample of long-term care veterans. A secondary purpose was to compare these findings with the results of previous studies in community facilities to determine ways in which the VA sample might differ. A repeated measures observational study was conducted in two VA facilities with 200 long-stay residents. Research staff conducted standardized observations during and between meals for 3 months. There was a trend for better feeding assistance care quality during meals in the VA sample, but there were still multiple aspects of care in need of improvement both during and between meals. Higher licensed nurse staffing levels in the VA should enable effective supervision and management, but observation-based measures of care quality are necessary for accurate information about daily feeding assistance care provision.

A Twitter-based survey on marijuana concentrate use.

PubMed

Daniulaityte, Raminta; Zatreh, Mussa Y; Lamy, Francois R; Nahhas, Ramzi W; Martins, Silvia S; Sheth, Amit; Carlson, Robert G

2018-06-01

The purpose of this paper is to analyze characteristics of marijuana concentrate users, describe patterns and reasons of use, and identify factors associated with daily use of concentrates among U.S.-based cannabis users recruited via a Twitter-based online survey. An anonymous Web-based survey was conducted in June 2017 with 687 U.S.-based cannabis users recruited via Twitter-based ads. The survey included questions about state of residence, socio-demographic characteristics, and cannabis use including marijuana concentrates. Multiple logistic regression analyses were conducted to identify characteristics associated with lifetime and daily use of marijuana concentrates. Almost 60% of respondents were male, 86% were white, and the mean age was 43.0 years. About 48% reported marijuana concentrate use. After adjusting for multiple testing, significant predictors of concentrate use included: living in "recreational" (AOR = 2.04; adj. p = .042) or "medical, less restrictive" (AOR = 1.74; adj. p = .030) states, being younger (AOR = 0.97, adj. p = .008), and daily herbal cannabis use (AOR = 2.57, adj. p = .008). Out of 329 marijuana concentrate users, about 13% (n = 44) reported daily/near daily use. Significant predictors of daily concentrate use included: living in recreational states (AOR = 3.59, adj. p = .020) and using concentrates for therapeutic purposes (AOR = 4.34, adj. p = .020). Living in states with more liberal marijuana policies is associated with greater likelihood of marijuana concentrate use and with more frequent use. Characteristics of daily users, in particular, patterns of therapeutic use warrant further research with community-recruited samples. Copyright © 2018 Elsevier B.V. All rights reserved.

An assessment of implementation of Community-Oriented Primary Care in Kenyan family medicine postgraduate medical education programmes

PubMed Central

Shabani, Jacob; Taché, Stephanie; Mohamoud, Gulnaz; Mahoney, Megan

2016-01-01

Background and objectives Family medicine postgraduate programmes in Kenya are examining the benefits of Community-Oriented Primary Care (COPC) curriculum, as a method to train residents in population-based approaches to health care delivery. Whilst COPC is an established part of family medicine training in the United States, little is known about its application in Kenya. We sought to conduct a qualitative study to explore the development and implementation of COPC curriculum in the first two family medicine postgraduate programmes in Kenya. Method Semi-structured interviews of COPC educators, practitioners, and academic stakeholders and focus groups of postgraduate students were conducted with COPC educators, practitioners and academic stakeholders in two family medicine postgraduate programmes in Kenya. Discussions were transcribed, inductively coded and thematically analysed. Results Two focus groups with eight family medicine postgraduate students and interviews with five faculty members at two universities were conducted. Two broad themes emerged from the analysis: expected learning outcomes and important community-based enablers. Three learning outcomes were (1) making a community diagnosis, (2) understanding social determinants of health and (3) training in participatory research. Three community-based enablers for sustainability of COPC were (1) partnerships with community health workers, (2) community empowerment and engagement and (3) institutional financial support. Conclusions Our findings illustrate the expected learning outcomes and important community-based enablers associated with the successful implementation of COPC projects in Kenya and will help to inform future curriculum development in Kenya. PMID:28155322

Telephone-Administered Cognitive Behavioral Therapy for Veterans Served by Community-Based Outpatient Clinics

ERIC Educational Resources Information Center

Mohr, David C.; Carmody, Timothy; Erickson, Lauren; Jin, Ling; Leader, Julie

2011-01-01

Objective: Multiple trials have found telephone-administered cognitive behavioral therapy (T-CBT) to be effective for the treatment of depression. The aim of this study was to evaluate T-CBT for the treatment of depression among veterans served by community-based outpatient clinics (CBOCs) outside of major urban areas. Method: Eighty-five veterans…

The Social Value of Community-Based Adult Education in Limerick City

ERIC Educational Resources Information Center

Neville, Patricia; O'Dwyer, Maria; Power, Martin J.

2014-01-01

This article documents the findings of a qualitative study into the social value of community-based adult education in Limerick City. The article demonstrates that participants experience significant improvements in numerous facets of their lives and we argue that it is crucial that we recognise the multiple and inter-connected social impacts that…

Practical strategies and perceptions from community pharmacists following their experiences with conducting pharmacy practice research: a qualitative content analysis.

PubMed

De Vera, Mary A; Campbell, Natasha K J; Chhina, Harpreet; Galo, Jessica S; Marra, Carlo

2017-10-26

While prior research identified barriers to conducting research in community pharmacies, there remains a need to better understand facilitators to ensure successful collaborations between academic researchers and pharmacists. Our objective was to determine the experiences and perspectives of community pharmacists who have recently conducted a pharmacy practice-based research study to gain in-depth understanding of challenges as well as facilitators and identify strategies and solutions. We conducted a qualitative study involving one-on-one semi-structured telephone interviews with community pharmacists following the completion of a practice-based research study in their pharmacies. Interview transcripts were analysed using inductive content analysis involving open coding, creating categories and abstraction into final themes. Eleven pharmacists participated in the qualitative interviews. We identified six major themes including: (1) barriers (e.g. time constraints); (2) facilitators (e.g. ideal pharmacy layout); (3) support and resources from academic researchers (e.g. helpfulness of training, easy-to-use study materials); (4) pharmacist-initiated strategies for conducting research (beyond prior suggestions from researchers); (5) suggestions for future pharmacy practice research; and (6) motivation for conducting pharmacy practice research. These findings informed practical strategies targeted at academic researchers and pharmacists, respectively, to facilitate the conduct of research in community pharmacists across various stages of the research process. Our study adds to better understanding of community pharmacists' perspectives on conducting research and identifies practical solutions that can be readily implemented by academic researchers and pharmacists participating in research. © 2017 Royal Pharmaceutical Society.

Agency responses to a system-driven implementation of multiple evidence-based practices in children's mental health services.

PubMed

Regan, Jennifer; Lau, Anna S; Barnett, Miya; Stadnick, Nicole; Hamilton, Alison; Pesanti, Keri; Bando, Lillian; Brookman-Frazee, Lauren

2017-09-19

Large mental health systems are increasingly using fiscal policies to encourage the implementation of multiple evidence-based practices (EBPs). Although many implementation strategies have been identified, little is known about the types and impacts of strategies that are used by organizations within implementation as usual. This study examined organizational-level responses to a fiscally-driven, rapid, and large scale EBP implementation in children's mental health within the Los Angeles County Department of Mental Health. Qualitative methods using the principles of grounded theory were used to characterize the responses of 83 community-based agencies to the implementation effort using documentation from site visits conducted 2 years post reform. Findings indicated that agencies perceived the rapid system-driven implementation to have both positive and negative organizational impacts. Identified challenges were primarily related to system implementation requirements rather than to characteristics of specific EBPs. Agencies employed a variety of implementation strategies in response to the system-driven implementation, with agency size associated with implementation strategies used. Moderate- and large-sized agencies were more likely than small agencies to have employed systematic strategies at multiple levels (i.e., organization, therapist, client) to support implementation. These findings are among the first to characterize organizational variability in response to system-driven implementation and suggest ways that implementation interventions might be tailored by organizational characteristics.

Beyond Adapting to Climate Change: Embedding Adaptation in Responses to Multiple Threats and Stresses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilbanks, Thomas J; Kates, Dr. Robert W.

2010-01-01

Climate change impacts are already being experienced in every region of the United States and every part of the world most severely in Arctic regions and adaptation is needed now. Although climate change adaptation research is still in its infancy, significant adaptation planning in the United States has already begun in a number of localities. This article seeks to broaden the adaptation effort by integrating it with broader frameworks of hazards research, sustainability science, and community and regional resilience. To extend the range of experience, we draw from ongoing case studies in the Southeastern United States and the environmental historymore » of New Orleans to consider the multiple threats and stresses that all communities and regions experience. Embedding climate adaptation in responses to multiple threats and stresses helps us to understand climate change impacts, themselves often products of multiple stresses, to achieve community acceptance of needed adaptations as co-benefits of addressing multiple threats, and to mainstream the process of climate adaptation through the larger envelope of social relationships, communication channels, and broad-based awareness of needs for risk management that accompany community resilience.« less

Integrating community health workers within Patient Protection and Affordable Care Act implementation.

PubMed

Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C; Trinh-Shevrin, Chau

2015-01-01

The Patient Protection and Affordable Care Act's (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers' role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers' unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models.

Integrating Community Health Workers Within Patient Protection and Affordable Care Act Implementation

PubMed Central

Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C.; Trinh-Shevrin, Chau

2015-01-01

Context The Patient Protection and Affordable Care Act’s (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. Objective This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Results Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers’ role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers’ unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Conclusion Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models. PMID:25414955

Go-along interviewing with LGBTQ youth in Canada and the United States.

PubMed

Porta, Carolyn M; Corliss, Heather L; Wolowic, Jennifer M; Johnson, Abigail Z; Fogel, Katie Fritz; Gower, Amy L; Saewyc, Elizabeth M; Eisenberg, Marla E

2017-01-01

Go-along interviews, which are interviews conducted whilst being in and moving within participant selected spaces, were conducted with 66 LGBTQ adolescents (14-19 years old) in their self-identified communities to explore perceived community attributes, including safe spaces, resources, and supports; this paper highlights methodological lessons learned. Successful recruitment in two countries and varied community settings required partnership with local LGBTQ supporting agencies, including school-based Gay Straight Alliances. Youth chose to walk, use public transportation, and drive to community locations, identifying numerous formal and informal resources in their communities. Participant reflections highlighted that go-along interviews can be conducted in safe ways that encourage LGBTQ youth to express themselves about communities in which they live, study, work, play, and relax.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme.

PubMed

Shah, Arya; Wheeler, Lydia; Sessions, Kristen; Kuule, Yusufu; Agaba, Edwin; Merry, Stephen P

2017-10-11

To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Qualitative thematic analysis revealed two major themes: (1) belief that any given patient's metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme

PubMed Central

2017-01-01

Objectives To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. Background A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Methods Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Results Qualitative thematic analysis revealed two major themes: (1) belief that any given patient’s metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. Conclusion As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness. PMID:29041798

Studs and protest-hypermasculinity: the tomboyism within black lesbian female masculinity.

PubMed

Lane-Steele, Laura

2011-01-01

In this article, I use the ethnographic work I conducted in the summer of 2009 with Black lesbian women from South Carolina to show how Black female masculinity has been influenced by historically based constructions of Black gender. I will argue that these studs strategically construct and perform their masculinity in ways that shield them from sexism, racism, and homophobia both in and out of their Black community. By adopting the particular type of masculinity common among their Black male peers, these studs can gain access to some levels of male privilege and power which, in turn, can act as useful defense mechanisms against multiple types of discrimination and oppression.

Community based participatory research of breastfeeding disparities in African American women.

PubMed

Kulka, Tamar Ringel; Jensen, Elizabeth; McLaurin, Sue; Woods, Elizabeth; Kotch, Jonathan; Labbok, Miriam; Bowling, Mike; Dardess, Pamela; Baker, Sharon

2011-08-01

OBJECTIVE: Lack of support for breastfeeding mothers has been consistently identified in the literature as a barrier for breastfeeding across racial and ethnic groups. Using a community-based participatory approach, academic and community-based partners conducted an iterative process to assess barriers, facilitators and potential mediating interventions for breastfeeding in the African-American community in Durham, North Carolina. METHODS: Eight focus groups were conducted with African-American mothers, fathers and grandmothers. Researchers transcribed and coded each focus group and analyzed using Atlas ti. 5.2. Patterns and themes that emerged informed the development of community stakeholder interviews; 41 interviews were conducted with community representatives. These findings informed the development of a support group pilot intervention. The pilot support groups were evaluated for increase in knowledge of attendees. RESULTS: Focus group and community interviews indicate that African Americans may disproportionately experience inadequate support for breastfeeding. This lack of support was reported in the home, the workplace, among peers, and from healthcare providers. The pilot support groups resulted in increased knowledge of breastfeeding among group participants OR=3.6 (95% CI: 2.5, 5.2). CONCLUSIONS: The findings from this research underscore the importance of a multi-level approach to breastfeeding support for African American women to address breastfeeding disparities.

The Impact of Community Violence on School-Based Research

ERIC Educational Resources Information Center

Velsor-Friedrich, Barbara; Richards, Maryse; Militello, Lisa K.; Dean, Kyle C.; Scott, Darrick; Gross, Israel M.; Romeo, Edna

2015-01-01

Research conducted on youth exposure to violence has generally focused on documenting the prevalence of community violence and its emotional and behavioral implications. However, there is a dearth of information related to the impact of violence on the implementation and evaluation of community and school-based programs. This commentary examines…

Hope and despair: community health assistants' experiences of working in a rural district in Zambia.

PubMed

Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

2014-05-25

In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. A phenomenological approach was used to examine CHAs' experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs' ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs' ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA's self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs' ability to deliver services. Programmes aimed at integrating community-based health workers into health systems should adequately consider multiple incentives, effective management, supervision and support from the district. These should be tailored towards enhancing the individual, health system and community characteristics that positively impact work motivation at the local level if such programmes are to effectively contribute towards improved primary healthcare.

Hope and despair: community health assistants’ experiences of working in a rural district in Zambia

PubMed Central

2014-01-01

Background In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. Methods A phenomenological approach was used to examine CHAs’ experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Results Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs’ ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs’ ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA’s self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs’ ability to deliver services. Conclusions Programmes aimed at integrating community-based health workers into health systems should adequately consider multiple incentives, effective management, supervision and support from the district. These should be tailored towards enhancing the individual, health system and community characteristics that positively impact work motivation at the local level if such programmes are to effectively contribute towards improved primary healthcare. PMID:24886146

Collaborations for Leadership in Applied Health Research and Care: lessons from the theory of communities of practice

PubMed Central

2011-01-01

Background The paper combines the analytical and instrumental perspectives on communities of practice (CoPs) to reflect on potential challenges that may arise in the process of interprofessional and inter-organisational joint working within the Collaborations for Leaderships in Applied Health Research and Care (CLAHRCs)--partnerships between the universities and National Health Service (NHS) Trusts aimed at conducting applied health research and translating its findings into day-to-day clinical practice. Discussion The paper discusses seminal theoretical literature on CoPs as well as previous empirical research on the role of these communities in healthcare collaboration, which is organised around the following three themes: knowledge sharing within and across CoPs, CoP formation and manageability, and identity building in CoPs. It argues that the multiprofessional and multi-agency nature of the CLAHRCs operating in the traditionally demarcated organisational landscape of the NHS may present formidable obstacles to knowledge sharing between various professional groupings, formation of a shared 'collaborative' identity, and the development of new communities within the CLAHRCs. To cross multiple boundaries between various professional and organisational communities and hence enable the flow of knowledge, the CLAHRCs will have to create an effective system of 'bridges' involving knowledge brokers, boundary objects, and cross-disciplinary interactions as well as address a number of issues related to professional and organisational identification. Summary The CoP approach can complement traditional 'stage-of-change' theories used in the field of implementation research and provide a basis for designing theory-informed interventions and evaluations. It can help to illuminate multiple boundaries that exist between professional and organisational groups within the CLAHRCs and suggest ways of crossing those boundaries to enable knowledge transfer and organisational learning. Achieving the aims of the CLAHRCs and producing a sustainable change in the ways applied health research is conducted and implemented may be influenced by how effectively these organisations can navigate through the multiple CoPs involved and promote the development of new multiprofessional and multi-organisational communities united by shared practice and a shared sense of belonging--an assumption that needs to be explored by further empirical research. PMID:21699712

Collaborations for leadership in applied health research and care: lessons from the theory of communities of practice.

PubMed

Kislov, Roman; Harvey, Gill; Walshe, Kieran

2011-06-23

The paper combines the analytical and instrumental perspectives on communities of practice (CoPs) to reflect on potential challenges that may arise in the process of interprofessional and inter-organisational joint working within the Collaborations for Leaderships in Applied Health Research and Care (CLAHRCs)--partnerships between the universities and National Health Service (NHS) Trusts aimed at conducting applied health research and translating its findings into day-to-day clinical practice. The paper discusses seminal theoretical literature on CoPs as well as previous empirical research on the role of these communities in healthcare collaboration, which is organised around the following three themes: knowledge sharing within and across CoPs, CoP formation and manageability, and identity building in CoPs. It argues that the multiprofessional and multi-agency nature of the CLAHRCs operating in the traditionally demarcated organisational landscape of the NHS may present formidable obstacles to knowledge sharing between various professional groupings, formation of a shared 'collaborative' identity, and the development of new communities within the CLAHRCs. To cross multiple boundaries between various professional and organisational communities and hence enable the flow of knowledge, the CLAHRCs will have to create an effective system of 'bridges' involving knowledge brokers, boundary objects, and cross-disciplinary interactions as well as address a number of issues related to professional and organisational identification. The CoP approach can complement traditional 'stage-of-change' theories used in the field of implementation research and provide a basis for designing theory-informed interventions and evaluations. It can help to illuminate multiple boundaries that exist between professional and organisational groups within the CLAHRCs and suggest ways of crossing those boundaries to enable knowledge transfer and organisational learning. Achieving the aims of the CLAHRCs and producing a sustainable change in the ways applied health research is conducted and implemented may be influenced by how effectively these organisations can navigate through the multiple CoPs involved and promote the development of new multiprofessional and multi-organisational communities united by shared practice and a shared sense of belonging--an assumption that needs to be explored by further empirical research.

Multiple perspective vulnerability analysis of the power network

NASA Astrophysics Data System (ADS)

Wang, Shuliang; Zhang, Jianhua; Duan, Na

2018-02-01

To understand the vulnerability of the power network from multiple perspectives, multi-angle and multi-dimensional vulnerability analysis as well as community based vulnerability analysis are proposed in this paper. Taking into account of central China power grid as an example, correlation analysis of different vulnerability models is discussed. Then, vulnerabilities produced by different vulnerability metrics under the given vulnerability models and failure scenarios are analyzed. At last, applying the community detecting approach, critical areas of central China power grid are identified, Vulnerable and robust communities on both topological and functional perspective are acquired and analyzed. The approach introduced in this paper can be used to help decision makers develop optimal protection strategies. It will be also useful to give a multiple vulnerability analysis of the other infrastructure systems.

Employment of Near Full-Length Ribosome Gene TA-Cloning and Primer-Blast to Detect Multiple Species in a Natural Complex Microbial Community Using Species-Specific Primers Designed with Their Genome Sequences.

PubMed

Zhang, Huimin; He, Hongkui; Yu, Xiujuan; Xu, Zhaohui; Zhang, Zhizhou

2016-11-01

It remains an unsolved problem to quantify a natural microbial community by rapidly and conveniently measuring multiple species with functional significance. Most widely used high throughput next-generation sequencing methods can only generate information mainly for genus-level taxonomic identification and quantification, and detection of multiple species in a complex microbial community is still heavily dependent on approaches based on near full-length ribosome RNA gene or genome sequence information. In this study, we used near full-length rRNA gene library sequencing plus Primer-Blast to design species-specific primers based on whole microbial genome sequences. The primers were intended to be specific at the species level within relevant microbial communities, i.e., a defined genomics background. The primers were tested with samples collected from the Daqu (also called fermentation starters) and pit mud of a traditional Chinese liquor production plant. Sixteen pairs of primers were found to be suitable for identification of individual species. Among them, seven pairs were chosen to measure the abundance of microbial species through quantitative PCR. The combination of near full-length ribosome RNA gene library sequencing and Primer-Blast may represent a broadly useful protocol to quantify multiple species in complex microbial population samples with species-specific primers.

Conduct of a Survey to Determine Why Blacks Do Not Have Sufficient Enrollment in Vocational-Technical Programs in Community Colleges, Area Vocational-Technical Centers and Secondary Schools, and Development of Strategies for Increasing the Number of Students Enrolling in Vocational-Technical Programs.

ERIC Educational Resources Information Center

West Virginia Research Coordinating Unit for Vocational Education, Huntington.

A project involving literature and demographic data reviews, survey development, survey administration, data analysis, and document preparation was conducted in West Virginia to determine why blacks do not have sufficient enrollments in vocational technical centers and secondary schools. Three separate multiple-choice questionnaires were developed…

Understanding Perspectives of African American Medicaid-Insured Women on the Process of Perinatal Care: An Opportunity for Systems Improvement.

PubMed

Roman, Lee Anne; Raffo, Jennifer E; Dertz, Katherine; Agee, Bonita; Evans, Denise; Penninga, Katherine; Pierce, Tiffany; Cunningham, Belinda; VanderMeulen, Peggy

2017-12-01

Objectives To address disparities in adverse birth outcomes, communities are challenged to improve the quality of health services and foster systems integration. The purpose of this study was to explore the perspectives of Medicaid-insured women about their experiences of perinatal care (PNC) across a continuum of clinical and community-based services. Methods Three focus groups (N = 21) were conducted and thematic analysis methods were used to identify basic and global themes about experiences of care. Women were recruited through a  local Federal Healthy Start (HS) program in Michigan  that targets services to African American women. Results Four basic themes were identified: (1) Pursuit of PNC; (2) Experiences of traditional PNC; (3) Enhanced prenatal and postnatal care; and (4) Women's health: A missed opportunity. Two global themes were also identified: (1) Communication with providers, and (2) Perceived socio-economic and racial bias. Many women experienced difficulties engaging in early care, getting more help, and understanding and communicating with their providers, with some reporting socio-economic and racial bias in care. Delays in PNC limited early access to HS and enhanced prenatal care (EPC) programs with little evidence of supportive transitions to primary care. Notably, women's narratives revealed few connections among clinical and community-based services. Conclusions The process of participating in PNC and community-based programs is challenging for women, especially for those with multiple health problems and living in difficult life circumstances. PNC, HS and other EPC programs could partner to streamline processes, improve the content and process of care, and enhance engagement in services.

The business case for provider participation in clinical trials research: an application to the National Cancer Institute's community clinical oncology program.

PubMed

Song, Paula H; Reiter, Kristin L; Weiner, Bryan J; Minasian, Lori; McAlearney, Ann Scheck

2013-01-01

Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions. The aim of this study was to explore whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case. We use a multiple case study methodology approach to examine the National Cancer Institute's community clinical oncology program, a long-standing federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semistructured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data. We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue. As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally funded PBRNs outside of oncology or to providers considering participation in any clinical trials research.

Strategies for Translating Evidence-Based Medicine in Lung Cancer into Community Practice.

PubMed

Rosenberg, Stephen A; Baschnagel, Andrew M; Bagley, Stephen J; Housri, Nadine

2017-01-01

The landscape of non-small cell lung cancer (NSCLC) treatment has rapidly evolved over the past decade. This is exemplified by the use of molecular targeted agents, immunotherapies, and newer technologies such as stereotactic body radiotherapy (SBRT). As the translation of preclinical discoveries into clinical practice continues, the effective dissemination and implementation of evidence-based treatment of NSCLC will remain a foremost challenge for oncologists. To further extend evidence-based medicine into the community setting, community oncologists are being engaged on multiple fronts including leadership and participation in national clinical trials and utilization of internet-based resources.

Diversity and Community Can Coexist.

PubMed

Stivala, Alex; Robins, Garry; Kashima, Yoshihisa; Kirley, Michael

2016-03-01

We examine the (in)compatibility of diversity and sense of community by means of agent-based models based on the well-known Schelling model of residential segregation and Axelrod model of cultural dissemination. We find that diversity and highly clustered social networks, on the assumptions of social tie formation based on spatial proximity and homophily, are incompatible when agent features are immutable, and this holds even for multiple independent features. We include both mutable and immutable features into a model that integrates Schelling and Axelrod models, and we find that even for multiple independent features, diversity and highly clustered social networks can be incompatible on the assumptions of social tie formation based on spatial proximity and homophily. However, this incompatibility breaks down when cultural diversity can be sufficiently large, at which point diversity and clustering need not be negatively correlated. This implies that segregation based on immutable characteristics such as race can possibly be overcome by sufficient similarity on mutable characteristics based on culture, which are subject to a process of social influence, provided a sufficiently large "scope of cultural possibilities" exists. © Society for Community Research and Action 2016.

Multiple-level stakeholder engagement in malaria clinical trials: addressing the challenges of conducting clinical research in resource-limited settings.

PubMed

Mtove, George; Kimani, Joshua; Kisinza, William; Makenga, Geofrey; Mangesho, Peter; Duparc, Stephan; Nakalembe, Miriam; Phiri, Kamija S; Orrico, Russell; Rojo, Ricardo; Vandenbroucke, Pol

2018-03-22

Multinational clinical trials are logistically complex and require close coordination between various stakeholders. They must comply with global clinical standards and are accountable to multiple regulatory and ethical bodies. In resource-limited settings, it is challenging to understand how to apply global clinical standards to international, national, and local factors in clinical trials, making multiple-level stakeholder engagement an important element in the successful conduct of these clinical trials. During the planning and implementation of a large multinational clinical trial for intermittent preventive treatment of malaria in pregnancy in resource-limited areas of sub-Saharan Africa, we encountered numerous challenges, which required implementation of a range of engagement measures to ensure compliance with global clinical and regulatory standards. These challenges included coordination with ongoing global malaria efforts, heterogeneity in national regulatory structures, sub-optimal healthcare infrastructure, local practices and beliefs, and perspectives that view healthcare providers with undue trust or suspicion. In addition to engagement with international bodies, such as the World Health Organization, the Malaria in Pregnancy Consortium, the Steve Biko Centre for Bioethics, and the London School of Hygiene and Tropical Medicine, in order to address the challenges just described, Pfizer Inc. and Medicines for Malaria Venture (the "Sponsoring Entities" for these studies) and investigators liaised with national- and district-level stakeholders such as health ministers and regional/local community health workers. Community engagement measures undertaken by investigators included local meetings with community leaders to explain the research aims and answer questions and concerns voiced by the community. The investigators also engaged with family members of prospective trial participants in order to be sensitive to local practices and beliefs. Engagement with key stakeholders at international and national levels enabled the Sponsoring Entities to address challenges by aligning the study design with the requirements of health and regulatory agencies and to understand and address healthcare infrastructure needs prior to trial initiation. Local stakeholder engagement, including community members, study participants, and family enabled the investigators to address challenges by ensuring that study design and conduct were adapted to local considerations and ensuring accurate information about the study aims was shared with the public. ClinicalTrials.gov, ID: NCT01103063 . Registered on 7 April 2010.

The relationship between tobacco access and use among adolescents: a four community study.

PubMed

Altman, D G; Wheelis, A Y; McFarlane, M; Lee, H; Fortmann, S P

1999-03-01

The objective of this study was to examine the effectiveness of a longitudinal community intervention on the reduction of tobacco sales to minors and subsequent effects on tobacco consumption by youths. The study was conducted in Monterey County, CA. Four rural communities were randomized into treatment and comparison arms of the study and middle and high school students in each of these communities completed surveys assessing knowledge, attitude, and behavior. The main outcome measures were retail tobacco sales to minors as measured through store visits (tobacco purchase surveys) and self-reported consumption of tobacco. Over a three-year period, a diverse array of community interventions were implemented in the intervention communities. These included community education, merchant education, and voluntary policy change. In the treatment communities, the proportion of stores selling tobacco to minors dropped from 75% at baseline to 0% at the final post-test. In the comparison communities, the proportions were 64% and 39%, respectively. Although the availability of tobacco through commercial outlets was reduced substantially in intervention communities, youths reported still being able to obtain tobacco from other sources. Predicted treatment effects on reported use of tobacco among youths were observed cross-sectionally and longitudinally for younger students (7th graders). The intervention did not impact tobacco use among older students (9th and 11th graders) although the trends were in the predicted direction for 9th graders. A significant intervention effect was found for sex--females in the intervention communities were less likely to use tobacco post-intervention than females in the comparison communities. Tobacco sales to minors can be reduced through a broad-based intervention. To prevent or reduce tobacco use by youths, however, multiple supply-and demand-focused strategies are needed.

[Relative factors in home safety evaluated by multilevel statistical models].

PubMed

Wang, Shu-mei; Zou, Jin-liang; Xu, Wen-yan; Yin, Ming-min

2010-09-01

To understand the situations of home establishments and the related domestic behaviors that causing injuries. A total of 9760 families with regular residents in a community in Shanghai were investigated. Questionnaire was designed based on the Guidelines for Conducting Community Surveys on Injuries and Violence and International Classification of External Causes of Injuries. Inside the home settings, relative factors were found on issues as fire protection and using of electricity. In terms of household settings, 14.85% of the families had smoke alarm systems in the kitchen; 40.75% had no windows set for emergence. 50% to 70% of the residents had the idea of safe behaviors, including 35.93% of the families stored cleaning products, other chemicals or medical substances in alternative containers, such as used drinking bottle. Only 1.81% of the people being investigated thought that home was also a high risk place where injury might occur and it was placed number 9 in a multiple choice questionnaire. Data from the multiple level model analysis showed that factors as number of family members, space, education, profession etc. were closely related to the situation of home settings and their resident's behaviors. Many injury related factors were found related to home establishments and people's daily behaviors at home which called for interventions to be taken.

Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study

PubMed Central

2012-01-01

Background The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results The team identified ten themes related to CDS and KM. These include: 1) workflow; 2) knowledge management; 3) data as a foundation for CDS; 4) user computer interaction; 5) measurement and metrics; 6) governance; 7) translation for collaboration; 8) the meaning of CDS; 9) roles of special, essential people; and 10) communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors. PMID:22333210

Professional Learning Communities' Impact on Science Teacher Classroom Practice in a Midwestern Urban School District

ERIC Educational Resources Information Center

Carpenter, Dan

2012-01-01

The purpose of this reputation-based, multiple-site case study was to explore professional learning communities' impact on teacher classroom practice. The goal of this research was to describe the administrator and teachers' perceptions with respect to professional learning communities as it related to teacher practice in their school. Educators…

Waveforms and Sonic Boom Perception and Response (WSPR): Low-Boom Community Response Program Pilot Test Design, Execution, and Analysis

NASA Technical Reports Server (NTRS)

Page, Juliet A.; Hodgdon, Kathleen K.; Krecker, Peg; Cowart, Robbie; Hobbs, Chris; Wilmer, Clif; Koening, Carrie; Holmes, Theresa; Gaugler, Trent; Shumway, Durland L.;

Lessons from White Lake - Connecting Students to their Community through Environmental Stewardship

NASA Astrophysics Data System (ADS)

Tate, Susan

2014-05-01

White Lake and its surrounding community have been negatively affected by shoreline degradation and wildlife habitat loss caused primarily by historical logging practices, and reduced water quality from industrial pollution and storm water runoff. This led to the lake being identified as a Great Lakes Area of Concern by the United States Environmental Protection Agency three decades ago. Local community partners have worked diligently in recent years to reverse habitat loss, and repair damaged ecosystems. The "H2O White Lake" (Healthy Habitats On White Lake) project has involved over seven hundred middle school students in grades six through eight over the course of the last five years. Students begin by researching the environmental history of the watershed and then they monitor six tributaries of the lake for nutrient pollution and habitat degradation. Students use the field experience as a community inventory to identify stewardship needs, for which they then identify solutions that take into account land usage and community behaviors. Class projects have focused on stream bank restoration, storm water management, eradication of invasive species, shoreline clean-up, and community outreach and education. This year, the project culminated in the first ever White Lake Environmental Film Festival, for which students had the opportunity to create their own short documentary. This multiple year place based education project allows students to apply their classroom studies of surface water and groundwater dynamics to an authentic, real-world situation, conduct themselves as scientists, and feel valuable through connections with community partners.

Community-Based Inquiry in Allied Health Biochemistry Promotes Equity by Improving Critical Thinking for Women and Showing Promise for Increasing Content Gains for Ethnic Minority Students

ERIC Educational Resources Information Center

Goeden, Terrah J.; Kurtz, Martha J.; Quitadamo, Ian J.; Thomas, Carin

2015-01-01

In the Community-Based Inquiry (CBI) instructional method, cooperative student groups complete case study activities based on scientific literature and conduct their own laboratory investigations that address authentic community needs. This study compared critical thinking and content knowledge outcomes between traditional Introduction to…

Consulting, Mediating, Conducting, and Supporting: How Community-Based Organizations Engage with Research to Influence Policy

ERIC Educational Resources Information Center

Winton, Sue; Evans, Michael P.

2016-01-01

Grounded in critical policy theories and democratic conceptions of research, case studies of three community-based organizations, one in Canada and two in the U.S., were analyzed to determine if and how the groups engaged with research in their efforts to influence education policy. The findings demonstrate that the community-based organizations…

Conducting an inventory of informal community-based resources for children with physical disabilities: enhancing access and creating professional linkages.

PubMed

Rosenberg, A E

2000-01-01

This article describes the process involved in conducting a sample inventory of community-based sports, recreation/leisure, and arts resources that include children with physical disabilities in Monroe County, New York. The inventory instrument, Community Resource Inventory for Children with Physical Disabilities, was designed to examine organizational or group capacity to provide activities for children with physical disabilities. The inventory was administered by phone to organizations and groups identified as meeting the definition of a community-based resource. One hundred and six CBR informants were interviewed, each reporting one or two recreational activities provided at their site. The activities included arts, sports, or leisure offerings, with a total of 127 activities identified in the sample. The results of the study support the premise that community-based resources are receptive to providing activities for children with physical disabilities and to potential collaboration with therapists. Numerous barriers exixts, however, including environmental inaccessibility, lack of personnel training, and including environmental inaccesssbility, lack of personnel training, and costs of participation. The results suggest several educational and system-based changes that may promote future collaborative efforts between therapists and community-based organizations.

Community perceptions on malaria and care-seeking practices in endemic Indian settings: policy implications for the malaria control programme.

PubMed

Das, Ashis; Das Gupta, R K; Friedman, Jed; Pradhan, Madan M; Mohapatra, Charu C; Sandhibigraha, Debakanta

2013-01-29

The focus of India's National Malaria Programme witnessed a paradigm shift recently from health facility to community-based approaches. The current thrust is on diagnosing and treating malaria by community health workers and prevention through free provision of long-lasting insecticidal nets. However, appropriate community awareness and practice are inevitable for the effectiveness of such efforts. In this context, the study assessed community perceptions and practice on malaria and similar febrile illnesses. This evidence base is intended to direct the roll-out of the new strategies and improve community acceptance and utilization of services. A qualitative study involving 26 focus group discussions and 40 key informant interviews was conducted in two districts of Odisha State in India. The key points of discussion were centred on community perceptions and practice regarding malaria prevention and treatment. Thematic analysis of data was performed. The 272 respondents consisted of 50% females, three-quarter scheduled tribe community and 30% students. A half of them were literates. Malaria was reported to be the most common disease in their settings with multiple modes of transmission by the FGD participants. Adoption of prevention methods was seasonal with perceived mosquito density. The reported use of bed nets was low and the utilization was determined by seasonality, affordability, intoxication and alternate uses of nets. Although respondents were aware of malaria-related symptoms, care-seeking from traditional healers and unqualified providers was prevalent. The respondents expressed lack of trust in the community health workers due to frequent drug stock-outs. The major determinants of health care seeking were socio-cultural beliefs, age, gender, faith in the service provider, proximity, poverty, and perceived effectiveness of available services. Apart from the socio-cultural and behavioural factors, the availability of acceptable care can modulate the community perceptions and practices on malaria management. The current community awareness on symptoms of malaria and prevention is fair, yet the prevention and treatment practices are not optimal. Promoting active community involvement and ownership in malaria control and management through strengthening community based organizations would be relevant. Further, timely availability of drugs and commodities at the community level can improve their confidence in the public health system.

Digital Booktalk: Creating a Community of Avid Readers, One Video at a Time

ERIC Educational Resources Information Center

Gunter, Glenda A.

2012-01-01

In this article the author presents a meta-analysis of the findings from several studies conducted over multiple years with various types of learners that investigated exemplar/signature pedagogical practices incorporating video to motivate otherwise reluctant and struggling learners. Noting that newer technologies are making today's learners less…

Lifelong Career Development Needs Assessment Study. Working Paper No. 3. Lifelong Career Development Project.

ERIC Educational Resources Information Center

Schoepke, JoAnn M.

The report presents findings from needs assessment studies conducted in three community college areas to examine the extent to which 161 severely handicapped adults in seven disability groups (orthopedic, visual, hearing, mental retardation, epilepsy, cerebral palsy, and multiple handicapping conditions) have acquired 22 life centered competencies…

Perceptions of Crisis Management in a K-12 School District

ERIC Educational Resources Information Center

Tucker, Joy

2012-01-01

This multiple-case qualitative study was conducted to examine the perceptions of community members, students, and staff regarding school crisis management following a 2006 tornado and 2010 bus accident in a small rural school district in Missouri. Online surveys were collected from 66 participants, and 10 follow-up interviews were completed with…

Drawing conclusions from within-group comparisons and selected subsets of data leads to unsubstantiated conclusions: Letter regarding Malakellis et al.

USDA-ARS?s Scientific Manuscript database

Malakellis et al. conducted an ambitious quasi-experimental evaluation of "multiple initiatives at [the] individual, community, and school policy level to support healthier nutrition and physical activity" among children. In the abstract they concluded, "There was some evidence of effectiveness of t...

COMPARISON OF RANDOM SITE SELECTION AT MULTIPLE INTENSITIES FOR THE ASSESSMENT OF THE OHIO RIVER FISH COMMUNITY

EPA Science Inventory

The Ohio River Valley Sanitation Commission (ORSANCO) is a compact of eight states representing interests in the Ohio River basin that has been instrumental in the development of biological monitoring of the Ohio River. In the past, ORSANCO has conducted intensive surveys by samp...

Experiments in evaluation capacity building: Enhancing brain disorders research impact in Ontario.

PubMed

Nylen, Kirk; Sridharan, Sanjeev

2017-05-08

This paper is the introductory paper on a forum on evaluation capacity building for enhancing impacts of research on brain disorders. It describes challenges and opportunities of building evaluation capacity among community-based organizations in Ontario involved in enhancing brain health and supporting people living with a brain disorder. Using an example of a capacity building program called the "Evaluation Support Program", which is run by the Ontario Brain Institute, this forum discusses multiple themes including evaluation capacity building, evaluation culture and evaluation methodologies appropriate for evaluating complex community interventions. The goal of the Evaluation Support Program is to help community-based organizations build the capacity to demonstrate the value that they offer in order to improve, sustain, and spread their programs and activities. One of the features of this forum is that perspectives on the Evaluation Support Program are provided by multiple stakeholders, including the community-based organizations, evaluation team members involved in capacity building, thought leaders in the fields of evaluation capacity building and evaluation culture, and the funders. Copyright © 2017. Published by Elsevier Ltd.

A comprehensive grid to evaluate case management's expected effectiveness for community-dwelling frail older people: results from a multiple, embedded case study.

PubMed

Van Durme, Thérèse; Schmitz, Olivier; Cès, Sophie; Anthierens, Sibyl; Maggi, Patrick; Delye, Sam; De Almeida Mello, Johanna; Declercq, Anja; Macq, Jean; Remmen, Roy; Aujoulat, Isabelle

2015-06-18

Case management is a type of intervention expected to improve the quality of care and therefore the quality of life of frail, community-dwelling older people while delaying institutionalisation in nursing homes. However, the heterogeneity, multidimensionality and complexity of these interventions make their evaluation by the means of classical approaches inadequate. Our objective was twofold: (i) to propose a tool allowing for the identification of the key components that explain the success of case management for this population and (ii) to propose a typology based on the results of this tool. The process started with a multiple embedded case study design in order to identify the key components of case management. Based on the results of this first step, data were collected among 22 case management interventions, in order to evaluate their expected effectiveness. Finally, multiple correspondence analyses was conducted to propose a typology of case management. The overall approach was informed by Wagner's Chronic Care Model and the theory of complexity. The study identified a total of 23 interacting key components. Based on the clustering of response patterns of the 22 case management projects included in our study, three types of case management programmes were evidenced, situated on a continuum from a more "socially-oriented" type towards a more "clinically-oriented" type of case management. The type of feedback provided to the general practitioner about both the global geriatric assessment and the result of the intervention turned out to be the most discriminant component between the types. The study design allowed to produce a tool that can be used to distinguish between different types of case management interventions and further evaluate their effect on frail older people in terms of the delaying institutionalisation, functional and cognitive status, quality of life and societal costs.

Randomized controlled pilot study of customized pamphlets to promote physical activity and symptom self-management in women with multiple sclerosis.

PubMed

Plow, Matthew; Bethoux, Francois; McDaniel, Corey; McGlynn, Mark; Marcus, Bess

2014-02-01

Investigate the feasibility and potential efficacy of a customized print-based intervention to promote physical activity and symptom self-management in women with multiple sclerosis. A randomly allocated two-group repeated measures design, with a delayed-treatment contact group serving as the control. Participants were randomized to receive the intervention immediately (n =14) or receive it at week 12 (n =16). Outcome measures were administered at weeks 1, 12, and 24. Community-based in metropolitan area. Thirty women with multiple sclerosis. Prescribing a home-exercise program and following up with customized pamphlets, which are matched to participants' stage of readiness to change physical activity behavior and physical activity barriers (e.g. encouraging self-management of symptoms). Physical Activity and Disability Survey-revised, Godin Leisure-Time Exercise Questionnaire, SF-12, Symptoms of Multiple Sclerosis Scale, and 6-minute walk test. Intent-to-treat analyses using mixed multivariate analysis of variance (MANOVA) were conducted on (1) physical activity levels and (2) health and function outcomes. The mixed MANOVAs for physical activity levels and health and function outcomes indicated significant improvements in the immediate group compared with the delayed group (i.e. condition by time interaction was significant, Wilks' λ = 0.59, F(2, 27) = 9.31, P = 0.001 and Wilks' λ = 0.70, F(4, 25) = 2.72, P = 0.052, respectively). The intervention had moderate to large effect sizes in improving physical activity levels (d = 0.63 to 0.89), perceptions of physical function (d = 0.63), and 6-minute walk test (d=0.86). This pilot study indicates that a customized print-based intervention shows promise in improving physical activity levels and health and function in women with multiple sclerosis.

From Design to Dissemination: Implementing Community-Based Participatory Research in Postdisaster Communities

PubMed Central

Kennedy, Suzanne; Krouse, Rebecca Z.; Grimsley, Faye; El-Dahr, Jane; Bordelon, Keith; Sterling, Yvonne; White, LuAnn; Barlow, Natasha; DeGruy, Shannon; Paul, Dorothy; Denham, Stacey; Hayes, Claire; Sanders, Margaret; Mvula, Mosanda M.; Thornton, Eleanor; Chulada, Patricia; Mitchell, Herman; Martin, William J.; Stephens, Kevin U.; Cohn, Richard D.

2016-01-01

Objectives. To review how disasters introduce unique challenges to conducting population-based research and community-based participatory research (CBPR). Methods. From 2007–2009, we conducted the Head-off Environmental Asthma in Louisiana (HEAL) Study in the aftermath of Hurricane Katrina in a Gulf Coast community facing an unprecedented triple burden: Katrina’s and other disasters’ impact on the environment and health, historic health disparities, and persistent environmental health threats. Results. The unique triple burden influenced every research component; still, most existing CBPR principles were applicable, even though full adherence was not always feasible and additional tailored principles govern postdisaster settings. Conclusions. Even in the most challenging postdisaster conditions, CBPR can be successfully designed, implemented, and disseminated while adhering to scientific rigor. PMID:27196662

Exploring the Position of Community-Based Nursing in Iran: A Qualitative Study

PubMed Central

Heydari, Heshmatolah; Rahnavard, Zahra; Ghaffari, Fatemeh

2017-01-01

ABSTRACT Background: Community-based nursing focuses on providing health services to families and communities in the second and third levels of prevention and this can improve the individuals, families and communities’ quality of life, and reduce the healthcare costs. The aim of this study was to explore the status of community-based nursing in Iran. Methods: This qualitative study was conducted from March to November 2015, in Tehran, Iran, using the content analysis approach. The study setting consisted of Iran and Tehran Faculties of Nursing and Midwifery, Tehran, Iran. The purposive sampling method was used. Twenty faculty members and Master’s and PhD students were interviewed by using the face-to-face semi-structured interview method. Moreover, two focus groups were conducted for complementing and enriching the study data. The data were analyzed using the Graneheim and Lundman’s approach to content analysis. The trustworthiness of the study findings was maintained by employing the Lincoln and Guba’s criteria of credibility, dependability, and confirmability. Results: In total, 580 codes were generated and categorized into three main categories of conventional services, the necessity for creating infrastructures, and multidimensional outcomes of community-based nursing. Conclusion: Introducing community-based nursing into nursing education curricula and creating ample job opportunities for community-based nurses seem clearly essential. PMID:29043284

Effectiveness of Winkler Litter Extraction and Pitfall Traps in Sampling Ant Communities and Functional Groups in a Temperate Forest.

PubMed

Mahon, Michael B; Campbell, Kaitlin U; Crist, Thomas O

2017-06-01

Selection of proper sampling methods for measuring a community of interest is essential whether the study goals are to conduct a species inventory, environmental monitoring, or a manipulative experiment. Insect diversity studies often employ multiple collection methods at the expense of researcher time and funding. Ants (Formicidae) are widely used in environmental monitoring owing to their sensitivity to ecosystem changes. When sampling ant communities, two passive techniques are recommended in combination: pitfall traps and Winkler litter extraction. These recommendations are often based on studies from highly diverse tropical regions or when a species inventory is the goal. Studies in temperate regions often focus on measuring consistent community response along gradients of disturbance or among management regimes; therefore, multiple sampling methods may be unnecessary. We compared the effectiveness of pitfalls and Winkler litter extraction in an eastern temperate forest for measuring ant species richness, composition, and occurrence of ant functional groups in response to experimental manipulations of two key forest ecosystem drivers, white-tailed deer and an invasive shrub (Amur honeysuckle). We found no significant effect of sampling method on the outcome of the ecological experiment; however, we found differences between the two sampling methods in the resulting ant species richness and functional group occurrence. Litter samples approximated the overall combined species richness and composition, but pitfalls were better at sampling large-bodied (Camponotus) species. We conclude that employing both methods is essential only for species inventories or monitoring ants in the Cold-climate Specialists functional group. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A picture's worth a thousand words: engaging youth in CBPR using the creative arts.

PubMed

Yonas, Michael A; Burke, Jessica G; Rak, Kimberly; Bennett, Antoine; Kelly, Vera; Gielen, Andrea C

2009-01-01

Engaging youth and incorporating their unique expertise into the research process is important when addressing issues related to their health. Visual Voices is an arts-based participatory data collection method designed to work together with young people and communities to collaboratively elicit, examine, and celebrate the perspectives of youth. To present a process for using the creative arts with young people as a participatory data collection method and to give examples of their perspectives on safety and violence. Using the creative arts, this study examined and illustrates the perspectives of how community factors influence safety and violence. Visual Voices was conducted with a total of 22 African-American youth in two urban neighborhoods. This method included creative arts-based writing, drawing, and painting activities designed to yield culturally relevant data generated and explored by youth. Qualitative data were captured through the creative content of writings, drawings, and paintings created by the youths as well as transcripts from audio recorded group discussion. Data was analyzed for thematic content and triangulated across traditional and nontraditional mediums. Findings were interpreted with participants and shared publicly for further reflection and utilization. The youth participants identified a range of issues related to community factors, community safety, and violence. Such topics included the role of schools and social networks within the community as safe places and corner stores and abandoned houses as unsafe places. Visual Voices is a creative research method that provides a unique opportunity for youth to generate a range of ideas through access to the multiple creative methods provided. It is an innovative process that generates rich and valuable data about topics of interest and the lived experiences of young community members.

A Picture’s Worth a Thousand Words: Engaging Youth in CBPR Using the Creative Arts

PubMed Central

Yonas, Michael A.; Burke, Jessica G.; Rak, Kimberly; Bennett, Antoine; Kelly, Vera; Gielen, Andrea C.

2010-01-01

Background Engaging youth and incorporating their unique expertise into the research process is important when addressing issues related to their health. Visual Voices is an arts-based participatory data collection method designed to work together with young people and communities to collaboratively elicit, examine, and celebrate the perspectives of youth. Objectives To present a process for using the creative arts with young people as a participatory data collection method and to give examples of their perspectives on safety and violence. Methods Using the creative arts, this study examined and illustrates the perspectives of how community factors influence safety and violence. Visual Voices was conducted with a total of 22 African-American youth in two urban neighborhoods. This method included creative arts-based writing, drawing, and painting activities designed to yield culturally relevant data generated and explored by youth. Qualitative data were captured through the creative content of writings, drawings, and paintings created by the youths as well as transcripts from audio recorded group discussion. Data was analyzed for thematic content and triangulated across traditional and nontraditional mediums. Findings were interpreted with participants and shared publicly for further reflection and utilization. Conclusion The youth participants identified a range of issues related to community factors, community safety, and violence. Such topics included the role of schools and social networks within the community as safe places and corner stores and abandoned houses as unsafe places. Visual Voices is a creative research method that provides a unique opportunity for youth to generate a range of ideas through access to the multiple creative methods provided. It is an innovative process that generates rich and valuable data about topics of interest and the lived experiences of young community members. PMID:20097996

The Student Guide for Career Analysis. Community Involvement/Career Education: An Experience-based Social Studies Program, Volume I.

ERIC Educational Resources Information Center

Kyle, James; And Others

The guide provides multiple experience-based activities for use by secondary social studies students as they examine occupational possibilities in their communities. The purposes of the materials are to help students evaluate themselves and their value systems, examine occupations, and become aware of the changing philosophy and value of work in…

Opening up their doors: perspectives on the involvement of the African American faith community in HIV prevention in four communities.

PubMed

Wooster, Joanna; Eshel, Ariela; Moore, Andrea; Mishra, Meenoo; Toledo, Carlos; Uhl, Gary; Aguero, Linda Wright-De

2011-09-01

In 1998, the U.S. government launched the Minority AIDS Initiative (MAI) to address growing ethnic and racial disparities in HIV/AIDS cases. The CDC performed an evaluation of its MAI-funded programs, including an assessment of community stakeholders' perspective on the involvement of the faith community in HIV prevention. Individual interviews (N = 113) were conducted annually over 3 years in four communities. The majority of participants described a change in faith community's attitudes toward HIV and a rise in HIV-related activities conducted by faith-based organizations. Participants attributed changes to faith-based funding, acknowledgment by African American community leadership that HIV is a serious health issue, and faith leaders' desire to become more educated on HIV/AIDS. Participants reported conservative faith doctrine and stigma as barriers to faith community involvement. The findings suggest that although barriers remain, there is an increased willingness to address HIV/AIDS, and the faith community serves as a vital resource in HIV prevention.

Community-based organizations in the health sector: A scoping review

PubMed Central

2012-01-01

Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks). Given the range of terms used to describe community-based organizations, this scoping review can be used to further map their meanings/definitions to develop a more comprehensive typology and understanding of community-based organizations. This information can be used in further investigations about the ways in which community-based organizations can be engaged in health system decision-making and the mechanisms available for facilitating or supporting their engagement. PMID:23171160

Community-based organizations in the health sector: a scoping review.

PubMed

Wilson, Michael G; Lavis, John N; Guta, Adrian

2012-11-21

Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry.We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks).Given the range of terms used to describe community-based organizations, this scoping review can be used to further map their meanings/definitions to develop a more comprehensive typology and understanding of community-based organizations. This information can be used in further investigations about the ways in which community-based organizations can be engaged in health system decision-making and the mechanisms available for facilitating or supporting their engagement.

Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study.

PubMed

Lebso, Meaza; Anato, Anchamo; Loha, Eskindir

2017-01-01

Anemia is defined as a condition in which there is less than the normal hemoglobin (Hb) level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia. Community based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration <11 g/dl was classified as anaemic. Stool examinations were also done. Structured questionnaire was used as a tool to collect sociodemographic characteristics, individual dietary diversity and level of household food security data. Multivariate logistic regression model was employed to determine the effect of explanatory variables like level of education, level of household food security, dietary diversity, trimester of pregnancy, family planning before pregnancy, deworming, gravidity, iron intake in current pregnancy and soil transmitted helminthes on dependent variable anemia. The prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%). Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11-3.69), trimester second (AOR = 3.09, 95%CI: 1.41-6.79) and third (AOR = 3.68, 95% CI: 1.67-8.08), gravidity three to five (AOR = 1.78, 95% CI: 1.03-3.07) and six and above (AOR = 2.59, 95%CI: 1.37-4.92), not supplemented with iron (AOR = 1.72, 95% CI: 1.02-2.91), low dietary diversity score (AOR = 3.18, 95% CI: 1.37-7.37) and hookworm infection (AOR = 2.69, 95%CI: 1.34-5.39). Anemia has moderate public health significance in the area. Community-based interventions should be enhanced considering the identified associated factors.

Cherokee Choices: a diabetes prevention program for American Indians.

PubMed

Bachar, Jeffrey J; Lefler, Lisa J; Reed, Lori; McCoy, Tara; Bailey, Robin; Bell, Ronny

2006-07-01

In 1999, the Centers for Disease Control and Prevention (CDC) provided Racial and Ethnic Approaches to Community Health 2010 (REACH 2010) funds to the Eastern Band of Cherokee Indians to develop a community-based intervention to improve the health of this rural, mountainous community in North Carolina. During the first year of the Cherokee Choices program, team members conducted formative research, formed coalitions, and developed a culturally appropriate community action plan for the prevention of type 2 diabetes, particularly among children. The Eastern Band of Cherokee Indians has higher rates of obesity and type 2 diabetes than the U.S. and North Carolina general populations. The Cherokee Choices program includes three main components: elementary school mentoring, worksite wellness for adults, and church-based health promotion. A social marketing strategy, including television advertisements and a television documentary series, supports the three components. School policy was altered to allow Cherokee Choices to have class time and after-school time devoted to health promotion activities. School staff have shown an interest in improving their health through attendance at fitness sessions. The credibility of the program has been validated through multiple invitations to participate in school events. Participants in the worksite wellness program have met dietary and physical activity goals, had reductions in body fat, and expressed enthusiasm for the program. A subcoalition has been formed to expand the worksite wellness component and link prevention efforts to health care cost reduction. Participants in the church program have walked more than 31,600 miles collectively.

Go-along interviewing with LGBTQ youth in Canada and the United States

PubMed Central

Porta, Carolyn M.; Corliss, Heather L.; Wolowic, Jennifer M.; Johnson, Abigail Z.; Fogel, Katie Fritz; Gower, Amy L.; Saewyc, Elizabeth M.; Eisenberg, Marla E.

2017-01-01

Go-along interviews, which are interviews conducted whilst being in and moving within participant selected spaces, were conducted with 66 LGBTQ adolescents (14-19 years old) in their self-identified communities to explore perceived community attributes, including safe spaces, resources, and supports; this paper highlights methodological lessons learned. Successful recruitment in two countries and varied community settings required partnership with local LGBTQ supporting agencies, including school-based Gay Straight Alliances. Youth chose to walk, use public transportation, and drive to community locations, identifying numerous formal and informal resources in their communities. Participant reflections highlighted that go-along interviews can be conducted in safe ways that encourage LGBTQ youth to express themselves about communities in which they live, study, work, play, and relax. PMID:28943992

Reducing Flood Impacts for Wellbeing of Arctic Communities through Collaboration among Community and Tribal Leaders, Scientists, and Emergency Man

NASA Astrophysics Data System (ADS)

Kontar, Y. Y.

2016-12-01

In Alaska and the Sakha Republic (Siberia), multiple communities are exposed to flooding every spring. A bilateral and multidisciplinary team was established, as part of the U.S. State Department FY2015-16 U.S.-Russia Peer-to-Peer Dialogue Initiative, to conduct the project Reducing Spring Flood Impacts for Wellbeing of Communities of the North. The project comprised community-based participatory research, education, and cultural activities that used flood sites in Alaska and Siberia as case studies. A diverse and bilateral team (community leaders, scientists, students, and emergency managers) was established to share experiences and identify best practices in mitigating the risk of and improving response to floods.This science-community collaboration has inspired a dialogue between present and future decision makers and community residents. Preliminary analysis revealed that community members in both regions are interested in collaborations with scientists to reduce flood risks and impacts. They are eager to share their experiences. However, scientists have to earn the trust of and develop a rapport with local leaders beforehand. Conflicts arise when communities perceive scientists as governmental representatives due to the fact that most scientific funds come from federal and state grants. Scientists are also held responsible for disasters, due to their roles in disaster forecasting and warnings. In both regions, impacted populations often blame the government for flood impacts; not unreasonably. Originally nomadic, native populations were forced to settle in floodplains by governments. Now, exposed to floods, they regard damage reimbursement as a predominantly governmental responsibility. Scientists can offer long-term solutions that would benefit communities at risk and governmental entities. However, it is important for scientists not to impose solutions, but instead initiate and maintain a dialogue about alternatives, especially as sensitive as relocation.

A review of instruments to measure interprofessional collaboration for chronic disease management for community-living older adults.

PubMed

Bookey-Bassett, Sue; Markle-Reid, Maureen; McKey, Colleen; Akhtar-Danesh, Noori

2016-01-01

It is acknowledged internationally that chronic disease management (CDM) for community-living older adults (CLOA) is an increasingly complex process. CDM for older adults, who are often living with multiple chronic conditions, requires coordination of various health and social services. Coordination is enabled through interprofessional collaboration (IPC) among individual providers, community organizations, and health sectors. Measuring IPC is complicated given there are multiple conceptualisations and measures of IPC. A literature review of several healthcare, psychological, and social science electronic databases was conducted to locate instruments that measure IPC at the team level and have published evidence of their reliability and validity. Five instruments met the criteria and were critically reviewed to determine their strengths and limitations as they relate to CDM for CLOA. A comparison of the characteristics, psychometric properties, and overall concordance of each instrument with salient attributes of IPC found the Collaborative Practice Assessment Tool to be the most appropriate instrument for measuring IPC for CDM in CLOA.

Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial.

PubMed

Goodkind, Jessica R; Amer, Suha; Christian, Charlisa; Hess, Julia Meredith; Bybee, Deborah; Isakson, Brian L; Baca, Brandon; Ndayisenga, Martin; Greene, R Neil; Shantzek, Cece

2017-02-01

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants' intervention experiences, and their feasibility and acceptability. In the current mixed-methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African, and Iraqi refugee adults and to engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013 and 2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, and postintervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community-academic partnerships engaged in RCTs.

CHALLENGES AND INNOVATIONS IN A COMMUNITY-BASED PARTICIPATORY RANDOMIZED CONTROLLED TRIAL

PubMed Central

Goodkind, Jessica R.; Amer, Suha; Christian, Charlisa; Hess, Julia Meredith; Bybee, Deborah; Isakson, Brian; Baca, Brandon; Ndaysenga, Martin; Greene, R. Neil; Shantzek, Cece

2016-01-01

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants’ intervention experiences, and their feasibility and acceptability. In the current mixed methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African and Iraqi refugee adults and engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013-2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, post-intervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community-academic partnerships engaged in RCTs. PMID:27179291

Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

PubMed

Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

2017-07-01

Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

HIV-related stigma within communities of gay men: a literature review.

PubMed

Smit, Peter J; Brady, Michael; Carter, Michael; Fernandes, Ricardo; Lamore, Lance; Meulbroek, Michael; Ohayon, Michel; Platteau, Tom; Rehberg, Peter; Rockstroh, Jürgen K; Thompson, Marc

2012-01-01

While stigma associated with HIV infection is well recognised, there is limited information on the impact of HIV-related stigma between men who have sex with men and within communities of gay men. The consequences of HIV-related stigma can be personal and community-wide, including impacts on mood and emotional well-being, prevention, testing behaviour, and mental and general health. This review of the literature reports a growing division between HIV-positive and HIV-negative gay men, and a fragmentation of gay communities based along lines of perceived or actual HIV status. The literature includes multiple references to HIV stigma and discrimination between gay men, men who have sex with men, and among and between many gay communities. This HIV stigma takes diverse forms and can incorporate aspects of social exclusion, ageism, discrimination based on physical appearance and health status, rejection and violence. By compiling the available information on this understudied form of HIV-related discrimination, we hope to better understand and target research and countermeasures aimed at reducing its impact at multiple levels.

Risk for Suicidal Ideation and Suicide Attempts Associated with Co-occurring Depression and Conduct Disorders in Early Adolescence

PubMed Central

Stoep, Ann Vander; Adrian, Molly; McCauley, Elizabeth; Crowell, Sheila; Stone, Andrea; Flynn, Cynthia

2013-01-01

This study investigates the early manifestation of co-occurring depression and conduct disorders as a predictor of heightened risk for later suicidal ideation and behavior in a community sample of 521 adolescents. Self-reported symptoms of depression and conduct disorder were evaluated in early 6th grade. Suicidal thoughts and behaviors were tracked through multiple assessments carried out over the middle school years. Compared to adolescents with depression symptoms only, conduct disorder symptoms only, or low psychopathology, those with co-occurring depression and conduct disorder symptoms had the highest risk for subsequent suicidal ideation, recurrent suicidal behaviors, and suicide attempts. PMID:21463356

Risk for suicidal ideation and suicide attempts associated with co-occurring depression and conduct problems in early adolescence.

PubMed

Vander Stoep, Ann; Adrian, Molly; McCauley, Elizabeth; Crowell, Sheila E; Stone, Andrea; Flynn, Cynthia

2011-06-01

This study investigates the early manifestation of co-occurring depression and conduct problems as a predictor of heightened risk for later suicidal ideation and behavior in a community sample of 521 adolescents. Self-reported symptoms of depression and conduct problems were evaluated in early 6th grade. Suicidal thoughts and behaviors were tracked through multiple assessments carried out over the middle school years. Compared to adolescents with depression symptoms only, conduct problem symptoms only, or low psychopathology, those with co-occurring depression and conduct problem symptoms had the highest risk for subsequent suicidal ideation, recurrent suicidal behaviors, and suicide attempts. © 2011 The American Association of Suicidology.

Wildlife in the Upper Great Lakes Region: a community profile.

Treesearch

Janine M. Benyus; Richard R. Buech; Mark D. Nelson

1992-01-01

Wildlife habitat data from seven Great Lakes National Forests were combined into a wildlife-habitat matrix named NORTHWOODS. The composite NORTHWOODS data base is summarized. Multiple queries of NORTHWOODS were used to profile the wildlife community of the Upper Great Lakes region.

Consuming untreated water in four southwestern Alaska Native communities: reasons revealed and recommendations for change.

PubMed

Ritter, Troy L; Lopez, Ellen D S; Goldberger, Rachel; Dobson, Jennifer; Hickel, Korie; Smith, Jeffrey; Johnson, Rhonda M; Bersamin, Andrea

2014-12-01

In this article, the authors provide the first in-depth account of why some Alaska Native people drink untreated water when treated water is available. Their qualitative research was conducted in four Alaska Native village communities that have treated water available from a centralized distribution point. Most respondents (n = 172; 82%) reported that some of their household's drinking water came from an untreated source. Motives for drinking untreated water emerged from analysis of open-ended questions about drinking water practice and could be categorized into six themes: chemicals, taste, health, access, tradition, and cost. Importantly, some residents reported consuming untreated water because they both liked untreated water and disliked treated water. As such, interventions to increase safe water consumption should address this dichotomy by providing education about the benefits of treated water alongside the risks involved with drinking untreated water. Based on the findings, the authors provide specific recommendations for developing behavior change interventions that address influences at multiple social-ecological levels.

The importance of social context in understanding and promoting low-income immigrant women's health.

PubMed

De Jesus, Maria

2009-02-01

Understanding the social context and realities of Cape Verdean women in the U.S. as well as other immigrant and ethnic/racial groups is important to promote their overall health and well-being more effectively. The aim of this study was to gain a contextual understanding from the perspectives of health promoters who work with marginalized women. In-depth, semi-structured interviews were conducted with nine Cape Verdean women health promoters about their perspectives and experiences of health promotion practice with immigrant women in their community. Using a Glaserian grounded theory approach to analysis, six salient themes describing women's social context emerged: community and domestic violence, loss and isolation, economic injustice, immigration-related issues and abuse, unequal gender-based power relations, and cultural taboos. These findings challenge health researchers and practitioners to understand health problems and health promotion not only at an individual level, but at multiple levels of influence including interpersonal, family, neighborhood, and structural levels.

Application of a gender-based approach to conducting a community health assessment for rural women in Southern Illinois.

PubMed

Zimmermann, Kristine; Khare, Manorama M; Wright, Cherie; Hasler, Allison; Kerch, Sarah; Moehring, Patricia; Geller, Stacie

2015-08-01

Rural populations in the United States experience unique challenges in health and health care. The health of rural women, in particular, is influenced by their knowledge, work and family commitments, as well as environmental barriers in their communities. In rural southern Illinois, the seven southernmost counties form a region that experiences high rates of cancer and other chronic diseases. To identify, understand, and prioritize the health needs of women living in these seven counties, a comprehensive gender-based community health assessment was conducted with the goal of developing a plan to improve women's health in the region. A gender-analysis framework was adapted, and key stakeholder interviews and focus groups with community women were conducted and analyzed to identify factors affecting ill health. The gender-based analysis revealed that women play a critical role in the health of their families and their communities, and these roles can influence their personal health. The gender-based analysis also identified several gender-specific barriers and facilitators that affect women's health and their ability to engage in healthy behaviors. These results have important implications for the development of programs and policies to improve health among rural women. Copyright © 2014 Elsevier Ltd. All rights reserved.

Seeing the community's perspective through multiple emic and etic vistas.

PubMed

Gaber, John

2017-12-01

Health impact assessment (HIA) researchers regularly use community input in their investigations to help them better understand local health issues. Community data is commonly associated with the lived experiences of local impacted residents known as 'emic' data. It is becoming more common practice for HIA researchers to access outside experts and stakeholders ('etic' data) during the community input phase of their investigations. Utilizing published international HIA data, I look at who HIA researchers invite when they seek to get 'community input' in their HIA investigations. The HIA database was generated from an internet investigation of published HIAs (in English) from 1999 to 2011 and focused particularly on single authored assessments that were conducted by governments, non-governmental organizations (NGOs) or universities. HIA researchers access a wide range of emic and etic community perspectives in their search for the 'community's view'. Government, NGO and university investigators access community perspectives differently, with university HIA researchers inviting more emic-oriented community vistas than both government and NGO researchers. University and government HIA investigators are more likely to invite multiple emic and etic community perspectives during their community participation projects than NGO researchers. NGO HIA investigators tend to either invite emic perspectives or etic perspectives for their community input with less mixing of the two views in a single project. The paper concludes with a discussion on how HIA researchers can frame the 'community's perspective' in their HIA investigations through a combination of both 'insider' and 'outsider' community input sampling strategies. Published by Oxford University Press 2016. This work is written by a US Government employee and is in the public domain in the US.

Community interventions providing care and support to orphans and vulnerable children: a review of evaluation evidence.

PubMed

Schenk, Katie D

2009-07-01

Children affected by HIV in their families and communities face multiple risks to their health, education and psychosocial wellbeing. Community interventions for children who have been orphaned or rendered vulnerable take many forms, including educational assistance, home-based care, legal protection and psychosocial support. Despite a recent influx of funding for programme implementation, there exists little evidence to inform policymakers about whether their investments are improving the lives of vulnerable children and meeting key benchmarks including the Millennium Development Goals. This paper reviews the current evidence base on evaluations of community interventions for orphans and vulnerable children (OVC) in high HIV-prevalence African settings, focusing on studies' methodologies. Sources reviewed include published research studies and evidence from the unpublished programmatic "grey literature" located through database and internet searches. A total of 21 studies, varying in scope and generalisability, were identified. Interventions reviewed address children's wellbeing through various strategies within their communities. Evaluation methodologies reflect quantitative and qualitative approaches, including surveys (with and without baseline or comparison data), costing studies, focus groups, interviews, case studies, and participatory review techniques. Varied study methodologies reflect diverse research questions, various intervention types, and the challenges associated with evaluating complex interventions; highlighting the need to broaden the research paradigm in order to build the evidence base by including quasi-experimental and process evaluation approaches, and seeking further insights through participatory qualitative methodologies and costing studies. Although findings overall indicate the value of community interventions in effecting measurable improvements in child and family wellbeing, the quality and rigour of evidence is varied. A strategic research agenda is urgently needed to inform resource allocation and programme management decisions. Immediate imperatives include building local technical capacity to conduct quantitative and qualitative evaluation research, and strengthening monitoring and evaluation systems to collect process and outcome data (including costing) on key support models. Donors and implementers must support the collection of sound empirical evidence to inform the development and scale-up of OVC programmes.

Factors influencing community nursing roles and health service provision in rural areas: a review of literature.

PubMed

Barrett, Annette; Terry, Daniel R; Lê, Quynh; Hoang, Ha

2016-02-01

This review sought to better understand the issues and challenges experienced by community nurses working in rural areas and how these factors shape their role. Databases were searched to identify relevant studies, published between 1990 and 2015, that focussed on issues and challenges experienced by rural community nurses. Generic and grey literature relating to the subject was also searched. The search was systematically conducted multiple times to assure accuracy. A total of 14 articles met the inclusion criteria. This critical review identified common issues impacting community nursing and included role definition, organisational change, human resource, workplace and geographic challenges. Community nurses are flexible, autonomous, able to adapt care to the service delivery setting, and have a diversity of knowledge and skills. Considerably more research is essential to identify factors that impact rural community nursing practice. In addition, greater advocacy is required to develop the role.

Mediation of the relationship between callous-unemotional traits and proactive aggression by amygdala response to fear among children with conduct problems.

PubMed

Lozier, Leah M; Cardinale, Elise M; VanMeter, John W; Marsh, Abigail A

2014-06-01

Among youths with conduct problems, callous-unemotional (CU) traits are known to be an important determinant of symptom severity, prognosis, and treatment responsiveness. But positive correlations between conduct problems and CU traits result in suppressor effects that may mask important neurobiological distinctions among subgroups of children with conduct problems. To assess the unique neurobiological covariates of CU traits and externalizing behaviors in youths with conduct problems and determine whether neural dysfunction linked to CU traits mediates the link between callousness and proactive aggression. This cross-sectional case-control study involved behavioral testing and neuroimaging that were conducted at a university research institution. Neuroimaging was conducted using a 3-T Siemens magnetic resonance imaging scanner. It included 46 community-recruited male and female juveniles aged 10 to 17 years, including 16 healthy control participants and 30 youths with conduct problems with both low and high levels of CU traits. Blood oxygenation level-dependent signal as measured via functional magnetic resonance imaging during an implicit face-emotion processing task and analyzed using whole-brain and region of interest-based analysis of variance and multiple-regression analyses. Analysis of variance revealed no group differences in the amygdala. By contrast, consistent with the existence of suppressor effects, multiple-regression analysis found amygdala responses to fearful expressions to be negatively associated with CU traits (x = 26, y = 0, z = -12; k = 1) and positively associated with externalizing behavior (x = 24, y = 0, z = -14; k = 8) when both variables were modeled simultaneously. Reduced amygdala responses mediated the relationship between CU traits and proactive aggression. The results linked proactive aggression in youths with CU traits to hypoactive amygdala responses to emotional distress cues, consistent with theories that externalizing behaviors, particularly proactive aggression, in youths with these traits stem from deficient empathic responses to distress. Amygdala hypoactivity may represent an intermediate phenotype, offering new insights into effective treatment strategies for conduct problems.

Multiple Stressors at the Land-Sea Interface: Cyanotoxins at the Land-Sea Interface in the Southern California Bight.

PubMed

Tatters, Avery O; Howard, Meredith D A; Nagoda, Carey; Busse, Lilian; Gellene, Alyssa G; Caron, David A

2017-03-09

Blooms of toxic cyanobacteria in freshwater ecosystems have received considerable attention in recent years, but their occurrence and potential importance at the land-sea interface has not been widely recognized. Here we present the results of a survey of discrete samples conducted in more than fifty brackish water sites along the coastline of southern California. Our objectives were to characterize cyanobacterial community composition and determine if specific groups of cyanotoxins (anatoxins, cylindrospermopsins, microcystins, nodularins, and saxitoxins) were present. We report the identification of numerous potentially harmful taxa and the co-occurrence of multiple toxins, previously undocumented, at several locations. Our findings reveal a potential health concern based on the range of organisms present and the widespread prevalence of recognized toxic compounds. Our results raise concerns for recreation, harvesting of finfish and shellfish, and wildlife and desalination operations, highlighting the need for assessments and implementation of monitoring programs. Such programs appear to be particularly necessary in regions susceptible to urban influence.

Multiple Stressors at the Land-Sea Interface: Cyanotoxins at the Land-Sea Interface in the Southern California Bight

PubMed Central

Tatters, Avery O.; Howard, Meredith D.A.; Nagoda, Carey; Busse, Lilian; Gellene, Alyssa G.; Caron, David A.

2017-01-01

Blooms of toxic cyanobacteria in freshwater ecosystems have received considerable attention in recent years, but their occurrence and potential importance at the land-sea interface has not been widely recognized. Here we present the results of a survey of discrete samples conducted in more than fifty brackish water sites along the coastline of southern California. Our objectives were to characterize cyanobacterial community composition and determine if specific groups of cyanotoxins (anatoxins, cylindrospermopsins, microcystins, nodularins, and saxitoxins) were present. We report the identification of numerous potentially harmful taxa and the co-occurrence of multiple toxins, previously undocumented, at several locations. Our findings reveal a potential health concern based on the range of organisms present and the widespread prevalence of recognized toxic compounds. Our results raise concerns for recreation, harvesting of finfish and shellfish, and wildlife and desalination operations, highlighting the need for assessments and implementation of monitoring programs. Such programs appear to be particularly necessary in regions susceptible to urban influence. PMID:28282935

Contextual factors as a key to understanding the heterogeneity of effects of a maternal health policy in Burkina Faso?

PubMed Central

Belaid, Loubna; Ridde, Valéry

2015-01-01

Burkina Faso implemented a national subsidy for emergency obstetric and neonatal care (EmONC) covering 80% of the cost of normal childbirth in public health facilities. The objective was to increase coverage of facility-based deliveries. After implementation of the EmONC policy, coverage increased across the country, but disparities were observed between districts and between primary healthcare centres (PHC). To understand the variation in coverage, we assessed the contextual factors and the implementation of EmONC in six PHCs in a district. We conducted a contrasted multiple case study. We interviewed women (n = 71), traditional birth attendants (n = 7), clinic management committees (n = 11), and health workers and district health managers (n = 26). Focus groups (n = 62) were conducted within communities. Observations were carried out in the six PHCs. Implementation was nearly homogeneous in the six PHCs but the contexts and human factors appeared to explain the variations observed on the coverage of facility-based deliveries. In the PHCs of Nogo and Tara, the immediate increase in coverage was attributed to health workers’ leadership in creatively promoting facility-based deliveries and strengthening relationships of trust with communities, users’ positive perceptions of quality of care and the arrival of female professional staff. The change of healthcare team at Iata’s PHC and a penalty fee imposed for home births in Belem may have caused the delayed effects there. Finally, the unchanged coverage in the PHCs of Fati and Mata was likely due to lack of promotion of facility-based deliveries, users’ negative perceptions of quality of care, and conflicts between health workers and users. Before implementation, decision-makers should perform pilot studies to adapt policies according to contexts and human factors. PMID:24633914

Community-based health and schools of nursing: supporting health promotion and research.

PubMed

Shannon, Crystal

2014-01-01

This article examines the role of community-based schools of nursing in the promotion of public health and research in poverty-stricken areas. This was a three-phase study (questionnaire and key-informants' interviews) that surveyed representatives of prelicensure associate and baccalaureate nursing schools (n=17), nursing-school key informants (n=6) and community leaders (n=10). A 13-question web-based survey and semi-structured interview of key informants elicited data on demographics, nursing program design, exposure of faculty and students to various research and health promotion methods, and beliefs about student involvement. Nursing schools participated minimally in community-based health promotion (CBHP) and community-based participatory research saw reduced need for student involvement in such activities, cited multiple barriers to active community collaboration, and reported restricted community partnerships. CBHP was recognized to be a valuable element of health care and student education, but is obstructed by many barriers. This study suggests that nursing schools are not taking full advantage of relationships with community leaders. Recommendations for action are given. © 2013 Wiley Periodicals, Inc.

Overcoming barriers to interprofessional education in gerontology: the Interprofessional Curriculum for the Care of Older Adults.

PubMed

Schapmire, Tara J; Head, Barbara A; Nash, Whitney A; Yankeelov, Pamela A; Furman, Christian D; Wright, R Brent; Gopalraj, Rangaraj; Gordon, Barbara; Black, Karen P; Jones, Carol; Hall-Faul, Madri; Faul, Anna C

2018-01-01

A fragmented workforce consisting of multiple disciplines with varying levels of training and limited ability to work as a team often provides care to older adults. Interprofessional education (IPE) is essential for preparing practitioners for the effective teamwork required for community-based, holistic, person-centered care of the older adults. Despite numerous programs and offerings to advance education and interdisciplinary patient care, there is an unmet need for geriatric IPE, especially as it relates to community-dwelling older adults and caregivers in medically underserved areas. A core group of university faculty from multiple disciplines received funding from the Health Resources and Services Administration Geriatric Workforce Enhancement Program to collaborate with community-based providers from several Area Agencies on Aging in the creation and implementation of the Interprofessional Curriculum for the Care of Older Adults (iCCOA). This geriatric curriculum is interprofessional, comprehensive, and community-based. Learners include third-year nursing students, nurse practitioner students, third-year medical students, internal medicine and family medicine residents, master's level social work students, third-year pharmacy students, pharmacy residents, third-year dental students, dental hygiene students, community-based organization professionals, practicing community organizers, and community health navigators. This article describes the efforts, successes, and challenges experienced with this endeavor, including securing funding, ensuring equal representation of the disciplines, adding new components to already crowded curricula, building curriculum on best practices, improving faculty expertise in IPE, managing logistics, and ensuring comprehensive evaluation. The results summarize the iCCOA components, as well as the interprofessional domains, knowledge, and competencies.

Overcoming barriers to interprofessional education in gerontology: the Interprofessional Curriculum for the Care of Older Adults

PubMed Central

Head, Barbara A; Nash, Whitney A; Yankeelov, Pamela A; Furman, Christian D; Wright, R Brent; Gopalraj, Rangaraj; Gordon, Barbara; Black, Karen P; Jones, Carol; Hall-Faul, Madri; Faul, Anna C

2018-01-01

A fragmented workforce consisting of multiple disciplines with varying levels of training and limited ability to work as a team often provides care to older adults. Interprofessional education (IPE) is essential for preparing practitioners for the effective teamwork required for community-based, holistic, person-centered care of the older adults. Despite numerous programs and offerings to advance education and interdisciplinary patient care, there is an unmet need for geriatric IPE, especially as it relates to community-dwelling older adults and caregivers in medically underserved areas. A core group of university faculty from multiple disciplines received funding from the Health Resources and Services Administration Geriatric Workforce Enhancement Program to collaborate with community-based providers from several Area Agencies on Aging in the creation and implementation of the Interprofessional Curriculum for the Care of Older Adults (iCCOA). This geriatric curriculum is interprofessional, comprehensive, and community-based. Learners include third-year nursing students, nurse practitioner students, third-year medical students, internal medicine and family medicine residents, master’s level social work students, third-year pharmacy students, pharmacy residents, third-year dental students, dental hygiene students, community-based organization professionals, practicing community organizers, and community health navigators. This article describes the efforts, successes, and challenges experienced with this endeavor, including securing funding, ensuring equal representation of the disciplines, adding new components to already crowded curricula, building curriculum on best practices, improving faculty expertise in IPE, managing logistics, and ensuring comprehensive evaluation. The results summarize the iCCOA components, as well as the interprofessional domains, knowledge, and competencies. PMID:29497345

The effects of interventions targeting multiple health behaviors on smoking cessation outcomes: a rapid realist review protocol.

PubMed

Minian, Nadia; deRuiter, Wayne K; Lingam, Mathangee; Corrin, Tricia; Dragonetti, Rosa; Manson, Heather; Taylor, Valerie H; Zawertailo, Laurie; Ebnahmady, Arezoo; Melamed, Osnat C; Rodak, Terri; Hahn, Margaret; Selby, Peter

2018-03-01

Health behaviors directly impact the health of individuals, and populations. Since individuals tend to engage in multiple unhealthy behaviors such as smoking, excessive alcohol use, physical inactivity, and eating an unhealthy diet simultaneously, many large community-based interventions have been implemented to reduce the burden of disease through the modification of multiple health behaviors. Smoking cessation can be particularly challenging as the odds of becoming dependent on nicotine increase with every unhealthy behavior a smoker exhibits. This paper presents a protocol for a rapid realist review which aims to identify factors associated with effectively changing tobacco use and target two or more additional unhealthy behaviors. An electronic literature search will be conducted using the following bibliographic databases: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, Social Science Abstracts, Social Work Abstracts, and Web of Science. Two reviewers will screen titles and abstracts for relevant research, and the selected full papers will be used to extract data and assess the quality of evidence. Throughout this process, the rapid realist approach proposed by Saul et al., 2013 will be used to refine our initial program theory and identify contextual factors and mechanisms that are associated with successful multiple health behavior change. This review will provide evidence-based research on the context and mechanisms that may drive the success or failure of interventions designed to support multiple health behavior change. This information will be used to guide curriculum and program development for a government funded project on improving smoking cessation by addressing multiple health behaviors in people in Canada. PROSPERO CRD42017064430.

Conceptualisation of knowledge construction in community service-learning programmes in nursing education.

PubMed

Mthembu, Sindi Z; Mtshali, Fikile G

2013-01-01

Practices in higher education have been criticised for not developing and preparing students for the expertise required in real environments. Literature reports that educational programmes tend to favour knowledge conformation rather than knowledge construction; however, community service learning (CSL) is a powerful pedagogical strategy that encourages students to make meaningful connections between the content in the classroom and real-life experiences as manifested by the communities. Through CSL, learning is achieved by the active construction of knowledge supported by multiple perspectives within meaningful real contexts, and the social interactions amongst students are seen to play a critical role in the processes of learning and cognition. This article reflects facilitators’ perspective of the knowledge construction process as used with students doing community service learning in basic nursing programmes. The aim of this article was to conceptualise the phenomenon of knowledge construction and thereby provide educators with a shared meaning and common understanding, and to analyse the interaction strategies utilised by nurse educators in the process of knowledge construction in community service-learning programmes in basic nursing education. A qualitative research approach based on a grounded theory research design was used in this article. Two nursing education institutions were purposively selected. Structured interviews were conducted with 16 participants. The results revealed that the knowledge construction in community service-learning programmes is conceptualised as having specific determinants, including the use of authentic health-related problems, academic coaching through scaffolding, academic discourse-dialogue, interactive learning in communities of learners, active learning, continuous reflection as well as collaborative and inquiry-based learning. Upon completion of an experience, students create and test generated knowledge in different contextual health settings. It was concluded that knowledge is constructed by students as a result of their interaction with the communities in their socio-cultural context and is mediated by their prior concrete experiences. The implication of this is that students construct knowledge that can be applied in their future work places.

Timing and technique impact the effectiveness of road-based, mobile acoustic surveys of bats.

PubMed

D'Acunto, Laura E; Pauli, Benjamin P; Moy, Mikko; Johnson, Kiara; Abu-Omar, Jasmine; Zollner, Patrick A

2018-03-01

Mobile acoustic surveys are a common method of surveying bat communities. However, there is a paucity of empirical studies exploring different methods for conducting mobile road surveys of bats. During 2013, we conducted acoustic mobile surveys on three routes in north-central Indiana, U.S.A., using (1) a standard road survey, (2) a road survey where the vehicle stopped for 1 min at every half mile of the survey route (called a "start-stop method"), and (3) a road survey with an individual using a bicycle. Linear mixed models with multiple comparison procedures revealed that when all bat passes were analyzed, using a bike to conduct mobile surveys detected significantly more bat passes per unit time compared to other methods. However, incorporating genus-level comparisons revealed no advantage to using a bike over vehicle-based methods. We also found that survey method had a significant effect when analyses were limited to those bat passes that could be identified to genus, with the start-stop method generally detecting more identifiable passes than the standard protocol or bike survey. Additionally, we found that significantly more identifiable bat passes (particularly those of the Eptesicus and Lasiurus genera) were detected in surveys conducted immediately following sunset. As governing agencies, particularly in North America, implement vehicle-based bat monitoring programs, it is important for researchers to understand how variations on protocols influence the inference that can be gained from different monitoring schemes.

Healthful Eating and Physical Activity in the Home Environment: Results from Multifamily Focus Groups

ERIC Educational Resources Information Center

Berge, Jerica M.; Arikian, Aimee; Doherty, William J.; Neumark-Sztainer, Dianne

2012-01-01

Objective: To explore multiple family members' perceptions of risk and protective factors for healthful eating and physical activity in the home. Design: Ten multifamily focus groups were conducted with 26 families. Setting and Participants: Community setting with primarily black and white families. Family members (n = 103) were aged 8 to 61…

Organizational Politics of Parental Engagement: The Intersections of School Reform, Anti-Immigration Policies, and Latinx Parent Organizing

ERIC Educational Resources Information Center

Scribner, Samantha M. Paredes; Fernández, Erica

2017-01-01

This article presents results from community-engaged research conducted with Latinx immigrant parents advocating for their students and themselves in and around an urban school engaged in multiple reforms, in a context affected by anti-immigrant policies and sentiments. The authors analyzed the intersection of organizing narratives related to…

The Unique Effects of Parental Alcohol and Affective Disorders, Parenting, and Parental Negative Affect on Adolescent Maladjustment

ERIC Educational Resources Information Center

Haller, Moira; Chassin, Laurie

2011-01-01

Using a high-risk community sample, multiple regression analyses were conducted separately for mothers (n = 416) and fathers (n = 346) to test the unique, prospective influence of parental negative affect on adolescent maladjustment (internalizing symptoms, externalizing symptoms, and negative emotionality) 2 years later over and above parental…

Essential Resources for Implementation and Sustainability of Evidence-Based Health Promotion Programs: A Mixed Methods Multi-Site Case Study.

PubMed

Dattalo, M; Wise, M; Ford Ii, J H; Abramson, B; Mahoney, J

2017-04-01

As of October 2016, use of federal Older Americans Act funds for health promotion and disease prevention will be restricted to the Administration on Aging's criteria for high-level evidence-based health promotion programs. Dissemination of these programs to rural communities remains limited. Therefore a strong need exists to identify strategies that facilitate program implementation and sustainability. The objective of this study was to compare organizational readiness and implementation strategies used by rural communities that achieved varying levels of success in sustaining evidence-based health promotion programs for older adults. We utilized a qualitative multi-site case study design to analyze the longitudinal experiences of eight rural sites working to implement evidence-based health promotion program over 3 years (8/2012-7/2015). Multiple sources of data (interviews, documents, reports, surveys) from each site informed the analysis. We used conventional content analysis to conduct a cross-case comparison to identify common features of rural counties that successfully implemented and sustained their target evidence-based health promotion program. Readiness to implement evidence-based programs as low at baseline as all site leaders described needing to secure additional resources for program implementation. Sites that successfully utilized six essential resources implemented and sustained greater numbers of workshops: (1) External Partnerships, (2) Agency Leadership Commitment, (3) Ongoing Source of Workshop Leaders, (4) Health Promotion Coordination Tasks Assigned to Specific Staff, (5) Organizational Stability, and (6) Change Team Engagement. The six essential resources described in this study can help rural communities assess their readiness to implement health promotion programs and work secure the resources necessary for successful implementation.

The Impact of Community Violence on School-Based Research.

PubMed

Velsor-Friedrich, Barbara; Richards, Maryse; Militello, Lisa K; Dean, Kyle C; Scott, Darrick; Gross, Israel M; Romeo, Edna

2015-12-01

Research conducted on youth exposure to violence has generally focused on documenting the prevalence of community violence and its emotional and behavioral implications. However, there is a dearth of information related to the impact of violence on the implementation and evaluation of community and school-based programs. This commentary examines the impact of community violence on a school-based research program. It is also a brief summary of the detrimental effects of exposure to community violence on psychological and academic functioning and health outcomes. An example of the impact of community violence on the implementation of a school-based asthma program will be addressed. Implications for school nurses will be discussed. © The Author(s) 2015.

An Overview of Measurement Method Tools Available to Communities for Conducting Exposure and Cumulative Risk Assessments

EPA Science Inventory

Community-based programs for assessing and mitigating nvironmental risks represent a challenge to participants because each brings a different level of understanding of the issues affecting the community. These programs often require the collaboration of several community sectors...

What community resources do older community-dwelling adults use to manage their osteoarthritis? A formative examination

PubMed Central

Martin, Kathryn Remmes; Schoster, Britta; Woodard, Janice

2011-01-01

Community resources can influence health outcomes, yet little research has examined how older individuals use community resources for osteoarthritis (OA) management. Six focus groups were conducted with 37 community-dwelling older adult African Americans and Caucasians who self-reported OA and resided in Johnston County, North Carolina. Descriptive analyses and qualitative constant comparison methodology revealed individuals use local recreational facilities, senior centers, shopping centers, religious organizations, medical providers, pharmacies and their social network for OA management. Participants also identified environmental characteristics (e.g., sidewalk conditions, curb-cuts, handicapped parking, automatic doors) that both facilitated and hindered use of community resources for OA management. Identified resources and environmental characteristics were organized around Corbin & Strauss framework tasks: medical/behavioral, role, and emotional management. As older Americans live with multiple chronic diseases, better understanding of what community resources are used for disease management may help improve the health of community-dwelling adults, both with and without OA. PMID:23049159

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana

PubMed Central

Challa, Sneha; Manu, Abubakar; Morhe, Emmanuel; Dalton, Vanessa K.; Loll, Dana; Dozier, Jessica; Zochowski, Melissa K.; Boakye, Andrew; Adanu, Richard; Hall, Kelli Stidham

2018-01-01

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15–24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women’s SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH. PMID:28296626

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana.

PubMed

Challa, Sneha; Manu, Abubakar; Morhe, Emmanuel; Dalton, Vanessa K; Loll, Dana; Dozier, Jessica; Zochowski, Melissa K; Boakye, Andrew; Adanu, Richard; Hall, Kelli Stidham

2018-04-01

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15-24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women's SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH.

Jail-to-community treatment continuum for adults with co-occurring substance use and mental disorders: study protocol for a pilot randomized controlled trial.

PubMed

Van Dorn, Richard A; Desmarais, Sarah L; Rade, Candalyn B; Burris, Elizabeth N; Cuddeback, Gary S; Johnson, Kiersten L; Tueller, Stephen J; Comfort, Megan L; Mueser, Kim T

2017-08-04

Adults with co-occurring mental and substance use disorders (CODs) are overrepresented in jails. In-custody barriers to treatment, including a lack of evidence-based treatment options and the often short periods of incarceration, and limited communication between jails and community-based treatment agencies that can hinder immediate enrollment into community care once released have contributed to a cycle of limited treatment engagement, unaddressed criminogenic risks, and (re)arrest among this vulnerable and high-risk population. This paper describes a study that will develop research and communication protocols and adapt two evidence-based treatments, dual-diagnosis motivational interviewing (DDMI) and integrated group therapy (IGT), for delivery to adults with CODs across a jail-to-community treatment continuum. Adaptations to DDMI and IGT were guided by the Risk-Need-Responsivity model and the National Institute of Corrections' implementation competencies; the development of the implementation framework and communication protocols were guided by the Evidence-Based Interagency Implementation Model for community corrections and the Inter-organizational Relationship model, respectively. Implementation and evaluation of the protocols and adapted interventions will occur via an open trial and a pilot randomized trial. The clinical intervention consists of two in-jail DDMI sessions and 12 in-community IGT sessions. Twelve adults with CODs and four clinicians will participate in the open trial to evaluate the acceptability and feasibility of, and fidelity to, the interventions and research and communication protocols. The pilot controlled trial will be conducted with 60 inmates who will be randomized to either DDMI-IGT or treatment as usual. A baseline assessment will be conducted in jail, and four community-based assessments will be conducted during a 6-month follow-up period. Implementation, clinical, public health, and treatment preference outcomes will be evaluated. Findings have the potential to improve both jail- and community-based treatment services for adults with CODs as well as inform methods for conducting rigorous pilot implementation and evaluation research in correctional settings and as inmates re-enter the community. Findings will contribute to a growing area of work focused on interrupting the cycle of limited treatment engagement, unaddressed criminogenic risks, and (re)arrest among adults with CODs. ClinicalTrials.gov, NCT02214667 . Registered on 10 August 2014.

The participatory vulnerability scoping diagram - deliberative risk ranking for community water systems

USGS Publications Warehouse

Howe, Peter D.; Yarnal, Brent; Coletti, Alex; Wood, Nathan J.

2013-01-01

Natural hazards and climate change present growing challenges to community water system (CWS) managers, who are increasingly turning to vulnerability assessments to identify, prioritize, and adapt to risks. Effectively assessing CWS vulnerability requires information and participation from various sources, one of which is stakeholders. In this article, we present a deliberative risk-ranking methodology, the participatory vulnerability scoping diagram (P-VSD), which allows rapid assessment and integration of multiple stakeholder perspectives of vulnerability. This technique is based on methods of deliberative risk evaluation and the vulnerability scoping diagram. The goal of the methodology is to engage CWS managers and stakeholders collectively to provide qualitative contextual risk rankings as a first step in a vulnerability assessment. We conduct an initial assessment using a case study of CWS in two U.S. counties, sites with broadly similar exposures but differences in population, land use, and other social sensitivity factors. Results demonstrate that CWS managers and stakeholders in the two case study communities all share the belief that their CWS are vulnerable to hazards but differ in how this vulnerability manifests itself in terms of the exposure, sensitivity, and adaptive capacity of the system.

Examining diffusion to understand the how of SASA!, a violence against women and HIV prevention intervention in Uganda.

PubMed

Starmann, Elizabeth; Heise, Lori; Kyegombe, Nambusi; Devries, Karen; Abramsky, Tanya; Michau, Lori; Musuya, Tina; Watts, Charlotte; Collumbien, Martine

2018-05-11

A growing number of complex public health interventions combine mass media with community-based "change agents" and/or mobilisation efforts acting at multiple levels. While impact evaluations are important, there is a paucity of research into the more nuanced roles intervention and social network factors may play in achieving intervention outcomes, making it difficult to understand how different aspects of the intervention worked (or did not). This study applied aspects of diffusion of innovations theory to explore how SASA!, a community mobilisation approach for preventing HIV and violence against women, diffused within intervention communities and the factors that influenced the uptake of new ideas and behaviours around intimate partner relationships and violence. This paper is based on a qualitative study of couples living in SASA communities and secondary analysis of endline quantitative data collected as part of a cluster randomised control trial designed to evaluate the impact of the SASA! The primary trial was conducted in eight communities in Kampala, Uganda between 2007 and 2012. The secondary analysis of follow up survey data used multivariate logistic regression to examine associations between intervention exposure and interpersonal communication, and relationship change (n = 928). The qualitative study used in-depth interviews (n = 20) and framework analysis methods to explore the intervention attributes that facilitated engagement with the intervention and uptake of new ideas and behaviours in intimate relationships. We found communication materials and mid media channels generated awareness and knowledge, while the concurrent influence from interpersonal communication with community-based change agents and social network members more frequently facilitated changes in behaviour. The results indicate combining community mobilisation components, programme content that reflects peoples' lives and direct support through local change agents can facilitate diffusion and powerful collective change processes in communities. This study makes clear the value of applying diffusion of innovations theory to illuminate how complex public health intervention evaluations effect change. It also contributes to our knowledge of partner violence prevention in a low-income, urban East African context. ClinicalTrials.gov # NCT00790959 . Registered 13th November 2008.

Baseline practices and user needs for Web dissemination of geotechnical data

USGS Publications Warehouse

Turner, L.L.; Brown, M.P.; Chambers, D.; Davis, C.A.; Diehl, J.; Hitchcock, C.S.; Holzer, T.L.; Nigbor, R.L.; Plumb, C.; Real, C.; Reimer, M.; Steidl, J.H.; Sun, J.I.; Tinsley, J.C.; Vaughn, D.; ,

2004-01-01

This paper presents the findings and recommendations of the User Scenario Work Group (USWG) in identifying a baseline of current practices within the geo-professional community and prioritizing desired functional requirements in the development of a comprehensive geotechnical information management system. This work was conducted as an initial phase of a larger project to demonstrate the effectiveness of a web based virtual data center for the dissemination of geotechnical data from multiple linked databases of various government and private sector organizations. An online survey was administered over the course of several months to practitioners across the nation. The results from the survey were compiled and examined to provide direction to the other project teams in the development of user-driven prototype data system.

An Institutional Perspective on Accountable Care Organizations.

PubMed

Goodrick, Elizabeth; Reay, Trish

2016-12-01

We employ aspects of institutional theory to explore how Accountable Care Organizations (ACOs) can effectively manage the multiplicity of ideas and pressures within which they are embedded and consequently better serve patients and their communities. More specifically, we draw on the concept of institutional logics to highlight the importance of understanding the conflicting principles upon which ACOs were founded. Based on previous research conducted both inside and outside health care settings, we argue that ACOs can combine attention to these principles (or institutional logics) in different ways; the options fall on a continuum from (a) segregating the effects of multiple logics from each other by compartmentalizing responses to multiple logics to (b) fully hybridizing the different logics. We suggest that the most productive path for ACOs is to situate their approach between the two extremes of "segregating" and "fully hybridizing." This strategic approach allows ACOs to develop effective responses that combine logics without fully integrating them. We identify three ways that ACOs can embrace institutional complexity short of fully hybridizing disparate logics: (1) reinterpreting practices to make them compatible with other logics; (2) engaging in strategies that take advantage of existing synergy between conflicting logics; (3) creating opportunities for people at frontline to develop innovative ways of working that combine multiple logics. © The Author(s) 2016.

Evidence-Based Implementation: The Role of Sustained Community-Based Practice and Research Partnerships

PubMed Central

Kilbourne, Amy M.; Neumann, Mary Spink; Waxmonsky, Jeanette; Bauer, Mark S.; Kim, Hyungin Myra; Pincus, Harold Alan; Thomas, Marshall

2017-01-01

This column describes a process for adapting an evidence-based practice in community clinics in which researchers and community providers participated and the resulting framework for implementation of the practice—Replicating Effective Programs–Facilitation. A two-day meeting for the Recovery-Oriented Collaborative Care study was conducted to elicit input from more than 50 stakeholders, including community providers, health care administrators, and implementation researchers. The process illustrates an effective researcher-community partnership in which stakeholders worked together not only to adapt the evidence-based practice to the needs of the clinical settings but also to develop the implementation strategy. PMID:22388527

Effects of multiple but low pesticide loads on aquatic fungal communities colonizing leaf litter.

PubMed

Talk, Anne; Kublik, Susanne; Uksa, Marie; Engel, Marion; Berghahn, Rüdiger; Welzl, Gerhard; Schloter, Michael; Mohr, Silvia

2016-08-01

In the first tier risk assessment (RA) of pesticides, risk for aquatic communities is estimated by using results from standard laboratory tests with algae, daphnids and fish for single pesticides such as herbicides, fungicides, and insecticides. However, fungi as key organisms for nutrient cycling in ecosystems as well as multiple pesticide applications are not considered in the RA. In this study, the effects of multiple low pesticide pulses using regulatory acceptable concentrations (RACs) on the dynamics of non-target aquatic fungi were investigated in a study using pond mesocosm. For that, fungi colonizing black alder (Alnus glutinosa) leaves were exposed to multiple, low pulses of 11 different pesticides over a period of 60days using a real farmer's pesticide application protocol for apple cropping. Four pond mesocosms served as treatments and 4 as controls. The composition of fungal communities colonizing the litter material was analyzed using a molecular fingerprinting approach based on the terminal Restriction Fragment Length Polymorphism (t-RFLP) of the fungal Internal Transcribed Spacer (ITS) region of the ribonucleic acid (RNA) gene(s). Our data indicated a clear fluctuation of fungal communities based on the degree of leaf litter degradation. However significant effects of the applied spraying sequence were not observed. Consequently also degradation rates of the litter material were not affected by the treatments. Our results indicate that the nutrient rich environment of the leaf litter material gave fungal communities the possibility to express genes that induce tolerance against the applied pesticides. Thus our data may not be transferred to other fresh water habitats with lower nutrient availability. Copyright © 2016. Published by Elsevier B.V.

AccrualNet: Addressing Low Accrual Via a Knowledge-Based, Community of Practice Platform

PubMed Central

Massett, Holly A.; Parreco, Linda K.; Padberg, Rose Mary; Richmond, Ellen S.; Rienzo, Marie E.; Leonard, Colleen E. Ryan; Quesenbery, Whitney; Killiam, H. William; Johnson, Lenora E.; Dilts, David M.

2011-01-01

Purpose: Present the design and initial evaluation of a unique, Web-enabled platform for the development of a community of practice around issues of oncology clinical trial accrual. Methods: The National Cancer Institute (NCI) conducted research with oncology professionals to identify unmet clinical trial accrual needs in the field. In response, a comprehensive platform for accrual resources, AccrualNet, was created by using an agile development process, storyboarding, and user testing. Literature and resource searches identified relevant content to populate the site. Descriptive statistics were tracked for resource and site usage. Use cases were defined to support implementation. Results: AccrualNet has five levels: (1) clinical trial macrostages (prestudy, active study, and poststudy); (2) substages (developing a protocol, selecting a trial, preparing to open, enrolling patients, managing the trial, retaining participants, and lessons learned); (3) strategies for each substage; (4) multiple activities for each strategy; and (5) multiple resources for each activity. Since its launch, AccrualNet has had more than 45,000 page views, with the Tools & Resources, Conversations, and Training sections being the most viewed. Total resources have increased 69%, to 496 items. Analysis of articles in the site reveals that 22% are from two journals and 46% of the journals supplied a single article. To date, there are 29 conversations with 43 posts. Four use cases are discussed. Conclusion: AccrualNet represents a unique, centralized comprehensive-solution platform to systematically capture accrual knowledge for all stages of a clinical trial. It is designed to foster a community of practice by encouraging users to share additional strategies, resources, and ideas. PMID:22379429

AccrualNet: Addressing Low Accrual Via a Knowledge-Based, Community of Practice Platform.

PubMed

Massett, Holly A; Parreco, Linda K; Padberg, Rose Mary; Richmond, Ellen S; Rienzo, Marie E; Leonard, Colleen E Ryan; Quesenbery, Whitney; Killiam, H William; Johnson, Lenora E; Dilts, David M

2011-11-01

Present the design and initial evaluation of a unique, Web-enabled platform for the development of a community of practice around issues of oncology clinical trial accrual. The National Cancer Institute (NCI) conducted research with oncology professionals to identify unmet clinical trial accrual needs in the field. In response, a comprehensive platform for accrual resources, AccrualNet, was created by using an agile development process, storyboarding, and user testing. Literature and resource searches identified relevant content to populate the site. Descriptive statistics were tracked for resource and site usage. Use cases were defined to support implementation. ACCRUALNET HAS FIVE LEVELS: (1) clinical trial macrostages (prestudy, active study, and poststudy); (2) substages (developing a protocol, selecting a trial, preparing to open, enrolling patients, managing the trial, retaining participants, and lessons learned); (3) strategies for each substage; (4) multiple activities for each strategy; and (5) multiple resources for each activity. Since its launch, AccrualNet has had more than 45,000 page views, with the Tools & Resources, Conversations, and Training sections being the most viewed. Total resources have increased 69%, to 496 items. Analysis of articles in the site reveals that 22% are from two journals and 46% of the journals supplied a single article. To date, there are 29 conversations with 43 posts. Four use cases are discussed. AccrualNet represents a unique, centralized comprehensive-solution platform to systematically capture accrual knowledge for all stages of a clinical trial. It is designed to foster a community of practice by encouraging users to share additional strategies, resources, and ideas.

Negotiating Contexts to Construct an Identity as a Mathematics Teacher

ERIC Educational Resources Information Center

Hodges, Thomas E.; Cady, Jo Ann

2012-01-01

The authors focused on 1 middle-grades mathematics teacher's identity and her efforts to implement standards-based instructional practices. As professionals, teachers participate in multiple professional communities and must negotiate and manage conflicting agendas. The authors analyze how the contexts of these communities influence the teacher's…

The Business Case for Provider Participation in Clinical Trials Research: An Application to the National Cancer Institute's Community Clinical Oncology Program

PubMed Central

Song, Paula H.; Reiter, Kristin L.; Weiner, Bryan J.; Minasian, Lori; McAlearney, Ann Scheck

2012-01-01

Background Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions. Purpose This study explores whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case. Methodology/Approach We use a multiple case study methodology approach to examine the National Cancer Institute's Community Clinical Oncology Program, a longstanding federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semi-structured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data. Findings We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis, and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue. Practice Implications As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally-funded PBRNs outside of oncology or to providers considering participation in any clinical trials research. PMID:23044836

Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review

PubMed Central

Kok, Maryse C; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline EW; Kane, Sumit S; Ormel, Hermen; Tijm, Mandy M; de Koning, Korrie AM

2015-01-01

Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors influence CHW performance. A systematic review was conducted to identify intervention design related factors influencing performance of CHWs. We systematically searched six databases for quantitative and qualitative studies that included CHWs working in promotional, preventive or curative primary health services in LMICs. One hundred and forty studies met the inclusion criteria, were quality assessed and double read to extract data relevant to the design of CHW programmes. A preliminary framework containing factors influencing CHW performance and characteristics of CHW performance (such as motivation and competencies) guided the literature search and review. A mix of financial and non-financial incentives, predictable for the CHWs, was found to be an effective strategy to enhance performance, especially of those CHWs with multiple tasks. Performance-based financial incentives sometimes resulted in neglect of unpaid tasks. Intervention designs which involved frequent supervision and continuous training led to better CHW performance in certain settings. Supervision and training were often mentioned as facilitating factors, but few studies tested which approach worked best or how these were best implemented. Embedment of CHWs in community and health systems was found to diminish workload and increase CHW credibility. Clearly defined CHW roles and introduction of clear processes for communication among different levels of the health system could strengthen CHW performance. When designing community-based health programmes, factors that increased CHW performance in comparable settings should be taken into account. Additional intervention research to develop a better evidence base for the most effective training and supervision mechanisms and qualitative research to inform policymakers in development of CHW interventions are needed. PMID:25500559

Enhanced Learning through Electronic Communities: A Research Review.

ERIC Educational Resources Information Center

Burgstahler, Sheryl; Swift, Catherine

This report, in support of the project "Enhanced Learning through Electronic Communities," investigated successful practices of electronic communities. A literature review was conducted and a survey was sent to 15 system operators of networks that had a community-based focus with ancillary educational components and networks that focused primarily…

Government bodies and their influence on the 2009 H1N1 health sector pandemic response in remote and isolated First Nation communities of sub-Arctic Ontario, Canada.

PubMed

Charania, N A; Tsuji, L J S

2011-01-01

First Nation communities were highly impacted by the 2009 H1N1 influenza pandemic. Multiple government bodies (ie federal, provincial, and First Nations) in Canada share responsibility for the health sector pandemic response in remote and isolated First Nation communities and this may have resulted in a fragmented pandemic response. This study aimed to discover if and how the dichotomy (or trichotomy) of involved government bodies led to barriers faced and opportunities for improvement during the health sector response to the 2009 H1N1 pandemic in three remote and isolated sub-arctic First Nation communities of northern Ontario, Canada. A qualitative community-based participatory approach was employed. Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the two (or three) government bodies of each study community. Data were manually transcribed and coded using deductive and inductive thematic analysis to reveal positive aspects, barriers faced, and opportunities for improvement along with the similarities and differences regarding the pandemic responses of each government body. Primary barriers faced by participants included receiving contradicting governmental guidelines and direction from many sources. In addition, there was a lack of human resources, information sharing, and specific details included in community-level pandemic plans. Recommended areas of improvement include developing a complementary communication plan, increasing human resources, and updating community-level pandemic plans. Participants reported many issues that may be attributable to the dichotomy (or trichotomy) of government bodies responsible for healthcare delivery during a pandemic. Increasing formal communication and collaboration between responsible government bodies will assist in clarifying roles and responsibilities and improve the pandemic response in Canada's remote and isolated First Nation communities.

Collaboration Strategies in Nontraditional Community-Based Participatory Research Partnerships: Lessons From an Academic–Community Partnership With Autistic Self-Advocates

PubMed Central

Nicolaidis, Christina; Raymaker, Dora; McDonald, Katherine; Dern, Sebastian; Ashkenazy, Elesia; Boisclair, Cody; Robertson, Scott; Baggs, Amanda

2012-01-01

Background Most community-based participatory research (CBPR) projects involve local communities defined by race, ethnicity, geography, or occupation. Autistic self-advocates, a geographically dispersed community defined by disability, experience issues in research similar to those expressed by more traditional minorities. Objectives We sought to build an academic–community partnership that uses CBPR to improve the lives of people on the autistic spectrum. Methods The Academic Autistic Spectrum Partnership in Research and Education (AASPIRE) includes representatives from academic, self-advocate, family, and professional communities. We are currently conducting several studies about the health care experiences and well-being of autistic adults. Lessons Learned We have learned a number of strategies that integrate technology and process to successfully equalize power and accommodate diverse communication and collaboration needs. Conclusions CBPR can be conducted successfully with autistic self-advocates. Our strategies may be useful to other CBPR partnerships, especially ones that cannot meet in person or that include people with diverse communication needs. PMID:21623016

Links between real and virtual networks: a comparative study of online communities in Japan and Korea.

PubMed

Ishii, Kenichi; Ogasahara, Morihiro

2007-04-01

The present study explores how online communities affect real-world personal relations based on a cross-cultural survey conducted in Japan and Korea. Findings indicate that the gratifications of online communities moderate the effects of online communities on social participation. Online communities are categorized into a real-group-based community and a virtual-network-based community. The membership of real-group-based online community is positively correlated with social bonding gratification and negatively correlated with information- seeking gratification. Japanese users prefer more virtual-network-based online communities, while their Korean counterparts prefer real-group-based online communities. Korean users are more active in online communities and seek a higher level of socializing gratifications, such as social bonding and making new friends, when compared with their Japanese counterparts. These results indicate that in Korea, personal relations via the online community are closely associated with the real-world personal relations, but this is not the case in Japan. This study suggests that the effects of the Internet are culture-specific and that the online community can serve a different function in different cultural environments.

Sensory-based niche partitioning in a multiple predator - multiple prey community.

PubMed

Falk, Jay J; ter Hofstede, Hannah M; Jones, Patricia L; Dixon, Marjorie M; Faure, Paul A; Kalko, Elisabeth K V; Page, Rachel A

2015-06-07

Many predators and parasites eavesdrop on the communication signals of their prey. Eavesdropping is typically studied as dyadic predator-prey species interactions; yet in nature, most predators target multiple prey species and most prey must evade multiple predator species. The impact of predator communities on prey signal evolution is not well understood. Predators could converge in their preferences for conspicuous signal properties, generating competition among predators and natural selection on particular prey signal features. Alternatively, predator species could vary in their preferences for prey signal properties, resulting in sensory-based niche partitioning of prey resources. In the Neotropics, many substrate-gleaning bats use the mate-attraction songs of male katydids to locate them as prey. We studied mechanisms of niche partitioning in four substrate-gleaning bat species and found they are similar in morphology, echolocation signal design and prey-handling ability, but each species preferred different acoustic features of male song in 12 sympatric katydid species. This divergence in predator preference probably contributes to the coexistence of many substrate-gleaning bat species in the Neotropics, and the substantial diversity in the mate-attraction signals of katydids. Our results provide insight into how multiple eavesdropping predator species might influence prey signal evolution through sensory-based niche partitioning. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Community Consultation and Public Disclosure: Preliminary Results From A New Model

PubMed Central

Ramsey, Cornelia A.; Quearry, Bonnie; Ripley, Elizabeth

2011-01-01

Emergency medicine research conducted under the exception from informed consent (EFIC) regulation enables critical scientific advancements. When EFIC is proposed, there is a requirement for broad community consultation and public disclosure regarding the risks and benefits of the study. At the present time, no clear guidelines or standards exist for conducting and evaluating the community consultation and public disclosure. This preliminary study tested the feasibility and acceptability of a new approach to community consultation and public disclosure for a large-scale EFIC trial by engaging community members in designing and conducting the strategies. The authors enrolled key community members (called Community Advocates for Research, or CARs) to use community-based participatory methods to design and implement community consultation and public disclosure. By partnering with community members who represent target populations for the research study, this new approach has demonstrated a feasible community consultation and public disclosure plan with greater community participation and less cost than previous studies. In a community survey, the percentage of community members reporting having heard about the EFIC trial more than doubled after employing the new approach. This article discusses initial implementation and results. PMID:21729187

Attitudes and Lifestyle Changes Following Jog Your Mind: Results from a Multi-Factorial Community-Based Program Promoting Cognitive Vitality among Seniors

ERIC Educational Resources Information Center

Laforest, Sophie; Lorthios-Guilledroit, Agathe; Nour, Kareen; Parisien, Manon; Fournier, Michel; Ellemberg, Dave; Guay, Danielle; Desgagnés-Cyr, Charles-Émile; Bier, Nathalie

2017-01-01

This study examined the effects on attitudes and lifestyle behavior of "Jog your Mind," a multi-factorial community-based program promoting cognitive vitality among seniors with no known cognitive impairment. A quasi-experimental study was conducted. Twenty-three community organizations were assigned either to the experimental group…

Multiple and mixed methods in formative evaluation: Is more better? Reflections from a South African study.

PubMed

Odendaal, Willem; Atkins, Salla; Lewin, Simon

2016-12-15

Formative programme evaluations assess intervention implementation processes, and are seen widely as a way of unlocking the 'black box' of any programme in order to explore and understand why a programme functions as it does. However, few critical assessments of the methods used in such evaluations are available, and there are especially few that reflect on how well the evaluation achieved its objectives. This paper describes a formative evaluation of a community-based lay health worker programme for TB and HIV/AIDS clients across three low-income communities in South Africa. It assesses each of the methods used in relation to the evaluation objectives, and offers suggestions on ways of optimising the use of multiple, mixed-methods within formative evaluations of complex health system interventions. The evaluation's qualitative methods comprised interviews, focus groups, observations and diary keeping. Quantitative methods included a time-and-motion study of the lay health workers' scope of practice and a client survey. The authors conceptualised and conducted the evaluation, and through iterative discussions, assessed the methods used and their results. Overall, the evaluation highlighted programme issues and insights beyond the reach of traditional single methods evaluations. The strengths of the multiple, mixed-methods in this evaluation included a detailed description and nuanced understanding of the programme and its implementation, and triangulation of the perspectives and experiences of clients, lay health workers, and programme managers. However, the use of multiple methods needs to be carefully planned and implemented as this approach can overstretch the logistic and analytic resources of an evaluation. For complex interventions, formative evaluation designs including multiple qualitative and quantitative methods hold distinct advantages over single method evaluations. However, their value is not in the number of methods used, but in how each method matches the evaluation questions and the scientific integrity with which the methods are selected and implemented.

The Training and Field Work Experiences of Community Health Workers conducting non-invasive, population-based screening for Cardiovascular Disease in Four Communities in Low and Middle-Income Settings

PubMed Central

Denman, Catalina A.; Montano, Carlos Mendoza; Gaziano, Thomas A.; Levitt, Naomi; Rivera-Andrade, Alvaro; Carrasco, Diana Munguía; Zulu, Jabu; Khanam, Masuma Akter; Puoane, Thandi

2015-01-01

Background Cardiovascular disease (CVD) is on the rise in low- and middle-income countries (LMIC) and is proving difficult to combat due to the emphasis on improving outcomes in maternal and child health and infectious diseases, against a backdrop of severe human resource and infrastructure constraints. Effective task-sharing from physicians or nurses to community health workers (CHWs) to conduct population-based screening for persons at risk, has the potential to mitigate the impact of CVD on vulnerable populations. CHWs in Bangladesh, Guatemala, Mexico, and South Africa were trained to conduct non-invasive population-based screening for persons at high risk for CVD. Objective (s) The objectives of this study were to quantitatively assess the performance of CHWs during training and to qualitatively capture their training and fieldwork experiences while conducting non-invasive screening for cardiovascular disease (CVD) risk in their communities. Methods Written tests were used to assess CHWs’ acquisition of content knowledge during training, and focus group discussions conducted to capture their training and fieldwork experiences. Results Training was effective at increasing the CHWs’ content knowledge of cardiovascular disease (CVD) and this knowledge was largely retained up to six months after the completion of field work. Common themes which need to be addressed when designing task sharing with CHWs in chronic diseases are identified, including language, respect, and compensation. The importance of having intimate knowledge of the community receiving services from design to implementation is underscored. Conclusions Effective training for screening for CVD in community settings should have a strong didactic core that is supplemented with culture-specific adaptations in the delivery of instruction. The incorporation of expert and intimate knowledge of the communities themselves is critical, from the design to implementation phases of training. Challenges such as role definition, defining career paths, and providing adequate remuneration, must be addressed. PMID:25754566

An Evaluation of Health Impact Assessments in the United States, 2011–2014

PubMed Central

Charbonneau, Diana; Cahill, Carol; Dannenberg, Andrew L.

2015-01-01

Introduction The Center for Community Health and Evaluation conducted a 3-year evaluation to assess results of health impact assessments (HIAs) in the United States and to identify elements critical for their success. Methods The study used a retrospective, mixed-methods comparative case study design, including a literature review; site visits; interviews with investigators, stakeholders, and decision makers for 23 HIAs in 16 states that were completed from 2005 through 2013; and a Web-based survey of 144 HIA practitioners. Results Analysis of interviews with decision makers suggests HIAs can directly influence decisions in nonhealth-related sectors. HIAs may also influence changes beyond the decision target, build consensus and relationships among decision makers and their constituents, and give community members a stronger voice in decisions that affect them. Factors that may increase HIA success include care in choosing a project or policy to be examined’ selecting an appropriate team to conduct the HIA; engaging stakeholders and decision makers throughout the process; crafting clear, actionable recommendations; delivering timely, compelling messages to appropriate audiences; and using multiple dissemination methods. Challenges to successful HIAs include underestimating the level of effort required, political changes during the conduct of the HIA, accessing relevant local data, engaging vulnerable populations, and following up on recommendations. Conclusion Results of this study suggest HIAs are a useful tool to promote public health because they can influence decisions in nonhealth-related sectors, strengthen cross-sector collaborations, and raise awareness of health issues among decision makers. PMID:25695261

Interactive effects of multiple climate change factors on ammonia oxidizers and denitrifiers in a temperate steppe.

PubMed

Zhang, Cui-Jing; Shen, Ju-Pei; Sun, Yi-Fei; Wang, Jun-Tao; Zhang, Li-Mei; Yang, Zhong-Ling; Han, Hong-Yan; Wan, Shi-Qiang; He, Ji-Zheng

2017-04-01

Global climate change could have profound effects on belowground microbial communities and subsequently affect soil biogeochemical processes. The interactive effects of multiple co-occurring climate change factors on microbially mediated processes are not well understood. A four-factorial field experiment with elevated CO2, watering, nitrogen (N) addition and night warming was conducted in a temperate steppe of northern China. Real-time polymerase chain reaction and terminal-restriction fragment length polymorphism, combined with clone library techniques, were applied to examine the effects of those climate change factors on N-related microbial abundance and community composition. Only the abundance of ammonia-oxidizing bacteria significantly increased by nitrogen addition and decreased by watering. The interactions of watering × warming on the bacterial amoA community and warming × nitrogen addition on the nosZ community were found. Redundancy analysis indicated that the ammonia-oxidizing archaeal community was affected by total N and total carbon, while the community of bacterial amoA and nosZ were significantly affected by soil pH. According to a structural equation modeling analysis, climate change influenced net primary production indirectly by altering microbial abundance and activities. These results indicated that microbial responses to the combination of chronic global change tend to be smaller than expected from single-factor global change manipulations. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Community Schools: a Public Health Opportunity to Reverse Urban Cycles of Disadvantage.

PubMed

Diamond, Catherine; Freudenberg, Nicholas

2016-12-01

Community schools link students, families, and communities to educate children and strengthen neighborhoods. They have become a popular model for education in many US cities in part because they build on community assets and address multiple determinants of educational disadvantage. Since community schools seek to have an impact on populations, not just the children enrolled, they provide an opportunity to improve community health. Community schools influence the health and education of neighborhood residents though three pathways: building trust, establishing norms, and linking people to networks and services. Through such services as school-based health centers, nutrition education, family mental health counseling, violence prevention, and sexuality education, these schools build on the multiple reciprocal relationships between health and education. By developing closer ties between community schools and neighborhood health programs, public health professionals can help to mobilize a powerful new resource for reducing the health and educational inequalities that now characterize US cities. We suggest an agenda for research, practice, and policy that can build the evidence needed to guide such a strategy.

A Rural Community's Involvement in the Design and Usability Testing of a Computer-Based Informed Consent Process for the Personalized Medicine Research Project

PubMed Central

Mahnke, Andrea N; Plasek, Joseph M; Hoffman, David G; Partridge, Nathan S; Foth, Wendy S; Waudby, Carol J; Rasmussen, Luke V; McManus, Valerie D; McCarty, Catherine A

2014-01-01

Many informed consent studies demonstrate that research subjects poorly retain and understand information in written consent documents. Previous research in multimedia consent is mixed in terms of success for improving participants’ understanding, satisfaction, and retention. This failure may be due to a lack of a community-centered design approach to building the interventions. The goal of this study was to gather information from the community to determine the best way to undertake the consent process. Community perceptions regarding different computer-based consenting approaches were evaluated, and a computer-based consent was developed and tested. A second goal was to evaluate whether participants make truly informed decisions to participate in research. Simulations of an informed consent process were videotaped to document the process. Focus groups were conducted to determine community attitudes towards a computer-based informed consent process. Hybrid focus groups were conducted to determine the most acceptable hardware device. Usability testing was conducted on a computer-based consent prototype using a touch-screen kiosk. Based on feedback, a computer-based consent was developed. Representative study participants were able to easily complete the consent, and all were able to correctly answer the comprehension check questions. Community involvement in developing a computer-based consent proved valuable for a population-based genetic study. These findings may translate to other types of informed consents, such as genetic clinical trials consents. A computer-based consent may serve to better communicate consistent, clear, accurate, and complete information regarding the risks and benefits of study participation. Additional analysis is necessary to measure the level of comprehension of the check-question answers by larger numbers of participants. The next step will involve contacting participants to measure whether understanding of what they consented to is retained over time. PMID:24273095

A rural community's involvement in the design and usability testing of a computer-based informed consent process for the Personalized Medicine Research Project.

PubMed

Mahnke, Andrea N; Plasek, Joseph M; Hoffman, David G; Partridge, Nathan S; Foth, Wendy S; Waudby, Carol J; Rasmussen, Luke V; McManus, Valerie D; McCarty, Catherine A

2014-01-01

Many informed consent studies demonstrate that research subjects poorly retain and understand information in written consent documents. Previous research in multimedia consent is mixed in terms of success for improving participants' understanding, satisfaction, and retention. This failure may be due to a lack of a community-centered design approach to building the interventions. The goal of this study was to gather information from the community to determine the best way to undertake the consent process. Community perceptions regarding different computer-based consenting approaches were evaluated, and a computer-based consent was developed and tested. A second goal was to evaluate whether participants make truly informed decisions to participate in research. Simulations of an informed consent process were videotaped to document the process. Focus groups were conducted to determine community attitudes towards a computer-based informed consent process. Hybrid focus groups were conducted to determine the most acceptable hardware device. Usability testing was conducted on a computer-based consent prototype using a touch-screen kiosk. Based on feedback, a computer-based consent was developed. Representative study participants were able to easily complete the consent, and all were able to correctly answer the comprehension check questions. Community involvement in developing a computer-based consent proved valuable for a population-based genetic study. These findings may translate to other types of informed consents, including those for trials involving treatment of genetic disorders. A computer-based consent may serve to better communicate consistent, clear, accurate, and complete information regarding the risks and benefits of study participation. Additional analysis is necessary to measure the level of comprehension of the check-question answers by larger numbers of participants. The next step will involve contacting participants to measure whether understanding of what they consented to is retained over time. © 2013 Wiley Periodicals, Inc.

Profiling Nematode Communities in Unmanaged Flowerbed and Agricultural Field Soils in Japan by DNA Barcode Sequencing

PubMed Central

Morise, Hisashi; Miyazaki, Erika; Yoshimitsu, Shoko; Eki, Toshihiko

2012-01-01

Soil nematodes play crucial roles in the soil food web and are a suitable indicator for assessing soil environments and ecosystems. Previous nematode community analyses based on nematode morphology classification have been shown to be useful for assessing various soil environments. Here we have conducted DNA barcode analysis for soil nematode community analyses in Japanese soils. We isolated nematodes from two different environmental soils of an unmanaged flowerbed and an agricultural field using the improved flotation-sieving method. Small subunit (SSU) rDNA fragments were directly amplified from each of 68 (flowerbed samples) and 48 (field samples) isolated nematodes to determine the nucleotide sequence. Sixteen and thirteen operational taxonomic units (OTUs) were obtained by multiple sequence alignment from the flowerbed and agricultural field nematodes, respectively. All 29 SSU rDNA-derived OTUs (rOTUs) were further mapped onto a phylogenetic tree with 107 known nematode species. Interestingly, the two nematode communities examined were clearly distinct from each other in terms of trophic groups: Animal predators and plant feeders were markedly abundant in the flowerbed soils, in contrast, bacterial feeders were dominantly observed in the agricultural field soils. The data from the flowerbed nematodes suggests a possible food web among two different trophic nematode groups and plants (weeds) in the closed soil environment. Finally, DNA sequences derived from the mitochondrial cytochrome oxidase c subunit 1 (COI) gene were determined as a DNA barcode from 43 agricultural field soil nematodes. These nematodes were assigned to 13 rDNA-derived OTUs, but in the COI gene analysis were assigned to 23 COI gene-derived OTUs (cOTUs), indicating that COI gene-based barcoding may provide higher taxonomic resolution than conventional SSU rDNA-barcoding in soil nematode community analysis. PMID:23284767

Preparing new nurse graduates for practice in multiple settings: a community-based academic-practice partnership model.

PubMed

West, Nikki; Berman, Audrey; Karshmer, Judith; Prion, Susan; Van, Paulina; Wallace, Jonalyn

2014-06-01

Responding to local and national concerns about the nursing workforce, the California Institute for Nursing and Health Care worked with private and public funders and community health care partners to establish community-based transition-to-practice programs for new RN graduates unable to secure nursing positions in the San Francisco Bay Area. The goals were to retain new RN graduates in nursing and further develop their skills and competencies to increase their employability. Leaders from academic and inpatient, ambulatory, and community-based practice settings, as well as additional community partners, collaboratively provided four 12- to 16-week pilot transition programs in 2010-2011. A total of 345 unemployed new nurse graduates enrolled. Eighty-four percent of 188 respondents to a post-program survey were employed in inpatient and community settings 3 months after completion. Participants and clinical preceptors also reported increases in confidence and competence. Copyright 2014, SLACK Incorporated.

Community assessment techniques and the implications for rarefaction and extrapolation with Hill numbers.

PubMed

Cox, Kieran D; Black, Morgan J; Filip, Natalia; Miller, Matthew R; Mohns, Kayla; Mortimor, James; Freitas, Thaise R; Greiter Loerzer, Raquel; Gerwing, Travis G; Juanes, Francis; Dudas, Sarah E

2017-12-01

Diversity estimates play a key role in ecological assessments. Species richness and abundance are commonly used to generate complex diversity indices that are dependent on the quality of these estimates. As such, there is a long-standing interest in the development of monitoring techniques, their ability to adequately assess species diversity, and the implications for generated indices. To determine the ability of substratum community assessment methods to capture species diversity, we evaluated four methods: photo quadrat, point intercept, random subsampling, and full quadrat assessments. Species density, abundance, richness, Shannon diversity, and Simpson diversity were then calculated for each method. We then conducted a method validation at a subset of locations to serve as an indication for how well each method captured the totality of the diversity present. Density, richness, Shannon diversity, and Simpson diversity estimates varied between methods, despite assessments occurring at the same locations, with photo quadrats detecting the lowest estimates and full quadrat assessments the highest. Abundance estimates were consistent among methods. Sample-based rarefaction and extrapolation curves indicated that differences between Hill numbers (richness, Shannon diversity, and Simpson diversity) were significant in the majority of cases, and coverage-based rarefaction and extrapolation curves confirmed that these dissimilarities were due to differences between the methods, not the sample completeness. Method validation highlighted the inability of the tested methods to capture the totality of the diversity present, while further supporting the notion of extrapolating abundances. Our results highlight the need for consistency across research methods, the advantages of utilizing multiple diversity indices, and potential concerns and considerations when comparing data from multiple sources.

A combination of supplements may reduce the risk of Alzheimer's disease in elderly Japanese with normal cognition.

PubMed

Bun, Shogyoku; Ikejima, Chiaki; Kida, Jiro; Yoshimura, Atsuko; Lebowitz, Adam Jon; Kakuma, Tatsuyuki; Asada, Takashi

2015-01-01

A number of studies have examined the effect of a single supplement against Alzheimer's disease (AD) with conflicting results. Taking into account the complex and multifactorial nature of AD pathogenesis, multiple supplements may be more effective. Physical activity is another prospect against AD. An open-label intervention study was conducted to explore a potential protective effect of multiple supplements and physical activity. Their interaction was also examined. Participants were community-dwelling volunteers aged 65 or older as of May 2001 in a rural area of Japan. Among 918 cognitively normal participants included in the analyses, 171 took capsules daily for three years that contained n-3 polyunsaturated fatty acid, Ginkgo biloba leaf dry extracts, and lycopene. Two hundred and forty one participants joined the two-year exercise intervention that included a community center-based and a home-based exercise program. One-hundred and forty eight participated in both interventions. A standardized neuropsychological battery was administered at baseline in 2001, the first follow-up in 2004-2005, and the second in 2008-2009. The primary outcome was AD diagnosis at follow-ups. A complementary log-log model was used for survival analysis. A total of 76 participants were diagnosed with AD during follow-up periods. Higher adherence to supplementation intervention was associated with lower AD incidence in both unadjusted and adjusted models. Exercise intervention was also associated with lower AD incidence in the unadjusted model, but not in the adjusted model. We hypothesized that the combination of supplements acted in a complementary and synergistic fashion to bring significant effects against AD occurrence.

Association of urinary metal profiles with altered glucose levels and diabetes risk: a population-based study in China.

PubMed

Feng, Wei; Cui, Xiuqing; Liu, Bing; Liu, Chuanyao; Xiao, Yang; Lu, Wei; Guo, Huan; He, Meian; Zhang, Xiaomin; Yuan, Jing; Chen, Weihong; Wu, Tangchun

2015-01-01

Elevated heavy metals and fasting plasma glucose (FPG) levels were both associated with increased risk of cardiovascular diseases. However, studies on the associations of heavy metals and essential elements with altered FPG and diabetes risk were limited or conflicting. The objective of this study was to evaluate the potential associations of heavy metals and essential trace elements with FPG and diabetes risk among general Chinese population. We conducted a cross-sectional study to investigate the associations of urinary concentrations of 23 metals with FPG, impaired fasting glucose (IFG) and diabetes among 2242 community-based Chinese adults in Wuhan. We used the false discovery rate (FDR) method to correct for multiple hypothesis tests. After adjusting for potential confounders, urinary aluminum, titanium, cobalt, nickel, copper, zinc, selenium, rubidium, strontium, molybdenum, cadmium, antimony, barium, tungsten and lead were associated with altered FPG, IFG or diabetes risk (all P< 0.05); arsenic was only dose-dependently related to diabetes (P< 0.05). After additional adjustment for multiple testing, titanium, copper, zinc, selenium, rubidium, tungsten and lead were still significantly associated with one or more outcomes (all FDR-adjusted P< 0.05). Our results suggest that multiple metals in urine are associated with FPG, IFG or diabetes risk. Because the cross-sectional design precludes inferences about causality, further prospective studies are warranted to validate our findings.

Grandparent caregiving among rural African Americans in a community in the American South: challenges to health and wellbeing.

PubMed

Clottey, Emmanuel N; Scott, Alison J; Alfonso, Moya L

2015-01-01

An increasing number of grandparents in rural USA are serving as primary caregivers for their grandchildren because of parental incarceration, addiction, joblessness, or illness. Low-income, African American women from the South are overrepresented in this growing population. There is a paucity of research exploring the challenges faced by rural grandparent caregivers, and past studies have not explicitly addressed the potential consequences of rural grandparent caregiving for health. The purpose of this qualitative study was to explore grandparent caregiving among rural, low-income, African American grandmothers in a community in the American South, and to identify challenges to health that arose in that context. McLeroy's social ecological model (SEM) was used to examine these challenges at multiple levels of influence. This qualitative interview-based study was conducted in a high-poverty community in rural Georgia. In-depth interviews were conducted with African American grandparent caregivers and key informants from local community-based organizations. A key informant assisted in identifying initial interview participants, and then snowball sampling was used to recruit additional participants. Interview questions were grouped under five domains (intrapersonal, interpersonal, community, organizational, and policy), according to the levels of the SEM. Iterative content analysis of interview transcripts was utilized. Transcripts were coded to identify text segments related to each domain of the SEM, which were grouped together for analysis by domain. Reflexive memo-writing aided in development of themes, and data quality was assessed using Lincoln and Guba's trustworthiness criteria. Rural African American grandparent caregivers faced a range of challenges to health. Direct physical challenges included chronic pain that interfered with sleep and daily functioning, mobility issues exacerbated by child care, and the pressure of managing their own medical conditions as well as their grandchildren's. Financial scarcity added to their vulnerability to poor health outcomes, especially when caregivers would forego purchase of medications or visits to the doctor because of expenses related to their grandchildren. In addition, lack of child care made health appointments and hospitalizations logistically difficult. Emotional strain was common as grandparent caregivers struggled to protect their grandchildren in communities where rates of drug use, HIV, and incarceration were high. Caregivers worried about their mortality and the related consequences for their grandchildren. Chronic stress, which is linked to a number of poor health outcomes, was self-reported by most rural grandparent caregivers. In this study, the challenges of rural grandparent caregiving among African American women posed multiple threats to health and wellbeing. Further research is needed, in different rural contexts and with different caregiver populations, to more thoroughly examine the health risks of grandparent caregiving. In addition, the development of multi-faceted interventions and programs will be critical to meeting the needs of rural grandparent caregivers. A few models for such programs exist, although resource shortfalls have often limited their impact.

Conducting Research With Community Groups.

PubMed

Doornbos, Mary Molewyk; Ayoola, Adejoke; Topp, Robert; Zandee, Gail Landheer

2015-10-01

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. Although several barriers to conducting research with community groups exist, community-based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This article presents case studies that demonstrate how CBPR principles guided the development of (a) a healthy body weight program for urban, underserved African American women; (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women; and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research-intensive academic environments. © The Author(s) 2015.

Conducting Research with Community Groups

PubMed Central

Doornbos, Mary Molewyk; Ayoola, Adejoke; Topp, Robert; Zandee, Gail Landheer

2016-01-01

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. While several barriers to conducting research with community groups exist, community based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This manuscript presents case studies that demonstrate how CBPR principles guided the development of: (a) a healthy body weight program for urban, underserved African-American women, (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women, and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research intensive academic environments. PMID:25724557

A review of improved ethical practices in environmental and public health research: case examples from native communities.

PubMed

Quigley, Dianne

2006-04-01

This article presents a review of 14 case studies and articles of research ethics issues in the conduct of environmental and public health research with Native American and other indigenous populations. The purpose of this review is to highlight new practices in the ethical conduct of research with native community populations. The findings from this review can promote more dialogue and policy development on the issue of community protections in research. Formal guidelines exist in ethical codes for individual rights as human subjects, but there is a lack of development on community rights in the ethics of research. This review illustrates how community-based participatory research practices can provide working guidelines that can overcome past research harms. More important, the compilations of guidelines offer tested field methods for improving the ethical conduct of research with native community populations.

Effects of a Pedometer-Based Telephone Coaching Intervention on Physical Activity Among People with Cardiac Disease in Urban, Rural and Semi-Rural Settings: A Replication Study.

PubMed

Sangster, Janice; Furber, Susan; Phongsavan, Philayrath; Redfern, Julie; Mark, Andrew; Bauman, Adrian

2017-04-01

This study aimed to determine the replicability of a pedometer-based telephone coaching intervention by comparing the outcomes of a study conducted in rural and urban settings to a study that previously found the same intervention effective in a semi-rural setting. Replication studies are conducted to assess whether an efficacious intervention is effective in multiple different settings. This study compared the outcomes of a pedometer-based coaching intervention implemented in urban and rural settings (replication study) with the same intervention implemented in a semi-rural setting (reference study) on physical activity levels. Improvements in total weekly physical activity time in the replication study were significant from baseline to six weeks (p<0.001 urban, p=0.006 rural) and remained significant at six months (p=0.029 urban, p=0.005 rural). These increases were comparable to those achieved in the original efficacy trial conducted in a semi-rural setting. The pedometer-based telephone coaching intervention increases physical activity levels of people with cardiac disease referred to a CR program in diverse settings. This replication study indicates the suitability of this minimal contact, low-cost intervention for further scaling-up to address unmet need in community-dwelling cardiac patients. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

Community-Based Review of Research Across Diverse Community Contexts: Key Characteristics, Critical Issues, and Future Directions

PubMed Central

Ford, Angela; Wat, Eric; Brayboy, Missy; Isaacs, Mei-Ling; Park, Alice; Strelnick, Hal; Seifer, Sarena D.

2015-01-01

A growing number of community-based organizations and community–academic partnerships are implementing processes to determine whether and how health research is conducted in their communities. These community-based research review processes (CRPs) can provide individual and community-level ethics protections, enhance the cultural relevance of study designs and competence of researchers, build community and academic research capacity, and shape research agendas that benefit diverse communities. To better understand how they are organized and function, representatives of 9 CRPs from across the United States convened in 2012 for a working meeting. In this article, we articulated and analyzed the models presented, offered guidance to communities that seek to establish a CRP, and made recommendations for future research, practice, and policy. PMID:25973834

Training Residential Staff to Conduct Trial-Based Functional Analyses

ERIC Educational Resources Information Center

Lambert, Joseph M.; Bloom, Sarah E.; Kunnavatana, S. Shanun; Collins, Shawnee D.; Clay, Casey J.

2013-01-01

We taught 6 supervisors of a residential service provider for adults with developmental disabilities to train 9 house managers to conduct trial-based functional analyses. Effects of the training were evaluated with a nonconcurrent multiple baseline. Results suggest that house managers can be trained to conduct trial-based functional analyses with…

Impact of 4.0% chlorhexidine cleansing of the umbilical cord on mortality and omphalitis among newborns of Sylhet, Bangladesh: design of a community-based cluster randomized trial.

PubMed

Mullany, Luke C; El Arifeen, Shams; Winch, Peter J; Shah, Rasheduzzaman; Mannan, Ishtiaq; Rahman, Syed M; Rahman, Mohammad R; Darmstadt, Gary L; Ahmed, Saifuddin; Santosham, Mathuram; Black, Robert E; Baqui, Abdullah H

2009-10-21

The World Health Organization recommends dry cord care for newborns but this recommendation may not be optimal in low resource settings where most births take place in an unclean environment and infections account for up to half of neonatal deaths. A previous trial in Nepal indicated that umbilical cord cleansing with 4.0% chlorhexidine could substantially reduce mortality and omphalitis risk, but policy changes await additional community-based data. The Projahnmo Chlorhexidine study was a three-year, cluster-randomized, community-based trial to assess the impact of three cord care regimens on neonatal mortality and omphalitis. Women were recruited mid-pregnancy, received a basic package of maternal and neonatal health promotion messages, and were followed to pregnancy outcome. Newborns were visited at home by local village-based workers whose areas were randomized to either 1) single- or 2) 7-day cord cleansing with 4.0% chlorhexidine, or 3) promotion of dry cord care as recommended by WHO. All mothers received basic messages regarding hand-washing, clean cord cutting, and avoidance of harmful home-base applications to the cord. Death within 28 days and omphalitis were the primary outcomes; these were monitored directly through home visits by community health workers on days 1, 3, 6, 9, 15, and 28 after birth. Due to report in early 2010, the Projahnmo Chlorhexidine Study examines the impact of multiple or single chlorhexidine cleansing of the cord on neonatal mortality and omphalitis among newborns of rural Sylhet District, Bangladesh. The results of this trial will be interpreted in conjunction with a similarly designed trial previously conducted in Nepal, and will have implications for policy guidelines for optimal cord care of newborns in low resource settings in Asia. ClinicalTrials.gov (NCT00434408).

A Model for Strengthening Collaborative Research Capacity: Illustrations From the Atlanta Clinical Translational Science Institute.

PubMed

Rodgers, Kirsten C; Akintobi, Tabia; Thompson, Winifred Wilkins; Evans, Donoria; Escoffery, Cam; Kegler, Michelle C

2014-06-01

Community-engaged research is effective in addressing health disparities but may present challenges for both academic institutions and community partners. Therefore, the need to build capacity for conducting collaborative research exists. The purpose of this study is to present a model for building research capacity in academic-community partnerships. The Building Collaborative Research Capacity Model was developed as part of the Community Engagement Research Program (CERP) of the Atlanta Clinical and Translational Science Institute (ACTSI). Six domains of collaborative research capacity were identified and used to develop a model. Inputs, activities, outputs, and outcomes of building collaborative research capacity are described. To test this model, a competitive request for applications was widely distributed and four community-based organizations were funded to participate in a 2-year program with the aim of conducting a pilot study and submitting a research proposal for funding to National Institutes of Health or another major funding agency. During the first year, the community-based organization partners were trained on conducting collaborative research and matched with an academic partner from an ACTSI institution. Three of the academic-community partnerships submitted pilot study results and two submitted a grant proposal to a national agency. The Building Collaborative Research Capacity Model is an innovative approach to strengthening academic-community partnerships. This model will help build needed research capacity, serve as a framework for academicians and community partners, and lead to sustainable partnerships that improve community health. © 2013 Society for Public Health Education.

Umpqua Community College: Its Economic Impact on Douglas County.

ERIC Educational Resources Information Center

Haugen, Roger E.

A study was conducted to assess the additional monies in circulation within Douglas County due to the existence of Umpqua Community College (UCC). Direct and indirect economic impact was calculated for the 1980-81 fiscal year based on UCC records and staff and student surveys conducted during February 1982. Study findings included the following:…

CARBON AND NUTRIENT FLOW THROUGH MULTIPLE TROPHIC LEVELS IN A CO2-ENRICHED SOUTHERN PINE FOREST COMMUNITY - FINAL TECHNICAL REPORT

USDA-ARS?s Scientific Manuscript database

The ability to predict the consequences of global change is predicated on our understanding of controls of energy and material flows through ecosystems. Research was conducted at the Forest Atmosphere CO2 Transfer and Storage-1 (FACTS-1) site at Duke University. This is a flagship experiment of the ...

Prevalence and psychosocial correlates of depressive symptoms in urban Chinese women during midlife.

PubMed

Wong, Carmen K M; Liang, Jun; Chan, Man L; Chan, Yin H; Chan, Laam; Wan, Kwong Y; Ng, Ming S; Chan, Dicken C C; Wong, Samuel Y S; Wong, Martin C S

2014-01-01

Depression is common in women with much research focusing on hormonal changes and menopausal symptoms but with little exploration of psychosocial problems in midlife. This study investigates the prevalence of clinically relevant depressive symptoms in midlife Chinese women and its association with psychosocial factors. A cross-sectional, community-based household survey of women aged 45 to 64 years of age was conducted in Hong Kong from September 2010 to March 2011. The structured questionnaire included demographic data, educational status, marital status and household income, as well as perceived current stressful events and significant life events in the past 12 months. Information on clinically relevant depressive symptoms was measured by the validated chinese Patient Health Questionnaire (PHQ-9). A total of 402 participants were recruited in the study period. Of the 393 women who completed the questionnaire, the prevalence of clinically relevant depressive symptoms (PHQ-9 score≧10) was 11.0%. In multiple regression analysis, being single/divorced/separated/widowed, having an educational level of primary school level or below, having multiple chronic diseases, loss of hobby or loss of close social support in the past 12 months in midlife were associated with clinically relevant depressive symptoms. Correlates of clinically relevant depressive symptoms in midlife Chinese women can be used to identify those at increased risk and potentiate further studies to explore early psychosocial and community interventions.

The critical role of communications in a multilevel obesity-prevention intervention: Lessons learned for alcohol educators.

PubMed

Hatfield, Daniel P; Sliwa, Sarah A; Folta, Sara C; Economos, Christina D; Goldberg, Jeanne P

2017-01-01

Multilevel interventions to prevent underage drinking are more effective than individual-level strategies, and messaging campaigns are key to such approaches. Recognizing the benefits of translating best practices across public health domains, this paper details the communications campaign from Shape Up Somerville (SUS), an exemplar for multilevel community-based approaches to address pediatric obesity, highlighting lessons learned for alcohol educators. All elements of SUS, including the communications strategy, were developed collaboratively with local partners. Communication initiatives included community-engaged brand development to unify diverse intervention components; school-based communications to promote new opportunities for healthy eating and physical activity; and media partnerships to promote healthy behaviors community-wide. The overall SUS intervention was effective in reducing prevalence of overweight/obesity among first- to third-graders in Somerville relative to control communities. Process evaluation showed that communications successfully reached diverse community segments and raised awareness of and receptivity to changes. Communications campaigns are essential components of multilevel interventions addressing public health challenges including obesity and underage drinking. Such communications should be developed collaboratively with the target audience and stakeholders, designed to engage community members at multiple levels through multiple channels within a systems framework, and sustained through local partnerships. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Clinical Trials in Your Community

Cancer.gov

The NCI Community Oncology Research Program (NCORP) is a national network of investigators, cancer care providers, academic institutions, and other organizations. NCORP conducts multi-site cancer clinical trials and studies in diverse populations in community-based healthcare systems across the United States and Puerto Rico.

The Effectiveness of Community Practice Interventions: A Review of the Literature

ERIC Educational Resources Information Center

Ohmer, Mary L.; Korr, Wynne S.

2006-01-01

Objective: Evidence-based practice is becoming increasingly important in social work and community practice. The authors reviewed existing research to assess the level of evidence available to guide community practice. Method: The authors conducted a review of the literature on community practice intervention research from 1985 to 2002 using…

Drug-Free Schools & Communities: Program Planning Guidelines & Community Inventory.

ERIC Educational Resources Information Center

Montana State Board of Crime Control, Helena.

This book is designed to provide Montana communities with the most current research-based information available concerning drug and alcohol prevention/education program planning. It also provides a concise overview of the programs being conducted in various Montana communities. It is intended for use as a resource manual, to provide readers with…

Effects of information, education, and communication campaign on a community-based health insurance scheme in Burkina Faso

PubMed Central

Cofie, Patience; De Allegri, Manuela; Kouyaté, Bocar; Sauerborn, Rainer

2013-01-01

Objective The study analysed the effect of Information, Education, and Communication (IEC) campaign activities on the adoption of a community-based health insurance (CHI) scheme in Nouna, Burkina Faso. It also identified the factors that enhanced or limited the campaign's effectiveness. Design Complementary data collection approaches were used. A survey was conducted with 250 randomly selected household heads, followed by in-depth interviews with 22 purposively selected community leaders, group discussions with the project management team, and field observations. Bivariate analysis and multivariate logistic regression models were used to assess the association between household exposure to campaign and acquisition of knowledge as well as household exposure to campaign and enrolment. Results The IEC campaign had a positive effect on households’ knowledge about the CHI and to a lesser extent on household enrolment in the scheme. The effectiveness of the IEC strategy was mainly influenced by: (1) frequent and consistent IEC messages from multiple media channels (mass and interpersonal channels), including the radio, a mobile information van, and CHI team, and (2) community heads’ participation in the CHI scheme promotion. Education was the only significantly influential socio-demographic determinant of knowledge and enrolment among household heads. The relatively low effects of the IEC campaign on CHI enrolment are indicative of other important IEC mediating factors, which should be taken into account in future CHI campaign evaluation. Conclusion The study concludes that an IEC campaign is crucial to improving the understanding of the CHI scheme concept, which is an enabler to enrolment, and should be integrated into scheme designs and evaluations. PMID:24314344

Effects of information, education, and communication campaign on a community-based health insurance scheme in Burkina Faso.

PubMed

Cofie, Patience; De Allegri, Manuela; Kouyaté, Bocar; Sauerborn, Rainer

2013-12-06

The study analysed the effect of Information, Education, and Communication (IEC) campaign activities on the adoption of a community-based health insurance (CHI) scheme in Nouna, Burkina Faso. It also identified the factors that enhanced or limited the campaign's effectiveness. Complementary data collection approaches were used. A survey was conducted with 250 randomly selected household heads, followed by in-depth interviews with 22 purposively selected community leaders, group discussions with the project management team, and field observations. Bivariate analysis and multivariate logistic regression models were used to assess the association between household exposure to campaign and acquisition of knowledge as well as household exposure to campaign and enrolment. The IEC campaign had a positive effect on households' knowledge about the CHI and to a lesser extent on household enrolment in the scheme. The effectiveness of the IEC strategy was mainly influenced by: (1) frequent and consistent IEC messages from multiple media channels (mass and interpersonal channels), including the radio, a mobile information van, and CHI team, and (2) community heads' participation in the CHI scheme promotion. Education was the only significantly influential socio-demographic determinant of knowledge and enrolment among household heads. The relatively low effects of the IEC campaign on CHI enrolment are indicative of other important IEC mediating factors, which should be taken into account in future CHI campaign evaluation. The study concludes that an IEC campaign is crucial to improving the understanding of the CHI scheme concept, which is an enabler to enrolment, and should be integrated into scheme designs and evaluations.

Barriers and Strategies Related to Qualitative Research on Genetic Ancestry Testing in Indigenous Communities.

PubMed

Blanchard, Jessica W; Tallbull, Gloria; Wolpert, Chantelle; Powell, Jill; Foster, Morris W; Royal, Charmaine

2017-07-01

Conducting genetics-related research with populations that have historically experienced considerable harm and little benefit from genetics research poses unique challenges for understanding community-based perceptions of new genetic technologies. This article identifies challenges and strategies for collecting qualitative data on the perceptions of direct-to-consumer (DTC) Genetic Ancestry tests (GAT) among diverse Indigenous communities. Based on a 3-year project related to perceptions, attitudes, and values associated with genetic ancestry testing among diverse Indigenous communities in Oklahoma, the engagement process revealed specific opportunities to improve the process of qualitative data collection related to GAT, and more broadly, to conduct genetics-related research with Indigenous communities in culturally and methodologically appropriate ways. Priority areas include issues related to participant recruitment and tribal advisory boards, challenges of self-identification as a recruitment mechanism, and the necessity of including Indigenous researchers in all aspects of the research process.

A Case Study Examination of Best Practices of Professional Learning Communities

ERIC Educational Resources Information Center

Akopoff, Tanya M.

2010-01-01

A current trend in education is that small teacher groups, called professional learning communities (PLC), are being advocated as a tool to help teachers reach struggling students. Educators planning to use PLC as an intervention strategy can benefit from research-based information about PLC best practices. This multiple case study addressed the…

The Role of Community, Family, Peer, and School Factors in Group Bullying: Implications for School-Based Intervention

ERIC Educational Resources Information Center

Mann, Michael J.; Kristjansson, Alfgeir L.; Sigfusdottir, Inga Dora; Smith, Megan L.

2015-01-01

Background: Although an ecological perspective suggests the importance of multiple levels of intervention, most bullying research has emphasized individual- and school-focused strategies. This study investigated community and family factors that influence school efforts to reduce odds of group bullying behavior and victimization. Methods: We used…

The Utilization of Community Mental Health Services by the Hispanic Elderly.

ERIC Educational Resources Information Center

Starrett,Richard A.; And Others

Multiple regression and path analyses of 29 demographic, social, and psychological variables were carried out to determine those variables that influenced the use of community-based mental health services by the Hispanic elderly. The variables were classified using the Andersen and Newman framework which conceptualizes the individual's demand for…

Utilizing novel diversity estimators to quantify multiple dimensions of microbial biodiversity across domains

PubMed Central

2013-01-01

Background Microbial ecologists often employ methods from classical community ecology to analyze microbial community diversity. However, these methods have limitations because microbial communities differ from macro-organismal communities in key ways. This study sought to quantify microbial diversity using methods that are better suited for data spanning multiple domains of life and dimensions of diversity. Diversity profiles are one novel, promising way to analyze microbial datasets. Diversity profiles encompass many other indices, provide effective numbers of diversity (mathematical generalizations of previous indices that better convey the magnitude of differences in diversity), and can incorporate taxa similarity information. To explore whether these profiles change interpretations of microbial datasets, diversity profiles were calculated for four microbial datasets from different environments spanning all domains of life as well as viruses. Both similarity-based profiles that incorporated phylogenetic relatedness and naïve (not similarity-based) profiles were calculated. Simulated datasets were used to examine the robustness of diversity profiles to varying phylogenetic topology and community composition. Results Diversity profiles provided insights into microbial datasets that were not detectable with classical univariate diversity metrics. For all datasets analyzed, there were key distinctions between calculations that incorporated phylogenetic diversity as a measure of taxa similarity and naïve calculations. The profiles also provided information about the effects of rare species on diversity calculations. Additionally, diversity profiles were used to examine thousands of simulated microbial communities, showing that similarity-based and naïve diversity profiles only agreed approximately 50% of the time in their classification of which sample was most diverse. This is a strong argument for incorporating similarity information and calculating diversity with a range of emphases on rare and abundant species when quantifying microbial community diversity. Conclusions For many datasets, diversity profiles provided a different view of microbial community diversity compared to analyses that did not take into account taxa similarity information, effective diversity, or multiple diversity metrics. These findings are a valuable contribution to data analysis methodology in microbial ecology. PMID:24238386

A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance

PubMed Central

2014-01-01

Background Greater use of antibiotics during the past 50 years has exerted selective pressure on susceptible bacteria and may have favoured the survival of resistant strains. Existing information on antibiotic resistance patterns from pathogens circulating among community-based patients is substantially less than from hospitalized patients on whom guidelines are often based. We therefore chose to assess the relationship between the antibiotic resistance pattern of bacteria circulating in the community and the consumption of antibiotics in the community. Methods Both gray literature and published scientific literature in English and other European languages was examined. Multiple regression analysis was used to analyse whether studies found a positive relationship between antibiotic consumption and resistance. A subsequent meta-analysis and meta-regression was conducted for studies for which a common effect size measure (odds ratio) could be calculated. Results Electronic searches identified 974 studies but only 243 studies were considered eligible for inclusion by the two independent reviewers who extracted the data. A binomial test revealed a positive relationship between antibiotic consumption and resistance (p < .001) but multiple regression modelling did not produce any significant predictors of study outcome. The meta-analysis generated a significant pooled odds ratio of 2.3 (95% confidence interval 2.2 to 2.5) with a meta-regression producing several significant predictors (F(10,77) = 5.82, p < .01). Countries in southern Europe produced a stronger link between consumption and resistance than other regions. Conclusions Using a large set of studies we found that antibiotic consumption is associated with the development of antibiotic resistance. A subsequent meta-analysis, with a subsample of the studies, generated several significant predictors. Countries in southern Europe produced a stronger link between consumption and resistance than other regions so efforts at reducing antibiotic consumption may need to be strengthened in this area. Increased consumption of antibiotics may not only produce greater resistance at the individual patient level but may also produce greater resistance at the community, country, and regional levels, which can harm individual patients. PMID:24405683

Indigenous community based participatory research and health impact assessment: A Canadian example

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kwiatkowski, Roy E., E-mail: roy_kwiatkowski@hc-sc.gc.c

The Environmental Health Research Division (EHRD) of the First Nations and Inuit Health Branch, Health Canada conducts science-based activities and research with Canadian Indigenous communities in areas such as climate change adaptation, environmental contaminants, water quality, biomonitoring, risk assessment, health impact assessment, and food safety and nutrition. EHRD's research activities have been specifically designed to not only inform Health Canada's policy decision-makers but as well, Indigenous community decision-makers. This paper will discuss the reasons why Indigenous community engagement is important, what are some of the barriers preventing community engagement; and the efforts by EHRD to carry out community-based participatory researchmore » activities with Indigenous peoples.« less

Community-Based Participatory Evaluation: The Healthy Start Approach

PubMed Central

Braithwaite, Ronald L.; McKenzie, Robetta D.; Pruitt, Vikki; Holden, Kisha B.; Aaron, Katrina; Hollimon, Chavone

2013-01-01

The use of community-based participatory research has gained momentum as a viable approach to academic and community engagement for research over the past 20 years. This article discusses an approach for extending the process with an emphasis on evaluation of a community partnership–driven initiative and thus advances the concept of conducting community-based participatory evaluation (CBPE) through a model used by the Healthy Start project of the Augusta Partnership for Children, Inc., in Augusta, Georgia. Application of the CBPE approach advances the importance of bilateral engagements with consumers and academic evaluators. The CBPE model shows promise as a reliable and credible evaluation approach for community-level assessment of health promotion programs. PMID:22461687

Community-based participatory evaluation: the healthy start approach.

PubMed

Braithwaite, Ronald L; McKenzie, Robetta D; Pruitt, Vikki; Holden, Kisha B; Aaron, Katrina; Hollimon, Chavone

2013-03-01

The use of community-based participatory research has gained momentum as a viable approach to academic and community engagement for research over the past 20 years. This article discusses an approach for extending the process with an emphasis on evaluation of a community partnership-driven initiative and thus advances the concept of conducting community-based participatory evaluation (CBPE) through a model used by the Healthy Start project of the Augusta Partnership for Children, Inc., in Augusta, Georgia. Application of the CBPE approach advances the importance of bilateral engagements with consumers and academic evaluators. The CBPE model shows promise as a reliable and credible evaluation approach for community-level assessment of health promotion programs.

What Does It Mean for Something to Be "Scientific"? Community Understandings of Science, Educational Attainment, and Community Representation among a Sample of 25 CBPR Projects

ERIC Educational Resources Information Center

Spears Johnson, Chaya R.; Kraemer Diaz, Anne E.; Arcury, Thomas A.

2017-01-01

Community-based participatory research (CBPR) seeks to conduct relevant, sustainable research that is tailored to the needs of the communities with which it is engaged through equitable collaboration between community representatives and professional researchers. Like other participatory approaches to research and planning, CBPR has been…

Building community while complying with the Affordable Care Act in the Lehigh Valley of Pennsylvania.

PubMed

Mathews, A Lanethea; Coyle, Bonnie S; Deegan, Michele Moser

2015-01-01

The Affordable Care Act (ACA) requires nonprofit hospitals to conduct community health needs assessments (CHNA) every 3 years. Best practices for CHNAs are still emerging and, along with growing economic pressures, contribute to uncertainty about the short- and long-term costs hospitals will face as a result of the ACA. This article describes a community-based partnership coordinated by a nonprofit hospital and a consortium of academic institutions as a model for conducting a CHNA. Similar partnerships offer key advantages in complying with the ACA: local academic institutions are existing stakeholders in the community--they possess research expertise and have a vested interested in shaping implementation strategies to improve health; the process of collaborating itself helps to generate community resources, conceive of community health as a shared and iterative enterprise, and mobilize community partners in supporting long-term health priorities. No CHNA is ever perfect, but there are compelling reasons for nonprofit hospitals to seek community-based partnerships, not only because such partnerships comply with the law but, more importantly, because they hold great promise for linking the CHNA process and results to the health realities of local communities, ultimately bolstering community engagement while creating shared health priorities.

Increasing community capacity for participatory evaluation of healthy eating and active living strategies through direct observations and environmental audits.

PubMed

Kemner, Allison L; Stachecki, Jessica R; Bildner, Michele E; Brennan, Laura K

2015-01-01

Local partnerships from the Healthy Kids, Healthy Communities initiative elected to participate in enhanced evaluation trainings to collect data through environmental audits and direct observations as well as to build their evaluation capacity. Environmental audit and direct observation tools and protocols were adapted for the relevant healthy eating and active living policy and environmental change approaches being conducted by the Healthy Kids, Healthy Communities partnerships. Customized trainings were conducted by the evaluation team to increase capacity and understanding for evaluation activities. A total of 87 trainings were conducted by the evaluation team in 31 Healthy Kids, Healthy Communities community partnerships. Data were collected for a total of 41 environmental audits and 17 direct observations. Community case examples illustrate how these trainings developed evaluation capacity. For instance, youth from one community presented environmental audit findings to local elected officials. The 31 partnerships participating in the community-based evaluation efforts resulted in 164 individuals trained in collecting context-specific data to assess the impact of healthy eating and active living policy and environmental strategies designed to create community change.

Promoting Physical Activity Among Native American Youth: a Systematic Review of the Methodology and Current Evidence of Physical Activity Interventions and Community-wide Initiatives.

PubMed

Fleischhacker, Sheila; Roberts, Erica; Camplain, Ricky; Evenson, Kelly R; Gittelsohn, Joel

2016-12-01

Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword-guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families, and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth.

Promoting physical activity among Native American youth: A systematic review of the methodology and current evidence of physical activity interventions and community-wide initiatives

PubMed Central

Roberts, Erica; Camplain, Ricky; Evenson, Kelly R.; Gittelsohn, Joel

2015-01-01

Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally-led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally-driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth. PMID:27294756

Identifying and characterizing key nodes among communities based on electrical-circuit networks.

PubMed

Zhu, Fenghui; Wang, Wenxu; Di, Zengru; Fan, Ying

2014-01-01

Complex networks with community structures are ubiquitous in the real world. Despite many approaches developed for detecting communities, we continue to lack tools for identifying overlapping and bridging nodes that play crucial roles in the interactions and communications among communities in complex networks. Here we develop an algorithm based on the local flow conservation to effectively and efficiently identify and distinguish the two types of nodes. Our method is applicable in both undirected and directed networks without a priori knowledge of the community structure. Our method bypasses the extremely challenging problem of partitioning communities in the presence of overlapping nodes that may belong to multiple communities. Due to the fact that overlapping and bridging nodes are of paramount importance in maintaining the function of many social and biological networks, our tools open new avenues towards understanding and controlling real complex networks with communities accompanied with the key nodes.

75 FR 18219 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... programs and resources. Plans, organizes and conducts studies of organizational structures, functional... Americans to remain at home by streamlining access to community-based care and empowering older adults to... American grantees to promote the development of State and Native American-administered, community-based...

Women and substance use: a qualitative study on sexual and reproductive health of women who use drugs in Delhi, India.

PubMed

Sharma, Vartika; Sarna, Avina; Tun, Waimar; Saraswati, Lopamudra Ray; Thior, Ibou; Madan, Ira; Luchters, Stanley

2017-11-19

To explore contextual factors that increase vulnerabilities to negative sexual and reproductive health (SRH) outcomes and possible differences in SRH-related behaviours and the needs of women who use drugs (WUD) through non-injecting and injecting routes. Qualitative study design using semi-structured in-depth interviews. Twenty women who injected drugs in the past 3 months and 28 women who reported using drugs through non-injecting routes in the past 1 month. Interviews were conducted at community-based, drop-in centres in Delhi, India. Study findings illustrate that WUD were sexually active and had multiple sex partners including clients of sex work. Transient relationships were reported and many participants engaged in unsafe sex. Factors which affected safe sex behaviours included: gender power imbalance, limited agency for decision-making, lack of accurate information for correct self-risk assessment, and being under the influence of drugs. Despite high awareness, low and inconsistent contraceptive use was reported. Some participants were coerced to conceive while a few others reported their inability to conceive. Violence was a key determinant for SRH outcomes. Perception of certain adverse health outcomes (such as infertility) to be 'common and expected among WUD' influenced access to healthcare. Further, healthcare providers' stigmatising attitudes and lack of women-centric services deterred women from uptake of healthcare services. Findings highlight that SRH-related behaviours and needs of this group are a complex interplay of multiple determinants which need to be addressed at all levels: individual, family, community and institutional. It is imperative to roll out a 'one-stop-shop' for a comprehensive package of health services. Expansion of existing drop-in-centres could be considered for setting-up community-based women-centric services with appropriate linkage to drug dependence treatment and reproductive health services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Women and substance use: a qualitative study on sexual and reproductive health of women who use drugs in Delhi, India

PubMed Central

Sharma, Vartika; Sarna, Avina; Tun, Waimar; Saraswati, Lopamudra Ray; Thior, Ibou; Madan, Ira; Luchters, Stanley

2017-01-01

Objectives To explore contextual factors that increase vulnerabilities to negative sexual and reproductive health (SRH) outcomes and possible differences in SRH-related behaviours and the needs of women who use drugs (WUD) through non-injecting and injecting routes. Design Qualitative study design using semi-structured in-depth interviews. Participants Twenty women who injected drugs in the past 3 months and 28 women who reported using drugs through non-injecting routes in the past 1 month. Setting Interviews were conducted at community-based, drop-in centres in Delhi, India. Results Study findings illustrate that WUD were sexually active and had multiple sex partners including clients of sex work. Transient relationships were reported and many participants engaged in unsafe sex. Factors which affected safe sex behaviours included: gender power imbalance, limited agency for decision-making, lack of accurate information for correct self-risk assessment, and being under the influence of drugs. Despite high awareness, low and inconsistent contraceptive use was reported. Some participants were coerced to conceive while a few others reported their inability to conceive. Violence was a key determinant for SRH outcomes. Perception of certain adverse health outcomes (such as infertility) to be ‘common and expected among WUD’ influenced access to healthcare. Further, healthcare providers’ stigmatising attitudes and lack of women-centric services deterred women from uptake of healthcare services. Conclusion Findings highlight that SRH-related behaviours and needs of this group are a complex interplay of multiple determinants which need to be addressed at all levels: individual, family, community and institutional. It is imperative to roll out a ‘one-stop-shop’ for a comprehensive package of health services. Expansion of existing drop-in-centres could be considered for setting-up community-based women-centric services with appropriate linkage to drug dependence treatment and reproductive health services. PMID:29158326

Trust of community health workers influences the acceptance of community-based maternal and child health services.

PubMed

Grant, Merridy; Wilford, Aurene; Haskins, Lyn; Phakathi, Sifiso; Mntambo, Ntokozo; Horwood, Christiane M

2017-05-29

Community health workers (CHWs) are a component of the health system in many countries, providing effective community-based services to mothers and infants. However, implementation of CHW programmes at scale has been challenging in many settings. To explore the acceptability of CHWs conducting household visits to mothers and infants during pregnancy and after delivery, from the perspective of community members, professional nurses and CHWs themselves. Primary health care clinics in five rural districts in KwaZulu-Natal, South Africa. A qualitative exploratory study was conducted where participants were purposively selected to participate in 19 focus group discussions based on their experience with CHWs or child rearing. Poor confidentiality and trust emerged as key barriers to CHW acceptability in delivering maternal and child health services in the home. Most community members felt that CHWs could not be trusted because of their lack of professionalism and inability to maintain confidentiality. Familiarity and the complex relationships between household members and CHWs caused difficulties in developing and maintaining a relationship of trust, particularly in high HIV prevalence settings. Professional staff at the clinic were crucial in supporting the CHW's role; if they appeared to question the CHW's competency or trustworthiness, this seriously undermined CHW credibility in the eyes of the community. Understanding the complex contextual challenges faced by CHWs and community members can strengthen community-based interventions. CHWs require training, support and supervision to develop competencies navigating complex relationships within the community and the health system to provide effective care in communities.

Diabetes Bingo: Research Prioritization with the Filipino Community

PubMed Central

Oculto, Tessie; Ramones, Emilyn; Caagbay, Cedric R

2010-01-01

This community-based participatory research, conducted in partnership between a European-American academic researcher and a professional group of Filipino nurses, aimed to determine the diabetes research priority for the Filipino community on the island of O‘ahu in Hawai‘i, and to evaluate the multi-voting technique to seek input from the community. The study design was a qualitative, cross-sectional interactive process consisting of an educational presentation followed by data collection from the audience. Ten community presentations about the impact of diabetes on the Filipino community were conducted by a Filipino nurse with participants (N = 265). Following the educational session, the participants selected priorities for research using a multi-vote technique developed as a Diabetes Bingo card. Community voting results identified prevention and a focus on adults as important priorities for research. Based on the results of the multi-voting, the research partners were able to come to consensus on a research priority area of prevention of type 2 diabetes in adults. Multi-voting using a Diabetes Bingo card, preceded by an educational presentation by a Filipino nurse, was a culturally competent community-based participatory research method that gave voice to the participants and direction to the research partners for future projects. The multi-voting technique was readily accepted and enjoyed by participants. PMID:21229487

Human-Forest interfaces in Hugumburda-Gratkhassu National Forest Priority Area, North-eastern Ethiopia.

PubMed

Kidane, Leul; Nemomissa, Sileshi; Bekele, Tamrat

2018-02-23

Traditional management regimes and knowledge systems of forest resources have shaped forests throughout the world where materials from individual species are harvested in a sustainable manner. To comprehend this, the vegetation of Hugumburda-Gratkhassu Forest was described and related to anthropogenic factors. Three ethnobotanical research methods were used to collect indigenous knowledge of the local inhabitants related to conservation and utilization of forest resources. Direct matrix ranking was conducted to discover local attitudes on species preference for multiple use. During this work, the 46 most important tree and shrub species were selected based on recommendations of local guides and key informants to determine the range of uses obtained from each species. Through paired comparison, activities supposed to be the major cause of degradation of the forest were adopted. Pairs of activities were then established from the relation n (n-1)/2. Each respondent was then asked to select an activity that he considered being a major problem to management of the forest. Semi-structured interviews were used to obtain information from sixty local informants to address community attitudes towards forest management and utilization. The result obtained from direct matrix ranking showed; that 20 out of 46 plant species compared had the highest scores and rank, indicating that these species are the most important and are exploited by the local communities for multiple purposes. The paired comparison exercise revealed logging for construction materials to be the major threat to the forest due to cutting of large volume of wood for construction of churches, health centers, schools and new houses. Juniperus procera, Olea europaea ssp. cuspidata, Rhus glutinosa, Ficus sur, Hagenia abyssinica, Cassipourea malosana and Acacia etbaica were the most selected and exploited plant species for these purposes. Survival of protected areas depends on the support of local communities, rather than on fences, fines, or even force. The local communities in the study area have a rich indigenous ecological knowledge to suggest appropriate solutions for improvement of the forest resources. Thus the old tradition of isolating forests from the community has to be avoided and the basic needs and traditional rights of the communities over the uses of forest resources should be recognized.

Development and Implementation of a School-based Obesity Prevention Intervention: Lessons Learned from Community-Based Participatory Research

PubMed Central

Uyeda, Kimberly; Bogart, Laura M.; Hawes-Dawson, Jennifer; Schuster, Mark A.

2010-01-01

Background National, state, and local policies aim to change school environments to prevent child obesity. Community-based participatory research (CBPR) can be effective in translating public health policy into practice. Objectives We describe lessons learned from developing and pilot testing a middle school-based obesity prevention intervention using CBPR in Los Angeles, California. Methods We formed a community–academic partnership between the Los Angeles Unified School District (LAUSD) and the UCLA/RAND Center for Adolescent Health Promotion to identify community needs and priorities for addressing adolescent obesity and to develop and pilot test a school-based intervention. Lessons Learned Academic partners need to be well-versed in organizational structures and policies. Partnerships should be built on relationships of trust, shared vision, and mutual capacity building, with genuine community engagement at multiple levels. Conclusion These lessons are critical, not only for partnering with schools on obesity prevention, but also for working in other community settings and on other health issues. PMID:20208226

Health Concerns of Northeastern Pennsylvania Residents Living in an Unconventional Oil and Gas Development County.

PubMed

McDermott-Levy, Ruth; Garcia, Victoria

2016-11-01

This study was conducted to describe the health concerns of residents of an unconventional oil and natural gas development (UOGD) community and identify methods to best disseminate health information to the residents. A qualitative descriptive study of 27 residents of Wyoming County, Pennsylvania, was conducted. Residents described their health concerns in terms of their changing community as a result of UOGD, their feelings of stress and powerlessness related to these changes, and the limited response of their local policymakers and protective agencies. There were indications of misinformation related to routine environmental health and UOGD environmental risks. Web-based educational programs with downloadable printed materials to bridge the knowledge gaps of residents and health professionals are recommended. Recommendations include public health nurses providing education to communities and other health professionals regarding environmental health risks, working with communities to advocate for health-protective regulations, and adopting a community-based participatory approach to meet the needs of community members. © 2016 Wiley Periodicals, Inc.

"Una mujer trabaja doble aqui": Vignette-based focus groups on stress and work for Latina blue-collar women in eastern North Carolina.

PubMed

Easter, Michele M; Linnan, Laura A; Bentley, Margaret E; DeVellis, Brenda M; Meier, Andrea; Frasier, Pamela Y; Kelsey, Kristine S; Campbell, Marci K

2007-01-01

Latina women are a growing percentage of the working population, and very little is known about their health needs and interests. The purpose of this article is to share qualitative research results gathered from Latina women with a particular focus on exploring stress and health. This project was a substudy of Health Works in the Community, a 5-year CDC-funded multiple risk-factor reduction trial using participatory action research approaches to address smoking, healthy eating, stress, and physical activity among blue-collar women from 12 manufacturing work sites in rural, eastern North Carolina. Five focus groups were conducted with trained, bilingual facilitators using a vignette-based moderator guide that appeared particularly effective with this population. Results from the focus groups are used to make recommendations for future research with Latinas and for developing effective work-site-based interventions to address issues of stress and health within this population.

Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

ERIC Educational Resources Information Center

Blackmer, Rachel; Hayes-Harb, Rachel

2016-01-01

We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

Community variations in population exposure to near-field tsunami hazards as a function of pedestrian travel time to safety

USGS Publications Warehouse

Wood, Nathan J.; Schmidtlein, Mathew C.

2013-01-01

Efforts to characterize population exposure to near-field tsunami threats typically focus on quantifying the number and type of people in tsunami-hazard zones. To develop and prioritize effective risk-reduction strategies, emergency managers also need information on the potential for successful evacuations and how this evacuation potential varies among communities. To improve efforts to properly characterize and differentiate near-field tsunami threats among multiple communities, we assess community variations in population exposure to tsunamis as a function of pedestrian travel time to safety. We focus our efforts on the multiple coastal communities in Grays Harbor and Pacific Counties (State of Washington, USA), where a substantial resident and visitor population is threatened by near-field tsunamis related to a potential Cascadia subduction zone earthquake. Anisotropic, path-distance modeling is conducted to estimate travel times to safety and results are merged with various population data, including residents, employees, public venues, and dependent-care facilities. Results suggest that there is substantial variability among communities in the number of people that may have insufficient time to evacuate. Successful evacuations may be possible in some communities assuming slow-walking speeds, are plausible in others if travel speeds are increased, and are unlikely in another set of communities given the large distances and short time horizon. Emergency managers can use these results to prioritize the location and determine the most appropriate type of tsunami risk-reduction strategies, such as education and training in areas where evacuations are plausible and vertical-evacuation structures in areas where they are not.

Community stakeholders' perceptions of barriers to childhood obesity prevention in low-income families, Massachusetts 2012-2013.

PubMed

Ganter, Claudia; Chuang, Emmeline; Aftosmes-Tobio, Alyssa; Blaine, Rachel E; Giannetti, Mary; Land, Thomas; Davison, Kirsten K

2015-03-26

The etiology of childhood obesity is multidimensional and includes individual, familial, organizational, and societal factors. Policymakers and researchers are promoting social-ecological approaches to obesity prevention that encompass multiple community sectors. Programs that successfully engage low-income families in making healthy choices are greatly needed, yet little is known about the extent to which stakeholders understand the complexity of barriers encountered by families. The objective of this study was to contextually frame barriers faced by low-income families reported by community stakeholders by using the Family Ecological Model (FEM). From 2012 through 2013, we conducted semistructured interviews with 39 stakeholders from 2 communities in Massachusetts that were participating in a multisector intervention for childhood obesity prevention. Stakeholders represented schools; afterschool programs; health care; the Special Supplemental Nutrition Program for Women, Infants, and Children; and early care and education. Interviews were audio-recorded, transcribed, coded, and summarized. Stakeholder reports of the barriers experienced by low-income families had a strong degree of overlap with FEM and reflected awareness of the broader contextual factors (eg, availability of community resources, family culture, education) and social and emotional dynamics within families (eg, parent knowledge, social norms, distrust of health care providers, chronic life stressors) that could affect family adoption of healthy lifestyle behaviors. Furthermore, results illustrated a level of consistency in stakeholder awareness across multiple community sectors. The congruity of stakeholder perspectives with those of low-income parents as summarized in FEM and across community sectors illustrates potential for synergizing the efforts necessary for multisector, multilevel community interventions for the prevention of childhood obesity.

A latent class analysis of social activities and health among community-dwelling older adults in Korea.

PubMed

Park, Mi Jin; Park, Nan Sook; Chiriboga, David A

2018-05-01

This study presents an empirical typology of social activity and its association with the depressive symptoms and self-rated health of community-dwelling older adults (n = 464) in South Korea. Latent class analysis (LCA) was used to classify the types of social activities. Data analyses were conducted using Mplus 7.2 program for LCA and SPSS 22.0 for multiple regression analyses. LCA identified people who fell into one of the four activity groups: Diverse, Community Center/Disengaged, Religion Plus, and Friendship/Leisure. Membership in these four groups predicted differences in depressive symptoms and self-rated health. Results indicate that typologies of social activity could enhance practitioners' understanding of activity patterns and their associations with health and well-being.

Intimate partner, familial and community violence among men who have sex with men in Namibia

PubMed Central

Stephenson, Rob; Hast, Marisa; Finneran, Catherine; Sineath, Craig R.

2015-01-01

Men who have sex with men in sub-Saharan Africa are known to experience high levels of violence, yet little research has focused on their perceptions of intimate partner violence (IPV). This study examines the perceived typologies and sources of multiple forms of violence, including IPV, family/community violence and discrimination from healthcare workers, among men who have sex with men in Namibia. Focus-group discussions and in-depth interviews were conducted with a 52 men residing in five cities across Namibia. Results indicate that violence, in varying forms, is commonplace in the lives of men who have sex with men in this community, and may be associated with HIV testing patterns. PMID:24735113

“Why We Stay”: Immigrants’ motivations for remaining in communities impacted by anti-immigration policy

PubMed Central

Valdez, Carmen R.; Valentine, Jessa L.; Padilla, Brian

2013-01-01

Although restrictive immigration policy reduces incentives for unauthorized immigrants to remain in the United States, many immigrants remain in their U.S. community in spite of the anti-immigration climate surrounding them. This study explores motivations shaping immigrants’ intentions to stay in Arizona after passage of Senate Bill 1070 in 2010, one of the most restrictive immigration policies in recent decades. We conducted three focus groups in a large metropolitan city in Arizona with Mexican immigrant parents (N = 25). Themes emerging from the focus groups described multiple and interlocking personal, family and community, and contemporary sociopolitical motivations to stay in their community, and suggest that some important motivating factors have evolved as a result of immigrants’ changing environment. Implications for research and social policy reform are discussed. PMID:23875853

Increases in HIV Testing and Case Detection from NIMH Project Accept (HPTN 043) among 16–32 Year Olds: A Randomized Community-Based Intervention in Tanzania, Zimbabwe, and Thailand

PubMed Central

Sweat, Michael; Morin, Stephen; Celentano, David; Mulawa, Marta; Singh, Basant; Mbwambo, Jessie; Kawichai, Surinda; Chingono, Alfred; Khumalo-Sakutukwa, Gertrude; Gray, Glenda; Richter, Linda; Kulich, Michal; Sadowski, Andrew; Coates, Thomas

2011-01-01

SUMMARY BACKGROUND HIV counseling and testing is the gateway to treatment and care and provides important preventative and personal benefits to recipients. However, in developing countries the majority of HIV infected persons have not been tested for HIV. Combining community mobilization, mobile community-based HIV testing and counseling, and post-test support may increase HIV testing rates. METHODS We randomly assigned half of 10 rural communities in Tanzania, 8 in Zimbabwe, and 14 in Thailand to receive a multiple component community-based voluntary counseling and testing (CBVCT) intervention together with access to standard clinic-based voluntary counseling and testing (SVCT). The control communities received only SVCT. The intervention was provided for approximately 3 years. The primary study endpoint is HIV incidence and is pending completion of the post-intervention assessment. This is a descriptive interim analysis examining the percentage of the total population aged 16–32 years tested for HIV across study arms, and differences in client characteristics by study arm. FINDINGS A higher percentage of 16–32 year-olds were tested in intervention communities than in control communities (37% vs. 9% in Tanzania; 51% vs. 5% in Zimbabwe; and 69% vs. 23% in Thailand). The mean difference between the percentage of the population tested in CBVCT versus SVCT communities was 40.4% across the 3 country study arm pairs, (95% CI 15.8% – 64.7%, p-value 0.019, df=2). Despite higher prevalence of HIV among those testing at SVCT venues the intervention detected 3.6 times more HIV infected clients in the CBVCT communities than in SVCT communities (952 vs. 264, p< 0.001). Over time the rate of repeat testing grew substantially across all sites to 28% of all those testing for HIV by the end of the intervention period. INTERPRETATION This multiple component, community-level intervention is effective at both increasing HIV testing rates and detecting HIV cases in rural settings in developing countries. PMID:21546309

Experiences of Antihomosexual Attitudes and Young Black Men Who Have Sex with Men in the South: A Need for Community-Based Interventions

PubMed Central

Ricks, JaNelle M.; McGladrey, Margaret; Crosby, Richard A.; Mena, Leandro A.; Ottmar, Jessica M.

2016-01-01

Abstract Purpose: In 2012, Jackson, Mississippi, had the third highest incidence rate of human immunodeficiency virus (HIV) among young Black men who have sex with men (MSM). The goal of this qualitative study (the initial phase of an HIV prevention clinical trial) was to explore how cultural norms regarding antihomosexual attitudes interfere with the safe sex practices and relationship norms of young Black MSM in Mississippi. Methods: Nine focus groups (N = 54) were conducted with young Black MSM aged 18–29. Participants were recruited through medical providers at local sexually transmitted infection clinics and through community organizers at local LGBT outreach programs. The data were analyzed through the use of grounded theory, multiple coders for consistency and intercoder reliability, and a qualitative data analysis software. Results: Three major themes were identified during the analysis: (1) resiliency and condom use, (2) inconsistent condom use among closeted young Black MSM, and (3) intimate partner violence (IPV) among closeted young Black MSM. Black MSM in Mississippi continue to be highly stigmatized within their social networks (i.e., families, sexual partners, and community). Conclusions: The findings suggest that cultural and community norms regarding antihomosexual attitudes may be a barrier to the practices of safe sex and a contributing factor to IPV among young Black MSM. There is a need for tailored interventions that address these cultural norms and establish social and community support for young Black MSM in Mississippi. PMID:26886074

Development and Use of Health-Related Technologies in Indigenous Communities: Critical Review

PubMed Central

Jacklin, Kristen; O'Connell, Megan E

2017-01-01

Background Older Indigenous adults encounter multiple challenges as their age intersects with health inequities. Research suggests that a majority of older Indigenous adults prefer to age in place, and they will need culturally safe assistive technologies to do so. Objective The aim of this critical review was to examine literature concerning use, adaptation, and development of assistive technologies for health purposes by Indigenous peoples. Methods Working within Indigenous research methodologies and from a decolonizing approach, searches of peer-reviewed academic and gray literature dated to February 2016 were conducted using keywords related to assistive technology and Indigenous peoples. Sources were reviewed and coded thematically. Results Of the 34 sources captured, only 2 concerned technology specifically for older Indigenous adults. Studies detailing technology with Indigenous populations of all ages originated primarily from Canada (n=12), Australia (n=10), and the United States (n=9) and were coded to four themes: meaningful user involvement and community-based processes in development, the digital divide, Indigenous innovation in technology, and health technology needs as holistic and interdependent. Conclusions A key finding is the necessity of meaningful user involvement in technology development, especially in communities struggling with the digital divide. In spite of, or perhaps because of this divide, Indigenous communities are enthusiastically adapting mobile technologies to suit their needs in creative, culturally specific ways. This enthusiasm and creativity, coupled with the extensive experience many Indigenous communities have with telehealth technologies, presents opportunity for meaningful, culturally safe development processes. PMID:28729237

Faunal Communities Are Invariant to Fragmentation in Experimental Seagrass Landscapes

PubMed Central

Marion, Scott R.; Lombana, Alfonso V.; Orth, Robert J.

2016-01-01

Human-driven habitat fragmentation is cited as one of the most pressing threats facing many coastal ecosystems today. Many experiments have explored the consequences of fragmentation on fauna in one foundational habitat, seagrass beds, but have either surveyed along a gradient of existing patchiness, used artificial materials to mimic a natural bed, or sampled over short timescales. Here, we describe faunal responses to constructed fragmented landscapes varying from 4–400 m2 in two transplant garden experiments incorporating live eelgrass (Zostera marina L.). In experiments replicated within two subestuaries of the Chesapeake Bay, USA across multiple seasons and non-consecutive years, we comprehensively censused mesopredators and epifaunal communities using complementary quantitative methods. We found that community properties, including abundance, species richness, Simpson and functional diversity, and composition were generally unaffected by the number of patches and the size of the landscape, or the intensity of sampling. Additionally, an index of competition based on species co-occurrences revealed no trends with increasing patch size, contrary to theoretical predictions. We extend conclusions concerning the invariance of animal communities to habitat fragmentation from small-scale observational surveys and artificial experiments to experiments conducted with actual living plants and at more realistic scales. Our findings are likely a consequence of the rapid life histories and high mobility of the organisms common to eelgrass beds, and have implications for both conservation and restoration, suggesting that even small patches can rapidly promote abundant and diverse faunal communities. PMID:27244652

Faunal Communities Are Invariant to Fragmentation in Experimental Seagrass Landscapes.

PubMed

Lefcheck, Jonathan S; Marion, Scott R; Lombana, Alfonso V; Orth, Robert J

2016-01-01

Human-driven habitat fragmentation is cited as one of the most pressing threats facing many coastal ecosystems today. Many experiments have explored the consequences of fragmentation on fauna in one foundational habitat, seagrass beds, but have either surveyed along a gradient of existing patchiness, used artificial materials to mimic a natural bed, or sampled over short timescales. Here, we describe faunal responses to constructed fragmented landscapes varying from 4-400 m2 in two transplant garden experiments incorporating live eelgrass (Zostera marina L.). In experiments replicated within two subestuaries of the Chesapeake Bay, USA across multiple seasons and non-consecutive years, we comprehensively censused mesopredators and epifaunal communities using complementary quantitative methods. We found that community properties, including abundance, species richness, Simpson and functional diversity, and composition were generally unaffected by the number of patches and the size of the landscape, or the intensity of sampling. Additionally, an index of competition based on species co-occurrences revealed no trends with increasing patch size, contrary to theoretical predictions. We extend conclusions concerning the invariance of animal communities to habitat fragmentation from small-scale observational surveys and artificial experiments to experiments conducted with actual living plants and at more realistic scales. Our findings are likely a consequence of the rapid life histories and high mobility of the organisms common to eelgrass beds, and have implications for both conservation and restoration, suggesting that even small patches can rapidly promote abundant and diverse faunal communities.

Indoor-Air Microbiome in an Urban Subway Network: Diversity and Dynamics

PubMed Central

Leung, Marcus H. Y.; Wilkins, David; Li, Ellen K. T.; Kong, Fred K. F.

2014-01-01

Subway systems are indispensable for urban societies, but microbiological characteristics of subway aerosols are relatively unknown. Previous studies investigating microbial compositions in subways employed methodologies that underestimated the diversity of microbial exposure for commuters, with little focus on factors governing subway air microbiology, which may have public health implications. Here, a culture-independent approach unraveling the bacterial diversity within the urban subway network in Hong Kong is presented. Aerosol samples from multiple subway lines and outdoor locations were collected. Targeting the 16S rRNA gene V4 region, extensive taxonomic diversity was found, with the most common bacterial genera in the subway environment among those associated with skin. Overall, subway lines harbored different phylogenetic communities based on α- and β-diversity comparisons, and closer inspection suggests that each community within a line is dependent on architectural characteristics, nearby outdoor microbiomes, and connectedness with other lines. Microbial diversities and assemblages also varied depending on the day sampled, as well as the time of day, and changes in microbial communities between peak and nonpeak commuting hours were attributed largely to increases in skin-associated genera in peak samples. Microbial diversities within the subway were influenced by temperature and relative humidity, while carbon dioxide levels showed a positive correlation with abundances of commuter-associated genera. This Hong Kong data set and communities from previous studies conducted in the United States formed distinct community clusters, indicating that additional work is required to unravel the mechanisms that shape subway microbiomes around the globe. PMID:25172855

The influence of socio-cultural interpretations of pregnancy threats on health-seeking behavior among pregnant women in urban Accra, Ghana.

PubMed

Dako-Gyeke, Phyllis; Aikins, Moses; Aryeetey, Richmond; McCough, Laura; Adongo, Philip Baba

2013-11-19

Although antenatal care coverage in Ghana is high, there exist gaps in the continued use of maternity care, especially utilization of skilled assistance during delivery. Many pregnant women seek care from different sources aside the formal health sector. This is due to negative perceptions resulting from poor service quality experiences in health facilities. Moreover, the socio-cultural environment plays a major role for this care-seeking behavior. This paper seeks to examine beliefs, knowledge and perceptions about pregnancy and delivery and care-seeking behavior among pregnant women in urban Accra, Ghana. A qualitative study with 6 focus group discussions and 13 in-depth interviews were conducted at Taifa-Kwabenya and Madina sub-districts, Accra. Participants included mothers who had delivered within the past 12 months, pregnant women, community members, religious and community leaders, orthodox and non-orthodox healthcare providers. Interviews and discussions were audio-taped, transcribed and coded into larger themes and categories. Evidence showed perceived threats, which are often given socio-cultural interpretations, increased women's anxieties, driving them to seek multiple sources of care. Crucially, care-seeking behavior among pregnant women indicated sequential or concurrent use of biomedical care and other forms of care including herbalists, traditional birth attendants, and spiritual care. Use of multiple sources of care in some cases disrupted continued use of skilled provider care. Furthermore, use of multiple forms of care is encouraged by a perception that facility-based care is useful only for antenatal services and emergencies. It also highlights the belief among some participants that care from multiple sources are complementary to each other. Socio-cultural interpretations of threats to pregnancy mediate pregnant women's use of available healthcare services. Efforts to encourage continued use of maternity care, especially skilled birth assistance at delivery, should focus on addressing generally perceived dangers to pregnancy. Also, the attractiveness of facility-based care offers important opportunities for building collaborations between orthodox and alternative care providers with the aim of increasing use of skilled obstetric care. Conventional antenatal care should be packaged to provide psychosocial support that helps women deal with pregnancy-related fear.

Visual methodologies and participatory action research: Performing women's community-based health promotion in post-Katrina New Orleans.

PubMed

Lykes, M Brinton; Scheib, Holly

2016-01-01

Recovery from disaster and displacement involves multiple challenges including accompanying survivors, documenting effects, and rethreading community. This paper demonstrates how African-American and Latina community health promoters and white university-based researchers engaged visual methodologies and participatory action research (photoPAR) as resources in cross-community praxis in the wake of Hurricane Katrina and the flooding of New Orleans. Visual techniques, including but not limited to photonarratives, facilitated the health promoters': (1) care for themselves and each other as survivors of and responders to the post-disaster context; (2) critical interrogation of New Orleans' entrenched pre- and post-Katrina structural racism as contributing to the racialised effects of and responses to Katrina; and (3) meaning-making and performances of women's community-based, cross-community health promotion within this post-disaster context. This feminist antiracist participatory action research project demonstrates how visual methodologies contributed to the co-researchers' cross-community self- and other caring, critical bifocality, and collaborative construction of a contextually and culturally responsive model for women's community-based health promotion post 'unnatural disaster'. Selected limitations as well as the potential for future cross-community antiracist feminist photoPAR in post-disaster contexts are discussed.

Using Analysis of Governance to Unpack Community-Based Conservation: A Case Study from Tanzania.

PubMed

Robinson, Lance W; Makupa, Enock

2015-11-01

Community-based conservation policies and programs are often hollow with little real devolution. But to pass a judgment of community-based or not community-based on such initiatives and programs obscures what is actually a suite of attributes. In this paper, we analyze governance around a specific case of what is nominally community-based conservation-Ikona Wildlife Management Area (WMA) in Tanzania-using two complementary sets of criteria. The first relates to governance "powers": planning powers, regulatory powers, spending powers, revenue-generating powers, and the power to enter into agreements. The second set of criteria derive from the understanding of governance as a set of social functions: social coordination, shaping power, setting direction, and building community. The analysis helps to detail ways in which the Tanzanian state through policy and regulations has constrained the potential for Ikona WMA to empower communities and community actors. Although it has some features of community-based conservation, community input into how the governance social functions would be carried out in the WMA was constrained from the start and is now largely out of community hands. The two governance powers that have any significant community-based flavor-spending powers and revenue-generating powers-relate to the WMA's tourism activities, but even here the picture is equivocal at best. The unpacking of governance that we have done, however, reveals that community empowerment through the processes associated with creating and recognizing indigenous and community-conserved areas is something that can be pursued through multiple channels, some of which might be more strategic than others.

Developing a smoke free homes initiative in Kerala, India.

PubMed

Nichter, Mimi; Padmajam, Sreedevi; Nichter, Mark; Sairu, P; Aswathy, S; Mini, G K; Bindu, V C; Pradeepkumar, A S; Thankappan, K R

2015-05-10

Results of the Global Adult Tobacco Survey in Kerala, India found that 42 % of adults were exposed to second hand smoke (SHS) inside the home. Formative research carried out in rural Kerala suggests that exposure may be much higher. Numerous studies have called for research and intervention on SHS exposure among women and children as an important component of maternal and child health activities. Community-based participatory research was carried out in Kerala. First, a survey was conducted to assess prevalence of SHS exposure in households. Next, a proof of concept study was conducted to develop and test the feasibility of a community-wide smoke free homes initiative. Educational materials were developed and pretested in focus groups. After feasibility was established, pilot studies were implemented in two other communities. Post intervention, surveys were conducted as a means of assessing changes in community support. At baseline, between 70 and 80 % of male smokers regularly smoked inside the home. Over 80 % of women had asked their husband not to do so. Most women felt powerless to change their husband's behavior. When women were asked about supporting a smoke free homes intervention, 88 % expressed support for the idea, but many expressed doubt that their husbands would comply. Educational meetings were held to discuss the harms of second hand smoke. Community leaders signed a declaration that their community was part of the smoke free homes initiative. Six months post intervention a survey was conducted in these communities; between 34 and 59 % of men who smoked no longer smoked in their home. The smoke free homes initiative is based on the principle of collective efficacy. Recognizing the difficulty for individual women to effect change in their household, the movement establishes a smoke free community mandate. Based on evaluation data from two pilot studies, we can project that between a 30 and 60 % reduction of smoking in the home may be achieved, the effect size determined by how well the smoke free home steps are implemented, the characteristics of the community, and the motivation of community level facilitators.

Knowledge Discovery/A Collaborative Approach, an Innovative Solution

NASA Technical Reports Server (NTRS)

Fitts, Mary A.

2009-01-01

Collaboration between Medical Informatics and Healthcare Systems (MIHCS) at NASA/Johnson Space Center (JSC) and the Texas Medical Center (TMC) Library was established to investigate technologies for facilitating knowledge discovery across multiple life sciences research disciplines in multiple repositories. After reviewing 14 potential Enterprise Search System (ESS) solutions, Collexis was determined to best meet the expressed needs. A three month pilot evaluation of Collexis produced positive reports from multiple scientists across 12 research disciplines. The joint venture and a pilot-phased approach achieved the desired results without the high cost of purchasing software, hardware or additional resources to conduct the task. Medical research is highly compartmentalized by discipline, e.g. cardiology, immunology, neurology. The medical research community at large, as well as at JSC, recognizes the need for cross-referencing relevant information to generate best evidence. Cross-discipline collaboration at JSC is specifically required to close knowledge gaps affecting space exploration. To facilitate knowledge discovery across these communities, MIHCS combined expertise with the TMC library and found Collexis to best fit the needs of our researchers including:

Community-based Participatory Research

PubMed Central

Holkup, Patricia A.; Tripp-Reimer, Toni; Salois, Emily Matt; Weinert, Clarann

2009-01-01

Community-based participatory research (CBPR), with its emphasis on joining with the community as full and equal partners in all phases of the research process, makes it an appealing model for research with vulnerable populations. However, the CBPR approach is not without special challenges relating to ethical, cultural, and scientific issues. In this article, we describe how we managed the challenges we encountered while conducting a CBPR project with a Native American community. We also suggest criteria that will enable evaluation of the project. PMID:15455579

Barriers and facilitators to implementing a patient-centered model of contraceptive provision in community health centers.

PubMed

Politi, Mary C; Estlund, Amy; Milne, Anne; Buckel, Christina M; Peipert, Jeffrey F; Madden, Tessa

2016-01-01

The Contraceptive CHOICE Project developed a patient-centered model for contraceptive provision including: (1) structured, evidence-based counseling; (2) staff and health care provider education; and (3) removal of barriers such as cost and multiple appointments to initiate contraception. In preparation for conducting a research study of the CHOICE model in three community health settings, we sought to identify potential barriers and facilitators to implementation. Using a semi-structured interview guide guided by a framework of implementation research, we conducted 31 qualitative interviews with female patients, staff, and health care providers assessing attitudes, beliefs, and barriers to receiving contraception. We also asked about current contraceptive provision and explored organizational practices relevant to implementing the CHOICE model. We used a grounded theory approach to identify major themes. Many participants felt that current contraceptive provision could be improved by the CHOICE model. Potential facilitators included agreement about the necessity for improved contraceptive knowledge among patients and staff; importance of patient-centered contraceptive counseling; and benefits to same-day insertion of long-acting reversible contraception (LARC). Potential barriers included misconceptions about contraception held by staff and providers; resistance to new practices; costs associated with LARC; and scheduling challenges required for same-day insertion of LARC. In addition to staff and provider training, implementing a patient-centered model of contraceptive provision needs to be supplemented by strategies to manage patient and system-level barriers. Community health center staff, providers, and patients support patient-centered contraceptive counseling to improve contraception provision if organizations can address these barriers.

Community temporal variability increases with fluctuating resource availability

PubMed Central

Li, Wei; Stevens, M. Henry H.

2017-01-01

An increase in the quantity of available resources is known to affect temporal variability of aggregate community properties. However, it is unclear how might fluctuations in resource availability alter community-level temporal variability. Here we conduct a microcosm experiment with laboratory protist community subjected to manipulated resource pulses that vary in intensity, duration and time of supply, and examine the impact of fluctuating resource availability on temporal variability of the recipient community. The results showed that the temporal variation of total protist abundance increased with the magnitude of resource pulses, as protist community receiving infrequent resource pulses (i.e., high-magnitude nutrients per pulse) was relatively more unstable than community receiving multiple resource pulses (i.e., low-magnitude nutrients per pulse), although the same total amounts of nutrients were added to each community. Meanwhile, the timing effect of fluctuating resources did not significantly alter community temporal variability. Further analysis showed that fluctuating resource availability increased community temporal variability by increasing the degree of community-wide species synchrony and decreasing the stabilizing effects of dominant species. Hence, the importance of fluctuating resource availability in influencing community stability and the regulatory mechanisms merit more attention, especially when global ecosystems are experiencing high rates of anthropogenic nutrient inputs. PMID:28345592

Community temporal variability increases with fluctuating resource availability

NASA Astrophysics Data System (ADS)

Li, Wei; Stevens, M. Henry H.

2017-03-01

An increase in the quantity of available resources is known to affect temporal variability of aggregate community properties. However, it is unclear how might fluctuations in resource availability alter community-level temporal variability. Here we conduct a microcosm experiment with laboratory protist community subjected to manipulated resource pulses that vary in intensity, duration and time of supply, and examine the impact of fluctuating resource availability on temporal variability of the recipient community. The results showed that the temporal variation of total protist abundance increased with the magnitude of resource pulses, as protist community receiving infrequent resource pulses (i.e., high-magnitude nutrients per pulse) was relatively more unstable than community receiving multiple resource pulses (i.e., low-magnitude nutrients per pulse), although the same total amounts of nutrients were added to each community. Meanwhile, the timing effect of fluctuating resources did not significantly alter community temporal variability. Further analysis showed that fluctuating resource availability increased community temporal variability by increasing the degree of community-wide species synchrony and decreasing the stabilizing effects of dominant species. Hence, the importance of fluctuating resource availability in influencing community stability and the regulatory mechanisms merit more attention, especially when global ecosystems are experiencing high rates of anthropogenic nutrient inputs.

The Greening of a Brownfield: A Community-Based Learning Project in Economics

ERIC Educational Resources Information Center

Kaufman, Dennis A.; Cloutier, Norman R.

2004-01-01

This paper describes a community-based learning (CBL) project involving the economic redevelopment of two environmentally contaminated former industrial sites or "brownfields." The study was conducted over four semesters by several economics classes and involved assembling a database, measuring the impact of the brownfields on…

Dissemination of Evidence-Based Practice: Can We Train Therapists from a Distance?

ERIC Educational Resources Information Center

Vismara, Laurie A.; Young, Gregory S.; Stahmer, Aubyn C.; Griffith, Elizabeth McMahon; Rogers, Sally J.

2009-01-01

Although knowledge about the efficacy of behavioral interventions for children with ASD is increasing, studies of effectiveness and transportability to community settings are needed. The current study conducted an effectiveness trial to compare distance learning vs. live instruction for training community-based therapists to implement the Early…

Community-Based Research Networks: Development and Lessons Learned in an Emerging Field.

ERIC Educational Resources Information Center

Stoecker, Randy; Ambler, Susan H.; Cutforth, Nick; Donohue, Patrick; Dougherty, Dan; Marullo, Sam; Nelson, Kris S.; Stutts, Nancy B.

2003-01-01

Compares seven multi-institutional community-based research networks in Appalachia; Colorado; District of Columbia; Minneapolis-St. Paul; Philadelphia; Richmond, Virginia; and Trenton, New Jersey. After reviewing the histories of the networks, conducts a comparative SWOT analysis, showing their common and unique strengths, weaknesses,…

Evaluation of Implementation of School/Community-Based Management. Final Report.

ERIC Educational Resources Information Center

Hawaii Business Roundtable, Honolulu.

A formative evaluation was conducted of two elementary schools that have been engaged in the School/Community-Based Management (SCBM) process in Hawaii. The evaluation process was aligned with the SCBM philosophy, which promotes shared decision making, shared responsibility, and collaboration. Stakeholders contributed to the evaluation, which…

An emotional contagion model for heterogeneous social media with multiple behaviors

NASA Astrophysics Data System (ADS)

Xiong, Xi; Li, Yuanyuan; Qiao, Shaojie; Han, Nan; Wu, Yue; Peng, Jing; Li, Binyong

2018-01-01

The emotion varies and propagates with the spatial and temporal information of individuals through social media, which uncovers several interaction mechanisms and features the community structure in order to facilitate individuals' communication and emotional contagion in social networks. Aiming to show the detailed process and characteristics of emotional contagion within social media, we propose an emotional independent cascade model in which individual emotion can affect the subsequent emotion of his/her friends. The transmissibility is introduced to measure the capability of propagating emotion with respect to an individual in social networks. By analyzing the patterns of emotional contagion on Twitter data, we find that the value of transmissibility differs on different layers and on different community structures. Extensive experiments were conducted and the results reveal that, the polar emotion of hub users can lead to the disappearance of opposite emotion, and the transmissibility makes no sense. The final emotional distribution depends on the initial emotional distribution and the transmissibilities. Individuals from a small community are more likely to change their mood by the influence of community leaders. In addition, we compared the proposed model with two other models, the emotion-based spreader-ignorant-stifler model and the standard independent cascade model. The results demonstrate that the proposed model can reflect the real-world situation of emotional contagion for heterogeneous social media while the computational complexities of all these three models are similar.

Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital.

PubMed

Musinguzi, Laban Kashaija; Turinawe, Emmanueil Benon; Rwemisisi, Jude T; de Vries, Daniel H; Mafigiri, David K; Muhangi, Denis; de Groot, Marije; Katamba, Achilles; Pool, Robert

2017-01-11

Community-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services. Data were collected through ethnographic fieldwork undertaken as part of a larger research program in Luwero District, Uganda, between 2012 and 2014. The main methods of data collection were participant observation in events organised by VHTs. In addition, a total of 91 in-depth interviews and 42 focus group discussions (FGD) were conducted with adult community members as part of the larger project. After preliminary analysis of the data, we conducted an additional six in-depth interviews and three FGD with VHTs and four FGD with community members on the role of VHTs. Key informant interviews were conducted with local government staff, health workers, local leaders, and NGO staff with health programs in Luwero. Thematic analysis was used during data analysis. The ability of VHTs to link communities with formal health care was affected by the stakeholders' perception of their roles. Community members perceive VHTs as working for and under instructions of "others", which makes them powerless in the formal health care system. One of the challenges associated with VHTs' linking roles is support from the government and formal health care providers. Formal health care providers perceived VHTs as interested in special recognition for their services yet they are not "experts". For some health workers, the introduction of VHTs is seen as a ploy by the government to control people and hide its inability to provide health services. Having received training and initial support from an NGO, VHTs suffered transition failure from NGO to the formal public health care structure. As a result, VHTs are entangled in power relations that affect their role of linking community members with formal health care services. We also found that factors such as lack of money for treatment, poor transport networks, the attitudes of health workers and the existence of multiple health care systems, all factors that hinder access to formal health care, cannot be addressed by the VHTs. As linking social capital framework shows, for VHTs to effectively act as links between the community and formal health care and harness the resources that exist in institutions beyond the community, it is important to take into account the power relationships embedded in vertical relationships and forge a partnership between public health providers and the communities they serve. This will ensure strengthened partnerships and the improved capacity of local people to leverage resources embedded in vertical power networks.

Community-based lifestyle modification of cardiovascular disease risks in middle-aged Japanese: a 27-month update.

PubMed

Fujii, Hiroko; Muto, Takashi; Haruyama, Yasuo; Nakade, Makiko; Kobayashi, Emiko; Ishisaki, Kaori; Yamasaki, Akiko

2010-04-01

Lifestyle modification is the cornerstone of preventive management for people with cardiovascular disease risks, such as obesity, hypertension, dyslipidemia and diabetes. This study investigated the effect of a 27-month community-based lifestyle intervention on the reduction of cardiovascular disease risks in middle-aged Japanese. Of 549 participants with cardiovascular disease risk factors of overweight, hypertension, dyslipidemia or diabetes enrolled in this non-randomized controlled study, 397 participants aged 39-71 years old completed all 3 serial surveys at baseline, 15 months and 27 months. For the intervention group (39 males and 174 females), 31 specific interventions including individual counselling and group sessions were conducted. The control group (64 males and 120 females) only received 7 newsletters providing health information and results of health checkups. Multiple logistic regression analysis adjusted for sex, each baseline risk category and age category showed that the proportion of those who were overweight or showed dyslipidemia risk were significantly lower in the intervention group only at 27 months [Odds ratio (OR): 0.43 (95% CI 0.20-0.94), OR: 0.43 (95% CI 0.21-0.87), respectively] and the proportion of those showing diabetes risk was significantly lower in the intervention group at both 15 months [OR: 0.42 (95% CI 0.18-0.97)] and 27 months [OR: 0.56 (95% CI 0.32-0.99)]. In conclusion, the 27-month community-based lifestyle modification of cardiovascular disease risks shows significant reductions in risks of diabetes, overweight and dyslipidemia in middle-aged Japanese.

Evaluation of a Community-Based Intervention to Promote Rear Seating for Children

PubMed Central

Greenberg-Seth, Jennifer; Hemenway, David; Gallagher, Susan S.; Ross, Julie B.; Lissy, Karen S.

2004-01-01

Objectives. We evaluated the short-term effect of a community-based effort to promote child rear seating in a low-income Hispanic community. Methods. Child seating patterns were observed pre- and postintervention at intersections in 1 intervention and 2 control cities. Brief interviews assessed exposure to program messages. Results. Child rear seating increased from 33% to 49% in the intervention city (P < .0001), which represented a greater increase than that in the control cities (P < .0001). The greatest improvement was observed in relatively higher-income areas. Rear seating was significantly correlated with reported program exposure. Incentives and exposure to the program across multiple channels seemed to have the greatest effect. Conclusions. Independent of legislation, community-based programs incorporating incentives can increase child rear seating. PMID:15249307

Community Air Monitoring for Pesticide Drift Using Pesticide Action Network's (PAN) Drift Catcher

NASA Astrophysics Data System (ADS)

Marquez, E.

2016-12-01

Community air monitoring projects for pesticides in the air have been conducted by PAN in collaboration with community members and locally based groups engaged around pesticide issues. PAN is part of an international network working to promote a just, thriving food system and replace the use of hazardous pesticides with ecologically sound alternatives. The Drift Catcher is an air-monitoring device with a design based on the California Air Resource Board's air monitoring equipment, and has been used in community-based projects in 11 states. Observations of pesticide drift made by community members cannot always be confirmed by regulatory agencies—if an inspection is made hours or days after a drift incident, the evidence may no longer be present. The Drift Catcher makes it possible to collect scientific evidence of pesticide drift in areas where people live, work, and play. One of the most recent Drift Catcher projects was done in California, in partnership with the Safe Strawberry Coalition and led by the statewide coalition Californians for Pesticide Reform. The data were used to support a call for stronger mitigation rules for the fumigant chloropicrin and to support a campaign asking for stronger pesticide rules to protect children attending school in close proximity to agricultural fields. The Drift Catcher data are used by organizers and community members to engage policymakers with the intention of making policy change on a local and/or statewide level. On the national level, PAN's Drift Catcher data has helped win regulatory recognition of volatilization drift for pesticides other than fumigants. Lessons learned from conducting community-based research projects will also be discussed. PAN is also currently assessing other community-based monitoring tools, such as community surveys and drift questionnaires that may allow communities to collect data that can also support the campaign work.

Tlokoeng Valley Community's Conceptions of Wetlands: Prospects for More Sustainable Water Resources Management

ERIC Educational Resources Information Center

Mokuku, Tšepo; Taylor, Jim

2015-01-01

This article explores prospects for community-based water resources management in Tlokoeng Valley, in the northern district of Lesotho. A qualitative survey was conducted to establish the pre-knowledge of the valley community. This provided a basis for a community education programme on wetlands conservation. Fifteen focus group interviews (FGIs)…

Enacting True Partnerships within Community-Based Learning: Faculty and Community Partners Reflect on the Challenges of Engagement

ERIC Educational Resources Information Center

Kerrigan, Seanna M.; Reitenauer, Vicki L.; Arevalo-Meier, Nora

2015-01-01

In the past two decades, the literature on campus-community partnerships as core components of pedagogies of engagement has grown exponentially. In this article, the director and a longtime faculty member of Portland State University's capstone program report on interviews conducted with ten faculty-community partner pairs, gleaning insights on…

Working towards More Effective Implementation, Dissemination and Scale-Up of Lower-Limb Injury-Prevention Programs: Insights from Community Australian Football Coaches

PubMed Central

2018-01-01

Disseminating lower-limb injury-prevention exercise programs (LL-IPEPs) with strategies that effectively reach coaches across sporting environments is a way of preventing lower-limb injuries (LLIs) and ensuring safe and sustainable sport participation. The aim of this study was to explore community-Australian Football (community-AF) coaches’ perspectives on the strategies they believed would enhance the dissemination and scale-up of LL-IPEPs. Using a qualitative multiple case study design, semi-structured interviews with community-AF coaches in Victoria, Australia, were conducted. Overall, coaches believed a range of strategies were important including: coach education, policy drivers, overcoming potential problem areas, a ‘try before you buy approach’, presenting empirical evidence and guidelines for injury-prevention exercise programs (IPEPs), forming strategic collaboration and working in partnership, communication and social marketing, public meetings, development of a coach hotline, and targeted multi-focused approaches. A shift to a culture whereby evidence-based IPEP practices in community-AF will take time, and persistent commitment by all involved in the sport is important. This will support the creation of strategies that will enhance the dissemination and scale-up of LL-IPEPs across community sport environments. The focus of research needs to continue to identify effective, holistic and multi-level interventions to support coaches in preventing LLIs. This could lead to the determination of successful strategies such as behavioural regulation strategies and emotional coping resources to implement LL-IPEPs into didactic curricula and practice. Producing changes in practice will require attention to which strategies are a priority and the most effective. PMID:29462913

Promoting youth physical activity in rural southern communities: practitioner perceptions of environmental opportunities and barriers.

PubMed

Edwards, Michael B; Theriault, Daniel S; Shores, Kindal A; Melton, Karen M

2014-01-01

Research on youth physical activity has focused on urban areas. Rural adolescents are more likely to be physically inactive than urban youth, contributing to higher risk of obesity and chronic diseases. Study objectives were to: (1) identify perceived opportunities and barriers to youth physical activity within a rural area and (2) identify rural community characteristics that facilitate or inhibit efforts to promote youth physical activity. Thirty in-depth interviews were conducted with expert informants in 2 rural southern US counties. Interviewees were recruited from diverse positions across multiple sectors based on their expert knowledge of community policies and programs for youth physical activity. Informants saw ball fields, natural amenities, and school sports as primary resources for youth physical activity, but they were divided on whether opportunities were abundant or scarce. Physical distance, social isolation, lack of community offerings, and transportation were identified as key barriers. Local social networks facilitated political action and volunteer recruitment to support programs. However, communities often lacked human capital to sustain initiatives. Racial divisions influenced perceptions of opportunities. Despite divisions, there were also examples of pooling resources to create and sustain physical activity opportunities. Developing partnerships and leveraging local resources may be essential to overcoming barriers for physical activity promotion in rural areas. Involvement of church leaders, school officials, health care workers, and cooperative extension is likely needed to establish and sustain youth rural physical activity programs. Allocating resources to existing community personnel and volunteers for continuing education may be valuable. © 2014 National Rural Health Association.

The training and fieldwork experiences of community health workers conducting population-based, noninvasive screening for CVD in LMIC.

PubMed

Abrahams-Gessel, Shafika; Denman, Catalina A; Montano, Carlos Mendoza; Gaziano, Thomas A; Levitt, Naomi; Rivera-Andrade, Alvaro; Carrasco, Diana Munguía; Zulu, Jabu; Khanam, Masuma Akter; Puoane, Thandi

2015-03-01

Cardiovascular disease (CVD) is on the rise in low- and middle-income countries and is proving difficult to combat due to the emphasis on improving outcomes in maternal and child health and infectious diseases against a backdrop of severe human resource and infrastructure constraints. Effective task-sharing from physicians or nurses to community health workers (CHW) to conduct population-based screening for persons at risk has the potential to mitigate the impact of CVD on vulnerable populations. CHW in Bangladesh, Guatemala, Mexico, and South Africa were trained to conduct noninvasive population-based screening for persons at high risk for CVD. This study sought to quantitatively assess the performance of CHW during training and to qualitatively capture their training and fieldwork experiences while conducting noninvasive screening for CVD risk in their communities. Written tests were used to assess CHW's acquisition of content knowledge during training, and focus group discussions were conducted to capture their training and fieldwork experiences. Training was effective at increasing the CHW's content knowledge of CVD, and this knowledge was largely retained up to 6 months after the completion of fieldwork. Common themes that need to be addressed when designing task-sharing with CHW in chronic diseases are identified, including language, respect, and compensation. The importance of having intimate knowledge of the community receiving services from design to implementation is underscored. Effective training for screening for CVD in community settings should have a strong didactic core that is supplemented with culture-specific adaptations in the delivery of instruction. The incorporation of expert and intimate knowledge of the communities themselves is critical, from the design to implementation phases of training. Challenges such as role definition, defining career paths, and providing adequate remuneration must be addressed. Copyright © 2015 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

The role of HIV-related knowledge and ethnicity in determining HIV risk perception and willingness to undergo HIV testing among rural women in Burkina Faso.

PubMed

Sarker, Malabika; Milkowski, Andrea; Slanger, Tracy; Gondos, Adam; Sanou, Aboubakary; Kouyate, Bocar; Snow, Rachel

2005-06-01

We conducted a random community based survey of 300 young (15-29 years) rural women in Nouna, Burkina Faso. Only one-third of women were aware that a person could have HIV without having symptoms and these women were significantly more likely to classify themselves to be at high risk for getting HIV. Furthermore, multiple partners, Bwaba ethnicity and having mentioned a health worker as a source of HIV information were significantly associated with perceived high personal risk. Perceived willingness to participate in VCT was high (69%). The dissemination of information on the asymptomatic nature of HIV infection could potentially be very important in forming risk perception, awareness, and their willingness to participate in HIV interventions.

A framework for streamlining research workflow in neuroscience and psychology

PubMed Central

Kubilius, Jonas

2014-01-01

Successful accumulation of knowledge is critically dependent on the ability to verify and replicate every part of scientific conduct. However, such principles are difficult to enact when researchers continue to resort on ad-hoc workflows and with poorly maintained code base. In this paper I examine the needs of neuroscience and psychology community, and introduce psychopy_ext, a unifying framework that seamlessly integrates popular experiment building, analysis and manuscript preparation tools by choosing reasonable defaults and implementing relatively rigid patterns of workflow. This structure allows for automation of multiple tasks, such as generated user interfaces, unit testing, control analyses of stimuli, single-command access to descriptive statistics, and publication quality plotting. Taken together, psychopy_ext opens an exciting possibility for a faster, more robust code development and collaboration for researchers. PMID:24478691

Teaching adolescents with severe disabilities to use the public telephone.

PubMed

Test, D W; Spooner, F; Keul, P K; Grossi, T

1990-04-01

Two adolescents with severe disabilities served as participants in a study conducted to train in the use of the public telephone to call home. Participants were trained to complete a 17-step task analysis using a training package which consisted of total task presentation in conjunction with a four-level prompting procedure (i.e., independent, verbal, verbal + gesture, verbal + guidance). All instruction took place in a public setting (e.g., a shopping mall) with generalization probes taken in two alternative settings (e.g., a movie theater and a convenience store). A multiple probe across individuals design demonstrated the training package was successful in teaching participants to use the telephone to call home. In addition, newly acquired skills generalized to the two untrained settings. Implications for community-based training are discussed.

Building and measuring infrastructure and capacity for community health assessment and health improvement planning in Florida.

PubMed

Abarca, Christine; Grigg, C Meade; Steele, Jo Ann; Osgood, Laurie; Keating, Heidi

2009-01-01

COMPASS (Comprehensive Assessment, Strategic Success) is the Florida Department of Health's community health assessment and health improvement planning initiative. Since 2002, COMPASS built state and county health department infrastructure to support a comprehensive, systematic, and integrated approach to community health assessment and planning. To assess the capacity of Florida's 67 county health departments (CHDs) to conduct community health assessment and planning and to identify training and technical assistance needs, COMPASS surveyed the CHDs using a Web-based instrument annually from 2004 through 2008. Response rate to the survey was 100 percent annually. In 2007, 96 percent of CHDs reported conducting assessment and planning within the past 3 years; 74 percent used the MAPP (Mobilizing for Action through Planning and Partnerships) framework. Progress was greater for the organizational and assessment phases of the MAPP-based work; only 10 CHDs had identified strategic priorities in 2007, and even fewer had implemented strategies for improving health. In 2007, the most frequently requested types of training were measuring success, developing goals and action plans, and using qualitative data; technical assistance was most frequently requested for program evaluation and writing community health status reports. Florida's CHDs have increased their capacity to conduct community health assessment and planning. Questions remain about sustaining these gains with limited resources.

The Health and Well-Being of Children: A Portrait of States and the Nation 2007. The National Survey of Children's Health 2007

ERIC Educational Resources Information Center

US Department of Health and Human Services, 2009

2009-01-01

While data sources exist to measure and monitor the health of children in the United States, few take into account the many contexts in which children grow and develop, including their family and community environments. The National Survey of Children's Health (NSCH), conducted in 2007, addresses multiple aspects of children's health and…

Examining the Effects of Online Enrollment on Course Outcomes Using Weighting Procedures after Multiple Imputation on a State-Wide University System

ERIC Educational Resources Information Center

Smith, Nichole Danielle

2017-01-01

According to the few quasi-experimental studies examining course outcomes for community college (Xu & Jaggars, 2011a, 2011b, 2013, 2014) and for-profit students (Bettinger, Fox, Loeb, & Taylor, 2014), there is a significant penalty for online students. No comparable research has been conducted on public four-year university students to…

Moving Beyond Motive-based categories of Targeted Violence

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weine, Stevan; Cohen, John; Brannegan, David

Today’s categories for responding to targeted violence are motive-based and tend to drive policies, practices, training, media coverage, and research. These categories are based on the assumption that there are significant differences between ideological and non-ideological actors and between domestic and international actors. We question the reliance on these categories and offer an alternative way to frame the response to multiple forms of targeted violence. We propose adopting a community-based multidisciplinary approach to assess risk and provide interventions that are focused on the pre-criminal space. We describe four capabilities that should be implemented locally by establishing and maintaining multidisciplinary responsemore » teams that combine community and law-enforcement components: (1) community members are educated, making them better able to identify and report patterns associated with elevated risk for violence; (2) community-based professionals are trained to assess the risks for violent behavior posed by individuals; (3) community-based professionals learn to implement strategies that directly intervene in causal factors for those individuals who are at elevated risk; and (4) community-based professionals learn to monitor and assess an individual’s risk for violent behaviors on an ongoing basis. Community-based multidisciplinary response teams have the potential to identify and help persons in the pre-criminal space and to reduce barriers that have traditionally impeded community/law-enforcement collaboration.« less

A comparison of phone-based and onsite-based fidelity for Assertive Community Treatment in Indiana

PubMed Central

McGrew, John H.; Stull, Laura G.; Rollins, Angela L.; Salyers, Michelle P.; Hicks, Lia J.

2014-01-01

Objective This study investigated the reliability, validity, and role of rater expertise in phone-administered fidelity assessment instrument based on the Dartmouth Assertive Community Treatment Scale (DACTS). Methods An experienced rater paired with a research assistant without fidelity assessment experience or a consultant familiar with the treatment site conducted phone based assessments of 23 teams providing assertive community treatment in Indiana. Using the DACTS, consultants conducted on-site evaluations of the programs. Results The pairs of phone raters revealed high levels of consistency [intraclass correlation coefficient (ICC)=.92] and consensus (mean absolute difference of .07). Phone and on-site assessment showed strong agreement (ICC=.87) and consensus (mean absolute difference of .07) and agreed within .1 scale point, or 2% of the scoring range, for 83% of sites and within .15 scale point for 91% of sites. Results were unaffected by the expertise level of the rater. Conclusions Phone based assessment could help agencies monitor faithful implementation of evidence-based practices. PMID:21632738

Community Interactive Research Workshop Series: Community Members Engaged as Team Teachers to Conduct Research.

PubMed

Nguyen-Truong, Connie Kim; Tang, Joannie; Hsiao, Chiao-Yun

2017-01-01

Vietnamese women are diagnosed with cervical cancer at twice the rate of non-Hispanic White women and the highest compared to Chinese, Filipino, Korean, and Japanese women. ἀ e Vietnamese Women's Health Project, a community-based participatory research partnership, was developed to address this concern. In earlier studies, community members received research training. To describe how we developed an innovative curricular research training framework. Community members developed their own learning goals and activities, taught alongside a nurse scientist, and participated in a community interactive research workshop series. Popular education principles were used to guide team teaching. Topics, learning goals, lesson plans, and an evaluation w ere de veloped t ogether. ἀ ree, 4 -5.5 h our workshops were hosted. Topics included qualitative research, art of hearing data, reflexivity, analysis, validity, and dissemination. Community members and a nurse scientist co-constructed knowledge through participatory methods. ἀe workshops ran concurrent to the study timeline to inform community members' research activities and vice versa. A range from 8 to 20 participants attended the workshops, of which six community members were team teachers and three facilitated at each workshop. In an evaluation, team teachers reported workshop strengths: an empathetic and trusting learn ing environment, a sense of ownership in learning, a greater under standing of roles in research partnerships, and a feel ing of safety to conduct research with academic investigators. Academic investigators need to be aware that co-constructing knowledge is foundational to long-term sustainability of community-based participatory research partnership (CBPR) partnerships, but requires building team capacity to conduct research collaboratively.

Multiple, but not traditional risk factors predict mortality in older people: the Concord Health and Ageing in Men Project.

PubMed

Hirani, Vasant; Naganathan, Vasi; Blyth, Fiona; Le Couteur, David G; Gnjidic, Danijela; Stanaway, Fiona F; Seibel, Markus J; Waite, Louise M; Handelsman, David J; Cumming, Robert G

2014-01-01

This study aims to identify the common risk factors for mortality in community-dwelling older men. A prospective population-based study was conducted with a median of 6.7 years of follow-up. Participants included 1705 men aged ≥70 years at baseline (2005-2007) living in the community in Sydney, Australia. Demographic information, lifestyle factors, health status, self-reported history of diseases, physical performance measures, blood pressure, height and weight, disability (activities of daily living (ADL) and instrumental ADLs, instrumental ADLs (IADLs)), cognitive status, depressive symptoms and blood analyte measures were considered. Cox regression analyses were conducted to model predictors delete time until of mortality. During follow-up, 461 men (27 %) died. Using Cox proportional hazards model, significant predictors of delete time to time to mortality included in the final model (p < 0.05) were older age, body mass index < 20 kg m(2), high white cell count, anaemia, low albumin, current smoking, history of cancer, history of myocardial infarction, history of congestive heart failure, depressive symptoms and ADL and IADL disability and impaired chair stands. We found that overweight and obesity and/or being a lifelong non-drinker of alcohol were protective against mortality. Compared to men with less than or equal to one risk factor, the hazard ratio in men with three risk factors was 2.5; with four risk factors, it was 4.0; with five risk factors, it was 4.9; and for six or more risk factors, it was 11.4, respectively. We have identified common risk factors that predict mortality that may be useful in making clinical decisions among older people living in the community. Our findings suggest that, in primary care, screening and management of multiple risk factors are important to consider for extending survival, rather than simply considering individual risk factors in isolation. Some of the "traditional" risk factors for mortality in a younger population, including high blood pressure, hypercholesterolaemia, overweight and obesity and diabetes, were not independent predictors of mortality in this population of older men.

Community Education for Family Planning in the U.S.: A Systematic Review.

PubMed

Carter, Marion W; Tregear, Michelle L; Moskosky, Susan B

2015-08-01

Community education may involve activities that seek to raise awareness and promote behavior change, using mass media, social media, and other media or interpersonal methods in community settings. This systematic review evaluated the evidence of the effects of community education on select short- and medium-term family planning outcomes. Using an analytic approach drawn from the U.S. Preventive Services Task Force, multiple databases were searched for articles published from January 1985 through February 2011 describing studies of community education related to family planning in the U.S. Included articles were reviewed and assessed for potential bias using a standardized process in 2011. An updated, targeted review for the 2011-2014 period was conducted in early 2015. Seventeen papers were identified. Most (nine) related to mass media interventions; three involved targeted print media, two involved text messaging or e-mail, two described outcome workers conducting community education, and one involved community theater. Study designs, strength of evidence, and levels of possible bias varied widely. Twelve of 15 studies that addressed outcomes such as increased awareness found positive associations with those outcomes, with six also reporting null findings. Seven of eight studies that addressed use of services reported positive associations, with two also reporting null findings. The targeted, additional review identified two other studies. Evidence related to community education for family planning purposes is limited and highly variable. As goals of community education are usually limited to shorter-term outcomes, the evidence suggests that a range of approaches may be effective. Published by Elsevier Inc.

Community Education for Family Planning in the U.S.

PubMed Central

Carter, Marion W.; Tregear, Michelle L.; Moskosky, Susan B.

2015-01-01

Context Community education may involve activities that seek to raise awareness and promote behavior change, using mass media, social media, and other media or interpersonal methods in community settings. This systematic review evaluated the evidence of the effects of community education on select short- and medium-term family planning outcomes. Evidence acquisition Using an analytic approach drawn from the U.S. Preventive Services Task Force, multiple databases were searched for articles published from January 1985 through February 2011 describing studies of community education related to family planning in the U.S. Included articles were reviewed and assessed for potential bias using a standardized process in 2011. An updated, targeted review for the 2011–2014 period was conducted in early 2015. Evidence synthesis Seventeen papers were identified. Most (nine) related to mass media interventions; three involved targeted print media, two involved text messaging or e-mail, two described outcome workers conducting community education, and one involved community theater. Study designs, strength of evidence, and levels of possible bias varied widely. Twelve of 15 studies that addressed outcomes such as increased awareness found positive associations with those outcomes, with six also reporting null findings. Seven of eight studies that addressed use of services reported positive associations, with two also reporting null findings. The targeted, additional review identified two other studies. Conclusions Evidence related to community education for family planning purposes is limited and highly variable. As goals of community education are usually limited to shorter-term outcomes, the evidence suggests that a range of approaches may be effective. PMID:26190841

Using Multiple Measures to Make Math Placement Decisions: Implications for Access and Success in Community Colleges

ERIC Educational Resources Information Center

Ngo, Federick; Kwon, William W.

2015-01-01

Community college students are often placed in developmental math courses based on the results of a single placement test. However, concerns about accurate placement have recently led states and colleges across the country to consider using other measures to inform placement decisions. While the relationships between college outcomes and such…

Engaging Residents in Community Change: The Critical Role of Trust in the Development of a Promise Neighborhood

ERIC Educational Resources Information Center

Geller, Joanna D.; Doykos, Bernadette; Craven, Krista; Bess, Kimberly D.; Nation, Maury

2014-01-01

Background: Currently, there is great enthusiasm surrounding place-based initiatives for school reform, such as the Harlem Children's Zone, Promise Neighborhoods, and other initiatives that attend to the multiple contexts that influence child development. However, past efforts to bridge schools, families, and communities have been undermined by…

The Power of Key: Celebrating 20 Years of Innovation at the Key Learning Community

ERIC Educational Resources Information Center

Kunkel, Christine

2007-01-01

The Key Learning Community in Indianapolis was the first school in the world to base its approach on the theory of multiple intelligences. Ms. Kunkel, Key's principal, reflects on the school's continuing growth and success--even in the face of pressures to standardize--and shares the history of its founding. (Contains 5 endnotes.)

State-Level Community Benefit Regulation and Nonprofit Hospitals' Provision of Community Benefits.

PubMed

Singh, Simone R; Young, Gary J; Loomer, Lacey; Madison, Kristin

2018-04-01

Do nonprofit hospitals provide enough community benefits to justify their tax exemptions? States have sought to enhance nonprofit hospitals' accountability and oversight through regulation, including requirements to report community benefits, conduct community health needs assessments, provide minimum levels of community benefits, and adhere to minimum income eligibility standards for charity care. However, little research has assessed these regulations' impact on community benefits. Using 2009-11 Internal Revenue Service data on community benefit spending for more than eighteen hundred hospitals and the Hilltop Institute's data on community benefit regulation, we investigated the relationship between these four types of regulation and the level and types of hospital-provided community benefits. Our multivariate regression analyses showed that only community health needs assessments were consistently associated with greater community benefit spending. The results for reporting and minimum spending requirements were mixed, while minimum income eligibility standards for charity care were unrelated to community benefit spending. State adoption of multiple types of regulation was consistently associated with higher levels of hospital-provided community benefits, possibly because regulatory intensity conveys a strong signal to the hospital community that more spending is expected. This study can inform efforts to design regulations that will encourage hospitals to provide community benefits consistent with policy makers' goals. Copyright © 2018 by Duke University Press.

Beyond Bushfires: Community, Resilience and Recovery - a longitudinal mixed method study of the medium to long term impacts of bushfires on mental health and social connectedness.

PubMed

Gibbs, Lisa; Waters, Elizabeth; Bryant, Richard A; Pattison, Philippa; Lusher, Dean; Harms, Louise; Richardson, John; MacDougall, Colin; Block, Karen; Snowdon, Elyse; Gallagher, Hugh Colin; Sinnott, Vikki; Ireton, Greg; Forbes, David

2013-11-04

Natural disasters represent an increasing threat both in terms of incidence and severity as a result of climate change. Although much is known about individual responses to disasters, much less is known about the social and contextual response and how this interacts with individual trajectories in terms of mental health, wellbeing and social connectedness. The 2009 bushfires in Victoria, Australia caused much loss of life, property destruction, and community disturbance. In order to progress future preparedness, response and recovery, it is crucial to measure and understand the impact of disasters at both individual and community levels. This study aims to profile the range of mental health, wellbeing and social impacts of the Victorian 2009 bushfires over time using multiple methodologies and involving multiple community partners. A diversity of communities including bushfire affected and unaffected will be involved in the study and will include current and former residents (at the time of the Feb 2009 fires). Participants will be surveyed in 2012, 2014 and, funding permitting, in 2016 to map the predictors and outcomes of mental health, wellbeing and social functioning. Ongoing community visits, as well as interviews and focus group discussions in 2013 and 2014, will provide both contextual information and evidence of changing individual and community experiences in the medium to long term post disaster. The study will include adults, adolescents and children over the age of 5. Conducting the study over five years and focussing on the role of social networks will provide new insights into the interplay between individual and community factors and their influence on recovery from natural disaster over time. The study findings will thereby expand understanding of long term disaster recovery needs for individuals and communities.

New Directions and Challenges in Preventing Conduct Problems in Early Childhood.

PubMed

Shaw, Daniel S; Taraban, Lindsay E

2017-06-01

In this article, we review advances in developing and preventing conduct problems in early childhood and identify challenges. Among the topics we address are expanding the targets of prevention programs beyond improving parenting skills, implementing family-based interventions during early childhood for families living in impoverished communities, making greater use of community platforms that serve young children at risk for early conduct problems, and incorporating techniques such as motivational interviewing to improve families' engagement in nontraditional mental health settings.

Common Infrastructure for Neo Scientific and Planetary Defense Missions

NASA Technical Reports Server (NTRS)

Adams, Robert; Wilks, Rodney

2009-01-01

While defending the Earth against collisions with asteroids and comets has garnered increasing attention over the past few decades, our knowledge of the threats and methods of mitigation remain inadequate. There exists a considerable gap in knowledge regarding the size, composition, location, internal structure and formation of near earth asteroids and comets. Although estimates have been made, critical experiments have not yet been conducted on the effectiveness of various proposed mitigation techniques. Closing this knowledge gap is of interest to both the planetary defense and planetary science communities. Increased scientific knowledge of asteroid and comet composition and structure can confirm or advance current theories about the formation of the solar system. This proposal suggests a joint effort between these two communities to provide an economical architecture that supports multiple launches of characterization and mitigation payloads with minimal response time. The science community can use this architecture for characterization missions of opportunity when multiple scientific targets or targets of uncommon scientific value present themselves, while the planetary defense community would be able to fire characterization or mitigation payloads at targets that present a threat to the Earth. Both communities would benefit from testing potential mitigation techniques, which would reveal information on the internal structure of asteroids and comets. In return, the Earth would have the beginnings of a viable response system should an impact threat prove real in the near future.

Online Social Support for Patients with Multiple Sclerosis: A Thematic Analysis of Messages Posted to a Virtual Support Community.

PubMed

Shavazi, Masoumeh Abbasi; Morowatisharifabad, Mohammad Ali; Shavazi, Mohammad Taghi Abbasi; Mirzaei, Masoud; Ardekani, Ali Mellat

2016-07-01

Currently with the emergence of the Internet, patients have an opportunity to exchange social support online. However, little attention has been devoted to different dimensions of online social support exchanged in virtual support communities for patients with multiple sclerosis (MS). To provide a rich insight, the aim of this qualitative study was to explore and categorize different dimensions of online social support in messages exchanged in a virtual support community for patients with MS. A total of 548 posted messages created during one year period were selected using purposive sampling to consider the maximum variation sampling. Prior-research-driven thematic analysis was then conducted. In this regard, we used the Cutruna and Suhr's coding system. The messages that could not be categorized with the used coding system were thematically analyzed to explore new additional social support themes. The results showed that various forms of social support including informational, emotional, network, esteem and tangible support were exchanged. Moreover, new additional social support themes including sharing personal experiences, sharing coping strategies and spiritual support emerged in this virtual support community. The wide range of online social support exchanged in the virtual support community can be regarded as a supplementary source of social support for patients with MS. Future researches can examine online social support more comprehensively considering additional social support themes emerging in the present study.

Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study

PubMed Central

Lebso, Meaza; Loha, Eskindir

2017-01-01

Background Anemia is defined as a condition in which there is less than the normal hemoglobin (Hb) level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia. Methods Community based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration <11 g/dl was classified as anaemic. Stool examinations were also done. Structured questionnaire was used as a tool to collect sociodemographic characteristics, individual dietary diversity and level of household food security data. Multivariate logistic regression model was employed to determine the effect of explanatory variables like level of education, level of household food security, dietary diversity, trimester of pregnancy, family planning before pregnancy, deworming, gravidity, iron intake in current pregnancy and soil transmitted helminthes on dependent variable anemia. Results The prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%). Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11–3.69), trimester second (AOR = 3.09, 95%CI: 1.41–6.79) and third (AOR = 3.68, 95% CI: 1.67–8.08), gravidity three to five (AOR = 1.78, 95% CI: 1.03–3.07) and six and above (AOR = 2.59, 95%CI: 1.37–4.92), not supplemented with iron (AOR = 1.72, 95% CI: 1.02–2.91), low dietary diversity score (AOR = 3.18, 95% CI: 1.37–7.37) and hookworm infection (AOR = 2.69, 95%CI: 1.34–5.39). Conclusion Anemia has moderate public health significance in the area. Community-based interventions should be enhanced considering the identified associated factors. PMID:29228009

Relative Roles of Deterministic and Stochastic Processes in Driving the Vertical Distribution of Bacterial Communities in a Permafrost Core from the Qinghai-Tibet Plateau, China.

PubMed

Hu, Weigang; Zhang, Qi; Tian, Tian; Li, Dingyao; Cheng, Gang; Mu, Jing; Wu, Qingbai; Niu, Fujun; Stegen, James C; An, Lizhe; Feng, Huyuan

2015-01-01

Understanding the processes that influence the structure of biotic communities is one of the major ecological topics, and both stochastic and deterministic processes are expected to be at work simultaneously in most communities. Here, we investigated the vertical distribution patterns of bacterial communities in a 10-m-long soil core taken within permafrost of the Qinghai-Tibet Plateau. To get a better understanding of the forces that govern these patterns, we examined the diversity and structure of bacterial communities, and the change in community composition along the vertical distance (spatial turnover) from both taxonomic and phylogenetic perspectives. Measures of taxonomic and phylogenetic beta diversity revealed that bacterial community composition changed continuously along the soil core, and showed a vertical distance-decay relationship. Multiple stepwise regression analysis suggested that bacterial alpha diversity and phylogenetic structure were strongly correlated with soil conductivity and pH but weakly correlated with depth. There was evidence that deterministic and stochastic processes collectively drived bacterial vertically-structured pattern. Bacterial communities in five soil horizons (two originated from the active layer and three from permafrost) of the permafrost core were phylogenetically random, indicator of stochastic processes. However, we found a stronger effect of deterministic processes related to soil pH, conductivity, and organic carbon content that were structuring the bacterial communities. We therefore conclude that the vertical distribution of bacterial communities was governed primarily by deterministic ecological selection, although stochastic processes were also at work. Furthermore, the strong impact of environmental conditions (for example, soil physicochemical parameters and seasonal freeze-thaw cycles) on these communities underlines the sensitivity of permafrost microorganisms to climate change and potentially subsequent permafrost thaw.

Relative Roles of Deterministic and Stochastic Processes in Driving the Vertical Distribution of Bacterial Communities in a Permafrost Core from the Qinghai-Tibet Plateau, China

PubMed Central

Tian, Tian; Li, Dingyao; Cheng, Gang; Mu, Jing; Wu, Qingbai; Niu, Fujun; Stegen, James C.; An, Lizhe; Feng, Huyuan

2015-01-01

Understanding the processes that influence the structure of biotic communities is one of the major ecological topics, and both stochastic and deterministic processes are expected to be at work simultaneously in most communities. Here, we investigated the vertical distribution patterns of bacterial communities in a 10-m-long soil core taken within permafrost of the Qinghai-Tibet Plateau. To get a better understanding of the forces that govern these patterns, we examined the diversity and structure of bacterial communities, and the change in community composition along the vertical distance (spatial turnover) from both taxonomic and phylogenetic perspectives. Measures of taxonomic and phylogenetic beta diversity revealed that bacterial community composition changed continuously along the soil core, and showed a vertical distance-decay relationship. Multiple stepwise regression analysis suggested that bacterial alpha diversity and phylogenetic structure were strongly correlated with soil conductivity and pH but weakly correlated with depth. There was evidence that deterministic and stochastic processes collectively drived bacterial vertically-structured pattern. Bacterial communities in five soil horizons (two originated from the active layer and three from permafrost) of the permafrost core were phylogenetically random, indicator of stochastic processes. However, we found a stronger effect of deterministic processes related to soil pH, conductivity, and organic carbon content that were structuring the bacterial communities. We therefore conclude that the vertical distribution of bacterial communities was governed primarily by deterministic ecological selection, although stochastic processes were also at work. Furthermore, the strong impact of environmental conditions (for example, soil physicochemical parameters and seasonal freeze-thaw cycles) on these communities underlines the sensitivity of permafrost microorganisms to climate change and potentially subsequent permafrost thaw. PMID:26699734

Empirically Supported Family-Based Treatments for Conduct Disorder and Delinquency in Adolescents

ERIC Educational Resources Information Center

Henggeler, Scott W.; Sheidow, Ashli J.

2012-01-01

Several family-based treatments of conduct disorder and delinquency in adolescents have emerged as evidence-based and, in recent years, have been transported to more than 800 community practice settings. These models include multisystemic therapy, functional family therapy, multidimensional treatment foster care, and, to a lesser extent, brief…

Exploring perceptions of community health policy in Kenya and identifying implications for policy change.

PubMed

McCollum, Rosalind; Otiso, Lilian; Mireku, Maryline; Theobald, Sally; de Koning, Korrie; Hussein, Salim; Taegtmeyer, Miriam

2016-02-01

Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change. We conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives, including those who will influence or be influenced by CHS policy change in Kenya (policymakers, sub-county health management teams, facility managers, community health extension worker (CHEW), community health workers (CHWs), clients and community members) in two purposively selected counties: Nairobi and Kitui. Qualitative data were digitally recorded, transcribed, translated and coded before framework analysis. There is widespread community appreciation for the existing strategy. High attrition, lack of accountability for voluntary CHWs and lack of funds to pay CHW salaries, combined with high CHEW workload were seen as main drivers for strategy change. Areas for change identified include: lack of clear supervisory structure including provision of adequate travel resources, current uneven coverage and equity of community health services, limited community knowledge about the strategy revision and demand for home-based HIV testing and counselling. This in-depth analysis which captures multiple perspectives results in robust recommendations for strategy revision informed by the Five Wonders of Change Framework. These recommendations point towards a more people-centred health system for improved equity and effectiveness and indicate priority areas for action if success of policy change through the roll-out of the revised strategy is to be realized. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Community Violence, Protective Factors, and Adolescent Mental Health: A Profile Analysis

ERIC Educational Resources Information Center

Copeland-Linder, Nikeea; Lambert, Sharon F.; Ialongo, Nicholas S.

2010-01-01

This study examined interrelationships among community violence exposure, protective factors, and mental health in a sample of urban, predominantly African American adolescents (N = 504). Latent Profile Analysis was conducted to identify profiles of adolescents based on a combination of community violence exposure, self-worth, parental monitoring,…

Obesity and the community food environment: a systematic review.

PubMed

Holsten, Joanna E

2009-03-01

To examine the relationship between obesity and the community and/or consumer food environment. A comprehensive literature search of multiple databases was conducted and seven studies were identified for review. Studies were selected if they measured BMI and environmental variables related to food outlets. Environmental variables included the geographic arrangement of food stores or restaurants in communities and consumer conditions such as food price and availability within each outlet. The study designs, methods, limitations and results related to obesity and the food environment were reviewed, and implications for future research were synthesized. The reviewed studies used cross-sectional designs to examine the community food environment defined as the number per capita, proximity or density of food outlets. Most studies indirectly identified food outlets through large databases. The studies varied substantially in sample populations, outcome variables, units of measurement and data analysis. Two studies did not find any significant association between obesity rates and community food environment variables. Five studies found significant results. Many of the studies were subject to limitations that may have mitigated the validity of the results. Research examining obesity and the community or consumer food environment is at an early stage. The most pertinent gaps include primary data at the individual level, direct measures of the environment, studies examining the consumer environment and study designs involving a time sequence. Future research should directly measure multiple levels of the food environment and key confounders at the individual level.

Translation of lifestyle modification programs focused on physical activity and dietary habits delivered in community settings.

PubMed

Stoutenberg, Mark; Stanzilis, Katie; Falcon, Ashley

2015-06-01

Lifestyle modification programs (LMPs) can provide individuals with behavioral skills to sustain long-term changes to their physical activity (PA) levels and dietary habits. Yet, there is much work to be done in the translation of these programs to community settings. This review identified LMPs that focused on changing both PA and dietary behaviors and examined common features and barriers faced in their translation to community settings. A search of multiple online databases was conducted to identify LMPs that included participants over the age of 18 who enrolled in LMPs, offered in community settings, and had the goal of improving both PA and dietary behaviors. Data were extracted on participant demographics, study design characteristics, and study outcome variables including changes in PA, dietary habits, body weight, and clinical outcomes. We identified 27 studies that met inclusion criteria. Despite high levels of retention and adherence to the interventions, varying levels of success were observed in increasing PA levels, improving dietary habits, reducing body weight, and improving clinic outcomes. LMPs addressing issues of PA and dietary habits can be successfully implemented in a community setting. However, inconsistent reporting of key components in the translation of these studies (participant recruitment, utilization of behavioral strategies) may limit their replication and advancement of future programs. Future efforts should better address issues such as identifying barriers to participation and program implementation, utilization of community resources, and evaluating changes across multiple health behaviors.

Successes and Lessons Learned From Implementing Community Health Worker Programs in Community-Based and Clinical Settings: Insights From the Gulf Coast.

PubMed

Sherman, Mya; Covert, Hannah; Fox, Laila; Lichtveld, Maureen

Community health workers (CHWs) are an increasingly viable component of the American health system. While organizations may be interested in incorporating CHWs into the health care workforce, there are challenges to doing so. This study characterizes the successes and lessons learned from implementing new CHW programs in clinical and community-based settings in 4 US Gulf states. Semistructured interviews were conducted with CHWs and their supervisors. Interviews were conducted with participants in 16 community-based organizations and federally qualified health centers located in coastal counties and parishes of Louisiana, Florida, Alabama, and Mississippi. Study participants consisted of 22 CHWs and 17 CHW supervisors. Although most challenges and strategies were reported by participants working in both clinical and community-based settings, some were workplace-specific. Participants from predominantly clinical settings described the importance of strengthening organizational cohesion and coordination, whereas participants from community-based participants discussed the need for specialized training for CHWs. In both work environments, participants indicated that CHW functioning was constrained by limited organizational resources, difficulty accessing the client population, and limited knowledge regarding the CHW's scope of practice. Strategies to improve CHW functioning in both settings included investing in local partnerships, streamlining resources, prioritizing strong communication and outreach, and establishing explicit operating procedures. The majority of participants noted that challenges lessened over time. Evaluating successes and lessons learned in CHW work is critical to maximize CHWs' abilities to address clients' health needs and promote health in underserved communities. This study provides important insights into how to successfully integrate CHWs into the public health workforce.

Student-to-Scientist (S2S) via the PACA Project: Connecting Astronomers, Educators and Students

NASA Astrophysics Data System (ADS)

Yanamandra-Fisher, P. A.

2015-12-01

Student to Scientist (S2S), provides pathways for observational and research tools for K-12 and undergraduate students to improve science proficiency through conducting real scientific observations. Our approach lies in the integration of professional and amateur astronomers, educators, students, and communicators to identify multiple paths for the student to become a scientist. I report on the ensuing project, also known as the PACA Project, which is an ecosystem of various activities that take advantage of the social media and immediate connectivity amongst amateur astronomers worldwide and that can be galvanized to participate in a given observing campaign. The PACA Project has participated in organized campaigns such as NASA Comet ISON Observing Campaign in 2013; NASA Comet Integrated Observations Campaign to observe Comet Siding Spring as it flew by very close to Mars on 19 October 2014. Currently the PACA Project is involved in the Ground-based Amateur campaign to observer ESA/Rosetta mission's target, 67P/Churyumov-Gerasimenko (CG) that is en route to its perihelion on 13 August 2015 (at the time of abstract submission). The PACA Project provides access to the professional community and the student/educator and informal/public communities via various social media like Facebook, Twitter, Flickr, Pinterest, Vimeo, Google+. With the popularity of mobile platforms and instant connections with other peers globally, the multi-faceted social universe has become a vital part of engagement of multiple communities. The PACA project currently has initiated a Comet Tails and Disconnection Events campaign to relate to the changing solar wind conditions. Other PACA projects include Saturn Solstice 2017 and outreach projects with Astroproject (India). These and other citizen-science enabled activities and their integration with S2S project will be discussed.

Beyond individual war trauma: domestic violence against children in Afghanistan and Sri Lanka.

PubMed

Catani, Claudia; Schauer, Elisabeth; Neuner, Frank

2008-04-01

To date, research on the psychosocial consequences of mass trauma resulting from war and organized violence on children has primarily focused on the individual as the unit of treatment and analysis with particular focus on mental disorders caused by traumatic stress. This body of research has stimulated the development of promising individual-level treatment approaches for addressing psychological trauma. In contrast, there is virtually no literature addressing the effects of mass trauma on the family and community systems. Research conducted in Sri Lanka and Afghanistan, two long-standing war-torn societies, found that in addition to multiple exposure to war or disaster-related traumatic events children also indicated high levels of exposure to family violence. These findings point to the need for conjoint family- and community-based programs of prevention and intervention that are specifically tailored for the context of the affected society. In particular, programs should take issues such as poverty, child labor, and parental alcohol use into account in assessing and treating children in the aftermath of mass trauma.

Barriers and Facilitators to Successful Transition from Long-Term Residential Substance Abuse Treatment

PubMed Central

Yuan, Yeqing; Herman, Daniel; Svikis, Dace; Nichols, Obie; Palmer, Erin; Deren, Sherry

2016-01-01

Although residential substance abuse treatment has been shown to improve substance use and other outcomes, relapse is common. This qualitative study explores factors that hinder and help individuals during the transition from long-term residential substance abuse treatment to the community. Semi-structured interviews were conducted with 32 individuals from residential substance abuse treatment. Based on the socio-ecological model, barriers and facilitators to transition were identified across five levels: individual, interpersonal, organizational, community, and policy. The major results indicate that primary areas of intervention needed to improve outcomes for these high-risk individuals include access to stable housing and employment, aftercare services and positive support networks; expanded discharge planning services and transitional assistance; and funding to address gaps in service delivery and to meet individuals’ basic needs. This study contributes to the literature by identifying transition barriers and facilitators from the perspectives of individuals in residential treatment, and by using the socio-ecological model to understand the complexity of this transition at multiple levels. Findings identify potential targets for enhanced support post-discharge from residential treatment. PMID:28132695

Barriers and facilitators to successful transition from long-term residential substance abuse treatment.

PubMed

Manuel, Jennifer I; Yuan, Yeqing; Herman, Daniel B; Svikis, Dace S; Nichols, Obie; Palmer, Erin; Deren, Sherry

2017-03-01

Although residential substance abuse treatment has been shown to improve substance use and other outcomes, relapse is common. This qualitative study explores factors that hinder and help individuals during the transition from long-term residential substance abuse treatment to the community. Semi-structured interviews were conducted with 32 individuals from residential substance abuse treatment. Based on the socio-ecological model, barriers and facilitators to transition were identified across five levels: individual, interpersonal, organizational, community, and policy. The major results indicate that primary areas of intervention needed to improve outcomes for these high-risk individuals include access to stable housing and employment, aftercare services and positive support networks; expanded discharge planning services and transitional assistance; and funding to address gaps in service delivery and to meet individuals' basic needs. This study contributes to the literature by identifying transition barriers and facilitators from the perspectives of individuals in residential treatment, and by using the socio-ecological model to understand the complexity of this transition at multiple levels. Findings identify potential targets for enhanced support post-discharge from residential treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

An individual-level meta-analysis assessing the impact of community-level sanitation access on child stunting, anemia, and diarrhea: Evidence from DHS and MICS surveys.

PubMed

Larsen, David A; Grisham, Thomas; Slawsky, Erik; Narine, Lutchmie

2017-06-01

A lack of access to sanitation is an important risk factor child health, facilitating fecal-oral transmission of pathogens including soil-transmitted helminthes and various causes of diarrheal disease. We conducted a meta-analysis of cross-sectional surveys to determine the impact that community-level sanitation access has on child health for children with and without household sanitation access. Using 301 two-stage demographic health surveys and multiple indicator cluster surveys conducted between 1990 and 2015 we calculated the sanitation access in the community as the proportion of households in the sampled cluster that had household access to any type of sanitation facility. We then conducted exact matching of children based on various predictors of living in a community with high access to sanitation. Using logistic regression with the matched group as a random intercept we examined the association between the child health outcomes of stunted growth, any anemia, moderate or severe anemia, and diarrhea in the previous two weeks and the exposure of living in a community with varying degrees of community-level sanitation access. For children with household-level sanitation access, living in a community with 100% sanitation access was associated with lowered odds of stunting (adjusted odds ratio [AOR] = 0.97, 95%; confidence interval (CI) = 0.94-1.00; n = 14,153 matched groups, 1,175,167 children), any anemia (AOR = 0.73; 95% CI = 0.67-0.78; n = 5,319 matched groups, 299,033 children), moderate or severe anemia (AOR = 0.72, 95% CI = 0.68-0.77; n = 5,319 matched groups, 299,033 children) and diarrhea (AOR = 0.94; 95% CI = 0.91-0.97); n = 16,379 matched groups, 1,603,731 children) compared to living in a community with < 30% sanitation access. For children without household-level sanitation access, living in communities with 0% sanitation access was associated with higher odds of stunting (AOR = 1.04, 95% CI = 1.02-1.06; n = 14,153 matched groups, 1,175,167 children), any anemia (AOR = 1.05, 95% CI = 1.00-1.09; n = 5,319 matched groups, 299,033 children), moderate or severe anemia (AOR = 1.04, 95% CI = 1.00-1.09; n = 5,319 matched groups, 299,033 children) but not diarrhea (AOR = 1.00, 95% CI = 0.98-1.02; n = 16,379 matched groups, 1,603,731 children) compared to children without household-level sanitation access living in communities with 1-30% sanitation access. Community-level sanitation access is associated with improved child health outcomes independent of household-level sanitation access. The proportion of children living in communities with 100% sanitation access throughout the world is appallingly low. Ensuring sanitation access to all by 2030 will greatly improve child health.

A qualitative evaluation of a faith-based breast and cervical cancer screening intervention for African American women.

PubMed

Matthews, Alicia K; Berrios, Nerida; Darnell, Julie S; Calhoun, Elizabeth

2006-10-01

This article presents a formative evaluation of a CDC Racial and Ethnic Approaches to Community Health (REACH) 2010 faith-based breast and cervical cancer early detection and prevention intervention for African American women living in urban communities. Focus groups were conducted with a sample of women (N=94) recruited from each church participating in the intervention. One focus group was conducted in each of the nine participating churches following completion of the 6-month REACH 2010 intervention. Transcribed data were coded to identify relevant themes. Key findings included (a) the acceptability of receiving cancer education within the context of a faith community, (b) the importance of pastoral input, (c) the effectiveness of personal testimonies and lay health advocates, (d) the saliency of biblical scripture in reinforcing health messages, (e) the effectiveness of multimodal learning aids, and (f) the relationship between cervical cancer and social stigma. Study findings have implications for enhancing faith-based breast and cervical cancer prevention efforts in African American communities.

From community-based pilot testing to region-wide systems change: lessons from a local quality improvement collaborative.

PubMed

Keyser, Donna J; Pincus, Harold Alan

2010-01-01

A community-based collaborative conducted a 2-year pilot study to inform efforts for improving maternal and child health care practice and policy in Allegheny County, Pennsylvania. (1) To test whether three small-scale versions of an evidence-based, systems improvement approach would be workable in local community settings and (2) to identify specific policy/infrastructure reforms for sustaining improvements. A mixed methods approach was used, including quantitative performance measurement supplemented with qualitative data about factors related to outcomes of interest, as well as key stakeholder interviews and a literature review/Internet search. Quantitative performance results varied; qualitative data revealed critical factors for the success and failure of the practices tested. Policy/infrastructure recommendations were developed to address specific practice barriers. This information was important for designing a region-wide quality improvement initiative focused on maternal depression. The processes and outcomes provide valuable insights for other communities interested in conducting similar quality improvement initiatives.

Implementing a comprehensive program for the prevention of conduct problems in rural communities: the Fast Track experience. The Conduct Problems Prevention Research Group.

PubMed

Bierman, K L

1997-08-01

Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program.

Predicting falls in older adults using the four square step test.

PubMed

Cleary, Kimberly; Skornyakov, Elena

2017-10-01

The Four Square Step Test (FSST) is a performance-based balance tool involving stepping over four single-point canes placed on the floor in a cross configuration. The purpose of this study was to evaluate properties of the FSST in older adults who lived independently. Forty-five community dwelling older adults provided fall history and completed the FSST, Berg Balance Scale (BBS), Timed Up and Go (TUG), and Tinetti in random order. Future falls were recorded for 12 months following testing. The FSST accurately distinguished between non-fallers and multiple fallers, and the 15-second threshold score accurately distinguished multiple fallers from non-multiple fallers based on fall history. The FSST predicted future falls, and performance on the FSST was significantly correlated with performance on the BBS, TUG, and Tinetti. However, the test is not appropriate for older adults who use walkers. Overall, the FSST is a valid yet underutilized measure of balance performance and fall prediction tool that physical therapists should consider using in ambulatory community dwelling older adults.

The Begun Center for Violence Prevention Research and Education at Case Western Reserve University

ERIC Educational Resources Information Center

Flannery, Daniel J.; Singer, Mark I.

2015-01-01

Established in the year 2000, the Begun Center for Violence Prevention Research and Education is a multidisciplinary center located at a school of social work that engages in collaborative, community-based research and evaluation that spans multiple systems and disciplines. The Center currently occupies 4,200 sq. ft. with multiple offices and…

Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners.

PubMed

Carlos, Ruth C; Sicks, JoRean D; Chang, George J; Lyss, Alan P; Stewart, Teresa L; Sung, Lillian; Weaver, Kathryn E

2017-12-01

Cancer care spans the spectrum from screening and diagnosis through therapy and into survivorship. Delivering appropriate care requires patient transitions across multiple specialties, such as primary care, radiology, and oncology. From the program's inception, the National Cancer Institute Community Oncology Research Program (NCORP) sites were tasked with conducting cancer care delivery research (CCDR) that evaluates structural, organizational, and social factors, including care transitions that determine patient outcomes. The aim of this study is to describe the capacity of the NCORP to conduct multidisciplinary CCDR that includes radiology and primary care practices. The NCORP includes 34 community and 12 minority and underserved community sites. The Landscape Capacity Assessment was conducted in 2015 across these 46 sites, composed of the 401 components and subcomponents designated to conduct CCDR. Each respondent had the opportunity to designate an operational practice group, defined as a group of components and subcomponents with common care practices and resources. The primary outcomes were the proportion of adult oncology practice groups with affiliated radiology and primary care practices. The secondary outcomes were the proportion of those affiliated radiology and primary care groups that participate in research. Eighty-seven percent of components and subcomponents responded to at least some portion of the assessment, representing 230 practice groups. Analyzing the 201 adult oncology practice groups, 85% had affiliated radiologists, 69% of whom participate in research. Seventy-nine percent had affiliated primary care practitioners, 31% of whom participate in research. Institutional size, multidisciplinary group practice, and ownership by large regional or multistate health systems was associated with research participation by affiliated radiology and primary care groups. Research participation by these affiliated specialists was not significantly different between the community and the minority and underserved community sites. Research relationships exist between the majority of community oncology sites and affiliated radiology practices. Research relationships with affiliated primary care practices lagged. NCORP as a whole has the opportunity to encourage continued and expanded engagement where relationships exist. Where no relationship exists, the NCORP can encourage recruitment, particularly of primary care practices as partners. Copyright © 2017. Published by Elsevier Inc.

Building a community-based culture of evaluation.

PubMed

Janzen, Rich; Ochocka, Joanna; Turner, Leanne; Cook, Tabitha; Franklin, Michelle; Deichert, Debbie

2017-12-01

In this article we argue for a community-based approach as a means of promoting a culture of evaluation. We do this by linking two bodies of knowledge - the 70-year theoretical tradition of community-based research and the trans-discipline of program evaluation - that are seldom intersected within the evaluation capacity building literature. We use the three hallmarks of a community-based research approach (community-determined; equitable participation; action and change) as a conceptual lens to reflect on a case example of an evaluation capacity building program led by the Ontario Brian Institute. This program involved two community-based groups (Epilepsy Southwestern Ontarioand the South West Alzheimer Society Alliance) who were supported by evaluators from the Centre for Community Based Research to conduct their own internal evaluation. The article provides an overview of a community-based research approach and its link to evaluation. It then describes the featured evaluation capacity building initiative, including reflections by the participating organizations themselves. We end by discussing lessons learned and their implications for future evaluation capacity building. Our main argument is that organizations that strive towards a community-based approach to evaluation are well placed to build and sustain a culture of evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Examining Neighborhood Social Cohesion in the Context of Community-based Participatory Research: Descriptive Findings from an Academic-Community Partnership.

PubMed

Bateman, Lori Brand; Fouad, Mona N; Hawk, Bianca; Osborne, Tiffany; Bae, Sejong; Eady, Sequoya; Thompson, Joanice; Brantley, Wendy; Crawford, Lovie; Heider, Laura; Schoenberger, Yu-Mei M

2017-01-01

The purpose of this article is to describe the process of conducting an assessment of neighborhood perceptions and cohesion by a community coalition-academic team created in the context of community-based participatory research (CBPR), to guide the design of locally relevant health initiatives. Guided by CBPR principles, a collaborative partnership was established between an academic center and a local, urban, underserved neighborhood in Birmingham, Alabama to identify and address community concerns and priorities. A cross-sectional survey was conducted in September 2016 among community residents (N=90) to examine perceptions of neighborhood characteristics, including social cohesion and neighborhood problems. The major concerns voiced by the coalition were violence and lack of neighborhood cohesion and safety. The community survey verified the concerns of the coalition, with the majority of participants mentioning increasing safety and stopping the violence as the things to change about the community and the greatest hope for the community. Furthermore, results indicated residents had a moderate level of perceived social cohesion (mean = 2.87 [.67]). The Mid-South TCC Academic and Community Engagement (ACE) Core successfully partnered with community members and stakeholders to establish a coalition whose concerns and vision for the community matched the concerns of residents of the community. Collecting data from different groups strengthened the interpretation of the findings and allowed for a rich understanding of neighborhood concerns.

Efficacy of the Fun For Wellness Online Intervention to Promote Multidimensional Well-Being: a Randomized Controlled Trial.

PubMed

Myers, Nicholas D; Prilleltensky, Isaac; Prilleltensky, Ora; McMahon, Adam; Dietz, Samantha; Rubenstein, Carolyn L

2017-11-01

Subjective well-being refers to people's level of satisfaction with life as a whole and with multiple dimensions within it. Interventions that promote subjective well-being are important because there is evidence that physical health, mental health, substance use, and health care costs may be related to subjective well-being. Fun For Wellness (FFW) is a new online universal intervention designed to promote growth in multiple dimensions of subjective well-being. The purpose of this study was to provide an initial evaluation of the efficacy of FFW to increase subjective well-being in multiple dimensions in a universal sample. The study design was a prospective, double-blind, parallel group randomized controlled trial. Data were collected at baseline and 30 and 60 days-post baseline. A total of 479 adult employees at a major university in the southeast of the USA were enrolled. Recruitment, eligibility verification, and data collection were conducted online. Measures of interpersonal, community, occupational, physical, psychological, economic (i.e., I COPPE), and overall subjective well-being were constructed based on responses to the I COPPE Scale. A two-class linear regression model with complier average causal effect estimation was imposed for each dimension of subjective well-being. Participants who complied with the FFW intervention had significantly higher subjective well-being, as compared to potential compliers in the Usual Care group, in the following dimensions: interpersonal at 60 days, community at 30 and 60 days, psychological at 60 days, and economic at 30 and 60 days. Results from this study provide some initial evidence for both the efficacy of, and possible revisions to, the FFW intervention.

Evaluation of a Community-Based Aging Intervention Program

ERIC Educational Resources Information Center

Hsu, Hui-Chuan; Wang, Chun-Hou; Chen, Yi-Chun; Chang, Ming-Chen; Wang, Jean

2010-01-01

This study evaluated the outcome and process of a community-based aging intervention program for the elderly in Taiwan. The program included education on nutrition and dietary behavior and on physical activities. Outcome and process evaluations were conducted. The program may have had some effects on decreasing some dietary behavioral problems and…

A Qualitative Exploration of Community-Based Organization Programs, Resources, and Training to Promote Adolescent Sexual Health

ERIC Educational Resources Information Center

McCarthy, Molly A.; Fisher, Christopher M.; Zhou, Junmin; Zhu, He; Pelster, Aja Kneip; Schober, Daniel J.; Baldwin, Kathleen; Fortenberry, J. Dennis; Goldsworthy, Richard

2015-01-01

Youth development professionals (YDPs) working at community-based organizations (CBOs) can promote adolescent sexual health through programs. This study explored the programs and resources that youth access at CBOs and training YDPs receive. Twenty-one semi-structured interviews were conducted with YDPs. Qualitative content analyses were conducted…

One Happy Union: Infusing Community-Based Learning Projects through Online Instruction

ERIC Educational Resources Information Center

Lee, Jason W.; Kane, Jennifer; Cavanaugh, Terence

2015-01-01

Both community-based learning (CBL) and online learning are popular pedagogical practices, with distinct benefits and issues for teaching and learning. The integration of these practices may seem challenging, but they can be compatible. This article seeks to provide effective examples and support for conducting CBL projects in online courses while…

[Relationship between Quality of Life (QOL) and cognitive function among community-dwelling elderly].

PubMed

Konagaya, Yoko; Watanabe, Tomoyuki; Ohta, Toshiki; Takata, Kazuko

2009-03-01

It has become important for elderly to live better rather than to live longer. There have been many reports about quality of life (QOL) of the elderly, but we have no knowledge about the relation between the QOL and the cognitive function. We investigated the relationship between the QOL and the cognitive function among community-dwelling elderly. A total of 12,059 community-dwelling elderly were invited to join a cognitive screening study by telephone (TICS-J) combined with a mailed QOL questionnaire. Among them, 1,920 subjects (age 71.87+/-5.50 (mean+/-SD) years old, duration of education 11.08+/-2.61 years) who completed both TICS-J and QOL questionnaire were actually measured. TICS-J was administered by the previously reported method, and the QOL questionnaire was developed based on the component of QOL proposed by Lawton, and consisted of 6 subscales (daily activity, satisfaction with health, satisfaction with human support, satisfaction with economic state, symptoms of depression, and positive mental attitude). Correlations were analyzed among the scores of TICS-J, age, duration of education, and scores on each QOL subscale. Multiple linear regression analysis was conducted after QOL subscale scores, adjusting for gender, age, and duration of education, were entered as dependent variables. Four out of 6 subscales scores of QOL showed significant differences between men and women. All QOL subscale scores showed significant differences between the two groups in the TICS-J scores. Partial correlations were seen among TICS-J scores and each QOL subscale score. Multiple linear regression analysis revealed significant influence of cognitive function by TICS-J on QOL subscales scores. Cognitive function was considered to have more influence on QOL scores than gender or age. TICS-J and the QOL questionnaire in this study were useful to evaluate the outcome of welfare in community-dwelling elderly.

Developing and Conducting a Dissertation Study through the Community-Based Participatory Research Approach.

PubMed

Nadimpalli, S B; Van Devanter, N; Kavathe, R; Islam, N

2016-06-01

The community-based participatory research (CBPR) approach has been shown to be innovative and effective in conducting research with communities experiencing health disparities. Doctoral nursing students, and other doctoral students in the health sciences, who are interested in this approach can benefit through structured CBPR training experiences in learning how to engage with communities, build community capacity, share resources, implement CBPR study plans, and disseminate results of CBPR-focused studies. The objectives of this case-study are to demonstrate ways in which one doctoral student aligned with academic mentors and a funded CBPR project to build a relationship with the Sikh Asian Indian (AI) community of New York City to develop and implement a CBPR-focused doctoral dissertation study. The purpose of the research was to examine the relationship between the experience of perceived discrimination and health outcomes in this community. CBPR methods utilized in developing the study entailed the author partaking in formal and informal CBPR learning experiences, building relationships with community and academic partners early on through volunteering, developing a research plan in collaboration with members of the community and academic partners, identifying an appropriate setting and methods for recruitment and data collection, increasing capacity and resources for all partners (the author, community, and academic), and presenting dissertation study findings to the community. In conclusion, CBPR-focused doctoral experiences are novel pedagogical and professional approaches for nursing and health science students which can lead to mutual benefits for all involved, and ultimately successful and effective community-based health research.

Systems Architecture of a Sea Base Surface Connector System in a 2020 Humanitarian Assistance/Disaster Relief Joint Operational Environment

DTIC Science & Technology

2010-09-01

groups; each group divided into multiple tribes and sub-tribes. The four main ethnic groups are the Hausa-Fulani, Yoruba , Igbo and Ijaw. Figure 41...major cities. The Hausa-Fulani dominate northern Nigeria and control Nigeria’s economic, military and political life. The Yoruba primarily reside in...2. Community and Ethnic Violence Nigeria has many cultures , constituting several different communities. Communities, from small villages to large

Cultivating Positive Youth Development, Critical Consciousness, and Authentic Care in Urban Environmental Education.

PubMed

Delia, Jesse; Krasny, Marianne E

2017-01-01

This paper addresses the issue of how to provide affordances for youth development in the context of environmental stewardship in cities. Urban environmental education encompasses place-based and action-oriented stewardship practices, including community gardening and vegetable production, often with the dual goals of developing youth and community assets. Yet in-depth understanding of how these goals are achieved is lacking. Using narrative inquiry, we explored participant experiences in a multi-year agriculture internship program conducted by the food justice organization East New York Farms! (ENYF) in Brooklyn, NY. Emerging from our conversations with youth were five themes defining their intern experience: ENYF as somewhere to belong, to be pushed, to grapple with complexity, to practice leadership, and to become yourself. We propose a theory of change that emphasizes politicized notions of caring as a foundation for cultivating developmental assets, including competence, contribution, and critical consciousness, among youth who participate in ENYF programs multiple years. This paper extends the literature on socio-environmental affordances to encompass urban environmental education programs, which incorporate physical and social features that act as affordances. Further, this paper describes a feedback loop in which youth afforded opportunities to develop assets through contributing to their community in turn create affordances for additional youth and adults.

Somali Immigrant Women and the American Health Care System: Discordant Beliefs, Divergent Expectations, and Silent Worries

PubMed Central

Pavlish, Carol Lynn; Noor, Sahra; Brandt, Joan

2010-01-01

The civil war in Somalia resulted in massive resettlement of Somali refugees. The largest diaspora of Somali refugees in the United States currently reside in Minnesota. Partnering with three community organizations in 2007–8, we implemented the Community Connections and Collaboration Project to address health disparities that Somali refugees experienced. Specifically, we examined factors that influenced Somali women’s health experiences. Utilizing a socio-ecological perspective and a social action research design, we conducted six community-based focus groups with 57 Somali women and interviewed 11 key informants including Somali healthcare professionals. Inductively coding, sorting and reducing data into categories, we analyzed each category for specific patterns. The categorical findings on healthcare experiences are reported here. We found that Somali women’s health beliefs related closely to situational factors and contrasted sharply with the biological model that drives Western medicine. These discordant health beliefs resulted in divergent expectations regarding treatment and healthcare interactions. Experiencing unmet expectations, Somali women and their healthcare providers reported multiple frustrations which often diminished perceived quality of health care. Moreover, silent worries about mental health and reproductive decision making surfaced. To provide high quality, transcultural health care, providers must encourage patients to voice their own health explanations, expectations, and worries. PMID:20494500

Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries.

PubMed

Pavlish, Carol Lynn; Noor, Sahra; Brandt, Joan

2010-07-01

The civil war in Somalia resulted in massive resettlement of Somali refugees. The largest diaspora of Somali refugees in the United States currently reside in Minnesota. Partnering with three community organizations in 2007-8, we implemented the Community Connections and Collaboration Project to address health disparities that Somali refugees experienced. Specifically, we examined factors that influenced Somali women's health experiences. Utilizing a socio-ecological perspective and a social action research design, we conducted six community-based focus groups with 57 Somali women and interviewed 11 key informants including Somali healthcare professionals. Inductively coding, sorting and reducing data into categories, we analyzed each category for specific patterns. The categorical findings on healthcare experiences are reported here. We found that Somali women's health beliefs related closely to situational factors and contrasted sharply with the biological model that drives Western medicine. These discordant health beliefs resulted in divergent expectations regarding treatment and healthcare interactions. Experiencing unmet expectations, Somali women and their healthcare providers reported multiple frustrations which often diminished perceived quality of health care. Moreover, silent worries about mental health and reproductive decision making surfaced. To provide high quality, transcultural health care, providers must encourage patients to voice their own health explanations, expectations, and worries. Copyright 2010 Elsevier Ltd. All rights reserved.

Physics Climate as Experienced by LGBT+ Physicists

NASA Astrophysics Data System (ADS)

Long, Elena

2012-02-01

In 2009, Elena Long created the LGBT+ Physicists website (http://lgbtphysicists.x10hosting.com) as a warehouse for resources useful for sexual and gender minorities working in physics. This resource has grown to include networking resources, lists of LGBT-friendly universities and localities, recommendations for enacting positive change in physics communities, and out-reach to other STEM-oriented LGBT organizations. This has been possible in large part by the dynamic community of LGBT+ physicists and allies looking to make physics more welcoming towards our community. In 2011, Elena used hir position as Member at Large on the executive committee of the Forum of Graduate Student Affairs (FGSA) to conduct a climate survey that included, among other things, the first serious look at LGBT+ demographics in physics. The survey focused particularly on issues of language heard and harassment experienced by physicists and was broken down into categories based on race, physical and mental ability, gender, and sexuality. Furthermore, it examined the outcomes of experienced harassment and the reasons for when harassment was not reported. Due to the nature of the study, overlapping demographics, especially ``multiple minorities,'' were also explored. This talk will give a brief history of the LGBT+ Physicists resource as well as an overview of the FGSA study.

Cultivating Positive Youth Development, Critical Consciousness, and Authentic Care in Urban Environmental Education

PubMed Central

Delia, Jesse; Krasny, Marianne E.

2018-01-01

This paper addresses the issue of how to provide affordances for youth development in the context of environmental stewardship in cities. Urban environmental education encompasses place-based and action-oriented stewardship practices, including community gardening and vegetable production, often with the dual goals of developing youth and community assets. Yet in-depth understanding of how these goals are achieved is lacking. Using narrative inquiry, we explored participant experiences in a multi-year agriculture internship program conducted by the food justice organization East New York Farms! (ENYF) in Brooklyn, NY. Emerging from our conversations with youth were five themes defining their intern experience: ENYF as somewhere to belong, to be pushed, to grapple with complexity, to practice leadership, and to become yourself. We propose a theory of change that emphasizes politicized notions of caring as a foundation for cultivating developmental assets, including competence, contribution, and critical consciousness, among youth who participate in ENYF programs multiple years. This paper extends the literature on socio-environmental affordances to encompass urban environmental education programs, which incorporate physical and social features that act as affordances. Further, this paper describes a feedback loop in which youth afforded opportunities to develop assets through contributing to their community in turn create affordances for additional youth and adults. PMID:29379456

Embracing diversity and transcultural society through community health practicum among college nursing students.

PubMed

Chang, Luna; Chen, Shu-Chuan; Hung, Shu-Ling

2018-05-19

Based on 2015 annual report of foreign spouse populations were above 507,266 people in Taiwan. Most of them (68%) came from Mainland China, 29% from south-east Asia. 92% of foreign spouses were female (2015). Therefore, a challenge arises for nursing students to provide care to clients with multiple cultural variations in Taiwan. The study objectives were to explore the related factors of cultural care competence and estimate the effects of a short-term reinforced cultural course. The study used a quasi-experimental design. All participants were investigated to measure that changed in cultural competence before and after the community practice period. Of 95 participants, 46 experimental group students engaged with 3 times workshops. The study was conducted from May to August in 2015 at Southern Taiwan. The study results showed a significantly improvement of transcultural nursing competence from comparing control group with experimental group by ANCOVA analysis (p < .05). The study approved that the cultural workshop along with the community health nursing practice curriculum might develop students' transcultural nursing competence. In the future, in order to providing cultural sensitively care, a sustained transcultural curriculum should be advocated at Nursing schools in Taiwan. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evaluating the effects of community-based organization engagement on HIV and AIDS-related risk behavior in Kenya.

PubMed

Riehman, Kara S; Kakietek, Jakub; Manteuffel, Brigitte A; Rodriguez-García, Rosalía; Bonnel, Rene; N'Jie, N'Della; Godoy-Garraza, Lucas; Orago, Alloys; Murithi, Patrick; Fruh, Joseph

2013-01-01

International donors have increasingly shifted AIDS funding directly to community-based organizations (CBOs) with the assumption that responding to the epidemic is best achieved at the community level. The World Bank, ICF Macro, and the National Council for Population and Development in Kenya, conducted a study to evaluate the community response in Kenya. The study used a quasi-experimental design comparing seven study communities and seven comparison communities in Nyanza Province and Western Province. We examined the impact of CBO activity on individual and community-level outcomes, including HIV knowledge, awareness and perceptions, sexual risk behavior, and social transformation (gender ideology and social capital). The study consisted of two components: a household survey conducted in all 14 communities, and qualitative data collected in a subset of communities. Individuals in communities with higher CBO engagement were significantly more likely to have reported consistent condom use. Higher CBO engagement was associated with some measures of social capital, including participation in local and national elections, and participation in electoral campaigns. CBOs provide added value in addressing the HIV and AIDS epidemic in very targeted and specific ways that are closely tied to the services they provide (e.g., prevention education); thus, increasing CBO engagement can be an effective measure in scaling up prevention efforts in those areas.

Building research capacity with members of underserved American Indian/Alaskan Native communities: training in research ethics and the protection of human subjects.

PubMed

Jetter, Karen M; Yarborough, Mark; Cassady, Diana L; Styne, Dennis M

2015-05-01

To develop a research ethics training course for American Indian/Alaskan Native health clinic staff and community researchers who would be conducting human subjects research. Community-based participatory research methods were used in facilitated discussions of research ethics centered around topics included in the Collaborative Institutional Training Initiative research ethics course. The community-based participatory research approach allowed all partners to jointly develop a research ethics training program that was relevant for American Indian/Alaskan Native communities. All community and clinic partners were able to pass the Collaborative Institutional Training Initiative course they were required to pass so that they could be certified to conduct research with human subjects on federally funded projects. In addition, the training sessions provided a foundation for increased community oversight of research. By using a collaborative process to engage community partners in research ethics discussions, rather than either an asynchronous online or a lecture/presentation format, resulted in significant mutual learning about research ethics and community concerns about research. This approach requires university researchers to invest time in learning about the communities in which they will be working prior to the training. © 2014 Society for Public Health Education.

Aboriginal and Torres Strait Islander community governance of health research: Turning principles into practice.

PubMed

Gwynn, Josephine; Lock, Mark; Turner, Nicole; Dennison, Ray; Coleman, Clare; Kelly, Brian; Wiggers, John

2015-08-01

Gaps exist in researchers' understanding of the 'practice' of community governance in relation to research with Aboriginal and Torres Strait Islander peoples. We examine Aboriginal community governance of two rural NSW research projects by applying principles-based criteria from two independent sources. One research project possessed a strong Aboriginal community governance structure and evaluated a 2-year healthy lifestyle program for children; the other was a 5-year cohort study examining factors influencing the mental health and well-being of participants. The National Health and Medical Research Council of Australia's 'Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander research' and 'Ten principles relevant to health research among Indigenous Australian populations' described by experts in the field. Adopt community-based participatory research constructs. Develop clear governance structures and procedures at the beginning of the study and allow sufficient time for their establishment. Capacity-building must be a key component of the research. Ensure sufficient resources to enable community engagement, conduct of research governance procedures, capacity-building and results dissemination. The implementation of governance structures and procedures ensures research addresses the priorities of the participating Aboriginal and Torres Strait Islander communities, minimises risks and improves outcomes for the communities. Principles-based Aboriginal and Torres Strait Islander community governance of research is very achievable. Next steps include developing a comprehensive evidence base for appropriate governance structures and procedures, and consolidating a suite of practical guides for structuring clear governance in health research. © 2015 National Rural Health Alliance Inc.

Prediction of HIV Sexual Risk Behaviors among Disadvantaged African American Adults using a Syndemic Conceptual Framework

PubMed Central

Nehl, Eric J.; Klein, Hugh; Sterk, Claire E.; Elifson, Kirk W.

2015-01-01

The focus of this paper is on HIV sexual risk taking among a community-based sample of disadvantaged African American adults. The objective is to examine multiple factors associated with sexual HIV risk behaviors within a syndemic conceptual framework. Face-to-face, computer-assisted, structured interviews were conducted with 1,535 individuals in Atlanta, Georgia. Bivariate analyses indicated a high level of relationships among the HIV sexual risks and other factors. Results from multivariate models indicated that gender, sexual orientation, relationship status, self-esteem, condom use self-efficacy, sex while the respondent was high, and sex while the partner was high were significant predictors of condomless sex. Additionally, a multivariate additive model of risk behaviors indicated that the number of health risks significantly increased the risk of condomless sex. This intersection of HIV sexual risk behaviors and their associations with various other behavioral, socio-demographics, and psychological functioning factors helps explain HIV risk-taking among this sample of African American adults and highlights the need for research and practice that accounts for multiple health behaviors and problems. PMID:26188618

A cross-sectional study for estimation of associations between education level and osteoporosis in a Chinese men sample.

PubMed

Yu, Cai-Xia; Zhang, Xiu-Zhen; Zhang, Keqin; Tang, Zihui

2015-12-09

The main aim of this study was to evaluate the association between education level and osteoporosis (OP) in general Chinese Men. We conducted a large-scale, community-based, cross-sectional study to investigate the association by using self-report questionnaire to assess education levels. The data of 1092 men were available for analysis in this study. Multiple regression models controlling for confounding factors to include education level were performed to explore the relationship between education level and OP. Positive correlations between education level and T-score of quantitative bone ultrasound (QUS-T score) were reported (β = 0.108, P value < 0.001). Multiple regression analysis indicated that the education level was independently and significantly associated with OP (P < 0.1 for all models). The men with lower education level had a higher prevalence of OP. The education level was independently and significantly associated with OP. The prevalence of OP was more frequent in Chinese men with lower education level. ClinicalTrials.gov Identifier: NCT02451397 ; date of registration: 05/28/2015).