scholarly journals Melanoma Disparities among US Hispanics: Use of the Social Ecological Model to Contextualize Reasons for Inequitable Outcomes and Frame a Research Agenda

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Valerie M. Harvey ◽  
Charlene W. Oldfield ◽  
Jarvis T. Chen ◽  
Karl Eschbach

Cutaneous melanoma is a significant public health concern, accounting for thousands of deaths annually in the US. Early detection and diagnosis are critical given the poor prognosis and limited treatment options of advanced-stage disease. While non-Hispanic whites have higher incidence rates of melanoma, Hispanics are typically diagnosed at later disease stages and suffer higher morbidity and mortality. Currently, there is a paucity of literature investigating the root causes underlying these trends among Hispanics. Given that Hispanics are the most rapidly expanding demographic segment in the US, it is essential for cancer control efforts to elucidate the major determinants of their poor melanoma outcomes. Herein, we use the social ecological model as a framework to explore the multitude of influences on melanoma disparities among Hispanics and provide recommendations for planning future studies and interventions.

Women ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 212-222
Author(s):  
Kobi V. Ajayi ◽  
Sonya Panjwani ◽  
Kelly Wilson ◽  
Whitney R. Garney

Contraceptive use is deemed one of the 10 greatest public health achievements of the 20th century because its benefits are universally acknowledged as a cornerstone for reducing global maternal morbidity and mortality. However, although the adoption of the Affordable Care Act in the United States (US) enhanced access to preventive health services, as well as increased contraceptive use, a considerable proportion of reproductive-aged women still have unmet reproductive health needs. Current data indicates gaps in contraceptive use patterns in the US, particularly among low-income women and those from racial/ethnic and gender minority subgroups, necessitating further investigation using an ecological approach. This narrative literature review aims to investigate the current perspective of contraceptive use in the US using the social-ecological model (SEM). Based on SEM levels, barriers to contraceptive use entail the following levels: individual (e.g., misbelief about the side effects of contraceptives), interpersonal (e.g., influence of family and friends), institutional (e.g., lack of training on how to use different types of contraceptives), community (e.g., societal stigma and shame), and policy (e.g., restrictive federal and states policies). Access to contraceptives for women is a system-level issue that necessitates consideration for multilevel strategies by key stakeholders to improve contraceptive uptake among vulnerable populations.


2016 ◽  
Vol 14 (3) ◽  
pp. 64-69 ◽  
Author(s):  
Brittany A. Lemus ◽  
Faviola Mercado ◽  
Tracy Bryars ◽  
Michele Mouttapa ◽  
Tracy Conkey ◽  
...  

Childhood overweight and obesity has been a significant public health concern in the United States for decades. School-based obesity prevention programs have been one strategy to address this issue. This article describes the implementation of a knowledge-based, healthy eating intervention delivered to 4th and 5th graders in a southern California school district. Trained graduate students implemented a nutrition education curriculum, consisting of three monthly lessons that would eventually be utilized and sustained by the schools’ Physical Education (PE) teachers in the following school year. As such, the intervention drew upon the Social Ecological Model (SEM) to describe how nutrition education could be implemented in a sustainable way to future generations of youth. Students were assessed on their knowledge and dietary behaviors at pre-test and after the final lesson. Students’ overall nutritional knowledge significantly increased from pre-test to post-test; however their self-reported eating behaviors (e.g., low fruit and vegetable consumption, and high consumption of chips, soda, and sweets) largely remained the same. Although the findings of this study were largely non-significant, we conclude that future interventions, which creatively address different levels of the target population’s environment, may have promise if they are sufficiently dosed.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ethan Cowan ◽  
Maria R. Khan ◽  
Siri Shastry ◽  
E. Jennifer Edelman

AbstractThe COVID-19 pandemic has resulted in unparalleled societal disruption with wide ranging effects on individual liberties, the economy, and physical and mental health. While no social strata or population has been spared, the pandemic has posed unique and poorly characterized challenges for individuals with opioid use disorder (OUD). Given the pandemic’s broad effects, it is helpful to organize the risks posed to specific populations using theoretical models. These models can guide scientific inquiry, interventions, and public policy. Models also provide a visual image of the interplay of individual-, network-, community-, structural-, and pandemic-level factors that can lead to increased risks of infection and associated morbidity and mortality for individuals and populations. Such models are not unidirectional, in that actions of individuals, networks, communities and structural changes can also affect overall disease incidence and prevalence. In this commentary, we describe how the social ecological model (SEM) may be applied to describe the theoretical effects of the COVID-19 pandemic on individuals with opioid use disorder (OUD). This model can provide a necessary framework to systematically guide time-sensitive research and implementation of individual-, community-, and policy-level interventions to mitigate the impact of the COVID-19 pandemic on individuals with OUD.


2021 ◽  
Vol 33 (6) ◽  
pp. 511-533
Author(s):  
Kenneth C. Hergenrather ◽  
Diona Emmanuel ◽  
Robert J. Zeglin ◽  
David J. Ruda ◽  
Scott D. Rhodes

In the United States, gay, bisexual men, and men who have sex with men (MSM) represent 86% of new HIV infections among males. Approximately 1 in 7 men with HIV are unaware of their HIV status (CDC, 2017, 2019a, 2020a). To explore influences on MSM HIV risk behavior, the authors performed a systematic review of quantitative studies conducted in the U.S. assessing what is purported as masculinity. From 30 identified studies, significant findings were framed within the Social Ecological Model (SEM) levels (e.g., Individual, Relationship, Community). SEM level themes were applied to create the Masculinity 10, a preliminary 10-item assessment to explore the influence of masculinity on MSM HIV risk behavior. To increase MSM engagement in HIV prevention and treatment, the influences of masculinity (e.g., attitude toward sexual minorities, appearance, emotion, temperament, substance use, sexual activity, social support, intimate relationships, health care) on HIV risk behavior should be further explored.


2018 ◽  
Vol 78 (1) ◽  
pp. 51-66 ◽  
Author(s):  
Odette Jack ◽  
Elaine Chase ◽  
Ian Warwick

Objective: This study aimed to investigate how well a single higher education institution (HEI) was perceived to be meeting the psychosocial support needs of refugee students and to identify possible ways in which the HEI might better promote refugee students’ psychosocial well-being. Design: Adopting an exploratory, focused case study design, the research employed a qualitative interpretive approach utilising three data collection methods: narrative inquiry, Photovoice and key informant interviews. The social ecological model and the health-promoting university approach guided the enquiry and analysis. Setting: A single HEI in London, UK. Results: Refugee student-participants reported stressful and traumatic experiences at different points in their migratory experience. Participants were motivated by being involved in education but identified barriers to seeking institutional support to improve their health and well-being. Student-participants and staff identified ways in which support for refugee student well-being could be improved. Conclusion: Refugee students were found to have specific health and well-being support needs which were not met due to a range of organisational constraints. The social ecological model and the health-promoting university offer frameworks for HEIs to respond better to the diverse health and well-being needs of students.


2020 ◽  
Author(s):  
Veronica L Richards ◽  
Renessa Williams ◽  
Nichole E Stetten ◽  
Shantrel S Canidate ◽  
Angel Algarin ◽  
...  

Abstract Background: Although evidence suggests HIV-related stigma directly affects health and behaviors, we have a limited understanding of stigma’s influence beyond the individual-level. We aimed to describe HIV-related stigma and strategies to reduce it in the Southeastern U.S. within the context of the social ecological model (SEM). Methods: Qualitative surveys were distributed in-person at community events, conferences, and via email to persons affected by HIV periodically over 8 months. The final sample size included 87 participants (33 persons living with HIV, 54 without HIV). A directed content analysis was used to code responses into five levels of the SEM (individual, interpersonal, community, institutional, and structural). Results: Multiple themes emerged within each level: Individual – knowledge, fear, internalization; Interpersonal – social network; Community – judgements, discrimination, community organizations, norms; Institutional – competent providers, healthcare services; and Structural – systemic barriers, language, education. Conclusions: The findings exemplify the need for a multi-level approach to intervene and reduce HIV-related stigma. Based on the experiences and suggestions of people affected by HIV, future interventions should include substantial consideration from persons affected by HIV.


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