scholarly journals The Pre-Kindergarten Learning Enterprise (PKLE)

2011 ◽  
Vol 15 (3) ◽  
pp. 19
Author(s):  
Kahina Lasfer ◽  
Art Pyster ◽  
Brian Sauser
Keyword(s):  
Health Care ◽  
Home Environment ◽  
Health Care Providers ◽  
Low Income ◽  
Weak Interactions ◽  
Financial System ◽  
Kindergarten Children ◽  
Care Providers ◽  
Role Of Parents ◽  
Effective Development

To meet the challenges that todays pre-Kindergarten children will face as adults, they need effective development and learning organizations. Together, those organizations form the pre-Kindergarten (pre-K) learning enterprise, whose characteristics and behaviors greatly influence what pre-K children learn and how well they learn it. In this paper, the pre-K learning enterprise is explicitly defined and modeled for the first time and then analyzed through a systems thinking lens using systemigrams and related causal loop diagrams. Defining and modeling the pre-K learning enterprise is itself valuable as a means to understand the various relationships that exist among the identified constituent systems (e.g., home environment, preschool, financial, health care, state, and government) and the stakeholders identified within the enterprise (e.g., parents, educators, health care providers, and policy makers). That value is enhanced through an analysis which reveals the predominant reliance of several key pre-K learning enterprise component systems on the financial system while exposing weak interactions among the three main participating systems (preschools, home environment, and government). Heavy reliance on the financial system in todays economy reduces the effectiveness of the pre-K learning enterprise. To ease such reliance on the financial system while enhancing key interrelationships, three improvements to the existing enterprise are postulated: (1) enhance the role of parents through better education on child development, learning, health and nutrition and their increased voluntary involvement with preschools, (2) reduce the dependency on the financial system and promote partnerships among preschools, sports facilities, libraries and other learning systems to share resources, and (3) enhance government role through implementation of curriculum standardization, assessment and evaluation, and an effective policy towards mandatory education of low-income children.

Immigrant Communities and COVID-19: Strengthening the Public Health Response

2021 ◽  
Vol 111 (S3) ◽  
pp. S224-S231
Author(s):  
Lan N. Đoàn ◽  
Stella K. Chong ◽  
Supriya Misra ◽  
Simona C. Kwon ◽  
Stella S. Yi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Immigrant Communities ◽  
Care Providers ◽  
Public Health Response ◽  
The Public ◽  
Public Health Infrastructure ◽  
Health Infrastructure

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

Prenatal Care among Low-Income Women

1994 ◽  
Vol 75 (3) ◽  
pp. 152-159 ◽  
Author(s):  
Marjorie A. Schaffer ◽  
Betty Lia-Hoagberg
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Low Income ◽  
Healthcare Personnel ◽  
Care Providers ◽  
Healthy Baby ◽  
Low Income Women ◽  
High Level

Forty low-income pregnant women were interviewed about the personal, family, and provider rewards and costs they experienced in obtaining prenatal care. The women identified important rewards as the health of their babies, their own health, partner's desire for a healthy baby, monitoring of the pregnancy by qualified healthcare personnel, and the evaluation of problems by health-care providers. The authors suggest strategies to strengthen personal, family, and provider rewards aimed at achieving a high level of prenatal care for low-income women.

Successful Strategies to Address Disparities: Insurer and Employer Perspectives

2020 ◽  
pp. 292-300
Author(s):  
Manali I. Patel ◽  
Richard Snyder ◽  
Otis Brawley
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Cancer Disparities ◽  
Care Providers ◽  
High Quality ◽  
Quality Cancer Care

Disparities in cancer have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Disparate cancer outcomes continue to affect many populations in the United States and globally, including racial and ethnic minorities, populations with low income and education, and residents of rural areas or low socioeconomic neighborhoods, among others. Addressing cancer disparities requires approaches that are multilevel. Addressing social determinants of health, such as removing obstacles to health (e.g., poverty, discrimination, access to housing and education, jobs with fair pay, and health care) can reduce cancer disparities. However, to achieve cancer health equity, multilevel approaches are required to ensure that access to high-quality cancer care and equitable receipt of evidence-based services can reduce cancer disparities. Policy, health system interventions, and innovative delivery and health care coverage approaches by private and public payers, employer-based payers, and labor union organizations can assist in ensuring access to and receipt of high-quality cancer care while addressing the high costs of care delivery. Partnerships among patients, caregivers, employers, health care providers, and health care payers can make impactful changes in the way in which cancer care is delivered and, in turn, can assist in reducing cancer disparities.

scholarly journals THE ROLE OF CULTURE AND LANGUAGE IN DEPRESSION CARE EXPERIENCES AMONG OLDER LATINAS/OS AND HEALTH CARE PROVIDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S585-S586
Author(s):  
Maria P Aranda ◽  
Janelle Christensen ◽  
Iris Aguilar
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Quality Care ◽  
Intervention Development ◽  
Relationship Building ◽  
Care Providers ◽  
Depression Care ◽  
Study Implementation ◽  
Shared Culture

Abstract Older Latinas/os face significant difficulties in accessing quality depression treatment due to cultural and language barriers. In our study, Programa Esperanza (a randomized behavioral trial), we conducted after-treatment, in-depth interviews with two groups: 21 low-income Latinas/os (55+) receiving psychosocial depression care (Problem Solving Treatment, and Psychoeducation) in a health care setting, and 22 staff (interventionists, supervisors) participating in study implementation. Speaking the same language was highlighted by both groups as an overarching factor in effective depression care, although matching providers and patients by country of origin was considered less a priority than a shared language. The mechanisms by which language serves as a facilitator of effective care were highlighted: fomenting rapport; facilitating the expression of feelings; shortening initial relationship-building; understanding nuanced words and linguistic expressions; etc. Similarly, we found that shared culture included themes around intervention uptake, decreased stigma, increased advocacy, enhanced identification of coping strategies, etc. Unlike patients, providers were more likely to speak in diverse narratives of “them,” and “us.” Given that depression is still a stigmatizing disorder in our society, asking for help and receiving quality care remain significant challenges for older persons in general, and older underrepresented minorities, in particular. Our work signals the importance of differentiating language from culture in intervention development for older, primarily Spanish-speaking Latinas/os with high medical comorbidity.

scholarly journals Lessons from the Research Field on Partnership in Pediatric Primary Care with Urban, Low-Income African American Parents

2019 ◽  
Vol 6 (3) ◽  
pp. 5
Author(s):  
Kara Koschmann ◽  
Mary C. Hooke
Keyword(s):  
Health Care ◽  
African American ◽  
Data Collection ◽  
Health Care Providers ◽  
Low Income ◽  
Research Field ◽  
Lessons Learned ◽  
African American Parents ◽  
Care Providers ◽  
Research Findings

Qualitative data collection offers a unique opportunity to partner with research participants. Lessons learned through the process of data collection with urban, low-income, African American parents are reflective of the research findings themselves. Carefully designed research studies can remove barriers and empower participants, broadening the reach and results. Recruitment within communities develops trust, and focus groups offer a more empowering method for interviewing marginalized populations. Parents desire to have solid partnerships with their children’s health-care providers so that with their providers’ guidance, their children can flourish. The process of implementing the research itself, and not just the results, reveals strategies for improving partnership between parents and health-care providers.

scholarly journals Communicating the risk of contracting Zika virus to low income underserved pregnant Latinas: A clinic-based study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241675
Author(s):  
Suhasini Ramisetty-Mikler ◽  
LeAnn Boyce
Keyword(s):  
Health Care ◽  
Latin American ◽  
Health Care Providers ◽  
Low Income ◽  
Zika Virus ◽  
Virus Transmission ◽  
Reproductive Age ◽  
Sexual Practices ◽  
Considerable Proportion ◽  
Care Providers

Objective Frequent travel between the Southern border states in the USA, Mexico, and Latin American countries increases the risk of the Zika virus (ZIKV) spread. Patient education on virus transmission is fundamental in decreasing the number of imported cases, particularly among pregnant women. Methods The study used cross-sectional methodology to investigate information sources and knowledge concerning the ZIKV virus among 300 under-served pregnant Latinas recruited from prenatal care clinics in the North Texas region. Bivariate and multiple logistic regression models were used to investigate associations between the primary outcomes and patient characteristics. Results Physicians, nurses, and families are the major sources for pregnancy information, while media/internet (65%) and physician/nurse (33%) are the main sources for ZIKV information. Less than one-half of the mothers reported that their physician/nurse did not discuss safe sexual practices or inquired about their sexual practices. A considerable proportion of women from the community clinic were neither warned nor queried about travel to ZIKV risk countries. There is an overall understanding of Zika virus transmission, symptoms, complications, and recommended guidelines. Younger age and single mother status are risk factors for lack of ZIKV knowledge. Foreign-born mothers are 2.5–3.0 times more likely to have knowledge on disease transmission, symptoms, and microcephaly condition. While, younger mothers (18–24) are less likely to have knowledge of ZIKV infection symptoms (fever, rash and pink eye) and transmission of infection via unprotected sexual (vaginal, anal, or oral) behavior, compared to older mothers. Conclusions Interventions are needed to heighten the knowledge of ZIKV, particularly among women of reproductive age and their male partners in the community health care setting. Our study underscores the need for health care providers to be trained in delivering messages to enhance risk perception during health emergencies to vulnerable and underserved families (lower economic background, language ability, and culture). During health emergencies, clinics must disseminate crucial information via multi modalities to ensure messages reach the targeted patients.

scholarly journals Women who have sex with women’s experiences with healthcare system in low-income countries: qualitative findings from Dar-es-Salaam, Tanzania

2021 ◽  
Vol 2 (3) ◽  
pp. 142-145
Author(s):  
Happiness P. Saronga ◽  
Jackline V. Mbishi ◽  
Saidah S. Bakar ◽  
Switbert R. Kamazima
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Low Income ◽  
Dar Es Salaam ◽  
Health Facilities ◽  
Low Income Countries ◽  
Care Providers ◽  
Public Health Facilities

Introduction: Women who have sex with women (WSW) have a right to access health care. Many studies have reported lower access to health services by sexual minorities in many parts of the world. This study explored WSW’s experiences in accessing health care in Tanzania with the intention of determining specific issues facing WSW when accessing health care services. Methods: This study was cross-sectional descriptive, and retrospective conduced in Dar-es-Salaam region, the largest commercial city in Tanzania. Study population included WSW aged 18 years and above who met inclusion criteria. Data was collected using focus group discussions (FGDs), in-depth interviews (IDIs), observation, and life stories. Data analysis applied thematic analysis. Results: Most WSW receive rightful health services from public and private health providers. However, transgender WSW face stigma, discrimination, and disrespect from some public health facilities. Private health care providers offer trust, privacy and confidentiality to WSW, although at a higher cost of services compared to public health facilities. Conclusion: Negative experiences with care may discourage WSW from seeking care or fully disclosing health concerns to providers limiting the extent of services offered.

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