scholarly journals Building a Prevention System: Infrastructure to Strengthen Health Promotion Outcomes

2021 ◽  
Vol 18 (4) ◽  
pp. 1618
Author(s):  
Monica Bensberg ◽  
Andrew Joyce ◽  
Erin Wilson
Keyword(s):  
Health Promotion ◽  
Chronic Disease ◽  
State Government ◽  
Large Scale ◽  
Population Level ◽  
Structured Interviews ◽  
Intervention Delivery ◽  
Systems Practice ◽  
Prevention System ◽  
Prevention Interventions

Prevention systems improve the performance of health promotion interventions. This research describes the establishment of the Australian state government initiative, Healthy Together Victoria’s (HTV) macro infrastructure for the delivery of large-scale prevention interventions. Methods: This paper reports on findings of 31 semi-structured interviews about participants’ understanding of systems thinking and their reflections of the strengths and weaknesses of the HTV prevention system. A chronic disease prevention framework informed the coding that was used to create a causal loop diagram and a core feedback loop to illustrate the results. Results: Findings highlighted that HTV created a highly connected prevention system that included a sizeable workforce, significant funding and supportive leadership. Operating guidelines, additional professional development and real-time evaluation were significant gaps, which hindered systems practice. For inexperienced systems thinkers, these limitations encouraged them to implement programs, rather than interact with the seemingly ambiguous systems methods. Conclusions: HTV was an innovative attempt to strengthen health promotion infrastructure, creating a common language and shared understanding of prevention system requirements. However, the model was inadequate for HTV to achieve population-level reductions in chronic disease as system oversight was missing, as was an intervention delivery focus. Clarity was needed to define the systems practice that HTV was seeking to achieve. Importantly, the HTV prevention system needed to be understood as complex and adaptive, and not prioritized as individual parts.

scholarly journals Recommendations for Effective Intersectoral Collaboration in Health Promotion Interventions: Results from Joint Action CHRODIS-PLUS Work Package 5 Activities

2020 ◽  
Vol 17 (18) ◽  
pp. 6474
Author(s):  
Djoeke van Dale ◽  
Lidwien Lemmens ◽  
Marieke Hendriksen ◽  
Nella Savolainen ◽  
Péter Nagy ◽  
...  
Keyword(s):  
Health Promotion ◽  
Chronic Disease ◽  
Joint Action ◽  
Success Factors ◽  
Intersectoral Collaboration ◽  
Structured Interviews ◽  
Context Specific ◽  
National Programs ◽  
Health Promotion Interventions ◽  
National Governments

The burden of chronic disease in Europe continues to grow. A major challenge facing national governments is how to tackle the risk factors of sedentary lifestyle, alcohol abuse, smoking, and unhealthy diet. These factors are complex and necessitate intersectoral collaboration to strengthen health promotion, counter-act the social determinants of health, and reduce the prevalence of chronic disease. European countries have diverse intersectoral collaboration to encourage health promotion activities. In the Joint Action CHRODIS-PLUS success factors for intersectoral collaboration within and outside healthcare which strengthen health promotion activities were identified with a mixed method design via a survey of 22 project partners in 14 countries and 2 workshops. In six semi-structured interviews, the mechanisms underlying these success factors were examined. These mechanisms can be very context-specific but do give more insight into how they can be replicated. In this paper, 20 health promotion interventions from national programs in CHRODIS PLUS are explored. This includes community interventions, policy actions, integrated approaches, capacity building, and training activities. The interventions involved collaboration across three to more than six sectors. The conclusion is a set of seven recommendations that are considered to be essential for fostering intersectoral collaboration to improve health-promoting activities.

Identifying Communities’ Perspectives on their Health Needs in Impoverished Villages to Guide Non-government Organizations’ Health Promotion Efforts in Guatemala

2020 ◽  
Vol 7 (5) ◽  
pp. 9-20
Author(s):  
Claudia Bale
Keyword(s):  
Health Promotion ◽  
Community Health ◽  
Health Care Access ◽  
Family Health ◽  
Community Based Participatory Research ◽  
Health Needs ◽  
Health Conditions ◽  
Personal Health ◽  
Structured Interviews ◽  
Non Profit

Objective: The aim of this mixed-methods study is to capture and understand impoverished Guatemalan community members’ perspectives of their own health needs on a community level in order to guide Hope of Life (HOL) Non-Profit organization’s health promotion interventions in the villages they serve. Methods: A modified health needs assessment survey was conducted with 96 participants from four impoverished villages in the department of Zacapa, Guatemala. Survey responses were analyzed for significant differences in 4-item individual, family, and community health scores across demographic variables and significant correlations with reported personal health conditions and children’s health conditions. Five semi-structured interviews were also conducted with community leaders from three of the villages surveyed. Interviews were audio recorded and responses were transcribed verbatim and translated from Spanish to English. Thematic analysis using HyperRESEARCH qualitative analysis software version 4.5.0. was conducted to identify major themes. Results: The mean age of the 96 participants surveyed was 40.4 years and the majority were women, married or in Union, and have children. Women reported a significantly lower individual and family health score than men. The most rural village included in the study had significantly lower family health scores than the three sub-urban villages in the study. Among the personal health problems reported by participants, alcohol consumption, dental problems, and malnutrition were significant predictors of lower individual health scores. Themes that emerged from the interview analysis included the greatest community health needs, perceived negative community health behaviors, barriers to health care access, HOL’s impact, and suggestions for community health promotion.   Conclusion: The results of this study reveal many unmet health needs and barriers to healthcare that Guatemalan village communities face. Community-based participatory research using a mixed approach voices communities’ perspective on their perceived needs and is an important tool to guide non-profit aid and intervention serving impoverished communities.

scholarly journals Hoots and harm reduction: a qualitative study identifying gaps in overdose prevention among women who smoke drugs

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Geoff Bardwell ◽  
Tamar Austin ◽  
Lisa Maher ◽  
Jade Boyd
Keyword(s):  
Harm Reduction ◽  
Illicit Drugs ◽  
Structural Violence ◽  
Structured Interviews ◽  
Overdose Prevention ◽  
Polysubstance Use ◽  
Reduction Strategies ◽  
Prevention Interventions ◽  
Negative Health Outcomes ◽  
Mixed Gender

Abstract Background Smoking or inhaling illicit drugs can lead to a variety of negative health outcomes, including overdose. However, most overdose prevention interventions, such as supervised consumption services (SCS), prohibit inhalation. In addition, women are underrepresented at SCS and are disproportionately impacted by socio-structural violence. This study examines women’s experiences smoking illicit drugs during an overdose epidemic, including their utilization of a women-only supervised inhalation site. Methods Qualitative research methods included on-site ethnographic observation and semi-structured interviews with 32 participants purposively recruited from the women-only site. Data were coded and analyzed using NVivo 12 and thematic analysis was informed by gendered and socio-structural understandings of violence. Results Participants had preferences for smoking drugs and these were shaped by their limited income, inability to inject, and perceptions of overdose risk. Participants expressed the need for services that attend to women’s specific experiences of gendered, race-based, and structural violence faced within and outside mixed-gender social service settings. Results indicate a need for sanctioned spaces that recognize polysubstance use and drug smoking, accommodated by the women-only SCS. The smoking environment further fostered a sociability where participants could engage in perceived harm reduction through sharing drugs with other women/those in need and were able to respond in the event of an overdose. Conclusions Findings demonstrate the ways in which gendered social and structural environments shape women’s daily experiences using drugs and the need for culturally appropriate interventions that recognize diverse modes of consumption while attending to overdose and violence. Women-only smoking spaces can provide temporary reprieve from some socio-structural harms and build collective capacity to practice harm reduction strategies, including overdose prevention. Women-specific SCS with attention to polysubstance use are needed as well as continued efforts to address the socio-structural harms experienced by women who smoke illicit drugs.

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

scholarly journals 214 Longitudinal Changes in Sleep Duration, Timing, Variability, and Stages during the COVID-19 Pandemic: Large-Scale Fitbit Data

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A86-A86
Author(s):  
Michael Grandner ◽  
Naghmeh Rezaei
Keyword(s):  
New York ◽  
Los Angeles ◽  
San Francisco ◽  
Sleep Duration ◽  
Large Scale ◽  
Age Groups ◽  
Population Level ◽  
Sleep Stages ◽  
Longitudinal Changes ◽  
Timing Variability

Abstract Introduction The COVID-19 pandemic has resulted in societal-level changes to sleep and other behavioral patterns. Objective, longitudinal data would allow for a greater understanding of sleep-related changes at the population level. Methods N= 163,524 deidentified active Fitbit users from 6 major US cities contributed data, representing areas particularly hard-hit by the pandemic (Chicago, Houston, Los Angeles, New York, San Francisco, and Miami). Sleep variables extracted include nightly and weekly mean sleep duration and bedtime, variability (standard deviation) of sleep duration and bedtime, and estimated arousals and sleep stages. Deviation from similar timeframes in 2019 were examined. All analyses were performed in Python. Results These data detail how sleep duration and timing changed longitudinally, stratified by age group and gender, relative to previous years’ data. Overall, 2020 represented a significant departure for all age groups and both men and women (P<0.00001). Mean sleep duration increased in nearly all groups (P<0.00001) by 5-11 minutes, compared to a mean decrease of 5-8 minutes seen over the same period in 2019. Categorically, sleep duration increased for some and decreased for others, but more extended than restricted. Sleep phase shifted later for nearly all groups (p<0.00001). Categorically, bedtime was delayed for some and advanced for others, though more delayed than advanced. Duration and bedtime variability decreased, owing largely to decreased weekday-weekend differences. WASO increased, REM% increased, and Deep% decreased. Additional analyses show stratified, longitudinal changes to sleep duration and timing mean and variability distributions by month, as well as effect sizes and correlations to other outcomes. Conclusion The pandemic was associated with increased sleep duration on average, in contrast to 2019 when sleep decreased. The increase was most profound among younger adults, especially women. The youngest adults also experienced the greatest bedtime delay, in line with extensive school-start-times and chronotype data. When given the opportunity, the difference between weekdays and weekends became smaller, with occupational implications. Sleep staging data showed that slightly extending sleep minimally impacted deep sleep but resulted in a proportional increase in REM. Wakefulness during the night also increased, suggesting increased arousal despite greater sleep duration. Support (if any) This research was supported by Fitbit, Inc.

Assessing Resource Environments to Target Prevention Interventions in Community Chronic Disease Control

2006 ◽  
Vol 17 (2S) ◽  
pp. 146-158 ◽  
Author(s):  
David Sloane ◽  
Lori Nascimento ◽  
Gwendolyn Flynn ◽  
LaVonna Lewis ◽  
Joyce Jones Guinyard ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Control ◽  
Prevention Interventions ◽  
Target Prevention

Preparing nurses for primary health care futures: how well do Australian nursing courses perform?

2010 ◽  
Vol 16 (3) ◽  
pp. 211 ◽  
Author(s):  
Helen Keleher ◽  
Rhian Parker ◽  
Karen Francis
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Curriculum Reform ◽  
Community Settings ◽  
Educational Preparation ◽  
Undergraduate Nursing ◽  
Primary Health ◽  
Prevention And Health Promotion

Health reform is increasingly targeted towards strengthening and expansion of primary health systems as care is shifted from hospitals to communities. The renewed emphasis on prevention and health promotion is intended to curb the tide of chronic disease and sustain effective chronic disease management, as well as address health inequities and increase affordable access to services. Given the scope of nurses’ practice, the success of Australia’s health system reforms are dependent on a nursing workforce that is appropriately educated and prepared for practice in community settings. This article reports on the results of an Australian national audit of all undergraduate nursing curricula to examine the extent of professional socialisation and educational preparation of nurses for primary health care. The results of the audit are compared with Australian nursing standards associated with competency in primary health care. The findings indicate that Australian nursing competencies are general in their approach to skills and knowledge, not specifying any particular competencies for primary health care, while undergraduate student preparation for practice in primary health and community settings is patchy and not keeping pace with reform agendas that promote expanded roles for nurses in primary health care, prevention and health promotion. The implication for nursing curriculum reform is that attention to achieving nursing graduate capacity for primary health care and health promotion is a priority.

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