‘You Are Kind of Like One of Us’: Exploring Researcher Positioning in Studying Community-Based Health Promotion Interventions Among Social Housing Residents of Danish, Turkish and Pakistani Origin

The practice of qualitative research demands reflexivity throughout the entire research process, with special attention directed towards researcher positioning. In this article, I explore how aspects and characteristics of my social situation positioned me contrary to my expectations regarding researcher positioning. I draw on individual interviews, focus group discussions and field notes about community-based health promotion interventions among residents of Danish, Turkish and Pakistani origin in a deprived social housing area in Denmark. Rather than insider-outsider positioning, the concept represented by the term ‘halfie’ unfolds the complexity of my researcher positioning: less minority ethnic than the residents of Turkish and Pakistani origin and less Danish than the residents of Danish origin, but similar to both, being a descendant of Sri Lankan Tamil origin brought up in a Danish social housing area. Finally, I present methodological and ethical implications of being a halfie in the context of qualitative health research.

SARS-CoV-2 transmission potential and rural-urban disease burden disparities across Alabama, Louisiana, and Mississippi, March 2020 — May 2021

Purpose: To quantify and compare SARS-CoV-2 transmission potential across Alabama, Louisiana, and Mississippi and selected counties with populations in the 50th, 75th, and 100th percentile. Methods: To determine the time-varying reproduction number Rt of SARS-CoV-2, we applied the R package EpiEstim to the time series of daily incidence of confirmed cases. Median Rt percentage change when policies changed was determined. Linear regression was performed between log10-transformed cumulative incidence and log10-transformed population size at four time points. Results: Stay-at-home orders, face mask mandates, and vaccinations were associated with the most significant reductions in SARS-CoV-2 transmission in the three southern states. Rt across the three states decreased significantly by 20% following stay-at-home orders. We observed varying degrees of reductions in Rt across states following other policies. Rural Alabama counties experienced higher per capita cumulative cases relative to urban ones as of June 17 and October 17, 2020. Meanwhile, Louisiana and Mississippi saw the disproportionate impact of SARS-CoV-2 in rural counties compared to urban ones throughout the study period. Conclusion: State and county policies had an impact on local pandemic trajectories. The rural-urban disparities in case burden call for evidence-based approaches in tailoring health promotion interventions and vaccination campaigns to rural residents.

Prevalence and Correlates of Serious Injuries among Adolescents in Mauritius

Introduction. Injuries are a major global health problem that affects teenagers in many countries. Though several studies have been done in many countries, little is known among adolescents in Mauritius. Therefore, our paper explored the prevalence and correlates of serious injuries among adolescents in Mauritius. Methods. We analysed the 2017 Global School-Based Student Health Survey (GSHS) data from Mauritius, using the Chi-square test and binomial logistic regression analysis with adjusted odds ratio (AOR) at 95% confidence interval (CI). Results. The prevalence of serious injuries among adolescents in Mauritius stood at 39.0%. Also, the predictors of serious injuries included sex (AOR = 0.70, CI = 0.58–0.81), physical attack (AOR = 0.47, CI = 0.39–0.57), being bullied (AOR = 0.48, CI = 0.48–0.70), suicide ideation (AOR = 0.65, CI = 0.49–0.85), hunger (AOR = 0.65, CI = 0.48–0.86), truancy from school (AOR = 0.77, CI = 0.63–0.93), marijuana use (AOR = 0.54, CI = 0.39–0.76), alcohol consumption (AOR = 0.64, CI = 0.70–0.98), and parental neglect (AOR = 0.83, CI = 0.70–0.98). Conclusion. The rate of injury among adolescents in Mauritius is moderately high, with sex, suicidal thought, hunger, truancy, drug use, and parental neglect as correlates. There is an urgent need for health promotion interventions at family, community, and school levels to deal with this level of serious injuries and the factors influencing such occurrences among these adolescents in Mauritius.

Overcoming Health Promotion Barriers in Rural Health: A Qualitative Analysis

Weight loss interventions are fraught with difficulties for older adults in rural areas due to transportation difficulties, reduced availability of staff, and lack of programs. Telemedicine can overcome these barriers. A qualitative analysis of data from 44 exit-interviews from a rural-based, older adult weight loss study, informed by thematic analysis, was conducted. Participant’s age was 73 years (73% female) and BMI was 36.5kg/m2. Distance to the site was 24 miles (31 min). Key themes included: a) telemedicine can help improve one’s health, is more practical than in-person visits, is less costly, and time efficient; b) the majority (60%) were initially apprehensive about using telemedicine, a fear that resolved quickly; c) setting up telemedicine was easy and acceptable, despite a quick learning curve; d) having a team member for troubleshooting was important. Using telemedicine in older adults with obesity residing in rural areas should be considered in health promotion interventions.

Where are all the men? A review of the barriers and facilitators to participation in health promotion interventions

Research shows that men in the U.S. experience significant morbidity and earlier mortality than women and are less likely to access, interpret, and apply health information to improve their outcomes. Although evidence-based health promotion programs have proven successful at increasing healthy lifestyle behaviors and reducing morbidity among older adults, older males are still significantly less likely to enroll and sustain participation in such health interventions. While studies have shown the barriers and facilitators to older adult participation in health programs in general, it is largely unknown why older male recruitment and participation in health promotion interventions remains so low. In this poster presentation, we conducted a thorough review of the last 20 years of existing research across a variety of academic search databases to outline the barriers, facilitators, and recommendations for increasing older male participation in health promotion programs. Of 1,194 initial search results, 383 article abstracts were thoroughly screened for inclusion, and 26 articles met all inclusion criteria. Included studies were coded and analyzed using Grounded Theory and reveal that masculine gender roles, as well as program scope, environment, and gender of the instructors and other participants, were important factors for male participation. Interventions should include men in all aspects of program planning and implementation, take into account men’s existing relationships and interests to create gender-sensitive programming, and clearly delineate the benefits to participation. Lastly, the field of public health would benefit by helping to normalize men’s participation in health promotion interventions.

Quantitative methods used to evaluate impact of health promotion interventions to prevent HIV infections: a methodological systematic review protocol

Background Combination prevention is currently considered the best approach to combat HIV epidemic. It is based upon the combination of structural, behavioral and biomedical interventions. Such interventions are frequently implemented in a health promoting manner due to their aims, the approach that was adopted and their complexity. The impact evaluation of these interventions often relies on methods inherited from the biomedical field. However, these methods have limitations and should be adapted to be relevant for these complex interventions. This systematic review aims to map the evidence-based methods used to quantify the impact of these interventions and analyze how these methods are implemented. Methods Three databases (Web of Science, Scopus, PubMed) will be used to identify impact evaluation studies of health promotion interventions that aimed at reducing the incidence or prevalence of HIV infection. Only studies based on quantitative design assessing intervention impact on HIV prevalence or incidence will be included. Two reviewers will independently screen studies based on titles and abstracts and then on the full text. The information about study characteristics will be extracted to understand the context in which the interventions are implemented. The information specific to quantitative methods of impact evaluation will be extracted using items from the Mixed Methods Appraisal Tool (MMAT), the guidelines for reporting Statistical Analyses and Methods in the Published Literature (SAMPL) and the guidelines for Strengthening The Reporting of Empirical Simulation Studies (STRESS). This review will be conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Discussion The impact evaluation of HIV prevention interventions is a matter of substantial importance given the growing need for evidence of the effectiveness of these interventions whereas they are increasingly complex. These evaluations allow to identify the most effective strategies to be implemented to fight the epidemic. It is therefore relevant to map the methods to better implement them and adapt them according to the type of intervention to be evaluated. Systematic review registration: PROSPERO CRD42020210825

Health promotion interventions for the control of hypertension in Africa, a systematic scoping review from 2011 to 2021

Background A proportion of hypertension patients live in developing countries with low awareness, poor control capabilities, and limited health resources. Prevention and control of hypertension can be achieved by applying both targeted and population-based health promotion interventions. This study synthesised the health promotion interventions for the control of hypertension in Africa. Methods An in-depth search of PubMed, CINAHL, EMBASE, Cochrane library, web of science, google scholar yielded 646 titles and 615 after duplicates were removed. Full text (112) was screened, and ten articles were selected. The data analysis method was thematic analysis through the incorporation of convergent synthesis. The major sub-themes that were identified were reduction in the prevalence of hypertension, increase in knowledge, impact and feasibility, role in the reduction of risk factors, and the cost associated with health promotion interventions. Results Health promotion interventions led to a remarkable decrease in the prevalence of hypertension, increased knowledge and awareness in the intervention compared to the control groups. Community-based interventions were noted to have a positive impact on people’s adoption of measures to reduce risk or identify early symptoms of hypertension. There was a significant relationship for the reduction in salt consumption, smoking, alcohol use, and increased physical activity after the administration of an intervention. Interventions using community health workers were cost-effective. Conclusion To sustain health promotion interventions and achieve control of hypertension especially in the long term, interventions must be culturally friendly and incorporate locally available resources in Africa.

Association of Occupational Distress and Low Sleep Quality with Syncope, Presyncope, and Falls in Workers

Syncope and presyncope episodes that occur during work could affect one’s safety and impair occupational performance. Few data are available regarding the prevalence of these events among workers. The possible role of sleep quality, mental stress, and metabolic disorders in promoting syncope, presyncope, and falls in workers is unknown. In the present study, 741 workers (male 35.4%; mean age 47 ± 11 years), employed at different companies, underwent clinical evaluation and blood tests, and completed questionnaires to assess sleep quality, occupational distress, and mental disorders. The occurrence of syncope, presyncope, and unexplained falls during working life was assessed via an ad hoc interview. The prevalence of syncope, presyncope, and falls of unknown origin was 13.9%, 27.0%, and 10.3%, respectively. The occurrence of syncope was associated with an increased risk of occupational distress (adjusted odds ratio aOR: 1.62, confidence intervals at 95%: 1.05–2.52), low sleep quality (aOR: 1.79 CI 95%: 1.16–2.77), and poor mental health (aOR: 2.43 CI 95%: 1.52–3.87). Presyncope was strongly associated with occupational distress (aOR: 1.77 CI 95%: 1.25–2.49), low sleep quality (aOR: 2.95 CI 95%: 2.08–4.18), and poor mental health (aOR: 2.61 CI 95%: 1.78–3.84), while no significant relationship was found between syncope or presyncope and metabolic syndrome. These results suggest that occupational health promotion interventions aimed at improving sleep quality, reducing stressors, and increasing worker resilience might reduce syncope and presyncope events in the working population.