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Background: Social capital can be used as a conceptual framework to include social context as a predictor of human papillomavirus (HPV) vaccination and cervical cancer screening behaviours. However, the effectiveness of interventions that use social capital as a mechanism to improve uptake of immunization and screening remains elusive. Objective: To synthesize empirical evidence on the impact of social capital interventions on HPV immunization and cervical cancer screening and describe key characteristics of such interventions. Methods: Using a rapid review methodology, a search of literature published between 2012 and 2022 was conducted in four databases. Two researchers assessed the studies according to inclusion criteria in a three-step screening process. Studies were assessed for quality and data concerning social capital and equity components and intervention impact were extracted and analyzed using narrative synthesis. Results: Seven studies met the inclusion criteria. Studies found improved knowledge, beliefs and intentions regarding HPV immunization and cervical cancer screening. None of the studies improved uptake of immunization; however, three studies found post-intervention improvements in uptake of cervical cancer screening. All studies either tailored their interventions to meet the needs of specific groups or described results for specific disadvantaged groups. Conclusion: Limited evidence suggests that interventions that consider and reflect local context through social capital may be more likely to increase the uptake of HPV immunization and cervical cancer screening. However, further research must be done to bridge the gap in translating improvements in knowledge and intention into HPV immunization and cervical cancer screening behaviours.
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BACKGROUND: Attitudes toward the human papillomavirus (HPV) vaccine and accuracy of information shared about this topic in web-based settings vary widely. As real-time, global exposure to web-based discourse about HPV immunization shapes the attitudes of people toward vaccination, the spread of misinformation and misrepresentation of scientific knowledge contribute to vaccine hesitancy. OBJECTIVE: In this study, we aimed to better understand the type and quality of scientific research shared on Twitter (recently rebranded as X) by vaccine-hesitant and vaccine-confident communities. METHODS: To analyze the use of scientific research on social media, we collected tweets and retweets using a list of keywords associated with HPV and HPV vaccines using the Academic Research Product Track application programming interface from January 2019 to May 2021. From this data set, we identified tweets referring to or sharing scientific literature through a Boolean search for any tweets with embedded links, hashtags, or keywords associated with scientific papers. First, we used social network analysis to build a retweet or reply network to identify the clusters of users belonging to either the vaccine-confident or vaccine-hesitant communities. Second, we thematically assessed all shared papers based on typology of evidence. Finally, we compared the quality of research evidence and bibliometrics between the shared papers in the vaccine-confident and vaccine-hesitant communities. RESULTS: We extracted 250 unique scientific papers (including peer-reviewed papers, preprints, and gray literature) from approximately 1 million English-language tweets. Social network maps were generated for the vaccine-confident and vaccine-hesitant communities sharing scientific research on Twitter. Vaccine-hesitant communities share fewer scientific papers; yet, these are more broadly disseminated despite being published in less prestigious journals compared to those shared by the vaccine-confident community. CONCLUSIONS: Vaccine-hesitant communities have adopted communication tools traditionally wielded by health promotion communities. Vaccine-confident communities would benefit from a more cohesive communication strategy to communicate their messages more widely and effectively.
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Vacunas contra Papillomavirus , Medios de Comunicación Sociales , Análisis de Redes Sociales , Vacilación a la Vacunación , Humanos , Investigación Biomédica , Conocimientos, Actitudes y Práctica en Salud , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Vacilación a la Vacunación/psicologíaRESUMEN
SETTING: Health inequities exist in rural communities across Canada, as rural residents are more likely than their urban counterparts to experience injuries, chronic conditions, obesity, and shorter life expectancy. Cooperative and coordinated action across sectors is required to both understand and address these complex public health issues. INTERVENTION: The Alberta Healthy Communities Approach (AHCA) is based on the values and core building blocks of the Healthy Communities Approach, a framework centred on building community capacity to support community-led actions on the determinants of health. Adaptations within the AHCA focused on implementation mechanisms with a 5-step process and supporting implementation and assessment tools for multisectoral team building. Local measurement of change was enhanced and focused on community capacity and multisectoral action stages. Between 2016 and 2019, the AHCA was piloted with 15 rural communities across Alberta with population sizes ranging from 403 to 15,051 people. OUTCOMES: While communities piloting the AHCA ranged in the level of diversity of their coalition membership and partnerships, members' reflections demonstrate that intentional engagement with diverse citizens and sectors is pivotal to collaboratively identifying local assets and priorities and mobilizing cross-sectoral action that will sustainably improve supportive environments for cancer and chronic disease prevention. IMPLICATIONS: Engaging across sectors, building partnerships, and establishing a multisectoral team increase diversity and can catalyze community-led prioritization and actions for asset-based community development. An increase in diversity may lead to increased investment and sustainability at the community level.
RéSUMé: LIEU: Il existe des iniquités en santé dans les communautés rurales de tout le Canada, car les résidents ruraux sont plus susceptibles que leurs homologues urbains de connaître des blessures, des affections chroniques, l'obésité et une espérance de vie plus courte. Une action coopérative et coordonnée entre plusieurs secteurs est nécessaire à la fois pour comprendre ces problèmes de santé publique complexes et pour les aborder. INTERVENTION: L'approche des Communautés en santé de l'Alberta (AHCA) repose sur les valeurs et les composantes de base de l'approche des Communautés en santé, un cadre axé sur le renforcement des moyens de proximité pour soutenir des actions communautaires sur les déterminants de la santé. Les adaptations de l'AHCA ont porté sur les mécanismes de mise en Åuvre de l'approche, dont un processus en cinq étapes et une aide à la création d'outils de mise en Åuvre et d'évaluation pour la consolidation d'équipes multisectorielles. Les instruments de mesure du changement à l'échelle locale ont été améliorés et recentrés sur les moyens de proximité et les étapes de l'action multisectorielle. Entre 2016 et 2019, l'AHCA a été mise à l'essai dans 15 communautés rurales de l'Alberta comptant entre 403 et 15 051 habitants. RéSULTATS: Les communautés dans lesquelles l'AHCA a été mise à l'essai présentaient différents degrés de diversité dans les membres et les partenaires de leurs coalitions, mais les réflexions des membres montrent que la mobilisation intentionnelle d'une forte mixité de citoyens et de secteurs est cruciale pour définir de façon concertée les priorités et les atouts locaux et pour mobiliser une action intersectorielle qui instaure durablement des milieux favorables à la prévention du cancer et des maladies chroniques. CONSéQUENCES: L'implication de plusieurs secteurs, la création de partenariats et la formation d'une équipe multisectorielle accroissent la diversité et peuvent accélérer la définition des priorités collectives et les actions de développement de proximité fondées sur les atouts. Une augmentation de la diversité peut mener à des investissements et à une durabilité accrus à l'échelle des communautés.
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Salud Pública , Población Rural , Alberta , Atención a la Salud , Estado de Salud , HumanosRESUMEN
BACKGROUND: The workplace provides a unique opportunity to intervene on tobacco use, by implementing multilevel interventions engaging diverse employees. Using the social ecological model (SEM), this scoping review aimed to synthesize descriptions of multilevel workplace tobacco control programs to create a health equity informed framework for intervention planning. METHODS: Multiple databases were searched for articles published from January 2010 to December 2020 meeting inclusion criteria (i.e., discussed multilevel tobacco cessation interventions that intervene, target, or incorporate two or more levels of influence, and one of the levels must be the workplace). Articles were screened by two independent researchers and included if they discussed multilevel tobacco cessation interventions that intervened, targeted, or incorporated two or more levels of influence. To integrate the extracted information into the SEM, we utilized the McLeroy et al. model and definitions to describe potential multilevel interventions and their determinants. RESULTS: Nine articles were included in this review. No studies intervened across all five levels (individual, interpersonal, institutional, community, and policy), and the most common levels of intervention were individual (e.g., individual counseling), interpersonal (e.g., group therapy), and institutional (e.g., interventions during work hours). Participation rates varied by key social determinants of health (SDOHs) such as age, gender, education and income. Barriers including cost and sustainability influenced successful implementation, while leadership endorsement and accessibility facilitated successful implementation. DISCUSSION/APPLICATION TO PRACTICE: Multilevel interventions targeting at least two SEM levels may reduce persistent health inequities if they address how SDOHs influence individual health behaviors. Employee characteristics impacted the success of tobacco cessation interventions, but more research is needed to understand the barriers and facilitators related to workplace characteristics.
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Nicotiana , Lugar de Trabajo , Consejo , Humanos , Liderazgo , Uso de TabacoRESUMEN
To improve health at the human, animal, and ecosystem interface, defined as One Health, training of researchers must transcend individual disciplines to develop a new process of collaboration. The transdisciplinary research approach integrates frameworks and methodologies beyond academic disciplines and includes involvement of and input from policy makers and members of the community. The authors argue that there should be a significant shift in academic institutions' research capacity to achieve the added value of a transdisciplinary approach for addressing One Health problems. This Perspective is a call to action for academic institutions to provide the foundations for this salient shift. The authors begin by describing the transdisciplinary approach, propose methods for building transdisciplinary research capacity, and highlight three value propositions that support the case. Examples are provided to illustrate how the transdisciplinary approach to research adds value through improved sustainability of impact, increased cost-effectiveness, and enhanced abilities to mitigate potentially harmful unintended consequences. The authors conclude with three key recommendations for academic institutions: (1) a focus on creating enabling environments for One Health and transdisciplinary research, (2) the development of novel funding structures for transdisciplinary research, and (3) training of "transmitters" using real-world-oriented educational programs that break down research silos through collaboration across disciplines.