RESUMO
OBJECTIVE: Despite evidence that Black individuals are confronted with various types of racial discrimination that put them at risk for alcohol and substance use disorders, no study in Canada has assessed the frequency and factors related to substance use in Black communities. This study thus aims to examine the frequency and factors related to substance use in Black communities in Canada. METHOD: A total of 845 Black individuals in Canada (76.6% female) completed questionnaires assessing substance use (i.e., alcohol, cannabis, and other drugs), everyday racial discrimination, resilience, religious involvement, and sociodemographic information. Multivariable regression analyses were used to determine factors related to substance use among Black individuals. RESULTS: The findings showed that 14.8% (95% CI [8.60, 20.94]) of participants reported using any substance (i.e., alcohol, cannabis, and other drugs) in the past 12 months. Men reported a significantly higher frequency of substance use than women (25.7% vs. 11.1%; x² = 27.67, p < .001). Everyday racial discrimination (ß = .27, p < .001) and place of birth (born in Canada, ß = .14, p < .001) were positively associated with substance use, whereas it was negatively associated with religiosity, resilience, and gender (being a female; ß = -.08, p < .05; ß = -.21, p < .001; ß = -.12, p < .001). CONCLUSIONS: Racial discrimination is associated with substance use among Black individuals in Canada. The study findings inform potential prevention and intervention strategies by examining protective factors related to substance use (e.g., religiosity, resilience, gender) among Black individuals. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Assuntos
Racismo , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , População Negra , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e QuestionáriosRESUMO
The Ebola Virus Disease (EVD) remains a global public health concern with multiple outbreaks over the last five years. This scoping review aimed to synthesize the current state of knowledge on awareness, education, and community mobilization programs on EVD prevention. A comprehensive search strategy was executed in October 2021 across eight databases (APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, Global Health, MEDLINE, Scopus, and Web of Science). According to the PRISMA flow diagram, out of the 4815 studies generated by the search, 33 were retained for extraction and were included in this scoping review. Findings revealed that cultural practices that increased the risk of Ebola transmission remain very prevalent, even educational and awareness campaigns. Levels of Ebola-related knowledge by community members varied widely. A large proportion of the Ebola-affected populations were not aware of modes of transmission and half were unaware of signs and symptoms. Interventions with deep community mobilization, collaboration and engagement were effective in changing cultural practices, and reducing rates of infection. Interventions in the health sector helped increase willingness to practice preventive methods and the maintenance of social distancing and patient handwashing. A majority of the population members received their information about EVD from the community and mass media (in most instances, through broadcasting stations). Community interventions with a collaborative approach are effective to prevent EVD. It is needed to build trust between communities and health care, but also to use local resources and cultural factors combined with the use of technologies of information to prevent EVD.
Assuntos
Surtos de Doenças , Promoção da Saúde , Doença pelo Vírus Ebola , Humanos , Surtos de Doenças/prevenção & controle , Escolaridade , Conhecimentos, Atitudes e Prática em Saúde , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/transmissão , Saúde Pública , Promoção da Saúde/métodosRESUMO
BACKGROUND: The COVID-19 pandemic impacted mental health, but the global evolution of mental health problems during the pandemic is unknown. We conducted a systematic review and meta-analysis of longitudinal studies to evaluate the global evolution of mental health problems during the pandemic. METHODS: To conduct this systematic review, we searched for published articles from APA PsycInfo (Ovid), CINAHL (EBSCOhost), Embase (Ovid), MEDLINE (Ovid), and Web of Science. Longitudinal (at least 2 waves during the COVID-19 pandemic) and peer-reviewed articles on mental health problems conducted as from 2020 and after were included in the current study. Of 394 eligible full texts, 64 articles were included in the analysis. We computed random effects, standardized mean differences, and log odds ratio (LOR) with 95 % CIs. The meta-analysis protocol was registered with PROSPERO (CRD42021273624). RESULTS: Results showed that anxiety (LOR = -0.33; 95 % CI, -0.54, -0.12) and depression symptoms (LOR = -0.12; 95 % CI, -0.21, -0.04) decreased from baseline to follow up. However, other mental health problems showed no change. Higher prevalence rates (40.9 %; 95 % CI, 16.1 %-65.8 %) of psychological distress were found in months after July 2020, respectively, while there were no significant month differences for the prevalence of other mental health problems. Higher means of anxiety (d = 3.63, 95 % CI, 1.66, 5.61), depression (d = 3.93; 95 % CI, 1.68, 6.17), and loneliness (d = 5.96; 95 % CI, 3.22, 8.70) were observed in May 2020. Higher prevalence of anxiety, depression, and PTSD and higher means of anxiety, depression and loneliness were observed in North America. The prevalence of psychological distress and insomnia was higher in Latin America and Europe, respectively. LIMITATIONS: There is a lack of longitudinal studies in some parts of the world, such as Africa, the Caribbean, India, the Middle East, in Latin America, and Asia. CONCLUSIONS: Results indicated that anxiety and depression symptoms decreased during the COVID-19 pandemic while other mental health problems showed no statistical change. The findings reveal that mental health problems peaked in April and May 2020. Prevalence of mental health problems remains high during the pandemic and mental health prevention, promotion and intervention programs should be implemented to mitigate the consequences of the COVID-19 pandemic on the global population.
Assuntos
COVID-19 , Pandemias , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , COVID-19/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Humanos , Saúde Mental , PrevalênciaRESUMO
PURPOSE: Many academic medical organizations issued statements in response to demand for collective action against racial injustices and police brutality following the murder of George Floyd in May 2020. These statements may offer insight into how medical schools and national organizations were reflecting on and responding to these incidents. The authors sought to empirically examine the initial statements published by academic medical organizations in response to societal concerns about systemic, anti-Black racism. METHOD: The authors searched for initial public statements released by a sample of academic medical organizations in Canada and the United States between May 25 and August 31, 2020. They assembled an archive with a purposive sample of 45 statements, including those issued by 35 medical schools and 10 national organizations. They analyzed the statements using Fairclough's 3-dimensional framework for critical discourse analysis (descriptive, interpretive, explanatory), which is a qualitative approach to systematically analyzing language and how it reflects and shapes social practice. RESULTS: Many statements used formal and analytical language and reflected hierarchical thinking and power differentials between statement producers and consumers. The authors identified several tensions in the statements between explicit messaging and implied ideologies (e.g., self-education vs action to address racism), and they found a lack of critical reflection and commitment to institutional accountability to address anti-Black racism in academic medicine. The authors also found that many statements minimized discussions of racism and de-emphasized anti-Black racism as well as portrayed anti-Black racism as outside the institution and institutional accountability. CONCLUSIONS: This research offers insight into how 45 academic medical organizations initially responded following the murder of George Floyd. Many of these statements included self-exculpatory and nonracist discursive strategies. While these statements may have been well intentioned, organizations must move beyond words to transformative action to abolish institutional racism in academic medicine.