Percepções e ações da equipe multiprofissional em saúde sobre a medicina tradicional indígena / Perceptions and actions of the multi-professional health team on traditional indigenous medicine / Percepciones y acciones del equipo multidisciplinario de salud sobre la medicina tradicional indígena

Objetivo: compreender as percepções e as ações de uma equipe multiprofissional em saúde quanto à prática da medicina tradicional indígena em uma Casa de Atenção à Saúde Indígena. Método: estudo qualitativo descritivo, realizado em uma de Casa de Apoio à Saúde Indígena em um município do Pará, que incluiu oito profissionais de uma equipe multiprofissional. A coleta de dados foi realizada no ano de 2018 e estes foram examinados pelo método da análise de conteúdo. Resultados: inserção e prática do cristianismo; ritos e lideranças xamânicas; e postura da equipe de multidisciplinar foram as categorias elencadas, que apontam os entendimentos e atuações da equipe multiprofissional e da organização espacial da Casa de Saúde do município. Considerações finais: há novos costumes e valores entre as etnias, em virtude da aproximação de grupos religiosos, cujas ações foram registradas e apreendidas pela equipe de trabalhadores em saúde.

Objective: understanding the perceptions and actions of a multi-professional health team regarding the practice of traditional indigenous medicine in an Indigenous Health Care Center. Method: this is a descriptive qualitative study carried out in an Indigenous Health Support Center in a municipality in the state of Pará, which included eight professionals from a multi-professional team. Data was collected in 2018 and examined using the content analysis method. Results: insertion and practice of Christianity; shamanic rites and leadership; and the attitude of the multidisciplinary team were the categories listed, which point to the understandings and actions of the multi-professional team and the spatial organization of the Health Center in the municipality. Final considerations: there are new customs and values among ethnic groups, due to the approach of religious groups, whose actions were recorded and apprehended by the team of health workers.

Objetivo: comprender las percepciones y acciones de un equipo multidisciplinario de salud sobre la práctica de la medicina tradicional indígena en una Casa de Atención para la Salud Indígena. Método: estudio descriptivo cualitativo, realizado en una Casa de Apoyo a la Salud Indígena de un municipio de Pará, que incluyó ocho profesionales de un equipo multidisciplinario. La recolección de datos se realizó en 2018 y los datos fueron sometidos al método de análisis de contenido. Resultados: inserción y práctica del cristianismo; ritos y líderes chamánicos; y actitud del equipo multidisciplinario fueron las categorías enumeradas, que indican la percepción y las acciones del equipo multidisciplinario y la organización espacial de la Casa de Salud del municipio. Consideraciones finales: existen nuevas costumbres y valores entre las etnias, debido a la presencia de grupos religiosos, el equipo de los trabajadores de la salud registró y aprendió las acciones de los indígenas.

Evaluating Two Educational Interventions for Enhancing COVID-19 Knowledge and Attitudes in a Sample American Indian/Alaska Native Population.

BACKGROUND: The COVID-19 pandemic has exacerbated existing healthcare disparities among American Indian/Alaska Native (AI/AN) populations rooted in historical traumas and systemic marginalization. METHODS: This study conducted at a single Indian Health Service (IHS) clinic in central Michigan evaluates two educational interventions for enhancing COVID-19 knowledge and attitudes in a sample AI/AN population. Utilizing a pre/post-intervention prospective study design, participants received either a video or infographic educational intervention, followed by a survey assessing their COVID-19 knowledge and attitudes. RESULTS: The results indicate significant improvements in knowledge and attitudes post-intervention, with both modalities proving effective. However, specific factors such as gender, political affiliation, and place of residence influenced COVID-19 attitudes and knowledge, emphasizing the importance of tailored interventions. CONCLUSIONS: Despite limitations, this study highlights the critical role of educational interventions in addressing vaccine hesitancy and promoting health equity within AI/AN communities. Moving forward, comprehensive strategies involving increased Indian Health Service funding, culturally relevant interventions, and policy advocacy are crucial in mitigating healthcare disparities and promoting health equity within AI/AN communities.

The development and current directions of a diversity specialty clinic: Implications for multicultural training in psychology.

Addressing systemic injustices and racism in training and clinical service provision are key next steps in clinical science. While the APA Multicultural Guidelines and accreditation standards have long emphasized this need, most graduate programs offer a single course on diversity, equity, and inclusion topics, which is inadequate to train and sustain culturally humble providers and redress systemic injustices and racism within psychology. Few "real-world" examples exist to guide the development of training models. We provide background on the development and components of a specialty clinic, the University of New Mexico's Cultural Counseling Center, whose mission is providing culturally informed clinical services to diverse clientele, and to infuse multicultural training throughout the graduate program. Informed by the racial-spatial framework for psychology and critical race theory, we describe our approach intended to: 1) offer applications for the operationalization and delivery of multicultural and antiracist training; 2) enhance supervisory models; and 3) increase awareness of structural competence. Our clinic, developed collaboratively among students and faculty, serves as a safe forum for dialogue around structural injustices and seeks to improve treatment for diverse clients and those underserved in mental health care. We discuss issues of student and faculty engagement and offer the perspectives of faculty and students of color, case examples illustrating our services, and current efforts to expand and formalize community collaborations. We offer a model that integrates coursework, informal activities, and multicultural supervision for comprehensive student training and that promotes a departmental culture of dialogue and support around equity, diversity, and justice.

Nurses Taking on Readiness Measures (N-TORM): A nurse-facilitated household emergency preparedness intervention feasibility study.

Aim: This research evaluated the effect of a nurse-facilitated intervention on elderly or medically frail community members' level of household emergency preparedness as measured in knowledge, actions taken, and supplies gathered. These community members had access and functional needs that must be accommodated during disasters to mitigate their increased risk of injury, illness, and death because of the disaster. With adequate preparedness, it is plausible these community members may survive the aftermath of a disaster without needing assistance from disaster responders. Methods: This was a non-randomized, single group, before-after feasibility study (N = 31) conducted in a one-on-one session with a nurse interventionist in an urban community setting in the United States of America. We used the Household Emergency Preparedness Instrument to measure intervention effectiveness and a Participant Experience Survey to evaluate participant satisfaction with the intervention. The intervention included an educational booklet that provided instruction to participants on how to create a disaster-related evacuation and communication plan and identify community resources. Upon completion of the booklet, participants received a complimentary disaster supply kit. Results: Mean general preparedness scores increased from 5.5 (SD = 4.1) pre-intervention to 20.2 (SD = 3.1) post-intervention (p < .001). Preparedness in all sub-scales also increased significantly (all ps < .001). Conclusions: Study findings provide support for the feasibility of the intervention to increase all measured aspects of emergency preparedness (knowledge, behaviors, and supplies) among elderly and medically frail adults with access and functional needs during disasters.

Study on the intervention effect of HCH integrated SMG health management model on community high-risk group of cardiovascular disease.

Objective: This study aimed to evaluate the integration of the Hospital-Community-Home (HCH) model with the Self-Mutual-Group (SMG) health management model for high-risk populations with cardiovascular disease in the Yuhua community of Shijiazhuang city. The study focused on implementing care interventions (HCH, SMG) with a specific emphasis on SMG to promote beneficial views/behaviors, enhance self-efficacy/agency, and address detrimental determinants of health, ultimately leading to durable changes and healthier lifestyles. Comparing the HCH model with the combined SMG model helps to comprehensively assess the strengths and weaknesses of different health management approaches. This comparison contributes to theoretical innovation and practical development in the field of health management, as well as improving patients' health outcomes and quality of life. Methods: This study employed a quasi-experimental design. Using stratified sampling, individuals who underwent health examinations in Community A and Community B from Shijiazhuang city between May 2023 and August 2023 were randomly selected. After informing the participants about the study and obtaining informed consent via telephone, high-risk patients with cardiovascular disease were screened based on their medical examination reports. Data on lifestyle behaviors, self-efficacy, medical responses, quality of life, and readmission rates were collected and compared before and after the intervention. Results: A total of 526 eligible participants were included, with 241 in the control group and 285 in the study group. After the intervention, there was no significant change in the proportions of smokers, alcohol consumers, and individuals engaging in leisure exercises in the control group. However, in the study group, the proportions of smokers and alcohol consumers significantly decreased, while the proportion of individuals engaging in leisure exercises significantly increased. After the intervention, both the study group and the control group showed significant increases in scores on the General Self-Efficacy Scale-Schwarzer (GSES) and the Seattle Angina Questionnaire (SAQ), with the study group scoring significantly higher than the control group. Avoidance and surrender scores significantly increased after the intervention, with the study group scoring significantly lower than the control group. Confrontation scores significantly increased after the intervention, with the study group scoring significantly higher than the control group. During the follow-up period, the study group had a significantly lower readmission rate than the control group. Conclusion: The integration of HCH with SMG health management model can significantly improve lifestyle behaviors, optimize medical responses, enhance self-efficacy and quality of life, and significantly reduce readmission rates among high-risk populations with cardiovascular disease.

Current Regulatory Issues for the Use of Probiotics.

The chapter provides an overview of the current regulatory challenges surrounding the use of probiotics. It explores the global regulatory landscape, noting the need for uniform regulations across various regions. It emphasizes that these inconsistencies pose challenges for consumers, healthcare professionals, and industry stakeholders. Furthermore, the chapter highlights the ongoing efforts at the Codex Alimentarius to establish harmonized probiotic guidelines. The chapter also discusses labeling regulations, stressing the need for more accurate and comprehensive information on probiotic products to aid in evidence-based decision-making. Finally, it addresses safety concerns, particularly for vulnerable populations like children, and calls for a multi-layered approach to safety assessments. The chapter concludes by advocating harmonizing regulations and guidelines to facilitate probiotics' safer and more effective use.

Ingredients of successful therapeutic relationships with foster youth according to key stakeholders in child welfare: A grounded theory analysis.

Foster youth reportedly have a significant need for mental health services and the quality of the therapeutic relationship can influence service engagement. We employed grounded theory methods to conduct interviews and focus groups with 48 key stakeholders in child welfare to deepen our theoretical understanding of therapeutic relationships with foster youth. The central theory that emerged was that a successful therapeutic relationship is an essential ingredient of the healing process for current and former foster youth. Participants identified hindrances to a successful therapeutic relationship, such as when therapist mishandles countertransference or inappropriately uses self-disclosure, as well as what therapists can do to build a successful therapeutic relationship, such as when a therapist fosters a secure attachment and promotes client agency. The findings offer insight into some of the important facets of building and maintaining a trusting and successful therapeutic relationship with current and former foster youth.

COVID-19 and influenza vaccine uptake in women with criminal-legal system involvement.

OBJECTIVE: Given their vulnerable health status and resource constraints, the perspectives of women with criminal-legal involvement (WCLI) are important but not usually represented in the literature on vaccine interest and vaccine hesitancy. This study aims to examine how the COVID-19 pandemic and vaccine affected the influenza vaccine uptake among WCLI. METHODS: A cross-sectional secondary analysis was conducted using data collected from the Tri-City study, which followed WCLI in three U.S. cities from 2019 to 2023. We mapped the distribution of influenza vaccine uptake in 2019-2023 and developed a composite outcome that reflected participants' patterns of Y/N to influenza vaccine, which were categorized into four groups: Influenza Vaccine Supportive, Influenza Vaccine Adaptive, Influenza Vaccine Discontinued, and Influenza Vaccine Resistant. RESULTS: Out of 507 people: 23.7% were Supportive, 8.5% Adaptive, 15.2% Discontinued and 38.3% Resistant. People who received the COVID vaccine had significantly lower odds of being identified as Discontinued (OR = 0.42, 95%CI = 0.20-0.87, p = .020) and Resistant (OR = 0.23, 95%CI = 0.13-0.43, p < .001), compared to the Supportive group. Mistrust toward COVID-19-related information was a significant independent predictor of being Adaptive (OR = 1.59, 95%CI = 1.08-2.35, p = .019), Discontinued (OR = 1.61, 95%CI = 1.15-2.25, p = .006), and Resistant (OR = 1.54, 95%CI = 1.19-2.00, p < .001) relative to Supportive. CONCLUSIONS: Vaccine hesitancy poses significant challenges to public health efforts, with apparent dampening effect across vaccines. Public health messaging and clinical interactions informed by best practices in communication tailored to the lived experience of all people, including women with criminal-legal system involvement, will be necessary to inform future interventions aimed at increasing vaccine uptake.

Health Information Source Patterns and Dietary Variety among Older Adults Living in Rural Japan.

Dietary variety is associated with some health outcomes among older adults. Rural areas, however, often have difficulty accessing health information that influences dietary variety. This study aimed to identify patterns of health information sources by using latent class analysis and assess their association with dietary variety among older adults aged ≥ 75 in rural Japan (n = 411). Three patterns of health information sources were identified: multi-sources (29.7%), television-only (53.5%), and non-sources (16.8%). In the multi-sources pattern, more people used television, radio, and newspapers. The television-only pattern had mostly television users, with fewer other sources. The non-sources pattern had many reporting "none." Logistic regression analysis revealed that the multi-sources pattern has a significant positive effect on dietary variety compared with the non-sources pattern (odds ratio: 5.434, 95% confidence interval: 1.792-16.472), even after adjusting for socioeconomic factors and physical health status. These findings underscore the positive impact of broad access to health information on the dietary habits of older individuals. The study highlights the importance of promoting access to diverse health information sources to enhance dietary variety and overall well-being among rural older adults.

Tailored Basic Life Support Training for Specific Layperson Populations-A Scoping Review.

Background: Basic life support (BLS) is a life-saving link in the out-of-hospital cardiac arrest chain of survival. Most members of the public are capable of providing BLS but are more likely to do so confidently and effectively if they undertake BLS training. Lay members of the public comprise diverse and specific populations and may benefit from tailored BLS training. Data on this topic are scarce, and it is completely unknown if there are any benefits arising from tailored courses or for whom course adaptations should be developed. Methods: The primary objective of this scoping review was to identify and describe differences in patient, clinical, and educational outcomes when comparing tailored versus standard BLS courses for specific layperson populations. This review was undertaken as part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation. Results: A primary search identified 1307 studies and after title, abstract, and full-text screening, we included eight publications reporting on tailored courses for specific populations. There were no studies reporting direct comparisons between tailored and standardized training. Seven (88%) studies investigated courses tailored for individuals with a disability, and only one study covered another specific population group (refugees). Overall, the quality of evidence was low as the studies did not compare tailored vs. non-tailored approaches or consisted of observational or pre-post-designed investigations. Conclusions: Tailored BLS education for specific populations is likely feasible and can include such groups into the pool of potential bystander resuscitation providers. Research into comparing tailored vs. standard courses, their cost-to-benefit ratio, how to best adapt courses, and how to involve members of the respective communities should be conducted. Additionally, tailored courses for first responders with and without a duty to respond could be explored.

Effects of Nasal Solution Incorporating Resveratrol and Carboxymethyl-Β-Glucan in Preschool Non-Atopic Children with Wheezing.

Upper respiratory tract infections (URTI) account for more than 80% of wheezing episodes in children with a high incidence of hospitalization in preschool age. Most children with symptoms of wheezing during an URTI are usually non-atopic. As the majority of wheezing episodes resulting from URTI are attributed to viral triggers, several studies have suggested the potential anti-inflammatory and antiviral properties of resveratrol. This study aims to identify the effect of resveratrol for pediatric non-atopic patients with recurrent wheezing triggered by URTIs. We conducted a prospective single-blind study to assess the effectiveness of a short course of nasal solutions incorporating resveratrol and carboxymethyl-ß-glucan, administered for 7 days at the onset of URTIs, compared to standard nasal lavage with 0.9% saline solution. A total of 19 patients entered the active group, 20 patients were assigned to the placebo group. The comparison of overall wheezing days (p < 0.001), mean wheezing days per month (p < 0.01), and wheezing episodes per patient (p < 0.001) in the two groups showed a significant reduction in the group receiving resveratrol compared with the placebo group, with less hospital access (p < 0.001) and oral corticosteroid administration (p < 0.01). Our findings seem to suggest that, in non-atopic children with recurrent wheezing secondary to URTIs, nasal resveratrol could be effective to prevent or reduce the occurrence of wheezing, when started from the onset of upper airway symptoms.

[Construction of a Predictive Model for Diabetes Mellitus Type 2 in Middle-Aged and Elderly Populations Based on the Medical Checkup Data of National Basic Public Health Service]. / åŸºäºŽå›½å®¶åŸºæœ¬å ¬å ±å«ç”ŸæœåŠ¡ä½“æ£€çš„ä¸­è€å¹´äºº2åž‹ç³–å°¿ç— é£Žé™©é¢„æµ‹æ¨¡åž‹æž„å»º.

Objective: To establish a universally applicable logistic risk prediction model for diabetes mellitus type 2 (T2DM) in the middle-aged and elderly populations based on the results of a Meta-analysis, and to validate and confirm the efficacy of the model using the follow-up data of medical check-ups of National Basic Public Health Service. Methods: Cohort studies evaluating T2DM risks were identified in Chinese and English databases. The logistic model utilized Meta-combined effect values such as the odds ratio (OR) to derive ß, the partial regression coefficient, of the logistic model. The Meta-combined incidence rate of T2DM was used to obtain the parameter α of the logistic model. Validation of the predictive performance of the model was conducted with the follow-up data of medical checkups of National Basic Public Health Service. The follow-up data came from a community health center in Chengdu and were collected between 2017 and 2022 from 7602 individuals who did not have T2DM at their baseline medical checkups done at the community health center. This community health center was located in an urban-rural fringe area with a large population of middle-aged and elderly people. Results: A total of 40 cohort studies were included and 10 items covered in the medical checkups of National Basic Public Health Service were identified in the Meta-analysis as statistically significant risk factors for T2DM, including age, central obesity, smoking, physical inactivity, impaired fasting glucose, a reduced level of high-density lipoprotein cholesterol (HDL-C), hypertension, body mass index (BMI), triglyceride glucose (TYG) index, and a family history of diabetes, with the OR values and 95% confidence interval (CI) being 1.04 (1.03, 1.05), 1.55 (1.29, 1.88), 1.36 (1.11, 1.66), 1.26 (1.07, 1.49), 3.93 (2.94, 5.24), 1.14 (1.06, 1.23), 1.47 (1.34, 1.61), 1.11 (1.05, 1.18), 2.15 (1.75, 2.62), and 1.66 (1.55, 1.78), respectively, and the combined ß values being 0.039, 0.438, 0.307, 0.231, 1.369, 0.131, 0.385, 0.104, 0.765, and 0.507, respectively. A total of 37 studies reported the incidence rate, with the combined incidence being 0.08 (0.07, 0.09) and the parameter α being -2.442 for the logistic model. The logistic risk prediction model constructed based on Meta-analysis was externally validated with the data of 7602 individuals who had medical checkups and were followed up for at least once. External validation results showed that the predictive model had an area under curve (AUC) of 0.794 (0.771, 0.816), accuracy of 74.5%, sensitivity of 71.0%, and specificity of 74.7% in the 7602 individuals. Conclusion: The T2DM risk prediction model based on Meta-analysis has good predictive performance and can be used as a practical tool for T2DM risk prediction in middle-aged and elderly populations.

Mapping the institutionalization of racism in the research about race and traumatic brain injury rehabilitation: implications for Black populations.

PURPOSE: Traumatic brain injury (TBI) is a chronic disease process and a public health concern that disproportionately impacts Black populations. While there is an abundance of literature on race and TBI outcomes, there is a lack of scholarship that addresses racism within rehabilitation care, and it remains untheorized. This article aims to illuminate how racism becomes institutionalized in the scientific scholarship that can potentially inform rehabilitation care for persons with TBI and what the implications are, particularly for Black populations. MATERIAL AND METHODS: Applying Bacchi's What's the Problem Represented to be approach, the writings of critical race theory (CRT) are used to examine the research about race and TBI rehabilitation comparable to CRT in other disciplines, including education and legal scholarship. RESULTS: A CRT examination illustrates that racism is institutionalized in the research about race and TBI rehabilitation through colourblind ideologies, meritocracy, reinforcement of a deficit perspective, and intersections of race and the property functions of whiteness. A conceptual framework for understanding institutional racism in TBI rehabilitation scholarship is presented. CONCLUSIONS: The findings from this article speak to the future of TBI rehabilitation research for Black populations, the potential for an anti-racist agenda, and implications for research and practice.

Critical race theory contributes to a comprehensive understanding of racism in the literature about race and traumatic brain injury (TBI) rehabilitation by asking how racism operates in the scholarship, including methods, analyses, interpretations, and conclusions.Applying a critical race theory lens in TBI rehabilitation has the potential to inform antiracist scholarship that holds important implications for critical rehabilitation research, practice, professional training, and policy.Implications for rehabilitation practice include opening up opportunities to address how race and racism shape rehabilitation outcomes to imagine different possibilities, programs, and futures for Black people with TBI with various communities of practice.

Healthcare workers' perspectives on a prescription phone program to meet the health equity needs of patients in the emergency department: a qualitative study.

OBJECTIVES: People experiencing homelessness and marginalization face considerable barriers to accessing healthcare services. Increased reliance on technology within healthcare has exacerbated these inequities. We evaluated a hospital-based prescription phone program aimed to reduce digital health inequities and improve access to services among marginalized patients in Emergency Departments. We examined the perceived outcomes of the program and the contextual barriers and facilitators affecting outcomes. METHODS: We conducted a constructivist qualitative program evaluation at two urban, academic hospitals in Toronto, Ontario. We interviewed 12 healthcare workers about their perspectives on program implementation and outcomes and analyzed the interview data using reflexive thematic analysis. RESULTS: Our analyses generated five interrelated program outcomes: building trust with patients, facilitating independence in healthcare, bridging sectors of care, enabling equitable care for marginalized populations, and mitigating moral distress among healthcare workers. Participants expressed that phone provision is critical for adequately serving patients who face barriers to accessing health and social services, and for supporting healthcare workers who often lack resources to adequately serve these patients. We identified key contextual enablers and challenges that may influence program outcomes and future implementation efforts. CONCLUSIONS: Our findings suggest that providing phones to marginalized patient populations may address digital and social health inequities; however, building trusting relationships with patients, understanding the unique needs of these populations, and operating within a biopsychosocial model of health are key to program success.

ABSTRAIT: OBJECTIFS: Les personnes sans abri et marginalisées font face à des obstacles considérables pour accéder aux services de santé. Le recours accru à la technologie dans les soins de santé a exacerbé ces inégalités. Nous avons évalué un programme de téléphones d'ordonnance en milieu hospitalier visant à réduire les inégalités en santé numérique et à améliorer l'accès aux services chez les patients marginalisés des services d'urgence. Nous avons examiné les résultats perçus du programme et les obstacles contextuels et facilitateurs qui influent sur les résultats. MéTHODES: Nous avons mené une évaluation qualitative constructiviste de programmes dans deux hôpitaux universitaires urbains de Toronto, en Ontario. Nous avons interviewé 12 travailleurs de la santé au sujet de leurs points de vue sur la mise en œuvre et les résultats du programme et analysé les données des entrevues au moyen d'une analyse thématique réflexive. RéSULTATS: Nos analyses ont généré cinq résultats de programme interdépendants : établir la confiance avec les patients, faciliter l'indépendance dans les soins de santé, rapprocher les secteurs de soins, permettre des soins équitables pour les populations marginalisées et atténuer la détresse morale chez les travailleurs de la santé. Les participants ont indiqué que la fourniture de services téléphoniques est essentielle pour servir adéquatement les patients qui font face à des obstacles à l'accès aux services de santé et aux services sociaux, et pour soutenir les travailleurs de la santé qui manquent souvent de ressources pour servir adéquatement ces patients. Nous avons cerné les principaux catalyseurs contextuels et les défis qui pourraient influer sur les résultats du programme et les efforts de mise en œuvre futurs. CONCLUSION: Nos résultats suggèrent que la fourniture de téléphones aux populations de patients marginalisés peut remédier aux inégalités numériques et sociales en matière de santé; cependant, établir des relations de confiance avec les patients, comprendre les besoins uniques de ces populations, La réussite du programme repose sur le fait de fonctionner dans un modèle biopsychosocial de la santé.

Using community-based participatory research methods to build the foundation for an equitable integrated health data system within a Canadian urban context.

Health inequalities amplified by the COVID-19 pandemic have disproportionately affected racialized and equity-deserving communities across Canada. In the Municipality of Peel, existing data, while limited, illustrates that individuals from racialized and equity-deserving communities continue to suffer, receive delayed care, and die prematurely. In response to these troubling statistics, grassroots community advocacy has called on health systems leaders in Peel to work with community and non-profit organizations to address the critical data and infrastructure gaps that hinder addressing the social determinants of health in the region. To support these advocacy efforts, we used a community-based participatory research approach to understand how we might build a data collection ecosystem across sectors, alongside community residents and service providers, to accurately capture the data about the social determinants of health. This approach involved developing a community engagement council, defining the problem with the community, mapping what data is actively collected and what is excluded, and understanding experiences of sociodemographic data collection from community members and service providers. Guided by community voices, our study focused on sociodemographic data collection in the primary care context and identified which service providers use and collect these data, how data are used in their work, the facilitators and barriers to data use and collection. Additionally, we gained insight into how sociodemographic data collection could be respectful, safe, and properly governed from the perspectives of community members. From this study, we identify a set of eight recommendations for sociodemographic data collection and highlight limitations. This foundational community-based work will inform future research in establishing data governance in partnership with diverse and equity-deserving communities.

The effectiveness of the in-person and online Gottman Seven Principles Couple Enhancement Program: A propensity score matching design.

This study investigates the effectiveness of the 12-h Gottman Seven Principles couple enhancement program delivered in person and online. In Norway, we recruited 490 participants and 242 people for a control group. All were in close relationships. The revised dyadic adjustment scale (RDAS) was used to assess the quality of their relationships before and after program participation, and at 6-month follow-up. Repeated measures ANOVA, t tests, reliable change, and multilevel multiple regression using propensity score matching to control for confounders were used to investigate the effectiveness of the course. The results demonstrate that the Gottman Seven Principles course improves couple relationships and is equally effective whether delivered in person or online. Furthermore, it does not matter whether there are therapists with a clinical background delivering the course, suggesting that the material itself is sufficient.

Combating COVID-19 health disparities in Black, Indigenous, and People of Colour Communities-A call for critical systems thinking.

RATIONALE: The Black, Indigenous, and People of Colour populations in the United States are disproportionately affected by the emerging health threat SARS-CoV-2, which causes COVID-19. AIMS AND OBJECTIVES: This paper aims to demonstrate the usefulness of critical systems thinking by using scenario planning based on epidemiological data and tying epidemiology with soft systems methodology to investigate COVID-19 disparities among disproportionately affected Black, Indigenous, and People of Colour populations. METHODS: Using a review of the COVID-19 literature and publicly available US COVID-19 data, critical systems thinking is applied in a scenario planning example and a call to link soft systems methodology with epidemiology. RESULTS: According to the four plausible Endgame scenarios, levels of community transmission as well as the current state transmission are based on the driving forces of the scenarios. In addition, soft systems methodology explores the effect on stakeholders and strengthens the picture of disease burden beyond sole reliance on traditional data sources. CONCLUSION: This analysis underscores employing critical systems thinking to critically assess diverse methods appropriate for the ongoing complexity of global crises. It is argued that critically engaged subjectivity should be given space alongside data-dependent objectivity. COVID-19 disparities are reliant on the social determinants of health's effects as driving forces on disease transmission in Black, Indigenous, and People of Colour populations. It is moreover argued that critical systems thinking is demonstrated by linking epidemiological evidence with scenario planning and soft systems methodology. This in turn supports a critical systems thinking approach to uncover the state of health disparities among minoritized communities under COVID-19.

Understanding Practical, Robust Implementation and Sustainability of Home-based Comprehensive Sexual Health Care: A Realist Review.

This review identifies which elements of home-based comprehensive sexual health care (home-based CSH) impacted which key populations, under which circumstances. A realist review of studies focused on home-based CSH with at least self-sampling or self-testing HIV and additional sexual health care (e.g., treatment, counseling). Peer-reviewed quantitative and qualitative literature from PubMed, Embase, Cochrane Register of Controlled Trials, and PsycINFO published between February 2012 and February 2023 was examined. The PRISM framework was used to systematically assess the reach of key populations, effectiveness of the intervention, and effects on the adoption, implementation, and maintenance within routine sexual health care. Of 730 uniquely identified records, 93 were selected for extraction. Of these studies, 60% reported actual interventions and 40% described the acceptability and feasibility. Studies were mainly based in Europe or North America and were mostly targeted to MSM (59%; 55/93) (R). Overall, self-sampling or self-testing was highly acceptable across key populations. The effectiveness of most studies was (expected) increased HIV testing. Adoption of the home-based CSH was acceptable for care providers if linkage to care was available, even though a minority of studies reported adoption by care providers and implementation fidelity of the intervention. Most studies suggested maintenance of home-based CSH complementary to clinic-based care. Context and mechanisms were identified which may enhance implementation and maintenance of home-based CSH. When providing the individual with a choice of testing, clear instructions, and tailored dissemination successful uptake of STI and HIV testing may increase. For implementers perceived care and treatment benefits for clients may increase their willingness to implement home-based CSH. Therefore, home-based CSH may determine more accessible sexual health care and increased uptake of STI and HIV testing among key populations.

Validating self-reported Toxic Release Inventory data using Benford's Law: investigating toxic chemical release hazards in floodplains.

Introduction: Acute and long-term health impacts from flooding related toxic chemical releases are a significant local health concern and can disproportionately impact communities with vulnerable populations; reliable release data are needed to quantify this hazard. Methods: In this paper, we analyze US Federal Emergency Management Agency designated floodplain data and US Environmental Protection Agency Toxic Release Inventory (TRI) data to determine if geographically manipulated databases adhere to Benford's Law. Results: We investigated multiple variants and discovered pollution releases adhere to Benford's Law and tests which thereby validates the self-reported toxic release dataset. Discussion: We find that Benford's Law applies to self-reported toxic chemical release and disposal data, indicating a lack of widespread data errors or manipulation.