Empowering mind-body wellness: effect of bundling seated exercises and psychoeducational rehabilitation using the teach-back approach on fatigue and coping of women postmastectomy.

BACKGROUND: Being diagnosed with Breast Cancer (BC) is a crisis that throws the patient's life out of balance. Cancer-related fatigue is a debilitating sign experienced by women during and after BC treatment. Regular physical exercise may help mitigate patients' fatigue, enhance coping abilities, improve their quality of life, and overall well-being. In parallel, psychological interventions are geared toward normalizing the lived painful experiences among oncology patients. OBJECTIVE: to examine the effect of bundling seated exercises and psychoeducational rehabilitation using the teach-back approach on fatigue and coping of women postmastectomy. METHODS: A quasi-experimental study was conducted in the Oncology Surgical Department and chemotherapy unit at the Alexandria Main University Hospital, Egypt. A total of 60 women were randomly allocated to either to the study or the control groups. Women in the study group practiced seated exercises and psychological rehabilitation interventions, including mindfulness breathing, problem-solving training, cognitive reframing technique, and thought stopping while the control group received the routine care. RESULTS: The study revealed a significant decline in the fatigue mean scores among participants in the intervention group from 136.10 ± 27.76 to 98.43 ± 25.99 (p < 0.001). Similarly, there was a significant decrease in the patients' mean scores of maladaptive coping, helplessness/ hopelessness (p = 0.014), and anxious preoccupation (p = 0.008). In contrast, there is a noticeable increment in the scores of adaptive coping, such as fighting spirit (p = 0.012), cognitive avoidance (p = 0.002), and fatalism (p = 0.009). CONCLUSION: Bundling seated exercises and psychological rehabilitation interventions using the teach-back approach have been proven to be simple and inexpensive non-pharmacological methods of reducing cancer-related fatigue and improving coping skills among women post-mastectomy. TRIAL REGISTRATION NUMBER: NCT06360276, ClinicalTrails.gov, Retrospectively registered (April 8th, 2024), URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT06360276 .

Aiming for transformations in power: lessons from intersectoral CBPR with public housing tenants (Québec, Canada).

Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF-LPF frameworks and suggestions to increase the transformative power of future studies.

Empowerment of Lay Mental Health Workers and Junior Psychologists Online in a Task-Shared, Rural Setting in Kerala, India.

BACKGROUND: Patients with severe mental health issues who live in isolated rural areas are difficult to reach and treat. Providing effective treatment is difficult because mental health problems are complex and require specialized knowledge from a range of professionals. Task-sharing with lay mental health workers (LMHWs) has potential but requires proper training and supervision to be effective. This article reports on the challenges and facilitators experienced in empowering LMHWs in their role, with the help of a technology supported supervision group. The study sought to understand the functioning of the Empowering Supervisory Group (ESG) in the context of junior psychologists and LMHWs in rural India, and investigate how they experienced it by exploring challenges, lessons and empowerment. METHODS: Qualitative analysis of interviews with the 22 ESG participants and their supervisors. RESULTS: A total of three discrete phases of supervision were identified where supervisors responded to the changing needs of the group. This began with building trust at a baseline level, tackling issues with competence and autonomy and finally experiencing meaning and impact through self-determination. The experience of empowerment even in an online setting was very beneficial given the challenges of working in rural areas. CONCLUSION: Empowerment based supervision of LMHWs and junior psychologists online enables a level of engagement that positions them to engage in community mental health practices with greater independence and confidence.

Sources of knowledge empowerment amongst pregnant women with TB disease: A qualitative study in South Africa.

BACKGROUND: Providing relevant knowledge to empower all pregnant women diagnosed and nondiagnosed with tuberculosis (TB) is essential worldwide. Proper dissemination of health information for pregnant women could assist in preventing TB complications amongst women and babies. The study aimed to describe the sources of knowledge that empower pregnant women diagnosed with TB and improve their quality of life in Limpopo Province, South Africa. METHODOLOGY: The study followed a qualitative, exploratory and descriptive research design. The study was conducted in 12 selected primary healthcare facilities in three crisis districts. Thirty-five pregnant women with TB disease were purposively selected, and face-to-face interviews were conducted to generate data, which were analysed using the thematic approach. Measures to ensure trustworthiness and ethical standards were adhered to. RESULTS: The findings of this study revealed that healthcare workers, community stakeholders, and TB ambassadors are the primary sources of knowledge dissemination for capacitating women diagnosed with TB. CONCLUSION: Most pregnant women lacked knowledge regarding TB ambassadors as sources of information for empowering women, community awareness campaigns, and Google searches as sources of information sharing. All stakeholders need to work together, considering the patients' charter for TB care that sets out the right for respect and information sharing. The emphasis of this study was on developing a comprehensive educational intervention that could assist in improving the quality of TB services offered to pregnant women.

Empowering the younger generation increases their willingness for intergenerational reconciliation in the context of climate change.

Climate change can evoke intergenerational conflict. Structural inequalities and their unequal impact on generations can increase perceptions of collective victimhood among the younger generation (< 30 years) and bear the risk of social tensions between the young and the elderly. An experimental study (N = 434) showed that younger people perceived an increased risk of future victimhood. In line with a needs-based approach, the young reported an increased desire to pursue agentic intergroup goals, indicating a heightened need for agency. However, when the young received empowering messages that affirmed their ingroup agency, their willingness to reconcile with the old generation increased, whereas informing them about non-agentic ingroup behavior did not affect reconciliation (between-subjects manipulation). While empowering messages from the outgroup ("Grannies for Future") that directly affirmed the young generations' agency for climate change mitigation as well as empowering messages from the ingroup that indirectly affirmed ingroup agency in domains unrelated to climate change both addressed the need for agency, only outgroup empowerment promoted intergenerational reconciliation. However, empowerment did not affect support for collective climate action. We discuss empowerment as an avenue for resolving intergroup conflict in the context of climate change and possible consequences for climate action and social change.

Women's empowerment, household dietary diversity, and child anthropometry among vulnerable populations in Odisha, India.

Women's empowerment has been promoted by researchers and development practitioners as one of the most promising strategies to address widespread hunger and malnutrition. However, the relationship between women's empowerment and dietary diversity and child nutrition has rarely been studied among vulnerable populations or individuals at greater risk of poor physical and social health status. Moreover, the effects of different domains of women's empowerment on nutritional outcomes, including dietary diversity and child anthropometry, have rarely been examined, especially with panel data. Using two rounds of panel data from 1900 households and fixed effects regression models, we analyze the effect of women's empowerment on household dietary diversity score (HDDS) and child anthropometry among the particularly vulnerable tribal groups in Odisha, India. We also estimate the effects of various decision-making domains of women's empowerment on HDDS and child anthropometry to understand which empowerment domains matter for nutrition. Results show that women's empowerment is positively associated with HDDS (coef. 0.41 food groups; p < 0.1) and reduces the prevalence of underweight (coef. 39%; p < 0.05) and wasting (coef. 56%; p < 0.1) in children but has no effect on the prevalence of child stunting. Women's empowerment in agricultural input use; output sales; income; food purchases; and credit, group membership, and employment contribute to improved dietary diversity and child nutrition. We conclude that women's empowerment contributes to improved dietary diversity and child nutrition and is a promising strategy to improve farm household diets and child nutrition among vulnerable populations. Strengthening women's empowerment through the promotion of women's access to land and other agricultural inputs, market participation, access to information, capital, and credit is important.

Fostering change, empowering faculty: comments on the NURSLITT study and the five-year rule.

The five-year rule must die. Despite an extensive literature search, the origins of the five-year rule remain unknown. In an era when the nursing profession is so focused on evidence-based practice, any approach that arbitrarily limits literature searches to articles published in the previous five years lacks scientific basis. We explore some reasons for the pervasiveness of the practice and suggest that librarians need to engage with nursing faculty, who are well-positioned to be change agents in this practice.

How Does an Online Mental Health Community on Twitter Empower Diverse Population Levels and Groups? A Qualitative Analysis of #BipolarClub.

BACKGROUND: Social media, including online health communities (OHCs), are widely used among both healthy people and those with health conditions. Platforms like Twitter (recently renamed X) have become powerful tools for online mental health communities (OMHCs), enabling users to exchange information, express feelings, and socialize. Recognized as empowering processes, these activities could empower mental health consumers, their families and friends, and society. However, it remains unclear how OMHCs empower diverse population levels and groups. OBJECTIVE: This study aimed to develop an understanding of how empowerment processes are conducted within OMHCs on Twitter by identifying members who shape these communities, detecting the types of empowerment processes aligned with the population levels and groups outlined in Strategy 1 of the Integrated People-Centred Health Services (IPCHS) framework by the World Health Organization (WHO), and clarifying members' involvement tendencies in these processes. METHODS: We conducted our analysis on a Twitter OMHC called #bipolarclub. We captured 2068 original tweets using its hashtag #bipolarclub between December 19, 2022, and January 15, 2023. After screening, 547 eligible tweets by 182 authors were analyzed. Using qualitative content analysis, community members were classified by examining the 182 authors' Twitter profiles, and empowerment processes were identified by analyzing the 547 tweets and categorized according to the WHO's Strategy 1. Members' tendencies of involvement were examined through their contributions to the identified processes. RESULTS: The analysis of #bipolarclub community members unveiled 5 main classifications among the 182 members, with the majority classified as individual members (n=138, 75.8%), followed by health care-related members (n=39, 21.4%). All members declared that they experience mental health conditions, including mental health and general practitioner members, who used the community as consumers and peers rather than for professional services. The analysis of 547 tweets for empowerment processes revealed 3 categories: individual-level processes (6 processes and 2 subprocesses), informal carer processes (1 process for families and 1 process for friends), and society-level processes (1 process and 2 subprocesses). The analysis also demonstrated distinct involvement tendencies among members, influenced by their identities, with individual members engaging in self-expression and family awareness support and health care-related members supporting societal awareness. CONCLUSIONS: The examination of the #bipolarclub community highlights the capability of Twitter-based OMHCs to empower mental health consumers (including those from underserved and marginalized populations), their families and friends, and society, aligning with the WHO's empowerment agenda. This underscores the potential benefits of leveraging Twitter for such objectives. This pioneering study is the very first to analyze how a single OMHC can empower diverse populations, offering various health care stakeholders valuable guidance and aiding them in developing consumer-oriented empowerment programs using such OMHCs. We also propose a structured framework that classifies empowerment processes in OMHCs, inspired by the WHO's Strategy 1 (IPCHS framework).

Parent Experiences of Empowerment: Understanding the Role of Parent Empowerment in Child Health Promotion.

BACKGROUND: Establishing healthy behaviors during a child's first 5 years is essential for healthy growth. Parents are targeted as agents of change because they serve as primary models of behavior during this period. Although parent-focused interventions often target empowerment as a driver of change, our understanding of how parents experience the process of empowerment in the context of child health promotion remains limited. OBJECTIVE: This qualitative study explored the process by which parents gain empowerment through participation in a health promotion intervention. METHODS: Semi-structured interviews were conducted with 37 low-income parents who participated in Parents Connect for Healthy Living (PConnect), a 10-week empowerment-centered obesity prevention intervention. Data were analyzed using inductive-deductive thematic analysis and guided by empowerment theories. RESULTS: Most parents were Hispanic/Latino (41%) and female (97%). Five themes emerged that correspond to the process by which parents gained empowerment: (1) friendships formed and relationships strengthened during PConnect, (2) parents strengthened relationships with their children and believed in their ability to parent successfully, (3) the experience of knowledge led to behavior change, (4) parents used new resources to improve family health, and (5) parents took action. CONCLUSION: Empowerment theory should be a component of health promotion programs.

Patient Empowerment for Those Living with Parkinson's Disease.

Parkinson's disease (PD) poses a number of challenges for individuals, affecting them physically, mentally, emotionally, and socially. The complex nature of PD necessitates empowering patients to address their unique needs and challenges, fostering improved health outcomes and a better quality of life. Patient empowerment is a multifaceted concept crucial to enhancing healthcare outcomes, particularly in chronic conditions such as PD. However, defining patient empowerment presents challenges due to its varied interpretations across disciplines and individuals. Essential components include access to information, development of self-care skills, and fostering a supportive environment. Strategies for patient empowerment encompass health literacy, education, and shared decision-making within a trusted healthcare provider-patient relationship. In PD, patient empowerment is crucial due to the disease's phenotypic variability and subjective impact on quality of life. Patients must navigate individualized treatment plans and advocate for their needs, given the absence of objective markers of disease progression. Empowerment facilitates shared decision-making and enables patients to communicate their unique experiences and management goals effectively. This paper provides a comprehensive overview of the dimensions and strategies associated with patient empowerment, its definition and the facilitators that are necessary, emphasizing its critical importance and relevance in Parkinson's management. At the end of this review is a personal perspective as one of the authors is a person with lived experience.

Empowerment strategies of the Mentor Mother peer support program among mothers who have migrated to Sweden: a photovoice study.

INTRODUCTION: A peer support intervention using 'Mentor Mothers' was implemented for mothers who had migrated to Sweden, living in socially disadvantaged communities. The Mentor Mothers had a high degree of freedom to develop strategies for facilitating empowerment of their clients according to perceived needs. This study aimed to investigate which empowerment facilitation strategies that Mentor Mothers perceived to be relevant, feasible and effective. METHODS: Photovoice was used to generate qualitative data. Participants took photographs of their work which were then discussed during a focus group discussion and six individual semi-structured interviews. Data were analysed using thematic analysis. RESULTS: Four overarching strategies to facilitate empowerment were identified, corresponding to distinctive perceived needs in the target group: (1) Informative support responded to a need for making sense of the external context, by helping mothers navigate society, the process of parenthood and cultural parenting norms. (2) Practical support addressed a need for managing challenges in daily life, by facilitating contacts with welfare services and authorities and to enhance parenting practices. (3) Psychosocial support addressed a need for improved mental wellbeing, by instilling feelings of safety and security in daily life, relationships and in contacts with public institutions. (4) Motivational support responded to a need for finding fulfilling purpose, by promoting social interaction, encouraging civic engagement and sharing the challenges and successes of others to inspire hope. CONCLUSIONS: These results highlight various aspects of peer support for empowerment facilitation that future interventions targeting immigrant parents can use in their intervention design.

Artificial intelligence empowering public health education: prospects and challenges.

Artificial Intelligence (AI) is revolutionizing public health education through its capacity for intricate analysis of large-scale health datasets and the tailored dissemination of health-related information and interventions. This article conducts a profound exploration into the integration of AI within public health, accentuating its scientific foundations, prospective progress, and practical application scenarios. It underscores the transformative potential of AI in crafting individualized educational programs, developing sophisticated behavioral models, and informing the creation of health policies. The manuscript strives to thoroughly evaluate the extant landscape of AI applications in public health, scrutinizing critical challenges such as the propensity for data bias and the imperative of safeguarding privacy. By dissecting these issues, the article contributes to the conversation on how AI can be harnessed responsibly and effectively, ensuring that its application in public health education is both ethically grounded and equitable. The paper's significance is multifold: it aims to provide a blueprint for policy formulation, offer actionable insights for public health authorities, and catalyze the progression of health interventions toward increasingly sophisticated and precise approaches. Ultimately, this research anticipates fostering an environment where AI not only augments public health education but also does so with a steadfast commitment to the principles of justice and inclusivity, thereby elevating the standard and reach of health education initiatives globally.

Public Health Youth Ambassador Program: Educating and Empowering the Next Generation of Public Health Leaders to Build Thriving Communities.

Through a collaboration among Fairfax County Health Department (FCHD), Fairfax County Public Schools (FCPS), Morehouse School of Medicine (MSM), George Mason University College of Public Health, federally qualified health centers, hospital systems, non-profits, and other agencies, this initiative targets underserved high school students as a way to increase diversity among community health professionals, build generational health, and provide participants with tools to enhance their post-secondary educational and career opportunities.

From the periphery to inclusion within the health system: promoting community health worker empowerment as a way forward.

BACKGROUND: Community health worker programmes have the potential to contribute critically towards universal health coverage. However, CHWs globally have often continued to operate on the periphery of the health care system, viewed as a non-essential cadre. This results in a workforce that often remains disempowered and under-supported. This paper presents evidence from a study conducted in a rural part of South Africa, to better understand issues of CHW prioritisation, integration, and empowerment. METHODS: We applied an analytical lens based on empowerment theory and conducted a secondary analysis of qualitative data emerging from a sub-study of a cRCT evaluating the effectiveness of supportive supervision for CHWs within a large-scale national CHW programme. The cRCT was conducted between 2017 and 2022, and 39 CHWs were included in the study. RESULTS: We organised our findings across the four domains of structural empowerment; information, resources, support, and opportunity, and mapped these domains against the domains of psychological empowerment. Our findings show how CHWs are still working in the periphery of the healthcare system. Without sufficient prioritisation, high level-support from national and district governments, and sufficient investments in programmatic domains-such as training, equipment, and supportive supervision-it is likely that the CHW cadre will continue to be seen as informal health care workers. CONCLUSIONS: CHW empowerment could be a lever to potentially transform the current health system towards universal coverage; however, this process can only happen with sufficient high-level prioritization and investment.