Should Communication Campaigns Promoting Vaccination Address Misinformation Beliefs? Implications from a Nationally Representative Longitudinal Survey Study among U.S. Adults.

Public health communication campaign planners must carefully consider whether misinformation beliefs are important to target and, ideally, correct. Guided by the reasoned action approach, we hypothesized that behavior-specific beliefs regarding COVID-19 vaccination would account for any observed relationship between general coronavirus misinformation beliefs (misinformation beliefs that are not specific to the anticipated consequences of COVID-19 vaccination) and subsequent vaccine uptake. To test our hypothesis, we used panel data from a two-wave nationally representative sample of U.S. adults pre- and post-vaccine availability (T1: July 2020, T2: April/June 2021, analytic sample: n = 665). Contrary to our hypothesis, we find a residual observed relationship between general coronavirus misinformation beliefs and subsequent vaccine uptake (AOR = 0.40, SE = 0.10). Intriguingly, our post-hoc analyses do show that after also adjusting for T2 behavioral beliefs, this association was no longer significant. With this and other justifications, we recommend that messages promoting vaccination prioritize targeting relevant behavioral beliefs.

Healthy lifestyle behaviors among teachers working in public primary schools and affecting factors.

Healthy lifestyle behaviors have been recognized as a key strategy to achieve a policy of health for all. The aim of this study was to determine the levels of health promotion lifestyle behavior among teachers working in public primary schools. The present study also investigated the effects of selected socio-demographic characteristics on these behaviors. The research was designed using the survey model, one of the quantitative research methods. The sample of the research consisted of public primary school teachers (n = 372). Research data were collected using the Health-Promotion Lifestyle Profile-II (HPLP-II) scale. As a result of the research, it was put forward that there were statistically significant differences in levels of health promotion lifestyle behaviors based on taking courses on health promotion, and following programs and articles about healthy living (p < 0.05). It was revealed that primary teachers' taking courses on health promotion, and following programs and articles affected their healthy lifestyle behaviors. Public primary school teachers' health promotion lifestyle behaviors were found to be moderate. It was found that the primary teachers obtained the highest mean score for the spiritual growth subscale of the health promotion lifestyle behaviors scale; however, the primary school teachers had the lowest mean score for the physical activity subscale, which indicates that they need support in improving their healthy lifestyle. Male teachers had higher mean scores in the physical activity subscale, whereas females had higher mean scores in all other subscales. Training programs to protect and improve the health of teachers should be organized.

Improving health and reducing health inequality: An innovation of digitalization?

RATIONALE: The association between digitalization and individual health has attracted increasing attention from both scholars and policymakers. Existing research, however, has not agreed on whether digitization can improve health or reduce health inequality. OBJECTIVE: The purpose of this study is to clarify whether and how the development of digitalization may be related to health and health disparities. METHODS: We rely on China Family Panel Studies (CFPS) surveys from 2012 to 2018 to obtain a sample of 82,471 observations to explore the impact of digitalization on self-rated health and health inequality and its transmission mechanisms. The hypotheses are tested by Ordinary Least Squares Modeling. RESULTS: As expected, digitalization is significantly and positively correlated with self-rated health. Furthermore, the development of digitalization has led to a notable decrease in health inequality. The influencing mechanisms of digitalization include income, healthcare consumption and health behaviors. Both dimensions of digitalization-internet development and digital finance-generate significant effects and the effects of internet development are greater. CONCLUSIONS: This study is the first to systematically investigate the impact of digitalization development on health and health inequality. Our findings provide evidence for the health promotion theory by clarifying the benefits of digitalization in improving residents' health and reducing health inequality. Therefore, utilizing the tools of digitalization efficiently could be a focus of policymakers aiming to accomplish the SDGs' health targets.

Mass media campaigns and the 'file drawer problem': A mixed methods study of how to avoid campaign failure.

Mass media campaigns are frequently used to address public health issues. Considering the considerable cost, there has been little analysis of why campaigns sometimes fail. This study used a sequential mixed methods approach to explore the mechanisms that can lead to failure and to identify what can be done to avoid or overcome common mistakes in campaign planning, implementation, and evaluation. We conducted interviews and a survey with 28 public health social marketing and mass media campaign experts over three rounds of research and analysed the data thematically, generating themes inductively. We identified four systemic factors that drive success: long-term strategic thinking and commitment, understanding the campaign context, doing and learning from evaluation, and fostering strong relationships. The factors did not operate in isolation, rather good (or poor) execution in one area was likely to influence performance in another. The experts also emphasised that a change of political context could drastically affect one or more of the identified factors. Our analysis showed that campaign failures are not simply individuals making mistakes. Systemic issues throughout the planning, execution, and evaluation phases need to be addressed if campaign outcomes are to improve.

Implementing a Community Engagement Model to Develop a Community-Driven Oral Health Intervention.

BACKGROUND: Using community-engaged research may result in interventions that reduce infant oral health disparities in underserved populations. OBJECTIVE: Develop community partnerships to create a sustainable infant oral health program that meets specific community-identified needs and provides an interprofessional education experience. METHODS: Partnering with the Homewood Community Engagement Center, researchers engaged and surveyed key community partners to assess the need for an infant oral health invention. LESSONS LEARNED: Community-identified organizing principles and barriers became the framework for, "Healthy Teeth, Healthy Me," a community-driven infant oral health program. Barriers, like access to care, were addressed with community-specific solutions like agreements with local dental clinical for referrals. CONCLUSIONS: Community partnerships can be leveraged to develop oral health programs that fit specific community needs and provide resources to families at greatest risk for child dental caries. Community engagement can be used to modify the intervention to meet oral health needs of other vulnerable communities.

Do health-promoting lifestyle approaches manage mental health among adolescent/young college students?

OBJECTIVES: College students are often still relatively young, making their mental health more likely to be overlooked. A healthy lifestyle is considered the key to preventing and controlling mental health problems nowadays. This study aimed to investigate whether health-promoting lifestyle approaches manage mental health among adolescent/young college students. METHODS: This cross-sectional study was conducted on 187 adolescent/young college students at Babol Medical Science University, Babol, Iran. Characteristic demographics, health-promoting lifestyle profile (HPLP), and general health questionnaire-28(GHQ-28) were filled out by students. The data were analyzed using correlation coefficient and simple and multiple linear regressions. RESULTS: The majority of participants were adolescents (66.8%), single (97.9%), and bachelor's students (70.1%). The mean of the HPLP and GHQ scores was 125.09±18.12, and 33.58±10.50, respectively. HPLP was a negative significant predictor of mental health (ß = -.261, P= .0001). There was a negative significant association between HPLP dimensions (except physical activity) and mental health. After adjusting for other variables, there was a significant relationship between HPLP with mother occupation (ß =.186, P=.038), and mother education (ß = -.219, P= .034). Furthermore, gender (ß = .175, P= .031), and occupation (ß =-.157, P= .040) were predictors of GHQ in adolescent/young college students. CONCLUSIONS: Regarding the health-promoting lifestyle situation among students and its relation with the better mental health, the design and implementation of HPLP education programs is recommended.

Mobilizing community-driven health promotion through community granting programs: a rapid systematic review.

BACKGROUND: Effective health promotion responds to the unique needs of communities. Community granting programs that fund community-driven health promotion initiatives are a potential mechanism to meet those unique needs. While numerous community health-focused programs are available, the various strategies used by granting programs to foster engagement, administer grants and support awardees have not been systematically evaluated. This rapid systematic review explores the administration of community granting programs and how various program components impact process and population health outcomes. METHODS: A systematic search was conducted across three databases: Medline, SocINDEX, and Political Science Database. Single reviewers completed screening, consistent with a rapid review protocol. Studies describing or evaluating community granting programs for health or public health initiatives were included. Data regarding program characteristics were extracted and studies were evaluated for quality. A convergent integrated approach was used to analyze quantitative and qualitative findings. RESULTS: Thirty-five community granting programs, described in 36 studies, were included. Most were descriptive reports or qualitative studies conducted in the USA. Program support for grant awardees included technical assistance, workshops and training, program websites, and networking facilitation. While most programs reported on process outcomes, few reported on community or health outcomes; such outcomes were positive when reported. Programs reported that many funded projects were likely sustainable beyond program funding, due to the development of awardee skills, new partnerships, and securing additional funding. From the perspectives of program staff and awardees, facilitators included the technical assistance and workshops provided by the programs, networking amongst awardees, and the involvement of community members. Barriers included short timelines to develop proposals and allocate funds. CONCLUSIONS: This review provides a comprehensive overview of health-related community granting programs. Grant awardees benefit from technical assistance, workshops, and networking with other awardees. Project sustainability is enhanced by the development of new community partnerships and grant-writing training for awardees. Community granting programs can be a valuable strategy to drive community health, with several key elements that enhance community mobilization. REGISTRATION: PROSPERO #CRD42023399364.

Theoretical approaches in the development of interventions to promote breastfeeding: A scoping review.

PROBLEM AND BACKGROUND: There is a low world rate of exclusive breastfeeding and a short duration of breastfeeding. More studies have constructed interventions to improve breastfeeding behavior, but the actual effect is not significant. AIM: The purpose of this review is identifying the ways that various theories have an influence on theory-based breastfeeding intervention studies. METHODS: A scoping review using Arksey and O'Malley's framework explored breastfeeding promotion practices. PubMed, The Cochrane Library, Web of Science, Embase, and CINAHL databases were searched from database creation to March 9, 2024. Building on previous research, key terms were used to search the literature. Data analysis involved descriptive and interpretive summaries of theories used and the proposed interventions. FINDINGS: An online search yielded 906 articles, with 28 meeting the inclusion criteria for the scoping review, including 5 reviews and 23 articles. Reviews demonstrated that interventions based on theories were more effective. Articles promoting breastfeeding used theories of self-efficacy (n = 9), theory of planned behavior (n = 8), social cognitive theory (n = 5) and individual and family self-management theory (n = 1). These theories were used in developing specific content of the intervention program (n = 20, 86.9%), constructing the framework of the program (n = 10, 43.5%), and evaluating outcomes (n = 19, 82.6%). Most interventions focused on education, professional support, and/or peer support for breastfeeding. CONCLUSION AND DISCUSSION: Theory can guide decisions and play a role in selecting a methodology or lens. Researchers should make deliberate choices in the use of a theory that relates to aspects of breastfeeding behavior. Future interventions based on theories should be more varied and effective and need to consider families' and social factors.

Designing a Community-Based Health Promotion Program for Older Adults Based on Perceived Usefulness, Service Experience, Perceived Value, and Behavioral Intention.

Improving nutritional intake contributes to maintaining the health and quality of life of the older population and reducing individual and societal healthcare costs. We collaborated with two community service hubs and a public health center in Taipei's Daan District to develop a personalized community-based health and nutrition program using service design. The design was validated through a model encompassing perceived usefulness, service experience, perceived value, and behavioral intention, analyzed using PLS-SEM modeling on 76 individuals. The results showed bidirectional influences among these factors. This study provides practical recommendations for formulating public health policies and health promotion programs for older adults.

Statistical analysis plan for a cluster randomised trial in Madhya Pradesh, India: community health promotion and medical provision and impact on neonates (CHAMPION2).

BACKGROUND: Neonatal mortality in India has fallen steadily and was estimated to be 24 per 1000 live births in the year 2017. However, neonatal mortality remains high in rural parts of the country. The Community Health Promotion and Medical Provision and Impact On Neonates (CHAMPION2) trial investigates the effect of a complex health intervention on neonatal mortality in the Satna District of Madhya Pradesh. METHODS/DESIGN: The CHAMPION2 trial forms one part of a cluster-randomised controlled trial with villages (clusters) randomised to receive either a health (CHAMPION2) or education (STRIPES2) intervention. Villages receiving the health intervention are controls for the education intervention and vice versa. The primary outcome is neonatal mortality. The effect of the active intervention on the primary outcome (compared to usual care) will be expressed as a risk ratio, estimated using a generalised estimating equation approach with robust standard errors that take account of clustering at village level. Secondary outcomes include maternal mortality, stillbirths, perinatal deaths, causes of death, health care and knowledge, hospital admissions of enrolled women during pregnancy or in the immediate post-natal care period or of their babies (during the neonatal period), maternal blood transfusions, and the cost effectiveness of the intervention. A total of 196 villages have been randomised and over 34,000 women have been recruited in CHAMPION2. DISCUSSION: This update to the published trial protocol gives a detailed plan for the statistical analysis of the CHAMPION2 trial. TRIAL REGISTRATION: Registry of India: CTRI/2019/05/019296. Registered on 23 May 2019. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MzExOTg=&Enc=&userName=champion2.

Integrating real-world skills and diabetes lifestyle coach training into a revised health promotion and communications course.

BACKGROUND AND PURPOSE: Effective communication skills are essential for all pharmacists, regardless of practice setting. An implicit need in pharmacy education is to emphasize direct application of these skills to future healthcare practice prior to experiential rotations. The aim of this article is to describe how we revised a required first professional year (P1) doctor of pharmacy course to achieve two main goals: 1) improve the course relevance by connecting content to real-world skills; and 2) qualify all pharmacy students at our institution as certified National Diabetes Prevention Program (DPP) lifestyle coaches upon course completion. EDUCATIONAL ACTIVITY AND SETTING: Lifestyle coach training approved by the Centers for Disease Control and Prevention (CDC) was integrated into a P1 communications course consisting of 14 modules that include: review of diabetes pathophysiology, group facilitation skills, social determinants of health, food tracking, action planning, participant retention and program administration. This content serves as a direct application of pre-existing course objectives related to knowledge (evidence-based theory) and skills (technical and counseling) required for effective communication with patients, families, and health professionals. FINDINGS: Between 2019 and 2022, the redesigned course was offered to 373 P1 students. Course evaluations during this time were consistently positive. The average evaluation score since DPP activities were integrated into the course was 3.41 (on a 4-point scale). Based upon course evaluations, students appreciated three main benefits of incorporating lifestyle coach certification into the pharmacy curriculum: 1) a certified skill that can differentiate them in the job market; 2) practice of skills on real patients under faculty supervision in the community setting; 3) early exposure to pharmacy patient care topics, thus contributing to professional identity. SUMMARY: Integration of lifestyle coach training into an existing core P1 pharmacy course increased application and assessment of communications skills and allowed wider availability of trained coaches to deliver DPP in the community.

Factors Influencing Health Promotion Lifestyle in Female Breast Cancer Survivors: The Role of Health Behavior Self-Efficacy and Associated Factors.

OBJECTIVES: To examine the factors influencing health-promoting lifestyles and the changes in health behavior self-efficacy and health-promoting lifestyles among female breast cancer survivors over a 6-month period. METHODS: A longitudinal design with purposive sampling was deployed. Data collection occurred at the baseline (T1), 3 months (T2), and 6 months (T3). In total, 53 breast cancer survivors agreed to participate. All participants completed the first two rounds of data collection, 49 participants completed data collection at the 6-month mark (T3). The Chinese versions of the Self-Rated Abilities for Health Practices Scale (SRAHP) and the Health-Promoting Lifestyle Profile (HPLP) were used. RESULTS: Health behavior self-efficacy and health-promoting lifestyle scores increased over time. Age, impaired cardiac function, those taking a career break, psychological well-being, and responsible health practice in self-efficacy for health behaviors were significant predictors of health-promoting lifestyle. CONCLUSIONS: Younger breast cancer survivors, those taking a career break, and those with poor health behavior self-efficacy were less likely to engage in a health-promoting lifestyle and may require guidance in improving overall health behaviors. IMPLICATIONS FOR NURSING PRACTICE: Healthcare providers should not only be aware of the suboptimal health promotion lifestyle in breast cancer survivors but also focus on enhancing health behavior self-efficacy. This is particularly crucial for younger breast cancer survivors or those currently unemployed.

Reduction in all-cause medical and caregiving costs through innovative health awareness projects in a rural area in Japan: a retrospective cohort study.

BACKGROUND: This study evaluates cost reduction in participants of a health awareness program (the Center of Healthy Aging Program, CHAP) in a Japanese rural area, characterized by an annual check-up and personalized interview on health issues and related risks immediately after the check-up. METHODS: This is a cross-sectional study using medical and caregiving costs and Japan-specific health check-up results in Hirosaki residents stored by the local government, which were individually-based linked to the CHAP information collected by Hirosaki University. This is the first study that used anonymized data with individually-based linkages to both a research institute and a local government in Japan under a strict limitation regarding linking to third-party data. We included residents who had been continuously enrolled for > 6 months as of 1 July 2015. We compared 5-year all-cause costs between three groups (with CHAP, with Japan-specific health check-up, and no check-up) using a multivariate negative binomial regression model considering risk factors including lifestyle habits and an inverse probability weight to adjust for baseline characteristics: age, sex, Charlson comorbidity index, baseline care level, and risk score of coronary heart diseases. RESULTS: A total of 384, 9805, and 32,630 residents aged 40-74 years were included for the CHAP, Japan-specific health check-up, and no check-up groups, respectively. The Japan-specific health check-up group showed older and higher Charlson comorbidity index than the others. After inverse probability weight adjusting, the amount of all-cause medical costs was significantly lower only in the CHAP group. Faster walking speed and exercise habits were independently associated with lower all-cause medical and caregiving costs. CONCLUSIONS: We demonstrated a 5-year all-cause cost reduction in residents who participated in the CHAP and also suggested the effect of exercise habits in Hirosaki, which indicated the significance of individually-based data linkages to external third-party data for all local governments to improve the health condition of residents.

The Use of Mobile Technologies to Promote Physical Activity and Reduce Sedentary Behaviors in the Middle East and North Africa Region: Systematic Review and Meta-Analysis.

BACKGROUND: The Middle East and North Africa (MENA) region faces unique challenges in promoting physical activity and reducing sedentary behaviors, as the prevalence of insufficient physical activity is higher than the global average. Mobile technologies present a promising approach to delivering behavioral interventions; however, little is known about the effectiveness and user perspectives on these technologies in the MENA region. OBJECTIVE: This study aims to evaluate the effectiveness of mobile interventions targeting physical activity and sedentary behaviors in the MENA region and explore users' perspectives on these interventions as well as any other outcomes that might influence users' adoption and use of mobile technologies (eg, appropriateness and cultural fit). METHODS: A systematic search of 5 databases (MEDLINE, Embase, CINAHL, Scopus, and Global Index Medicus) was performed. Any primary studies (participants of all ages regardless of medical condition) conducted in the MENA region that investigated the use of mobile technologies and reported any measures of physical activity, sedentary behaviors, or user perceptions were included. We conducted a narrative synthesis of all studies and a meta-analysis of randomized controlled trials (RCTs). The Cochrane risk-of-bias tool was used to assess the quality of the included RCTs; quality assessment of the rest of the included studies was completed using the relevant Joanna Briggs Institute critical appraisal tools. RESULTS: In total, 27 articles describing 22 interventions (n=10, 37% RCTs) and 4 (15%) nonexperimental studies were included (n=6141, 46% women). Half (11/22, 50%) of the interventions included mobile apps, whereas the other half examined SMS. The main app functions were goal setting and self-monitoring of activity, whereas SMS interventions were primarily used to deliver educational content. Users in experimental studies described several benefits of the interventions (eg, gaining knowledge and receiving reminders to be active). Engagement with the interventions was poorly reported; few studies (8/27, 30%) examined users' perspectives on the appropriateness or cultural fit of the interventions. Nonexperimental studies examined users' perspectives on mobile apps and fitness trackers, reporting several barriers to their use, such as perceived lack of usefulness, loss of interest, and technical issues. The meta-analysis of RCTs showed a positive effect of mobile interventions on physical activity outcomes (standardized mean difference=0.45, 95% CI 0.17-0.73); several sensitivity analyses showed similar results. The trim-and-fill method showed possible publication bias. Only 20% (2/10) of the RCTs measured sedentary behaviors; both reported positive changes. CONCLUSIONS: The use of mobile interventions for physical activity and sedentary behaviors in the MENA region is in its early stages, with preliminary evidence of effectiveness. Policy makers and researchers should invest in high-quality studies to evaluate long-term effectiveness, intervention engagement, and implementation outcomes, which can inform the design of culturally and socially appropriate interventions for countries in the MENA region. TRIAL REGISTRATION: PROSPERO CRD42023392699; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392699.

Community infant safe sleep and breastfeeding promotion and population level-outcomes: A mixed methods study.

PROBLEM: In the U.S., sudden unexpected infant deaths due to accidental suffocation and strangulation in bed are increasing. Though breastfeeding is a protective factor against sudden unexpected infant death, motivations to breastfeed often couple with unsafe infant sleep practices. Racial/ethnic disparities are present in sudden unexpected infant death, accidental suffocation and strangulation in bed, and breastfeeding. BACKGROUND: Promoting infant safe sleep and breastfeeding through community-level initiatives could address disparities in related outcomes. AIM: Investigate the relationship between community-level strategies and associated state-level outcomes for infant safe sleep and breastfeeding. METHODS: We employed an intervention mixed methods framework and exploratory sequential design. The qualitative component entailed a hermeneutical phenomenological framework to analyze key informant interview data from seven U.S. community-level providers participating in a practice improvement initiative. The quantitative component entailed descriptively analyzing infant safe sleep and breastfeeding indicators from the 2019 Pregnancy Risk Assessment Monitoring System and Ohio Pregnancy Assessment Survey. Qualitative and quantitative data were linked through embedded integration. FINDINGS: We identified two mixed insights: gaps in promotion and outcomes, and persistent disparities between infant safe sleep and breastfeeding promotion and outcomes. DISCUSSION: Our findings indicate conversational approaches could improve infant safe sleep and breastfeeding promotion, outcomes, and relative disparities. We find that community collaboration is needed to address organizational capacity limitations in promoting infant safe sleep and breastfeeding. CONCLUSION: Community-level organizations and providers should consider tailoring program offerings and care delivery to include conversational approaches and community collaboration to promote infant safe sleep and breastfeeding and decrease relative disparities in outcomes.

Whole-of-school physical activity implementation in the context of the Dubai Fitness Challenge.

INTRODUCTION: Physical activity (PA) promotion among school-aged youth is a global health priority. Recommendations for such promotion include implementing whole-of-school approaches that maximize resources across the school environment. This study examined schools' participation in an annual, government-led, and emirate-wide initiative in Dubai, called the Dubai Fitness Challenge, in which the goal is to accrue 30 minutes of PA every day for 30 days (as such, the initiative is colloquially referred to as "Dubai 30x30"). METHODS: A mixed-methods design was employed for this study. Three schools were recruited using convenience sampling. Participants were 18 physical education teachers, 20 classroom teachers, 2 principals and 45 students. Data sources included surveys, focus groups, and interviews. Data were analyzed using descriptive statistics, multinomial logistic regression, and open and axial coding to develop themes. RESULTS: School staff reported that most Dubai 30x30 activities were provided in physical education, at break times during school, and before and after school. Students reported that they mainly participated in Dubai 30x30 activities during physical education and occasionally participated in activities after school and on weekends. During school, students were more likely to reach higher PA intensity levels when they were in contexts other than the regular classroom setting. Among school staff, physical education teachers were most involved and classroom teachers were least involved in promoting Dubai 30x30. Parent engagement was high. Staff perceived that Dubai 30x30 brought the community together, but physical education teachers also indicated there was a lack of implementation guidance and they felt burdened. Participants believed Dubai 30x30 increased PA participation and helped to promote their schools. DISCUSSION: This study provides an initial glimpse into schools' participation in Dubai 30x30 and suggests that a whole-of-school PA lens is useful in gleaning information that could help to increase and optimize PA opportunities for students.

Establishing an EU-wide front-of-pack nutrition label: Review of options and model-based evaluation.

This paper reviews the effectiveness of four types of front-of-pack nutrition labels (FoPLs) in influencing calorie purchases. The four FoPL types are poised for unified implementation across European countries. Further, this study extends its analysis to evaluate the impacts of the voluntary adoption of these FoPLs within 27 EU nations. Nutri-Score displays higher potential for yielding positive health and economic outcomes, compared with other FoPLs. Across EU countries, Nutri-Score is projected to avert nearly two million cases of non-communicable diseases, in total, between 2023 and 2050. Keyhole demonstrates effects of a similar magnitude but with no statistical significance. Nutri-Repere shows smaller impacts, while Nutri-Couleurs has non-significant effects. Nutri-Score is projected to significantly lower annual healthcare spending by 0.05%, whereas the other labels have negligible impacts. By reducing cases of disease, FoPLs have the potential to improve employment and work productivity. Nutri-Score surpasses the other labels with an estimated annual gain of 10.6 full-time equivalent workers per 100,000 individuals of working age across EU countries. In all, mandatory implementation of any of the four labels would lead to greater effects than those obtained with a voluntary implementation, providing evidence to inform legislation proposal for an EU-wide nutrition labelling system.

A Systematic Review of the Effectiveness of Cervical Cancer Screening and Prevention Interventions for African American Women: Implications for Promoting Health Equity.

African American women suffer under the burden of cervical cancer as they are first in mortality, diagnosed at later stages, and have a survivorship rate that is lower than the national average. The aim of our review is to evaluate the effectiveness of cervical cancer screening and prevention interventions for African American women living in the United States and to assess their commitment to health equity. A literature search was conducted using PubMed, Embase, CINAHL, and Scopus using MeSH terms related to cervical cancer, human papillomavirus (HPV), screening and prevention, and African Americans. This resulted in 1970 articles. Studies were included if they promoted cervical screening or prevention, sampled African American women aged 18 and over, and evaluated interventions. Among the 23 articles that met inclusion criteria, there were a wide variety of intervention strategies, that is, community health workers, patient navigation, patient reminders, self-sampling collection, and HPV vaccination. Health education interventions, when coupled with patient navigation or community health workers, were effective in promoting screening participation (odds ratio: 2.43, 95% confidence interval: 1.47-4.02). There were mixed results regarding the incorporation of health equity principles. This review supports the importance of incorporating health equity principles and community based methods in screening and prevention interventions. Future research and practice should incorporate African American women's perspectives in intervention development and implementation.

Community Health Worker Implementation and Cost Analysis of a Plant-Based Nutrition Program.

OBJECTIVE: This study describes program implementation through a research-restaurant partnership and assesses participant satisfaction, program costs, and percent body weight changes. METHODS: Participants (n = 60) in a virtual synchronous (n = 43) or virtual asynchronous (n = 17) 12-week plant-based nutrition program received restaurant vouchers. Class satisfaction data were collected weekly. Assessments were completed at baseline, 3 months, and 9 months, along with interviews (n = 13) between 3 and 9 months. The costing approach estimated costs per participant. Interviews were coded using a content analysis and constant comparative method. RESULTS: Participants rated the intervention favorably. Program costs were $198.63/participant, and participants' willingness to pay postintervention was $101.50 ± $63.90. Participants shared satisfaction with course content, the restaurant partnership, and suggestions for future delivery. No changes in participants' percent body weight were observed between 3 and 9 months (P = 0.98), indicating maintenance of 3-month weight loss. CONCLUSIONS AND IMPLICATIONS: A research-restaurant partnership successfully implemented a nutrition program and generated positive feedback. With the lifting of coronavirus disease 2019 pandemic restrictions, future research can now test alternative implementation methods (in person vs online) in other restaurants.