Dietary Supplement Use in Transmasculine People: Results of an Online Survey of Volunteer Adults.

INTRODUCTION: Health inequities and disparities in nutrition research exist among transmasculine people. A dearth of evidence on dietary supplement use and motivations exist, partially due to constrained collection of sex and gender identity in national surveys. OBJECTIVE: We sought to investigate common motivations and use of dietary supplements in a voluntary survey of transmasculine people. METHODS: A total of 48 participants completed an online survey detailing dietary supplement use, motivations, and demographic information. RESULTS: 64.5 and 90.0% of participants reported use of 1+ dietary supplement within the past 30-days and during some point in their lifetime, respectively. Top reported product types used included multivitamins (52%), melatonin (52%), vitamin D (46%), vitamin C (35%), fish oil (33%), B-vitamins or B-complex (31%), iron (29%), green tea (29%), biotin (25%), cranberry (23%), zinc (23%), protein powder (23%), probiotics (23%), and calcium (21%). There was no relationship between the number of supplements reported and participant age, BMI, income, or mastectomy status (p > 0.05). Participants reported top motivations being for "improving my overall health" (60.4%), "maintaining health" (54.2%), to "supplement my diet due to not getting enough from food"(41.7%), "mental health" (39.6%), and to "prevent colds, boost immune system" (33.3%). CONCLUSION: Transmasculine people in our study reported a high use of dietary supplements. Differences in the types of products and number of products used, as well as specific motivations for use likely exist within this subpopulation, however, future nationally-representative longitudinal studies are needed to fully elucidate these patterns and for informing evidence-based nutrition guidance.

Experiences of integrating community volunteers as extensions of the primary care team to help support older adults at home: a qualitative study.

BACKGROUND: Increasing the integration of community volunteers into primary health care delivery has the potential to improve person-focused, coordinated care, yet the use of volunteers in primary care is largely unexplored. Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) is a multi-component intervention involving trained community volunteers functioning as extensions of primary care teams, supporting care based on older adults' health goals and needs. This study aimed to gain an understanding of volunteer experiences within the program and client and health care provider perspectives on the volunteer role. METHODS: This study used a qualitative descriptive approach embedded in a pragmatic randomized controlled trial. Participants included Health TAPESTRY volunteers, health care providers, volunteer coordinator, and program clients, all connected to two primary care practice sites in a large urban setting in Ontario, Canada. Data collection included semi-structured focus groups and interviews with all participants, and the completion of a measure of attitudes toward older adults and self-efficacy for volunteers. Qualitative data were inductively coded and analyzed using a constant comparative approach. Quantitative data were summarized using descriptive statistics. RESULTS: Overall, 30 volunteers and 64 other participants (clients, providers, volunteer coordinator) were included. Themes included: 1. Volunteer training: "An investment in volunteers"; 2. Intergenerational volunteer pairing: "The best of both worlds"; 3. Understanding the volunteer role and its scope: "Lay people involved in care"; 4. Volunteers as extensions of primary care teams: "Being the eyes where they live"; 5. The disconnect between volunteers and the clinical team: "Is something being done?"; 6. "Learning… all the time": Impacts on volunteers; and 7. Clients' acceptance of volunteers. CONCLUSIONS: This study showed that it is possible to integrate community volunteers into the primary care setting, adding human connections to deepen the primary care team's understanding of their patients. Program implementation suggestions that emerged included: using role play in training, making volunteer role boundaries and specifications clear, and making efforts to connect volunteers and the primary care team they are supporting. This exploration of stakeholder voices has the potential to help improve volunteer program uptake and acceptability, as well as volunteer recruitment, retention, and training. TRIAL REGISTRATION: For RCT: https://clinicaltrials.gov/ct2/show/NCT02283723, November 5, 2014.

Communities as 'renewable energy' for healthcare services? a multimethods study into the form, scale and role of voluntary support for community hospitals in England.

OBJECTIVE: To examine the forms, scale and role of community and voluntary support for community hospitals in England. DESIGN: A multimethods study. Quantitative analysis of Charity Commission data on levels of volunteering and voluntary income for charities supporting community hospitals. Nine qualitative case studies of community hospitals and their surrounding communities, including interviews and focus groups. SETTING: Community hospitals in England and their surrounding communities. PARTICIPANTS: Charity Commission data for 245 community hospital Leagues of Friends. Interviews with staff (89), patients (60), carers (28), volunteers (35), community representatives (20), managers and commissioners (9). Focus groups with multidisciplinary teams (8 groups across nine sites, involving 43 respondents), volunteers (6 groups, 33 respondents) and community stakeholders (8 groups, 54 respondents). RESULTS: Communities support community hospitals through: human resources (average=24 volunteers a year per hospital); financial resources (median voluntary income = £15 632); practical resources through services and activities provided by voluntary and community groups; and intellectual resources (eg, consultation and coproduction). Communities provide valuable supplementary resources to the National Health Service, enhancing community hospital services, patient experience, staff morale and volunteer well-being. Such resources, however, vary in level and form from hospital to hospital and over time: voluntary income is on the decline, as is membership of League of Friends, and it can be hard to recruit regular, active volunteers. CONCLUSIONS: Communities can be a significant resource for healthcare services, in ways which can enhance patient experience and service quality. Harnessing that resource, however, is not straight forward and there is a perception that it might be becoming more difficult questioning the extent to which it can be considered sustainable or 'renewable'.

Evaluation of an Innovative, Hospital-Based Volunteer Doula Program.

OBJECTIVE: To evaluate program growth, doula characteristics, patient satisfaction, and characteristics and perceptions of labor and delivery nurses who work with volunteer doulas in a hospital-based volunteer doula program. DESIGN: Descriptive quantitative. SETTING: An academic health center in the southeastern United States with approximately 4,000 births per year. PARTICIPANTS: Participants (N = 519) included volunteer doulas (n = 80), labor and delivery nurses (n = 24), and women who were supported by doulas (n = 415). METHODS: We evaluated program growth by the number of doulas and women supported over time. We developed surveys to evaluate doula characteristics, patient satisfaction, and characteristics and perceptions of labor and delivery nurses who work with volunteer doulas. RESULTS: From 2012 to 2018, the number of Birth Partners doulas increased from 25 to 80. The annual number of women who received intrapartum care from doulas increased from 88 in 2012 to 477 in 2018. Doula characteristics included race, ethnicity, age, student or nonstudent status, and ability to speak Spanish. Of the 1,185 women who received doula support from 2015 to 2018, 415 (35%) responded to the patient satisfaction survey. Most were satisfied with the physical support (n = 379, 97.63%), emotional support (n = 384, 96.88%), doula care (n = 410, 96.34%), and support for family/friends (n = 346, 95.38%). All of the labor and delivery nurses who responded (n = 24, 100%) agreed or strongly agreed that doulas were important members of the maternity care team. CONCLUSION: In this evaluation, we highlight rapid program growth, expansion of services, and demographic characteristics of volunteer doulas; patient satisfaction with doula care; and acceptance of volunteer doulas among nursing staff. The data provided herein can be used to inform future development and guide the implementation of similar volunteer doula programs at other institutions.

Assessing the religious roots of volunteer work in middle and late life.

Research reveals that older people do a significant amount of volunteer work. Moreover, a good deal of this volunteering takes place in religious institutions. The purpose of this study is to examine how social factors in the church influence the decision to volunteer. The analyses are conducted in two steps. First, data from a longitudinal nationwide survey of older people are used to show that increases in spiritual support (i.e., assistance from fellow church members that is designed to bolster religious beliefs and behaviors) are associated with increases in the frequency of volunteer work. Second, cross-sectional analyses from the same survey suggest that spiritual support is associated with volunteering in part because it promotes greater compassion. However, the magnitude of the relationship between compassion and volunteering is fairly modest.

Volunteers in specialist palliative care: a survey of adult services in the United Kingdom.

BACKGROUND: Worldwide, the demand for specialist palliative care is increasing but funding is limited. The role of volunteers is underresearched, although their contribution reduces costs significantly. Understanding what volunteers do is vital to ensure services develop appropriately to meet the challenges faced by providers of palliative care. OBJECTIVE: The study's objective is to describe current involvement of volunteers with direct patient/family contact in U.K. specialist palliative care. DESIGN: An online survey was sent to 290 U.K. adult hospices and specialist palliative care services involving volunteers covering service characteristics, involvement and numbers of volunteers, settings in which they are involved, extent of involvement in care services, specific activities undertaken in each setting, and use of professional skills. RESULTS: The survey had a 67% response rate. Volunteers were most commonly involved in day care and bereavement services. They entirely ran some complementary therapy, beauty therapy/hairdressing, and pastoral/faith-based care services, and were involved in a wide range of activities, including sitting with dying patients. CONCLUSIONS: This comprehensive survey of volunteer activity in U.K. specialist palliative care provides an up-to-date picture of volunteer involvement in direct contact with patients and their families, such as providing emotional care, and the extent of their involvement in day and bereavement services. Further research could focus on exploring their involvement in bereavement care.

Online video bridges gap between orientation and first session for arts in medicine volunteers.

An online video assignment was developed to facilitate transition from the orientation session to the first contact with hospital patients for music therapy majors and other students enrolled in an Arts in Medicine service learning course (AIMS). All students (N = 84) completed a 2 hour hospital orientation session. After the orientation session the experimental group (n = 42) completed an online video assignment before volunteering at the hospital The control group (n = 42) began volunteering after the orientation session without completing the video assignment. Analysis indicates the majority of both groups initiated their first session independently without assistance from other AIMS volunteers, an experienced AIM volunteer, an AIM assistant, or hospital staff member. The majority of both groups also engaged at least one patient during their first visit at the hospital. Content analysis of "first contact" weekly reports, however, indicated experimental group students wrote longer reports and included more positive comments, particularly about patients, compared to control group students. Volunteers in the experimental group also began their contacts as scheduled on the course calendar compared to later starting dates of control group volunteers.

Promoting childbirth companions in South Africa: a randomised pilot study.

BACKGROUND: Most women delivering in South African State Maternity Hospitals do not have a childbirth companion; in addition, the quality of care could be better, and at times women are treated inhumanely. We piloted a multi-faceted intervention to encourage uptake of childbirth companions in state hospitals, and hypothesised that lay carers would improve the behaviour of health professionals. METHODS: We conducted a pilot randomised controlled trial of an intervention to promote childbirth companions in hospital deliveries. We promoted evidence-based information for maternity staff at 10 hospitals through access to the World Health Organization Reproductive Health Library (RHL), computer hardware and training to all ten hospitals. We surveyed 200 women at each site, measuring companionship, and indicators of good obstetric practice and humanity of care. Five hospitals were then randomly allocated to receive an educational intervention to promote childbirth companions, and we surveyed all hospitals again at eight months through a repeat survey of postnatal women. Changes in median values between intervention and control hospitals were examined. RESULTS: At baseline, the majority of hospitals did not allow a companion, or access to food or fluids. A third of women were given an episiotomy. Some women were shouted at (17.7%, N = 2085), and a few reported being slapped or struck (4.3%, N = 2080). Despite an initial positive response from staff to the childbirth companion intervention, we detected no difference between intervention and control hospitals in relation to whether a companion was allowed by nursing staff, good obstetric practice or humanity of care. CONCLUSION: The quality and humanity of care in these state hospitals needs to improve. Introducing childbirth companions was more difficult than we anticipated, particularly in under-resourced health care systems with frequent staff changes. We were unable to determine whether the presence of a lay carer impacted on the humanity of care provided by health professionals. TRIAL REGISTRATION: Current Controlled Trials ISRCTN33728802.

Reconocimiento y aceptacion de la labor de promotora, por parte de la comunidad de Cogua, Cundinamarca / Recognition and acceptance of the health promotor work, by the community of Cogua, Cundinamarca

Se realizo una encuesta de opinion para saber el reconocimiento y la aceptacion que el trabajo de la promotora de salud tiene en la comunidad y un cuestionario abierto para conocer la imagen que tiene la promotora de salud de su labor. Para el primero, se tomo una muestra estratificada de 231 familias del area rural de Cogua. Se considero reconocimiento o aceptacion el porcentaje igual o mayor que 60%respecto al significado de la promotora de salud, el 87%la definio como una persona da servicios de salud y previene enfermedad, y el 13%no la reconoce como agente de salud. En cuanto al conocimiento que tiene la comunidad sobre las actividades de la promotora, el 14%nombro mas de 5 y el 86%menos de 5. En relacion a la calidad del servicio, el 87%opina que es bueno porque beneficia la salud de la comunidad y el bienestar de las personas, y el 13%considera que es mala. Explorando las espectativas de la comunidad en relacion a la labor, el 72%espera colaboracion, capacitacion, atencion de consulta, el 28%no manifesto espectativas. El 79%cree importante la presencia de la promotora en la vereda. En caso de enfermedad, el 43%acude al medico y el 57%a la promotora. El 79%aplica sus ensenanzas. En el analisis del cuestionario dirigido a las promotoras de salud se encontro que se identifican como "voceras de salud de la comunidad", "el vinculo entre la comunidad y las agencias de salud" estan satisfechas con su labor de ayuda y orientacion sobre servicios de salud.

[Integration of health development cooperation into the cultural and socioeconomic context of the operational area: work of the Putina medical team in Peru]. / Erwägungen zur Integration medizinischer Entwicklungszusammenarbeit in den kulturellen und sozioökonomischen Kontext des Einsatzgebietes: Zum Beispiel der Arbeit des Putina-Arzteteams in Peru.

Contrasting with what happened with the indio traditional medicine and with the Western medical knowledge the Spaniards imported, industrialized nations' medicine, through its growing ability to fight infectious diseases, has sharpened in Peru in the 20th century the social disparity between the well-to-do upper classes and the poor masses. In order to alleviate this situation, efforts have been undertaken since the 1940's in the Department of Puno, the poorest of the country, in order to bring to the rural population the benefits of modern medicine. Since 1971, a team of Swiss physicians, integrated into the Peruvian Ministry of Health, works in the Putina area in several State health centers. There are presently five doctors for a 130,000 inhabitants population, collaborating in the setting up of basic health services. The most important pillars of the programme, which should be able to function without physicians, if need be, are voluntary health auxiliaries, chosen by their own community (1 per 500 people). State employed auxiliary nurses (1 per 5000 people), and Peruvian State Registered nurses, entrusted with training and supervisory tasks. The progress of the programme, in terms of the growing independence of the basic health system, is described, as are potentialities and limits in bringing it closer to the indigenous traditional medicine. Through the example of the supply of basic drugs, it is pointed out how setbacks suffered in the last two years, are illustrative of the country political crisis and of its growing dependency on industrialized nations.

A community-oriented program for training and using volunteers.

Eleven women volunteers from the Arvada, Colorado, community were provided intensive training in communication and other variables related to effective functioning in a community mental health center. Volunteers were then provided various placements within the center. Results indicated that the volunteers' communication effectiveness levels increased significantly from pretest to posttest and as compared to a control group of students going through a mental health program. Volunteers also received favorable evaluation rating from their practicum supervisors. The paper will discuss the procedures, benefits, and considerations involved in developing and utilizing volunteers.