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1.
Work ; 78(1): 3-27, 2024.
Article in English | MEDLINE | ID: mdl-38578915

ABSTRACT

BACKGROUND: Health and Social Care (HSC) workers face psychological health risks in the workplace. While many studies have described psychological injuries in HSC workers, few have examined the determinants. Previous research has primarily focused on hospitals, lacking systematic reviews of community-based settings. OBJECTIVE: To systematically identify and appraise current evidence on the determinants of psychological injuries among HSC workers in community settings. METHODS: Searches were conducted in three bibliographic databases, supplemented by citation searches. Included studies focused on community-based HSC workers, reporting statistical associations between psychological injury and personal, health, occupational, or organizational factors. Quantitative studies published in English between January 1, 2000 and August 15, 2023 were included. Quality appraisal was undertaken using the JBI critical appraisal checklist. RESULTS: Sixty-six studies were included. Study quality was highly variable, and all studies were cross-sectional. Twenty-three studies linked psychological injury with occupational factors (e.g. low job control, high job demands and low job satisfaction). Thirteen studies observed an association between work environment and psychological injury, and a further eleven between workplace social support and psychological injury. Fewer studies have examined the relationship between psychological injury and personal/individual factors. CONCLUSION: Occupational and organisational factors are significantly associated with psychological health among HSA workers, in community settings. These aspects of job design, work environment and workplace relationships are modifiable, suggesting an opportunity for work design interventions to improve workers' psychological health and reduce the prevalence of psychological injury in this sector.


Subject(s)
Social Workers , Workplace , Humans , Health Personnel/psychology , Health Personnel/statistics & numerical data , Job Satisfaction , Social Support , Social Workers/psychology , Workplace/psychology , Workplace/standards
3.
Aust J Prim Health ; 2024 Feb 08.
Article in English | MEDLINE | ID: mdl-38326030

ABSTRACT

BACKGROUND: The HeLP-GP trial aimed to increase the capacity of practice nurses to deliver weight management to overweight and obese patients through an intervention comprising a health check, a lifestyle app and/or telephone coaching. This paper describes implementation through the lens of organisational readiness with emphasis on the role of the practice nurse. METHODS: Routinely collected mixed method research data including practice surveys, field notes, and diaries and process data were mapped against the domains: motivation to implement, general capacity and intervention-specific capacity. RESULTS: Organisational readiness varied considerably, particularly the domain of intervention-specific capacity. Practice nurse turnover negatively impacted the implementation, affecting half of the practices. We observed a general lack of practice-based support for intervention delivery, and varying levels of interest, skill and confidence in delivering the intervention. Nurses struggled to complete the research and intervention tasks in a timely way. Conducting risk assessments and referring to coaching were generally not problematic; however, we noted lower confidence levels with the lifestyle app and instructing patients to use it. CONCLUSIONS: We found a lack of general 'readiness' inherent in the nursing role, particularly related to their capacity to complete intervention tasks and practice-level support to implement the intervention. For nurses in general practice to fulfil their potential in supporting patients to reduce risk and adopt healthier life choices, our study indicates that more could be done to improve their workforce positioning and remuneration, which may, in turn, improve continuity of care, retention and individual motivation.

4.
JMIR Mhealth Uhealth ; 12: e45942, 2024 Feb 09.
Article in English | MEDLINE | ID: mdl-38335014

ABSTRACT

BACKGROUND: The Health eLiteracy for Prevention in General Practice trial is a primary health care-based behavior change intervention for weight loss in Australians who are overweight and those with obesity from lower socioeconomic areas. Individuals from these areas are known to have low levels of health literacy and are particularly at risk for chronic conditions, including diabetes and cardiovascular disease. The intervention comprised health check visits with a practice nurse, a purpose-built patient-facing mobile app (mysnapp), and a referral to telephone coaching. OBJECTIVE: This study aimed to assess mysnapp app use, its user profiles, the duration and frequency of use within the Health eLiteracy for Prevention in General Practice trial, its association with other intervention components, and its association with study outcomes (health literacy and diet) to determine whether they have significantly improved at 6 months. METHODS: In 2018, a total of 22 general practices from 2 Australian states were recruited and randomized by cluster to the intervention or usual care. Patients who met the main eligibility criteria (ie, BMI>28 in the previous 12 months and aged 40-74 years) were identified through the clinical software. The practice staff then provided the patients with details about this study. The intervention consisted of a health check with a practice nurse and a lifestyle app, a telephone coaching program, or both depending on the participants' choice. Data were collected directly through the app and combined with data from the 6-week health check with the practice nurses, the telephone coaching, and the participants' questionnaires at baseline and 6-month follow-up. The analyses comprised descriptive and inferential statistics. RESULTS: Of the 120 participants who received the intervention, 62 (52%) chose to use the app. The app and nonapp user groups did not differ significantly in demographics or prior recent hospital admissions. The median time between first and last app use was 52 (IQR 4-95) days, with a median of 5 (IQR 2-10) active days. App users were significantly more likely to attend the 6-week health check (2-sided Fisher exact test; P<.001) and participate in the telephone coaching (2-sided Fisher exact test; P=.007) than nonapp users. There was no association between app use and study outcomes shown to have significantly improved (health literacy and diet) at 6 months. CONCLUSIONS: Recruitment and engagement were difficult for this study in disadvantaged populations with low health literacy. However, app users were more likely to attend the 6-week health check and participate in telephone coaching, suggesting that participants who opted for several intervention components felt more committed to this study. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12617001508369; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373505. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2018-023239.


Subject(s)
Mobile Applications , Obesity , Overweight , Humans , Australasian People , Australia , General Practice , Obesity/therapy , Overweight/therapy , Adult , Middle Aged , Aged
5.
BMJ Open ; 14(2): e077877, 2024 02 02.
Article in English | MEDLINE | ID: mdl-38309760

ABSTRACT

INTRODUCTION: The objective of this parallel group, randomised controlled trial is to evaluate a community health navigator (CHN) intervention provided to patients aged over 40 years and living with chronic health conditions to transition from hospital inpatient care to their homes. Unplanned hospital readmissions are costly for the health system and negatively impact patients. METHODS AND ANALYSIS: Patients are randomised post hospital discharge to the CHN intervention or usual care. A comparison of outcomes between intervention and control groups will use multivariate regression techniques that adjust for age, sex and any independent variables that are significantly different between the two groups, using multiple imputation for missing values. Time-to-event analysis will examine the relationship between seeing a CHN following discharge from the index hospitalisation and reduced rehospitalisations in the subsequent 60 days and 6 months. Secondary outcomes include medication adherence, health literacy, quality of life, experience of healthcare and health service use (including the cost of care). We will also conduct a qualitative assessment of the implementation of the navigator role from the viewpoint of stakeholders including patients, health professionals and the navigators themselves. ETHICS APPROVAL: Ethics approval was obtained from the Research Ethics and Governance Office, Sydney Local Health District, on 21 January 2022 (Protocol no. X21-0438 and 2021/ETH12171). The findings of the trial will be disseminated through peer-reviewed journals and national and international conference presentations. Data will be deposited in an institutional data repository at the end of the trial. This is subject to Ethics Committee approval, and the metadata will be made available on request. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN 12622000659707). ARTICLE SUMMARY: The objective of this trial is to evaluate a CHN intervention provided to patients aged over 40 years and living with chronic health conditions to transition from hospital inpatient care to their homes.


Subject(s)
Public Health , Quality of Life , Humans , Adult , Middle Aged , Australia , Patient Transfer , Hospitals , Randomized Controlled Trials as Topic
6.
Ethn Health ; 29(2): 199-207, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37941107

ABSTRACT

OBJECTIVES: This study identifies and analyzes barriers to sexual and gynecological health care Black women face at a Historically Black College or University (HBCU) and a Predominantly White Institution (PWI) in southeastern America. DESIGN: Participants identified as Black women who were sexually active, age 18-25, and undergraduate students. The research team conducted in-depth interviews across two campuses via Zoom. Interviews were coded using inductive thematic analysis. RESULTS: We derived six specific themes that summarize Black female college students' barriers to care: Patient-provider Interactions, Economic Determinants of Health, Social Support, Access to Care, Lack of Primary Care, and No Challenges. CONCLUSION: Reproductive and sexual health disparities can be mitigated with attention to diversity in medical school, affordable care, and teaching young women to prioritize their care for long-term reproductive health.


Subject(s)
Reproductive Health , Sexual Health , Humans , Female , Adolescent , Young Adult , Adult , Sexual Behavior , Racial Groups , Students
7.
J Appl Psychol ; 109(2): 293-306, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37616111

ABSTRACT

Previous research on the psychological effect of job change has revealed a honeymoon-hangover pattern during the turnover process. However, there is a dearth of evidence on how individuals react and adapt to multiple job changes over their working lives. This study distinguishes adaptation to a single job change in the short term from adaptation to the process of job change in the long term. Drawing on two large-scale, long-running panel data sets from Britain and Australia, it examined how job satisfaction trajectory evolved as individuals made a series of consecutive job changes since they first entered the labor market. Our fixed effect analyses show that in both countries, individuals experienced a stronger honeymoon effect with each successive job change, before gradually reverting to their baseline job satisfaction. In short, the amplitude of the honeymoon-hangover effect increased across multiple job changes. By distinguishing "adaptation to change" from "change in adaptation," this study generates original insights into the role of job mobility in facilitating career development and extends set point theory from understanding the impact of single life events to recurring life events. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Job Satisfaction , Occupations , Humans , Australia , Personal Satisfaction
8.
BMC Health Serv Res ; 23(1): 977, 2023 Sep 11.
Article in English | MEDLINE | ID: mdl-37697280

ABSTRACT

BACKGROUND: People with serious mental illness die about 20 years earlier than the general population from preventable diseases. Shared-care arrangements between general practitioners and mental health services can improve consumers' access to preventive care, but implementing shared care is challenging. This scoping review sought to describe current evidence on the barriers and facilitators to the participation and engagement of primary care (specifically general practitioners) in shared-care arrangements with community mental health services for preventive health care of this population. METHODS: We searched Medline, Embase, CINAHL, Scopus, APA PsychINFO and EBM Reviews from 2010 to 2022. Data was extracted against a Microsoft Excel template developed for the review. Data was synthesised through tabulation and narrative methods. RESULTS: We identified 295 records. After eligibility screening and full-text review, seven studies were included. Facilitators of engagement included a good fit with organisation and practice and opportunities to increase collaboration, specific roles to promote communication and coordination and help patients to navigate appointments, multidisciplinary teams and teamwork, and access to shared medical/health records. Barriers included a lack of willingness and motivation on the part of providers and low levels of confidence with tasks, lack of physical structures to produce capacity, poor alignment of funding/incentives, inability to share patient information and challenges engaging people with severe mental illness in the service and with their care. CONCLUSION: Our results were consistent with other research on shared care and suggests that the broader literature is likely to be applicable to the context of general practitioner/mental health services shared care. Specific challenges relating to this cohort present difficulties for recruitment and retention in shared care programs. Sharing "goals and knowledge, mutual respect" and engaging in "frequent, timely, accurate, problem-solving communication", supported by structures such as shared information systems are likely to engage primary care in shared care arrangements more than the traditional focus on incentives, education, and guidelines.


Subject(s)
Community Mental Health Services , Mental Disorders , Mental Health Services , Humans , Preventive Health Services , Mental Disorders/therapy , Primary Health Care
9.
Home Healthc Now ; 41(4): 190-196, 2023.
Article in English | MEDLINE | ID: mdl-37417570

ABSTRACT

As treatments for end-stage heart failure (ESHF) have become more available, patients with ESHF may encounter decisional dilemmas as their condition progresses and they seek more comfort-based care. Those who want to continue therapeutic treatments such as inotropic therapy, may face the challenge of finding a hospice agency willing to integrate this therapy into the hospice benefit model. This article highlights one hospice agency's willingness to explore common barriers to admitting patients receiving inotropic therapy, and addresses the trajectory of patient care when hospice collaboratively partners with cardiology services. It outlines operational development for providing cardiac focused care in hospice, and speaks to next steps for expanding these services. Most importantly, it acknowledges the profound effect on patients who are offered the choice to return home with hospice while receiving cardiac therapeutic care.


Subject(s)
Heart Failure , Hospice Care , Hospices , Humans , Heart Failure/drug therapy , Hospitalization
10.
Scand J Psychol ; 64(4): 512-526, 2023 Aug.
Article in English | MEDLINE | ID: mdl-36744852

ABSTRACT

Examining the Raine cohort study, we tested the trait continuity hypothesis by examining the extent that young adults' (25-29 years old) self-reported HEXACO personality can be statistically predicted from multi-dimensional parental temperament ratings collected in infancy (1-2 years old). The study incorporated a lagged design (two waves), a large sample size (n = 563), and examined both temperament and personality as both dimensions and profiles. Overall, we found very limited evidence of trait continuity, with generally very weak and few statistically significant observed associations of infant temperament with early adulthood personality. Relations were weak whether profile or dimension-based operationalizations of both phenomena were adopted. Additionally, controlling for sex affected the relations of temperament and personality only to a small extent for most of the traits, and moderation effects of sex were generally zero-to-trivial in size. Altogether, parent-rated temperament in infancy seems to provide little information about HEXACO personality in early adulthood.


Subject(s)
Personality , Temperament , Young Adult , Humans , Infant , Adult , Child, Preschool , Cohort Studies , Personality Disorders , Parents
11.
BMC Prim Care ; 24(1): 57, 2023 02 27.
Article in English | MEDLINE | ID: mdl-36850020

ABSTRACT

BACKGROUND: Australia has one of the highest rates of overweight and obesity in the developed world, and this increasing prevalence and associated chronic disease morbidity reinforces the importance of understanding the attitudes, views, and experiences of patients and health providers towards weight management interventions and programs. The purpose of this study was to investigate patients, family practitioners and family practice nurses' perceptions and views regarding the receipt or delivery of weight management within the context of the HeLP-GP intervention. METHODS: A nested qualitative study design including semi-structured interviews with family practitioners (n = 8), family practice nurses (n = 4), and patients (n = 25) attending family practices in New South Wales (n = 2) and South Australia (n = 2). The patient interviews sought specific feedback about each aspect of the intervention and the provider interviews sought to elicit their understanding and opinions of the strategies underpinning the intervention as well as general perceptions about providing weight management to their patients. Interviews were recorded and transcribed verbatim, and coding and management conducted using NVivo 12 Pro. We analysed the interview data using thematic analysis. RESULTS: Our study identified three key themes: long-term trusting and supportive relationships (being 'in it for the long haul'); initiating conversations and understanding motivations; and ensuring access to multi-modal weight management options that acknowledge differing levels of health literacy. The three themes infer that weight management in family practice with patients who are overweight or obese is challenged by the complexity of the task and the perceived motivation of patients. It needs to be facilitated by positive open communication and programs tailored to patient needs, preferences, and health literacy to be successful. CONCLUSIONS: Providing positive weight management in family practice requires ongoing commitment and an open and trusting therapeutic relationship between providers and patients. Behaviour change can be achieved through timely and considered interactions that target individual preferences, are tailored to health literacy, and are consistent and positive in their messaging. Ongoing support of family practices is required through funding and policy changes and additional avenues for referral and adjunctive interventions are required to provide comprehensive weight management within this setting.


Subject(s)
Family Practice , General Practice , Humans , Overweight/prevention & control , Obesity/epidemiology , Obesity/prevention & control , Research Design
12.
J Appl Psychol ; 108(7): 1207-1222, 2023 Jul.
Article in English | MEDLINE | ID: mdl-36455018

ABSTRACT

Proactivity at work is generally assumed to be preceded by positive motivational states with positive outcomes for employees. However, recent perspectives suggest downsides to proactive behavior, including that it can be driven by negative emotions or experienced as depleting for employees. Bringing these previously disconnected ideas together, we utilize cognitive-motivational-relational and self-determination theories to holistically examine the negative antecedents of proactivity and its outcomes. We argue that employees, particularly those with high impression management motives, experience burnout when financial precarity and fear drive them to proactively learn new skills. We test and show support for these hypotheses in a four-wave study of 1,315 university employees during the beginning of the COVID-19 pandemic, an external event that threatened employees' financial security. Theoretically, our findings broaden our understanding of the antecedents and consequences of proactivity, while expanding the role of fear at work beyond "flight" responses to include motivating protective effort. Practically, our findings help to understand both how employees proactively develop their skills in light of financial precarity and how these proactive efforts are experienced as depleting. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Burns , COVID-19 , Humans , Pandemics , Motivation , Fear
13.
J Racial Ethn Health Disparities ; 10(5): 2374-2396, 2023 10.
Article in English | MEDLINE | ID: mdl-36171496

ABSTRACT

Black and Latino sexual minority men (SMM) continue to be disproportionately impacted by HIV. We utilized eight components of the Meaningful Involvement of People Living with HIV/AIDS (MIPA) framework to assess the engagement of Black and Latino SMM. Thirty-six (36) studies were included in the literature review. Forty-two percent of studies were Black SMM-specific, followed by Latino SMM-specific (31%) studies. Twenty-eight percent of studies were conducted among both groups. Most studies (72%) were intervention-related and focused on HIV prevention. The top five most common methods of community engagement were focus groups (39%), followed by interviews (36%), community-based participatory research (14%), the utilization of community advisory boards or peer mentorship (11%), and the establishment of multi-stakeholder coalitions, observations, or surveys (8%). We documented at least 7 MIPA components in 47% of the included studies. Community-based participatory research was more commonly utilized to engage Latino SMM. Researchers were more likely to initiate the engagement across all included studies. Few studies documented how Black and Latino SMM perceived the engagement. Engagement responsiveness was a well-documented MIPA component. In terms of engagement power dynamics, there were several examples of power imbalances, especially among Black SMM-specific studies. The inclusion of Black and Latino SMM had robust impacts on HIV research and interventions. There were limited examples of engagement capacity and maintenance. This is one of the first studies focused on utilizing MIPA to document the engagement of SMM of color. MIPA served as a useful framework for understanding the engagement of SMM of color in the US HIV response. The engagement of SMM of color is critical to reducing health inequities.


Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , Sexual and Gender Minorities , Male , Humans , Homosexuality, Male , HIV Infections/prevention & control , Skin Pigmentation
14.
J Fam Commun ; 23(3-4): 241-257, 2023.
Article in English | MEDLINE | ID: mdl-38312846

ABSTRACT

The study used Black feminist theory and methods to examine messages about the composition of, and potential differences in the sexual health that Black women received from male and female loved ones. Black feminist theory grounded the study by ensuring Black women were involved in research team composition, design, recruitment, and data analysis. Our inductive thematic analysis of focus group data from 24 Black women revealed seven themes: Indirect Communication, Absence of Communication, Messages to Shield, and Prepare from male figures. The themes from female figures included: Absence of Communication, Open Communication, and Empowerment, Pleasure, and Judgment-Free Communication. A seventh theme that connected across gender focused on Objectification and Gender Stereotypes. Findings of the study suggest that there is a need for greater focus on improving family communication about sex for Black women and the need to center communication that empowers Black women to engage in healthy sexual practices.

15.
BMJ Open ; 12(11): e060393, 2022 11 30.
Article in English | MEDLINE | ID: mdl-36450426

ABSTRACT

OBJECTIVES: To evaluate a multifaceted intervention on diet, physical activity and health literacy of overweight and obese patients attending primary care. DESIGN: A pragmatic two-arm cluster randomised controlled trial. SETTING: Urban general practices in lower socioeconomic areas in Sydney and Adelaide. PARTICIPANTS: We aimed to recruit 800 patients in each arm. Baseline assessment was completed by 215 patients (120 intervention and 95 control). INTERVENTION: A practice nurse-led preventive health check, a mobile application and telephone coaching. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were measured at baseline, 6 and 12 months, and included patient health and eHealth literacy, weight, waist circumference and blood pressure. Secondary outcomes included changes in diet and physical activity, preventive advice and referral, blood lipids, quality of life and costs. Univariate and multivariate analyses of difference-in-differences (DiD) estimates for each outcome were conducted. RESULTS: At 6 months, the intervention group, compared with the control group, demonstrated a greater increase in Health Literacy Questionnaire domain 8 score (ability to find good health information; mean DiD 0.22; 95% CI 0.01 to 0.44). There were similar differences for domain 9 score (understanding health information well enough to know what to do) among patients below the median at baseline. Differences were reduced and non-statistically significant at 12 months. There was a small improvement in diet scores at 6 months (DiD 0.78 (0.10 to 1.47); p=0.026) but not at 12 months. There were no differences in eHealth literacy, physical activity scores, body mass index, weight, waist circumference or blood pressure. CONCLUSIONS: Targeted recruitment and engagement were challenging in this population. While the intervention was associated with some improvements in health literacy and diet, substantial differences in other outcomes were not observed. More intensive interventions and using codesign strategies to engage the practices earlier may produce a different result. Codesign may also be valuable when targeting lower socioeconomic populations. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN 12617001508369) (http://www.ANZCTR.org.au/ACTRN12617001508369.aspx). TRIAL PROTOCOL: The protocol for this trial has been published (open access; https://bmjopen.bmj.com/content/8/6/e023239).


Subject(s)
Health Literacy , Telemedicine , Humans , Overweight/prevention & control , Quality of Life , Australia , Obesity/prevention & control , Chronic Disease , Primary Health Care
16.
Article in English | MEDLINE | ID: mdl-36231367

ABSTRACT

Support from social networks buffers against negative effects of stress but is disrupted by incarceration. Few studies examine incarceration, social support networks, and health among Black sexual minority men (BSMM) and Black transgender women (BTW). We conducted a secondary analysis using HIV Prevention Trials Network 061 (HPTN 061), a sample of BSMM/BTW recruited from six US cities. We measured associations between recent incarceration reported at six months follow-up and social support networks at twelve months follow-up, and cross-sectional associations between support networks and twelve-month health outcomes (e.g., sexual partnerships, substance use, healthcare access and depressive symptoms). Among the analytic sample (N = 1169), recent incarceration was associated with small medical support networks (adjusted risk ratio [aRR] 1.16, 95% CI 1.01, 1.34) and small financial support networks (aRR 1.18, 95% CI 1.04, 1.35). Support networks were associated with multiple partnerships (adjusted prevalence ratio [aPR] 0.77, 95% CI 0.65, 0.90), unhealthy alcohol use (aPR 1.20, 95% CI 0.96, 1.51), and depressive symptoms (aPR 1.16, 95% CI 0.99, 1.36). Incarceration adversely impacts social support networks of BSMM/BTW, and support networks were associated with a range of important health outcomes.


Subject(s)
HIV Infections , Sexual and Gender Minorities , Transgender Persons , Cross-Sectional Studies , Female , HIV Infections/epidemiology , Homosexuality, Male , Humans , Male , Social Networking , Social Support
17.
BMC Prim Care ; 23(1): 157, 2022 06 21.
Article in English | MEDLINE | ID: mdl-35729493

ABSTRACT

BACKGROUND: Government-subsidised general practice management plans (GPMPs) facilitate chronic disease management; however, impact on cardiovascular disease (CVD) is unknown. We aimed to determine utilisation and impact of GPMPs for people with or at elevated risk of CVD. METHODS: Secondary analysis of baseline data from the CONNECT randomised controlled trial linked to Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) claims. Multivariate regression examining the association of GPMP receipt and review with: (1) ≥ 1 MBS-subsidised allied health visit in the previous 24 months; (2) adherence to dual cardioprotective medication (≥ 80% of days covered with a dispensed PBS prescription); and (3) meeting recommended LDL-cholesterol and blood pressure (BP) targets concurrently. RESULTS: Overall, 905 trial participants from 24 primary health care services consented to data linkage. Participants with a GPMP (46.6%, 422/905) were older (69.4 vs 66.0 years), had lower education (32.3% vs 24.7% high school or lower), lower household income (27.5% vs 17.0% in lowest bracket), and more comorbidities, particularly diabetes (42.2% vs 17.6%) compared to those without a GPMP. After adjustment, a GPMP was strongly associated with allied health visits (odds ratio (OR) 14.80, 95% CI: 9.08-24.11) but not higher medication adherence rates (OR 0.82, 95% CI: 0.52-1.29) nor meeting combined LDL and BP targets (OR 1.31, 95% CI: 0.72-2.38). Minor differences in significant covariates were noted in models using GPMP review versus GPMP initiation. CONCLUSIONS: In people with or at elevated risk of CVD, GPMPs are under-utilised overall. They are targeting high-needs populations and facilitate allied health access, but are not associated with improved CVD risk management, which represents an opportunity for enhancing their value in supporting guideline-recommended care.


Subject(s)
Cardiovascular Diseases , National Health Programs , Aged , Australia/epidemiology , Cardiovascular Diseases/epidemiology , Disease Management , Government , Humans , United States
18.
Nat Rev Psychol ; 1(7): 378-392, 2022.
Article in English | MEDLINE | ID: mdl-35574235

ABSTRACT

Self-determination theory has shaped our understanding of what optimizes worker motivation by providing insights into how work context influences basic psychological needs for competence, autonomy and relatedness. As technological innovations change the nature of work, self-determination theory can provide insight into how the resulting uncertainty and interdependence might influence worker motivation, performance and well-being. In this Review, we summarize what self-determination theory has brought to the domain of work and how it is helping researchers and practitioners to shape the future of work. We consider how the experiences of job candidates are influenced by the new technologies used to assess and select them, and how self-determination theory can help to improve candidate attitudes and performance during selection assessments. We also discuss how technology transforms the design of work and its impact on worker motivation. We then describe three cases where technology is affecting work design and examine how this might influence needs satisfaction and motivation: remote work, virtual teamwork and algorithmic management. An understanding of how future work is likely to influence the satisfaction of the psychological needs of workers and how future work can be designed to satisfy such needs is of the utmost importance to worker performance and well-being.

19.
AIDS Behav ; 26(Suppl 1): 100-111, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34417672

ABSTRACT

African Americans in the southern United States continue to be disproportionately affected by HIV. Although faith-based organizations (FBOs) play important roles in the social fabric of African American communities, few HIV screening, care, and PrEP promotion efforts harness the power of FBOs. We conducted 11 focus groups among 57 prominent African American clergy from Arkansas, Mississippi, and Alabama. We explored clergy knowledge about the Ending the HIV Epidemic: A Plan for America (EHE); normative recommendations for how clergy can contribute to EHE; and how clergy can enhance the HIV care continua and PrEP. We explored how clergy have responded to the COVID-19 crisis, and lessons learned from pandemic experiences that are relevant for HIV programs. Clergy reported a moral obligation to participate in the response to the HIV epidemic and were willing to support efforts to expand HIV screening, treatment, PrEP and HIV care. Few clergy were familiar with EHE, U = U and TasP. Many suggested developing culturally tailored messages and were willing to lend their voices to social marketing efforts to destigmatize HIV and promote uptake of biomedical interventions. Nearly all clergy believed technical assistance with biomedical HIV prevention and care interventions would enhance their ability to create partnerships with local community health centers. Partnering with FBOs presents important and unique opportunities to reduce HIV disparities. Clergy want to participate in the EHE movement and need federal resources and technical assistance to support their efforts to bridge community activities with biomedical prevention and care programs related to HIV. The COVID-19 pandemic presents opportunities to build important infrastructure related to these goals.


Subject(s)
COVID-19 , HIV Infections , Black or African American , Clergy , HIV Infections/epidemiology , HIV Infections/prevention & control , Humans , Pandemics , SARS-CoV-2 , United States/epidemiology
20.
J Sex Res ; 59(9): 1122-1132, 2022.
Article in English | MEDLINE | ID: mdl-34874790

ABSTRACT

Little is known about Black college women's openness to participating in sexual health care research. Guided by literature on Black feminism, the current study involved qualitative interviews with 39 Black Women (aged 19-25, mean age 20.7) from one historically Black university and one predominantly white university who answered questions about participating in research on the sexual health of Black women. Results from our thematic analysis found that participants were willing to participate in research when they were recruited by trusted community members, particularly Black female researchers. The women were willing to participate because they saw the value in having Black women's perspectives on sexual health research and improving Black women's lives. We found that participants believed that non-Black women researchers should receive training to increase understanding of the issues facing Black women and create safe and judgment-free spaces to engage Black Women in sexual health research. Participants wanted non-Black female and all male researchers to demonstrate a genuine interest in their lives as Black women. The findings highlight the importance of listening to the perspectives of participants and their experiences with sexual health care providers.


Subject(s)
Sexual Behavior , Sexual Health , United States , Female , Male , Humans , Young Adult , Adult , Universities , Narration , Health Services Research
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