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1.
Texto & contexto enferm ; 29: e20180250, Jan.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1059129

RESUMO

ABSTRACT Objective: to analyze the health promotion practices developed by nurses in the care of people with non-transmittable chronic disease in primary health care, in scientific publications, between 2007 and 2017. Method: an integrative literature review of a qualitative approach, conducted in five databases, in which was read and critical analysis of the studies in order to know the practices of health promotion. Results: 40 articles were selected and organized according to the fields of the Ottawa Charter: public policies, reorientation of health services, creation of personal skills, reinforcement of community action and favorable environments. Thus, most of the experiments were mainly related to two fields of action: development of personal skills and reorientation of the health system. There is a movement towards the development of a health promotion in which the collective, the social determinants of health and multidisciplinarity are advocated. Conclusion: some limits were identified that need to be overcome, among which stands out the inter-sectoral work that needs to grow beyond the health sector.


RESUMEN Objetivo: analizar las prácticas de promoción de la salud llevadas a cabo por los enfermeros al cuidar d personas con enfermedades crónicas no transmisible en la atención primaria de la salud, en publicaciones científicas de 2007 a 2017. Método: revisión integradora de la literatura con enfoque cualitativo realizada en cinco bases de datos, en las que se efectuó una lectura y un análisis crítico de los estudios de modo de conocer las prácticas de promoción de la salud. Resultados: se seleccionaron 40 artículos y se los organizó de acuerdo con los campos de la Carta de Ottawa: políticas públicas, reorientación de los servicios de salud, desarrollo de habilidades personales, refuerzo de la acción comunitaria y ambientes favorables. De esta manera, la mayor parte de las experiencias se relacionó principalmente con dos campos de acción: desarrollo de habilidades personales y reorientación del sistema de salud. Se nota un desplazamiento en dirección al desarrollo de un enfoque de promoción de salud en el que se promueve lo colectivo, los determinantes sociales de la salud y de la multidisciplinariedad. Conclusión: se identificaron algunos límites que deben superarse, dentro de los cuales se destaca el trabajo intersectorial que debe extenderse más allá dl sector de la salud.


RESUMO Objetivo: analisar as práticas de promoção da saúde desenvolvidas pelos enfermeiros no cuidado às pessoas com doença crônica não transmissível na atenção primária à saúde, em publicações científicas entre de 2007 e 2017. Método: revisão integrativa de literatura de abordagem qualitativa, realizada em cinco bases de dados, nos quais se fez uma leitura e análise crítica dos estudos de modo a conhecer as práticas de promoção da saúde. Resultados: foram selecionados 40 artigos, sendo organizados de acordo com os campos da Carta de Ottawa: políticas públicas, reorientação dos serviços de saúde, criação de habilidades pessoais, reforço da ação comunitária e ambientes favoráveis. Dessa forma, a maior parte das experiências estava relacionada principalmente a dois campos de ação: desenvolvimento de habilidades pessoais e reorientação do sistema de saúde. Observou-se um movimento em direção ao desenvolvimento de uma promoção da saúde em que se preconiza o coletivo, os determinantes sociais da saúde e a multidisciplinaridade. Conclusão: identificaram-se alguns limites que precisam ser transpostos, dentre os quais se destaca o trabalho intersetorial que precisa crescer para além do setor saúde.


Assuntos
Atenção Primária à Saúde , Doença Crônica , Enfermagem , Política Pública , Participação da Comunidade , Promoção da Saúde , Literatura , Cuidados de Enfermagem
2.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193593

RESUMO

OBJETIVOS: Evaluar la efectividad de una intervención comunitaria de formación profesional para jóvenes en riesgo de exclusión social, en la salud autopercibida, la autoestima y el consumo de sustancias (alcohol, tabaco y cannabis). Evaluar la satisfacción de los participantes. MÉTODOS: Diseño: estudio de intervención pre-post. Emplazamiento: tres barrios de renta baja de Barcelona durante 2013-2017. Participantes: 185 participantes, de 21 años de media y predominio masculino (65,5%). Intervención: programa de 4 meses de formación profesional de diferentes disciplinas e itinerarios orientados a la inserción laboral. Mediciones principales: análisis bivariado (McNemar) para datos apareados, comparando la salud autopercibida, autoestima y consumos pre-post intervención. Modelos de regresión de Poisson para las variables resultado, ajustando por variables explicativas. Además, se evaluó la satisfacción con el programa a través de un cuestionario y una discusión grupal. RESULTADOS: la salud autopercibida era elevada antes de la intervención (87,7% hombres y 82,1% mujeres) y se mantuvo tras ella (90,6% y 83,9% respectivamente). Los niveles elevados de autoestima previos a la intervención (92,8% en hombres y 92,9% mujeres) aumentaron tras ella (95,5% y 100% respectivamente), de forma significativa en las mujeres (p < 0,05). El consumo de sustancias no varió tras la intervención. La satisfacción con el programa fue elevada. CONCLUSIÓN: la intervención parece haber mejorado la autoestima en las mujeres, un colectivo con elevado desempleo y normalmente infrarrepresentado en los programas formativos. Esta intervención no incidió en el consumo de sustancias. Los programas de inserción laboral para jóvenes pueden promover factores beneficiosos para la salud mental


OBJECTIVES: To evaluate the effectiveness of a community occupational training intervention for young people at risk of social exclusion on self-perceived health, self-esteem and substance use (alcohol, tobacco and cannabis). To assess participant's satisfaction. METHODS: Design: Quasi-experimental before-after study. Setting: Three low-income neighbourhoods in Barcelona during 2013-2017. Participants: 185 participants with an average age of 21 years and mainly males (65.5%). Intervention: Four-month programme on specific occupational skills and itineraries oriented towards occupational integration. Most important measurements: Bivariate analysis (McNemar test) for paired data to compare self-rated health and self-esteem pre-intervention and post-intervention. Poisson regression models for result variables, adjusting for explanatory variables. In addition, satisfaction with the programme was evaluated by means of a questionnaire and group discussion. RESULTS: Pre-intervention self-rating was good (87.7% men and 82.1% women) and remained good post-intervention (90.6% and 83.9% respectively). Pre-intervention self-esteem was good (92.8% in men and 92.9% in women) and increased after the intervention (95.5% and 100% respectively). This was statistically significant in women (P<0.05). Substance use was unaltered after the intervention. Satisfaction with the programme was high. CONCLUSION: The intervention appears to have improved self-esteem among young women, who are an important group among the unemployed, as they are usually underrepresented in training and professional programmes. Programmes that foster young people moving into working life may also promote factors beneficial to mental health


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Participação da Comunidade , Capacitação Profissional , Populações Vulneráveis/psicologia , Autoimagem , Transtornos Relacionados ao Uso de Substâncias/psicologia , Usuários de Drogas/psicologia
3.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193596

RESUMO

La soledad y el apoyo social deficiente están reconocidos como predictores de morbimortalidad. Cuando una persona mayor vive sola y no recibe soporte familiar ni social para corregir desviaciones en su autocuidado, se produce una sobreutilización de servicios sanitarios y, posiblemente, un aumento de los ingresos hospitalarios. En 2018, el Consell de Salut del Centro de Salud (CS) República Argentina de Valencia realizó un estudio piloto de detección y abordaje de soledad no deseada en las personas del barrio en el que se estableció que un 45% de las personas que vivían solas y eran mayores de 75 años tendrían un posible diagnóstico de aislamiento social. OBJETIVOS: implementar una red comunitaria de voluntariado de acompañamiento-vigilancia en autocuidados para personas mayores con aislamiento social en el área del CS República Argentina, con el soporte del «Programa de acompañamiento en salud constante» (PASC) de la Cruz Roja, en colaboración con el centro de salud, y estudiar la relación entre soledad y salud. MÉTODOS: mediante un diseño escalado de detección y diagnóstico de aislamiento social, con la participación de técnicos de la Cruz Roja, profesionales del centro de salud y la colaboración de voluntariado de acompañamiento a personas mayores participantes. RESULTADOS: en 7 meses 1.200 personas fueron sensibilizadas de forma directa sobre la soledad y 49 voluntarios del barrio desarrollaron labores de acompañamiento y asistencia a talleres formativos y lúdicos. Los profesionales sanitarios analizaron 216 casos: 149 (69%) no se sintieron solos y 67 (31%) fueron diagnosticados de aislamiento social (código correspondiente a V64.01 según CIE-9). Participaron en el proyecto 54 personas (25%). Existe asociación entre la escala de detección de la soledad existencial (EDSOL) y la participación en el proyecto. La sensación de soledad no deseada presenta correlación positiva con problemas de movilidad, cronicidad y una tendencia de asociación con otras variables de salud (consumo elevado de fármacos, percepción negativa de calidad de vida, etc.). CONCLUSIONES: las intervenciones comunitarias promovidas desde el centro de salud sobre personas que viven solas contribuyen al abordaje del aislamiento no deseado y a su vez generan un barrio más solidario


Loneliness and poor social support are widely recognized as predictors of morbidity and mortality. When an elderly person lives alone and does not receive family or social support to correct minor deviations in basic self-care processes, this leads to overuse of health services and possibly, increased hospital admissions. In 2018, the Consell de Salut of the República Argentina Primary Health Centre in Valencia, began a pilot study to detect and tackle unwanted loneliness in people from the neighbourhood, in which it was established that 45% of people aged over 75 years old who lived alone may be diagnosed with social isolation. OBJECTIVES: To establish a community network of accompanying-surveillance volunteers in self-care for socially isolated elderly people in the area of the República Argentina Primary Care Centre with the support of the Red Cross Constant Health Accompaniment Programme. The specific objective is to study the relationship between loneliness and health. METHODS: Using a scaled design for the detection and diagnosis of social isolation, with the participation of the Red Cross technicians, professionals from the health center, and the collaboration of volunteer support for elderly participants. RESULTS: Over seven months a total of 1200 people have been directly made aware about loneliness and 49 volunteers from the neighbourhood performed accompaniment work and attended training and recreational workshops. Health professionals analyzed 216 cases, of which 149 (69%) did not feel alone and the remaining 67 (31%) were diagnosed with social isolation (code V64.01 according to ICD-9). A total of 54 (25%) agreed to take part in the project. An association was observed between the scale for detection of existential loneliness (EDSOL) and participation in the project. The feeling of unwanted loneliness correlates positively with mobility problems, chronicity and a tendency of association with other health variables such as high consumption of drugs and negative perception of quality of life. CONCLUSIONS: Community interventions promoted by the Primary Health Centre on people who live alone contribute to tackling unwanted isolation, which at the same time generates a more supportive neighbourhood


Assuntos
Humanos , Masculino , Feminino , Idoso , Participação da Comunidade/métodos , Redes Comunitárias , Idoso Fragilizado/psicologia , Programas Voluntários , Agências Voluntárias , Solidão , Argentina , Qualidade de Vida
4.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-193597

RESUMO

En 2006 nace una ONG en Boulembou (A 500 km de Dakar), fundada por cooperantes e inmigrantes del pueblo en nuestro país, donde se hicieron estudios para definir el entorno y asambleas y comités para priorizar intervenciones. OBJETIVOS: conocer el funcionamiento de un proyecto comunitario y formar parte de una ONG de codesarrollo, así como obtener y valorar los resultados de sus acciones a medio y largo plazo sobre la población. MÉTODOS: codesarrollo (las personas inmigrantes ayudan en realizar intervenciones en sus países de origen) y salud comunitaria (acciones para mejorar la salud de una comunidad más allá de la individual). RESULTADOS: el pueblo tiene agua potable, huertos, centro de salud (enfermero, comadrona y agentes de salud) y mejoras en la escuela. DISCUSIÓN: el enfoque y las líneas de trabajo realizadas desde un punto de vista comunitario y de codesarrollo han permitido que los proyectos se autogestionen y autofinancien para poder seguir evolucionando y progresando


An NGO was founded in 2006 in Boulembou (located 500 km from Dakar). It was founded by aid workers and immigrants from this town to our country. Studies were performed there to define the setting and to start meetings and committees to prioritize interventions. OBJECTIVES: To ascertain the operation of a community project and be part of a co-development NGO in addition to obtaining and evaluating the impact of its actions on the population in the medium and long term. METHODS: Co-development (immigrants assist with development in countries of origin) and community health (actions targeted at improving community health). RESULTS: The town now has drinking water from fountains, orchards and a healthcare centre (with a nurse, midwife and healthcare agents) in addition to school improvements. DISCUSSION: Projects were implemented from a community and co-development point of view and have facilitated self-management and self-financing to continue evolving and progressing by themselves


Assuntos
Humanos , Masculino , Feminino , Criança , Participação da Comunidade , Organizações , Atenção Primária à Saúde/métodos , Emigrantes e Imigrantes , Cooperação Internacional , Senegal , Saúde Pública , Avaliação de Programas e Projetos de Saúde
5.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192934

RESUMO

INTRODUCCIÓN: ¿cómo seguir trabajando la orientación y participación comunitaria en Atención Primaria durante la pandemia por COVID-19?. OBJETIVOS Y MÉTODOS: observar, describir, reflexionar y documentar aspectos relativos a la atención comunitaria en el momento actual de pandemia por COVID-19 en los equipos de Atención Primaria (EAP) de Aragón. Estudio exploratorio-descriptivo observacional transversal con enfoque cualitativo, con dos fases. 1ª: recopilación de experiencias comunitarias y localización de informantes clave. 2ª: descripción de acciones comunitarias. Análisis descriptivo y tipo DAFO. RESULTADOS: se detectaron 47 iniciativas. Participaron 11 expertas y 54 informantes clave. El 66,6% consideró el rol de los EAP como consultores/colaboradores. El 64,9% de las iniciativas contempló la diversidad. El 49,1% no sabía si valoraron diferencias por género. Destacaron la importancia de lo comunitario para superar la crisis y la cooperación y coordinación con la comunidad e instituciones locales. DISCUSIÓN: protocolos con orientación biomédica, miedo e incertidumbre por la COVID-19 dificultaron el desarrollo de iniciativas comunitarias; frente a esto, fue clave la trayectoria comunitaria previa de los EAP, el trabajo en equipo, con especial relevancia el de las trabajadoras sociales, y su motivación. La participación del EAP como colaborador refuerza la importancia del liderazgo compartido. Son necesarios espacios colaborativos, apoyo institucional y coordinación intersectorial. CONCLUSIÓN: durante la pandemia, las comunidades deben ser parte de la respuesta; la orientación comunitaria de los EAP es clave. Es preciso visibilizar, acompañar y reforzar el trabajo comunitario y estimular la coordinación con Salud Pública


INTRODUCTION: How to continue working on community guidance and participation in Primary Care during the COVID-19 pandemic?. OJECTIVES AND METHODS: To observe, report, reflect and document autonomous community experiences of Aragonese Primary Care Teams (PCT) during the COVID-19 pandemic. A two-phase exploratory-descriptive observational, cross-sectional study with a qualitative approach. Phase 1: compilation of experiences in community health and location of key informants. Phase 2: description of community actions. Descriptive and SWOT analysis. RESULTS: A total of 47 initiatives were detected; 11 experts and 54 key informants took part. A total of 66.6% considered the role of the PCT as consultants or collaborators; 64.9% of initiatives considered diversity. A total of 49.1% did not know whether they evaluated differences by sex. They highlighted the importance of the community to overcome the crisis, and cooperation and coordination with community and local institutions. DISCUSSION: Protocols with biomedical guidance, fear and uncertainty due to COVID-19 hindered development of community initiatives. In light of this, the previous community trajectory of PCTs, teamwork with special relevance of social workers and their motivation were fundamental. PCT involvement as a partner strengthens the importance of shared leadership. Collaborative spaces, institutional support and intersectoral coordination are all necessary. CONCLUSION: During the pandemic, communities must be part of the response; PCT community guidance is essential. Visibility, working alongside and strengthening community work and stimulating public health coordination are all necessary requirements


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Vírus da SARS/patogenicidade , Serviço Social/organização & administração , Assistência ao Paciente/tendências , Serviços de Saúde Comunitária/organização & administração , Participação da Comunidade/tendências , Pandemias/estatística & dados numéricos , Estudos Transversais , Pesquisa sobre Serviços de Saúde/tendências
7.
J UOEH ; 42(3): 231-236, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32879187

RESUMO

To reach the target of ending the dengue epidemic by 2030, all effort shall be made to minimize the dengue transmission across the country through effective, efficient, low-cost and sustainable programs. In Indonesia, the evidence of community empowerment on dengue prevention is insufficient. The objective of this study is to explore the opinion of community and larva monitoring workers (Jumantik cadre) on dengue prevention. A structured free listing interview was conducted in April-May 2019 by targeting two groups: the community and larva workers in one village of Sleman, Yogyakarta. Door to door interviews were done until the quota and saturation were reached. Each group was asked four free listing questions. The analysis was performed in these stages: transcribing, coding, combining by the question, and calculating the salience score. The most salient score about vector control in the larva cadre was not hanging up dirty clothes; in the community it was cleaning the bathtub. Both groups cited themself as the salient motivator in joining the vector control. Protecting the environment and keeping healthy were the reasons for participating in the vector control. The larva cadre stated community refusal as the main challenge. The community cited the importance of larva cadre: to monitor the presence of larva. Community empowerment on dengue vector control has not been effortlessly executed at the bottom level.


Assuntos
Participação da Comunidade , Dengue/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Dengue/epidemiologia , Feminino , Humanos , Indonésia/epidemiologia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
PLoS One ; 15(9): e0238560, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32877453

RESUMO

We illustrate and study the evolution of reported infections over the month of March in New York State as a whole, as well as in each individual county in the state. We identify piecewise exponential trends, and search for correlations between the timing and dynamics of these trends and statewide mandated measures on testing and social distancing. We conclude that the reports on April 1 may be dramatically under-representing the actual number of statewide infections, an idea which is supported by more recent retroactive estimates based on serological studies. A follow-up study is underway, reassessing data until June 1, using additional measures for validation and monitoring for effects of the PAUSE directive, and of the reopening timeline.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Comportamento , Betacoronavirus/isolamento & purificação , Participação da Comunidade , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Surtos de Doenças , Seguimentos , Hospitalização , Humanos , New York/epidemiologia , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/virologia
10.
WHO South East Asia J Public Health ; 9(2): 104-106, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32978341

RESUMO

Sex workers have been one of the marginalized groups that have been particularly affected by India's stringent lockdown in response to the coronavirus disease 2019 (COVID-19) pandemic. The sudden loss of livelihood and lack of access to health care and social protection intensified the vulnerabilities of sex workers, especially those living with HIV. In response, Ashodaya Samithi, an organization of more than 6000 sex workers, launched an innovative programme of assistance in four districts in Karnataka. Since access to antiretroviral therapy (ART) was immediately disrupted, Ashodaya adapted its HIV outreach programme to form an alternative, community-led system of distributing ART at discreet, private sites. WhatsApp messaging was used to distribute information on accessing government social benefits made available in response to the COVID-19 pandemic. Other assistance included advisory messages posted in WhatsApp groups to raise awareness, dispel myths and mitigate violence, and regular, discreet phone check-ins to follow up on the well-being of members. The lessons learnt from these activities represent an important opportunity to consider more sustainable approaches to the health of marginalized populations that can enable community organizations to be better prepared to respond to other public health crises as they emerge.


Assuntos
Participação da Comunidade , Infecções por Coronavirus/epidemiologia , Infecções por HIV/tratamento farmacológico , Pandemias , Pneumonia Viral/epidemiologia , Profissionais do Sexo , Antirretrovirais/uso terapêutico , Infecções por HIV/epidemiologia , Humanos , Índia/epidemiologia
11.
J Frailty Aging ; 9(4): 238-243, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32996561

RESUMO

BACKGROUND: Frailty prevention is one of social prescriptions for an aging society. That requires community level intervention. OBJECTIVES: This study examined frailty checkup supporters' (FCSs') intentions to engage in human-resource development and training activities (i.e., leadership activities) and related factors. DESIGN: Cross-sectional study. SETTING: Three municipalities in suburban area, Eastern Japan. PARTICIPANTS: Forty-five of 59 FCSs completed anonymous self-administered questionnaires. MEASUREMENTS: Questionnaire sought information regarding their sociodemographic data, their perceptions and experiences of FCS activities, and their intentions to participate in human-resource development and training activities. Participants were divided into a high intention (HI) and low intention group (LI). The two groups were compared using quantitative and qualitative data. RESULTS: Eleven FCSs reported intending to engage in leader-related activities. Factors associated with FCSs' intentions were finding FCS activities rewarding and the willingness to continue performing FCS activities. The participants who changed their daily activities (p = .041) and perceptions regarding contributing to the community (p = .018) showed significantly higher intention than LI participants. Free description about the changes in perceptions and lifestyles as a consequence of participating in FCS activities were analyzed qualitatively. FCSs who changed their daily activities and perspectives about contributing to the community described positive changes in both the groups. Meanwhile, FCSs who did not change their daily activities and perspectives about contributing to the community described their reason only in the LI group. CONCLUSIONS: The results might encourage FCSs to participate in training and guidance activities, as they have positive experiences and receive recognition obtained through participation in such activities.


Assuntos
Participação da Comunidade/psicologia , Fragilidade/prevenção & controle , Intenção , Cidades , Estudos Transversais , Humanos , Japão , Inquéritos e Questionários
12.
Child Adolesc Ment Health ; 25(3): 187-188, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32791558

RESUMO

The COVID-19 pandemic is having a pervasive effect on young people's mental health and well-being, giving rise to feelings of deep uncertainty and lack of control. Inspired by Amartya Sen's capabilities framework, we argue that building capacity and creating opportunities for community and civic engagement during this time will help young people gain agency and well-being. We highlight two key areas for participatory engagement: coproduction of research, and peer-led interventions. Providing capabilities for young people's agency not only builds personal resilience, but also strengthens the quality of our research, interventions and overall response to the global health crisis.


Assuntos
Infecções por Coronavirus , Saúde Mental , Pandemias , Pneumonia Viral , Psicologia do Adolescente , Resiliência Psicológica , Incerteza , Adolescente , Betacoronavirus , Criança , Participação da Comunidade , Humanos , Psicologia da Criança
13.
Cad Saude Publica ; 36(8): e00151620, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32756764

RESUMO

This essay aims to discuss the foundations and possibilities for community participation in the fight against COVID-19. The first part discusses the meanings of community, defined according to geographic, aggregate-interest, or epidemiological criteria. In the context of the pandemic, none of the three perspectives can be considered alone. The essay discusses the need to link different approaches in order to produce socially contextualized health interventions. Next, the authors present the four main models in the international literature that provide the basis for community participation practices in various countries. The analysis of community participation in the context of COVID-19 uses conceptual systematization based on two meta-narratives: utilitarian and social justice. The utilitarian perspective involves measures to restrict social contact. Participation is thus understood as collaboration in implementing measures that contribute to controlling the problem. The social justice perspective especially addresses the social determinants of health and reduction in social inequalities. The approach focuses on community empowerment and the search for solutions to the social and economic problems that determine the spread of COVID-19 and other diseases. The essay concludes on the peculiarities and importance of each approach. Community participation in the fight against COVID-19 should consider the emergency contexts to strengthen the health system and the defense of the social protection system and democracy.


Assuntos
Participação da Comunidade , Infecções por Coronavirus , Teoria Ética , Pandemias , Pneumonia Viral , Justiça Social , Betacoronavirus , Brasil , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
14.
PLoS One ; 15(8): e0237519, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810162

RESUMO

INTRODUCTION: Microfinance is a widely promoted developmental initiative to provide poor women with affordable financial services for poverty alleviation. One popular adaption in South Asia is the Self-Help Group (SHG) model that India adopted in 2011 as part of a federal poverty alleviation program and as a secondary approach of integrating health literacy services for rural women. However, the evidence is limited on who joins and continues in SHG programs. This paper examines the determinants of membership and staying members (outcomes) in an integrated microfinance and health literacy program from one of India's poorest and most populated states, Uttar Pradesh across a range of explanatory variables related to economic, socio-demographic and area-level characteristics. METHOD: Using secondary survey data from the Uttar Pradesh Community Mobilization project comprising of 15,300 women from SHGs and Non-SHG households in rural India, we performed multivariate logistic and hurdle negative binomial regression analyses to model SHG membership and duration. RESULTS: While in general poor women are more likely to be SHG members based on an income threshold limit (government-sponsored BPL cards), women from poorest households are more likely to become members, but less likely to stay members, when further classified using asset-based wealth quintiles. Additionally, poorer households compared to the marginally poor are less likely to become SHG members when borrowing for any reason, including health reasons. Only women from moderately poor households are more likely to continue as members if borrowing for health and non-income-generating reasons. The study found that an increasing number of previous pregnancies is associated with a higher membership likelihood in contrast to another study from India reporting a negative association. CONCLUSION: The study supports the view that microfinance programs need to examine their inclusion and retention strategies in favour of poorest household using multidimensional indicators that can capture poverty in its myriad forms.


Assuntos
Participação da Comunidade/estatística & dados numéricos , Organização do Financiamento/estatística & dados numéricos , Acesso aos Serviços de Saúde , Serviços de Saúde Materno-Infantil , Grupos de Autoajuda/organização & administração , Adolescente , Adulto , Características da Família , Feminino , Organização do Financiamento/organização & administração , Letramento em Saúde/economia , Letramento em Saúde/organização & administração , Promoção da Saúde , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Índia/epidemiologia , Recém-Nascido , Serviços de Saúde Materno-Infantil/economia , Serviços de Saúde Materno-Infantil/organização & administração , Serviços de Saúde Materno-Infantil/provisão & distribução , Pessoa de Meia-Idade , Pobreza/economia , Pobreza/estatística & dados numéricos , Gravidez , População Rural/estatística & dados numéricos , Grupos de Autoajuda/estatística & dados numéricos , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
15.
PLoS Negl Trop Dis ; 14(8): e0008428, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32853197

RESUMO

Vector-borne diseases are a major cause of morbidity and mortality worldwide. Aedes-borne diseases, in particular, including dengue, chikungunya, yellow fever, and Zika, are increasing at an alarming rate due to urbanisation, population movement, weak vector control programmes, and climate change. The World Health Organization calls for strengthening of vector control programmes in line with the Global Vector Control Response (GVCR) strategy, and many vector control programmes are transitioning to this new approach. The Singapore dengue control programme, situated within the country's larger vision of a clean, green, and sustainable environment for the health and well-being of its citizens, provides an excellent example of the GVCR approach in action. Since establishing vector control operations in the 1960s, the Singapore dengue control programme succeeded in reducing the dengue force of infection 10-fold by the 1990s and has maintained it at low levels ever since. Key to this success is consideration of dengue as an environmental disease, with a strong focus on source reduction and other environmental management methods as the dominant vector control strategy. The programme collaborates closely with other government ministries, as well as town councils, communities, the private sector, and academic and research institutions. Community engagement programmes encourage source reduction, and house-to-house inspections accompanied by a strong legislative framework with monetary penalties help to support compliance. Strong vector and epidemiological surveillance means that routine control activities can be heightened to specifically target dengue clusters. Despite its success, the programme continues to innovate to tackle challenges such as climate change, low herd immunity, and manpower constraints. Initiatives include development of novel vector controls such as Wolbachia-infected males and spatiotemporal models for dengue risk assessment. Lessons learnt from the Singapore programme can be applied to other settings, even those less well-resourced than Singapore, for more effective vector control.


Assuntos
Dengue/prevenção & controle , Controle de Mosquitos/métodos , Controle de Mosquitos/organização & administração , Aedes/virologia , Animais , Participação da Comunidade , Dengue/epidemiologia , Humanos , Mosquitos Vetores/virologia , Singapura/epidemiologia
16.
Cochrane Database Syst Rev ; 8: CD011504, 2020 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-32761615

RESUMO

BACKGROUND: After decades of decline since 2005, the global prevalence of undernourishment reverted and since 2015 has increased to levels seen in 2010 to 2011. The prevalence is highest in low- and middle-income countries (LMICs), especially Africa and Asia. Food insecurity and associated undernutrition detrimentally affect health and socioeconomic development in the short and long term, for individuals, including children, and societies. Physical and economic access to food is crucial to ensure food security. Community-level interventions could be important to increase access to food in LMICs. OBJECTIVES: To determine the effects of community-level interventions that aim to improve access to nutritious food in LMICs, for both the whole community and for disadvantaged or at-risk individuals or groups within a community, such as infants, children and women; elderly, poor or unemployed people; or minority groups. SEARCH METHODS: We searched for relevant studies in 16 electronic databases, including trial registries, from 1980 to September 2019, and updated the searches in six key databases in February 2020. We applied no language or publication status limits. SELECTION CRITERIA: We included randomised controlled trials (RCTs), cluster randomised controlled trials (cRCTs) and prospective controlled studies (PCS). All population groups, adults and children, living in communities in LMICs exposed to community-level interventions aiming to improve food access were eligible for inclusion. We excluded studies that only included participants with specific diseases or conditions (e.g. severely malnourished children). Eligible interventions were broadly categorised into those that improved buying power (e.g. create income-generation opportunities, cash transfer schemes); addressed food prices (e.g. vouchers and subsidies); addressed infrastructure and transport that affected physical access to food outlets; addressed the social environment and provided social support (e.g. social support from family, neighbours or government). DATA COLLECTION AND ANALYSIS: Two authors independently screened titles and abstracts, and full texts of potentially eligible records, against the inclusion criteria. Disagreements were resolved through discussion or arbitration by a third author, if necessary. For each included study, two authors independently extracted data and a third author arbitrated disagreements. However, the outcome data were extracted by one author and checked by a biostatistician. We assessed risk of bias for all studies using the Effective Practice and Organization of Care (EPOC) risk of bias tool for studies with a separate control group. We conducted meta-analyses if there was a minimum of two studies for interventions within the same category, reporting the same outcome measure and these were sufficiently homogeneous. Where we were able to meta-analyse, we used the random-effects model to incorporate any existing heterogeneity. Where we were unable to conduct meta-analyses, we synthesised using vote counting based on effect direction. MAIN RESULTS: We included 59 studies, including 214 to 169,485 participants, and 300 to 124, 644 households, mostly from Africa and Latin America, addressing the following six intervention types (three studies assessed two different types of interventions). Interventions that improved buying power: Unconditional cash transfers (UCTs) (16 cRCTs, two RCTs, three PCSs): we found high-certainty evidence that UCTs improve food security and make little or no difference to cognitive function and development and low-certainty evidence that UCTs may increase dietary diversity and may reduce stunting. The evidence was very uncertain about the effects of UCTs on the proportion of household expenditure on food, and on wasting. Regarding adverse outcomes, evidence from one trial indicates that UCTs reduce the proportion of infants who are overweight. Conditional cash transfers (CCTs) (nine cRCTs, five PCSs): we found high-certainty evidence that CCTs result in little to no difference in the proportion of household expenditure on food and that they slightly improve cognitive function in children; moderate-certainty evidence that CCTs probably slightly improve dietary diversity and low-certainty evidence that they may make little to no difference to stunting or wasting. Evidence on adverse outcomes (two PCSs) shows that CCTs make no difference to the proportion of overweight children. Income generation interventions (six cRCTs, 11 PCSs): we found moderate-certainty evidence that income generation interventions probably make little or no difference to stunting or wasting; and low-certainty evidence that they may result in little to no difference to food security or that they may improve dietary diversity in children, but not for households. Interventions that addressed food prices: Food vouchers (three cRCTs, one RCT): we found moderate-certainty evidence that food vouchers probably reduce stunting; and low-certainty evidence that that they may improve dietary diversity slightly, and may result in little to no difference in wasting. Food and nutrition subsidies (one cRCT, three PCSs): we found low-certainty evidence that food and nutrition subsidies may improve dietary diversity among school children. The evidence is very uncertain about the effects on household expenditure on healthy foods as a proportion of total expenditure on food (very low-certainty evidence). Interventions that addressed the social environment: Social support interventions (one cRCT, one PCS): we found moderate-certainty evidence that community grants probably make little or no difference to wasting; low-certainty evidence that they may make little or no difference to stunting. The evidence is very uncertain about the effects of village savings and loans on food security and dietary diversity. None of the included studies addressed the intervention category of infrastructure changes. In addition, none of the studies reported on one of the primary outcomes of this review, namely prevalence of undernourishment. AUTHORS' CONCLUSIONS: The body of evidence indicates that UCTs can improve food security. Income generation interventions do not seem to make a difference for food security, but the evidence is unclear for the other interventions. CCTs, UCTs, interventions that help generate income, interventions that help minimise impact of food prices through food vouchers and subsidies can potentially improve dietary diversity. UCTs and food vouchers may have a potential impact on reducing stunting, but CCTs, income generation interventions or social environment interventions do not seem to make a difference on wasting or stunting. CCTs seem to positively impact cognitive function and development, but not UCTs, which may be due to school attendance, healthcare visits and other conditionalities associated with CCTs.


Assuntos
Participação da Comunidade/economia , Países em Desenvolvimento , Assistência Alimentar/economia , Abastecimento de Alimentos/economia , Renda , Desnutrição/prevenção & controle , Adulto , Criança , Cognição , Participação da Comunidade/métodos , Dieta , Abastecimento de Alimentos/métodos , Transtornos do Crescimento/prevenção & controle , Humanos , Desnutrição/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Apoio Social , Síndrome de Emaciação/prevenção & controle
17.
PLoS One ; 15(8): e0237166, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745148

RESUMO

This study aims to clarify the factors associated with the gradual withdrawal from society in older adults. We defined the stages of follow-up difficulty based on four follow-up surveys on non-respondents of longitudinal mail surveys in community-dwelling older adults to examine the main factors associated with the stages of follow-up difficulty. We conducted a follow-up mail survey (FL1) with respondents of a baseline survey, and three more follow-up surveys with the non-respondents of each previous survey: simplified mail (FL2), postcard (FL3), and home visit surveys (FL4). The respondents of each follow-up survey were defined as a stage of follow-up difficulty; their characteristics concerning social participation and interaction at baseline in each stage were analyzed. The number of respondents in the FL1, FL2, FL3, and FL4 stages and non-respondents (NR) were as follows: 2,361; 462; 234; 84; and 101, respectively. Participation in hobby groups in FL2 and FL3, sports groups in FL4, and neighborhood association and social isolation in NR were significantly associated with the stage of follow-up difficulty. Based on these results, we conclude that the following factors are associated with each stage of follow-up difficulty: 1) a decline in instrumental activities of daily living in the FL2 and FL3 stages, 2) dislike for participating in physical activity such as sports in the FL4 stage, and 3) social isolation, not even belonging to a neighborhood association due to low social interaction in the NR group.


Assuntos
Atividades Cotidianas , Envelhecimento/psicologia , Vida Independente/estatística & dados numéricos , Perda de Seguimento , Comportamento Social , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Participação da Comunidade , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Inquéritos e Questionários/estatística & dados numéricos
18.
PLoS One ; 15(8): e0237320, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32780775

RESUMO

Ghana Health Service (GHS) has strengthened community-based surveillance (CBS) to facilitate early detection and rapid reporting of health events of all origins. Since June 2017, GHS has employed an event-based surveillance approach at the community level in a phased manner. CBS coverage has broadened from 2 to 30 districts across Ghana. Through this effort, capacity was built across all administrative levels in these districts to detect, report, triage, and verify signals, and to perform risk assessment and investigate events. Data were collected and analyzed during an evaluation of initial 2-district implementation in March 2018 and during expanded 30-district implementation in March 2019. Between September 2018 and March 2019, 317 health events were detected through CBS. These events included vaccine-preventable disease cases, acute hemorrhagic conjunctivitis outbreaks, clusters of unexpected animal deaths, and foodborne illness clusters. Eighty-nine percent of the 317 events were reported to district-level public health staff within 24 hours of detection at the community level, and 87% of all detected events were responded to within 48 hours of detection. CBS detected 26% of all suspected vaccine-preventable disease cases that were reported from implementing districts through routine disease surveillance. GHS strengthened CBS in Ghana to function as an early warning system for health events of all origins, advancing the Global Health Security Agenda.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Participação da Comunidade , Saúde Global , Implementação de Plano de Saúde/organização & administração , Programas Nacionais de Saúde/organização & administração , Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/epidemiologia , Conjuntivite Hemorrágica Aguda/epidemiologia , Conjuntivite Hemorrágica Aguda/prevenção & controle , Surtos de Doenças/prevenção & controle , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/prevenção & controle , Gana , Humanos , Governo Local , Medição de Risco/métodos
19.
PLoS One ; 15(8): e0237327, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32797074

RESUMO

INTRODUCTION: In order to foster dental and dental hygiene practices that are inclusive, sensitive to diversity, equitable, and without prejudice, a call to broadly teach cultural diversity within dental and dental hygiene education has been made. The research question of this study was "to what extent can an interactive and open dialogue about substance use, queer health, and social responsibility foster transformative learning?" METHODS: A collaborative and interdisciplinary project engaged the community as a teacher over the Summer and Fall of 2019 to address issues of substance use, queer health, and social responsibility and was delivered to 55 first-year undergraduate dental and 23 third-year dental hygiene students over three educational sessions. Dental and dental hygiene students were asked to reflect, in writing, on each session using between 200 and 400 words. Textual information from students' self-reflections and from the community's feedback were analyzed thematically for content (e.g., codes and themes). RESULTS: In total, 128 written reflections-for an average of 42 reflections per session-were gathered and analyzed interactively by the authors. Three major themes emerged: feeling privileged, breaking stereotypes, and coalescing learning. Feedback from the participating community members highlighted changes to be implemented in these sessions in the future, including more opportunities for small group activities in class. CONCLUSIONS: The three major themes that emerged from the thematic analysis of the self-reflections and community member feedback (feeling privileged, breaking stereotypes, and coalescing leaning) further highlighted the impact of community-driven curricula on students' learning in regard to substance use, queer health, and social responsibility. Further work is critical to understand the impact of such a pedagogy on students' practices once they leave their undergraduate programs.


Assuntos
Participação da Comunidade , Educação em Odontologia/métodos , Práticas Interdisciplinares , Higiene Bucal/psicologia , Canadá , Currículo , Humanos , Aprendizagem , Educação de Pacientes como Assunto , Minorias Sexuais e de Gênero/psicologia , Responsabilidade Social , Estudantes de Odontologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
20.
Artigo em Inglês | PAHO-IRIS | ID: phr-52534

RESUMO

[ABSTRACT]. Community engagement is crucial for public health initiatives, yet it remains an under-studied process within national disease elimination programs. This report shares key lessons learned for community engagement practices during a malaria outbreak response in the Los Tres Brazos neighborhood of urban Santo Domingo, Dominican Republic from 2015-2016. In this two-year period, 233 cases of malaria were reported—more than seven times the number of cases (31) reported in the previous two years. The initial outbreak response by the national malaria program emphasized “top-down” interventions such as active surveillance, vector control, and educative talks within the community. Despite a transient reduction in reported cases in mid-2015, transmission resurged at the end of 2015. The program responded by introducing active roles for trained community members that included door-to-door fever screening, testing with rapid diagnostic tests and treatment. Malaria cases declined significantly throughout 2016 and community-based active surveillance infrastructure helped to detect and limit a small episode of transmission in 2017. Results from qualitative research among community members revealed two key factors that facilitated their cooperation with community-based surveillance activities: motivation to help one’s community; and trust among stakeholders (community health workers, their neighbors and other key figures in the community, and malaria program staff and leadership). This experience suggests that community-led interventions and the program’s willingness to learn and adapt under changing circumstances can help control malaria transmission and pave the way for elimination.


[RESUMEN]. La participación de la comunidad es crucial para las iniciativas de salud pública, pero sigue siendo un proceso poco estudiado dentro de los programas nacionales de eliminación de enfermedades. En este informe se presentan las principales lecciones aprendidas respecto de las prácticas de participación comunitaria durante la respuesta al brote de malaria en el barrio Los Tres Brazos de la zona urbana de Santo Domingo, República Dominicana, de 2015 a 2016. En este período de dos años se notificaron 233 casos de malaria, más de siete veces el número de casos (31) notificados en los dos años anteriores. La respuesta inicial al brote por parte del programa nacional de malaria hizo hincapié en intervenciones "de arriba abajo" como la vigilancia activa, el control de vectores y las charlas educativas dentro de la comunidad. A pesar de la reducción transitoria de los casos notificados hacia mediados de 2015, la transmisión resurgió a finales de ese año. El programa respondió introduciendo funciones activas para miembros de la comunidad capacitados que incluían la detección de fiebre de casa en casa, pruebas de diagnóstico rápido y tratamiento. Los casos de malaria disminuyeron significativamente durante 2016 y la infraestructura de vigilancia activa basada en la comunidad ayudó a detectar y contener un episodio pequeño de transmisión en 2017. Los resultados de la investigación cualitativa entre los miembros de la comunidad revelaron dos factores clave que facilitaron su cooperación con las actividades de vigilancia basadas en la comunidad: la motivación para ayudar a la propia comunidad y la confianza entre las partes interesadas (los trabajadores sanitarios de la comunidad, los vecinos y otros actores clave de la comunidad, y el personal y la dirección del programa de lucha contra la malaria). Esta experiencia indica que las intervenciones dirigidas por la comunidad y la voluntad del programa de aprender y adaptarse a las circunstancias cambiantes pueden ayudar a controlar la transmisión de la malaria y facilitar el camino para su eliminación.


Assuntos
Malária , Relações Comunidade-Instituição , Participação da Comunidade , Erradicação de Doenças , República Dominicana , Relações Comunidade-Instituição , Participação da Comunidade , Erradicação de Doenças , República Dominicana
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