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2.
J Environ Manage ; 278(Pt 2): 111508, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33129026

RESUMO

Responding to accelerating climate change impacts requires broad and effective engagement with stakeholders, at multiple geographic and governance levels. Stakeholder participation has been hailed as a facilitated approach in climate change adaptation that supports social learning, depolarization of perceptions, and fosters collective action. But stakeholder participation remains loosely interpreted and evaluating measures are limited. This study employs social network analysis (SNA) to investigate how social relations among stakeholders, which emerge as a result of participation, are associated with stakeholder learning, as changes in perceptions of climate change. We hypothesized that reciprocal ties of understanding, respect, and influence can predict changes in perceptions of climate change. This approach was applied to a case study in Deal Island Peninsula, Maryland (USA) where local residents, scientists, and government officials met from 2016 to 2018 to collaboratively manage the impacts of sea-level rise in their communities. We found that social relations based on mutual understanding, respect,and influence are positively associated with perceptions of climate change. We provide a detailed conceptualization and implementation of a network-based approach that may serve as a potential quantitative performance measure of stakeholder participation processes in climate change adaptation. Overall, this study provides empirical evidence of the role that emerging social relations have on enhancing or constraining social learning among stakeholders in the Deal Island Peninsula project.


Assuntos
Aclimatação , Mudança Climática , Ilhas , Maryland , Participação dos Interessados
3.
Artigo em Inglês | MEDLINE | ID: mdl-33357173

RESUMO

Background: Public health surveillance is crucial for supporting a rapid and effective response to public health emergencies. In response to the coronavirus disease (COVID-19) pandemic, an enhanced surveillance system of hospitalised COVID-19 patients was established by the Victorian Department of Health and Human Services (DHHS) and the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre. The system aimed to reduce workforce capacity constraints and increase situational awareness on the status of hospitalised patients. Methods: The system was evaluated, using guidelines from the United States Centers for Disease Control and Prevention, against eight attributes: acceptability; data quality; flexibility; representativeness; simplicity; stability; timeliness; and usefulness. Evidence was generated from stakeholder consultation, participant observation, document review, systems review, issues log review and audits. Data were collected and analysed over a period of up to three months, covering pre- and post-implementation from March to June 2020. Results: This system was rapidly established by leveraging established relationships and infrastructure. Stakeholders agreed that the system was important but was limited by a reliance on daily manual labour (including weekends), which impeded scalability. The ability of the system to perform well in each attribute was expected to shift with the severity of the pandemic; however, at the time of this evaluation, when there were an average 23 new cases per day (0.3 cases per 100,000 population per day), the system performed well. Conclusion: This enhanced surveillance system was useful and achieved its key DHHS objectives during the COVID-19 public health emergency in Victoria. Recommendations for improvement were made to the current and future systems, including the need to plan alternatives to improve the system's scalability and to maintain stakeholder acceptability.


Assuntos
/epidemiologia , Hospitalização/estatística & dados numéricos , Vigilância da População/métodos , Saúde Pública/métodos , /diagnóstico , Confiabilidade dos Dados , Humanos , Avaliação de Programas e Projetos de Saúde , Saúde Pública/normas , Administração em Saúde Pública , Participação dos Interessados , Fatores de Tempo , Vitória/epidemiologia
4.
Semin Perinatol ; 44(7): 151288, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33317710

RESUMO

The rapid rise of novel coronavirus disease 2019 (COVID-19) cases led the American Society for Reproductive Medicine (ASRM) to recommend immediate cessation of all new fertility treatment cycles on March 17, 2020. Controversial from the start, providers and patients expressed their opposition through online petitions, surveys, and other forums. While the impact of a delay in access to reproductive care is unknown, previous studies are reassuring that a delay in the timespan of months may not affect clinical outcomes. However, dropout from care during this pandemic remains a serious concern. Effective therapies against the virus and a vaccine are not on the immediate horizon. Accepting COVID-19 will likely be a part of our lives for the near future necessitates the modification of fertility protocols to keep patients, providers, and staff as safe as possible. We believe fertility treatment is an urgent, essential service that can be performed safely and responsibly during this pandemic.


Assuntos
Assistência à Saúde , Infertilidade/terapia , Guias de Prática Clínica como Assunto , Técnicas de Reprodução Assistida , Tempo para o Tratamento , Feminino , Humanos , Controle de Infecções , Infertilidade/diagnóstico , Participação dos Interessados , Estados Unidos
5.
Pan Afr Med J ; 35(Suppl 2): 146, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193961

RESUMO

Prevention of exposure to the COVID-19 virus in the general population is an essential strategy to slow community transmission. This paper shares the experiences and challenges of community engagement in COVID-19 prevention in the Kilimanjaro region, Northern Tanzania implemented by our team from the Institute of Public Health (IPH), Kilimanjaro Christian Medical University College (KCMUCo) in collaboration with the COVID-19 response team in the Moshi Municipality. We conducted an education session with the COVID-19 response team and together brainstormed transmission hotspots and which interventions would be most feasible in their settings. The first hotspot identified was crowded local market spaces. Suggested interventions included targeted and mass public health education through the engagement of market opinion leaders, public announcements, and radio shows. We conducted participatory rural appraisal techniques to enable market vendors and clients to visualize two-meter distances and provided a prototype hand-washing facility that was foot operated. We found mass public health educational campaigns essential to inform and update the public about COVID-19 pandemic and to address rumors and misinformation, which hampers compliance with public health interventions. Coordinated efforts among stakeholders in the country are necessary to develop context-specific prevention and case management strategies following the national and international guidelines. Local ownership of recommended interventions is necessary to ensure compliance.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis/organização & administração , Participação da Comunidade , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Desinfecção das Mãos/instrumentação , Educação em Saúde/métodos , Educação em Saúde/organização & administração , Humanos , Colaboração Intersetorial , Liderança , Meios de Comunicação de Massa , Aplicativos Móveis , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Instalações Privadas , Saúde Pública , População Rural , Participação dos Interessados , Tanzânia/epidemiologia
6.
PLoS One ; 15(10): e0239985, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33045009

RESUMO

BACKGROUND: As part of a five year plan (2019-2023), the Informed Health Choices Project, is developing and evaluating resources for helping secondary school students learn to think critically about health claims and choices. We will bring together key stakeholders; such as secondary school teachers and students, our main target for the IHC secondary school resources, school administrators, policy makers, curriculum development specialists and parents, to enable us gain insight about the context. OBJECTIVES: To ensure that stakeholders are effectively and appropriately engaged in the design, evaluation and dissemination of the learning resources.To evaluate the extent to which stakeholders were successfully engaged. METHODS: Using a multi-stage stratified sampling method, we will identify a representative sample of secondary schools with varied characteristics that might modify the effects of the learning resources such as, the school location (rural, semi-urban or urban), ownership (private, public) and ICT facilities (under resourced, highly resourced). A sample of schools will be randomly selected from the schools in each stratum. We will aim to recruit a diverse sample of students and secondary school teachers from those schools. Other stakeholders will be purposively selected to ensure a diverse range of experience and expertise. RESULTS: Together with the teacher and student networks and the advisory panels, we will establish measurable success criteria that reflect the objectives of engaging stakeholders at the start of the project and evaluate the extent to which those criteria were met at the end of the project. CONCLUSION: We aim for an increase in research uptake, improve quality and appropriateness of research results, accountability and social justice.


Assuntos
Participação dos Interessados/psicologia , Estudantes/psicologia , Comportamento de Escolha , Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde , Humanos , Projetos de Pesquisa , Professores Escolares/psicologia , Instituições Acadêmicas
7.
PLoS One ; 15(10): e0239897, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33045018

RESUMO

Violence-free family ties, non-violent peers or attachment to society have been pointed out as protective factors against different types of extremism and violent radicalization by international literature. However, more detail needs to be provided about which specific aspects within these realms (friendship/family/community) are effective in challenging violence and how they operate in practice. Recent research conducted under the framework of the PROTON project (Horizon 2020) has analyzed the social and ethical impacts of counter-terrorism and organized crime policies in six European countries. In this article we discuss some identified common features among practices that, developed by organized actors operating at the local level (e.g.: grassroots-based associations, educational institutions, other type of organized networks for prevention, NGOs), are contributing to preventing youth violent radicalization, a phenomenon of growing concern in Europe and beyond. Standing on a solid rejection to violence, these shared features are the following: a bottom-up approach in setting allies with key stakeholders from the community or/and family members to intervene; the promotion of trustworthy and healthy friendship relationships; debunking the lure surrounding violent subjects ("false heroes") and violence in the different contexts, especially in the socioeducational one.


Assuntos
Controles Informais da Sociedade/métodos , Meio Social , Participação dos Interessados , Violência/prevenção & controle , Adolescente , Europa (Continente) , Feminino , Humanos , Masculino , Violência/psicologia , Adulto Jovem
8.
Cardiovasc J Afr ; 31(2): 103-110, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33094797

RESUMO

Data collected by PASCAR for the World Heart Federation's Cardiovascular Diseases Scorecard project in Africa are presented. We summarise the strengths, threats, weaknesses and priorities identified from the collected data, which need to be considered in conjunction with the associated sections in the accompanying infographic. Data sets that were used include open-source data from the World Bank, World Health Organization and government publications.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Serviços Preventivos de Saúde/organização & administração , Adolescente , Adulto , Idoso , Camarões/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Comorbidade , Prestação Integrada de Cuidados de Saúde/organização & administração , Feminino , Acesso aos Serviços de Saúde/organização & administração , Nível de Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Formulação de Políticas , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Determinantes Sociais da Saúde , Participação dos Interessados , Adulto Jovem
9.
J Glob Health ; 10(2): 020103, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33110502

RESUMO

The COVID-19 pandemic has put health systems, economies and societies under unprecedented strain, calling for innovative approaches. Scotland's government, like those elsewhere, is facing difficult decisions about how to deploy digital technologies and data to help contain, control and manage the disease, while also respecting citizens' rights. This paper explores the ethical challenges presented by these methods, with particular emphasis on mobile apps associated with contact tracing. Drawing on UK and international experiences, it examines issues such as public trust, data privacy and technology design; how changing disease threats and contextual factors can affect the balance between public benefits and risks; and the importance of transparency, accountability and stakeholder participation for the trustworthiness and good-governance of digital systems and strategies. Analysis of recent technology debates, controversial programmes and emerging outcomes in comparable countries implementing contact tracing apps, reveals sociotechnical complexities and unexpected paradoxes that warrant further study and underlines the need for holistic, inclusive and adaptive strategies. The paper also considers the potential role of these apps as Scotland transitions to the 'new normal', outlines challenges and opportunities for public engagement, and poses a set of ethical questions to inform decision-making at multiple levels, from software design to institutional governance.


Assuntos
Busca de Comunicante/ética , Transmissão de Doença Infecciosa/ética , Direitos Humanos/ética , Aplicativos Móveis/ética , Pandemias/ética , Betacoronavirus , Busca de Comunicante/métodos , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Governo , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Escócia/epidemiologia , Participação dos Interessados , Tecnologia/ética
10.
Artigo em Inglês | PAHO-IRIS | ID: phr-52937

RESUMO

[ABSTRACT]. Objective. To identify how countries have positioned themselves to fight against all forms of malnutrition. Methods. Qualitative, exploratory, and descriptive study of the statements of 91 out of the 127 (71.7%) countries that issued declarations in the Second International Conference on Nutrition. Results. According to the analysis of the official statements from the Conference, countries still responded to nutrition issues in a traditional way. Food systems were part of the narrative and mentioned as part of the problem and solution, but little thought was given to their determinants. Conclusions. The Decade of Action on Nutrition is spurred on by the urgent need to coordinate global endeavors in the fight against malnutrition and could aggregate efforts in prioritizing actions to address the determinants rather than the biological outcomes of malnutrition–which requires commitments–; and strengthening the countries’ ability to implement robust regulatory measures. These measures could be empowered through efforts across different levels, making use of multilateral spaces, and through strengthening civil society participation, including developing better mechanisms for the recognition and control of conflicts of interest across different political spaces.


[RESUMEN]. Objetivo. Identificar la posición de los países para luchar contra todas las formas de malnutrición. Métodos. Estudio cualitativo, exploratorio y descriptivo de las declaraciones de 91 de los 127 (71,7%) países que emitieron declaraciones en la Segunda Conferencia Internacional sobre Nutrición. Resultados. Según el análisis de las declaraciones oficiales en la Conferencia, los países siguieron respondiendo a problemas relacionados con la nutrición de manera tradicional. Se mencionaron los sistemas alimentarios como parte del problema y la solución, pero se prestaba poca atención a sus determinantes. Conclusiones. El Decenio de Acción sobre la Nutrición se ve impulsado por la urgente necesidad de coordinar los esfuerzos mundiales en la lucha contra la malnutrición y podría aunar los esfuerzos dirigidos a priorizar las acciones para abordar los determinantes de la malnutrición en lugar de sus resultados biológicos –lo que requiere compromisos–; y a fortalecer la capacidad de los países para aplicar medidas regulatorias sólidas. Esas medidas podrían potenciarse mediante esfuerzos a distintos niveles, aprovechando los entornos multilaterales, y mediante el fortalecimiento de la participación de la sociedad civil, incluida la elaboración de mejores mecanismos para el reconocimiento y el control de los conflictos de intereses en distintos espacios políticos.


Assuntos
Segurança Alimentar e Nutricional , Política Nutricional , Desnutrição , Participação dos Interessados , Segurança Alimentar e Nutricional , Política Nutricional , Desnutrição , Participação dos Interessados
11.
J Environ Qual ; 49(3): 603-612, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-33016399

RESUMO

There is growing recognition of the importance of involving stakeholders in solution-oriented multidisciplinary environmental research projects. Management of nutrients to address water pollution is a wicked problem requiring multidisciplinary research and participation of stakeholders. Here, we frame participatory research as shared discovery, a deliberative, focused engagement process that serves as a directional guide for how research unfolds during the entire span of a project. We explore its application within a 5-yr, multidisciplinary research project seeking innovative solutions to nutrient management challenges in four agriculturally influenced small watersheds in the Chesapeake Bay basin. This process involved deliberate development of a stakeholder engagement strategy and structure, which included a specific research team dedicated to implementing shared discovery throughout. Recognizing that stakeholders involved in nutrient and watershed management engage at multiple scales, we developed a biscalar approach to engage stakeholders at both a regional or state policy level and within the local study watersheds. Early collaboration allowed stakeholders to be participatory in developing research questions and shaping research design, which made research results more applicable to the identified problems. The biscalar framework for engagement was a novel approach that allowed researchers to incorporate both broader policy concepts into research and local concerns and concepts specific to the small study watersheds, allowing solutions to be tailored to local needs. Although infusing research with stakeholder engagement and input from the outset is a time-consuming process, it bolsters research design and products and leads to greater application of research to solve nutrient pollution-a wicked problem indeed.


Assuntos
Pessoal Administrativo , Participação dos Interessados , Humanos , Nutrientes , Poluição da Água/prevenção & controle
12.
PLoS One ; 15(9): e0238574, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32877447

RESUMO

Large-scale marine protected areas (LSMPAs), MPAs greater than 100,000km2, have proliferated in the past decade. However, the value of LSMPAs as conservation tools is debated, in both global scientific and policy venues as well as in particular sites. To add nuance and more diverse voices to this debate, this research examines the perspectives of stakeholders directly engaged with LSMPAs. We conducted a Q Method study with forty LSMPA stakeholders at five sites, including three established LSMPAs (the Marianas Trench Marine National Monument, United States; the Phoenix Islands Protected Area, Kiribati; the National Marine Sanctuary, Palau) and two sites where LSMPAs had been proposed at the time of research (Bermuda and Rapa Nui (Easter Island), Chile). The analysis reveals five distinct viewpoints of LSMPAs. These include three more optimistic views of LSMPAs we have named Enthusiast, Purist, and Relativist. It also depicts two more cautious views of LSMPAs, which we have named Critic and Skeptic. The findings demonstrate the multi-dimensionality of stakeholder viewpoints on LSMPAs. These shared viewpoints have implications for the global LSMPA debate and LSMPA decision-makers, including highlighting the need to focus on LSMPA consultation processes. Better understanding of these viewpoints, including stakeholder beliefs, perspectives, values and concerns, may help to facilitate more nuanced dialogue amongst LSMPA stakeholders and, in turn, promote better governance of LSMPAs.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Participação dos Interessados
13.
PLoS One ; 15(9): e0238446, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966298

RESUMO

Knowledge mobilisation is required to "bridge the gap" between research, policy and practice. This activity is dependent on the amount, richness and quality of the data published. To understand the impact of a changing climate on commercial species, stakeholder communities require better knowledge of their past and current situations. The common cockle (Cerastoderma edule) is an excellent model species for this type of analysis, as it is well-studied due to its cultural, commercial and ecological significance in west Europe. Recently, C. edule harvests have decreased, coinciding with frequent mass mortalities, due to factors such as a changing climate and diseases. In this study, macro and micro level marine historical ecology techniques were used to create datasets on topics including: cockle abundance, spawning duration and harvest levels, as well as the ecological factors impacting those cockle populations. These data were correlated with changing climate and the Atlantic Multidecadal Oscillation (AMO) index to assess if they are drivers of cockle abundance and harvesting. The analyses identified the key stakeholder communities involved in cockle research and data acquisition. It highlighted that data collection was sporadic and lacking in cross-national/stakeholder community coordination. A major finding was that local variability in cockle populations is influenced by biotic (parasites) and abiotic (temperature, legislation and harvesting) factors, and at a global scale by climate (AMO Index). This comprehensive study provided an insight into the European cockle fishery but also highlights the need to identify the type of data required, the importance of standardised monitoring, and dissemination efforts, taking into account the knowledge, source, and audience. These factors are key elements that will be highly beneficial not only to the cockle stakeholder communities but to other commercial species.


Assuntos
Conservação dos Recursos Naturais/métodos , Disseminação de Informação/métodos , Participação dos Interessados/psicologia , Animais , Cardiidae , Europa (Continente) , Pesqueiros , Alimentos Marinhos/análise , Frutos do Mar
14.
PLoS One ; 15(9): e0238990, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925981

RESUMO

The aim of this study was to determine the main characteristics of a "good teacher" through the use of questionnaires designed to assess teaching skills and competences, considering the point of view of teachers, principals, and students. In total, 82 teachers, 14 principals, and 625 middle-school students from 5 public schools in São Paulo state participated in this study. Two questionnaires were applied, one designed for teachers and principals and the other for students. First, teachers and principals completed their specific questionnaire, after which the other questionnaire was applied to the students. Both questionnaires contained multiple choice questions related to eight distinct subsections. The questions were answered through the use of a Likert scale, varying from 1 ("totally disagree") to 5 ("totally agree"). The comparisons of the frequency of responses among all questionnaire subsections between teachers and principals were analyzed using a Chi-Square and the z-test, with P-values adjusted to the Bonferroni method. The statistical significance level was set as P < 0.05. The subsection "class atmosphere" presented the highest percentage of response "totally agree", closely followed by "professional engagement". Significant differences (P < 0.05) in responses were observed between teachers and principals for "teaching planning and practice", "use of time and material resources to develop classes", and "professional engagement" domains. In summary, it was demonstrated that some teaching characteristics might be more important than others, with some of these characteristics exhibiting significant differences between groups. Nevertheless, it is crucial to emphasize that all assessed educational domains may be recognized as critical teaching qualities, as all of them presented high levels of "totally agree" responses.


Assuntos
Professores Escolares/psicologia , Capacitação de Professores/métodos , Ensino/normas , Adolescente , Adulto , Brasil , Criança , Avaliação Educacional , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Conhecimento , Masculino , Pessoa de Meia-Idade , Professores Escolares/normas , Instituições Acadêmicas , Participação dos Interessados/psicologia , Estudantes/psicologia , Inquéritos e Questionários
15.
Afr J AIDS Res ; 19(3): 186-197, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32938320

RESUMO

Achieving the United Nations' 90-90-90 goals has proven challenging in most settings and the ambitious 95-95-95 goals seem even more elusive. However, in Eswatini - a lower-middle-income country in sub-Saharan Africa with the highest HIV prevalence in the world - an estimated 92% of people living with HIV know their status. We conducted 26 in-depth interviews with stakeholders from policy, implementation, donor, local advocacy and academic sectors to elicit the facilitators and inhibitors to HIV testing uptake in Eswatini. Background data and related reports and policy documents (n = 57) were also reviewed. Essential facilitators included good governance via institutional and national budgetary commitments, which often led to swift adoption of globally recommended programs and standards. The integration of HIV testing into all points of care fostered a sense that testing was part of routine care, which reduced stigma. Challenges, however, centred on social norms that disadvantage certain groups with high ongoing HIV risk (such as key populations, adolescent girls and young women), a heavy reliance on external donor funding, and stigma that had subsided but nevertheless persisted. Amid concerns about whether the 90-90-90 targets could be achieved by 2020, the experience of Eswatini provides tangible insights into factors that have successfully influenced HIV testing uptake and may thus prove informative for other countries.


Assuntos
Infecções por HIV/diagnóstico , Programas de Rastreamento/normas , Participação dos Interessados , Essuatíni/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Entrevistas como Assunto , Masculino , Programas de Rastreamento/estatística & dados numéricos , Risco , Estigma Social
16.
PLoS One ; 15(9): e0239276, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941520

RESUMO

Good Participatory Practice (GPP) guidelines support and direct community engagement practices in biomedical HIV prevention trials, however no standardized metrics define the implementation and evaluation of these practices. Collaboratively, the Community Program staff of the HIV Vaccine Trials Network (HVTN) and the HIV Prevention Trials Network (HPTN) created a metric to describe, monitor, and evaluate one component of GPP, recruitment practices, in two HIV monoclonal Antibody Mediated Prevention (AMP) clinical trials, HVTN 703/HPTN 081 and HVTN 704/HPTN 085. Through consultation with community representatives from each clinical research site (hereafter "site(s)"), who made up the study Community Working Groups, recruitment strategy descriptors were developed for both trials to characterize responses to "How did you hear about the AMP study?" The Community Working Groups also helped to define and establish time points that were selected to allow comparisons across sites. Data were collected by 43 of 46 clinical research sites from January 1, 2017 to February 28, 2018. All 43 sites used multiple recruitment strategies successfully, but strategies varied by region. Globally, referrals was the most efficient and effective recruitment strategy as evidenced by the screening: enrollment ratio of 2.2:1 in Africa, and 2.1:1 in the Americas/Switzerland. Print materials were also valuable globally (3:1 Africa, 4.2:1 Americas/Switzerland). In Africa, in-person outreach was also quite effective (2.3:1) and led to the most enrollments (748 of 1186, 63%). In the Americas/Switzerland, outreach was also effective (2.6:1), but internet use resulted in the most screens (1893 of 4275, 44%) and enrollments (677 of 1531, 44%), compared to 12 of 2887 (0.4%) and 2 of 1204 (0.1%) in Africa, respectively. Standardized metrics and data collection aid meaningful comparisons of optimal community engagement methods for trial enrollment. Internet strategies had better success in the Americas/Switzerland than in sub-Saharan African countries. Data are essential in outreach staff efforts to improve screening-to-enrollment ratios. Because the effectiveness of recruitment strategies varies by region, it is critical that clinical research sites tailor community engagement and recruitment strategies to their local environment, and that they are supported with resources enabling use of a range of approaches.


Assuntos
Ensaios Clínicos como Assunto , Participação da Comunidade/métodos , Características Culturais , Infecções por HIV/prevenção & controle , Participação dos Interessados , África ao Sul do Saara , América , Educação em Saúde/métodos , Humanos , Seleção de Pacientes , Seleção de Pessoal/métodos , Suíça , Vacinação/métodos
17.
Br J Sports Med ; 54(22): 1314-1320, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32912847

RESUMO

Early disclosure of possible concussive symptoms has the potential to improve concussion-related clinical outcomes. The objective of the present consensus process was to provide useful and feasible recommendations for collegiate athletic departments and military service academy leaders about how to increase concussion symptom disclosure in their setting. Consensus was obtained using a modified Delphi process. Participants in the consensus process were grant awardees from the National Collegiate Athletic Association and Department of Defense Mind Matters Research & Education Grand Challenge and a multidisciplinary group of stakeholders from collegiate athletics and military service academies. The process included a combination of in-person meetings and anonymous online voting on iteratively modified recommendations for approaches to improve concussion symptom disclosure. Recommendations were rated in terms of their utility and feasibility in collegiate athletic and military service academy settings with a priori thresholds for retaining, discarding and revising statements. A total of 17 recommendations met thresholds for utility and feasibility and are grouped for discussion in five domains: (1) content of concussion education for athletes and military service academy cadets, (2) dissemination and implementation of concussion education for athletes and military service academy cadets, (3) other stakeholder concussion education, (4) team and unit-level processes and (5) organisational processes. Collectively, these recommendations provide a path forward for athletics departments and military service academies in terms of the behavioural health supports and institutional processes that are needed to increase early and honest disclosure of concussion symptoms and ultimately to improve clinical care outcomes.


Assuntos
Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Revelação , Medicina Militar/educação , Medicina Esportiva/educação , Atletas/educação , Técnica Delfos , Humanos , Medicina Militar/organização & administração , Militares/educação , Medicina Esportiva/organização & administração , Participação dos Interessados , Estados Unidos , Universidades
18.
PLoS One ; 15(9): e0238613, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915822

RESUMO

BACKGROUND: In January 2020, the coronavirus disease 2019 (COVID-19) started to spread in Italy. The Italian government adopted urgent measures to slow its spread. Enforcing compliance with such measures is crucial in order to enhance their effectiveness. Engaging citizens in the COVID-19 preventive process is urgent today both in Italy and around the world. However, to the best of our knowledge, no previous studies have investigated the role of health engagement in predicting citizens' compliance with health emergency containment measures. METHOD: An online survey was administered between February 28 and March 4, 2020 on a representative sample of 1000 Italians. The questionnaire included a measure of health engagement (Patient Health Engagement Scale), a 5-item Likert scale ranging from 1 to 7, resulting in 4 positions that describe the psychological readiness to be active in one's own health management, and a series of ad hoc items intended to measure citizens' perceived susceptibility and severity of the disease, orientation towards health management, trust in institutional bodies, health habits and food consumption. To investigate the relationship between health engagement and these variables, ANOVA analysis, logistic regression and contingency tables with Pearson's chi-squared analysis have been carried out. RESULTS: Less engaged people show higher levels of perceived susceptibility to the virus and severity of the disease; they are less trustful of scientific and healthcare authorities, they feel less self-effective in managing their own health-both in normal conditions and under stress-and are less prone to cooperate with healthcare professionals. Low levels of health engagement also are associated with a change in the usual purchase behavior. CONCLUSIONS: The Patient Health Engagement model (PHE) provides a useful framework for understanding how people will respond to health threats such as pandemics. Therefore, intervention studies should focus on raising their levels of engagement to increase the effectiveness of educational initiatives intended to promote preventive behaviors.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pneumonia Viral/psicologia , Participação dos Interessados , Adolescente , Adulto , Idoso , Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Comportamento Alimentar , Feminino , Fidelidade a Diretrizes , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Assunção de Riscos
19.
J Am Board Fam Med ; 33(5): 645-649, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32989057

RESUMO

The COVID-19 outbreak is a stark reminder of the ongoing challenge of emerging and reemerging disease, the human cost of pandemics and the need for robust research.1 For primary care, the advent of COVID-19 has forced an unprecedented wave of practice change. In turn, Practice-Based Research Networks (PBRNs) must rapidly pivot to address the changing environment and the critical challenges faced by primary care. The pandemic has also impacted the ability of PBRNs to deploy traditional research methods such as face-to-face patient and provider interactions, practice facilitation, and stakeholder engagement. Providers need more relevant, patient-centered evidence and the skills to effect change. These skills will become more important than ever as primary care practices evolve in response to the current COVID-19 pandemic and the disparities in health outcomes highlighted by COVID-19 and the global Black Lives Matter social movement for justice. Throughout this issue, authors detail the work conducted by PBRNs that demonstrate many of these evolving concepts. Articles explore how PBRNs can evaluate COVID-19 in primary care, the role of PBRNs in quality improvement, stakeholder engagement, prevention and chronic care management, and patient safety in primary care.


Assuntos
Betacoronavirus , Redes Comunitárias/tendências , Infecções por Coronavirus , Pesquisa sobre Serviços de Saúde/tendências , Pandemias , Pneumonia Viral , Atenção Primária à Saúde/tendências , Redes Comunitárias/organização & administração , Pesquisa sobre Serviços de Saúde/métodos , Pesquisa sobre Serviços de Saúde/organização & administração , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Humanos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Projetos de Pesquisa , Participação dos Interessados , Estados Unidos
20.
J Am Board Fam Med ; 33(5): 774-778, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32989072

RESUMO

BACKGROUND: Primary care practice-based research networks (PBRNs) are critical laboratories for generating evidence from real-world settings, including studying natural experiments. Primary care's response to the novel coronavirus-19 (COVID-19) pandemic is arguably the most impactful natural experiment in our lifetime. EVALUATING THE IMPACT OF COVID-19: We briefly describe the OCHIN PBRN of community health centers (CHCs), its partnership with implementation scientists, and how we are leveraging this infrastructure and expertise to create a rapid research response evaluating how CHCs across the country responded to the COVID-19 pandemic. COVID-19 RESEARCH ROADMAP: Our research agenda focuses on asking: How has care delivery in CHCs changed due to COVID-19? What impact has COVID-19 had on the delivery of preventive services in CHCs? Which PBRN services (e.g., data surveillance, training, evidence synthesis) are most impactful to real-world practices? What decision-making strategies were used in the PBRN and its practices to make real-time changes in response to the pandemic? What critical factors in successfully and sustainably transforming primary care are illuminated by pandemic-driven changes? DISCUSSION AND CONCLUSIONS: PBRNs enable real-world evaluation of practice change and natural experiments, and thus are ideal laboratories for implementation science research. We present a real-time example of how a PBRN Implementation Laboratory activated a response to study a historic natural experiment, to help other PBRNs charting a course through this pandemic.


Assuntos
Betacoronavirus , Centros Comunitários de Saúde/tendências , Redes Comunitárias/tendências , Infecções por Coronavirus , Assistência à Saúde/tendências , Pesquisa sobre Serviços de Saúde/tendências , Pandemias , Pneumonia Viral , Atenção Primária à Saúde/tendências , Centros Comunitários de Saúde/organização & administração , Redes Comunitárias/organização & administração , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Prática Clínica Baseada em Evidências , Pesquisa sobre Serviços de Saúde/métodos , Pesquisa sobre Serviços de Saúde/organização & administração , Humanos , Ciência da Implementação , Disseminação de Informação , Inovação Organizacional , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , Participação dos Interessados , Estados Unidos
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