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1.
Front Health Serv Manage ; 38(1): 32-38, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431817

RESUMO

SUMMARY: Fighting the global COVID-19 pandemic has shifted from immediate response efforts to recognition of the long-term effects on the mental health and well-being of the general population and healthcare workforce. Leaders need to understand the vital role of behavioral health services in a population-based, integrated healthcare framework and address the needs of the behavioral health workforce to successfully deploy services in their organizations and communities.During the ongoing national response to COVID-19, three major trends have emerged: (1) a shift to telehealth and digital care, (2) greater awareness of the impact on the workforce of the shift to digital care, and (3) an open dialogue to counteract the stigma and discrimination related to mental illness and to emphasize mental well-being instead. When they address stigma and discrimination, healthcare leaders embrace a more holistic approach that welcomes behavioral health professionals as equal, vital members of the care team. They help their organizations advance the mental well-being of all.


Assuntos
COVID-19/psicologia , COVID-19/terapia , Pessoal de Saúde/psicologia , Promoção da Saúde/organização & administração , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Estigma Social , Telemedicina/organização & administração , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Objetivos Organizacionais , Pandemias , SARS-CoV-2 , Estados Unidos
2.
Front Health Serv Manage ; 38(1): 39-44, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431818

RESUMO

SUMMARY: Well-being, engagement, and burnout among clinicians are interconnected, and the common denominator is energy. Decades of research show that employees' energy is a decisive factor in achieving organizational outcomes. Knowing this, healthcare leaders can create well-being programs with measurable outcomes that make a positive impact on the bottom line. Just as important, leaders can avoid wasting money on fruitless efforts. How can clinician well-being be incorporated in organizational culture and strategic and operational plans? What are the special challenges to achieving clinician well-being? What key leadership actions promote and protect the well-being of clinicians? Which approaches are most effective during a crisis such as the COVID-19 pandemic? This article addresses those questions by presenting the rationale and methodology behind well-being programs that also address engagement and burnout so that clinicians can succeed in times of crisis and beyond.


Assuntos
Atitude do Pessoal de Saúde , Esgotamento Profissional/psicologia , COVID-19/terapia , Atenção à Saúde/organização & administração , Pessoal de Saúde/psicologia , Promoção da Saúde/organização & administração , Engajamento no Trabalho , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Objetivos Organizacionais , Pandemias , SARS-CoV-2
3.
J Health Commun ; 26(6): 402-412, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34292858

RESUMO

As the United States continues to be ravaged by COVID-19, it becomes increasingly important to implement effective public health campaigns to improve personal behaviors that help control the spread of the virus. To design effective campaigns, research is needed to understand the current mitigation intentions of the general public, diversity in those intentions, and theoretical predictors of them. COVID-19 campaigns will be particularly challenging because mitigation involves myriad, diverse behaviors. This study takes a person-centered approach to investigate data from a survey (N = 976) of Pennsylvania adults. Latent class analysis revealed five classes of mitigation: one marked by complete adherence with health recommendations (34% of the sample), one by complete refusal (9% of the sample), and three by a mixture of adherence and refusal. Statistically significant covariates of class membership included relatively positive injunctive norms, risk due to essential workers in the household, personal knowledge of someone who became infected with COVID-19, and belief that COVID-19 was a leaked biological weapon. Additionally, trait reactance was associated with non-adherence while health mavenism was associated with adherence. These findings may be used to good effect by local healthcare providers and institutions, and also inform broader policy-making decisions regarding public health campaigns to mitigate COVID-19.


Assuntos
COVID-19/prevenção & controle , Comportamentos Relacionados com a Saúde , Promoção da Saúde/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pennsylvania/epidemiologia , Inquéritos e Questionários , Adulto Jovem
4.
Int J Behav Nutr Phys Act ; 18(1): 99, 2021 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-34273973

RESUMO

BACKGROUND: Physical activity is related to many positive health outcomes, yet activity levels of many children are low. Researchers have suggested that family-based interventions may improve physical activity behaviors of both children and their parents. In this study, we evaluated the "Active 1 + FUN" program, which was designed based on tenets of self-determination theory. Intervention components included free sporting equipment, ten coach-led workshops and activity sessions, and one booster session. METHODS: We evaluated the intervention program using a randomized controlled trial. One hundred seventy-one families were randomly allocated to either an experimental group or a wait-list control group. Participants were exposed to program contents over a nine-month period, while families in the control did not receive any form of intervention. Measured constructs included moderate-to-vigorous physical activity, co-physical activity behaviors, fundamental movement skills, BMI, and several self-reported questionnaire outcomes. Hierarchical linear modeling was used to compare changes in measured outcomes across the two groups. RESULTS: No significant intervention effects were found for children's and parents' accelerometer-measured moderate-to-vigorous physical activity, or their co-physical activity. However, in terms of children's fundamental movement skills, a significant Time*Group interaction (B = 0.52, 95% CI [0.07, 0.96] for Times 1 to 2; B = 0.24, 95% CI [0.01, 0.48] for Times 1 to 3) in favor of the experimental group was found. CONCLUSIONS: Results suggested that the "Active 1 + FUN" program was effective in improving children's fundamental movement skills. Additional research is needed to examine how family-based initiatives could effectively improve physical activity behaviors too. TRIAL REGISTRATION: ANZCTR, ACTRN12618001524280. Registered 11 September 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375660 .


Assuntos
Exercício Físico/psicologia , Saúde da Família , Promoção da Saúde/organização & administração , Relações Pais-Filho , Pais/educação , Avaliação de Programas e Projetos de Saúde/métodos , Adulto , Criança , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Atividade Motora , Pais/psicologia , Autonomia Pessoal
5.
J Prev Med Hyg ; 62(1): E25-E32, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34322613

RESUMO

Introduction: Hand cleansing and disinfection is the most efficient method for reducing the rates of hospital-acquired infections which are a serious medical and economic problem. Striving to ensure the maximum safety of the therapeutic process, we decided to promote hand hygiene by implementing the educational program titled "Clean Care is a Safer Care". The occurrence of the COVID-19 pandemic affected the compliance with procedures related to the sanitary regime, including the frequency and accuracy of hand decontamination by medical personnel. Objective: The objective of the study was to assess the usefulness of the educational program titled "Clean Care is a Safer Care" as a tool for increasing compliance with hand hygiene principles. Methods: We monitored the compliance with the hygiene procedure before implementation of the program as well as during the hand hygiene campaign by means of direct observation as well as the disinfectant consumption rates. Results: In the initial self-assessment survey, the hospital had scored 270/500 points (54%). Preliminary audit revealed the hygiene compliance rate at the level of 49%. After broad-scaled educational efforts, the semi-annual audit revealed an increase in hand hygiene compliance rate up to 81% (hospital average) while the final audit carried out after one year of campaigning revealed a compliance rate of 77%. The final score for the hospital increased to 435/500 points. Conclusions: COVID-19 pandemic dramatically increased accuracy of proper hand hygiene procedures and consumption of disinfectant agents. The educational program has succeeded to reach its goal; however, long-term educational efforts are required to maintain and improve the quality of provided services.


Assuntos
COVID-19/prevenção & controle , Fidelidade a Diretrizes , Higiene das Mãos/normas , Recursos Humanos em Hospital , Promoção da Saúde/organização & administração , Humanos , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
6.
J Allied Health ; 50(2): e63-e66, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34061942

RESUMO

INTRODUCTION: The health status of adults with disabilities is recognized as a formal health disparity. Due to COVID-19, participation in wellness programs for this population has been restricted. To provide program participants with continued accessibility, one regional wellness program for adults with disabilities adopted a virtual format. The purpose of this research is to determine the effectiveness of a virtual wellness program for this population. METHODS: Study subjects consisted of adults with disabilities who participated in a regional virtual wellness program. A survey was developed and disseminated electronically to study participants through Qualtrics software. Part 1 of the survey included demographic information, while Part 2 surveyed participants' perceptions and satisfaction with the virtual program using a 5-point Likert scale. RESULTS: 10 out of 14 participants responded to the survey. Results indicated that the majority (80%) of participants utilized the program at least 1-2 times/week. All participants reported that, despite preferring in-person wellness classes, they were satisfied with the virtual format of the program. Positive responses were also reported for survey items related to self-perceived health and functional benefits from participation, degree of staff and peer support offered through virtual means, ease of technology use, and the degree of safety within the virtual environment. DISCUSSION: Given the health status of adults with disabilities during an ongoing global pandemic, continued restrictions limiting participation with in-person wellness programs is anticipated. Virtual formats may offer an advantageous solution to provide adults with disabilities with continued access to this essential programming. While the current study showed positive self-perceived health and functional benefits from participation, further research is needed to determine the effectiveness of this format through expanded and standardized objective outcome measures and to better understand factors that may impact participation.


Assuntos
COVID-19/epidemiologia , Pessoas com Deficiência/educação , Exercício Físico/fisiologia , Promoção da Saúde/organização & administração , Telemedicina/organização & administração , Adulto , Idoso , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Satisfação do Paciente , SARS-CoV-2
7.
Rev Esp Salud Publica ; 952021 Jun 17.
Artigo em Espanhol | MEDLINE | ID: mdl-34135301

RESUMO

OBJECTIVE: In the last decades, in Spain, the interest shown towards community participation in health has been growing. However, there are no evidence-based guidelines to promote community participation in health. For this reason, between 2017 and 2018 the AdaptA GPS project was carried out through 10 working groups from 10 autonomous communities, to adapt the NG44 community participation guide in health from the NICE institute in the United Kingdom to the Spanish context. The objective of this article was to evaluate the adaptation process (the aspects to be improved and the resulting learning) of the AdaptA GPS project through the evaluation of its participants. METHODS: A qualitative evaluation was carried out through two questionnaires with open-ended questions, self-administered in each working group, one by the group coordinator and one by the whole working group (between 6 and 10 people per group), and the answers were analysed thematically. RESULTS: Three main themes were identified that reflect the perspectives of the participants about the adaptation process: positive factors (participatory methodology, collaborative work and diversity of participants), aspects that could be improved (scarce people's participation and lack of funding) and acquired learning (working in network and the importance of promoting research in this field). CONCLUSIONS: The AdaptA GPS project was an innovative project that favored the creation of networks and synergies, fostering co-production thanks to its participatory approach, which has laid the foundations for future collaborative processes of community engagement.


Assuntos
Participação da Comunidade , Promoção da Saúde/organização & administração , Humanos , Pesquisa Qualitativa , Espanha
9.
Rev Colomb Psiquiatr ; 50(3): 199-213, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34108740

RESUMO

Background: College and university students are a population vulnerable to mental disorders, especially during the COVID-19 pandemic. Their mental health has been affected by confinement, difficulties in the development of academic activities, and the demands of new pedagogical modalities. We aimed to respond to the question: what are the actions around a) promotion and prevention, b) mental symptoms care, and c) pedagogical adaptations that can be developed in order to improve the mental health of college and university students? Methods: We conducted a critical synthesis from a systematic review of the literature. A search was made for scientific articles with descriptive, analytical, empirical or evaluative designs, as well as web resources of organisations related to the topic. A synthesis was carried out based on the three aspects of the question by means of a constant comparative method, until the aggregation of actions by similarity in the actors. We anticipated low evidence quality; therefore, a standardised evaluation was not performed. Results: We explored 68 articles and 99 web resources. After reviewing the full text, 12 scientific articles and 11 web resources were included. As general guidelines, we found that the most frequent suggestion is the design of a specific structured mental health programme within universities, one that should be multidisciplinary, inclusive, dynamic and culturally sensitive. All actions taken by the university should be reported and published periodically so that students and other members of the university community are clear about them. Ideally, it is suggested to keep them until the post-pandemic period and include alumni. Regarding a) promotion and prevention, digital psychoeducation was recommended, with information about healthy lifestyles, common emotional reactions to epidemics, coping strategies and warning signs. Peer participation is suggested as a support strategy, as well as spaces for social interaction that focus not only on academic aspects but also on leisure. Screening for mental symptoms is suggested through frequent submission of online forms or mobile applications. In addition to mental health, it is important to inquire about the degree of satisfaction of basic and technology-related needs. For b) the care of mental symptoms, one of the actions commonly identified was a consulting centre that can provide mental health care by telephone, by technology, and even in person --if required --, with permanent availability with rapid response teams for crisis situations, such as suicidal behaviour and domestic violence. For c) pedagogical adaptations, fluent communication is an indispensable requirement; having clear instructions on academic activities can reduce uncertainty and therefore anxiety. The teaching and pedagogical staff at the institution can offer direct advice (via video calls or online group meetings) to provide support in study habits, degree-specific material and mental health. Conclusions: Included resources suggest the creation of a programme that specifically addresses the mental health of students. This synthesis can provide guidelines that facilitate decision-making by the university, without losing sight of the fact that the institution and the student are immersed in a complex context, with circumstances and other actors at various levels that also intervene in mental health. Research is required on the evolution of the mental health situation and the effect of the actions that are being taken.


Assuntos
COVID-19/psicologia , Promoção da Saúde , Transtornos Mentais , Serviços de Saúde Mental , Saúde Mental , Serviços de Saúde para Estudantes , Estudantes/psicologia , COVID-19/prevenção & controle , Saúde Global , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/etiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Fatores de Risco , Apoio Social , Serviços de Saúde para Estudantes/métodos , Serviços de Saúde para Estudantes/organização & administração , Ensino , Universidades
10.
J Med Internet Res ; 23(7): e27448, 2021 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-34133314

RESUMO

BACKGROUND: The beginning of the COVID-19 pandemic presented many sudden challenges regarding food, including grocery shopping changes (eg, reduced store hours, capacity restrictions, and empty store shelves due to food hoarding), restaurant closures, the need to cook more at home, and closures of food access programs. Eat Well Saskatchewan (EWS) implemented a 16-week social media campaign, #eatwellcovid19, led by a dietitian and nutrition student that focused on sharing stories submitted by the Saskatchewan public about how they were eating healthy during the COVID-19 pandemic. OBJECTIVE: The goal of this study was to describe the implementation of the #eatwellcovid19 social media campaign and the results from the evaluation of the campaign, which included campaign performance using social media metrics and experiences and perspectives of campaign followers. METHODS: Residents of Saskatchewan, Canada, were invited to submit personal stories and experiences to EWS about how they were eating healthy during the COVID-19 pandemic from April to August 2020. Each week, one to three stories were featured on EWS social media platforms-Facebook, Instagram, and Twitter-along with evidence-based nutrition information to help residents become more resilient to challenges related to food and nutrition experienced during the COVID-19 pandemic. Individuals who submitted stories were entered into a weekly draw for a Can $100 grocery gift card. Social media metrics and semistructured qualitative interviews of campaign followers were used to evaluate the #eatwellcovid19 campaign. RESULTS: In total, 75 stories were submitted by 74 individuals on a variety of topics (eg, grocery shopping, traditional skills, and gardening), and 42 stories were featured on social media. EWS shared 194 #eatwellcovid19 posts across social media platforms (Facebook: n=100; Instagram: n=55; and Twitter: n=39). On Facebook, #eatawellcovid19 reached 100,571 followers and left 128,818 impressions, resulting in 9575 engagements. On Instagram, the campaign reached 11,310 followers, made 14,145 impressions, and received 823 likes and 15 comments. On Twitter, #eatwellcovid19 made 15,199 impressions and received 424 engagements. Featured story submission posts had the best engagement on Facebook and the most likes and comments on Instagram. The EWS social media pages reported increases in their following during the campaign (Instagram: +30%; Facebook: +14%; and Twitter: +12%). Results from the interviews revealed that there were two types of campaign followers: those who appreciated hearing the stories submitted by followers, as it helped them to feel connected to the community during social isolation, and those who appreciated the evidence-based information. CONCLUSIONS: Numerous stories were submitted to the #eatwellcovid19 social media campaign on various topics. On Instagram and Facebook, posts that featured these stories had the highest engagement. During this campaign, EWS's social media following increased by more than 10% on each platform. The approach used for the #eatwellcovid19 campaign could be considered by others looking to develop health promotion campaigns.


Assuntos
COVID-19 , Dieta Saudável , Promoção da Saúde/organização & administração , Promoção da Saúde/estatística & dados numéricos , Pandemias , Pesquisa Qualitativa , Mídias Sociais/estatística & dados numéricos , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Saskatchewan/epidemiologia , Adulto Jovem
11.
Med Educ Online ; 26(1): 1917488, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33944707

RESUMO

Problem: The novel coronavirus SARS-CoV-2 disease (COVID-19) impacted medical learner well-being and serves as a unique opportunity to understand medical learner wellness. The authors designed a formal needs assessment to assess medical learners' perspectives regarding distress related to disrupted training environments. This Rapid Communication describes findings from a qualitative study which defined medical learner wellness and validated five wellness domains.Approach: We conducted follow-up telephone interviews to an online needs assessment survey to identify a learner definition for wellness and to validate five wellness domains, including social, mental, physical, intellectual, and occupational wellness. Using purposive and maximal variation sampling, 27 students were interviewed from July-August 2020. Thematic analysis was performed using a deductive thematic approach to qualitative analysis.Outcomes: Medical learners defined wellness as a general [holistic] sense of personal well-being - the opportunity to be and to do what they most need and value. Learners validated all five wellness domains for medical education. Learners acknowledged the need for an adoptable and adaptable holistic framework for wellness in medical education.Next steps: We recommend academic medical institutions consider learner wellness a key component of medical education to cultivate learners as a competent collective of self-reliant, scholarly experts. We encourage evaluation of wellness domains in diverse medical learner populations to identify feasible interventions potentially associated with improvements in medical learner wellness.


Assuntos
COVID-19/epidemiologia , Educação Médica/organização & administração , Promoção da Saúde/organização & administração , Estudantes de Medicina/psicologia , Adulto , Comunicação , Currículo , Feminino , Nível de Saúde , Humanos , Entrevistas como Assunto , Aprendizagem , Masculino , Saúde Mental , Determinação de Necessidades de Cuidados de Saúde , Saúde do Trabalhador , Pandemias , Pesquisa Qualitativa , SARS-CoV-2
12.
J Occup Health ; 63(1): e12224, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33955633

RESUMO

OBJECTIVES: Little is known about workplace measures against coronavirus disease 2019 (COVID-19) in Japan during the winter of 2020, especially in micro-, small-, and medium-sized enterprises (MSMEs). This study aimed to provide an overview of the current situation of anti-COVID-19 measures in Japanese enterprises during the winter, considering company size. METHODS: This study was an Internet-based nationwide cross-sectional study. Individuals who were registered as full-time workers were invited to participate in the survey. Data were collected using an online self-administered questionnaire in December 2020. The chi-squared test for trend was performed to calculate the P-value for trend for each workplace measure across company sizes. RESULTS: For the 27 036 participants, across company sizes, the most prevalent workplace measure was encouraging mask wearing at work, followed by requesting that employees refrain from going to work when ill and restricting work-related social gatherings and entertainment. These measures were implemented by approximately 90% of large-scale enterprises and by more than 40% of micro- and small-scale enterprises. In contrast, encouraging remote working was implemented by less than half of large-scale enterprises and by around 20% of micro- and small-scale enterprises. There were statistically significant differences in all workplace measures by company size (all P < .001). CONCLUSIONS: We found that various responses to COVID-19 had been taken in workplaces. However, some measures, including remote working, were still not well-implemented, especially in smaller enterprises. The findings suggest that occupational health support for MSMEs is urgently needed to mitigate the current wave of COVID-19.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Promoção da Saúde/organização & administração , Serviços de Saúde do Trabalhador/organização & administração , Local de Trabalho/organização & administração , Adulto , Estudos Transversais , Humanos , Japão , Masculino , Saúde do Trabalhador/estatística & dados numéricos
13.
J Sch Health ; 91(7): 535-540, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33954993

RESUMO

BACKGROUND: Adjustments in teaching resources and school meal programs are urgently needed during the COVID-19 pandemic. This study examined teaching resources that would have been helpful when schools closed, and how school meal programs should be changed in the 2020-2021 school year. METHODS: In October 2020, a 27-item, cross-sectional, online survey was administered to 99 teachers and staff members in an urban, Midwestern school district. Data were analyzed using frequencies and proportions, and open-ended responses were analyzed using content analysis. RESULTS: Online teaching was difficult for teachers and students, and training for online teaching, improved Internet access, and more time for grading or office hours would have been helpful when schools closed. Meal programs were offered by 86% of schools after closing, and many participants supported continuing meal programs for 2020-2021. Resources needed to continue meal programs included funding for meal reimbursement, transportation to the meal sites, and more staff. Suggested changes to meal programs included offering more variety or more food, and solving transportation issues. CONCLUSION: Addressing these concerns can improve school and community health. Findings will inform efforts to enhance online teaching and improve and continue school meal programs as the world continues to be affected by COVID-19.


Assuntos
COVID-19/epidemiologia , Serviços de Alimentação/organização & administração , Serviços de Saúde Escolar/organização & administração , População Urbana/estatística & dados numéricos , Estudos Transversais , Promoção da Saúde/organização & administração , Humanos , Política Nutricional , Estudantes/estatística & dados numéricos
14.
J Sch Health ; 91(7): 550-554, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33954998

RESUMO

BACKGROUND: The COVID-19 pandemic presents unique opportunities for preexisting school telemedicine programs to reach pediatric populations that might otherwise experience a lapse in health care services. METHODS: A retrospective analysis of one of the largest school-based telemedicine programs in the country, based in the Dallas-Fort Worth (DFW), Texas was conducted that included 7021 pediatric patients who engaged in telehealth visits from 2014 to 2019. RESULTS: Asthma or other respiratory disease was the primary diagnosis (28.4%), followed by injury or trauma (18.4%), digestive disorders (6.9%), and ear/eye/skin disease (6.9%). More participants were from the North (34.4%) and West (33.2%) ISD compared to the South (20.6%) and East (11.7%) schools. Likewise, the majority of COVID-19 cases were in the North (61.8%) and West (31.6%) DFW regions, leading to 989 (59.9%) and 551 (33.4%) deaths, respectively. CONCLUSIONS: School-based telehealth programs have the potential to reach large pediatric populations most in need of health care due to COVID-19-related lapses in services, and to address COVID-19-related health issues as schools reopen. In the future, utilization could be expanded to contact tracing, testing, and screening for COVID-19.


Assuntos
COVID-19/terapia , Serviços de Saúde Escolar/organização & administração , Instituições Acadêmicas/organização & administração , Telemedicina/organização & administração , Adolescente , COVID-19/epidemiologia , Criança , Feminino , Promoção da Saúde/organização & administração , Humanos , Masculino , Telemedicina/estatística & dados numéricos
15.
J Sch Health ; 91(7): 584-591, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33973241

RESUMO

BACKGROUND: In 2014, the Hawaii Department of Education (DOE), the only statewide school system in the United States, predominately enrolled children (keiki) from underserved communities and lacked school nurses or a school health program. Chronic absenteeism due to health concerns was identified as a barrier to academic success. METHODS: The DOE and a public university created Hawaii Keiki: Healthy and Ready to Learn (HK), a program to provide school-based services for 170 Title 1 schools in urban and rural settings and build momentum for statewide collective action. HK has maintained support from public and private entities to address student health. RESULTS: This paper describes 5 years of program development, implementation, and continuing challenges. Most recently in 2020-2021, HK pivoted in the face of school campus closings due to COVID-19 with strategic plans, including telehealth, to move forward in this changed school environment. CONCLUSIONS: The HK program has increased awareness of students' needs and is addressing the imperative to build health services within public schools. The multipronged approach of building awareness of need, providing direct services, educating future care providers, and supporting sound policy development, has an impact that goes beyond any one individual area.


Assuntos
Saúde da Criança/estatística & dados numéricos , Proteção da Criança/estatística & dados numéricos , Redes Comunitárias/organização & administração , Promoção da Saúde/organização & administração , Serviços de Saúde Escolar/organização & administração , Adolescente , COVID-19/prevenção & controle , Criança , Comportamento Cooperativo , Hawaii , Humanos , Avaliação de Programas e Projetos de Saúde
16.
Med Arch ; 75(1): 4-10, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34012191

RESUMO

Background: The key considerations for healthy aging are diversity and inequity. Diversity means that there is no typical older person. Policy should be framed to improve the functional ability of all older people, whether they are robust, care dependent or in between. Objective: The aim of this article is to describe negative influence of Corona pandemic (COVID-19) for realization of the WHO project about Healthy Aging global strategy proposed in the targets "Health for all". Methods: Authors used descriptive model for this cross-sectional study based on facts in analyzed scientific literature deposited in on-line databases about healthy aging concept of the prevention and treatment of the people who will come or already came to the "third trimester of the life". Results and Discussion: Some 80-year-olds have levels of physical and mental capacity that compare favorably with 30-year-olds. Others of the same age may require extensive care and support for basic activities like dressing and eating. Policy should be framed to improve the functional ability of all older people, whether they are robust, care dependent or in between. Inequity reflects a large proportion (approximately 75%) of the diversity in capacity and circumstance observed in older age is the result of the cumulative impact of advantage and disadvantage across people's lives. Importantly, the relationships we have with our environments are shaped by factors such as the family we were born into, our sex, ethnicity, level of education and financial resources. Conclusion: COVID-19 pandemic "celebrated" one year of existing in almost all countries in the world with very difficult consequences for whole population. But in the first risk group are old people who have in average 6 to 7 co-morbidities. WHO recommended some measures to improve prevention and treatment this category of population, but COVID-19 pandemic stopped full realization of Decade of Healthy Aging project.


Assuntos
Promoção da Saúde/organização & administração , Nível de Saúde , Envelhecimento Saudável , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Avaliação Geriátrica/estatística & dados numéricos , Geriatria/normas , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Organização Mundial da Saúde
17.
Health Secur ; 19(S1): S41-S49, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33961489

RESUMO

Vulnerable refugee communities are disproportionately affected by the ongoing COVID-19 pandemic; existing longstanding health inequity in these communities is exacerbated by ineffective risk communication practices about COVID-19. Culturally and linguistically appropriate health communication following health literacy guidelines is needed to dispel cultural myths, social stigma, misinformation, and disinformation. For refugee communities, the physical, mental, and social-related consequences of displacement further complicate understanding of risk communication practices grounded in a Western cultural ethos. We present a case study of Clarkston, Georgia, the "most diverse square mile in America," where half the population is foreign born and majority refugee. Supporting marginalized communities in times of risk will require a multipronged, systemic approach to health communication including: (1) creating a task force of local leaders and community members to deal with emergent issues; (2) expanding English-language education and support for refugees; (3) including refugee perspectives on risk, health, and wellness into risk communication messaging; (4) improving cultural competence and health literacy training for community leaders and healthcare providers; and (5) supporting community health workers. Finally, better prepared public health programs, including partnerships with trusted community organizations and leadership, can ensure that appropriate and supportive risk communication and health education and promotion are in place long before the next emergency.


Assuntos
COVID-19/terapia , Agentes Comunitários de Saúde/organização & administração , Assistência à Saúde Culturalmente Competente/organização & administração , Promoção da Saúde/organização & administração , Indicadores Básicos de Saúde , Refugiados/estatística & dados numéricos , COVID-19/epidemiologia , Georgia , Humanos , Determinação de Necessidades de Cuidados de Saúde/organização & administração
18.
Afr J AIDS Res ; 20(2): 158-164, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33998958

RESUMO

Background: In Zimbabwe, adolescent girls and young women (AGYW) experience high rates of HIV and other sexual and reproductive health challenges. In 2013, the Zimbabwe Ministry of Health and Child Care partnered with the United Nations Population Fund to implement the Sista2Sista programme, a structured peer group intervention aimed at improving health outcomes among vulnerable in- and out-of-school AGYW.Methods: Programme data was analysed for 91 612 AGYW aged 10-24 years old who participated in Sista2Sista from 2013 to 2019. Logistic regression was used to determine odds ratios (OR) and evaluate programme exposure as a factor in a set of defined variables.Results: 58 471 AGYW (63.82%) graduated from the Sista2Sista programme by completing at least 30 of 40 exercises. Graduates were more likely to take an HIV test (2.78 OR 95% CI 2.52-3.10), less likely to get married (0.63 OR 95% CI 0.55-0.73) and less likely to drop out of school (0.60 OR 95% CI 0.53-0.69). At higher thresholds of programme completion, additional positive outcomes were observed. Participants who completed all 40 exercises were more likely to return to school (1.41 OR 95% CI 1.18-1.69), more likely to use contraception (1.38 OR 95% CI 1.21-1.56), more likely to report sexual abuse (1.76 OR 95% CI 1.17-2.66), and less likely to become pregnant as adolescents (0.41 OR 95% CI 0.24-0.72). Individual counselling improved the likelihood of programme graduation.Conclusions: The Sista2Sista programme had a positive effect on HIV and other sexual health outcomes among vulnerable AGYW in Zimbabwe. Strategies to improve graduation rates should be explored.


Assuntos
Infecções por HIV/prevenção & controle , Promoção da Saúde/estatística & dados numéricos , Grupo Associado , Saúde Reprodutiva/estatística & dados numéricos , Adolescente , Criança , Feminino , Violência de Gênero/prevenção & controle , Violência de Gênero/estatística & dados numéricos , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Promoção da Saúde/organização & administração , Humanos , Casamento/estatística & dados numéricos , Gravidez , Gravidez na Adolescência/prevenção & controle , Gravidez na Adolescência/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Evasão Escolar/estatística & dados numéricos , Adulto Jovem , Zimbábue/epidemiologia
20.
Nutrients ; 13(4)2021 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-33917366

RESUMO

Although peer-led education and support may improve breastfeeding practices, there is a paucity of evidence on the effectiveness of such interventions in the Ethiopian context. We designed a cluster-randomized trial to evaluate the efficacy of a breastfeeding education and support intervention (BFESI) on infant growth, early initiation (EI), and exclusive breastfeeding (EBF) practices. We randomly assigned 36 clusters into either an intervention group (n = 249) receiving BFESI by trained Women's Development Army (WDA) leaders or a control group (n = 219) receiving routine care. The intervention was provided from the third trimester of pregnancy until five months postpartum. Primary study outcomes were EI, EBF, and infant growth; secondary outcomes included maternal breastfeeding knowledge and attitude, and child morbidity. The intervention effect was analysed using linear regression models for the continuous outcomes, and linear probability or logistic regression models for the categorical outcomes. Compared to the control, BFESI significantly increased EI by 25.9% (95% CI: 14.5, 37.3%; p = 0.001) and EBF by 14.6% (95% CI: 3.77, 25.5%; p = 0.010). Similarly, the intervention gave higher breastfeeding attitude scores (Effect size (ES): 0.85SD; 95% CI: 0.70, 0.99SD; p < 0.001), but not higher knowledge scores (ES: 0.15SD; 95% CI: -0.10, 0.41SD; p = 0.173). From the several growth and morbidity outcomes evaluated, the only outcomes with significant intervention effect were a higher mid-upper arm circumference (ES: 0.25cm; 95% CI: 0.01, 0.49cm; p = 0.041) and a lower prevalence of respiratory infection (ES: -6.90%; 95% CI: -13.3, -0.61%; p = 0.033). Training WDA leaders to provide BFESI substantially improves EI and EBF practices and attitude towards breastfeeding.


Assuntos
Aleitamento Materno , Desenvolvimento Infantil/fisiologia , Mães/educação , Assistência Perinatal/métodos , Sistemas de Apoio Psicossocial , Adolescente , Adulto , Feminino , Seguimentos , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Humanos , Lactente , Recém-Nascido , Grupo Associado , Assistência Perinatal/organização & administração , Período Pós-Parto , Gravidez , Terceiro Trimestre da Gravidez , Avaliação de Programas e Projetos de Saúde , População Rural , Fatores de Tempo , Adulto Jovem
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