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1.
Orthop Clin North Am ; 51(2): 219-225, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32138859

RESUMO

Global health delivery is a complex initiative requiring dedicated personnel to achieve a successful program. To be most beneficial, global health delivery should focus on cultural competence, bidirectional education, and capacity building through direct and purposeful means. The authors present the expansion of their global health delivery program in Ecuador focusing on the evolution of the program from a medical mission trip to a multilayered program that helps foster engagement, education, and learning while helping children who might not otherwise have access to care, along with future directions and potential methods to decrease the need for such initiatives in Ecuador.


Assuntos
Relações Comunidade-Instituição/tendências , Ortopedia/organização & administração , Ortopedia/tendências , Desenvolvimento de Programas , Assistência à Saúde/organização & administração , Assistência à Saúde/tendências , Equador , Previsões , Saúde Global , Educação em Saúde , Humanos , Internacionalidade
3.
Forensic Sci Int ; 306: 110062, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786514

RESUMO

The renowned work of Clyde Snow and the development of the Equipo Argentino de Anthropología Forense (EAAF) team has inspired the use of forensic anthropological and archaeological skills in human rights interventions around the world. Whether for medico-legal intervention and acquisition of evidence or humanitarian repatriation and identification of human remains, forensic expertise has garnered attention in the global arena. Arguably fulfilling evidentiary and psychosocial needs, there has been growing interest in this post-conflict redress. However, as part of the critique of these interventions, scholars and practitioners have pointed out - primarily in medico-legal investigations - a lack of sensitization of local communities regarding forensic work, increasing the potential for re-traumatization, unrealistic expectations, or an unintentional increase in political tensions. Research regarding forensic intervention and human remains have permeated social sciences, peace and conflict studies, and science and technology studies, revealing both intentional and unintentional impacts of forensic sciences after mass violence. In an effort to mitigate negative impacts of medico-legal or humanitarian interventions, the research described here sought to sensitize communities in Uganda about forensic methods. Findings from this study suggest that sensitization is necessary and desired, and that a multi-step approach can assist in managing expectations.


Assuntos
Conflitos Armados , Antropologia Forense/organização & administração , Sobreviventes/psicologia , Altruísmo , Arqueologia , Recursos Audiovisuais , Sepultamento , Relações Comunidade-Instituição , Grupos Focais , Antropologia Forense/educação , Direitos Humanos , Humanos , População Rural , Uganda
4.
BMC Public Health ; 19(1): 1665, 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31829223

RESUMO

BACKGROUND: Building trust and engaging the community are important for biomedical trials. This was core to the set up and delivery of the EBOVAC-Salone and PREVAC Ebola vaccine trials in Sierra Leone during and following the 2014-2016 West African Ebola epidemic. Local community liaison teams (CLT) engaged with the community through public meetings, radio chat shows, and other activities, while a social science team (SST) assessed community members' and participants' perceptions and regularly updated the clinical team to adapt procedures to improve the acceptability and compliance of the trial. The objective of this study was to examine the community engagement (CE) program in these trials and to identify potential barriers and facilitators. METHODS: Fifteen CLT and SST members participated in in-depth interviews and 23 community members attended three focus groups to discuss the Ebola vaccine trials and their experiences and perspectives of the CE activities. RESULTS: A key aim of the CE program was to build trust between the community and the trial. Four main principles (the "four R's") evolved from the discussions with team members and the community that influenced this trust: reciprocity, relatability, relationships and respect. The CLT and SST ensured reciprocal communication between the trial team and the community. The CLT delivered key messages from the trial, whilst the SST completed ethnographic research in the field to uncover rumors and perceptions of the trial in the community. These ethnographic findings were shared with the CLT and addressed in targeted messaging to the community. Both the CLT and SST approached the communities in an egalitarian manner, by dressing modestly, speaking local dialects, and using relatable examples. Appreciation and understanding of the importance of interpersonal relationships and respect for the people, their customs, and traditions also played a large role in the CE program. CONCLUSION: These findings provide an in-depth understanding of how interdisciplinary community liaison and social science teams can work with a clinical team to strengthen trust. The four R's suggest the ways in which trust relations are central to CE and confidence in vaccine trials, and could offer an approach to CE in vaccine trials.


Assuntos
Ensaios Clínicos como Assunto/organização & administração , Participação da Comunidade , Relações Comunidade-Instituição , Vacinas contra Ebola/administração & dosagem , Epidemias/prevenção & controle , Grupos Focais , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Respeito , Serra Leoa/epidemiologia , Confiança/psicologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-31623297

RESUMO

The articles in this special issue on New Directions in Environmental Communication in the International Journal of Environmental Research and Public Health present new research and perspectives on engaging communities impacted by Superfund sites-the hazardous waste sites that have been identified by the U.S. Environmental Protection Agency (EPA) as needing cleanup. In particular, these articles focus on the community engagement cores (CECs) that work with affected communities as part the Superfund Research Program at the National Institute of Environmental Health Sciences (NIEHS). The purpose of this closing article is to highlight important themes evident across the eight articles in the special issue. When considered together, the findings reveal important lessons learned about community engagement and environmental communication, but also reveal that much more remains to be known. Recommendations are made for how these teams can continue to practice, reflect on, and research community engagement in ways that build toward a better understanding and implementation of best practices.


Assuntos
Relações Comunidade-Instituição/tendências , Exposição Ambiental/efeitos adversos , Substâncias Perigosas/efeitos adversos , Locais de Resíduos Perigosos , National Institute of Environmental Health Sciences (U.S.) , Saúde Pública , Humanos , Estados Unidos
8.
Artigo em Inglês | MEDLINE | ID: mdl-31505766

RESUMO

Extreme summertime heat is a significant public health threat that disproportionately impacts vulnerable urban populations. Research on health impacts of climate change (including increasing intensity, duration, and frequency of hot weather) is sometimes designed and implemented without the involvement of the communities being studied, i.e., "community-placed" not "community-based." We describe how the Heatwaves, Housing, and Health: Increasing Climate Resiliency in Detroit (HHH) partnership engaged relevant communities by integrating a community-based participatory research (CBPR) approach into an existing, academic-designed research project through a steering committee of community and academic partners. Using a case study approach, we analyze program documentation, partnership evaluation questionnaires, and HHH steering committee meeting notes. We describe the CBPR process by which we successfully collected research data in Detroit during summer 2016, engaged in collaborative analysis of data, and shared results with Detroit residents. Evaluations of the partnership over 2 years show community involvement in research; enhanced capacities; success in securing new grant funding; and ways that CBPR strengthened the validity, relevance, and translation of research. Engaging communities as equal partners using CBPR, even after a study is underway, can strengthen research to understand and address the impacts of extreme heat on health and equity in urban communities.


Assuntos
Pesquisa Participativa Baseada na Comunidade/métodos , Equidade em Saúde , Cidades , Clima , Participação da Comunidade , Relações Comunidade-Instituição , Habitação , Humanos , Michigan
9.
MMWR Morb Mortal Wkly Rep ; 68(35): 757-761, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31487274

RESUMO

Community-based organizations have a long history of engagement with public health issues; these relationships can contribute to disaster preparedness (1,2). Preparedness training improves response capacity and strengthens overall resilience (1). Recognizing the importance of community-based organizations in community preparedness, the Office of Emergency Preparedness and Response in New York City's (NYC's) Department of Health and Mental Hygiene (DOHMH) launched a community preparedness program in 2016 (3), which engaged two community sectors (human services and faith-based). To strengthen community preparedness for public health emergencies in human services organizations and faith-based organizations, the community preparedness program conducted eight in-person preparedness trainings. Each training focused on preparedness topics, including developing plans for 1) continuity of operations, 2) emergency management, 3) volunteer management, 4) emergency communications, 5) emergency notification systems, 6) communication with persons at risk, 7) assessing emergency resources, and 8) establishing dedicated emergency funds (2,3). To evaluate training effectiveness, data obtained through online surveys administered during June-September 2018 were analyzed using multivariate logistic regression. Previously described preparedness indicators among trained human services organizations and faith-based organizations were compared with those of organizations that were not trained (3). Participation in the community preparedness program training was associated with increased odds of meeting preparedness indicators. NYC's community preparedness program can serve as a model for other health departments seeking to build community preparedness through partnership with community-based organizations.


Assuntos
Participação da Comunidade/estatística & dados numéricos , Relações Comunidade-Instituição , Planejamento em Desastres/organização & administração , Organizações Religiosas/organização & administração , Prática de Saúde Pública , Humanos , Cidade de Nova Iorque , Avaliação de Programas e Projetos de Saúde
10.
BMC Public Health ; 19(1): 1130, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31420034

RESUMO

BACKGROUND: In 2014, Vietnam was the first Southeast Asian country to commit to achieving the World Health Organization's 90-90-90 global HIV targets (90% know their HIV status, 90% on sustained treatment, and 90% virally suppressed) by 2020. This pledge represented further confirmation of Vietnam's efforts to respond to the HIV epidemic, one feature of which has been close collaboration with the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). Starting in 2004, PEPFAR supported community outreach programs targeting high-risk populations (people who inject drugs, men who have sex with men, and sex workers). To provide early evidence on program impact, in 2007-2008 we conducted a nationwide evaluation of PEPFAR-supported outreach programs in Vietnam. The evaluation focused on assessing program effect on HIV knowledge, high-risk behaviors, and HIV testing among high-risk populations-results relevant to Vietnam's push to meet global HIV goals. METHODS: We used a mixed-methods cross-sectional evaluation design. Data collection encompassed a quantitative survey of 2199 individuals, supplemented by 125 in-depth interviews. Participants were members of high-risk populations who reported recent contact with an outreach worker (intervention group) or no recent contact (comparison group). We assessed differences in HIV knowledge, risky behaviors, and HIV testing between groups, and between high-risk populations. RESULTS: Intervention participants knew significantly more about transmission, prevention, and treatment than comparison participants. We found low levels of injection drug-use-related risk behaviors and little evidence of program impact on such behaviors. In contrast, a significantly smaller proportion of intervention than comparison participants reported risky sexual behaviors generally and within each high-risk population. Intervention participants were also more likely to have undergone HIV testing (76.1% vs. 47.0%, p < 0.0001) and to have received pre-test (78.0% vs. 33.7%, p < 0.0001) and post-test counseling (80.9% vs. 60.5%, p < 0.0001). Interviews supported evidence of high impact of outreach among all high-risk populations. CONCLUSIONS: Outreach programs appear to have reduced risky sexual behaviors and increased use of HIV testing services among high-risk populations in Vietnam. These programs can play a key role in reducing gaps in the HIV care cascade, achieving the global 90-90-90 goals, and creating an AIDS-free generation.


Assuntos
Relações Comunidade-Instituição , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/estatística & dados numéricos , Comportamento de Redução do Risco , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Medição de Risco , Assunção de Riscos , Profissionais do Sexo/psicologia , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual/psicologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Inquéritos e Questionários , Vietnã/epidemiologia
11.
BMC Public Health ; 19(1): 1168, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455324

RESUMO

BACKGROUND: Tuberculosis (TB) remains a major global public health problem in many developing countries including Kingdom of Saudi Arabia (KSA). Patient compliance with anti-tuberculosis treatment is a determining factor in controlling the spread of TB. This study compares the default rate and the perception of their treatment among TB patients being treated by means of a community mobile outreach approach, with those of patients being treated by means of a facility-based Directly Observed Treatment Short course (DOTS) in the Jeddah region of Saudi Arabia. METHODS: A comparative cross-sectional study of 200 TB patients who presented at the Madain Alfahd Primary Health Care Center (PHCC) Jeddah, between January 2018 and November 2018 was undertaken. In one group, randomly assigned patients were served by mobile outreach teams who administered oral anti-TB treatment under the DOTS regime. In the other group, the patients were treated by means of the traditional facility-based DOTS treatment. A questionnaire measuring patient attitudes and understanding of the disease and their treatment modes was completed by patients at the beginning of their treatment, and again after 3 months. The results were analysed by means of independent and Paired T Tests, along with chi square analysis. RESULTS: We found that the overall default rate among those patients served by our mobile outreach team was only 3%, compared with a 22% default rate among non-mobile team treated patients (p = < 0.001). A major change in the attitude and understanding scores of patients was noted in both groups after 3 months. A significant difference was also noted in the mean compliance scores (mobile team served =58.43 and facility-based =55.55, p < 0.001) after 3 months of treatment. CONCLUSION: Our study indicated that treatment by means of our mobile outreach DOTS can offer an effective strategy for the treatment of TB patients. A reduced patient default rate and a better understanding of the disease and its treatment confirmed a positive impact of mobile outreach teams on these patients. Treating TB patients by means of mobile outreach teams can thus be recommended as a means for the cure and prevention of the further spread of the disease.


Assuntos
Antituberculosos/uso terapêutico , Relações Comunidade-Instituição , Terapia Diretamente Observada , Cooperação do Paciente/estatística & dados numéricos , Telemedicina/organização & administração , Tuberculose/tratamento farmacológico , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Arábia Saudita , Inquéritos e Questionários , Adulto Jovem
12.
Adv Physiol Educ ; 43(3): 401-407, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31408382

RESUMO

Since fall 2015, the University of Virginia's (UVA) Engineering Student Council (ESC) has partnered with the nonprofit Virginia Science Olympiad (VASO) organization to host a Science Olympiad (SciOly) state tournament in Charlottesville, Virginia, each spring. This annual tournament brings over 2,000 middle and high school students, teachers, and parents to the UVA campus, and teams of 15-17 people from roughly 90 schools across Virginia participate in 46 different events (23 middle school, Division B; 23 high school, Division C) relating to the science, technology, engineering, and mathematics (STEM) fields throughout the day-long competition. The national SciOly organization sets the events and rules to comply with national education standards, and the VASO board coordinates the teams and tournaments within the state. By collaborating with VASO, UVA ESC was able to plan a large-scale SciOly tournament at UVA in approximately 10 mo with the support of the UVA School of Engineering and Applied Science. Since this event was planned and executed solely by undergraduates in cooperation with the nonprofit organization, there were institutional hurdles that were overcome through the months of planning. The Virginia SciOly state tournament has continued to be held at UVA with the support and cooperation of the UVA ESC and VASO, and bringing this tournament to UVA has allowed for increased excitement for participating K-12 students and a mitigated burden to the VASO organizers in planning the state competition. This paper aims to provide a resource for other universities to support STEM activities in K-12 outreach organizations, like SciOly, in the future.


Assuntos
Relações Comunidade-Instituição , Instituições Acadêmicas , Ciência/educação , Estudantes , Universidades , Adolescente , Criança , Relações Comunidade-Instituição/tendências , Feminino , Humanos , Masculino , Instituições Acadêmicas/tendências , Ciência/tendências , Universidades/tendências , Virginia
13.
Rev. bras. ativ. fís. saúde ; 23: 1-6, fev.-ago. 2019. fig
Artigo em Inglês | LILACS | ID: biblio-1026732

RESUMO

This study aimed to describe the transition from the intervention protocols of the research project entitled "Active Environment" to the conception of the university extension program known as "EducAtivo". Considering the complexity of the context of physical activity promotion and the need to understand its processes, this manuscript justifies itself as it addresses such need by reporting the procedures adopted along the extension program implementation. The result of this transition is the current proposal of EducAtivo, aimed at creating opportunities for health experiences and reflection, using physical activities/body practices as a health education strategy, apart from approaching related top-ics such as healthy eating. With an itinerant design, this program implements its activities in social spaces, bringing the university closer to the community. Furthermore, EducAtivo welcomes students from different courses, fostering qualification for multi-professional work, since this is fundamental in the health field. Fundraising has been sought, aiming to improve and increase the program


Objetivou-se descrever a transição dos protocolos de intervenção da pesquisa "Ambiente Ativo" à construção do programa de extensão universitária "EducAtivo". Considerando a complexidade do cenário da promoção da atividade física e a necessidade de compreensão de seus processos, este manuscrito se justifica à medida que vai ao encontro de tal necessidade ao relatar os procedimentos adotados no decurso da implementação do pro-grama de extensão. O resultado dessa transição consiste na atual proposta do EducAtivo, que tem por objetivo criar oportunidades à vivência e reflexão em saúde, lançando mão das atividades físicas/práticas corporais como estratégia de educação em saúde, além de abordar temáticas correlatas, como alimentação saudável. De caráter itinerante, o programa realiza atividades em espaços sociais, aproximando a universidade da comunidade e recebe estudantes de diferentes cursos, fomentando a capacitação para atuação multiprofissional, fundamental no campo da saúde. Busca-se aprimorar e ampliar o programa com a captação de recursos


Assuntos
Exercício , Relações Comunidade-Instituição , Promoção da Saúde
14.
Ophthalmic Epidemiol ; 26(6): 408-415, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31272270

RESUMO

Purpose: The Key Informant (KI) case finding method, which trains community members to screen children for eye problems and refer them to eye services, is a common strategy to identify and refer children with blindness and visual impairment. However, studies to date have not determined the benefit and cost of adding KIs to routine outreach activities.Methods: Four eye programs in Madagascar with established outreach camps added KIs to a portion of their camps distributed equally throughout their service region over a one year period. KIs recorded children screened and their attendance at an outreach camp. Outreach personnel used standardized registration forms to gather age, sex, visual acuity, diagnosis and treatment data. Costs were gathered for the KI program and outreach camps.Results: In one year, the 4 eye programs held 138 outreach camps, 43 with KIs. The KI camps were more productive than regular camps seeing an average of 61 and 24 children and 50 and 19 children with an eye problem, for KI and regular camps, respectively. The KI camps also saw more children with moderate or severe visual impairment or blindness with 21 and 8 children (per 10 camps) for KI and regular camps, respectively. A KI camp cost $463 ($642 vs. $179) more than a regular camp and $3 ($8 vs. $11) more per child seen.Conclusion: The KI method significantly increased the number of children attending outreach camps, at all levels of visual impairment and blindness, at a modest increase in costs.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Assistência à Saúde/organização & administração , Transtornos da Visão/diagnóstico , Cegueira/diagnóstico , Criança , Pré-Escolar , Serviços de Saúde Comunitária/economia , Relações Comunidade-Instituição , Assistência à Saúde/economia , Feminino , Custos de Cuidados de Saúde , Humanos , Lactente , Madagáscar , Masculino , Estudos Prospectivos , Transtornos da Visão/economia
16.
J Trauma Acute Care Surg ; 87(2): 456-462, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31349352

RESUMO

An effective injury prevention program is an important component of a successful trauma system. Maintaining support for a hospital-based injury prevention program is challenging, given competing institutional and trauma program priorities and limited resources. In light of those pressures, the American College of Surgeons Committee on Trauma mandates that trauma centers demonstrate financial support for an injury prevention program as part of the verification process, recognizing that hospital administrators might see such support as discretionary and ripe as a target for expense reduction efforts. This Topical Update from the American Association for the Surgery of Trauma Injury Prevention Committee focuses on strategies to be more effective with the limited resources that are allocated to hospital-based injury prevention programs. First, this review tackles two of the many social determinates of violence, including activities aimed at mitigating the impact of both community violence exposure and intimate partner/domestic violence. Developing or participating in coalitions for injury prevention, both in general with any injury prevention initiative, and specifically while developing a hospital-based violence intervention program, efficiently extends the hospital's efforts by gaining access to expertise, resources, and influence over the target population that the hospital might otherwise have difficulty impacting. Finally, the importance of systematic program evaluation is explored. In an era of dwindling resources for injury prevention, both at the national level and the institutional level, it is important to measure the effectiveness of injury prevention efforts on the target population, and when necessary, make changes to programs to both improve their effectiveness and to assist organizations in making wise choices in the use of their limited resources.


Assuntos
Exposição à Violência/prevenção & controle , Violência por Parceiro Íntimo/prevenção & controle , Ferimentos e Lesões/prevenção & controle , Relações Comunidade-Instituição , Hospitais , Humanos , Avaliação de Programas e Projetos de Saúde , Sociedades Médicas , Traumatologia/organização & administração , Estados Unidos , Ferimentos e Lesões/etiologia
18.
PLoS Biol ; 17(6): e3000348, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31242174

RESUMO

Technological breakthroughs in the past two decades have ushered in a new era of biomedical research, turning it into an information-rich and technology-driven science. This scientific revolution, though evident to the research community, remains opaque to nonacademic audiences. Such knowledge gaps are likely to persist without revised strategies for science education and public outreach. To address this challenge, we developed a unique outreach program to actively engage over 100 high-school students in the investigation of multidrug-resistant bacteria. Our program uses robotic automation and interactive web-based tools to bridge geographical distances, scale up the number of participants, and reduce overall cost. Students and teachers demonstrated high engagement and interest throughout the project and valued its unique approach. This educational model can be leveraged to advance the massive open online courses movement that is already transforming science education.


Assuntos
Educação/métodos , Disseminação de Informação/métodos , Robótica/educação , Adolescente , Automação , Relações Comunidade-Instituição/tendências , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Internet , Masculino , Instituições Acadêmicas , Estudantes , Ensino/educação , Tecnologia
19.
J Emerg Manag ; 17(3): 213-216, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31245832

RESUMO

The University of Nebraska Medical Center's, College of Public Health modeled a student response team after similar successful programs at Emory University and the University of North Carolina. The team was created for three specific scenarios: epidemiology outbreak assistance, points of dispensing assistance, and monitoring social media in a disaster. Graduate students in public health are an overlooked volunteer resource. Many have prior work experience and are eager for the opportunity to gain additional practical experience while demonstrating classroom knowledge about the foundations of public health. Requesting agencies gain access to a dependable, replenishable volunteer pool. Academic institutions are encouraged to create teams to serve local communities, giving students access to serve local communities and to give students access to valuable applied experience that can be beneficial as they enter the public health workforce.


Assuntos
Relações Comunidade-Instituição , Desastres , Estudantes de Saúde Pública/psicologia , Voluntários , Humanos , Nebraska , Saúde Pública , Faculdades de Saúde Pública/organização & administração , Universidades
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