A Pandemic Adaptation and Its Aftermath: Using AI and In-Person Facilitation for Community Health Education in Liberia and the United States.

Health promotion commonly focuses on supporting youth wellness, as health behaviors acquired in childhood and adolescence tend to have a significant impact on an individual's future. Adolescent health education is associated with positive health and educational outcomes, yet young people experience barriers to fully engaging in learning about health issues that are often unique to their social location. Barriers for successful engagement in health education for African diaspora youth in North American and European contexts may include school initiatives built around engagement models that do not center Black youth; for Black youth in majority-Black societies, barriers may include access to resources or exclusionary practices based on other social characteristics. Global health promotion has used a variety of multimodal educational tools from radio to more recently online engagement, especially in African contexts, to reach young people. This essay shares experiences using AI and in-person facilitation to engage in community health education with youth in Liberia and the United States. In our practice, we found that there are far more underlying systemic and structural similarities to the inequities experienced between African and Black American youth and that utilizing AI tools alongside of in-person discussion may contribute to better outcomes for youth health education.

How Public Libraries Help Immigrants Adjust to Life in a New Country: A Review of the Literature.

Public library programs and services offer opportunities to help immigrants navigate daily life in unfamiliar surroundings and a new language. For example, language classes address the social determinants of health as they encourage social participation and community ties and help develop friendships. The purpose of this research was to conduct a narrative literature review to understand how immigrants use public libraries and how public library services influence the social determinants of health for immigrant populations. Keyword searches were conducted on five databases to identify research papers that met the inclusion criteria: empirical studies published in English between 2000 and 2020 related to immigrants' use of public libraries. Thirty-one articles were included in the analysis. Thematic coding identified cross-cutting themes within the sample using the framework of the social-ecological model. Immigrants commonly use public libraries for programs (e.g., language learning), collections (e.g., borrowing books), and services (e.g., asking librarians questions). Immigrant patrons often reported satisfaction with library programs, services, and collections in the language of the host country. A frequent criticism was the relevance and accessibility of collections in their heritage language. In addition, library staff demographics often did not reflect those of immigrant patrons. Health-enhancing benefits associated with library use included increased confidence and self-esteem, cultural integration and preservation, trust and relationships (e.g., making friends), community awareness and engagement, and political integration. Future research and practice areas include collaboration between public health and library professionals to develop library programming that maximizes health and well-being among immigrants.

Evaluation of Five Data-to-Action Workshops to Enhance Capacity for Tobacco Control.

BACKGROUND: Five data-to-action workshops were conducted during 2016-2019 with participants from 38 countries. The purpose of the workshops is to use data to inform and disseminate tobacco prevention and control strategies. We evaluated the workshops using the Kirkpatrick Model for evaluation of trainings. METHODS: We evaluated the data-to-action workshops in three topic areas: (1) if the workshop was clear, useful, engaging, and relevant to the participant's work, (2) self-reported knowledge and skills for tobacco control topics, and (3) intention to apply the knowledge learned. We used nonparametric tests (one-sided Wilcoxon signed-rank test) and conducted descriptive analysis to assess the difference between pre- and postworkshop scores in each topic area. Free text data from open-ended responses were analyzed in Excel using thematic content analysis. RESULTS: Participants reported the workshop had a clear purpose (93.6%, n = 73), was well organized (94.9%, n = 74), and relevant to their work (96.2%, n = 76). There was a statistically significant increase in median learning scores across all three knowledge and five skills topic areas (p < 0.05); more than 95% of participants intended to apply the knowledge they obtained during the workshop and planned to perform new skills learned in the workshop. CONCLUSIONS: Programs interested in replicating a similar successful model may incorporate a mix of modes of instruction and hands-on experiences, as well as focus on the selection of the right audience, for their workshops. These workshops pose an opportunity for countries to enhance use and dissemination of their tobacco control data.

Developing Community-Based Mentorship: Supporting Health Science Training in Historically Marginalized Communities.

Community mentors can play a unique and critical role in developing and supporting graduate and health professional student learning in underresourced community-based settings. These mentors can benefit from extra preparation for a potentially unfamiliar role as teachers about complex social and structural challenges faced by the populations with which they work. Encouraging mentors to recognize and share their valuable expertise while developing their teaching skills can (1) improve mentors' abilities to work effectively with graduate-level and health science students from multiple disciplines, (2) bolster student learning about important historical social and structural determinants of participants' health, and (3) help students understand the broader context within which organizations serving vulnerable populations operate. As such, in one full-time, community-engaged, interdisciplinary practicum program, Bridging the Gaps-Pittsburgh, part of the multiinstitutional Bridging the Gaps Network, a half-day mentor workshop has been required for two decades for new community mentors to develop their capacity to be community-based teachers of largely graduate-level health science students. Additionally, program staff aim to support mentors and connect them to faculty and community resources in a variety of ways. Our model supports the argument that applied learning by health professional students in community settings can be significantly enhanced through building and supporting the capacity of community mentors to act as recognized teachers in areas of community expertise.

Parent Attendance in a Family-Based Preventive Intervention Delivered in Latin America and the United States.

In Latin America, there is an increasing interest in the implementation and dissemination of evidence-based, family-centered interventions to prevent youth behavioral problems. While families' participation in interventions is integral to achieving the interventions' desired impact, little is known about what predicts Latin American families' attendance. The current study provides a unique opportunity to explore the participation of families living in the United States, Ecuador, and Chile in an evidence-based intervention, Familias Unidas. We tested for differences in attendance rates, family functioning variables, and adolescent behavioral problem variables, then applied a hierarchical multiple regression to (a) identify which variables significantly predicted program attendance and (b) assess whether the country in which the intervention was implemented in moderated the relationship between predictors and program attendance. On average, Chilean and Ecuadorian parents were more engaged and attended more sessions than parents living in the United States. Across samples, there was significant differences in family functioning and adolescent behavioral problem variables. However, effective parent-adolescent communication was the only significant predictor of lower program attendance. A significant interaction effect revealed that even though Chilean parents had high parent-adolescent communication, they were more likely to attend sessions, compared to parents living in the United States. We highlight the promise of engaging and retaining families, across U.S. and Latin American samples, into a culturally syntonic, family-based intervention, and discuss potential explanations for success in Chile and Ecuador. Researchers interested in implementing interventions in Latin America could utilize these findings to better target participants and intervention efforts.

A Scoping Review of Literature About Mental Health and Well-Being Among Immigrant Communities in the United States.

Immigration-both the experience of migrating and events after migration-can affect the mental health and well-being of immigrants and their communities. However, evidence suggests that immigrants in the United States do not access mental health services to the same extent as nonimmigrants. In particular, immigrant adolescents and young adults may have unique stressors related to their developmental stage, experiences in school and with peer groups, and shifting roles within family systems. This scoping review summarizes findings from published research studies and practitioner-focused gray literature about the mental health needs of immigrant communities in the United States. The review finds that specific mental health needs vary across factors like age, racial/ethnic group, immigration status, and place of residency. Findings also indicate that structural factors like immigration-related laws affect both access to mental health services and stressors in the overall environment for immigrants and their families. This review also explores models of community-level initiatives that utilize strengths-based approaches to promoting mental health and well-being among immigrant communities. Findings highlight the need for a better understanding of the mental health needs and current barriers to care among diverse immigrant populations, as immigration continues to play a major role in U.S. public policy and discourse. The COVID-19 pandemic taking place as this article goes to press in 2020 also raises questions regarding health equity and access for marginalized populations, including immigrants and their communities, and so these findings also indicate the need for further interdisciplinary research to assess intersections among the pandemic's many impacts, including those related to mental health and well-being.

Clínica Comunitaria Esperanza: Strategy for Health Promotion and Engagement With Hispanic Communities.

A 2009 community needs assessment highlighted the health care gap facing Hispanic residents in Hampton, Virginia, one of the major cities served by Eastern Virginia Medical School (EVMS). Survey respondents indicated the following as health care barriers: language, lack of knowledge, and lack of a community health center. EVMS students worked to bridge the health care gap between existing needs and services by establishing and maintaining the Clínica Comunitaria Esperanza, a culturally and linguistically competent student-run free clinic serving uninsured Hispanics in the Hampton Roads area. This article provides a model for engaging effectively with a priority population through partnerships that facilitate understanding of the community concerns, values, culture, and existing local resources that serve as determinants of health. This article further illustrates how the integration of two preexisting EVMS programs, the HOPES (Health Outreach Partnership of EVMS Students) Clinic and the Medical Spanish program, has supported the development and sustainability of Clínica Comunitaria Esperanza. The HOPES Clinic is a student-run free clinic that provides both general and specialty care to uninsured patients. EVMS' Medical Spanish program is a longitudinal service learning initiative composed of medical students, faculty, and staff dedicated to providing inclusive health care to meet the needs of the local Spanish-speaking community.

Service Learning Trips Abroad Benefit Both Communities and Seasoned Health Educators.

Service learning experiences abroad provide an excellent opportunity for seasoned health educators to share their skills with underresourced communities in other parts of the world while enriching their own professional development. Health educators have not traditionally participated in short-term medical service trips, which have become a popular humanitarian effort, yet their contributions can expand the scope of these efforts. With our responsibilities often focused on assessing needs, planning, implementing, and evaluation, seasoned health educators can provide guidance for new initiatives and share health promotion materials and other resources with communities in other parts of the world. In this commentary, I detail my experience as the first health educator to volunteer with a medical brigade that has served a rural community in Honduras for nearly two decades, and describe my added contribution of a brief intervention to address teen pregnancy during the brigade's annual, medically oriented visit. I also reflect on the benefits to my professional growth from this opportunity to immerse myself in four very familiar areas of responsibility for health education in a new and unknown setting.

The Tribal Tobacco Education and Policy Initiative: Findings From a Collaborative, Participatory Evaluation.

While the reduction in the overall U.S. smoking prevalence has been declared one of the top 10 public health achievements of the past century, the growing disparity in smoking between American Indians and the general population is one of the biggest challenges of the 21st century. Minnesota in particular has very high smoking rates among American Indians (59%). Tribal Nations in Minnesota share a past of attempted cultural genocide and a present of restoring the strength of their cultural teachings, including the prominence of traditional tobacco as a sacred "first medicine." The Tribal Tobacco Education and Policy initiative works to address this complex and challenging context. This article describes results of a participatory evaluation from 2010 to 2013 in four Minnesota Tribal Nations-three Ojibwe and one Dakota. Tribal Tobacco Education and Policy coordinators used their cultural knowledge to develop community-level strategies, identifying appropriate strategies from best practices on tobacco advocacy, while drawing on the strengths of their own sovereignty and sacred tobacco traditions. Tribal coordinators generated support for policy change by conducting culturally relevant education, engaging tribal members, and nurturing relationships. This approach resulted in norm changes, practices toward restoring traditional tobacco, informal policies, and tribal resolutions to advance smoke-free policies.

A Community Health Worker Intervention for Diabetes Self-Management Among the Tz'utujil Maya of Guatemala.

Despite the high prevalence of diabetes in rural Guatemala, there is little education in diabetes self-management, particularly among the indigenous population. To address this need, a culturally relevant education intervention for diabetic patients was developed and implemented in two rural communities in Guatemala. An evaluative research project was designed to investigate if the structured, community-led diabetes self-management intervention improved selected health outcomes for participants. A one-group, pretest-posttest design was used to evaluate the effectiveness of the educational intervention by comparing measures of health, knowledge, and behavior in patients pre- and postintervention. A survey instrument assessed health beliefs and practices and hemoglobin A1c (HgA1c) measured blood glucose levels at baseline and 4 months post initiation of intervention (n = 52). There was a significant decrease (1.2%) in the main outcome measure, mean HgA1c from baseline (10.1%) and follow-up (8.9%; p = .001). Other survey findings were not statistically significant. This study illustrates that a culturally specific, diabetes self-management program led by community health workers may reduce HgA1c levels in rural populations of Guatemala. However, as a random sample was not feasible for this study, this finding should be interpreted with caution. Limitations unique to the setting and patient population are discussed in this article.

An instructional design model for culturally competent community health worker training.

The Texas Public Health Training Center (TPHTC) provides quality training and education for the full spectrum of public health workers. As part of this mission, the TPHTC creates continuing education modules for nontraditional public health workers, such as community health workers (CHWs), through a culturally competent curriculum development process. CHWs, like many public health workers, must be certified by the state of Texas to practice within its borders, and continuing education is required to maintain certification. By involving CHWs and community members in its curriculum development process, the TPHTC is able to produce training modules that are more suitable for this unique and important segment of the public health workforce. The iterative curriculum development process is described here, along with a state-approved curriculum resulting from this method. As the value of the nontraditional public health workforce gains more recognition, sound curriculum design will be increasingly important to support and strengthen these nontraditional professions.

The use of international service learning initiatives for global health education: case studies from Rwanda and Mexico.

Global health education and health promotion have the potential to engage students, scholars, and practitioners in ways that go beyond the classroom teaching routine. This engagement in global communities, can range from reflection on continuing deep-seated questions about human rights and civic responsibility to the use of health education and promotion-related theoretical, intellectual, and practical skills. In the arena of global health education and promotion, these skills also range from leadership and advocacy to decision making, critical and creative thinking, teamwork, and problem solving. In recent times, there has been a growing interest in cross-cultural collaborations and educational initiatives to improve stakeholder's understanding of global health principles and practices, to enrich the experiences of health professionals, and to improve the lives of those who are disenfranchised and live across borders. In this article of Health Promotion Practice, we highlight two unique cases of cross-national collaborations and provide a glimpse of the various shapes and forms taken by cross-cultural educational initiatives for global health education and promotion. We summarize the history, philosophy, and current working practices relevant to these collaborations, keeping in view the global health domains, competencies, and activities. In addition, we also compare the key components and activities of these two case studies from Rwanda and Mexico, wherein communities in these two countries collaborated with academic institutions and health professionals in the United States.