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Challenges and Opportunities in Community Health

Challenges and Opportunities in Community Health

Moses, M. O. (2023)

Abstract

The study assesses the role of Mobile learning in supporting Community Health Workers’ continuous learning using a Smartphone application. The Community Health Workers are members of the community commonly known as Village Health Teams in Uganda. This group is presumed not be a priority for training. The aim is to objectify using Mobile learning affordances to support Community Health Workers’ training, an activity presently considered to be irregular and underfunded. This is achieved through the implementation of a Mobile App prototype used as a learning tool for digitized training content on the subject of diseases, reproductive health, sanitation, and family wellbeing. The study involved 41 participants categorized as Community Health Workers, community health students, and Community Health Leaders who selectively participated in piloting the mobile application, responded of a survey questionnaire, took an interview and attended a feedback session. The study examined the availability of Smartphone devices, ease of Mobile App use, challenges of the existing approach to training and information delivery, Mobile Application accessibility issues, and anticipated technical challenges. Despite the conspicuous challenges of mobile technology in a rural setting, 97% of the participants indicated that Mobile learning is a favorable alternative to support the training of Community Health Workers, though, only 48% had access to a Smartphone. Attrition of volunteer workers was identified as the primary challenge to the training of Community Health Workers.  The identified advantages relate to geographic convenience, cost of training, numerous mobile services, ease of access, update, storage, and sharing of content. However, imminent bottlenecks identified include the availability of Smartphone devices among Community Health Workers, lack of electricity, unreliable networks, and lack of internet data. Notable interventions from stakeholders aiming to mitigate the challenges are highlighted.

Mensah, E., Karim, M., Ogunmuyiwa, O., Alema‐Mensah, E., Darko, F., & Kolla, K. V. (2023)

Abstract

Objective: The study examined the mental health conditions experienced by working mothers as caregivers in Georgia, United States during the COVID-19 pandemic, the causes and outcomes of the mental health conditions experienced, and the coping mechanisms they employed.

Methods: A mixed methods cross-sectional study design was used to collect data from 132 working mothers in Georgia across six domains using Qualtrics. Quantitative data was analyzed using SPSS and SAS. Qualitative data was analyzed using a thematic approach.

Results: Working mothers experienced depression and anxiety while providing care during the pandemic. The lack of access to childcare and family support (12.5%), home schooling (18.1%), and juggling work and family (25.6%) contributed to the mental health conditions experienced, which led to anger (12.5%), aggression towards partners (11.3%), and the inability to sleep (18.8%). Coping mechanisms employed were drinking (1.3%), smoking (5.6%) and arguing with a spouse (8%).

Conclusion:  While the pandemic affected the mental health of many adults in the US, working mothers providing care were among the population hardest hit. Although the immediate threat of COVID-19 has abated, its impact on mental health cannot be overlooked.  By focusing primarily on the mental health of working mothers as caregivers during the pandemic, the study draws attention to, and underscores the need for targeted interventions and policies to be put in place to respond to the mental health needs of this population in the event of a future global health emergency.

Joachin, M., Okoye, A. E., Yvette, N., Thomas, N. A., Kosisochukwu, N., Emesobum, M., Samuel, E., Chinedu, O., & Kenechukwu, N. (2024)

Abstract

Background/Aim: Poor Maternal and Child Health service indicators have been a recurring Public Health challenge in Nigeria since the documentation of National Maternal, Newborn, and Child Health (NMNCH) statistics began in the early 1990s. This study was aimed at identifying the factors that affect the utilization of Maternal and Child Health services among women of childbearing age attending urban Primary Health Care centers in Enugu State (Abakpa and Uwani).

Methodology: This was a retrospective and descriptive cross-sectional study and data was collected through a self-administered questionnaire. 296 respondents participated and analysis of data was done using Statistical Package for Social Sciences (SPSS) version 20.0. The findings revealed that the number of deliveries in the health centers was highest in 2018 with a total of 378 deliveries compared to 2016 & 2017 with 280 and 254 deliveries respectively. The total number of under 5 children receiving yellow fever/ measles vaccine in the health center increased throughout the years with a total of 1493 vaccinations in 2016, 1510 in              2017, and 2083 in 2018.

Results: It was also observed that the main factors that enhanced Maternal and Child Health (MCH) services in the health centers were decreased maternal age, maternal educational status, affordability of services rendered, good attitude of health workers, and the proximity of both health centers to the homes of the respondents. On the other hand, increased maternal age, poor maternal education, high parity, and long waiting hours experienced by the patients were the major factors hindering the utilization of services rendered in the health centers.

Conclusion: To improve utilization of MCH services as identified by the women include; advocacy and sensitization campaigns, community dialogue, and upgrading of the existing health care centers.

Mishra, M., Dana, S., Kurup, P., Kureshi, U., Vijayan, S. K., & Dave, N. (2023)

Abstract

Health workers are central to the COVID-19 pandemic response, balancing additional service delivery needs while preserving access to essential health services and deploying COVID-19 vaccines. They also face higher risks of infection in their efforts to protect the greater community and are exposed to hazards such as psychological distress, fatigue and stigma.

Methodology: A retrospective cross sectional study is carried out among the health care workers residing Gujrat, India. A cross sectional study was carried out among the sample of 600 registered health care workers,(specialist, general physian, nurses, others) who were active during covid pandemics. Online questionnaire (DASS 21 and Maslach burnout inventory) were distributed to the participants to evaluate their stress, anxiety and depression status.

Results: Around 48.1 % participants were suffering from mild-moderate to severe level of depression. Anxiety was found to effect around 60% of health care workers. And almost 68% of health care worker has suffered from stress. The burnout level was also very high among health care worker (table 5). It was found that 52% participants were having low-moderate to high level of burnout.

Conclusion: Stressfulness of work, and practice management were factors in which reality was experienced to be worse than expected. Also, finding a suitable practice was something that appeared more difficult than expected in their early career. Burnout is recognized as a potential problem within a broad range of occupations, and within many different countries.

Alkhatry, M., Hamadi, H., Alwahedi, A., Muzaki, Z., Ahmed, F., Almasri, B., Housen, F., Bataweel, M., Alabar, E., & Eltayeb, H. (2023)

Abstract

Obesity poses a multifaceted challenge in the United Arab Emirates (UAE), demanding a comprehensive review of its epidemiology, causes, prevention strategies, and challenges. This article explores the intricate web of factors contributing to obesity, emphasizing a multidisciplinary approach that engages nutritionists, exercise physiologists, behavioral therapists, and surgeons. The epidemiology reveals a concerning rise in obesity rates, necessitating targeted interventions. Demographic influences, cultural dynamics, dietary patterns, sedentary lifestyles, and genetic factors are dissected to provide a nuanced understanding. Health implications extend beyond body weight, impacting public health systems and imposing an economic burden.

Prevention strategies encompass childhood obesity initiatives, community-based interventions, workplace wellness programs, and government policies. Challenges in implementing these strategies include cultural perceptions of body image, access to healthcare services, socioeconomic disparities, and resistance to change. Cultural sensitivity emerges as a key theme, guiding interventions tailored to align with diverse cultural norms. Multidisciplinary care, leveraging technology, community engagement, and educational programs are explored as integral components of a holistic approach.

This review emphasizes the need for societal commitment, empowering communities and individuals, policy advocacy, and the pivotal role of healthcare professionals in the fight against obesity. Future perspectives call for sustained commitment, research investment, and the integration of technology to pave the way for a healthier UAE. This review also provides a roadmap for forging a healthier future, acknowledging the complexity of obesity, and offering insights into tailored, culturally sensitive interventions.

Xia, J., James, C., Vimla, P., Yuchun, Z., Jay, S., Chang, L., and Sonsoles, De L. (2024)

Abstract

Hypothesis generation is an early and critical step in any hypothesis-driven clinical research project. Because it is not yet a well-understood cognitive process, the need to improve the process goes unrecognized. Without an impactful hypothesis, the significance of any research project can be questionable, regardless of the rigor or diligence applied in other steps of the study, e.g., study design, data collection, and result analysis. In this perspective article, the authors provide a literature review on the following topics first: scientific thinking, reasoning, medical reasoning, literature-based discovery, and a field study to explore scientific thinking and discovery. Over the years, scientific thinking has shown excellent progress in cognitive science and its applied areas: education, medicine, and biomedical research. However, a review of the literature reveals the lack of original studies on hypothesis generation in clinical research. The authors then summarize their first human participant study exploring data-driven hypothesis generation by clinical researchers in a simulated setting. The results indicate that a secondary data analytical tool, VIADS—a visual interactive analytic tool for filtering, summarizing, and visualizing large health data sets coded with hierarchical terminologies, can shorten the time participants need, on average, to generate a hypothesis and also requires fewer cognitive events to generate each hypothesis. As a counterpoint, this exploration also indicates that the quality ratings of the hypotheses thus generated carry significantly lower ratings for feasibility when applying VIADS. Despite its small scale, the study confirmed the feasibility of conducting a human participant study directly to explore the hypothesis generation process in clinical research. This study provides supporting evidence to conduct a larger-scale study with a specifically designed tool to facilitate the hypothesis-generation process among inexperienced clinical researchers. A larger study could provide generalizable evidence, which in turn can potentially improve clinical research productivity and overall clinical research enterprise.

Greenbaum, J. (2024)

Abstract

Millions of children and adults are forcibly displaced from their homes each year, with a significant proportion seeking refuge in the European Union. Before, during and after their migration journey they may experience multiple trauma events that may lead to significant stress and complicate their adjustment to the host country. Physical, emotional and behavioral responses to adversity (the traumatic stress response) vary and are influenced by numerous factors, notably by cultural beliefs and norms. Culturally responsive healthcare professionals who serve migrant patients are in a unique position to recognize signs and symptoms of traumatic stress, and provide basic, practical interventions. Given the large number of migrant individuals at risk for significant behavioral health issues and the relatively limited number of mental health professionals available to treat them, resources are best allocated if the primary healthcare provider is equipped to offer formal or informal “screening” for traumatic stress (e.g., use a culturally adapted and validated clinical tool or ‘screen’ with open-ended questions about the migration experience, current patient wellbeing, and daily stressors). They may then offer a basic intervention for the majority of patients with mild-moderate symptoms of stress, while referring those with severe symptoms to trained mental health specialists. This article reviews the types of trauma often experienced by migrant families and the nature of the traumatic stress response. It explores how culture may impact manifestations of traumatic stress and influence discussions of trauma between patients/caregivers and healthcare professionals. Moreover, it outlines the roles of the primary healthcare professional and their organization in recognizing and responding to the needs of these vulnerable patients. Screening options, basic psychoeducation strategies and the importance of community resources are discussed. The need for clinical protocols and a trauma-informed healthcare facility, as well as staff education regarding migration-related health and behavioral health needs, cultural responsivity, and trauma-informed care is emphasized, and resources are provided.

Amos, M. and Naomi, W. (2024)
 

Abstract

Objective: The objective of the study was to investigate the Sexual and Reproductive Health (SRH) issues among Adolescents Living with HIV (ALHIV) in Gweru rural district in Zimbabwe.

Design: A cross sectional mixed method research design was used with qualitative and quantitative methods.

Setting: The study was conducted in Gweru rural district community.

Subjects: A total of 112 questionnaires were administered to ALHIV, four focus group discussions (FGDs) were conducted with ALHIV in Gweru rural district, and six key informant interviews with key informants were held at district and national levels.

Results: All respondents were not in relationships, while 94 percent lacked general understanding of relationships. All respondents reported that they were not sexually active, although 62 percent intend to have sex in future. Seventy-eight percent lacked comprehensive knowledge of HIV transmission. Respondents were aware of few modern contraception methods namely female condoms (39 percent), male condoms (37 percent) and the pill (25 percent). Adolescents Living with HIV (ALHIV) mainly access HIV related services in Gweru rural district. There is limited access to SRH services besides HIV treatment as 41 percent of ALHIV reported talking to a health service provider about SRH issues such as sexuality, family planning, condoms, sexually transmitted infections, pregnancy and childbearing.

Conclusion: The key SRH issues facing ALHIV include lack of comprehensive knowledge on SRH issues, such as sexuality, relationships, prevention of HIV re-infection, pregnancy and childbearing and family planning. There is also limited access to SRH services. Adolescents living with HIV in Gweru rural district face barriers to accessing SRH services at policy, programmatic, community, family and individual levels.

Parisa, G. (2024)

Abstract

Developing drugs for brain disorders poses significant hurdles. These challenges stem from the scarcity of optimal models for preclinical drug testing and the often observed lack of translation from preclinical to human clinical trials. Further complexity arises from the specific targeting required in many brain disorders, with drug delivery often impeded by the necessity to cross the blood-brain barrier (BBB). As such, the search for novel and efficient platforms for preclinical drug development is a vibrant area of research. In acknowledgment of the limitations of animal tests – such as the lack of translation owing to species differences – and in alignment with the principles of reduction, refinement, and replacement (3Rs), the scientific community is moving towards promoting animal-free drug development plans. In this context, human brain organoids are rapidly emerging as potential alternatives to traditional methods. These early-stage in vitro models, mirroring in vivo complexities, hold great promise for preclinical drug testing for brain disorders. Stable organoid phenotypes and the uncovering of disease-specific features could soon elevate them to a valuable strategy in pharmaceutical testing for a range of brain disorders. Recent advancements in assay-ready organoid platforms and microfluidic chips present considerable potential for the application of human brain organoids in drug development. This commentary briefly discusses the generation of human brain organoids and their application in drug development with existing examples, focusing on their potential use in preclinical drug development for migraine, a prevalent, complex, and disabling brain disorder. The associated challenges and opportunities will also be outlined.

Joanne, S. (2024)

Abstract

Background: Individuals with disabilities have the right to be teamed with service dogs for support. Healthcare professionals must be prepared to provide culturally congruent care to service dog teams. To provide culturally congruent care attributes that describe a culture must be known. Little to date is known about the perspectives of individuals teamed with service dogs.

Purpose: This study examined characteristics of individuals teamed with service dogs, their perspectives on service dogs, benefits of their service dog, and experiences of receiving healthcare.

Method: A cross-sectional survey was conducted with individuals teamed with service dogs in the United States (N =270).

Discussion: While there is great diversity among individuals with disabilities within this culture is a community of individuals teamed with service dogs. Individuals teamed with service dogs, including those for vision and hearing, share attributes that describe them as a cultural community. This understanding is fundamental to culturally congruent care for service dog teams.

Systematic Review of the Trajectory Patterns of Distress Over the Cancer Continuum Among People Living with Cancer in the United States

Jane, M., Karry, W., Kayla, S., and Gwen, W. (2024)

Abstract

Purpose: Recommendations have been made for distress screening for all newly diagnosed cancer patients at their initial consult and along the cancer continuum. This review aims to synthesize the literature presenting distress trajectories of people living with cancer by describing distress trajectories by cancer site, assessment in the cancer continuum, by sex, and by instruments used.

Methods: A systematic review identified 5,792 quantitative studies that included distress trajectories associated with people living with cancer. Databases searched included Ovid-Medline, Scopus, PubMed, Web of Science, JSTOR, ScienceDirect, Wiley Interscience, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO. Data from 20 studies were extracted and summarized.

Results: Among the 20 studies, the five trajectory types described are low remaining low, low worsening to clinically highrecovery (low to high and back down to low), clinically high improving to low, and clinically high remaining clinically high. Of the 1,625 people living with cancer, 16% (262 people living with cancer) had trajectories with distress measuring high on their final outcome measure. Only 9 out of 20 studies described the distress trajectory over the full cancer continuum, from diagnosis through treatment and into follow-up care.

Conclusion: To advance current knowledge on ideal intervention times for clinicians in efficiently addressing distress among people living with cancer, distress measures collected throughout the cancer continuum for individual cancers are needed.

Moses, M. O. (2023b)

Abstract

The study assesses the role of Mobile learning in supporting Community Health Workers’ continuous learning using a Smartphone application. The Community Health Workers are members of the community commonly known as Village Health Teams in Uganda. This group is presumed not be a priority for training. The aim is to objectify using Mobile learning affordances to support Community Health Workers’ training, an activity presently considered to be irregular and underfunded. This is achieved through the implementation of a Mobile App prototype used as a learning tool for digitized training content on the subject of diseases, reproductive health, sanitation, and family wellbeing. The study involved 41 participants categorized as Community Health Workers, community health students, and Community Health Leaders who selectively participated in piloting the mobile application, responded of a survey questionnaire, took an interview and attended a feedback session. The study examined the availability of Smartphone devices, ease of Mobile App use, challenges of the existing approach to training and information delivery, Mobile Application accessibility issues, and anticipated technical challenges. Despite the conspicuous challenges of mobile technology in a rural setting, 97% of the participants indicated that Mobile learning is a favorable alternative to support the training of Community Health Workers, though, only 48% had access to a Smartphone. Attrition of volunteer workers was identified as the primary challenge to the training of Community Health Workers.  The identified advantages relate to geographic convenience, cost of training, numerous mobile services, ease of access, update, storage, and sharing of content. However, imminent bottlenecks identified include the availability of Smartphone devices among Community Health Workers, lack of electricity, unreliable networks, and lack of internet data. Notable interventions from stakeholders aiming to mitigate the challenges are highlighted.

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