Assistance Program Research Articles

Athafnafólk í opinberri stefnumótun á óvissutímum: Hvernig hugmyndin um notendastýrða persónulega aðstoð varð að veruleika á Íslandi

Þessi rannsókn leitast við að útskýra tímamótaákvörðun í þjónustu við fatlað fólk á Íslandi. Opinber stefnumótun hefur löngum einkennst af hægfara breytingum, sem gerast í smáum skrefum. Stundum bregður þó svo við að meiriháttar breytingar verða og stefnumál, sem verið hefur baráttumál hagsmunahópa um margra ára skeið, ná fram að ganga. Dagskrárkenningar leitast við að útskýra meiriháttar stefnubreytingar með því m.a. að beina athyglinni að því hvernig og hvers vegna tiltekin málefni koma til kasta stjórnvalda á hverju tíma. Bandaríski stjórnmálafræðingurinn, John W. Kingdon, setti fyrst fram kenningu sína um straumana þrjá og glugga tækifæranna fyrir rúmum 30 árum. Nýlegar rannsóknir evrópskra stjórnmálafræðinga halda því nú fram að nálgun Kingdons geti varpað ljósi á það hvernig það pólitíska kerfi sem stefnumótunin fer fram í virkar og hvernig hegðun og aðferðir þátttakenda í ferlinu hafa áhrif. Í þessari eigindlegu rannsókn er skoðað hvernig hugmyndin um notendastýrða persónulega aðstoð (NPA) varð að veruleika á Íslandi. Rannsóknin byggir á fyrirliggjandi gögnum og viðtölum við lykilfólk um þá framvindu mála sem leiddi til ákvörðunar um að innleiða NPA hér á landi. Rannsóknin lýsir því hvernig og undir hvaða kringumstæðum NPA komst á dagskrá stjórnvalda. Niðurstöðurnar sýna hvernig breytingar á verkaskiptingu milli ríkis og sveitarfélaga gáfu tækifæri fyrir nýja hugmyndafræði sem nýttist bæði notendum, viðskiptahagsmunum og pólitískum hagsmunum. Niðurstöðurnar benda til þess að þar hafi ekki aðeins verið réttur maður á réttum stað á réttum tíma, heldur varpa þær fræðilegu ljósi á það hvað einkennir athafnafólk í opinberri stefnumótun og hvernig og hvers vegna það skiptir máli á óvissutímum í stjórnmálum.

Are food and nutrition assistance programs fostering an equitable early care and education (ECE) food environment? A systematic review utilizing the RE-AIM framework

BackgroundHealth inequities related to poor diet, food insecurity, and obesity negatively affect children from low-income minority families. The USDA administers Food and Nutrition Assistance Programs (FNAPs) in Early Care and Education settings (ECEs) to safeguard the health of vulnerable children. However, the extent to which FNAPs provide an equitable food environment in ECEs remains unclear. ObjectiveExamine FNAPs’ association with young children's (2–6 years) food environment in ECE through a systematic review using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The primary focus is to operationalize RE-AIM in ECE context and evaluate FNAPs' association with the ECE food environment using an equity lens. Measurable outcomesFood environment dimensions were assessed at three levels: ECE setting (availability, accessibility, affordability, acceptability, accommodation); ECE provider (feeding practices); and child (dietary intake, food insecurity, BMI percentile). ResultsThe review included 38 articles (cross-sectional=30, mixed method=1, pre-post=5, longitudinal=2) with Child and Adult Care Food Program (CACFP; n = 35), Farm to ECE (n = 2), and Food Bank-ECE program partnership (n = 1). No study addressed all RE-AIM indicators. CACFP participation showed positive association with healthy food availability (n = 28), feeding practices (n = 12), child dietary intake (n = 6), and reduced risk of being overweight (n = 1). Farm to ECE interventions showed increased local food affordability (n = 1) and children's acceptance of healthy foods (n = 1). No study addressed foods served in ECEs to accommodate cultural diversity, special dietary needs, developmental disabilities, or reported child food insecurity. ConclusionCACFP emerges as the most prevalent FNAP nationally for having potential to improve ECE food availability and feeding practices, but further research is needed to address equity gaps by examining its impact on child outcomes (dietary intake, BMI percentile) across diverse geographic locations (urban vs. rural), ECE organizational structures (center-based vs. home-based), and demographic characteristics of ECE providers and children.

Equity in practice: Lessons from a cohort-based model for community voice and input in data linkage and use

Objective and ApproachCross-sector data sharing and linkage can transform information about individuals into actionable intelligence to build stronger, healthier, and more just communities. Yet, the use of cross-sector data can also reinforce legacies of racist policies and produce inequitable resource allocation, access, and outcomes. To avoid this, we must embed data equity practices throughout the data life cycle and provide mechanisms for community voice and input. However, few integrated data systems are doing this well. To combat this challenge, AISP designed a 30-month technical assistance program–the Equity in Practice Learning Community (EiPLC)--to collaboratively develop guidance and models for centering racial equity in data integration. This session provides an overview of our EiPLC Scope & Sequence, a curriculum we designed to guide this work. Currently, 10 jurisdictions in the U.S. are receiving coaching around this curriculum and shifting their data integration practices to advance equity. ResultsTo date, progress has been nonlinear, with positive results. Work in action across the cohorts includes changes to cross-agency data governance, collaborative research agendas, legal agreements, staffing, and community participation practices including. ConclusionsWhile these efforts are nascent, progress is evident and site team members indicate growth as individuals and as site teams. Key features of success include a focus on building relationships, establishing working norms, grappling with racialized histories, and interrogating the role of structural racism and systems of power. ImplicationsThe EiPLC provides a successful model for supporting sites to embed data equity principles throughout the data life cycle.

OTO-IVM is a method of fertility preservation for patients with ovarian tumors

Introduction. An increasing number of patients of reproductive age get cancer and are highly interested in preserving fertility. Survival rates for cancer patients are improving. Methods of reproductive technologies are being improved to preserve the ability to bear children. Rehabilitation aimed to ensure a satisfactory quality of life takes on a new meaning, and with the development of new technologies, the level of possible assistance also changes. Today, rehabilitation measures for cancer patients of reproductive age should undoubtedly include all possible ways to preserve and restore fertility. Aim: preservation of fertility in patients with ovarian tumors. Material and Methods. After ovariectomy, the ovaries were transported to the embryology laboratory, where oocyte-cumulus complexes were extracted and subsequently matured using the OTO-IVM (ovarian tissue oocyte in vitro maturation) method. The resulting mature oocytes (Metaphase II) were cryopreserved by vitrification or, if a partner was available, fertilized by ICSI (intracytoplasmic sperm injection), the embryos were cultured to the blastocyst stage and also cryopreserved by vitrification. Cryopreserved oocytes and embryos can be used by patients after cancer treatment in assisted reproductive technology programs. Results. A total of 218 OCCs were recovered, 29.8 % were degraded oocytes (n=65). The proportion of OCC suitable for ripening was 153 (70.2 %). After 36 or 48 hours, 65 oocytes matured in 13 patients, which amounted to 42.5 % of oocytes without signs of degradation. In 11 patients the OCC was removed from the tumor-affected ovary. 149 oocytes were obtained, of which 50 (33.6 %) were oocytes with signs of degradation. The remaining 99 (66.4 %) of OCCs had satisfactory quality; after maturation, the Metaphase II stage reached in 49 (49.5 %) of oocytes. As a result, biological material was cryopreserved in 13 of 15 patients: 5 embryos and 60 oocytes.

Perceptions of Overweight/Obesity and the Role of Food Assistance Programs in Obesity Prevention in Lima, Peru: A Qualitative Study Before and After the COVID-19 Pandemic

ABSTRACT The study objective was to assess the perceived role of food assistance programs (FAPs) in overweight/obesity prevention in Lima, Peru and how these perceptions changed over time. Focus groups and interviews were conducted with FAP beneficiaries and administrators in 2009 and 2021. Participants perceived overweight/obesity to be an important issue, especially in 2021 due to the COVID-19 pandemic. Participants expressed that FAPs could address overweight/obesity through educational activities. Over time, beneficiaries made more concrete recommendations for FAPs to offer healthier foods, whereas administrators made less of these recommendations. The Peruvian government should consider FAPs as avenues for overweight/obesity interventions.

Inequities in Self-Reported Social Risk Factors by Sexual Orientation and Gender Identity

Sexual minority (ie, people who self-identify as gay, lesbian, bisexual, and other nonheterosexual identities) and gender minority (ie, people who self-identify as transgender, nonbinary, or other noncisgender identities) adults report worse health outcomes compared with heterosexual and cisgender adults, respectively. Although social risk factors (SRFs; eg, housing instability) are associated with health outcomes, little is known about the prevalence of SRFs among sexual and gender minority adults. To examine differences in the prevalence of SRFs by sexual orientation and gender identity among adults. This cross-sectional study used Behavioral Risk Factor Surveillance System data collected from January 2022 to February 2023 for adults aged 18 years or older residing in 22 US states. Self-reported sexual orientation and gender identity. Outcome measures were dissatisfaction with life, lack of emotional support, social isolation, employment loss in the past 12 months, Supplementary Nutrition Assistance Program participation in the past 12 months, insufficient food, inability to pay bills, inability to pay utilities, lack of transportation, and stress. Survey weights were applied. Multivariable linear regression models were used to measure the association between sexual orientation and gender identity for each outcome. The study sample comparing outcomes by sexual orientation included 178 803 individuals: 84 881 men (48.5%; 92.9% heterosexual; 7.1% sexual minority) and 93 922 women (51.5%; 89.4% heterosexual; 10.6% sexual minority). The study sample comparing outcomes by gender identity included 182 690 adults (99.2% cisgender; 0.8% gender minority). Of sexual minority women, 58.1% reported at least 1 SRF compared with 36.5% of heterosexual women. Sexual minority women were significantly more likely to report social isolation (difference, 7.4 percentage points [PP]; 95% CI, 4.9-10.0 PP) and stress (difference, 12.2 PP; 95% CI, 9.8-14.7 PP) compared with heterosexual women. A greater proportion of sexual minority men (51.1%) reported at least 1 SRF than heterosexual men (34.0%); the largest magnitudes of inequity were in dissatisfaction with life (difference, 7.9 PP; 95% CI, 5.8-10.1 PP) and stress (difference, 6.7 PP; 95% CI, 4.5-8.9 PP). Of gender minority adults, 64.1% reported at least 1 SRF compared with cisgender adults (37.1%). Gender minority adults were significantly more likely to report social isolation (difference, 14.8 PP; 95% CI, 9.9-19.7 PP) and stress (difference, 17.0 PP; 95% CI, 11.9-22.1 PP). In this cross-sectional study, sexual and gender minority adults were significantly more likely to report multiple SRFs. These findings suggest that policies and community-based systems to advance socioeconomic equity among sexual and gender minority adults are critical.

Optimalisasi Pembelajaran di Desa Wungurejo melalui Program Pendampingan Pendidikan oleh Mahasiswa KKN Posko 50

This study evaluates the educational assistance program carried out by KKN Post 50 students from UIN Walisongo Semarang in Wungurejo Village, Kendal, with the aim of improving the quality of education and children's learning motivation. This program includes various activities such as KKN Teaching, Scholar Village, and KKN Edu-Competition, which adopts the Participatory Learning and Action (PLA) method to encourage active interaction between students and the community. Despite the challenges of equal distribution of participants, activities such as calligraphy and smart learning succeeded in attracting the interest of children, who felt that it was helpful in understanding the subject matter and was more motivated to learn. Positive responses from parents and teachers show that the presence of KKN students contributes to overcoming the shortage of educators and increasing children's enthusiasm for learning. The results of the evaluation show that this activity is effective and has a positive impact, and it is hoped that it can continue to be developed to improve the quality of education in the village.

Using technology to reduce learning costs and improve program comprehension: Lessons from a survey experiment on Supplemental Nutrition Assistance Program

AbstractThe Supplemental Nutrition Assistance Program (SNAP) provides food assistance to those in need, and while the program reaches many who are eligible, program participation falls short of reaching all who are eligible. One factor contributing to this gap in participation is difficulty understanding program eligibility, a common challenge with means‐tested benefit programs. Governments have attempted to improve public understanding of these complex programs using a range of tools to reduce learning costs, yet we know little about the extent to which these tools work and why. This preregistered survey experiment tests three commonly used methods of communicating SNAP program information, including a flyer, screening tool, and video. Cumulatively, our findings demonstrate that efforts to reduce SNAP learning costs are generally effective at improving comprehension recall and that the type of intervention matters, with the video increasing comprehension scores more than the flyer and screening tool. However, the impact of the intervention does not vary substantially according to household income.

Making Financial Assistance Programs Equitable and Accessible

This Viewpoint discusses the lack of oversight and uniformity in hospitals’ financial assistance programs and the impact on patient access.

Analysis Of Family Economic Resilience Against Early Marriage Practices In Mayang Village

This research aims to measure the economic resilience of families involved in early marriage in Mayang Village, Jember Regency. Using a mixed methods approach that combines quantitative and qualitative methods, data was collected through observation, interviews, documentation, and surveys of 50 respondents who met the criteria. Data analysis using multiple linear regression shows that family income, mother's education level, and access to social assistance programs significantly affect family economic resilience. The data processing in this research uses Descriptive Statistical Analysis to describe the economic characteristics of families, such as income, expenditure, and welfare indicators. The results of this study indicate that early marriage has a significant impact on the economic resilience of families in Mayang Village, as reflected in decreased income and increased health burdens. These findings also highlight the importance of women's economic empowerment programs and improved access to education as efforts to enhance the welfare of families involved in early marriage. Interventions targeting education, health, and changes in social norms are crucial for improving the economic resilience of families in Mayang Village.

Oncology Healthcare Professionals’ Awareness and Uptake of the Employee Assistance Programme in Three Public Healthcare Facilities in KwaZulu-Natal, South Africa

Institutional psychosocial support services have gained traction, globally, more so within the context of healthcare facilities. This is mainly due to the recognition that institutional psychosocial support services are beneficial to both employees and employers, alike. However, while these institutional psychosocial support services are important, their uptake remains relatively low. With the focus being on the employee assistance programme (EAP), this study aimed to explore the awareness and uptake of institutional psychosocial support services among oncology healthcare professionals (OHPs) in public healthcare facilities in KwaZulu-Natal (KZN), South Africa. Using the interpretative phenomenological approach, the qualitative study was conducted in three public healthcare facilities that offer oncology services in KZN. Semi-structured in-depth interviews were conducted among 31 participants who were OHPs in the three public healthcare facilities. Thematic data analysis produced two main themes and six respective sub-themes. The main themes were awareness of institutional psychosocial support services and low uptake of institutional psychosocial support services, mainly owing to adequate personal support systems, privacy and confidentiality concerns, and stigma. The study findings point to the need for stronger EAPs that are needs-based, promoted regularly, and evaluated, in public healthcare facilities. To encourage service uptake and address privacy, confidentiality and stigma concerns, innovative and non-stigmatising ways of promoting these services are required, including hybrid approaches to the provision of EAP services. The study findings can provide a valuable contribution to the continued development and strengthening of institutional psychosocial support services in public healthcare facilities.

Understanding Food Insecurity and Participation in Food Assistance Programs among Hispanic/Latino Residents of Hialeah, Florida, before and during the COVID-19 Pandemic

The 63.6 million Hispanic individuals living in the United States constitute the largest ethnic or racial minority group in the country. Hispanic/Latino households report a high prevalence of food insecurity, and often, food-insecure individuals cope by turning to emergency and federal food assistance programs for immediate or long-term assistance. This paper focuses on Hialeah, Florida, a predominantly Hispanic/Latino city in Miami-Dade County. It examines which demographic factors influence participation in food assistance programs and the occurrences of periods of disrupted food access. This study examines two questions: (1) What factors are associated with participation in food assistance programs? (2) To what extent did study participants use food assistance programs before and during the COVID-19 pandemic? We conducted a survey and collected 684 responses from April to August 2022. We gathered data on participants’ identities, household attributes, and their usage of federal and emergency food assistance programs. We used Pearson’s chi-square tests to identify significant associations between food assistance usage, food access, and respondents’ demographic characteristics. We also used binary logistic regression models to assess probabilities. The findings of this research are significant, indicating that the COVID-19 pandemic exacerbated food access challenges in Hispanic/Latino households in 2022. The data also revealed that low-income households, respondents below the age of 40, individuals born in the United States, those with low educational attainment, and those living in multifamily households had the highest likelihood of using food assistance programs. Single- and non-single-parent households, employment status, languages spoken at home, and number of children in the household were also statistically significant factors in predicting food assistance usage. This research provides valuable insights into how individuals in a city responded to the pandemic by utilizing food assistance programs.

Heterogeneous effects of government energy assistance programs: Covid-19 lockdowns in the republic of Georgia

During the Covid-19 pandemic, the governments of many countries adopted measures to support the population during the lockdowns and periods of reduced economic activity. In the Republic of Georgia, in April 2020 the government announced that it would pay the electricity bills of residential customers in April and May 2020, effectively making electricity free, as long as usage would not exceed 200 kWh/month. Consumers using more than 200 kWh would pay the regular tariff on the entire consumption (not just the kWh above 200). In August 2020, the government announced that the policy would be in force again in November and December 2020, and January and February 2021. We examine meter readings from a 10 % sample of the country's customers base outside of the Tbilisi city limits to see if the response to the policy is consistent with the predictions from economic theory. We find that, as suggested by economic theory, in the months when the policy is in place low-volume consumers increase their electricity usage and high-volume consumers decrease it in an effort to make the 200 kWh mark. However, we do not find any evidence of “bunching” at 200 kWh or of a “hole” thereafter. The average household increased usage by some 5 % above and beyond their normal. This figure however masks considerable heterogeneity in the effects of the policy across urban, rural, and “high mountain” status areas.

Barriers and Facilitators to Online Grocery Shopping Among Supplemental Nutrition Assistance Program (SNAP) Participants: A Mixed Method Study

ABSTRACT This mixed methods study explored online grocery shopping perceptions by surveying individuals who do and do not receive SNAP benefits (n = 129) and by conducting interviews with SNAP recipients (n = 26) who have grocery shopped online. T-tests assessed survey findings, codebook thematic analysis was used to identify qualitative themes, and results were interpreted collectively. Survey results found no differences in perceptions of online grocery shopping between SNAP and non-SNAP recipients (p-values = 0.2-1.0) and that 97% of SNAP recipients felt comfortable using SNAP online. Five qualitative themes were identified and provided context to the survey results. The study findings can inform policy actions within SNAP.

Horizontal Inequality in Healthcare Utilisation in Rural Sabah, Malaysia

Ensuring universal access to healthcare is essential for societal equity. However, significant inequalities exist within global healthcare systems, resulting in unequal access to services and divergent health outcomes. Socioeconomic inequity, poor living conditions, and inadequate healthcare infrastructure perpetuate poor health among poor communities. Despite greater healthcare needs, economically disadvantaged populations face substantial barriers to obtaining necessary services. This research evaluates the equitable aspect of healthcare utilisation in Sabah’s rural areas to guide policy formulation. Nabawan, a rural area in Sabah with high poverty rates, was selected to assess income-related inequality and inequity in healthcare utilisation. Using the horizontal equity index and decomposition analysis, it was found that economic status significantly influences healthcare distribution, typically favouring the affluent. Central to this analysis is the concept of “equal treatment for equal need,” ensuring individuals with similar healthcare needs receive similar care regardless of economic status. Results indicate that wealthier individuals are slightly more likely to utilise healthcare services, although the difference is minimal. To address disparities, enhancing targeted financial assistance programs like PeKa B40 could reduce out-of-pocket expenses for low-income households. Additionally, increasing healthcare funding for rural infrastructure and training local healthcare workers can ensure equitable access for all households.

Optimalisasi Pelaksanaan Program KALIMASADA dalam Pendampingan Layanan Administrasi Kependudukan di Kelurahan Nginden Jangkungan Surabaya

This article will discuss the role of students in carrying out assistance in population administration services through optimizing the implementation of the KALIMASADA Program in the Surabaya City Population and Civil Registration Service, especially in the Nginden Jangkungan Subdistrict area, Surabaya. This program aims to increase public literacy regarding the importance of population administration, provide direct assistance to the community and optimize Population Administration services in Nginden Jangkungan Village. The method used in the population administration services assistance program is a participatory approach with descriptive methods. A participatory approach is an approach that formulates regional or village development needs that prioritize the community. Students carry out field trip surveys directly to the community. The results of this mentoring program show that the role of students in assisting with population administration services really helps the community in fulfilling population administration documents. This assistance activity can help the community understand the importance of population administration documents and fulfill population administration documents.

Enhancing access to expensive oncology medications in Pakistan: The critical role of pharmaceutical patient assistance programs in oncology care.

This article aims to explore the access of patient assistance program (PAPs) and the role of pharmacists in improving access to oncology care in Pakistan. PAPs aim to reduce the financial burden of cancer in Pakistan, with pharmaceutical companies providing medication at reduced costs, ranging from 33% to 90%. Pharmacists play a pivotal role in managing these programs, facilitating PAP, pharmacist, oncology care setting, cancer therapy more accessible to those who faced financial barriers to accessing them.

The Impact of Socio-Economic Factors on Maternal Health in Rural Africa

Maternal health was a critical indicator of societal well-being, reflecting the quality of healthcare systems and socio-economic conditions. In rural Africa, maternal health outcomes were alarmingly poor, with high maternal mortality rates persisting despite global efforts. This review explored the impact of socio-economic factors on maternal health in rural Africa, focusing on economic barriers, educational attainment, gender inequality, access to healthcare services, and social support networks. Economic barriers such as poverty and healthcare costs significantly limit access to essential maternal care. Educational attainment influences health literacy and the utilization of maternal healthcare services, with higher education levels correlating with better health outcomes. Gender inequality and entrenched cultural norms restrict women’s autonomy and decision-making power, negatively affecting maternal health. Access to healthcare services in rural areas is severely constrained by geographic isolation, inadequate infrastructure, and resource limitations. Social support networks, including family, friends, community members, and traditional birth attendants, play a crucial role in maternal health by providing emotional, informational, and practical support. This review used a comprehensive analysis of existing literature to discuss these factors and propose solutions to improve maternal health outcomes in rural Africa. Strategies such as financial assistance programs, expanding educational opportunities, empowering women, improving healthcare infrastructure, and strengthening social support networks are essential for addressing these challenges. By implementing these targeted interventions, significant improvements in maternal health can be achieved, leading to healthier mothers and stronger communities in rural Africa. Keywords: Maternal Health, Socio-Economic Factors, Rural Africa, Gender Inequality, Healthcare Access.

Programming the onset of ovarian stimulation: from early follicular phase start to oral contraceptive pill, to luteal phase E2, Duostim, and random start oral contraceptive protocols

Ovarian stimulation has been the single most efficient measure ever taken in assisted reproductive technology for improving outcomes by harvesting multiple oocytes and ultimately, embryos. Today, ovarian stimulation protocols consist of administrating exogenous gonadotropins to override the natural mechanisms that control the ovulatory quota to one in humans. For practicality issues, there have been numerous attempts to control, or "program," when ovarian stimulation is initiated to improve functionality and in turn efficacy for assisted reproductive technology programs. The different options for controlling the onset of ovarian stimulation currently available are discussed here, as well as the novel possibility of using progestins for blocking premature ovulation.

ICE Detainer Requests Were Associated With Lower Medicaid And SNAP Enrollment Among Eligible Adults, 2011-19.

Legislative policies that criminalize immigrants have a "chilling effect" on public program participation among eligible immigrants. However, little is known about the effect of local enforcement actions by Immigration and Customs Enforcement (ICE). In this study, we linked county-level data on the number of detainer requests (or immigration holds) issued by ICE to individual-level data from the 2011, 2016, and 2019 American Community Surveys. We fit adjusted logistic regression models to assess the association between detainer requests and enrollment in Medicaid and the Supplemental Nutrition Assistance Program (SNAP) among those likely eligible for each program in US-born versus immigrant households. A higher volume of detainer requests was associated with lower enrollment in both Medicaid and SNAP, particularly among adults in households with at least one immigrant relative to US-born households. We observed the most pronounced effects in 2011 and 2019.