Changes In Attitudes Research Articles

Assessment of Hospital Infection Prevention and Control Practices: Insights from Kampala International University Teaching Hospital, Ishaka, Uganda

The study aimed to identify factors affecting hospital infection prevention and control practices among medical personnel at Kampala International University Teaching Hospital in Ishaka, Uganda. The research was conducted using a quantitative descriptive research design. The result revealed that 76% of respondents felt they had sufficient knowledge about infection control and prevention practices. However, 34% of respondents found precautionary measures interfered with their work, and 70% recap needles after use. Only 32% reported a 0.3% chance of acquiring HIV after a needle stick injury. The study also showed 44% of respondents had received training on hand washing within 6 months. Most respondents 78% were able to wash hands before and after procedures. Only 44% of respondents had received training on waste segregation within a 6-month period. Policies and guidelines also influenced infection prevention and control practices. 52% of respondents considered the hospital infection prevention and control committee active, and 78% of them believed that waste segregation and post-exposure prophylaxis policies were available in their departments. The study found that hand washing is being carried out as recommended due to adequate on-the-job training. However, 54% of staff perceive hand washing as a challenge, and 78% were able to wash hands before and after every procedure as recommended. Only 30% of workers have access to a regular supply of soap and detergents for washing hands. Waste segregation is being practiced as recommended, but challenges persist for medical personnel. The management team should integrate infection prevention and control into the regular supervision of healthcare providers. The study suggests that promoting hand washing in a hospital requires adequate training, facilities, supplies, staffing, and a positive attitude. It recommends frequent hand washing training, accessible running water infrastructure, disposable towels, and soap and detergents. Staff should be trained on attitude change and proper waste segregation. Keywords: Hospital, Infection, Waste, Hand washing, supplies, training.

One Health intervention for elimination of anthrax in an endemic district of Odisha: A baseline and endline study

BackgroundThis study was to compare a baseline and endline survey which were conducted to assess the changes in knowledge, attitude and practices about anthrax disease among the communities after One Health intervention for the elimination of human anthrax in an endemic district of Odisha. MethodsA total of 2670 respondents were interviewed during the baseline and 2511 for the endline survey using a structured questionnaire by multi-stage sampling method. Descriptive statistics were used and logistic regression was performed to estimate the relationship between the variables and knowledge of anthrax. ResultsOut of the total participants in the study, males were about 76.25% in baseline and 72.08% in endline and about half of the total respondents were illiterate. Majority of the respondents had reported agriculture as their main occupation during both surveys. More than 50% of the respondents had livestock in their houses and farming was the main purpose for keeping them in both surveys. Around 20.26% of respondents knew about anthrax in baseline which raised to 53.64% after One Health intervention. Almost 21.29% of livestock owners had vaccinated their animals against anthrax disease throughout baseline, which increased to 66.5% during the endline survey. ConclusionThis study highlights a significant surge in both knowledge and practices related to anthrax within the community after the implementation of intervention packages based on the One Health approach. The outcome of our study signified the importance of One Health interventions to address the health challenges related to zoonotic diseases in tribal communities. The data could be useful for local Governments to incorporate such an approach in their health policy to eliminate human anthrax.

The Effect of Exclusive Breastfeeding Education on Changes in Knowledge and Attitudes of Toddler Mothers

Optimal breastfeeding practices contribute greatly to the quality of a child's growth and development. Breast milk is considered a golden feeding of nutrients in infants. Mothers have a big role in improving the quality of their children's health. This study aims to determine the effect of exclusive breastfeeding education on the knowledge and attitudes of mothers of toddlers in the working area of the Tiong Ohang Health Centre. The research is a quasi-experiment with a design with a two-group pretest and posttest approach conducted in July 2023 in the working area of the Tiong Ohang Health Center, East Kalimantan, Indonesia. The sample of this study was 36 under five mothers. The data is then collected and then analyzed with the Wilcoxon test. Results show that the effect of exclusive breastfeeding education using leaflet media on increasing knowledge of mothers under five (p = 0.000). There is an influence of exclusive breastfeeding education using brochure media on increasing the knowledge of mothers of toddlers (p = 0.002). There is an influence of exclusive breastfeeding education using leaflet media on changes in the attitudes of mothers under five (p = 0.001). There is no effect of exclusive breastfeeding education using brochure media on changes in the knowledge of mothers under five (0.132). Leaflet media is more effective to use than brochure media. This finding is empirical evidence that nutrition education is needed to continue to be encouraged, especially in remote areas

Shattered housing

Do negative housing shocks lead to persistent changes in household attitudes toward housing and homeownership? We use the residential destruction of Germany during World War II (WWII) as a quasi-experiment and exploit the reasonably exogenous region-by-cohort variation in destruction exposure. We find that WWII-experiencing cohorts from high destruction regions are significantly less likely to be homeowners decades later, controlling for regional differences and household characteristics. Underlying this effect are changes in household attitudes toward homeownership that also extend to preferences for housing consumption, with little or no support for risk preferences, income and wealth effects, or supply-side factors.

The Effect of PENEMIA (Prevention of Anemia) Video-Based Education on Anemic Pregnant Women on Changes in Knowledge and Attitudes

Pregnant women are a group that is very vulnerable to nutritional problems including anemia. around 41.8% of pregnant women are anemic worldwide. Lack of knowledge and attitudes are the main causes of anemia. This study aims to determine the effect of PENEMIA (Prevention of Anemia) video-based education for anemic pregnant women on changes in knowledge and attitudes at the Harapan Baru Community Health Center, Samarinda City. The research is a quasi-experimental design with one group pre-test post-test design carried out in May - June 2023 in the working area of the Harapan Baru Health Center, Samarinda City, East Kalimantan, Indonesia. A total of 36 anemic pregnant women were involved as respondents by determining inclusion and exclusion criteria. The data was then collected and analyzed using the Wilcoxon test. Our findings show that the difference in the level of knowledge of pregnant women before and after being given PENEMIA education obtained a p-value of 0.000. This means that there is an influence of PENEMIA education on pregnant women's knowledge. The attitudes show differences in the attitudes of pregnant women before and after being given education with a p-value of 0.000, which means there is an influence of nutritional education on the attitudes of pregnant women. PENEMIA educational videos are very effective in increasing the knowledge and attitudes of pregnant women. It is hoped that this education will continue in society

Attitudes Toward COVID-19 Vaccines Among Pregnant and Recently Pregnant Individuals

Pregnant people and infants are at high risk of severe COVID-19 outcomes. Understanding changes in attitudes toward COVID-19 vaccines among pregnant and recently pregnant people is important for public health messaging. To assess attitudinal trends regarding COVID-19 vaccines by (1) vaccination status and (2) race, ethnicity, and language among samples of pregnant and recently pregnant Vaccine Safety Datalink (VSD) members from 2021 to 2023. This cross-sectional surveye study included pregnant or recently pregnant members of the VSD, a collaboration of 13 health care systems and the US Centers for Disease Control and Prevention. Unvaccinated, non-Hispanic Black, and Spanish-speaking members were oversampled. Wave 1 took place from October 2021 to February 2022, and wave 2 took place from November 2022 to February 2023. Data were analyzed from May 2022 to September 2023. Self-reported or electronic health record (EHR)-derived race, ethnicity, and preferred language. Self-reported vaccination status and attitudes toward monovalent (wave 1) or bivalent Omicron booster (wave 2) COVID-19 vaccines. Sample- and response-weighted analyses assessed attitudes by vaccination status and 3 race, ethnicity, and language groupings of interest. There were 1227 respondents; all identified as female, the mean (SD) age was 31.7 (5.6) years, 356 (29.0%) identified as Black race, 555 (45.2%) identified as Hispanic ethnicity, and 445 (36.3%) preferred the Spanish language. Response rates were 43.5% for wave 1 (652 of 1500 individuals sampled) and 39.5% for wave 2 (575 of 1456 individuals sampled). Respondents were more likely than nonrespondents to be White, non-Hispanic, and vaccinated per EHR. Overall, 76.8% (95% CI, 71.5%-82.2%) reported 1 or more COVID-19 vaccinations; Spanish-speaking Hispanic respondents had the highest weighted proportion of respondents with 1 or more vaccination. Weighted estimates of somewhat or strongly agreeing that COVID-19 vaccines are safe decreased from wave 1 to 2 for respondents who reported 1 or more vaccinations (76% vs 50%; χ21 = 7.8; P < .001), non-Hispanic White respondents (72% vs 43%; χ21 = 5.4; P = .02), and Spanish-speaking Hispanic respondents (76% vs 53%; χ21 = 22.8; P = .002). Decreasing confidence in COVID-19 vaccine safety in a large, diverse pregnant and recently pregnant insured population is a public health concern.

Media use for Soygari: A case study of women’s behaviour to nutrition-specific information in south west Nigeria

Gari is the most popular form in which cassava is consumed in most households in Nigeria. However, gari is deficient in most food nutrients and its excessive consumption without supplementation leads to malnutrition. Soygari (Gari fortified with soyabean) could help reduce malnutrition if positive behaviour is elicited through appropriate Communication Media (CM). However, empirical evidence on suitable CM mix to elicit positive behaviour towards Soygari nutrition is scarce. Therefore, CM mix for behavioural change in Soygari nutrition information dissemination among rural households in southwestern Nigeria was investigated. This study evaluated the effect of consistent dosage of Soygari information on rural women’s behaviour in South Western Nigeria. A quasi-experimental research design was used. Data were collected from 224 women in soybean-producing households in the region through a systematic sampling procedure. This study trained women in Soygari information for twelve weeks using podcasts (audio and video messages), and interactive (demonstrations and visual teaching methods). The study targeted change in women’s knowledge, attitude, and utilization. Empirical analyses are described in tables and percentages, while parametric tests were used to analyze a priori hypotheses. The podcast method influenced higher change in Knowledge (Δx ̅ = 2.68) and attitude (Δx ̅=5.94) of women while a higher change in utilization (Δx ̅= 7.32) was found among women exposed to the interactive method. A significant difference existed in the utilization (T = 4.018; p &lt; 0.05) of Soygari among women exposed to the podcast and interactive methods. Both media types effectively promoted positive behavioural change towards Soygari nutrition among rural households in South western Nigeria. Audio and practical demonstration mix were most suitable. An interactive method of communication is best if the target of nutrition information is for immediate household utilization. Multiple dosages of information can be a motivation to change an already existing human behaviour even when distractions exist. Key words: Change in behaviour, Soygari, Nutrition-Specific diet, media use, Women

Peer and land-based approaches for fostering empowering and healthy relationships with Indigenous and northern young people in the Northwest Territories.

Indigenous and Northern women in Canada experience high rates of intimate partner violence (IPV), and this is particularly true in the Northwest Territories (NWT). Adolescents are also at increased risk of IPV, which has far-reaching, lifelong effects. Indigenous youth are particularly vulnerable to IPV due to ongoing effects of intergenerational trauma caused by colonialism, racism and residential school legacies. We explored attitudes towards IPV and the healthy relationship knowledge, skills, and experiences among participants of Fostering Open eXpression among Youth (FOXY) and Strength, Masculinities, and Sexual Health (SMASH) Peer Leader Retreats in the NWT. Multi-method approaches included quantitative surveys youth completed before and immediately following retreats. Quantitative analysis from retreats (2018-2021) included 240 participants aged 12-19 (mean age 14.5) who reported ever having an intimate partner. Most were from the FOXY program (64.2%), Indigenous (69.6%) and heterosexual (66.4%). Qualitative methods included Focus Group Discussions (FGD) (n = 69) conducted with peer leaders and apprentices (n = 311) and youth and adult staff (n = 14 FGDs, n = 165 participants). We thematically analysed FGDs to explore healthy relationship knowledge and skills, alongside paired t-tests to examine pre/post retreat changes in attitudes towards IPV. Qualitative findings suggest that leadership and embodied learning were effective in equipping youth with violence prevention and healthy relationship skills. While young women were committed to sharing knowledge and skills about healthy relationships in their communities, young men resonated with values of respect and appreciated support to identify and express emotions. Participants across programmes demonstrated their belief that healthy intimate relationships have communal, relational and intergenerational benefits. Quantitatively, we found a statistically significant reduction in attitudes accepting of IPV among young women, but no changes were noted among young men. Findings contribute to emergent evidence on strengths-based, culturally-responsive IPV prevention programming. Components of effective IPV prevention programming with young men merit further exploration.

Good reasons for bad behavior: a randomized controlled experiment on the impact of narrative reading and writing on empathic concern, perspective-taking, and attitude.

Empathic concern and perspective-taking may contribute to avoiding stigmatization of adverse health behavior. Narrative writing has been shown to be effective in promoting perspective-taking and empathy. But since narrative writing is time consuming, we tested in the present study narrative reading as an alternative, more parsimonious approach. In a randomized controlled experiment, we compared writing a narrative text about a fictitious person who displays disapproved of health behavior to reading such a text and to a control condition in which participants wrote about an unrelated topic. With a sample of n = 194 participants, we investigated the impact of writing and reading a narrative text on promoting empathic concern and perspective-taking as well as on attitude change. We found that both writing and reading a narrative text about the fictitious character increased empathic concern, F(1, 191) = 32.85, p < 0.001, part. η2 = 0.15, and perspective-taking, F(1, 191) = 24.76, p < 0.001, part. η2 = 0.12, more strongly than writing about an unrelated topic. Writing and reading a narrative text also resulted in a more positive attitude toward this person, F(1, 191) = 17.63, p < 0.001, part. η2 = 0.08. Simply reading a narrative text was equally efficient as narrative writing with respect to empathic concern, p = 0.581, perspective-taking, p = 0.629, and attitude, p = 0.197. The finding that narrative reading is as effective as narrative writing suggests that the readers appear to be able to comprehend and engage with the story being told. When narrative reading is as effective as narrative writing, it can succeed with reduced effort in increasing empathic concern, perspective-taking, and attitude. We discuss the benefits of this approach for reducing stigmatization of adverse health behavior.

Dampak Sosial dan Ekonomi Pandemi Covid-19 Terhadap Pedagang Buah Di Kecamatan Curup Kabupaten Rejang Lebong

The study of the Social and Economic Impact of the Covid-19 Pandemic on Fruit Traders in Curup District, Rejang Lebong Regency, aims to analyze the social impact of the COVID-19 pandemic on fruit traders and analyze the economic impact of the COVID-19 pandemic on fruit traders in Curup District. This research was conducted in February - March 2022 in Curup District, Rejang Lebong Regency, with the consideration that in Curup District is part of the livelihood as a livelihood and includes quite a lot of fruit traders. The analytical method used in this study is the Wilcoxon signed rank test analysis method, using the SPSS Statistics for windows software as a tool. Processed using excel software. The results showed that the impact of changes in social behavior and maintaining cleanliness that occurred to traders in Curup District, it has been tested that the indicator variables before and before the covid-19 pandemic on changes in attitude and maintaining cleanliness experienced a significant decrease from 0.05, meaning that there was a change between before and before the COVID-19 pandemic. The economic impact has been tested on indicators of changes in income before and before the covid-19 pandemic, the value of which is small from 0.05, which means there is a change, the covid-19 pandemic situation has a negative impact on economic traders causing a decrease in the monthly average

Lilith: Da Subversão à Demonização - A Ascensão do Deus Patriarcal

This study investigates the evolution of the figure of Lilith over time, from her origin in paganism to her reinterpretation by Christianity. Originally recognized as a goddess associated with fertility, female sexuality, and creative power, Lilith underwent transformations in her narrative, reflecting changes in attitudes towards the divine feminine and female power. The study employed a bibliographic methodological approach to identify dominant narratives, aiming to honor Lilith’s true nature as a goddess who celebrates the strength and beauty of the feminine.

Qualitative evaluation of an edutainment intervention to prevent age-disparate transactional sex in Tanzania: Changes in educational aspirations and gender equitable attitudes towards work.

Age-disparate transactional sex is a major contributor to the disproportionate rates of HIV experienced by adolescent girls in sub-Saharan Africa, and a key driver of unintended adolescent pregnancy. This paper comprises one element of the impact evaluation of the Learning Initiative on Norms, Exploitation and Abuse (LINEA) radio drama intervention to prevent age-disparate transactional sex. It provides new insights into the radio drama's influence on distal drivers of age-disparate transactional sex identified in formative research: girls' own educational aspirations, and gendered attitudes towards work. The intervention, which targeted adolescent girls and their caregivers in the Shinyanga Region of Tanzania, uses an edutainment approach to prevent transactional sex between girls aged 12-16 years and men at least 5-10 years older. We distributed the 39-episode radio drama on USB flash drives to 331 households and conducted longitudinal in-depth interviews with 59 participants. We conducted a thematic analysis of endline (December 2021) transcripts from 23 girls, 18 women caregivers, and 18 men caregivers of girls (n = 59), and midline (November 2021) transcripts from a sub-sample of these participants: 16 girls, 16 women and 13 men (n = 45). Findings suggest the radio drama created an enabling environment for preventing age-disparate transactional sex by increasing girls' motivation to focus on their studies and remain in school. There was also strong evidence of increased gender-equitable attitudes about work among girls and women and men caregivers. These supported women joining the workforce in positions traditionally reserved for men and challenging the male provider role. Our findings suggest that the LINEA radio drama can supplement interventions that address structural drivers of age-disparate transactional sex. The radio drama may also have impacts beyond preventing age-disparate transactional sex, such as reducing girls' HIV morbidity and mortality, and challenging attitudes that promote sexual and gender-based violence to foster more gender-equitable communities across Tanzania.

Posttraumatic growth and rehabilitative resources of the combatants and demobilized servicemen

The combat experience of military and demobilized persons combines the influence of combat and non-combat stressors with combat conditions and stressors associated with being in the combat zone, which leads to severe personal injury, symptoms of posttraumatic stress disorder and severe stress adaptive capacity. The resource of mastering combat stress is vitality, which is confirmed by the general viable position of the subjects, focused on effective self-development. Combatants show marked signs of maladaptation, but half of them report an increase in the value of life, spiritual growth and a general trend of personal growth, with women significantly exceeding men in terms of increasing personal strength. The aim of the research is to reveal the indicators of posttraumatic growth and personality rehabilitative resources of combatants and demobilized servicemen. Therefore, the posttraumatic growth of combatants goes hand in hand with attempts to adapt to a difficult situation. The main strategies for resisting stress in these conditions are cognition and recourse to physical activity. It is the resource of physical activity that is significantly positively correlated with indicators of posttraumatic personal growth. Personality posttraumatic growth indicators have been substantiated: change in attitude toward others, emergence of new opportunities, increase in strength of personality, spiritual changes, increase in the value of life, and general posttraumatic growth. The resource of rehabilitation potential, which is little used, is the appeal to the sphere of imagination and emotional sphere. The military does not sufficiently use the resources of faith and search for social support, which in crisis conditions are productive strategies. Sustainability is an important component of personal rehabilitation potential, but at this stage of a difficult situation, the personal resources involved are a person’s activity in overcoming difficulties, his/her desire to act and win, the desire not to lose this meaning, to express their personal potential.

Conflicts in the Negotiations Between China and Britain on the Return of Hong Kong

Hong Kong became a British colony in 1840. In the 1980s, the PRC government took the opportunity that Britain sent officials to sound out China’s attitude towards the Hong Kong issue to introduce “one country, two systems” policy. Because the British government, led by Margaret Thatcher, repeatedly made difficulties against China on treaty and sovereignty issues, the negotiation process was challenging. After three changes of attitude in negotiation, the British government gradually realized the tough position of the Chinese government and agreed to return Hong Kong’s sovereignty. However, Hong Kong has encountered the dramatically changing of world pattern over these 40 years. Anti-China movements in Hong Kong have colluded with overseas organizations, repeatedly set off riots and conflicts. Under such conflicts, the restoration of social order and economic development in Hong Kong need to re-examine the government organizations and policies within it, as well as the “one country, two systems”. This paper takes the Sino-British negotiations as the starting point, makes a detailed analysis of the game between the two sides in the negotiations. By relating them with the actual situation of Hong Kong society, especially the 2019 riots, the paper analyzes the Hong Kong problem and examines the roots of the ongoing conflicts in Hong Kong.

Cultural Appropriation for Improved Knowledge Acquisition in Medical Education.

Culture is an essential component that governs all aspects of human behavior. Superstition is an irrational belief observed in almost all cultures. It is linked to one or more factors like supernatural powers, good luck, bad omen, fiction, illegitimate activity, absurd narration, folk tales, or practice without any rational basis. A cross-sectional social experiment was conducted to evaluate the effect of cultural appropriation as a tool to enhance medical knowledge acquisition and attitudinal development in medical education. The experiment was designed to target a non-medical population. Four superstition-oriented videos were developed with 20 scientific pieces of information related to forensic medicine. A data collection sheet was developed on Microsoft form with 16 questions was distributed on the participants. Out of the 986 participants, 763 (77.5%) watched the whole set of videos. About 55-95% of responders demonstrated knowledge acquisition of all the questions. There was a statistically significant difference between those who watched the videos and those who did not. When participants were asked about the most important information they remember from the videos, their answers fell into two main categories; information related to core scientific knowledge (80% of participants) and information not related to the core knowledge (16% of respondents). The top three areas for the reasons why people wanted to watch the videos were curiosity, knowledge, and career. A change in attitudes was reported among the participants where 80% of responders demonstrated curiosity to know more about this world, 46% responders reported developing more respect for the forensic physician and 43% revealed their ignorance about this great hidden world. Cultural appropriation could be a needed strategy to accommodate for upscale in education. Learners might validate that learning happens through a door that adopts not only honours their culture and adapts to it.

Online sexual violence prevention on a female college campus in India: Evaluation of the RISE-ON program

BackgroundSexual violence represents a severe problem for young Indian women and requires effective prevention. Since face-to-face prevention programs are limited in reach, we developed the online sexual violence prevention program RISE-ON consisting of three modules, namely Gender, Sexual Violence, and Bystander Education. The study's objective is to investigate the short-term effects of the RISE-ON modules on participants’ knowledge and attitudes. MethodA total of N = 244 female college students from Delhi aged 17 to 22 were randomly assigned to 1 of 3 groups with two of the three modules. By design, each group functions as a treatment group for the two included modules and as a control group for the third, missing module. ResultsFrom pre- to posttest, there were significantly larger increases of participants’ knowledge on gender, sexual violence, and bystander education in the treatment than in the control group. Concerning attitudes, we found significant increases for gender awareness and bystander attitudes across all groups. ConclusionsThis study demonstrates that the RISE-ON modules are effective in terms of increasing knowledge, but there were no module-specific changes of attitudes. Thus, future online prevention programs need to focus increasingly on attitudes, especially attitudes about sexual violence, and behavior change.

Comparative analysis of epidemic public opinion and policies in two regions of China based on big data

Since the outbreak of COVID-19 (Corona Virus Disease 2019), the Chinese government has taken strict measures to prevent and control the epidemic. Although the spread of the virus has been controlled, people’s daily life and work have been affected and restricted to varying degrees. Thus people have different sentiments, these may affect people’s implementation and compliance with the policies, thus affecting the effectiveness of epidemic prevention and control. At present, few pieces of literature have analyzed the relationships between people’s feelings, policies, and epidemic trends. The object of this paper is to analyze the text content on social media, to find out the impact of the epidemic blockade policy on the public mood and the concerns expressed by the public about policies changes, and the interaction between policies and epidemic states at different stages of the epidemic. In this paper, we collected the posts of two cities where the epidemic occurred at the same time for analysis and comparative study. On the one hand, we revealed the changes in public attention and attitudes in the two regions during the epidemic, the other hand, it also reflects the differences in public sentiment between the two regions, as well as the correlation between emotions and policies and epidemic trends when different policies are adopted under different circumstances. The obtained results have a certain guiding significance for public health departments to formulate reasonable epidemic prevention policies.

Neural alignment during outgroup intervention predicts future change of affect towards outgroup.

While social psychology studies have shown that paradoxical thinking intervention has a moderating effect on negative attitudes toward members from rival social groups (i.e. outgroup), the neural underpinnings of the intervention have not been studied. Here, we investigate this by examining neural alignment across individuals at different phases during the intervention regarding Covid-19 vaccine-supporters' attitudes against vaccine-opposers. We raise two questions: Whether neural alignment varies during the intervention, and whether it predicts a change in outgroup attitudes measured via a survey 2 days after the intervention and compared to baseline. We test the neural alignment using magnetoencephalography-recorded neural oscillations and multiset canonical correlation analysis. We find a build-up of neural alignment which emerges at the final phase of the paradoxical thinking intervention in the precuneus-a hub of mentalizing; there was no such effect in the control conditions. In parallel, we find a behavioral build-up of dissent to the interventional stimuli. These neural and behavioral patterns predict a prosocial future change in affect and actions toward the outgroup. Together, these findings reveal a new operational pattern of mentalizing on the outgroup, which can change the way individuals may feel and behave toward members of that outgroup.

Using Project Extension for Community Healthcare Outcomes to Enhance Substance Use Disorder Care in Primary Care: Mixed Methods Study.

Substance use and overdose deaths make up a substantial portion of injury-related deaths in the United States, with the state of Ohio leading the nation in rates of diagnosed substance use disorder (SUD). Ohio's growing epidemic has indicated a need to improve SUD care in a primary care setting through the engagement of multidisciplinary providers and the use of a comprehensive approach to care. The purpose of this study was to assess the ability of the Weitzman Extension for Community Healthcare Outcomes (ECHO): Comprehensive Substance Use Disorder Care program to both address and meet 7 series learning objectives and address substances by analyzing (1) the frequency of exposure to the learning objective topics and substance types during case discussions and (2) participants' change in knowledge, self-efficacy, attitudes, and skills related to the treatment of SUDs pre- to postseries. The 7 series learning objective themes included harm reduction, team-based care, behavioral techniques, medication-assisted treatment, trauma-informed care, co-occurring conditions, and social determinants of health. We used a mixed methods approach using a conceptual content analysis based on series learning objectives and substances and a 2-tailed paired-samples t test of participants' self-reported learner outcomes. The content analysis gauged the frequency and dose of learning objective themes and illicit and nonillicit substances mentioned in participant case presentations and discussions, and the paired-samples t test compared participants' knowledge, self-efficacy, attitudes, and skills associated with learning objectives and medication management of substances from pre- to postseries. The results of the content analysis indicated that 3 learning objective themes-team-based care, harm reduction, and social determinants of health-resulted in the highest frequencies and dose, appearing in 100% (n=22) of case presentations and discussions. Alcohol had the highest frequency and dose among the illicit and nonillicit substances, appearing in 81% (n=18) of case presentations and discussions. The results of the paired-samples t test indicated statistically significant increases in knowledge domain statements related to polysubstance use (P=.02), understanding the approach other disciplines use in SUD care (P=.02), and medication management strategies for nicotine (P=.03) and opioid use disorder (P=.003). Statistically significant increases were observed for 2 self-efficacy domain statements regarding medication management for nicotine (P=.002) and alcohol use disorder (P=.02). Further, 1 statistically significant increase in the skill domain was observed regarding using the stages of change theory in interventions (P=.03). These findings indicate that the ECHO program's content aligned with its stated learning objectives; met its learning objectives for the 3 themes where significant improvements were measured; and met its intent to address multiple substances in case presentations and discussions. These results demonstrate that Project ECHO is a potential tool to educate multidisciplinary providers in a comprehensive approach to SUD care.

GenZs environmental attitudes and ecology behavior nexus: Urgent education message

Environmental education in schools is critical to help decrease plastic litter pollution because plastic pollution could be the most significant health problem of the 21st century. Our research examined the environmental behaviors and attitudes of Generation Z (Gen Z) high school and undergraduate students in South Texas, USA. The research was important because we need to understand what young people believe and value if we are going to see any change in environmental behavior. Results supported research on how teachers can influence student environmental attitudes, behaviors, and knowledge with education. Feedback from students revealed significant attitude change and a rich narrative of pollution and watershed ecology knowledge and behavior themes. These themes disclosed that a holistic environmental science curriculum is necessary to connect Earth systems with the plastic litter pollution cycle.