Empowerment-based Interventions Research Articles

Effectiveness of empowerment-based self-management interventions on patients with chronic metabolic diseases: a systematic review and meta-analysis.

Management of chronic metabolic diseases has recently become an important global health issue. Extensive research on empowerment-based self-management interventions (EBSMIs) for patients with chronic metabolic diseases has been conducted, but no systematic review has evaluated their effects. To evaluate the effects of EBSMIs on patients with chronic metabolic diseases. A systematic review and meta-analysis was conducted. Five electronic databases (Airiti Library, CINAHL, Cochrane Library, PubMed/ MEDLINE, and Index of Taiwan Periodical Literature System) were searched from the earliest year available to October 2012. Controlled trials about the effectiveness of interventions on patients with chronic metabolic diseases were included. Each study was appraised by three reviewers and assigned a level of evidence based on the modified Jadad scale. Extracted data were entered and analyzed using Review Manager 5.2. Nineteen studies were reviewed. Most studies showed that EBSMIs improved patients' hemoglobin A1c test (HbA1c) (p < .00001), waist circumference (p = .02), and empowerment level (p = .004). Four studies compared the effect on body weight and body mass index, but the overall effect was not significant (p = .33 and .73, respectively). Five studies compared the effect on self-efficacy, four of which indicated significant increase. However, the overall effect on self-efficacy was not compared because studies used different scales. EBSMIs improved HbA1c test results, waist circumference, self-efficacy, and empowerment level in patients with chronic metabolic diseases. When implementing the EBSMIs, healthcare institutions need to provide training programs related to empowerment from which health professionals can acquire competence in patient empowerment. Moreover, healthcare leaders should assess and overcome barriers (e.g., time, manpower, cost, etc.) to implementing EBSMIs in clinical settings.

Coping strategies and health in a national sample of sexual minority women.

Coping strategies have been shown to significantly influence mental and physical health among heterosexual and medically ill populations. These associations have not been thoroughly examined among sexual minority women, who are known to shoulder a high burden of disease. This study assesses the impact of adaptive and maladaptive coping on mental and physical health among 1,381 lesbian and bisexual women and examines the potential mediating role of maladaptive coping in explaining bisexual women's poorer health relative to lesbians. Participants completed a web-based survey that assessed demographic characteristics, social support, adaptive and maladaptive coping strategies, and mental and physical health. Maladaptive coping strategies, especially behavioral disengagement and self-blame, were significantly associated with mental and physical health. Coping was more strongly predictive of mental health than physical health, and maladaptive coping more strongly predictive of health outcomes than demographics, social support, and adaptive coping. Interactions between social support and coping were generally not significant. Additionally, bisexual women reported more adverse mental and physical health outcomes than lesbians, and maladaptive coping significantly mediated these relationships. Providers working with sexual minority women may wish to pay particular attention to maladaptive coping strategies, countering these with adaptive, empowerment-based interventions.

Effects of the empowerment-based selfmanagement interventions in patients with chronic metabolic diseases: a systematic review

Effects of the empowerment-based selfmanagement interventions in patients with chronic metabolic diseases: a systematic review

Pathways to Empowerment in Substance Abuse Prevention: Citizen Participation, Sense of Community, and Police Responsiveness in an Urban U.S. Setting

Community-based substance abuse prevention initiatives often rely on the empowerment of community residents. Few studies, however, have examined predictors of empowerment in substance abuse prevention contexts. This study tested a path model that included two environment-related variables (i.e., residents’ awareness of community substance abuse problems and perceived incivilities in their community), two variables representing residents’ perceptions of their community (i.e., sense of community and perceived police responsiveness to drug crime) and citizen participation as predictors of the intrapersonal component of psychological empowerment. The model was found to provide a good fit to the data from a random sample of urban residents (n=283) who participated in an evaluation of a National Institute of Justice community policing initiative in the Southwestern United States. Findings suggest that empowerment-based interventions aimed at preventing substance abuse and its related harmful consequences should incorporate activities that specifically address sense of community and police responsiveness to drug crime. Limitations and directions for future research are discussed.

Effectiveness of an empowerment-based intervention for psoriasis among patients attending a medical spa

There is increasing interest in the management of chronic diseases through patient self-efficacy procedures. Very few studies are available assessing the efficacy of empowerment-based educational interventions for psoriasis patients. To evaluate an educational programme for increasing empowerment, in a spa setting (Comano, Italy). An educational intervention with pre-post test for empowerment evaluation was employed with patients assigned either to a control (balneotherapy) or an experimental group (balneotherapy plus empowerment-based educational interventions) (quasi-experimental). The outcome measures were self-reported scores through validated tools for empowerment, severity of disease and quality of life, assessed before and after a single two-hour empowerment-based educational intervention. A total of 136 patients completed the study (control n. 49; experimental n. 87). The experimental group reported higher levels of empowerment with improved knowledge about the disease as compared to the control group. After the balneotherapy, both groups reported a positive effect on quality of life. Patients' characteristics linked to intervention effectiveness were identified. A single empowerment-based educational intervention has the potential to increase psoriasis patients' empowerment by means of increased knowledge. It is advisable to promote it as a standardized, low-cost practice for motivated patients.

The mediating role of empowerment for African American women experiencing intimate partner violence.

Intimate Partner Violence (IPV) is a significant societal problem associated with Posttraumatic Stress Disorder (PTSD) and depression, which in turn can cause impairment in a variety of areas. Previous research suggests that African American women experience more frequent and severe IPV than White women, yet report fewer PTSD symptoms related to their abuse. One proposed explanation for this relationship is that African American women are more resilient due to internal coping methods such as empowerment; however, this relationship has yet to be empirically tested. The current study investigates the role of empowerment in mediating IPV-related psychological distress in a sample of African American and White battered women (N = 204). As hypothesized, personal empowerment mediated the relationships between race and PTSD and race and depression, suggesting that empowered African American women may demonstrate greater resiliency when faced with IPV. Results are discussed in terms of their implication for developing culturally-sensitive empowerment-based interventions for battered women.

Pill Taking From the Perspective of HIV-Infected Women Who Are Vulnerable to Antiretroviral Treatment Failure

We conducted this longitudinal qualitative study to gain in-depth understanding of HIV-infected women's experiences with antiretroviral (ARV) regimens, exploring from their perspective what medication taking was like for them and what it meant in the context of their everyday lives. We engaged 55 participants over a 2-year period in 10 narrative-eliciting interviews. From their medication stories, we were able to track a 2-year prospective pattern of self-reported adherence for each individual who was prescribed ARVs. In this article we focus on the medication experiences of a subsample of 14 women who persistently had difficulties taking ARVs as prescribed, detailing their descriptions and evaluations of pill taking. Results suggest that rather than judging themselves harshly for nonadherence, they perceived their at-odds pill taking to be personally meaningful and accomplished for good purpose. Their rationales provide insights for more nuanced, empowerment-based interventions for individuals who are vulnerable to ARV treatment failure.

Domestic Violence in Refugee Families in Australia

It has been identified that immigrant and refugee women are particularly at risk in cases of domestic violence. This article reveals the qualitative research findings from a study into the significance of traumatic history, social and economic context, cultural differences and changed gender identities on the perceptions and experiences of domestic violence in refugee families. The study was undertaken with a sample of refugee men and women from Iraq, Ethiopia, Sudan, Serbia, Bosnia and Croatia. Compounding contextual factors concerning structurally based inequalities, culturally emerged challenges, social dissonance, psychological stress and patriarchal foundations are revealed. Informed by an intersectional framework that recognizes gender oppression as modified by intersections with other forms of inequality, the article argues the case for community-managed projects involving multi-level empowerment-based interventions to prevent domestic violence.

Emancipatory Politics, Critical Evaluation and Government Policy

Abstract: The aspirations of emancipatory or empowerment-based social interventions, such as those inscribed in Health Canada’s and the World Health Organization’s Ottawa Charter, require a significant reconstruction of traditional evaluation practices. The prevailing response to this need has been the inclusion of “empowering” research techniques in the evaluation activity. The author argues that empowering research techniques cannot, in and of themselves, effectively inform and support the political aspirations of emancipatory intervention; such aspirations instead demand a dramatic shift in the institutional role of evaluation research and the focus of the evaluative gaze. Drawing from elements of Habermas’s theory of communicative action, the author outlines the dimensions of a critical approach to evaluation that is more consistent with the principles underscoring emancipatory intervention. The Treasury Board’s guide to program evaluation is used as illustration, to demonstrate the implications of such an approach for conventional evaluation questions.