Enhance Community Health Research Articles

Evaluation of a novel approach to community health care delivery in Ifanadiana District, Madagascar.

Despite widespread adoption of community health (CH) systems, there are evidence gaps to support global best practice in remote settings where access to health care is limited and community health workers (CHWs) may be the only available providers. The nongovernmental health organization Pivot partnered with the Ministry of Public Health (MoPH) to pilot a new enhanced community health (ECH) model in rural Madagascar, where one CHW provided care at a stationary CH site while additional CHWs provided care via proactive household visits. The program included professionalization of the CHW workforce (i.e., targeted recruitment, extended training, financial compensation) and twice monthly supervision of CHWs. For the first eighteen months of implementation (October 2019-March 2021), we compared utilization and proxy measures of quality of care in the intervention commune (local administrative unit) and five comparison communes with strengthened community health programs under a different model. This allowed for a quasi-experimental study design of the impact of ECH on health outcomes using routinely collected programmatic data. Despite the substantial support provided to other CHWs, the results show statistically significant improvements in nearly every indicator. Sick child visits increased by more than 269.0% in the intervention following ECH implementation. Average per capita monthly under-five visits were 0.25 in the intervention commune and 0.19 in the comparison communes (p<0.01). In the intervention commune, 40.3% of visits were completed at the household via proactive care. CHWs completed all steps of the iCCM protocol in 85.4% of observed visits in the intervention commune (vs 57.7% in the comparison communes, p-value<0.01). This evaluation demonstrates that ECH can improve care access and the quality of service delivery in a rural health district. Further research is needed to assess the generalizability of results and the feasibility of national scale-up as the MoPH continues to define the national community health program.

Effects of community-based educational video interventions on nutrition, health, and use of health services in low- and middle-income countries: systematic review and meta-analysis

Abstract Context Health education using videos has been promoted for its potential to enhance community health by improving social and behavior change communication. Objective To provide stakeholders in maternal and child health with evidence that can inform policies and strategies integrating video education to improve maternal, newborn, and child health. Data sources Five databases (MEDLINE, Embase, Scopus, Web of Science, and CENTRAL) were searched on January 28, 2022, and November 10, 2022 (updated search). Quantitative and qualitative studies conducted in low- and middle-income countries on the effects of video-based interventions on nutrition, health, and health service use were eligible. There was no restriction on time or language. Study selection was done in 2 stages and in duplicate. Data extraction A total of 13 710 records were imported to EndNote. Of these, 8226 records were screened by title and abstract using Rayyan, and 76 records were included for full-text evaluation. Results Twenty-nine articles (n = 12 084 participants) were included in this systematic review, and 7 were included in the meta-analysis. Video interventions improved knowledge about newborn care (n = 234; odds ratio [OR], 1.20; 95% confidence interval [CI], 1.04–1.40), colostrum feeding (n = 990; OR, 60.38; 95%CI, 18.25–199.78), continued breastfeeding (BF; n = 1914; OR, 3.79; 95%CI, 1.14–12.64), intention to use family planning (FP) (n = 814; OR, 1.57; 95%CI, 1.10–2.23), and use of FP (n = 864; OR, 6.55; 95%CI, 2.30–18.70). Video interventions did not result in reduced prelacteal feeding or improvement in early initiation of BF. The qualitative studies showed that video interventions were acceptable and feasible, with perceived impacts on communities. Conclusion This systematic review and meta-analysis indicated that video interventions improved knowledge of newborn care, colostrum feeding, and continuing BF, and the intention to use FP. Given the high levels of heterogeneity and inconsistency in reporting, more research with stronger designs is recommended. Systematic review registration PROSPERO registration no. CRD42022292190.

Enhancing community health: Veterinary services for underserved areas in Costa Rica with a One Health Approach

In underserved areas of Costa Rica, community veterinary services aim to provide comprehensive care for companion animals, covering preventive, therapeutic, and surgical medicine. Emphasizing a One Health approach, our model focuses on animal welfare, health, and public well-being in vulnerable regions. The project's goal is to ensure the overall well-being of animals, people, and the environment by collaboratively addressing animal health issues and recognizing their interconnected impact on optimal health. Limited resources in underprivileged areas, including restricted access to veterinary care for pets, pose challenges to overall health. Despite its global health benefits, the absence of companion animal veterinary care in these regions has been largely overlooked. Our One Health approach not only addresses animal health but also has a significant impact on human and environmental health, economies, and social factors. This innovative strategy is a pioneering effort to tackle complex health issues in Costa Rica.

Enhancing Primary Care and Community Health: A NAPCRG Report on 2 Conferences.

Enhancing Primary Care and Community Health: A NAPCRG Report on 2 Conferences.

Enhancing Community Health Sustainability Through Use of Maqasid Al-Shariah Theory

Enhancing Community Health Sustainability Through Use of Maqasid Al-Shariah Theory

Enhancing community health sustainability through the use of &lt;i&gt;Maqasid Al-Shariah&lt;/i&gt; theory

Enhancing community health sustainability through the use of &lt;i&gt;Maqasid Al-Shariah&lt;/i&gt; theory

Optimization of the 5-plex digital PCR workflow for simultaneous monitoring of SARS-CoV-2 and other pathogenic viruses in wastewater

Wastewater-based epidemiology is a valuable tool for monitoring pathogenic viruses in the environment, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19). While quantitative polymerase chain reaction (qPCR) is widely used for pathogen surveillance in wastewater, it can be affected by inhibition and is limited to relative quantification. Digital PCR (dPCR) offers potential solutions to these limitations. In this study, a 5-plex dPCR workflow was optimized for the simultaneous detection of SARS-CoV-2, influenza A virus, enteroviruses (EnV), and noroviruses of genogroups I (NoV-GI) and GII (NoV-GII) in wastewater samples. Wastewater samples (n = 36) were collected from a wastewater treatment plant in Japan between August and October 2022. The optimization included the evaluation of singleplex and 5-plex dPCR assays, and two different concentration methods, extraction kits, and dPCR approaches. The performance of singleplex and 5-plex dPCR assays showed comparable linearity and reliability, with the 5-plex assays showing greater efficiency. The polyethylene glycol (PEG) precipitation method showed better performance over the centrifugation method, two-step reverse transcription (RT)-dPCR over the one-step RT-dPCR, and AllPrep PowerViral DNA/RNA Kit showed better performance than the QIAamp Viral RNA Mini Kit. The optimal workflow therefore included PEG precipitation, the AllPrep PowerViral DNA/RNA Kit, and two-step RT-dPCR. This workflow was selected to monitor the presence of SARS-CoV-2 and other pathogenic viruses in wastewater samples in a 5-plex dPCR approach, yielding promising results. SARS-CoV-2 RNA was detected in the majority of samples, with NoV-GI, NoV-GII, and EnV also being detected. The successful optimization and application of the 5-plex dPCR assay for pathogen surveillance in wastewater offers significant benefits, including enhanced community health assessment and more effective responses to public health threats.

Assessment of the Quality of Health Facilities &amp; Infrastructure to Support District Regional and City Planning Facilities

Health facilities are a kind of public infrastructure essential for enhancing community health standards. According to statistical data from the city of Batam, the population of the Nongsa Keluran Batu Besar sub-district was 29,198 in 2020. The majority of respondents perceived the quality of medical personnel services for the general public in Batu Besar Village as satisfactory, evidenced by 50% of respondents. The quality of administrative services for the general public in Batu Besar Village was also deemed satisfactory, as indicated by 45% of respondents. Furthermore, the quality of pharmacist services for the general public in the Batu Besar sub-district was regarded as moderately satisfactory, supported by 47.5% of respondents. The quality of BPJS services for the general people in the Batu Besar sub-district is commendable. This is substantiated by the proportion of responses, which is 52.5%. The level of nursing services for the general people in the Batu Besar sub-district is commendable. This is evidenced by the number of replies, which is 70%. A majority of respondents, 65%, perceived the equipment facilities for the general public in Batu Besar Village as satisfactory, while 60% regarded the room facilities as reasonably good. A majority of respondents, constituting 40%, perceived the public parking facilities in Batu Besar Village as highly satisfactory.

Enhancing community health system resilience: lessons learnt during the COVID-19 pandemic in Uganda through the qualitative inquiry of the COVID Task Force.

This study aimed to explore the elements of a resilient community health system during the COVID-19 pandemic and discuss whether the frameworks described in previous studies can be applied to real-world situations with those who implemented the Community Engagement Strategy, a strategy to make health systems work in their communities during health crises in Uganda. Focus group discussions (22 participants in total) were conducted with COVID Task Force members in four districts in Uganda in March 2022. These districts implemented a Community Engagement Strategy to ensure that health systems in their communities continued to function during health scares, and have been evaluated to ensure that the strategies have been implemented. A thematic analysis was applied. From the results some factors which can enhance the resiliency of community health systems were identified: including health "knowledge," "communication," "governance," and "resources" health. The most important elements changed depending on the phase of the outbreak. VHTs are the key players in the transition from knowledge-and resource-oriented initiatives to communication and governance by community residents. COVID-19, a new infectious disease, provides lessons for a resilient community health system. First, the health system should be flexible enough to be able to change the elements on which it is focused, and second, VHTs play an important role in the flexibility of the health system. This suggests that it is time to assess whether VHTs are still able to continue their activities after the pandemic is over, and whether the environment, including financial and non-financial support, has improved.

Lights, Facts, and Goals: A Novel Framework to Enhance Community Health Messaging Campaign Design, Implementation, and Assessment.

The spread of health misinformation has made the task of health communicators more difficult. However, the success of health messaging hinges not only on meaningful message content but also on the credibility of who is delivering the message. "Trusted messengers," like local leaders and community-based organizations, have a greater ability to influence improvements in community health, due to their shared cultural experience with their communities. Health communication agencies should empower trusted messengers with the tools they need to succeed in health communication. One tool critical for their success is a succinct health messaging framework to plan and implement health messaging. Marketing has "See, Think, Do"-a simple, practical framework used to influence consumer purchases. As a more trustworthy corollary, we propose the "Lights, Facts, and Goals" framework, a concise, authentic, and transparent method for planning, implementing, and assessing health messaging campaigns that influence health improvements. "Lights" refers to different methods of reaching communities like trusted messengers, advertisements, and text messages. "Facts" refers to key sourced scientific information relevant to a specific aspect of community health. "Goals" refers to actions community members can take to improve their health in connection with the communicated health facts. This article describes how the "Lights, Facts, and Goals" framework both simplifies the creation and communication of scientifically sound health messaging and strengthens the partnership between health agencies and trusted messengers in the community. Through "Lights, Facts, and Goals," community-based organizations, community leaders, and their partners will be more effective at improving community health through messaging.

A Socio-Ecological Approach to A Community-Based Health Promotion Intervention on the U.S.-Mexico Border: Insights and Lessons Learned During the COVID-19 Pandemic

The Healthy Families Healthy Kids Initiative (HFHKI) is a community-based initiative developed based on the socio-ecological model to address preventive health care needs in El Paso County, Texas, one of the most economically and health-challenged border communities in the United States. HFHKI’s three main goals are to increase access to experiential learning and health education, service delivery, and sustainable systems/linkages of care. These were accomplished through seven critical activities. We present the rationale, background, setting, and conceptual framework for the initiative, followed by the methods used to develop and assess the success of the activities and results of our project outcomes. We end with a discussion of lessons learned and future directions. We also share insights gained from our community health promotion intervention during the COVID-19 pandemic, which will enrich current conversations among applied social scientists. Overall, our project served 2,347 participants of all age ranges during our first year of project implementation across all 7 activities. We recommend the use of the socio-ecological model in designing, implementing, and improving health interventions aimed at enhancing family and community health, with each intervention tailored to the needs of different segments of the community. While the need to contain the COVID-19 virus amid the pandemic has created challenges in health promotion efforts, the need to help affected communities regain control of their health cannot be stressed enough. Our project can serve as an implementation framework for community-based projects on the U.S.-Mexico border.

A Prospective Study of Injection Drug Use and Jail Readmission in Two Western North Carolina Counties.

Injection drug use among people admitted to rural jails has significant implications for both infectious disease transmission and incarceration patterns. This study examines the relationship between injection drug use, jail readmission, and detention duration to inform interventions designed specifically for this understudied correctional setting. The Comprehensive Addiction and Psychological Evaluation-5 (CAAPE-5) was administered to a random sample of adults admitted to two county detention centers in Western North Carolina. Data regarding readmission and the length of detention were obtained for the 12-month study period. Participants included 420 adults, aged 18-66 years. Nearly three-quarters (70.9%) met criteria for at least one substance use disorder (SUD) and almost half (45.7%) met criteria for multiple SUDs. Approximately half (45.2%) reported injecting drugs, with the majority (71.6%) reporting injecting methamphetamine, followed by 51.1% who injected opioids. People who injected drugs were 1.83 times more likely (95% CI = 1.17-2.87) than those who did not inject to be admitted on multiple occasions and also spent a significantly longer amount of time detained (IRR = 1.34, 95% CI = 1.02-1.77) during the 12-month follow-up period. The study was limited to jails in two counties and injection-related factors may vary from other facilities. The association between drug injection and longer detention periods presents an opportunity to engage people with infectious disease screening and substance use services in jails. Connection to stable primary and behavioral health care after release is a high priority in enhancing community health.

Transforming Disability into Ability: The Niche of Occupational Therapy in the Multi-Rehabilitation Team at Healthcare Services

Occupational therapy aims to optimize daily activities and performance by addressing the body and mind. It focuses on helping individuals overcome physical or psychological impairments that hinder their engagement in desired occupations. Occupational therapists undergo comprehensive education and work in various healthcare settings, providing assessment, intervention, and reevaluation to many clients. The field encompasses diverse conditions and utilizes evidence-based frameworks to tailor treatment plans. Incorporating occupational therapy into healthcare policies is crucial for enhancing community health and well-being, as it contributes to standardized healthcare provision in developed countries.

Towards Key Principles for the Design and Implementation of Nature Prescription Programs

The health benefits of nature are well recognised. However, nature prescriptions (nature-based health interventions) are not routine in many health systems. We interviewed health stakeholders (n = 13) who prescribe and provide nature prescriptions, to identify enablers and barriers surrounding nature prescriptions in Australia. Participants emphasised the importance of collaboration between health disciplines, community, government and industry sectors, alongside appropriate infrastructure. Patient-centred, accessible care supporting behavioural change and social wellbeing was enabling. Participants identified a need for increased awareness, accessible local resources and responsiveness regarding climate change. The findings reveal key considerations to inform effective implementation of nature prescribing for enhanced community health.

The Future of Sexually Transmitted Infection Research: Understanding Adolescent Perspectives for Implementation of a Chlamydia Vaccine

PurposeDespite advancements in developing a vaccine for Chlamydia trachomatis (CT), vaccine hesitancy has historically limited the adoption of sexually transmitted infection immunization. This report investigates adolescent perspectives toward a potential CT vaccine and vaccine research. MethodsAs part of the Technology Enhanced Community Health Nursing (TECH-N) study, conducted from 2012–2017, we surveyed 112 adolescents and young adults aged 13–25 years who presented with pelvic inflammatory disease regarding their perspectives on a CT vaccine and willingness to participate in vaccine research. Descriptive statistical analyses were conducted. ResultsMost participants were African American (95%), on Medicaid (89%), and sexually experienced (100%). Most respondents would accept a vaccine (95%) and preferred a provider's recommendation (86%) over parents, partners, or friends. A majority (70%) would not be embarrassed to participate in research. DiscussionRespondents showed favorable attitudes toward CT vaccination and research in this high-risk study population.

Factors Influencing Utilization of Routine Health Information for Decision Making Among Health Workers: A Case Study of Health Facilities in Moyo District, Uganda

Health information is a powerful vehicle for enhancing community health and it highlights both the problems and opportunities that exist for development. In Uganda, there are cases where decisions have been made without using health information in primary health care units. The existing capacity inadequacy to efficiently utilize information to track service use patterns over time to determine the impacts of policy and service delivery improvements in Uganda is one of the key weaknesses. With the support of the Ministry of Health, the government of Uganda is implementing projects to build and enhance the nation's web-based national health information system (DHIS2), which collects data from all health systems and allows for making decisions based on evidence on the delivery of health services. The broad study objective was to establish the factors influencing the utilization of routine health information for decisions making among the health workers. The research design was based on an analytical cross-sectional design. The target population for this study was 260 health workers specifically targeting those involved in the use of routine utilization of health information. Purposive sampling was used to select the key informants and other respondents were selected using simple and stratified random sampling. The self-administered structured questionnaire and key informants' interviews were used to collect data from respondents. The analysis of the quantitative data was done using descriptive statistics consisting of tables, bar graphs, pie charts, frequency, percentages, mean and standard deviations. Logistic regression analysis was conducted for establishing the association amongst the variables. The study established that technical factors (χ2=801.069; p=0.001), organizational factors (χ2=895.224; p=0.000), and behavioural factors (χ2=994.559; p=0.000) had a significant influence on utilization of routine health information for decision making. Talk of significant predictors of utilization of routine health information for decision making, technical factors (p = 0.013) had the greatest influence on utilization of routine health information for decision making among health workers at health facilities followed by organizational factors (p = 0.049). The study recommends that management of health facilities in Moyo district to create organizational culture through increased demand for and use of routine health information for evidence-based decision making in all aspects. The study further established areas of the routine health information system that requires to be reinforced and backed up to ensure the use of routine data in health facility to make decisions.

A review to investigate the nutrient profile of the nutrient-dense seed Lepidium sativum L.

Lepidium sativum is an annual, underutilized herb that belongs to the Brassicaceae family and has similar basic properties like mustard and water cress. Garden cress is grown throughout the Middle East, Europe, and the United States. Garden cress seeds are known throughout history for their medicinal properties and are cultivated for a variety of culinary purposes. Seeds have been used to treat many disorders such as asthma, uterine tumours, ulcers, colds, wounds, skin problems, irregular menstrual cycles, ischias, and ethmoidal polyps because of their nutritional and antioxidant activity. Besides showing strong medicinal properties, garden cress seeds have a rich proximate profile with high concentrations of energy, protein, ash, fat, and fibre compared to the common staple cereals and millets. Various parts of garden cress plants like leaves and seeds are consumed in many forms such as salad, sprouts and spices. The seeds are bitter in taste, thus to improve taste and quality, different processing techniques like roasting, germination, soaking and boiling etc. are used. Malnutrition is currently a major concern in all segments of society and garden cress seeds being rich in protein and energy can be utilized to combat malnutrition. The objective of this review is to enhance community health by consolidating a scientific understanding of the nutritional composition of L. sativum.

A Meta-Analysis of Social Ecological Correlates of Physical Activity Among Koreans.

From the viewpoint of behavioral medicine, analyzing various factors that determine physical activity (PA) is necessary to promote PA participation. In this study we aimed to identify the impact of constructs within the social ecological model (SEM) on PA within the Korean population. We reviewed journal articles and dissertations published between February 2012 and May 2022 in this meta-analysis. We searched the Korean Education Research Information Service (KERIS), Korean Information Service System (KISS), National Digital Library (NDL), PubMed Central (PMC), SCOPUS, and Web of Sciences; and we located 13 studies to include in this review. Collectively, these studies indicated that most SEM constructs were significantly correlated with PA. Self-efficacy was most strongly correlated (0.67), followed by perceived benefits (0.48), quality of exercise facilities (0.37), accessibility of exercise facilities (0.33), friend support (0.29), and family support (0.23). These data provide practical information for basing a PA promotion strategy on SEM to enhance community health through behavioral psychology.

Development of a mobile health infrastructure for non-communicable diseases using design science research method: a case study

In this paper, we share our experience in designing and developing a mobile health (mHealth) infrastructure for non-communicable diseases (NCD) in rural areas in Indonesia called NusaHealth. The NusaHealth project builds a digital healthcare infrastructure involving universities, healthcare providers, and communities in an mHealth approach that puts patients at the center of health care. The Design Science Research Methodology (DSRM) framework was adopted in designing the mHealth application. The infrastructure to connect the mobile device network with the hospital information system was also developed. Our finding indicates that designing and developing an mHealth solution for rural areas in developing countries needs comprehensive approach and the implementation process should involve related partners and stakeholders. The NusaHealth was implemented in rural areas in Yogyakarta province in Indonesia. While Yogyakarta province successfully implemented the NusaHealth in rural areas, different activities need to be conducted to enhance community health by developing a formal mHealth system supported by local health district offices’ policies and regulations.

Virtual, bilingual English-Spanish community nutrition and exercise classes: Barriers and opportunities

Objective: Regular exercise and healthy eating are important contributors to a person’s overall health and well-being. To enhance community health, Keck School of Medicine of the University of Southern California medical students have been leading in-person nutrition, cooking and exercise classes for community members at the Los Angeles County Wellness Center. In September 2020, due to the COVID-19 pandemic, students pivoted to teaching through a virtual platform. In this study, we evaluated community participants’ experiences attending virtual, bilingual nutrition, cooking and exercise classes; the efficacy of virtual classes in providing education; participants’ preference for virtual versus in-person classes; and potential advantages and disadvantages of the virtual versus in-person formats. Design: Cross-sectional study design. Setting: Following 22 virtual classes between September 2020 and April 2021, participants completed an online Qualtrics survey. Methods: Quantitative data were descriptively analysed within Qualtrics using the Sign test. Qualitative free response data were analysed by coding responses for common themes using an inductive approach. Results: There were 326 responses from 130 unique participants. Satisfaction was high for nutrition and exercise classes (99%), and 98% of participants reported they would make healthy nutrition and exercise behaviour changes. Participants preferred online classes compared to in-person classes ( p = .0008). Barriers to attending in-person classes included lack of childcare, transport issues and COVID-19 risk. Conclusion: Virtual classes were well-received and effective. Virtual classes circumvented some of the barriers to in-person class attendance, and many participants preferred virtual classes to in-person classes.