Health Programs Research Articles

Social Deprivation and Multimorbidity Among Community-Based Health Center Patients in the United States.

Multimorbidity - having 2 or more chronic diseases - is a national public health concern that entails burdensome and costly care for patients, their families, and public health programs. Adults residing in socially deprived areas often have limited access to social and material resources. They also experience a greater multimorbidity burden. We conducted a retrospective cohort analysis of electronic health record (EHR) data from 678 community-based health centers (CHCs) in 27 states from the Accelerating Data Value Across a National Community Health Center (ADVANCE) Network, a clinical research network, from 2012-2019. We used mixed-effects Poisson regression to examine the relationship of area-level social deprivation (eg, educational attainment, household income, unemployment) to chronic disease accumulation among a sample of patients aged 45 years or older (N = 816,921) residing across 9,362 zip code tabulation areas and receiving care in safety-net health organizations. We observed high rates of chronic disease among this national sample. Prevalence of multimorbidity varied considerably by geographic location, both within and between states. People in more socially deprived areas with Social Deprivation Index (SDI) scores in quartiles 2, 3, and 4 had greater initial chronic disease counts - 17.1%, 17.7%, and 18.0%, respectively - but a slower rate of accumulation compared with people in the least-deprived quartile. Our findings were consistent for models of the composite SDI and those evaluating disaggregated measures of area-level educational attainment, household income, and unemployment. Social factors play an important role in the development and progression of multimorbidity, which suggests that an assessment and understanding of area-level social deprivation is necessary for developing public health strategies to address multimorbidity.

National stakeholder consultation on how to measure care home residents' quality of life.

The Developing research resources And minimum data set for Care Homes' Adoption and use or DACHA study aims to create a prototype minimum data set combining residents' information recorded by care homes with their data held in health and social care data sets. The DACHA minimum data set will contain information on quality of life. Internationally and in the UK, there is no consensus on collecting information on quality of life in a standardised format equivalent to the consensus for health measures. This paper describes an online consultation with stakeholder representatives about how to measure the quality of life of residents in UK older-adult care homes, for inclusion in the DACHA minimum data set. We drew on principles of the Delphi technique, identifying participants knowledgeable about living, working in and visiting care homes, and preference scoring. We used a bespoke online research engagement platform (Thiscovery, www.thiscovery.org, Cambridge, UK) to engage the participants. Participants included care home staff and managers, old age specialists (clinical/research), commissioners/providers/regulators, primary care professionals, relatives/family carers of care home residents. The consultation is complementary to DACHA's research and patient and public involvement and engagement activities, which have involved people living in care homes; thus, care home residents were not included in this consultation. The first round asked 30 participants to rank the most important principles and domains to consider when measuring quality of life in care homes. Responses to round 1 informed the selection of quality of life measures that round 2 (September 2022) participants were asked to report their familiarity with and confidence in a range of outcome measures all of which met the criteria identified as important in round 1. Recruitment was extended in round 2, and 72 individuals participated. Based on the rankings and the qualitative feedback in round 2, we included four of the shortlisted quality of life outcome measures in DACHA's prototype minimum data set for care homes. The qualitative feedback suggested a shared understanding across the different representative groups about the strengths and limitations of the selected measures. This work makes an important contribution, understanding the opportunities that quality of life measures pose for different stakeholder groups as regular users of care home resident data. In future DACHA work, interviews and focus groups will collect further data about the perceptions of care home staff who completed measures during the pilot study and about the usefulness of the data collected via these measures. The quality-of-life section of the DACHA minimum data set can contribute to informing similar care home data sets internationally. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR127234.

Spiritual Growth and Stress Management of Physical Education Sport and Health Students

The purpose of this research was to identify the spiritual growth and stress management of Physical Education, Health and Recreation students. The method of this research was qualitative. The respondents to this study were students of the Physical Education, Health and Recreation study program at the Faculty of Sports and Health Sciences, Universitas Negeri Surabaya. The sampling technique used was quota sampling, which was determined by researchers to include as many as 170 students. The data collection technique was a survey with a questionnaire filled out online. The research instrument used was the Health Promoting Lifestyle Profile II instrument, which was adjusted to the characteristics of the activities of Physical Education, Health and Recreation students in the sub-questions about spiritual growth and stress management. The research data were processed descriptively and correlatively using Pearson Correlation analysis. The results of the Pearson Correlation test showed a significance value of. 000 < 0.05, so it was stated that the two variables were correlated. Spiritual growth and stress management, with a Pearson Correlation value of.728, have a degree of relationship with a strong correlation. The significance value of.728 is positive, indicating that the relationship between spiritual growth and stress management increases with the assumption that the higher the spiritual growth, the higher the stress management. The conclusion of this study is that the spiritual growth of Physical Education, Health and Recreation students has a positive correlation with stress management. This study contributes to providing recommendations for conducting stress management activities for students.

One Hundred Years of Pyrethroid Chemistry: A Still-Open Research Effort to Combine Efficacy, Cost-Effectiveness and Environmental Sustainability

A century after the first scientific research on the chemical structures of pyrethrins was published (in 1923), this paper aims to provide an exhaustive review of the historical research pathways and relative turning points that led to the discovery and mass production of pyrethroids, which have become among the most commercially successful insecticides. These compounds, which are not specific to any particular pest, are used globally and offer cost-effective advantages against a broad spectrum of pests in both agricultural and non-agricultural situations. They are utilized in the context of both harvest and post-harvest applications, as well as in the implementation of public health programs and veterinary applications. Currently, the research for new pyrethroids has essentially reached a standstill due to the increasingly widespread occurrence of insecticide resistance in pests. Nevertheless, several research paths remain open regarding these pesticides. This paper represents the current state of knowledge regarding pyrethroids, exposing both their advantages and disadvantages. Moreover, further investigation, at the molecular level, on their mode of action (MoA) could be very useful to improve their specificity. The results of this review may stimulate additional research for the development of novel pyrethroids having enhanced efficacy, low cost and reduced environmental impact.

A scoping review on the errors in medical certification of the cause of death in India.

Medical certification of the cause of death provides epidemiological information for developing cause-specific mortality and disease trends, guiding the monitoring of health programmes and allocating health resources. Therefore, providing correct information on the cause of death is essential. This study describes the errors in medical certification of the cause of death in India. We conducted a scoping review through a systematic inquiry in four databases, PubMed, ProQuest, Google Scholar and EBSCO, for all published articles reporting errors in medical certification of cause of death in India between December 31, 1998 and December 31, 2020. The review outcomes were the proportion of major and minor certification errors reported. Out of 135 screened studies, 20 were included based on the eligibility criteria. We observed a high proportion of certification errors and a large proportion of variation. Major certification errors were in the form of incorrect underlying cause of death (8.5-99.2%) and incorrect chain of events leading to death (12-64.7%). Minor certification errors in the form of missing clerical details, abbreviations and illegible handwriting were 0.3-100 per cent. The proportion of incomplete death certificates ranged between 12-100 per cent. Absence of time intervals was the most common type of certification error (62.3-99.5%). Training of doctors to accurately certify the medical cause of death and its addition to medical education is urgently needed to ensure accurate information for mortality-related statistics. A uniform methodology for auditing and reporting errors in medical certification of cause of death should be adopted.

Engagement challenges in digital mental health programs: hybrid approaches and user retention of an online self-knowledge journey in Brazil.

Digital mental health interventions (DMHIs) have surged in popularity over the last few years. However, adherence to self-guided interventions remains a major hurdle to overcome. The current study utilized a phased implementation design, incorporating diverse samples and contexts to delve into the engagement challenges faced by a recently launched online mental health platform in Brazil with self-evaluation forms. Employing an iterative mixed-methods approach, including focus groups, online surveys, and think-aloud protocols, the research aims to evaluate user satisfaction, identify barriers to adherence, and explore potential hybrid solutions. Engagement in the platform was evaluated by descriptive statistics of the number of instruments completed, and qualitative interviews that were interpreted thematically. In the fully self-guided mode, 2,145 individuals registered, but a substantial majority (88.9%) engaged with the platform for only 1 day, and merely 3.3% completed all activities. In another sample of 50 participants were given a choice between online-only or a hybrid experience with face-to-face meetings. 40% of individuals from the hybrid group completed all activities, compared to 8% in the online-only format. Time constraints emerged as a significant barrier to engagement, with suggested improvements including app development, periodic reminders, and meetings with healthcare professionals. While the study identified weaknesses in the number and length of instruments, personalized results stood out as a major strength. Overall, the findings indicate high satisfaction with the mental health platform but underscore the need for improvements, emphasizing the promise of personalized mental health information and acknowledging persistent barriers in a digital-only setting.

A Dedicated Graduate Certificate in Health Equity: A Novel Approach to Increase the Future Physician Capacity to Address Health Inequities.

Pervasive health inequities require new approaches to medical education to equip future physicians to address unjust disparities in health outcomes. Few curricula exist that focus on development of competencies and leadership skills in health equity, and little is known about the content that should be included. Vanderbilt University Medical Center and Vanderbilt University School of Medicine developed and implemented the Graduate Certificate in Health Equity (CHE) to address this educational gap. The CHE proposal was approved in summer 2019, enrollment began in October 2019, and the first course was offered in February 2020. The CHE includes 11 objectives, and programming spans medical school years 2 to 4. Students must complete 2 foundational courses, 2 health equity-focused electives, and a health equity immersion experience. Seventy-three students have enrolled since the CHE launched in academic year 2019 to 2020. In year 1, 14 third-year students enrolled in an inaugural condensed version and 16 second-year students enrolled in the full program. In subsequent years, 16 students (year 2), 15 students (year 3), and 12 students (year 4) enrolled. To date, 38 medical students have graduated. The CHE has engaged 16 community partners, including community health centers, immigrant and refugee services, rural health programs, and the LGBTQI+ community, as lecturers and hosts for immersion experiences. Future work will focus on updating objectives and developing a rigorous evaluation scheme. The CHE team members will follow up with graduates to determine how the CHE influenced their care for marginalized and minoritized patients, ability to identify and address systemic and structural barriers, and career development. The CHE is a potential model for other institutions to adapt and implement. Accruing a critical mass of institutions with health equity-focused programming for medical students is necessary to develop future leaders in health equity.

Barriers to the Uptake of Tickborne Disease Prevention Measures: Connecticut, Maryland 2016-2017.

Public health programs promote numerous tickborne disease (TBD) prevention measures. However, measures are not frequently or consistently performed. Describe barriers to consistent use of 4 commonly promoted TBD prevention measures. We conducted an online survey (n=1883) evaluating behaviors regarding TBD prevention measures including conducting tick checks, applying insect repellents, showering/bathing, and applying chemical or natural pesticides to residential yards. Respondents could select reasons for never, rarely, or sometimes performing these measures. Descriptive analysis and logistic regression modeling evaluated associations between the 3 most cited barriers for each measure and select demographic variables. The survey was administered to residents in high Lyme disease incidence counties of Connecticut and Maryland, 2016-2017. For tick checks (n=800), the most cited barriers were forgetting (63%), not spending time in tick habitat (28%), and too much trouble (11%). For applying insect repellents (n=1303), the most cited barriers were forgetting (38%), personal safety concerns (24%), and too much trouble (19%). For showering/bathing 2 hours after outdoor activity in tick habitat (n=1080), the most cited barriers were being unaware of the prevention measure (51%), too much trouble (18%), and forgetting (18%). For applying chemical pesticides to yards (n=1320), the most cited barriers were having environmental (45%), pet safety (31%), and personal safety concerns (28%). Lastly, for applying natural pesticides to yards (n=1357), the most cited barriers were being unaware of natural pesticides (31%), having cost concerns (23%), and not being concerned about ticks on property (16%). Forgetting, too much trouble, unawareness, and safety concerns were primary barriers to using several TBD prevention measures. Education regarding effectiveness, safety, and timing may increase uptake of certain measures. These challenges can be difficult to address, highlighting the need for passive TBD prevention measures, such as a Lyme disease vaccine.

Examining the development and utilisation of Community-Based Health Information Systems (CBHIS) in Africa: A Scoping Review

Introduction The community-based health information system (CBHIS) is a vital component of the community health system, as it assesses community-level healthcare service delivery and generates data for community health programme planning, monitoring, and evaluation. CBHIS promotes data-driven decision-making, by identifying priority interventions and programs, guiding resource allocation, and contributing to evidence-based policy development. Objective This scoping review aims to comprehensively examine the use of CBHIS in African countries, focusing on data generation, pathways, utilization of CBHIS data, community accessibility to the data and use of the data to empower communities. Methods We utilised Arksey and O'Malley's scoping review methodology. We searched eight databases: PubMed, EMBASE, HINARI, Cochrane Library, Web of Science, Scopus, Google Scholar, and grey literature databases (Open Grey and OAIster). We synthesized findings using a thematic approach. Results Our review included 55 articles from 27 African countries, primarily in Eastern and Southern Africa, followed by West Africa. Most of the studies were either quantitative (42%) or qualitative (33%). Paper-based systems are primarily used for data collection in most countries, but some have adopted electronic/mobile-based systems or both. The data flow for CBHIS varies by country and the tools used for data collection. CBHIS data informs policies, resource allocation, staffing, community health dialogues, and commodity supplies for community health programmes. Community dialogue is the most common approach for community engagement, empowerment, and sharing of CBHIS data with communities. Community empowerment tends towards health promotion activities and health provider-led approaches. Conclusion CBHIS utilizes both paper-based and electronic-based systems to collect and process data. Nevertheless, most countries rely on paper-based systems. Most of the CBHIS investments have focused on its digitization and enhancing data collection, process, and quality. However, there is a need to shift the emphasis towards enabling data utilisation at the community level and community empowerment.

Addressing Mental Health Disparities in the Latine Child and Adolescent Patient Population: A School-Based Mental Health Program Perspective

Addressing Mental Health Disparities in the Latine Child and Adolescent Patient Population: A School-Based Mental Health Program Perspective

Advancing school education: A proposal for modernizing the school subject “Physical Education” for today’s needs

Individual behavior is considered the most significant determinant of health (GoInvo, 2017). There are six primary lifestyle factors—physical activity (PA), diet, substance use, sleep, stress, and relationships—that collectively contribute to a holistic concept of health and well-being (American College of Lifestyle Medicine, n.d.). Evidence shows that the widespread adoption of unhealthy lifestyle habits is associated with contemporary changes in children’s phenotypes, making them more vulnerable to chronic health issues that can persist into adulthood (Hruby & Hu, 2015). This is linked to the increasing prevalence of overweight and obesity among children and adolescents, which has risen dramatically from 8% in 1990 to 20% in 2022 (World Health Organization, 2024). Educational settings provide an ideal environment for developing lifelong healthy habits, as the cultivation of such habits requires prolonged commitment. Physical education (PE) is a school-based subject with the potential to promote an active lifestyle; however, concerns persist regarding its adequacy and effectiveness in other aspects of health promotion (United Nations Educational, Scientific and Cultural Organization, 2014). This perspective study discusses the theoretical and practical aspects of modernizing PE curriculum, including its implications for public health policy. Methods We conducted a concise overview of the literature for this perspective study, highlighting school-based health programs and identifying key advocative approaches, with the aim of providing foundational insights for the present health-policy proposal. Results From a holistic perspective, we propose that PE should evolve into lifestyle education (LE), aiming to integrate all six factors of lifestyle medicine within the educational framework. Through the LE approach, children and adolescents can acquire a comprehensive package of health-related knowledge, skills, and competencies that extend beyond PA and encompass all lifestyle components. However, transitioning from PE to LE may impact the structure of the curricula and necessitate stablishing a supplementary curriculum titled sport education (SE), aiming to enhance students’ sport-related skills such as teamwork, leadership, resilience, and strategic thinking, while also promoting abilities in stress management, concentration, and emotional regulation. To effectively transition from PE to LE and SE, educational authorities and policymakers must provide comprehensive demonstrations outlining vision, mission, goals, roles, and detailed guidelines tailored to diverse school levels and student demographics, considering factors such as gender, BMI, (dis)abilities, and socioeconomic status. Conclusion Establishing school-based LE appears crucial for addressing the growing pandemic of chronic health conditions from their earliest origins. Alongside its direct effects of individual health, LE also appears to be beneficial in promoting children’s social and cognitive growth, optimizing their academic performance, and increasing the likelihood of their future occupational success. Therefore, implementing LE is crucial before expecting children and adolescents to adhere to the existing health-related recommendations. References American College of Lifestyle Medicine. (n.d.). What is lifestyle medicine? https://lifestylemedicine.org/ GoInvo. (2017). Determinants of health. https://www.goinvo.com/vision/determinants-of-health/ Hruby, A., & Hu, F. B. (2015). The epidemiology of obesity: A big picture. Pharmacoeconomics, 33, 673-689. https://doi.org/10.1007/s40273-014-0243-x United Nations Educational, Scientific and Cultural Organization. (2014). World-wide survey of school physical education: Final report 2013. https://unesdoc.unesco.org/ark:/48223/pf0000229335 World Health Organization. (2024). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

Two Case Presentations with Unexpected Outcomes after Childhood Trauma

Bowlby developed the theory of attachment, describing it as a lasting emotional bond between human beings, manifested by seeking proximity to caregivers, especially in times of distress. Children adjust their behavior to prevent separation from their primary attachment figure – someone who provides support, protection and care. Attachment theory provides a favorable framework for understanding our two cases and their developmental paths.We report two cases of female individuals, both of whom had a family history of psychiatric disease and experienced early parental separation with the grandparents playing significant roles in their upbringing. The two cases had radically different outcomes: one was diagnosed with schizophrenia and the other with generalized anxiety-depressive disorder. We attempt to analyze the reasons for the disparate outcomes of these two cases through the framework of numerous published studies that highlight protective and risk factors for psychiatric disease, studies that highlight the impact of traumatic events in childhood on a child’s biological, psychological and social development, as well as through the lens of psychodynamic and attachment theories. Throughout the analysis, the importance of early intervention is made clear: both through various treatment modalities and preventive measures, as well as by providing successful mental health programs directed towards the destigmatization of children with mental health problems.

Relationship between Physical Activity Levels, Quality of Life, and Sociodemographic Attributes among Adults in Tabuk, Saudi Arabia: A Direction toward Sustainable Health

Physical activity (PA) improves quality of life (QOL), yet the relationship between PA, QOL, and sociodemographic factors in Saudi Arabia remains underexplored. This study examined this relationship among 369 adults from Tabuk City, Saudi Arabia. The questionnaire measured PA levels and QOL using the Arabic versions of the International Physical Activity Questionnaire and the 36-item Short-Form Health Survey (SF-36), respectively. Data analyses included chi-square, Mann–Whitney U, and Kruskal–Wallis H tests alongside a multivariate regression analysis. Among the SF-36 scores, marital status (p = 0.005), history of chronic diseases (p = 0.004), and medication use (p = 0.001) showed significant differences; pain (80.6 ± 21.5) and energy/fatigue (63.0 ± 18.5) scored highest and lowest, respectively; and sex was significantly associated with PA levels (p = 0.001). The average total SF-36 score was 69.5 ± 15.7, and 42.5% of participants reported low PA. Participants with moderate PA had significantly higher SF-36 scores (p = 0.003), energy/fatigue (p < 0.0001), emotional wellbeing (p = 0.009), and general health (p = 0.004) scores compared with those with low PA. The significant association between PA and QOL underscores the need for sustainable health programs to enhance and maintain PA in alignment with the Saudi Vision 2030 QOL program. It can also inform the development of targeted interventions to enhance PA levels and improve QOL aspects within communities, considering specific sociodemographic attributes to ensure effectiveness and inclusivity.

Abstract A123: Awareness of human papillomavirus (HPV) and its vaccine and telehealth: Results from the Health Information National Trends Survey (HINTS) 6, 2022 in the United States

Abstract Background: Human Papillomavirus (HPV) vaccination is essential to prevent occurrences of a variety of HPV associated cancers. The awareness of HPV and its vaccine could be associated with the use of telehealth. The aims of this study were to examine the association between awareness of HPV and HPV vaccine with receiving telehealth for health care within the past year. Methods: Data from the Health Information National Trends Survey (HINTS) 6 (N=5,887) were utilized. Dependent variable was awareness of HPV and HPV vaccine. The independent variable was those who received care from a doctor or health professional using telehealth. Weighted multivariable logistic regression was performed to determine association of awareness of HPV and its vaccine with receiving healthcare using telehealth while adjusting for age, gender, race, education, and census region. Results: The study sample consisted of 68.28% awareness of HPV and 63.47% awareness of HPV vaccine. After controlling for covariates, we found those who were aware of HPV and HPV vaccine have received telehealth care (aOR=1.40, 95%CI:1.11-1.78; aOR= 1.40, 95%CI:1.09 -1.80), respectively. In the adjusted model, the awareness of HPV for being female (aOR=2, 95%CI:1.60-2.48) and college graduates (aOR=3.80, 95%CI: 2.59-6.56). In the adjusted model, the awareness of HPV vaccine for being female (aOR= 2.68, 95%CI:2.13-3.36) and college graduates (aOR=4.68,95%CI:2.77-7.91). HPV and HPV vaccine awareness, Non Hispanic Whites had significantly higher adjusted odds compared to other race/ethnicity groups. Conclusion: Hence public health programs could be directed to promote use of telehealth to increase awareness of HPV causing cancers, reduce stigma associated with vaccination, boost healthcare recommendation and uptake of HPV vaccination considering socio demographic factors. Citation Format: Manali Desai, Iman Igab, Ogochukwu Ezeigwe, Devesh Malgave. Awareness of human papillomavirus (HPV) and its vaccine and telehealth: Results from the Health Information National Trends Survey (HINTS) 6, 2022 in the United States [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A123.

A randomized controlled trial of a virtual community-based mental health and substance use program in the Philippines

Purpose This study aims to evaluate the delivery of a virtual community-based mental health and substance use program for Filipino drug users during the COVID-19 pandemic. Design/methodology/approach It used a randomized control longitudinal design with data collected prior to the program and every two months for 10 months. The programs focused on building recovery skills, life skills and family modules. Program length ranged from a brief intervention of three sessions to 24 sessions depending on whether clients were low risk, moderate risk or those arrested for drug use. Findings Results revealed significant improvements in recovery skills of participants in the treatment group compared to those in the control group. Mental health illness symptoms decreased for both control and treatment groups; however, no differences were found in recovery capital and cravings. Research limitations/implications The lack of significant changes in certain variables, such as recovery capital, requires more data to understand the barriers to enable greater recovery. The study was limited to virtual delivery of rehabilitation services conducted during the COVID-19 pandemic. Future studies may wish to compare modalities of online and onsite delivery to enable a comparison of effectiveness. Practical implications Results suggest the feasibility of virtual delivery of mental health and substance use treatment implemented by trained paraprofessionals. However, it also highlights the necessity to build the capacity of service providers and address connectivity challenges. Social implications Stigma and discrimination prevent people who use drugs from seeking treatment. Virtual delivery of mental health and substance use treatment can provide a platform where people can seek help while maintaining some privacy. Originality/value The study provides evidence from under-represented populations – persons who use drugs in the Philippines.

Parental Factors Related to COVID-19 Prevention Behavior in Children with Intellectual Disability: Partial Least Square Structural Equation Modeling

Efforts to prevent COVID-19 in children with intellectual disability require the role of parents. Even though the vaccine has been implemented, the most important effort is to implement health protocols. Implementing health protocols cannot be separated from knowledge, attitudes, intentions, subjective norms, and social support from parents. This research aims to determine the influence of knowledge, attitudes, intentions, subjective norms, and social support on the COVID-19 prevention behavior of parents of children with intellectual disability. This type of research is descriptive correlational research, and the developed model is validated using the partial least squares structural equality modeling (PLS-SEM) approach based on data collected from 100 parents of children with intellectual disabilities taken using purposive sampling at Semarang Municipal Special Schools.The study results show that parental characteristics, namely education, influence attitudes, which can ultimately affect parental intentions. Parental education also affects social norms, namely social support and subjective norms, which can determine COVID-19 prevention behavior. Parental education is a priority in public health strategies because it can directly shape attitudes, intentions, and social norms that can improve the health of children with intellectual disabilities. Health programs and education for parents must be focused and carried out consistently and continuously.

Bringing local food education to workplaces: Assessing needs for a health and wellness program

Bringing local food education to workplaces: Assessing needs for a health and wellness program

Social validity of acceptance-based workplace mental health training for use in a low resource setting. A qualitative study with Ugandan mental health providers

In low-resource settings, working age adults suffer a disproportionately higher mental health burden due to precarious work environments; yet access to evidence-based worksite mental health promotion programs remains severely limited due to the lack of professional service providers. Alternative mental wellness programs that are affordable, accessible and help build resilience to deal with the daily demands of work and life need to be introduced in workplaces of low-resource contexts. Such programs should however be acceptable and of social importance to the targeted contexts. Acceptance-based approaches meet these criteria but have mainly been implemented and evaluated in high-income countries. Gauging the appropriateness of such programs for low-resource workplace settings before wide-scale implementation is necessary. We engaged n = 14 mental health providers living and working in Kampala-Uganda in a one-day workshop focused on using acceptance and commitment training in the workplace. During in-depth interviews, these providers shared feedback on the social importance of the program’s goals and effects, and acceptability of the program’s procedures to Ugandan society. A deductive thematic approach was used to analyze data (codes organized according to a priori thematic categories that aligned with the Social Validity Framework). Findings showed that the program’s goals and effects were gauged as socially significant and the training process was acceptable. However, key adjustments were recommended, including introducing communal values into the program, reducing session load, integrating mental health awareness strategies, and adding contextually relevant metaphors. These adjustments are likely to enhance the appropriateness of this type of acceptance-based worksite mental health promotion program for use in Uganda.

Implementation and Service Delivery Status of the Mental Health Law in the Province of Zamboanga del Norte

Mental health had been a growing concern while mental illness had been increasing in number worldwide. The enactment of the Mental Health Law or RA 11036 in 2018 hoped to bring about better delivery of mental health services as well as uphold the rights of patients. This led the proponent to investigate the implementation and service delivery status of the mental health law in the province of Zamboanga del Norte. Employing a descriptive-qualitative design, the study assessed the implementation of the various government agencies on the Mental Health Law as well as the delivery of mental health services in the province of Zamboanga del Norte. There were 50 mental health professionals interviewed through phone, messenger, and Google form using a structured interview guide. Data gathered through the interviews were analyzed using thematic analysis. Results revealed that most of the government agencies were able to implement the law rating from 35.72% to 100% of the implementation. Eleven themes emerged such as poor knowledge about the mental health law, no proper seminars/training about mental health law, mental health is not a priority program, lack of coordination with the various agencies involved, difficulty managing mental health crises, non-inclusive mental health program, insufficient mental health services, multitasking of mental health providers, lack of mental health professionals, stigmatized attitude towards mental illness and support from LGU. It was revealed in this study that the implementation of the mental health law in the province is not fully implemented. Furthermore, the delivery of mental health services is also insufficient. As a recommendation, the primary implementing agency must exert more effort in cascading the law to all implementing agencies and mental health professionals down to the barangay level for the law to be understood and implemented. In addition, mental health services should be improved as well as the inclusion of a mental health facility.

Emergency Response Competencies Strengthened by Sustainable Education: First Aid Training Program for Teachers

The primary aim of this study is to assess the knowledge, attitudes, and skills of primary school teachers regarding the management of musculoskeletal trauma through first aid interventions and to determine the effectiveness of a sustainable training program. The preparedness of 138 teachers who received first aid training for trauma intervention and the impact of these trainings on health practices were examined by pre- and post-tests. It was determined that 87% of the teachers participating in the study had not received emergency trauma training before. Pre-training test results showed that the participants had a low level of awareness. However, the increase in mean scores from 6 to 16 and the decrease in standard deviation after the training revealed a significant increase in teachers’ knowledge, attitudes, and skills. These results suggest that emergency trauma training programs significantly increase teachers’ ability to respond to emergencies and emphasize the importance of sustainable first aid training. Analyses based on gender and branch revealed that post-training test scores were similar and all teachers showed high performance. The findings emphasize the need for systematic and comprehensive emergency trauma training programs for all teachers and the importance of these programs for sustainable health and safety practices.