Health Promotion Services Research Articles

Evaluating Strategies to Promote Effective, Multidisciplinary Team Collaboration in School Mental Health

Multidisciplinary teams of school- and community-employed mental health, health, and educational staff work together in schools to offer a full continuum of mental health promotion, prevention, early intervention, and treatment services and supports. Intentional teaming structures and practices are essential to ensure teams deliver effective, coordinated services and supports. The current study investigated the extent to which continuous quality improvement strategies improved school mental health team performance during a 15-month national learning collaborative for 24 school district teams. All teams significantly improved their average teaming performance from baseline to the end of the collaborative (t(20) = −5.20, p < .001). Plan-Do-Study-Act (PDSA) cycles allowed teams to rapidly evaluate specific quality improvement changes to improve their performance. Teams with the most improvement focused on increasing multidisciplinary team membership, avoiding duplication and promoting efficiency, and connecting to community mental health providers/resources.

Role Distinctions and Role Overlap Among Behavioral Health Providers.

Integrated behavioral health care (IBHC) models are a growing trend for health care delivery, particularly in the primary setting. Clinicians working within IBHC contexts provide a spectrum of behavioral health services, including screening, prevention and health promotion, assessment, and treatment services. Integration of behavioral health providers into primary and specialty medical settings addresses the significant need for behavioral health services, improves care quality, improves patient experience, and reduces costs of care, access issues, and delays in service provision. While benefits are clear, what type of model to implement and which behavioral health care providers to include in that model remain elusive. This is partly due to the failure of IBHC models to include all behavioral health providers in their design, a lack of clarity of the expertise of each provider, and how providers work together. IBHC models are also complicated by contextual issues such as the relative availability of each profession, population health needs in different clinic populations, and financial factors. The purpose of this manuscript is to the clarify roles and responsibilities of different behavioral health professions including similarities and differences in their training, areas of unique expertise (role distinctions), shared responsibilities (role overlap), and relative cost and availability in the United States.

Social Media Misinformation Effect on Mental Health in Covid 19: A Review Study

Mental health is a global concern in the current era, which has also been prioritized as one of the sustainable development goals. The impact of COVID-19 was not only limited to physical health; it also affected the individuals psychologically. According to the statistics, individuals were busy sparing time in social media regardless the accuracy of the content, which lead to misinformation effect. Misinformation effect was one of the serious issues faced by the individuals at the time of COVID 19. Anxiety, stress, depression, fears are the symptoms reported by the individuals. This paper attempts to contribute the literature regarding the social media misinformation effect on mental health in COVID-19. Further studies can also be done based on the psychological impact of misinformation effect from an Indian perspective that will also help to develop the social networking initiative for promoting health services and public safety.Classification-JEL: I12 AcknowledgementThe scholar namely Dr. Rajeev Sijariya is the awardee of ICSSR Research Project. This paper is largely an outcome of the Research Project “Triple Bottom line approach for resilient recovery and resurgence amid Covid 19:- An Eco-Social Psychological framework for Bharat 5.0 in new normal”, sponsored by the Indian Council of Social Science Research (ICSSR). However, the responsibility for the facts stated, opinions expressed, and the conclusions drawn is entirely that of the authors.

The Autism Intervention Research Network on Physical Health (AIR-P) Charter.

In the United States, autistic individuals experience disparate physical- and mental-health-related quality of life across the lifespan relative to non-autistic individuals. In recognition of these disparities, the Autism Intervention Research Network on Physical Health (AIR-P) seeks to establish and maintain a research network to enhance the health and well-being across the lifespan of autistic individuals, particularly for underserved and vulnerable populations. This charter serves as the initial charter for the AIR-P; as a network, we plan to continue to revise and elaborate on the contents of this charter as our research advances and as we continue to forge new partnerships and collaborations.The purpose of the AIR-P is to support innovative life course intervention research that promotes optimal health and well-being across the lifespan of autistic individuals in 6 key areas: (1) primary care services and quality, (2) community-based lifestyle interventions, (3) gender, sexuality, and reproductive health, (4) health systems and services, (5) neurology, and (6) genetics. The network will establish and maintain an interdisciplinary, multicenter research network for scientific collaboration and infrastructure to increase the life expectancy and quality of life for autistic individuals, with a focus on underserved populations.As a network, the AIR-P aligns with the neurodiversity movement and views autism as an identity akin to gender and race, not a condition that requires a cure. This is reflected in our approach to promoting the health and well-being of autistic individuals.All research supported within the network will be vetted and/or codeveloped by the Autistic Researcher Review Board, caregivers and family members of autistic individuals, and other stakeholders.The network will create an infrastructure for anyone, including early-career investigators and investigators seeking to begin a program of research in autism and physical health, to conduct research related to the physical health of autistic individuals. Any individual or organization may join the network, as well as access and contribute to the robust research infrastructure we are developing and maintaining.Our network seeks to advance research on physical health beyond a medical model and deficit-oriented approach toward promoting the multidimensional health, well-being, and thriving of autistic individuals and their families.The network seeks to address disparities in the access, quality, and utilization of health-promoting services and supports for autistic individuals, particularly for underserved or marginalized populations. The network will aim to ensure that all research supported within the network benefits participants representative of low-income, racial or ethnic minority, immigrant, female, Indigenous, geographically remote, gender identity minority, and sexual orientation minority populations. This may require modifications to usual recruitment, data collection, and analytic methods that mitigate barriers to participation.The AIR-P seeks to advance the evidence base of high-quality research across the lifespan for autistic individuals and their families. Areas in which there is currently no existing evidence base, the AIR-P seeks to spur innovative research and engage experts across the United States to guide policy and clinical practice in these areas.The mission of the AIR-P is to develop a robust research infrastructure that will foster measurable improvements in optimal physical health and well-being across the lifespan of autistic individuals and their families.The AIR-P envisions a future in which autistic individuals experience optimal multidimensional health and well-being.The following values are central to all of our activities: Respect, integration, and equitable access to supports and services that promote optimal health and well-being for autistic individualsSelf-determination and integration of autistic individuals in all facets of the networkIndividualized and culturally appropriate health careDiversity within the network, programs, and societyStewardship of public resources and measurable accountabilityA commitment to helping individuals by strengthening communities and systems

Preventative Services Use and Risk Reduction for Potentially Preventative Hospitalizations Among People With Traumatic Spinal Cord Injury

ObjectiveTo examine the risk of potentially preventable hospitalizations (PPHs) for adults (18 years or older) with traumatic spinal cord injury (TSCI) to identify the most common types of preventable hospitalizations and their associative risk factors. DesignCohort study. SettingUsing 2007-2017 U.S. claims data from the Optum Clinformatics Data Mart, we identified adults (18 years or older) with diagnosis of TSCI (n=5380). Adults without TSCI diagnosis were included as controls (n=1,074,729). Using age and sex, we matched individuals with and without TSCI (n=5173) with propensity scores to address potential selection bias. Generalized linear regression was applied to examine the risk of TSCI on PPHs. Models were adjusted for age; sex; race and ethnicity; Elixhauser comorbidity count; any cardiometabolic, psychological, and musculoskeletal chronic conditions; U.S. Census Division; socioeconomic variables; and use of certain preventative care services. Adjusted odds ratios were compared within a 4-year follow-up period. ParticipantsAdults with and without TSCI (N=5,173). InterventionNot applicable. Main Outcomes MeasuresAny PPH and specific PPHs ResultsAdults with TSCI had higher risk for any PPH (odds ratio [OR], 1.67; 95% CI,1.20-2.32), as well as PPHs because of urinary tract infection (UTI) (OR, 3.78; 95% CI, 2.47-5.79), hypertension (OR, 3.77; 95% CI, 1.54-9.21), diabetes long-term complications (OR, 2.54; 95% CI, 1.34-4.80), and pneumonia (OR, 1.71; 95% CI. 1.21-2.41). Annual wellness visit was associated with reduced PPH risk compared with cases and controls without annual wellness visit (OR, 0.57; 95% CI, 0.46-0.71) and among people with TSCI (OR, 0.69; 95% CI, 0.55-0.86) compared with cases without annual wellness visit. ConclusionsAdults with TSCI are at a heightened risk for PPH. They are also more susceptible to certain PPHs such as UTIs, pneumonia, and heart failure. Encouraging the use of preventative or health-promoting services, especially for respiratory and urinary outcomes, may reduce PPHs among adults with TSCI.

Challenge to improve Japan's deplorable HPV vaccination rate by local government actions.

In Japan, in 2013, following reports of several alleged adverse reactions in young girls following vaccination, the previously successful national human papillomavirus infection (HPV) vaccination program collapsed rapidly. In the 8 years since vaccination rates have hovered near zero. In October of 2020, in an attempt to mitigate this lingering disaster, the Japanese Ministry of Health, Labor, and Welfare (MHLW) agency finally revised its HPV vaccination informational leaflet that was designed to be distributed by local governments nationwide. Prior to this revision, Toyonaka City, in Japan's Osaka province, had already begun sending out their own unique leaflet to girls in the targeted 6th-10th grades. As a preview of how MHLW's revised leaflet might eventually succeed, we have studied the HPV vaccination results from Toyonaka City's experiment. This study was a population-based analysis that compared the monthly rates of new vaccinations in girls of a targeted grade school age group. We looked at rates before and after the leaflets were sent by Toyonaka City's Division of Health Promotion and Senior Services. The vaccination rates between April 2020 and March 2021 were improved across all grades; 1.2% in 6th grade (p=0.000185), 2.5% in 7th grade (p < 0.0001), 3.5% in 8th grade (p < 0.0001), 6.8% in 9th grade (p < 0.0001), and a remarkable 16.5% in 10th grade (p < 0.0001). When a local government sends an HPV informational leaflet targeted at young girls, it can significantly improve their HPV vaccination rates.

Management, Communication in the Health Institution

If we look around, we can easily notice that the world would not function without communication. How could we express our thoughts and what we want unless we say it, show it and touch it? Therefore, the business world could not function without interpersonal communication either, especially in the health institutions. The beginning of the research was based on the hypothesis that communication had to be open for the system to function, and employees satisfied with the working atmosphere and the relationship with the facility management. It was assumed that verbal communication was the most common form of communication, which often resulted in conflicts among health professionals. The research showed that the respondents were aware of the importance of creating effective communication, both within the same health care facility and outside it, especially conversation, assuming that they can convey the most important information in the shortest possible time. The data on formal communication at workplace indicated that employees believe that communication with their colleagues did not have to be formal, because in that way collective work would be more productive and the working atmosphere more pleasant. It is very important for every health care institution to invest enough funds in the activities, such as the health service promotion. Teamwork, health managers and employees contributed to the development of the health institution.

Community Health Workers’ Role in Addressing Farmworker Health Disparities

ABSTRACT Community health workers (CHWs) are uniquely positioned to connect migrant and seasonal farmworkers to health promotion and clinical services. However, research on CHWs’ experiences, particularly related to their provision of health education to farmworkers, is limited. To explore CHWs’ practices and challenges in conducting health education outreach, we conducted three focus group discussions with farmworker health CHWs (N = 28) in North Carolina in the spring of 2020. We analyzed the focus group transcripts, and we compared the code outputs, thematic code summaries, and memos maintained throughout the analytic process to examine the experiences of CHWs in acquiring and disseminating health information and resources, including use of technology. We identified three themes related to CHWs’ experiences providing health information to farmworkers. First, CHWs described short-term preparation, immediately before providing health outreach, and long-term activities, devoted to maintaining and improving their capacity to provide relevant health information to farmworkers. Second, they described their use of health education delivery methods, including open-ended questions, participatory and interactive approaches, and non-verbal aids. Third, participants described their current use of technology and related challenges, as well as the technology needed to enhance health outreach, including internet access. Findings reveal opportunities to improve farmworker health education through professional development for CHWs, identification of preferred methods of health education delivery to farmworkers, and provision of technology to farmworker-serving organizations. Establishing rural internet access and equipping outreach organizations with technology would position CHWs to be maximally effective as they strive to reduce farmworkers’ health inequities. Abbreviations: CHW: Community health worker; FGD: focus group discussion; NC: North Carolina.

Attributes of Organizational Health Literacy in Health Care Centers in Iran: A Qualitative Content Analysis Study.

Organizational Health Literacy (OHL) is described as a new concept to remote health organizations to implement practices, policies, and systems that make it easier for patients to use, understand, and navigate health information to take care their own health. In Iran, there is no consensus on the attributes of OHL, and its practical implications and scope have not been evaluated. This manuscript is one of the first attempts to explain the attributes of the OHL in health care centers in Iran. This study is a content analysis survey, which was guided by the attributes of the OHL provided by Brach et al. and 26 semi-structured interviews were conducted with Iranian health professionals and employees of healthcare organizations from June 2020 to January 2021. A data analysis was performed using the MAXQDA 10 software. Across the study, ten sub-themes, 21 subcategories, and 67 codes emerged. The 10 main attributes of OHL were management, integration of health literacy in the organization, workforce, participation, range of HL skills, HL strategies, access, media variety, the role of the organization in crisis, and costs. These attributes may guide the planning of health care centers improvements and have the potential to promote health service reforms and public health policy.

Barriers to health care services among US-based undocumented Latinx immigrants within the sociopolitical climate under the Trump administration: A comparative analysis between client experiences and provider perceptions

As President Biden's administration works towards a ‘fair and humane’ immigration overhaul, it becomes critical to examine the implications of immigration policies/laws under the Trump administration on the well-being of undocumented residents to inform equitable reformations. We investigate challenges faced by undocumented Latinx immigrants in accessing health care services in the sociopolitical climate under the Trump administration. This study, which follows a similar study among frontline service providers, presents key findings from 23 in-depth interviews with Latinx individuals. Understanding their experiences is necessary to advance access to health-promoting services and uphold the human right to health. Our study participants' narratives document multiple barriers to health care services, many notably exacerbated by increasingly restrictive immigration policies/laws and heightened punitive interior enforcement practices under the Trump administration. As the nation awaits equitable immigration reform, health care organizations should immediately incorporate, amplify, or alter programs/practices to facilitate access among their undocumented clients. Focused organizational changes have the potential to reduce unmet health needs, minimize financial burdens for families, and curtail potential public health threats, the latter a particularly imperative goal within the current COVID-19 pandemic. We also distill conclusions drawn from our interviews with clients and their convergence with and divergence from conclusions drawn from our related research with providers. While providers recognize the negative impact of sociopolitical factors on their clients' access to health care services, client experiences illuminate potential gaps in their understanding. Bridging understanding between providers and clients can improve access, utilization, and retention in health care services.

UPAYA PENINGKATAN KEGIATAN PROMOSI KESEHATAN MELALUI MEDIA DIGITAL DI PUSKESMAS PAKEL TULUNGAGUNG

The Indonesian government has declared a health development paradigm based on a healthy paradigm, which means that health development must prioritize promotive and preventive efforts, without neglecting curative and rehabilitative efforts. The purpose of this residency is to find out how the process of providing health promotion services is, the types of communication media used in the process of disseminating health promotion information and the community's use of the communication media used. Problem identification using fishbone analysis. Then look for alternative solutions to existing problems with ultrasound. Next, problem solving analysis is carried out based on a SWOT analysis. The results of the study stated that the problem that needs to be prioritized for completion is that the team needs web-design and content creator training. The strategy that can be applied to this residency activity is to conduct web-design and content creator training. After the training, it was found that the participants' evaluations were very good (86%) good (14%), very in accordance with the theme (80%) appropriate (20%), the delivery of the resource persons was very good (60%) good (40%), considered this training was very useful (86%) and useful (14%).

Youth and suicidality: Correlates among clients attending youth mental health promotion clinics in India.

Suicidality among youth is one of the most challenging public health issues. A thorough understanding of the risk factors that contribute to youth suicidality is necessary. The main aim of the study is to estimate the proportion of suicidality and understand factors associated with suicidality amongst clients attending youth mental health promotion clinics in Karnataka, India. A retrospective cross-sectional case record analysis was performed utilising data from real-time digitised management information system specifically developed for the programme. All case records of clients aged 15 to 35 years who received mental health promotion (MHP) services between January 2017 and December 2020 across 30 districts of Karnataka were included in this analysis. Multivariate logistic regression analysis was performed with suicidality among clients as outcome. Socio-demographic characteristics, issues reported, feelings/emotions that indicate underlying mental health issue/crisis, being aware of suicidality among friends and family and personal habits (smoking/chewing tobacco and drinking alcohol) were considered potential exposure variables. Overall proportion of suicidality among youth presenting to youth mental health promotion clinics in Karnataka was 3.5% (357/10,340). Among factors associated with suicidality, the strongest association was found among those clients who reported attempted suicide among friends (AOR 8.94; 95% CI 5.95-13.45), family members (AOR 5.50; 95% CI 3.66-8.29), being anxious (AOR 4.90; 95% CI 3.43-6.99), inability to trust anyone (AOR 4.07; 95% CI 2.75-6.03), had issues of Gender, Sex and Sexuality (AOR 3.16; 95% CI 1.93-5.17) and relationship issues (AOR 2.77; 95% CI 2.05-3.73). The results alert all institutions, organisations and departments that cater to services and development of youth, to be sensitive towards risk factors of suicidality. The study advocates youth mental health promotion clinics to be equipped with measures/interventions to identify and manage such risk factors. This study has implications for Youth mental health promotion in India and other similar South-East Asian countries.

Analysis of death causes of residents in poverty-stricken Areas in 2020: take Liangshan Yi Autonomous Prefecture in China as an example

BackgroundContinuous surveillance of death can measure health status of the population, reflect social development of a region, thus promote health service development in the region and improve the health level of local residents. Liangshan Yi Autonomous Prefecture was a poverty-stricken region in Sichuan province, China. While at the end of 2020, as the announcement of its last seven former severely impoverished counties had shaken off poverty, Liangshan declared victory against poverty. Since it is well known that the mortality and cause of death structure will undergo some undesirable changes as the economy develops, this study aimed to reveal the distribution of deaths, as well as analyze the latest mortality and death causes distribution characteristics in Liangshan in 2020, so as to provide references for the decision-making on health policies and the distribution of health resources in global poverty-stricken areas.MethodsLiangshan carried out the investigation on underreporting deaths among population in its 11 counties in 2018, and combined with the partially available data from underreporting deaths investigation data in 2020 and the field experience, we have estimated the underreporting rates of death in 2020 using capture-recapture (CRC) method. The crude mortality rate, age-standardized mortality rate, proportion and rank of the death causes, potential years of life lost (PYLL), average years of life lost (AYLL), potential years of life lost rate (PYLLR), standardized potential years of life lost (SPYLL), premature mortality from non-communicable diseases (premature NCD mortality), life expectancy and cause-eliminated life expectancy were estimated and corrected.ResultsIn 2020, Liangshan reported a total of 16,850 deaths, with a crude mortality rate of 608.75/100,000 and an age-standardized mortality rate of 633.50/100,000. Male mortality was higher than female mortality, while 0-year-old mortality of men was lower than women’s. The former severely impoverished counties’ age-standardized mortality and 0-year-old mortality were higher than those of the non-impoverished counties. The main cause of death spectrum was noncommunicable diseases (NCDs), and the premature NCD mortality of four major NCDs were 14.26% for the overall population, 19.16% for men and 9.27% for women. In the overall population, the top five death causes were heart diseases (112.07/100,000), respiratory diseases (105.85/100,000), cerebrovascular diseases (87.03/100,000), malignant tumors (73.92/100,000) and injury (43.89/100,000). Injury (64,216.78 person years), malignant tumors (41,478.33 person years) and heart diseases (29,647.83 person years) had the greatest burden on residents in Liangshan, and at the same time, the burden of most death causes on men were greater than those on women. The life expectancy was 76.25 years for overall population, 72.92 years for men and 80.17 years for women, respectively, all higher than the global level (73.3, 70.8 and 75.9 years).ConclusionsTaking Liangshan in China as an example, this study analyzed the latest death situation in poverty-stricken areas, and proposed suggestions on the formulation of health policies in other poverty-stricken areas both at home and abroad.

Users' Experiences With the NoHoW Web-Based Toolkit With Weight and Activity Tracking in Weight Loss Maintenance: Long-term Randomized Controlled Trial.

BackgroundDigital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience largely determines whether they are used, which is a precondition for effectiveness.ObjectiveThe primary aim of this study is to evaluate user experiences with the NoHoW Toolkit (TK)—a DBCI that targets weight loss maintenance—over a 12-month period by using a mixed methods approach and to identify the main strengths and weaknesses of the TK and the external factors affecting its adoption. The secondary aim is to objectively describe the measured use of the TK and its association with user experience.MethodsAn 18-month, 2×2 factorial randomized controlled trial was conducted. The trial included 3 intervention arms receiving an 18-week active intervention and a control arm. The user experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6, and 12 months of use. The questionnaires also included open-ended items that were thematically analyzed. Focus group interviews were conducted after 6 months of use and thematically analyzed to gain deeper insight into the user experience. Log files of the TK were used to evaluate the number of visits to the TK, the total duration of time spent in the TK, and information on intervention completion.ResultsThe usability level of the TK was rated as satisfactory. User acceptance was rated as modest; this declined during the trial in all the arms, as did the objectively measured use of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. The following 4 themes were identified in the qualitative data: engagement with features, decline in use, external factors affecting user experience, and suggestions for improvements.ConclusionsThe long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance, and content of the DBCI before and during the trial, similar to how a commercial app would be optimized. In a trial setting, the users should be made aware of how to use the intervention and what its requirements are, especially when there is more intensive intervention content.Trial RegistrationISRCTN Registry ISRCTN88405328; https://www.isrctn.com/ISRCTN88405328International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2019-029425

Utilization of elderly health promotion services during COVID 19 in Iran: A cross-sectional study.

The outbreak of COVID-19 pandemic has made it difficult for older adults to utilize ordinary elder services. This cross-sectional study investigated the status of feeling the need, seek, and utilization of health promotion services among older adults in Ardabil, Iran, covered by the country's comprehensive health system during the pandemic. This descriptive-analytical and cross-sectional study was conducted on 739 elderly people in Ardabil province. Cluster random sampling method was used for sampling. Data were gathered by referring trained individuals to the place of residence of the selected older adults Questionnaires were consisted of three parts: demographic information, household's economic status, and feeling the need, seek, and utilization from health promotion services. Multivariate logistic regression was used to separately model the need, seeking for, and utilization of health promotion services in STATA ver. 14. The mean age of the older adults in this study was 68.88 ± 4.72 years. The results indicate that men showed significantly greater need, seek for, and utilization of health promotion services during COVID- 19 than women. According to the results, people over the age of 80 had 4.08 times (95% confidence interval [CI]: 1.99-12.60) more need and utilization of health services than the older adults under 65 years. The results also indicate that use of health promotion services was significantly associated with being married (3.74, 95% CI: 1.22-2.62), having primary insurance and supplementary insurance (1.92, 95% CI: 1.21-3.12), and obesity (2.05, 95% CI: 1.13-3.76) in P < 0.05 level. Based on the results, people with chronic disease and obesity were more likely to utilize health promotion services. Findings suggest that the access and utilization of inpatient and outpatient health services by the elderly in the COVID-19 pandemic has somewhat decreased, which could be due to the fear of the disease being referred to health centers by the elderly. Hence, enabling conditions such as parental health care were major factors affecting health-seeking habits among the Iranian elder population.

Is Health Literacy Clue on the Self-Efficacy of Diabetes Patients?

Objective: This research was conducted to evaluate the relationship between health literacy level and self-efficacy in patients with diabetes mellitus. Methods: This cross-sectional study was conducted inpatient and outpatient clinic of internal medicine at the city hospital. The sample of the study consisted of 700 conscious patients diagnosed with diabetes mellitus for at least one year. The data of the study were collected using the Health Literacy Questionnaire-European Union Scale and Type 2 Diabetes Self-Efficacy Scale. Data were analyzed using regression analysis and correlation analyses. Results: In this study, the level of health literacy general index was sufficient level, and the average of the self-efficacy scale was high. It was observed that health promotion and health service literacy level were effectived in estimating the self-efficacy level of diabetes patients. As the health literacy level of patients for health service and health promotion increased, general self-efficacy level increased. Conclusion: Health promotion and health service literacy level are effective in estimating the self-efficacy level of diabetes patients.

Effect of health extension service on under-five child mortality and determinants of under-five child mortality in Derra district, Oromia regional state, Ethiopia: A cross-sectional study.

Objectives:Under-five child mortality is the highest in Ethiopia even though it decreased steadily in the last two decades. Hence, this study aimed to identify the risk factors and effects of Health Extension Service on under-five child mortality per mother in Derra district, Ethiopia.Methods:The study used a three-stage sampling technique and a random sample of 446 mothers. Cross-sectional data were collected using a structured interview and analyzed using descriptive and inferential (propensity score and Poisson regression) analysis.Results:One-fourth (23.5%) of mothers experienced at least one under-five child mortality in the last 13 years and the propensity score analysis also indicated that utilizing and model in the Health Extension program reduced under-five child mortality per mother by 29.84% and 15.71%, respectively. The Poisson regression model identified that kebeles, not utilized health extension program (incidence rate ratio 2.25, 95% confidence interval (1.33, 3.85)), not model in health extension program (incidence rate ratio 1.79, 95% confidence interval (1.07, 3.18)), primary educational level (incidence rate ratio 0.14, 95% confidence interval (0.18, 0.91)), mother aged at first birth less than 20 years (incidence rate ratio 1.82, 95% confidence interval (1.90, 3.05)), source of drinking water not pipped (incidence rate ratio 2.36, 95% confidence interval (1.20, 3.18)), and child delivered at home (incidence rate ratio 2.48, 95% confidence interval (1.26, 4.8)) significantly influence under-five child mortality per mother at 5% level of significance.Conclusion:Health extension service utilization reduced under-five child mortality per mother, and education level, source of drinking water, place of child delivery, and place of residence (kebele) were significant risk factors for under-five child mortality per mother. The health sectors and district health offices should work on health extension program to increase the community awareness of basic preventive and promotive health services and minimize risk factors of under-five child mortality.

Can a new role, the (Trainee) Associate Psychological Practitioner (T/APP), add value in General Practice? Results from the pilot year evaluation.

The deployment of (Trainee) Associate Psychological Practitioners (T/APPs) to deliver brief psychological interventions focusing on preventing mental health deterioration and promoting emotional wellbeing in General Practice settings is a novel development in the North West of England. As the need and demand for psychological practitioners increases, new workforce supply routes are required to meet this growth. To evaluate the clinical impact and efficacy of the mental health prevention and promotion service, provided by the T/APPs and the acceptability of the role from the perspective of the workforce and the role to T/APPs, patients and services. A mixed-methods design was used. To evaluate clinical outcomes, patients completed measures of wellbeing (WEMWBS), depression (PHQ-9), anxiety (GAD-7) and resilience (BRS) at the first session, final session and at a 4-6 week follow-up. Paired-samples t-tests were conducted comparing scores from session 1 and session 4, and session 1 and follow-up for each of the four outcome measures. To evaluate acceptability, questionnaires were sent to General Practice staff, T/APPs and patients to gather qualitative and quantitative feedback on their views of the T/APP role. Quantitative responses were collated and summarised. Qualitative responses were analysed using inductive summative content analysis to identify themes. T-test analysis revealed clinically and statistically significant reductions in depression and anxiety and elevations in wellbeing and resiliency between session 1 and session 4, and at follow-up. Moderate-large effect sizes were recorded. Acceptability of the T/APP role was established across General Practice staff, T/APPs and patients. Content analysis revealed two main themes: positive feedback and constructive feedback. Positive sub-themes included accessibility of support, type of support, patient benefit and primary care network benefit. Constructive sub-themes included integration of the role and limitations to the support. The introduction of T/APPs into General Practice settings to deliver brief mental health prevention and promotion interventions is both clinically effective and acceptable to patients, General Practice staff and psychology graduates.

Factors affecting relationship issues among clients attending youth mental health promotion services in India.

BACKGROUND:India today is home for the largest youth population in the world. Youth is a formative phase transitioning from childhood to adulthood. Relationship is fundamental for a healthy and satisfactory life. Relationships assume importance and maturity during adolescence and youth. Relationships and mental health have a bidirectional effect. The effect of relationships on mental health is stronger than vice versa.MATERIALS AND METHODS:Two-year case record analysis of 8595 beneficiaries aged 15–35 years attending youth guidance centers (Yuva Spandana Kendras) in Karnataka, India, was undertaken to understand factors affecting relationship issues among them. Multivariate logistic regression was performed with any beneficiary having a relationship issue as outcome.RESULTS:Being a student (adjusted odds ratio [AOR] = 1.49; 95% confidence interval [CI] = 1.18–1.89), occupation (AORbusiness/salaried = 3.04; 95% CI = 2.10–4.40 and AORothers = 1.72; 95% CI = 1.22–2.44), marital status (AORmarried = 1.42; 95% CI = 1.06–1.90 and AORothers = 3.44; 95% CI = 1.45–8.15), having health and lifestyle issues (AOR = 3.61; 95% CI = 3.05–4.27), personality issues (AOR = 2.88; 95% CI = 2.43–3.41), safety issues (AOR = 6.28; 95% CI = 5.01–7.87), gender, sex, and sexuality issues (AOR = 3.10; 95% CI = 1.93–4.98), suicidality (AOR = 1.82; 95% CI = 1.17–2.85), alcohol use (AOR = 5.43; 95% CI = 3.92–7.41), and different emotions experienced (AOR ranging from 0.37 to 3.50), had significant association with relationship issues.CONCLUSION:Investing in health promotion interventions focusing on these precursors of relationship issues among youth seems strategic. Our findings have implications for other states in India and other low-middle-income countries like India.

Street Posyandu: Early reproductive health promotion services and media for people in street situations

The phenomenon of children on the streets is currently a severe problem in several cities in Indonesia. Women and children are the most vulnerable groups in the street community during the pandemic. Due to the complexity of people's health problems in street situations that are influenced by social and economic factors, this community service is expected to bridge the barriers to health access, especially reproductive health. This program aims to provide initial health services for people in street situations. Street Posyandu is expected to be a role model for the government and private sectors in dealing with people's health problems in street situations. The Street Posyandu program uses a persuasive approach. The technology used to support the Street Posyandu is the creation of a monitoring system and recording of maternal and child health conditions for street community. Posyandu Jalanan is realized by continuing to prioritize promotive and preventive services without neglecting curative (treatment) and rehabilitative (health restoration) aspects. The specific suggestion to be conveyed in this program is that the stakeholders need to redesign the form of health services aimed at communities in street situations.