Interpersonal Level Research Articles

Multilevel Factors Impacting Substance Use Treatment Access, Engagement, and Racial Equity Among Opioid Overdose Survivors in Boston, MA.

There are well-documented racial/ethnic inequities in drug-related overdoses and access to evidence-based opioid use services nationally and in Boston, MA. To qualitatively explore the drivers of racial/ethnic inequities in access to opioid use disorder treatment and services in Boston. Semi-structured qualitative interviews. Using purposive sampling, researchers recruited 59 opioid overdose survivors in Boston who self-identified as Black, Hispanic or Latino/a/x, and/or White. Interviewers administered a socio-demographic and drug use survey, and used a semi-structured interview guide to explore experiences with and perspectives on substance use treatment and services. Participants' racial/ethnic identities were distributed across three subgroups: non-Hispanic Black (n = 18; 31%), non-Hispanic White (n = 18; 31%), and Latino/a/x (n = 23; 39%). Qualitative analysis identified multiple themes that were organized into four social-ecological levels after analysis. At the individual level, some participants emphasized the importance of personal responsibility and individual motivation in determining access to services. Participants expressed a range of perspectives about using medication for opioid use disorder treatment; Black and Latino/a/x participants were more likely than White participants to have critical perspectives. At the interpersonal level, experiences of bias, stigma, and racism from staff in healthcare and treatment settings were common. At the program/process level, participants described challenges connecting to services following overdose and barriers within specific programs, with Black and Latino/a/x participants experiencing particular gaps. At the systems level, the limited availability of housing, employment, and mental health care negatively impacted treatment access and engagement. A racism lens was used during data interpretation to apply the themes at a broader population level. Through this lens, the identified barriers can be understood to have a disproportionate impact on people of color. Findings call for programmatic and policy solutions that address racism, break down stigma, and ensure equitable access to evidence-based services and social supports.

Prevalence and predictors of internet use among Ghanaian older adults: evidence from the Ghana 2021 Population and Housing Census

Internet use among older adults has several beneficial impacts on their health and general wellbeing. However, there are limited studies on internet use among older adults in low- and middle-income countries, including Ghana. Also, studies on internet use among older adults have used surveys rather than census data, which minimises the potential for sampling bias and improves representativeness. Therefore, this study used census data to examine the prevalence and predictors of internet use among Ghanaian older adults. This study utilised the Ghana 2021 Population and Housing Census. The data were analysed using Pearson’s chi-square test and binary logistic regression. Overall, 52.9% of older adults used the internet 3 months preceding the census. Older adults mainly use mobile phones to access the internet. The significant predictors of internet use were age, sex, educational status, marital status, religious affiliation, place of residence, sight and hearing impairment, household wealth status, and ecological zone. Internet use among Ghanaian older adults was relatively high. Policymakers should consider these intrapersonal (age, sex, educational status, and sight and hearing impairments), interpersonal (marital status and household wealth), institutional (religious affiliation), and community (place of residence and ecological zone) level factors when developing interventions to promote internet use among older adults.

Reciprocity and prosocial behavior in democratic dynamic

Prosocial behavior (CP) currently presents some conceptual overlaps with the construct of reciprocity, understood here as a lubricant of democratic dynamics. The proposed study is based on a research agreement between the Universities of Palermo and Malaga, to test the relationship between CP and reciprocity and the multiple dimensions that intervene on the two constructs at the individual, interpersonal and community level. A structural equation model (with the Lisrel method) was used to assess whether the principle of equity, belief in a just world, sense of community and neighborhood norm increase CP and whether this together with worldview and social trust, in turn, increase positive reciprocity and decrease negative reciprocity. The analyses presented are partial and concern the sample of Palermo, consisting of 307 subjects, residing in the eight districts of the city. From the analysis of the data, the parameters of the model are satisfactory even if the effect of the sense of community is not significant.

Exploring barriers and facilitators to feeding children with minimal or no "Junk Food": Insights from Mexican women.

This study aims to investigate the factors that promote or hinder the feeding of children with minimal or no ultra-processed products to inform the design of an mHealth strategy in Mexico and prevent child malnutrition among the economically vulnerable. An exploratory qualitative study was conducted, involving 24 in-depth face-to-face interviews with caregivers of children aged 24-59 months from both urban and rural communities. To analyze the data, we used thematic analysis and incorporated a few elements of grounded theory. More barriers than facilitators were identified. Key barriers included: misconceptions and the widespread availability of junk food through an extensive network of grocery stores; neighbors and family gifting junk food; the association of soda with celebrations; the practice of indulging children with junk food; and the normalization of junk food consumption by both adults and children. Facilitators included: caregivers' awareness of the health risks associated with junk food; economic constraints limiting junk food purchases; support from husbands in regulating children's junk food consumption; the presence of a family member with diabetes; specific cultural beliefs about children's digestive health; as well as displacement of "healthy" foods that nourish children. Based on our findings, we formulated recommendations for interventions at intrapersonal, interpersonal, organizational, community, and public policy levels to support healthier feeding practices for children.

Healing-Centered Restorative Justice

This concept paper maps out an approach to restorative justice that enriches current trauma-informed understandings and promotes healing and repair. The paper draws upon many sources, including qualitative research undertaken between 2021-23 in Israel/Palestine and New Zealand/Aotearoa, and an ongoing collaborative research project in the U.S. It also incorporates gathered wisdom on trauma and healing from leading experts across many disciplines. The paper begins by delineating different understandings of trauma, including personal, collective, historical, and structural forms. It then highlights three critical perspectives that offer useful insights into how the field of restorative justice can more effectively achieve its transformational potential: (1) Indigenous/collectivist perspectives; (2) positive psychology-related perspectives; and (3) transformative justice/abolitionist perspectives. The paper goes on to reframe these critical perspectives as core features of healing-centered restorative justice: first, a contextualized, multi-dimensional understanding of trauma; second, a strengths orientation toward human behavior; and third, a relational worldview grounded in interconnectedness, mutuality, and shared responsibility. By adopting this holistic and humanistic framework, restorative justice scholars and practitioners can develop effective and culturally sustaining conflict transformation processes that contribute to healing and repair at individual, interpersonal, and systemic levels of society.

The role of family doctors in developing primary care systems in Asia: a systematic review of qualitative research conducted in middle-income countries 2010-2020.

The Asia Pacific Region's middle-income countries (MICs) face unique challenges in the ongoing development of primary care (PC) systems. This development is complicated by systemic factors, including rapid policy changes and the introduction of private healthcare services, as well as the mounting challenges associated with ageing populations and increasing rates of chronic diseases. Despite the widespread acknowledgement of the importance of family doctors in the development of PC services, relatively little is known about how these roles have developed in Asian MICs. To address this gap, this systematic review presents a synthesis of recent research focused on the role of family doctors within the PC systems of MICs in the Asia Pacific Region. We searched six electronic databases (CINAHL Complete, Embase, PsycINFO, PubMed, Web of Science, and Index Medicus for the South-East Asia Region and Western Pacific) for peer-reviewed qualitative literature published between January 2010 and December 2020. The quality of the studies was evaluated using the Critical Appraisal Skills Programme tool. Eighteen articles were included in the analysis. Findings from these articles were extracted and synthesised using qualitative thematic synthesis. We used the Rainbow Framework to analyse the interconnections within health systems at the macro, meso and micro levels. Our analysis of the included articles showed that family doctors play a crucial role in bridging the gap between hospitals and communities. They are essential in adopting holistic approaches to health and wellbeing and are in a unique position to try and address social, psychological, and biological aspects of health. Our findings also highlight the influence of policy changes at the macro level on the role and responsibilities of family doctors at the meso (organisational) and micro (interpersonal) levels. Limited research has explored the role of family doctors in the ongoing development of primary care systems in MICs in the Asia Pacific Region. The findings of this review have significant implications for policymakers and healthcare administrators involved in ongoing improvements to and strengthening of PC systems. Areas of particular concern relate to policy linked with training and workforce development, insurance systems and public awareness of what primary care services are.

“Balancing work and movement”: barriers and enablers for being physically active at Indian workplaces – findings from SMART STEP trial

BackgroundNon-communicable diseases are rising rapidly in low- and middle-income countries, leading to increased morbidity and mortality. Reducing sedentary behavior (SB) and increasing physical activity (PA) offer numerous health benefits. Workplaces provide an ideal setting for promoting SB/PA interventions; however, understanding the barriers and enablers is crucial for optimizing these interventions in workplace environments.MethodsNested within a cluster randomised controlled trial (the SMART-STEP trial), the present study employed in-depth interviews with 16 office workers who have completed 24 weeks of two distinct (technology assisted and traditional) workplace SB/PA interventions. Using a deductive analysis, semi-structured interviews were administered to explore the barriers and enablers to the SB/PA interventions at individual, interpersonal and organisational level using the socio-ecological model.ResultsSeveral individual (poor goal setting, perceived health benefits & workload, attitude, intervention engagement), interpersonal (lack of peer support) and organisational (task prioritisation, lack of organisational norm and material or social reward) barriers were identified. Indian women engaged in desk-based office jobs often find themselves burdened with intense home and childcare responsibilities, often without sufficient support from their spouses. A primary concern among Indian office workers is the poor awareness and absence of cultural norms regarding the health risks associated with SB.ConclusionsRaising awareness among workplace stakeholders—including office workers, peers, and the organization—is crucial before designing and implementing SB/PA interventions in Indian workspaces. Personalized interventions for Indian female office workers engaged in desk-bound work are warranted.

Dietary Behaviour of Pregnant Women in Ethiopia: The Missing Aspect of Care.

Background: Nutrition and adequate dietary intake during pregnancy strongly influence the health and well-being of the mother, as well as the physical and cognitive development of the unborn child. While previous studies have documented factors associated with the dietary behaviour of pregnant women in Ethiopia, a comprehensive overview is missing. Objective: The aim of this study was to close this research gap. Methodology: We conducted a mapping review, including 37 studies published between 2000 and 2022 in our analysis. Dietary behaviour refers to all phenomena related to food choice, eating behaviour and dietary intake. We used an innovative approach by integrating a socio-ecological framework with UNICEF's conceptual framework on maternal and child nutrition, which specifies multidimensional individual, underlying and enabling determinants associated with the nutritional status of women. Importantly, we integrated a focus on care for women and healthy environments. Results: A total of 68 factors were identified as influencing the dietary behaviour of pregnant women, with a focus on the intra- (31/68) and interpersonal (21/68) levels, while factors at the community (11/68) and the institutional levels (5/68) were scarce. Few studies investigated socio-cultural aspects, such as gender roles, decision-making power and workload of women, psychological factors and eating practices related to food taboos. None of the studies explored the influence of resources at the institutional level. Conclusions: This attests that the focus in maternal nutrition is still placed on the individual responsibility of women, instead of addressing the structural conditions that would enable women to access resources such as land, education and nutrition information.

Impact of the COVID-19 pandemic on Canadian performing and creative artists: An interpretive descriptive study using the social-ecological model.

Public health restrictions during the Coronavirus-2019 (COVID-19) pandemic in Canada have substantially reduced the work and income of performing and creative artists. We aimed to understand how factors at the public policy, community, organizational, interpersonal and individual levels affected Canadian performing and creative artists' health and livelihood during the pandemic. We interviewed 14 creative and performing artists from an academic hospital-based healthcare center in Toronto, Canada. In addition, we conducted secondary data analysis on an existing set of 17 transcribed interviews from a quality improvement study that included relevant information to answer the present study's research question. We applied an interpretive descriptive approach to our qualitative inquiry and used the social-ecological model (SEM) as our analytic framework. We identified factors at all levels of the SEM that tended to synergistically affect the health and livelihood of artists during the COVID-19 pandemic. Public health restrictions and government financial assistance programs have downstream effects on other levels. During the pandemic, many artists sensed an overwhelming loss of community, financial instability, and limited access to healthcare; which in turn affected their health. For those who accessed financial assistance programs, the stability of income afforded time for rest without the stress of food insecurity or housing instability. Use of the SEM as an analytic framework reflects the multidirectional intricacy and dynamic interplay among factors operating within and across all five levels, bringing to light potential areas of improvement at various levels to strengthen resilience and reduce risk factors associated with artists' health and healthcare access. Findings also accentuated the fragility of precarious work that inundates the performing arts industry, which emphasizes the need for interventions and policies to address this issue. Such interventions might include financial support programs for artists, access to affordable healthcare services, and efforts to strengthen social support networks within the arts community.

Barriers and facilitators of retention in care after cervical cancer screening: patients’ and healthcare providers’ perspectives

BackgroundCervical cancer continues to threaten women’s health, especially in low-resource settings. Regular follow-up after screening and treatment is an effective strategy for monitoring treatment outcomes. Consequently, understanding the factors contributing to patient non-attendance of scheduled follow-up visits is vital to providing high-quality care, reducing morbidity and mortality, and unnecessary healthcare costs in low-resource settings.MethodsA descriptive qualitative study was done among healthcare providers and patients who attended the cervical cancer screening clinic at Mbarara Regional Referral Hospital in southwestern Uganda. In-depth interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and thematically analysed in line with the social-ecological model to identify barriers and facilitators.ResultsWe conducted 23 in-depth interviews with 5 healthcare providers and 18 patients. Health system barriers included long waiting time at the facility, long turnaround time for laboratory results, congestion and lack of privacy affecting counselling, and healthcare provider training gaps. The most important interpersonal barrier among married women was lacking support from male partners. Individual-level barriers were lack of money for transport, fear of painful procedures, emotional distress, and illiteracy. Inadequate and inaccurate information was a cross-cutting barrier across the individual, interpersonal, and community levels of the socio-ecological model. The facilitators were social support, positive self-perception, and patient counselling.ConclusionsOur study revealed barriers to retention in care after cervical cancer screening, including lack of partner support, financial and educational constraints, and inadequate information. It also found facilitators that included social support, positive self-perception, and effective counselling.

“I Don’t Expect the University to Support Queers”: Identity Management and Ambivalence toward Institutional Support for Queer University Students in China

Drawing on in-depth interviews with 17 participants, this study explores the experiences of Chinese queer university students in managing their queer identity on campus. A range of strategies is outlined, including passing, covering, being implicitly out, and being explicitly out. This study also presents participants’ expectations regarding institutional support, as well as their ambivalence toward it. While participants expressed various expectations of university support, they simultaneously considered institutional support difficult or impossible due to the campus climate and broader political context. Informed by queer theory and the concept of heteronormativity, this paper engages in a queer critique of Chinese higher education, examining the manifestations of heteronormativity at both institutional and interpersonal levels. Situated within the context of Xi Jinping’s presidency, which has reinforced political control over higher education in China, this study examines the impact of intensified authoritarianism on the campus experiences of queer university students. In this challenging environment, the study highlights a unique facet of contemporary China, providing empirical insights into the power dynamics among queer individuals, educational institutions, and the party-state.

Healthcare providers perspective of chronic pain management in persons with traumatic spinal cord injury accessing the public system in a region of South Africa

Purpose Persons with traumatic spinal cord injury (PWTSCI) have expressed a lack of education from healthcare providers and poor shared-decision making between providers and clients. The aim was to explore the healthcare providers’ perspective on factors influencing the optimal management of chronic pain. Methods Healthcare providers were recruited from two institutions at tertiary healthcare level. Interviews explored current chronic pain management practices, influencing factors and recommendations for improvement. Data saturation occurred after interviewing 11 participants. Thematic analysis was used through a socio-ecological model. Results The challenges to optimal pain management include appropriate assessment and management of psychological health (intrapersonal level), substance abuse amongst patients (intrapersonal level), access to medication for providers and lack of knowledge by providers (interpersonal and organizational level). To improve chronic pain management, an interdisciplinary team approach should be operationalized at policy and organizational level, monitoring and adjustment of interventions should take place (interpersonal), and family members/caregivers should be involved in the planning and monitoring (interpersonal). Conclusion Factors, at the interpersonal, intrapersonal, organizational and policy levels, influence optimal chronic pain management in the traumatic spinal cord injury (TSCI) population. To mitigate challenges, guidelines for chronic pain management should be developed, particularly for low-resourced developing countries.

Barriers and facilitators of cervical cancer screening literacy among rural women with HIV attending rural public health facilities in East Central Uganda: a qualitative study using the integrated model of health literacy

BackgroundSeveral rural public health facilities in East Central Uganda have sub-optimal, below 50%, levels of uptake of cervical cancer screening services among women with HIV. This is attributed to low cervical cancer screening literacy: limited ability to access, understand, appraise, and apply cervical cancer screening information. This research identified multi-level (health facility, community, interpersonal and individual) barriers, and facilitators of accessing, understanding, and applying cervical cancer screening information among rural women with HIV attending rural public health facilities in East Central Uganda to inform interventions.MethodsWe conducted ten Focus Group Discussions with rural women aged 25–49 years with HIV attending four selected rural public health facilities: thirty women who had ever screened for cervical cancer and thirty women who had never screened for cervical cancer across different age categories. Data was collected using a guide based on the Integrated model of health literacy. Thematic analysis was used for analysis. Competences (accessing, understanding and applying cervical cancer screening information) and categories of factors (health system, community, interpersonal and individual factors) of the integrated model of health literacy were deductively derived whereas barriers and facilitators were deductively derived from women’s statements.ResultsLack of communication materials and inability to access information were health facility and individual barriers of accessing cervical cancer screening information respectively. Facilitators of accessing information were access to information at health facility, community, and interpersonal levels and women’s ability to access information. Barriers and facilitators of understanding cervical cancer information were related to communication materials, provision of health education and women’s concentration during health education. Barriers and facilitators of applying cervical cancer screening information were related to communication and provision of cervical cancer screening services at health facility level, and interpersonal level from peers, partners and other family members as well as women’s ability to: understand information and access to cervical cancer screening services at individual level.ConclusionsThis study emphasizes the influence of multi-level factors on cervical cancer screening literacy among rural women with HIV attending rural public health facilities in East Central Uganda. Improving uptake of cervical cancer screening services among these women requires multi-level interventions.

Faith and Intimate Partner Violence in Rural South Africa

Intimate partner violence (IPV) is the most common form of violence against women and is associated with risk factors at the individual, interpersonal and societal level. Women often resort to various coping mechanisms to manage their daily lives due to the complex nature by which these factors interact. We qualitatively interviewed a cohort of rural women participating in a microfinance “plus” program in South Africa where women received loans for small-scale business ventures and received training sessions on gender norms. Our findings detailed women’s experiences of IPV and the role of faith as a coping mechanism for navigating economic hardship and abuse. Belief in a higher power was predominant in almost every interview, offering a sense of purpose and optimism for the future amid precarious circumstances. Interventions for violence prevention need to consider the important role that faith can play in strengthening women’s sense of self and preventing IPV.

What explains adolescents’ physical activity and sports participation during the COVID-19 pandemic? – an interpretable machine learning approach

ABSTRACT Adolescents’ physical activity (PA) and sports participation declined due to the COVID-19 pandemic. This study aimed to determine the critical socio-ecological factors for PA and sports participation using a machine learning approach. We did a cross-sectional secondary data analysis utilising the 2021 National Survey of Children’s Health (NSCH) dataset (N=16,166; 49.0% female). We applied an interpretable machine learning approach (e.g. decision tree-based models) that examined the critical factors associated with PA and sports participation. The factors related to the intrapersonal, interpersonal, organisational, and community levels of the socio-ecological model. Out of the 25 factors examined, our findings unveiled the 11 critical factors associated with PA and the 10 critical factors associated with sports participation. Factors at the intrapersonal levels (e.g. age, screen time, and race) held greater importance to PA than those at the other three levels. While interpersonal factors (e.g. parent participation in children’s events/activities, family’s highest educational level, and family income level) were most important for sports participation. This study identified that the common critical factors of physical activity and sports participation during the COVID-19 pandemic mainly relied on intrapersonal and interpersonal levels. Unique factors were discussed.

Building the capacity of older adults and community: findings from a developmental evaluation of United Way British Columbia's social prescribing programs for older adults.

Older adults with higher needs are ideal candidates for social prescribing interventions, given the complex and intersectoral nature of their needs. This article describes findings from a developmental evaluation of 19 social prescribing programs for older adults at risk of frailty. An evaluation of the programs was conducted from 2020 to 2023. We used data from three components of the evaluation: (1) initial evaluation data collected in 2020 and 2021; (2) program profiles developed in 2022; and (3) co-creation sessions conducted in 2023. From startup until March 2023, the programs served a total of 2544 older adults. The community connectors identified factors at the individual, interpersonal, institutional, community and policy levels that contributed to the successful implementation and delivery of their programs (e.g. physician champions, communities of practice, strong pre-existing relationships with the health care system), as well as challenges (e.g. limited capacity of family physicians, lack of community resources). There was strong agreement among community connectors that successful social prescribing programs should include the following core elements: (1) making connections to needed community resources; (2) co-creation of a wellness plan with long-term clients or clients who require intensive supports; (3) ongoing follow-up and check-ins for clients with wellness plans; and (4) an assessment and triaging process for the prioritization of clients. To leverage the full potential of social prescribing interventions, it is essential that programs engage with a range of health and social care providers, that community connectors are skilled and well supported, and that adequate investments are made in the nonprofit and voluntary sector.

Relationships Between Socioecological Factors and Self-Efficacy to Participate in Physical Activity for Adults With Chronic Musculoskeletal Pain: An Integrative Review.

Self-efficacy for leisure-time or health-promoting physical activity (SEPA) is a psychosocial determinant of physical activity. The socioecological model can provide a robust perspective of SEPA. The objective of this study was to synthesize the evidence on multilevel correlates of SEPA among individuals with chronic musculoskeletal pain. The second aim examined the extent to which socioecological disparities are associated with SEPA among individuals with chronic musculoskeletal pain. An integrative review was conducted. Included studies needed to investigate the relationship between SEPA and socioecological factors at the interpersonal, institutional, community, and/or macrosystem level among adults with chronic musculoskeletal pain (≥3months). Searches in PubMed, EMBASE, PsycINFO, and CINAHL were performed (December 30, 2020, and October 12, 2022), yielding 4047 records after duplicates were removed. Two independent reviewers completed screening, full-text reviews, and data extraction. After title and abstract screening and full-text reviews, 17 studies were included. The constant comparison method included: data reduction, data display, data comparison, and conclusion drawing/verification. Quality of evidence was assessed using the Joanna Briggs Institute appraisal tools. Five themes emerged with respect to relationships between SEPA and socioecological factors: social relations, social comparisons, patient-provider relationship, organizational resources, and accessibility to physical activity. Relationships between interpersonal factors and SEPA were most prominently studied. One study examined and addressed potential disparities in SEPA at the macrosystem level. A spectrum of relationships from supporting to straining SEPA were found at the interpersonal level. Relationships between institutional, community, and macrosystem factors and SEPA were comparably sparse. Gaps in the literature were identified regarding how health disparities present across the socioecological model with respect to SEPA. Clinicians can use this review to evaluate how SEPA can be supported or threatened by factors across the socioecological model. This may be a preliminary step towards examining and addressing health disparities in SEPA.

Exploring barriers to physical activity participation among female nursing students adhering to specific social-cultural norms in Indonesia: A qualitative study.

The prevalence of insufficient physical activity is common among nursing students and impacts their academic performance. Research on obstacles to physical activity (PA) among religious women, notably Muslims, is limited. This study aimed to explore barriers to PA among Indonesian Muslim female nursing students and gather suggestions for overcoming those barriers. This study used a qualitative descriptive design. Two focus groups were conducted with 12 Muslim female nursing students in Makassar, Indonesia. Interviews were audio-recorded and transcribed verbatim. The data were collected from May and July 2019. Inductive thematic analysis was used to identify core themes and sub-themes. Thematic analysis identified barriers to PA across four main themes: intrapersonal, interpersonal, institutional, and social-cultural related to religious context. Each theme included two to three sub-themes, totaling nine categories of PA participation barriers. Intrapersonal barriers consisted of low motivation, emotional states, and a sedentary lifestyle. Interpersonal challenges included a lack of family or friend support and family obligations. Institutional barriers involved academic workload prioritization, school environment inaccessibility, and absence of athletic curriculum policy. Socio-cultural barriers posed by religious expectations included gender-related concerns and modest dressing. Drawing from their perspectives as Muslim female nursing students, study participants proposed six strategies to address these barriers. Proposed solutions include promoting PA through Apps, forming female team-up clubs, providing designated exercise spaces, and implementing mandatory athletic courses for nursing students at the institutional level. Additionally, offering female instructors and private exercise rooms could reduce the barriers from a socio-cultural perspective caused by religious expectations. The study found that Muslim female nursing students with dual roles face increased barriers to PA participation, driven by intrapersonal and interpersonal levels, nursing learning load, and religious norms. Schools could build environments to meet the religious expectations within Indonesian society to promote PA for Muslim female nursing students. For example, the practical strategies include offering private rooms or female instructors when they physically exercise in school.

Nurses' health during the COVID-19 pandemic in Switzerland: A longitudinal study with mixed methods design

Nurses' health during the COVID-19 pandemic in Switzerland: A longitudinal study with mixed methods design Abstract: Background: The COVID19 pandemic has had a significant impact on healthcare systems worldwide. Nurses have played a crucial role in responding to the crisis, often at the expense of their own health and wellbeing. Aim: The aim of the study was to investigate the physical and mental health status as well as the resources of certified nurses during the pandemic, in German-speaking Switzerland. Methods: In a longitudinal study with a mixed methods design, data were collected among nurses from acute hospitals between 2021 and 2022 using a questionnaire survey and focus group interviews. The data were analysed using multiple regression analysis, knowledge mapping and the Neuman system model. Results: The results show improvements in health, quality of life and job satisfaction, and a decrease in stress; whereby influencing extrapersonal factors are, among others, reorganisations within hospitals with the active involvement of nurses. On the interpersonal level, support from managers or colleagues proved helpful. At the intrapersonal level, the recognition of the nurses' competencies was deemed particularly important, to help them to remain healthy during the pandemic. Conclusions: Increased recognition, participation, training and career opportunities as well as flexible working models need to be implemented in the long term to ensure a sustainable improvement of the health and well-being of nurses.

Dehumanization in the United States carceral system: Pathways to policy reform

AbstractThis narrative review examines the cumulative dehumanization process within the United States carceral system, highlighting how current policies perpetuate harm and undermine the well‐being of incarcerated individuals. Through a narrative review of interdisciplinary research, we explore the psychological, sociological, and legal dimensions of life within prison walls. We argue that the cumulative dehumanization inherent in these practices not only risks the safety and futures of prisoners but also creates environments that increase the likelihood of rule infractions and extended sentences. We identify and highlight the process of dehumanization across individual, interpersonal, institutional, and systemic levels. Our analysis focuses on three critical policy areas: the goals and directives of the Federal Bureau of Prisons, the use of subminimum wages and forced labor, and the impact of fees on prisoners’ access to healthcare. By prioritizing respect, fairness, and humane treatment, we can dismantle the structures perpetuating dehumanization and harm.Public Significance StatementThis paper reviews the research surrounding cumulative dehumanization in prison life. It provides three policy recommendations in order to combat the dehumanization of prisoners, including changing the directive of the Bureau of Prisons, ending the use of subminimal wages, and removing fees from prisoners seeking medical treatment.