Community Intervention Research Articles

Assessing Attitudes and Perceptions of High-Risk, Low-Resource Communities Towards Cardiopulmonary Resuscitation and Public-Access Defibrillation

Background: Layperson cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are vital for improving survival rates after out-of-hospital cardiac arrest (OHCA), yet their application varies by community demographics. We evaluated the concerns and factors influencing willingness to perform CPR and use AEDs among laypersons in high-risk, low-resource communities. Methods: From April 2022 to March 2024, laypersons in Northern Manhattan’s Community District 12 completed surveys assessing their attitudes toward CPR and AED use before attending Hands-Only CPR training. Fisher’s Exact Test assessed differences in concerns and willingness to perform CPR and AED use across racial-ethnic groups and compared low-resource communities with high-resource groups consisting of non-clinical staff across eight ambulatory sites. Results: Among 669 participants from low-resource communities, 64% identified as Hispanic, 58% were under 40 years of age, and 67% were female. Significant knowledge gaps were identified: 62% had never learned CPR, and 77% were unfamiliar with AEDs. Top concerns about giving CPR included fear of incorrect performance (67%), causing harm (56%), and legal repercussions (53%). Willingness to perform CPR was most influenced by familiarity with the victim. The primary barrier to AED use was a lack of operational knowledge (66%). Non-Hispanic Black participants expressed significantly greater concerns than their Non-Hispanic White counterparts. Participants in high-resource settings (n = 309) showed higher training rates, albeit with similar apprehensions about CPR and AED use. Conclusions: Concerns regarding CPR and AED use stem from a lack of confidence and training, particularly predominant in certain racial-ethnic groups. Targeted, culturally sensitive community interventions could potentially address these barriers, enhance preparedness, and improve OHCA survival rates.

A Bleed From the Distal Anastomosis Site of a Bypass Graft From the Left Common Iliac Artery to the Celiac Trunk Treated With a Surgeon-Modified Fenestrated Endograft.

The use of surgeon-modified fenestrated endograft to treat a bleeding complication in the common iliac artery. An Endurant limb graft was modified on back table in theater after planning the fenestration using a semi-automated centerline. The Endurant stent was planned to land flush at the aortic bifurcation. The Endurant limb was partially deployed until the fenestration opened facing the anastomosis to enable rotation and axial movement of the stent graft, if needed. By obtaining access from the contralateral common femoral artery, the fenestration was cannulated using up-and-over technique and bypass graft cannulated. The Endurant stent graft was then fully deployed. Through a separate puncture in the ipsilateral sheath, the fenestration was re-cannulated using a hydrophilic wire, and a balloon-expandable covered stent was introduced through a 7F sheath and then flared in a kissing fashion along with the Endurant stent. The distal part of the Endurant limb was extended with a bare metal stent into the external iliac artery. Control angiography was satisfactory, and bleeding was controlled. Surgeon-modified stent graft in the iliac arteries can be used even in the context of non-aneurysmal disease to treat patients in high-risk emergency situations and could be part of the armamentarium of the vascular surgeon. Physician-modified endografts are increasingly being used by vascular surgeons and interventional radiologists to treat patients with complex aorto-iliac aneurysms in whom custom-made endograft provided by the manufacturer is too expensive to produce and/or patient requires urgent surgery. Data on the use of physician-modified endografts to treat non-aneurysmal disease is lacking. This technical note highlights the use of physician-modified endograft to treat a patient with bleeding complication from the distal anastomosis of an iliac artery to coeliac trunk bypass graft in whom open surgery posed unacceptable high morbidity and mortality risks. This technical note continues to add more information and knowledge to the vascular surgery / interventional radiology communities on the use of physician-modified endografts and also adds another tool in the armamentarium of teams involved.

Engaging older adults in diagnostic safety: implementing a diagnostic communication note sheet in a primary care setting

IntroductionAdults over the age of 65 are at a higher risk for diagnostic errors due to a myriad of reasons. In primary care settings, a large contributor of diagnostic errors are breakdowns in information gathering and synthesis throughout the patient-provider encounter. Diagnostic communication interventions, such as the Agency for Healthcare Research and Quality's “Be the Expert on You” note sheet, may require adaptations to address older adults' unique needs.MethodsWe recruited and partnered with older adult patients (n = 6) in focus group sessions to understand their perspectives on diagnostic communication and the existing AHRQ note sheet. A two-page communication and clinic workflow tool was developed and implemented over a 6-month period using three Plan-Do-Check-Act cycles. Physicians, nurses, staff, and patients were surveyed.ResultsMost older adult patients (n = 31) found the tailored diagnostic communication note sheet to be easy-to-use, helpful for provider communication, and would recommend its use to other patients. Physicians and staff members were satisfied with the note sheet and described few challenges in using it in practice.DiscussionOur findings contribute to the growing body of evidence around diagnostic safety interventions and patient engagement by demonstrating the feasibility and benefits of actively involving older adult patients in quality initiatives.

Evaluation of Sorghum-Oat-Soybean Ready-To-Use Therapeutic Food (RUTF) on Nutritional Recovery and Biochemical Profiles in Rats

Mortality due to severe acute malnutrition is one of the leading causes of death especially among children in developing countries. Ready-to-use therapeutic foods (RUTFs) have become the beacon of hope in the new management scene of malnutrition. The study is aimed at the management and assessing the effectiveness of nutritional rehabilitation of malnourished rats. A 33-day study was conducted on 20 Wistar rats which were divided into five different cages randomly and were fed with varying ratios of Sorghum-Oat-Soybean (SOS) Ready-to-Use-Therapeutic Food (RUTF) formulations as well as two controls RUTFS. Results showed pre-starvation body weights of the experimental animals ranged from 104.76g (S1 group) to 106.37g (C0 group). Subsequent to 5 days of starvation, a significant reduction in body weight was observed, with values ranging from 75.05g (S1 group) to 76.11g (S3 group). Following 21 days of nutritional intervention with SOS-RUTF, significant inter-group differences (p < 0.05) were detected in body and organ weights; hemoglobin, cholesterol, and triglyceride levels, ALT, AST, and ALP enzyme activities. The three SOS-RUTFs findings with of different ratios study revealed that SOS-RUTF enhanced formulations brought back the body weight, and organ weight was normal, balanced the biochemical parameters and corrected the hepatic and bone enzyme activities to near normal. These findings have important implications for the treatment of severe acute malnutrition. The study shows that the easily available, inexpensive, and nutritious SOS-RUTF can be used in clinical nutrition and is viable as an option for use in community interventions. This is especially so in developing countries where proper nutritious food is a luxury.

Student-Led Falls Prevention Program for Community-Dwelling Older Adults in a Rural Community: A Pilot Study.

A third of community-dwelling adults over the age of 65 years fall each year, making falls a significant concern for the elderly. Older people living in community-dwellings account for 73% of fall-related hospitalisations in older populations. Little is known about identifying, reaching at-risk people, and delivering these interventions in rural communities. Our aim was two-fold. To test the utility of a student-led program in identifying community-dwelling elderly people at high risk for falls in a rural and remote setting. To determine client satisfaction with the falls prevention program. Rural and remote community settings in Queensland, Australia. Forty community-dwelling older adults from the MMM 4 and 6 regions. This pilot study utilised a cross-sectional design and convenience sampling approach. A validated falls risk self-reported checklist and a screening checklist for general practitioners were used to identify older adults at risk of falling. During the home visit, participants were assessed for their cognition, balance and home safety. A client satisfaction survey was completed via telephone 3 months following the home visits. Several risk factors for falls were identified, including unsafe use of equipment, absence of Medi alerts, insufficient supervision, lack of support, inappropriate footwear, behavioural concerns and environmental hazards. Most participants reported that the home assessment was valuable and made their homes safer. An innovative student-led placement model has the potential to provide much-needed access to falls prevention services and minimise falls among community-dwelling older adults in rural and remote locations.

North American Pilot of TBIconneCT: A Social Communication Intervention via Telehealth for Individuals With Traumatic Brain Injury and Their Conversation Partners.

The purpose of this pilot investigation was to identify formative feedback to guide the development of a North American version of the TBIconneCT program. A secondary purpose was to examine the feasibility of delivering the intervention by graduate students. Two cohorts of individuals with chronic brain injuries and their communication partners were recruited for a 10-week, modified TBIconneCT program delivered by graduate student clinicians via telehealth. Eight dyads were recruited for the first cohort, but only four dyads completed the investigation. Ten dyads participated in the second cohort, but only seven dyads completed the investigation. Along with pre and post self-reported measures of communication and participation, participants completed an interview about their experiences. Interviews were transcribed and qualitatively coded using reflexive thematic analysis. Participants from both cohorts improved in all pre- and postmeasures of communication and participation; however, gains were modest across the cohorts. Qualitative analyses were conducted separately by cohort, as results from the first cohort informed modifications that were implemented in the second cohort, primarily to address Australian English dialects. Across both contexts, overarching constructs included "participant perspectives regarding outcomes," "assessments of the effectiveness of specific portions of the program," and "suggestions for improvement." The modified TBIconneCT program (North American pilot version) produced modest gains in measures of social communication, participation, and quality of life. Qualitative analyses provided insights into the strengths and weaknesses of the modified program, along with suggestions for refinement of the pilot version.

Social participation challenges and response strategies identified by adults aging with a disability

AbstractSocial participation is likely to decrease among older adults as disability levels increase. However, it is a modifiable determinant of health that can impact older adults' well‐being and quality of life. Thus, this secondary data analysis aimed to understand what challenges older adults aging with a mobility or vision disability face with social participation, as well as their solutions for addressing those challenges. Interview data were obtained from the Aging, Challenges, Concerns, and Everyday Solution Strategies study. Six activities were chosen based on a taxonomy of social activities and a conceptual model of participation. Frequency counts were gathered through a thematic analysis to understand the number of challenges and response strategies. Over half of the older adults who had a mobility disability shared that visiting family and friends (57%) was their most challenging social activity. The identified challenges hindering them from completing the social activity were primarily personal, followed by accessibility and environmental. Older adults with a vision disability shared that going to entertainment events or activities (26%) was their most challenging social activity. Resources, such as community interventions, can support older adults with mobility or vision disabilities in participating in social activities. As such, future research, policy, and interventions should consider external support components to assist older adults with a mobility or vision disability with social participation.

SUSTAINABLE DEMENTIA CARE: CLINICAL, PROGRAMMATIC, AND PUBLIC HEALTH PERSPECTIVES

Abstract When considering the dissemination and implementation of evidence-based innovations in aging, sustainability is a driving concern but understudied outcome. Sustainability refers to “is the extent to which a newly implemented intervention is maintained or institutionalized within a service setting’s ongoing, stable operations” (Lewis et al., 2017). Although attention in dementia care is beginning to pivot to issues related to successful dissemination and implementation of a growing number of evidence-based innovations, concerns related to the maintenance of long-term care adoption of dementia care interventions in clinical, community, and public health contexts remain pressing. Beyond dementia care and in the broader field of implementation science, available research on sustainability is limited with challenges ranging from heterogeneity in definitions, measurement, follow-up periods and similar issues. The objective of this symposium is to initiate a scientific and practice agenda as it relates to sustainability for dementia care interventions. We will feature presentations on dementia care sustainability from public health, community, clinical, and scientific perspectives. Following this symposium, we aim to establish a framework to better achieve sustainability of evidence-based and evidence-informed dementia care innovations across key settings and communities.

비구어 자폐 범주성 장애 영유아를 위한 의사소통 조기교육에 대한 연구 동향 및 과제

Children with non-verbal autism spectrum disorder(ASD) have difficulties with social interaction and social development because of their limited verbal expression. Early intervention for children with non-verbal ASD has been shown to significantly improve their communication skills and reduce their ASD symptoms. Therefore, the aim of this study was to explore the trends in early communication intervention programs for children with non-verbal ASD overseas and to discuss the practicality of applying them in Korea. The results of the study showed that a total of 22 relevant studies were conducted between 1998 and 2023. Most of the studies were single-subject studies, and 45.5% of the studies involved parents as interventionists. In 68.2% of the studies trained interventionists, including parents, reported that the most important target skills were found to be verbal communication, joint attention and eye contact. Based on these findings, practical implications for national early intervention programs are discussed herein.

Perception of dating violence in adolescents through the identification of "Red flags" and "Green flags" in a community intervention

Perception of dating violence in adolescents through the identification of "Red flags" and "Green flags" in a community intervention

Pre-diabetes virtual health management community (VHMC) intervention and group interaction management model in China: a randomised clinical trial protocol

IntroductionIndividuals with pre-diabetes are at high risk for developing type 2 diabetes mellitus (T2DM), which makes them prone to serious complications such as stroke, kidney failure, blindness and lower-limb amputation....

Functional Monomers Equipped Microgel System for Managing Parkinson's Disease by Intervening Chemokine Axis-mediated Nerve Cell Communications.

The complex pathology of Parkinson's disease (PD) requires comprehensive understanding and multi-pronged interventions for communication between nerve cells. Despite new developments in nanotechnology in the treatment of PD, in-depth exploration of their biological effects, in particular, the specific mechanisms of inflammation inhibition are lacking. Herein, using the stable cascade catalysis channel formed by polydopamine (PDA), imidazole groups, and Cu ions, a microgel system comprising functional monomers [superoxide dismutase (SOD) with double bonds, PDA, 2-methacryloyloxy ethyl phosphorylcholine (MPC), and Cu ions] is proposed for managing PD. The microgel can be efficiently delivered to the brain aided by MPC, after which a multi-level regulatory strategy targeting neurons and microglia can be initiated. The catalytic activity cascade elicited by SOD and Cu ions can regulate the anti-inflammatory phenotypic transformation of microglia by relieving oxidative stress. Meanwhile, the dopamine (DA) released from PDA can facilitate DA storage and neurogenesis, inhibiting CX3CL1 release and the CX3CR1 receptor on microglia and further regulating the CX3CL1/CX3CR1-NF-κB-NLRP3 signaling pathway in microglia to inhibit neuroinflammation. Therefore, the proposed microgel delivery system with functional monomers represents a promising therapeutic strategy for managing neuroinflammation and promoting neurogenesis in PD by intervening chemokine axis-mediated communication between neurons and microglia.

Adapting Advance Care Planning Interventions for Hispanic Communities Across the U.S.

Health inequities in Hispanic populations require community-engaged solutions. Engaging Hispanic communities in research related to advance care planning (ACP) is critical to inform the development and evaluation of culturally appropriate interventions. To understand how to best adapt and implement Spanish-language ACP interventions in Hispanic communities across the US. We apply the Framework for Reporting Adaptations and Modifications to Evidence-based Interventions (FRAME) to detail experiences during implementation of the national Project Talk Trial (PTT) that delivers two ACP interventions using a community-based delivery model. Semi-structured interviews with Hispanic community event hosts and research assistants (RAs) were conducted to explore challenges and solutions to implementation. Thematic analysis was applied to transcripts. Three themes from the community hosts (n = 9) were: (1) certified translation professional services were inadequate to successfully adapt interventions for diverse Hispanic communities; (2) a lack of Spanish-speaking RAs undermined the intention to address health inequities in the research; and (3) cultural norms, such as RSVP systems, differ in Hispanic populations. Themes from the RA interviews (n = 7) include: (1) discomfort with being unable to communicate appropriately with the research participants; and (2) improved connection and event flow when bilingual RAs attended events. Our work highlights the value of a strong community-based delivery model, attention to local dialects and cultural nuances, the need for Spanish-speaking workforce and for balancing fidelity across national sites with adaptability when conducting rigorous research. The trial titled "Engaging underserved communities in end-of-life conversations: a cluster, randomized controlled trial" is registered at clinicaltrials.gov [NCT04612738].

Proposing an Individual-in-Contexts Model for Reimagining Suicide Screening, Assessment, and Intervention in Black Communities

Suicidality affects millions of people in the United States every year. Despite its pervasiveness, suicidality often impacts minoritized communities disproportionately. For example, Black communities, with historically low suicidality rates, have experienced significant increases in deaths by suicide in the last two decades. Such increases have occurred in unique and complex individual and contextual relationships such as historical trauma, racialized ecological injustices, structural and institutional racism, resource-deprived communities, forced family separation through over-incarceration, interpersonal discrimination, and internalized shame. While traditional psychiatric, psychological, and public health approaches have undoubtedly prevented some suicides, these fields of study often overlook or obscure the interconnections between upstream, oppressive systemic dynamics and downstream, individual-level factors that uniquely contribute to suicidality in Black communities. To address these oversights and limitations, and to re-imagine human services professionals’ suicide screening, assessment, and intervention with Black communities, The Individual-in-Contexts Model (ICM) is offered. This model integrates critical, ecological, contextual, and Black feminist scholarship frameworks, and provides rationale for specific human services research, practice, and policy recommendations.

The role of psychology and communication skills in orthodontic practice: a systematic review

Effective communication and psychological strategies are integral to orthodontic practice, influencing patient satisfaction, adherence, and overall treatment outcomes. This systematic review, conducted in accordance with PRISMA guidelines and registered with PROSPERO (ID: CRD42024560432), examined the role of these strategies in orthodontic care and their integration into educational curricula. A comprehensive search identified studies focusing on communication and psychological interventions in orthodontics. The findings emphasize that patient-centered communication enhances understanding, adherence, and satisfaction. Structured approaches, such as personalized follow-up reminders and digital tools like social media, have shown significant improvements in patient engagement. Psychosocial factors, including anxiety and body image concerns, were identified as critical barriers to adherence, necessitating tailored psychological support and empathy-based communication. Additionally, gaps in orthodontic education were identified, with recommendations for integrating simulations, interprofessional education, and ongoing training into curricula to address these challenges. This review underscores the importance of addressing the psychological and communicative dimensions of orthodontic care, providing actionable recommendations for enhancing patient outcomes and optimizing educational practices. Future research should explore the long-term impact of these strategies and assess their effectiveness across diverse populations.

A Mix-method Study Leveraging Social Media for Health Behavior Change: From Tweets to Transformation

Abstract Introduction: Social media platforms have emerged as powerful tools for disseminating public health messages and influencing health-related behaviors. This study aimed to explore the role of social media in public health communication and behavior change interventions. Methods: A mixed-methods approach was employed, combining quantitative analysis of social media data, online surveys, in-depth interviews, and focus group discussions. The social media data analysis included sentiment, network, and content analysis. The study analyzed 543 social media posts and 1190 comments, and surveyed 687 respondents. Results: Official accounts had higher reach (50,000 impressions per–post) compared to user-generated content (25,000 impressions) and influencer posts (30,000 impressions). However, user-generated and influencer content exhibited higher engagement (1500 likes, comments, shares per–post vs. 800 for official accounts). Sentiment analysis revealed polarized responses, with 40% of user-generated content expressing negative sentiments, particularly toward COVID-19 vaccination and mask mandates. Among 687 survey respondents, 65% reported that exposure to public health messaging influenced their health-related behaviors. Qualitative analysis identified effective strategies such as tailoring messages, collaborating with influencers, and employing interactive content formats, while also highlighting challenges including misinformation (reported by 62% of respondents), resource constraints, and public mistrust. Conclusion: The study highlights both the potential and challenges of leveraging social media for public health communication. Considering social media’s impact on promoting positive health-related behaviors, a comprehensive framework was proposed emphasizing robust monitoring systems, cross-sector collaborations, capacity building, data-driven approaches, and ethical guidelines.

‘Neo-collectivisation’ through property rights reforms: Villager empowerment and state building in urbanising China

Over the past two decades, property rights reforms in China’s peri-urban regions have succeeded in granting villagers individual rights to their collective assets. It has been argued that these reforms will lead to the demise of China’s long-established rural collective system. However, based on in-depth research and case studies in southern China, we conclude that these reform initiatives have been upheld by the state and villagers to sustain and improve, rather than destroy, rural collectivism. The implementation of formal titling through shareholding reforms has not engendered full privatisation and the dissolution of collective entities; instead, it has given rise to an alternative form of rural collectivity that has reshaped the power dynamics between the state and the villagers in daily governance. While this ‘neo-collectivist’ approach appears to have empowered villagers by enhancing their rights to collective assets and benefits, it has also strengthened the governing capacity of the socialist state by extending and legitimising its interventions in Chinese rural communities.

Comprehensive Review of Mental Health Integration, Community Health Services, And Technological Innovations for Vulnerable Populations

Incorporating mental into community health services, in addition to technology, has become core to meeting the health needs of the vulnerable populace. This review aims to evaluate the impact of such integration on the increase of access, equity, and quality of care. It reveals how community interventions backed by technologies such as telemedicine, Mobile Health applications, and Artificial Intelligence are shaping the care of such populations. Sample findings, therefore, reveal enhanced positive mental health outcomes, service utilization, and integration into the community. Other issues include technology learning and the availability of resources, while Delaney acknowledges the applicability of the recommendations for relevant policy changes for future research.

Unveiling environmental identities: a mixed methods analysis of non-profit communication

To address environmental issues, it is important to strengthen individuals' environmental self-identities. This research explored how environmental non-profit organizations (NPOs) use and perceive communication interventions (social norms, perceived environmental responsibility, and social comparison feedback) that could make the environmental social - and self-identities of their community salient. This is achieved by combining a quantitative content analysis of social media posts (n = 448), with six in depth-interviews with communication professionals working in NPOs. We found that descriptive social norms (25.7%) are the most frequently used intervention by NPOs. However, these norms can reduce personal responsibility for environmental actions, and NPOs rarely combine them with personal responsibility messages or injunctive norms, which could tackle this issue. Secondly, we found that the NPO communication professionals are implicitly focusing on increasing the group identification with the organization by using advocates and personal communication with their members. Furthermore, the included NPOs mainly communicate with individuals who already hold environmental values. Consequently, the study identifies a current mismatch between this environmentally conscious audience and the interventions the NPOs are utilizing. Descriptive social norms, which are widely used by the NPOs, are more appropriate for the general public-an audience with weaker connections to the NPOs but one they aim to reach more in the future. In contrast, injunctive and dynamic social norms, both minimally employed by the NPOs, appear more suitable for their current environmental audience. Last, we found that NPOs emphasize their responsibility in addressing environmental issues (20,8%) but neglect to acknowledge governmental efforts (0,9%), which could enhance citizens' environmental self-identity and promote pro-environmental behaviors. This study provides insight into more effective NPO communication strategies, particularly through better audience segmentation and integrating different types of social norms to enhance pro-environmental identities and behaviors.

Supporting those experiencing food insecurity: A scoping review of the role of a dietitian.

Increasing levels of food insecurity in the United Kingdom (UK) suggest an imperative to consider the role of dietitians in supporting people who may have insufficient access to safe and nutritious food. To explore the available evidence on the (i) role of a dietitian, (ii) impact of support and (iii) training needs of dietitians to support those with inadequate access to food. Scoping review methodology was used to identify qualitative, quantitative and grey literature on the role of dietitians in supporting those with/or at risk of food insecurity. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to report the evidence reviewed for this study. Methods included multiple literature searches, charting of data extracted, and content analysis. The data of interest included the country of study, study methodology, the population of interest, the role of a dietitian, the measures, tools or guidance used and a summary of key findings. In total, 466 studies were identified, following the removal of duplicate records, 243 records were screened for inclusion; the full text of 95 articles was reviewed for eligibility, and 19 were included in the review. Articles were summarised descriptively using tables and synthesised to identify emerging themes. Overarching themes of dietitians' role included, (i) identification and screening of food insecurity, (ii) facilitating community interventions and (iii) policy development. Dietitians hold a range of roles to support people at risk of or experiencing food insecurity. However, there are considerable gaps in current training programmes, and a paucity of evidence describing the impact dietitians have on improving nutrition outcomes for those individuals at risk of or experiencing food insecurity.