Partner Engagement Research Articles

Abstract B19: Screen to Save (S2S) implementation across National Outreach Network (NON) region 2

Abstract Background: S2S aims to increase colorectal cancer (CRC) screening rates among community members aged 50-75 years from racially and ethnically diverse communities. The National Cancer Institute's (NCI) National Outreach Network (NON) and Partnerships to Advance Cancer Health Equity (PACHE) community health educators (CHEs) are implementing a culturally sensitive, evidence-based nationwide CRC outreach and screening initiative. This poster reports on S2S activities within NON Region 2 among multilingual and multicultural populations. Methods: NCI tasked sites with conducting phase 1 or phase 1 and 2 of S2S. Phase 1 consists of CRC prevention, early detection, and screening education via NCI CRC resources and materials. Phase 2 consists of providing the education and fecal immunochemical test (FIT) kits to those who qualify. Both phases consist of pre- and post-knowledge assessments coupled with demographic information of attendees. A 3-month follow-up survey is administered post the S2S session to determine participants' CRC-screening- related actions. Effective strategies for initiative recruitment include electronic and in-person flyer dissemination, social media postings, and community partner engagement. Colorectal cancer models, a miniature portable toilet, and an NCI-developed S2S PowerPoint presentation have been utilized across the region as educational tools. Results: Four NON and PACHE CHEs in the region are implementing the S2S initiative with the aid of community partnerships. To date, more than 81 individuals have received CRC education through a total of 5 S2S sessions. A total of 66 FIT kits have been disseminated and 16 returned. Conclusion: Lessons learned from this ongoing initiative include the importance of having a multilevel educational approach and collaborations at local, state, and national levels for CRC education and screening. Leveraging partnerships for CRC education and screening is an effective strategy to improve CRC awareness and promote FIT uptake. Citation Format: Khaliah F. Fleming, Jomar D. Lopez. Screen to Save (S2S) implementation across National Outreach Network (NON) region 2 [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B19.

Strengthening the links between mapping, planning and global engagement for disease elimination: lessons learnt from trachoma

BackgroundTrachoma is the leading infectious cause of blindness. Until recently, reliable data on the global extent of the disease, detailed plans for elimination, and government, donor and partner engagement were...

Do perceived contraception attitudes influence abortion stigma? Evidence from Luanda, Angola

Abortion stigma is influenced by a variety of factors. Previous research has documented a range of contributors to stigma, but the influence of perceived social norms about contraception has not been significantly investigated. This study assesses the influence of perceived social norms about contraception on abortion stigma among women in Luanda, Angola. This analysis uses data from the 2012 Angolan Community Family Planning Survey. Researchers employed multi-stage random sampling to collect demographic, social, and reproductive information from a representative sample of Luandan women aged 15–49. Researchers analyzed data from 1469 respondents using chi-square and multiple logistic regression. Researchers analyzed women’s perceptions of how their partners, friends, communities, and the media perceived contraception, and examined associations between those perceptions and respondents’ abortion stigma. Stigma was approximated by likelihood to help someone get an abortion, likelihood to help someone who needed medical attention after an abortion, and likelihood to avoid disclosing abortion experience. Higher levels of partner engagement in family planning discussion were associated with increased stigma on two of the three outcome measures, while higher levels of partner support of contraception were associated with decreased stigma. Perceived community acceptance of family planning and media discussion of family planning were associated with a decrease in likelihood to help someone receive an abortion. These results suggest that increasing partner support of family planning may be one strategy to help reduce abortion stigma. Results also suggest that some abortion stigma in Angola stems not from abortion itself, but rather from judgment about socially unacceptable pregnancies.

The role of male partners in women\u2019s participation in research during pregnancy: a case study from the partners demonstration project

The exclusion of pregnant women from health research remains a significant challenge globally. In settings where cultural traditions and gender norms support a more restricted decision-making role for women in general, little is known about the attitudes of male partners toward the inclusion of women in research during pregnancy. Understanding the expectations of both men and women in such cultural settings offers an opportunity to engage and address local ethical concerns to improve women’s access to research during pregnancy and enhance intervention development. In this paper, we present a qualitative research ethics case study, drawn from the Partners Demonstration Project of pre-exposure prophylaxis (PrEP) in Kenya, regarding the role of male partners in decision-making to continue PrEP during pregnancy. PrEP is an effective HIV prevention tool; however, since pregnant women were excluded from early PrEP clinical trials, safety and efficacy data during pregnancy are limited. Given continued high rates of HIV infection for women, some pregnant women are now being provided with PrEP or are involved in PrEP research. Men and women in our study were equally concerned about the health risks of PrEP to the fetus and depended on healthcare provider guidance to understand these risks. Because the demonstration project enrolled couples, an implicit social expectation for many women’s continuation of PrEP during pregnancy was consultation with male partners. Some women reported that consenting to participate was exclusively a woman’s decision; however, many reported that they deferred to their male partner’s opinion and support during the decision-making process. Most male partners believed women should not participate in research studies without their partner’s permission, while a few men believed participation was ultimately a woman’s decision. We suggest that relational autonomy can support a middle ground for informed consent that promotes women’s autonomy while accommodating partner engagement.

Congruity of observed social support behaviors and couple relationship quality

AbstractThis study examined the role of congruity in couples' social support behaviors on relational outcomes. Participants (N = 123 couples, Mage = 26.91, SD = 8.46) completed surveys on relationship satisfaction and discord. Positive and negative behaviors were then observed during supportive interactions. Results revealed that the detrimental effect of negative behaviors on satisfaction was buffered by a partner's engagement in fewer negative behaviors or intensified by more negative behaviors. Further, the beneficial effect of positive behaviors on reducing discord was amplified by a partner's engagement in more positive behaviors or offset by fewer positive behaviors. Last, the detrimental effect of negative behaviors on discord was buffered by a partner's engagement in more positive behaviors. These findings highlight the complex nature of dyadic relationships and provide insights for developing interventions focused on improving romantic relationship quality.

Experience including men in a novel short message service (SMS) approach to improve postpartum family planning education and counseling in Kenya

Objectives: Male partner engagement in family planning is hypothesized to reduce unmet need, yet few interventions have incorporated men. This randomized controlled trial evaluated a two-way SMS family planning counseling intervention among postpartum women and couples. We describe experience with male recruitment and enrollment, and compare baseline characteristics by partner enrollment.

Photovoice and Photodocumentary for Enhancing Community Partner Engagement and Student Learning in a Public Health Field School in Cape Town

Background: Field school research, which begins by considering community partners as pedagogues and thus exploring their perspectives on student learning, is uncommon. Photovoice is a method for self-expression of such marginalized voices. Purpose: Describe the photovoice to photodocumentary process and present results of its evaluation. Methodology/Approach: We employed photovoice with the local guides who accompany community health research field school students in Cape Town. Guides were prompted to take photographs of what students may not see or understand about their community. These were discussed at three workshops and developed into a photodocumentary for inclusion in the curriculum. Twenty-one students completed an open-ended questionnaire. These, and student/staff discussions, were thematically analyzed. Findings/Conclusion: Students reported learning about cultural practices which otherwise would not be visible to them. They felt greater connection to their guides who they saw in a new light, and became aware of how topic-specificity drew attention away from overarching characteristics of community life. Questions raised might be better explored through facilitated discussion rather than question-and-answer sessions alone. Implications: Field schools depend on academic–community partnerships. Photovoice can create space for community partner reflection on student learning and the co-creation of effective pedagogical tools valued by students.

Preterm birth: the role of knowledge transfer and exchange

BackgroundPreterm birth (PTB) is the leading cause of death in children under age five. Healthcare policy and other decision-making relevant to PTB may rely on obsolete, incomplete or inapplicable research evidence, leading to worsened outcomes. Appropriate knowledge transfer and exchange (KTE) strategies are an important component of efforts to reduce the global PTB burden. We sought to develop a ‘landscape’ analysis of KTE strategies currently used in PTB and related contexts, and to make recommendations for optimising programmatic implementation and for future research.MethodsIn the University of California, San Francisco’s Preterm Birth Initiative, we convened a multidisciplinary working group and examined KTE frameworks. After selecting a widely-used, adaptable, theoretically-strong framework we reviewed the literature to identify evidence-based KTE strategies. We analysed KTE approaches focusing on key PTB stakeholders (individuals, families and communities, healthcare providers and policymakers). Guided by the framework, we articulated KTE approaches that would likely improve PTB outcomes. We further applied the KTE framework in developing recommendations.ResultsWe selected the Linking Research to Action framework. Searches identified 19 systematic reviews, including two ‘reviews of reviews’. Twelve reviews provided evidence for KTE strategies in the context of maternal, neonatal and child health, though not PTB specifically; seven reviews provided ‘cross-cutting’ evidence that could likely be generalised to PTB contexts.For individuals, families and communities, potentially effective KTE strategies include community-based approaches, ‘decision aids’, regular discussions with providers and other strategies. For providers, KTE outcomes may be improved through local opinion leaders, electronic reminders, multifaceted strategies and other approaches. Policy decisions relevant to PTB may best be informed through the use of evidence briefs, deliberative dialogues, the SUPPORT tools for evidence-informed policymaking and other strategies.Our recommendations for research addressed knowledge gaps in regard to partner engagement, applicability and context, implementation strategy research, monitoring and evaluation, and infrastructure for sustainable KTE efforts.ConclusionsEvidence-based KTE, using strategies appropriate to each stakeholder group, is essential to any effort to improve health at the population level. PTB stakeholders should be fully engaged in KTE and programme planning from its earliest stages, and ideally before planning begins.

Realising the Potential of Universities as Significant Development Actors in Post-conflict Societies: A Case Study of the Solomon Islands National University

Interest in the transformational potential of education has seen development partners prioritise support for basic education. Tertiary education has tended to be considered in narrow and instrumental terms focused on supporting economic growth through vocational education and training. Development partners have largely overlooked the much broader potential of the sector to engage with a wide range of development challenges. This article focuses on the role of national universities as significant development actors. With their broad institutional mandates, national universities have an institutional capacity to engage with complex processes of nation, state and peace-building. These processes are important in explaining the emergence and persistence of conflict in fragile developing country environments, and are particularly challenging for development partners to engage with. Realising the potential of universities as significant national development institutions will require development partners to broaden how they approach tertiary education and provide different forms of institutional support. Drawing on an empirical case study of the establishment of the Solomon Islands National University (SINU) in Solomon Islands, a small island post-conflict fragile state in the south-west Pacific, this article considers: (i) the practical challenges faced in building a national university and realising its potential as a significant development institution; and (ii) the challenges and opportunities for development partner engagement in helping national universities realise such potential.

Engagement in European social dialogue: an investigation into the role of social partner structural capacity

AbstractDespite the importance of social dialogue for the European social model, there has been little attention to the factors that account for social partner engagement with European social dialogue. On the basis of data from 28 European sectoral social dialogue committees, this article investigates structural factors that account for the conclusion of European sectoral social dialogue agreements. It is found that actors' organisational density is a necessary but not sufficient factor for successful European social dialogue and four different categories of sectoral social partner engagement with European social dialogue are identified.

Community-Engaged Modeling of Geographic and Demographic Patterns of Multiple Public Health Risk Factors.

Many health risk factors are intervention targets within communities, but information regarding high-risk subpopulations is rarely available at a geographic resolution that is relevant for community-scale interventions. Researchers and community partners in New Bedford, Massachusetts (USA) collaboratively identified high-priority behaviors and health outcomes of interest available in the Behavioral Risk Factor Surveillance System (BRFSS). We developed multivariable regression models from the BRFSS explaining variability in exercise, fruit and vegetable consumption, body mass index, and diabetes prevalence as a function of demographic and behavioral characteristics, and linked these models with population microdata developed using spatial microsimulation to characterize high-risk populations and locations. Individuals with lower income and educational attainment had lower rates of multiple health-promoting behaviors (e.g., fruit and vegetable consumption and exercise) and higher rates of self-reported diabetes. Our models in combination with the simulated population microdata identified census tracts with an elevated percentage of high-risk subpopulations, information community partners can use to prioritize funding and intervention programs. Multi-stressor modeling using data from public databases and microsimulation methods for characterizing high-resolution spatial patterns of population attributes, coupled with strong community partner engagement, can provide significant insight for intervention. Our methodology is transferrable to other communities.

Virtual Partnerships: Engaging Students in E-service Learning Using Computer-mediated Communication

Computer-mediated communication has important implications for future classroom learning which is no longer spatially bound or centred around text books. It has the ability to incorporate real-life learning whereby students can make important contributions towards solving global problems without having to leave the campus. This study looked at the impact of virtual communication processes and online tools on student and partner engagement in an on-campus undergraduate unit which enables Australian students to create communication campaigns for a non-government organization in India. The study found that the communication exchanges provided students with opportunities for intercultural dialogue, both in real and virtual spaces, and how to use Information and Communications Technology (ICT) and media within a social justice framework within a transnational working environment. Internet technologies have become part of the daily communication pattern of a new generation of students, who see it as their natural environment in which to learn, play and work. It is thus important to expand students’ use of the global digital network from superficial social interactions towards activities which enable them to become active and informed global citizens.

Facilitators and barriers to uptake and adherence to lifelong antiretroviral therapy among HIV infected pregnant women in Uganda: a qualitative study

BackgroundIn 2012, Uganda started implementing lifelong antiretroviral therapy (ART) for prevention of mother to child transmission (PMTCT) in line with the WHO 2012 guidelines. This study explored experiences of HIV infected pregnant and breastfeeding women regarding barriers and facilitators to uptake and adherence to lifelong ART.MethodsThis was a cross-sectional qualitative study conducted in three districts (Masaka, Mityana and Luwero) in Uganda, between February and May 2014. We conducted in-depth interviews with 57 pregnant and breastfeeding women receiving care in six health facilities, who had been on lifelong ART for at least 6 months. Data analysis was done using a content thematic approach with Atlas-ti software.ResultsInitiation of lifelong ART was done the same day the mother tested HIV positive. Several women felt the counselling was inadequate and had reservations about taking ART for life. The main motivation to initiate and adhere to ART was the desire to have an HIV-free baby. Adherence was a challenge, ranging from not taking the drugs at the right time, to completely missing doses and clinic appointments. Support from their male partners and peer family support groups enhanced good adherence. Fear to disclose HIV status to partners, drug related factors (side effects and the big size of the tablet), and HIV stigma were major barriers to ART initiation and adherence. Transition from antenatal care to HIV chronic care clinics was a challenge due to fear of stigma and discrimination.ConclusionsIn order to maximize the benefits of lifelong ART, adequate preparation of women before ART initiation and on-going support through family support groups and male partner engagement are critical, particularly after birth and cessation of breastfeeding.

Offering pre-exposure prophylaxis for HIV prevention to pregnant and postpartum women: a clinical approach.

Introduction: HIV prevention during pregnancy and lactation is critical for both maternal and child health. Pregnancy provides a critical opportunity for clinicians to elicit women’s vulnerabilities to HIV and offer HIV testing, treatment and referral and/or comprehensive HIV prevention options for the current pregnancy, the postpartum period and safer conception options for future pregnancies. In this commentary, we review the safety of oral pre-exposure prophylaxis with tenofovir/emtricitabine in pregnant and lactating women and suggest opportunities to identify pregnant and postpartum women at substantial risk of HIV. We then describe a clinical approach to caring for women who both choose and decline pre-exposure prophylaxis during pregnancy and postpartum, highlighting areas for future research.Discussion: Evidence suggests that pre-exposure prophylaxis with tenofovir/emtricitabine is safe in pregnancy and lactation. Identifying women vulnerable to HIV and eligible for pre-exposure prophylaxis is challenging in light of the myriad of individual, community, and structural forces impacting HIV acquisition. Validated risk calculators exist for specific populations but have not been used to screen and offer HIV prevention methods. Partner testing and engagement of men living with HIV are additional means of reaching at-risk women. However, women’s vulnerabilities to HIV change over time. Combining screening for HIV vulnerability with HIV and/or STI testing at standard intervals during pregnancy is a practical way to prompt providers to incorporate HIV screening and prevention counselling. We suggest using shared decision-making to offer women pre-exposure prophylaxis as one of multiple HIV prevention strategies during pregnancy and postpartum, facilitating open conversations about HIV vulnerabilities, preferences about HIV prevention strategies, and choosing a method that best meets the needs of each woman.Conclusion: Growing evidence suggests that pre-exposure prophylaxis with tenofovir/emtricitabine during pregnancy and lactation is safe and effective. Shared decision-making provides one approach to identify at-risk women and offers pre-exposure prophylaxis but requires implementation research in diverse clinical settings. Including pregnant and breastfeeding women in future HIV prevention research is critical for the creation of evidence-driven public health policies and clinical guidelines.

The Role of Difficult Childhood Behaviors on Intimate Partner Violence

The relationship between family stress (FS) and intimate partner violence (IPV) is well established, but whether the presence of a difficult child moderates the relationship between FS and later IPV was unclear. To fill this important gap in the literature, data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) database were used to determine whether child difficulty (CD) and family stress at child age 6 interact in the prediction of IPV at child age 8. In a parallel analysis to replicate findings, the interaction between child difficulty and family stress at child age 12 was assessed in the prediction of IPV at child age 14. Hypotheses were tested using multiple linear regression at the p<0.05 threshold for statistical significance. Analyses controlled for child gender at child age 6 and for child gender, caregiver depression, substance abuse in the household and household SES at child age 12. The moderator hypothesis was validated in the research when predicting from child difficulty and family stress at child age 6 to IPV at child age 8 and also statistically significant at child age 12 to IPV at child age 14. These findings have important implications in assisting mental health providers with developing novel interventions, which may help reduce IPV. Further examination of the impact difficult behavior of a child may contribute to family stress may enhance our ability to reduce partner engagement in violence and its indirect psychosocial sequelae.

The Role of Attachment Behaviors in the Link between Relationship Satisfaction and Depression in Clinical Couples: Implications for Clinical Practice.

Using dyadic, clinical data from 104 couples in committed relationships, the purpose of this study was to determine whether relationship satisfaction was associated with depression through perceived partner attachment behaviors-accessibility, responsiveness, and engagement-for both men and women. We found that one's satisfaction in the relationship was the lens through which they viewed their partner's attachment behaviors and-women's relationship satisfaction was the lens through which her male partner viewed her attachment behaviors. Finally, women's relationship satisfaction is associated with both individuals' depression through her perceived partner's accessibility, responsiveness, and engagement. The findings from this study are important because they provide clinically relevant and mutable constructs in which clinicians can intervene at an attachment level in distressed marriages with depressed partners.

Social inclusion in the post-conflict state of Nepal: Donor practice and the political settlement

Fragile states constitute a challenging operating environment. Yet, the role of development partner engagement on issues of social inclusion, identity politics, or horizontal inequalities in such fragile environments has not received the attention these complex issues warrant. The attitudes of development actors, their level of commitment, bias, risk management, and understanding of the political settlement can have a real bearing on the effectiveness of such efforts to promote inclusion. In Nepal, certain development partners have faced elite backlash for their engagement on social inclusion, while others have been more successful. This article asks what lessons can be learned from these experiences for those interested in promoting social inclusion in fragile states through development assistance.

Multiwork, work-family/family-work conflict and satisfaction with life

Abstract The aim of my study was to determine what relations exist between work and family demands, W-F/F-W conflict and job satisfaction, satisfaction with marriage, and life satisfaction among multiworkers and monoworkers. Research involved 218 multiworkers and 218 employees with single employment, who filled out a survey, the Organizational Climate Questionnaire, the W-F/F-W Conflict Technique, the Job Description Questionnaire, the Marital Communication Questionnaire, and Satisfaction with Life Scale. From the data obtained referring to multiworkers, it is shown that W-F conflict is directly affected by the number of working hours, commuting time, job demands, rewards, and leave control. F-W conflict is directly affected by number of children aged up to six years, partner engagement, and the number of children aged 12‒15 years. Satisfaction with life results from satisfaction with marriage and job satisfaction (stronger relationship). Considering the monoworkers, W-F conflict is directly affected by the number of working hours, commuting time, and the rewards at work. F-W conflict is directly affected by engagement of the partner and the depreciation in the relationship. Satisfaction with life results from satisfaction with marriage (stronger relation) and job satisfaction. These results contribute to deeper knowledge on the multiwork phenomenon.

An interview with Stephen Waddington, Partner and Chief Engagement Officer at Ketchum and Visiting Professor in Practice, Newcastle University, Past President of the Chartered Institute for Public Relations (UK)

&lt;p&gt;In May 2015, the Journal of Professional Communication’s senior associate editor, Dr. Terry Flynn, sat down with Stephen Waddington, Partner and Chief Engagement Officer with Ketchum and past-president of the Chartered Institute for Public Relations in the United Kingdom (UK) to discuss and reflect upon his perspectives on the future of the profession and the challenges that are on the horizon for practitioners and current students of the profession. Waddington discussed how his formative training as an engineer in the UK has helped him to create new systems and processes to better understand and manage the multifaceted challenges that organizations now face within the public arena. Together with a number of UK and European professionals, Waddington has lead a number of crowd-sourced publications and learning tools designed to future-proof the practice of public relations.&lt;/p&gt;&lt;p&gt;©Journal of Professional Communication, all rights reserved.&lt;/p&gt;

Adult Attachment Styles, Destructive Conflict Resolution, and the Experience of Intimate Partner Violence.

Although there is ample evidence linking insecure attachment styles and intimate partner violence (IPV), little is known about the psychological processes underlying this association, especially from the victim's perspective. The present study examined how attachment styles relate to the experience of sexual and psychological abuse, directly or indirectly through destructive conflict resolution strategies, both self-reported and attributed to their opposite-sex romantic partner. In an online survey, 216 Spanish undergraduates completed measures of adult attachment style, engagement and withdrawal conflict resolution styles shown by self and partner, and victimization by an intimate partner in the form of sexual coercion and psychological abuse. As predicted, anxious and avoidant attachment styles were directly related to both forms of victimization. Also, an indirect path from anxious attachment to IPV victimization was detected via destructive conflict resolution strategies. Specifically, anxiously attached participants reported a higher use of conflict engagement by themselves and by their partners. In addition, engagement reported by the self and perceived in the partner was linked to an increased probability of experiencing sexual coercion and psychological abuse. Avoidant attachment was linked to higher withdrawal in conflict situations, but the paths from withdrawal to perceived partner engagement, sexual coercion, and psychological abuse were non-significant. No gender differences in the associations were found. The discussion highlights the role of anxious attachment in understanding escalating patterns of destructive conflict resolution strategies, which may increase the vulnerability to IPV victimization.