Perceptions Of Community Members Research Articles

Acceptability of emergent Aedes aegypti vector control methods in Ponce, Puerto Rico: A qualitative assessment.

Aedes aegypti control has been fraught with challenges in Puerto Rico. The government has implemented commonly used vector control methods, but arboviral epidemics still occur. It is necessary to explore new Ae. aegypti control methods. This study aimed to understand the perceptions of community members in Ponce, Puerto Rico about emergent and traditional Ae. aegypti vector control methods and determine their acceptability and support for these methods. We identified the type of information needed to increase support for emergent vector control methods, and the preferred strategies to disseminate this information. Four group discussions were conducted with a total of 32 participants representing eight of the 14 clusters participating in the Communities Organized for the Prevention of Arboviruses (COPA), a project designed to mobilize communities in Ponce, Puerto Rico to prevent diseases transmitted by mosquitoes. Group discussions began with an overview of different methods used for controlling Ae. aegypti mosquitoes. These overviews facilitated participant understanding of the mosquito control methods presented. Use of source reduction, autocidal gravid ovitraps (AGO), and manual application of larvicide for arboviral mosquito control received support from almost all participants. Vector control methods that use more familiar techniques in Puerto Rico such as truck-mounted larvicide spraying (TMLS) and insecticide residual spraying received support from most participants. More than half of participants supported the use of emergent mosquito control methods including Wolbachia suppression, Wolbachia replacement, or genetically modified mosquitoes (GMM). Participants preferred to receive vector control information through house-to-house visits with the distribution of written materials, followed by dissemination of information through traditional (i.e., radio, television) and social media. The detailed information resulting from this study was used to develop messages for a communications campaign to garner future community support. Community acceptance and support are critical for the success of vector control programs using emergent mosquito control methods.

COVID-19 and COVID-19 vaccination experiences and perceptions and their predictors among community members during the COVID-19 pandemic in Ebonyi state, Nigeria: an analytical cross-sectional study

BackgroundCOVID-19 is still a disease of global public health importance which requires long term application of control measures as millions of new infections or re-infections and thousands of related deaths still occur worldwide and the risk of an upsurge from new strains of the virus continues to be a threat. The decrease in the use of and non-use of preventive public health measures are among the factors fuelling the disease. The (previous) experiences and perceptions of people regarding the COVID-19 pandemic, COVID-19 vaccination, and the vaccination process are factors that will influence subsequent use of preventive/control measures. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the community members in Ebonyi state, Nigeria.MethodsWe conducted an analytical cross-sectional study between March 12 and May 9, 2022 among all consenting/assenting community members aged 15 years and above in 28 randomly selected geographical clusters. A structured interviewer-administered electronic questionnaire in KoBoCollect installed in android devices was used to collect data which was analysed using descriptive statistics and bivariate and multivariate generalized estimating equations.ResultsOf the 10,825 community members surveyed: only 31.6% had strong COVID-19 experience and perception, 72.2% had good COVID-19 vaccination expectation and perception, and only 54.2% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent/level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of attitude towards COVID-19 and COVID-19 vaccination and level of knowledge about COVID-19. Other important predictors were marital status, educational level, and main occupation.ConclusionsThis study’s evidence, including the identified predictors, will inform subsequent policy actions regarding COVID-19 in the strategies to improve the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of community members (and their use of preventive/control measures) in Ebonyi state and Nigeria, and other similar contexts. It will also inform future policy actions/strategies regarding similar diseases.

FACTORS CONTRIBUTING TO POOR HEALTH-SEEKING BEHAVIORS AMONG HIV ADOLESCENTS ATTENDING ART CLINIC AT KALAGALA HEALTH CENTRE IV, LUWERO DISTRICT. A CROSS-SECTIONAL STUDY.

Background: The purpose of the study: was to find out individual, community, and health facility-related factors contributing to poor health-seeking behaviors among HIV adolescents attending the ART clinic at Kalagala Health Centre IV, Luwero district. Methodology: A cross-sectional study design using a simple random sampling technique sampled 50 respondents. A questionnaire with open and ended questions written in English language was used as the data collection tool and data was analyzed manually by use of tally sheets and presented in tables and figures by support of narratives. Findings: The majority of the respondents were 18-19 years old (46%), female (60%), and in secondary school (52%). Many (92%) perceived ART as very important, (58%) had ever been exposed to drug adverse effects, and (38%) missed prescribed ART medications ART due to forgetfulness. Respondents (48%) affirmed that their parents don’t usually support them in taking medication, (48%) noted that community members were unfriendly towards HIV-positive adolescents, and (82%) were day scholars. When it came to the health facilities (60%) of the respondents noted the waiting time was quite long, (64%) reported that the attitudes of health workers were fair, (70%) agreed that they received adequate counseling services in regards to timely ART, (56%) reported a very far distance from their homes to the health facility. Conclusion: Exposure to drug adverse effects missed prescribed medications due to forgetfulness, unsupportive parents/caretakers, unpleasant perceptions of community members towards HIV-positive adolescents, tight school programs, long waiting times, spiteful attitudes of health workers, and distances from homes to health facilities were the foremost factors contributing to poor health-seeking behaviors among adolescents on ART. Recommendation: Kalagala Health Center IV administration should build a good client-based relationship with adolescents so that they can freely express themselves and develop their preferred mode for accessing timely ART.

Temporal public perceptions and experiences during water service disruptions: the case of Jackson, Mississippi

Failures in urban water systems are becoming a common occurrence in the US due to disasters, aging infrastructure, and financial constraints, among other concerns. For example, Jackson, Mississippi has experienced reoccurring water outages, burdening community members as they must seek alternative water sources. Prior research has primarily focused on technical, institutional, and public health aspects of water crises, with limited attention to community perspectives. Understanding such social aspects can shed light on, for example, community priorities, levels of trust, mental health concerns, and communication gaps. Here, we document the temporal experiences and perceptions of community members during the Jackson Water Crises. To do so, we qualitatively analyzed news media data and employed topic modeling techniques on social media data from two years, capturing two service disruption events. Our results reveal the cascading impacts of water outages on end-users, including financial, social, and technical issues. For example, over time, results indicate that trust in the government and water providers in Jackson eroded, which may hinder public support. Our results show that social media can be a useful tool for utilities to understand public perceptions in real-time. Recommendations proposed here can inform future responses to water crises in Jackson and other communities, ensuring end-users’ perspectives are incorporated.

Perceptions towards management of acute malnutrition by community health volunteers in northern Kenya.

Child undernutrition is a persistent challenge in arid and semi-arid areas due to low and erratic rainfall, recurrent droughts and food insecurity. In these settings, caregivers face several challenges in accessing health services for sick and/or malnourished children, including long distances to health facilities, harsh terrain, and lack of money to pay for transportation costs to the health facilities, leading to low service coverage and sub-optimal treatment outcomes. To address these challenges and optimize treatment outcomes, the World Health Organization recommends utilizing community health volunteers (CHVs) to manage acute malnutrition in the community. This study explored the perceptions of community members regarding acute malnutrition treatment by CHVs in Turkana and Isiolo counties in Kenya. The study utilized a cross-sectional study design and included a purposive sample of caregivers of children, CHVs, officers who trained and supervised CHVs and community leaders in the intervention area. Focus group discussions and key informant interviews were used to explore perceptions towards the management of acute malnutrition by CHVs. Generally, caregivers and CHVs perceived the intervention to be beneficial as it readily addressed acute malnutrition treatment needs in the community. The intervention was perceived to be acceptable, effective, and easily accessible. The community health structure provided a platform for commodity supply and management and CHV support supervision. This was a major enabler in implementing the intervention. The intervention faced operational and systemic challenges that should be considered before scale-up.

Mind the gap: Community member perceptions of shortcomings in diversity and inclusivity of local energy projects in Germany

Germany's Energiewende aims to have 80 percent of the nation's electricity generated from renewables by 2030. One promising approach to building acceptance lies in the involvement of citizens by collaboratively determining and creating CE projects. Through an idealistic lens, CE reflects energy democracy of, by, and for the people.However, CE projects in Germany have faltered for years. While structural causes undoubtedly exist, another crucial reason lies in the project structure. We found that membership is not proportionately represented and members hold divergent attitudes towards CE. We conclude that more diversified projects for various groups of participants should be promoted.

Challenges to Implementation of a CHW-led COPD Screening and Referral in rural Uganda

Abstract Chronic obstructive pulmonary disease (COPD) ranks as the third leading cause of global mortality. In rural areas of low- and middle-income countries (LMICs), COPD screening and diagnostic services remain often inaccessible. This study seeks to comprehend the implementation challenges of a Community Health Worker (CHW)-led program for COPD in Nakaseke, rural Uganda. During September and October 2022, this qualitative study explored the perceptions of Community Members, CHWs, and Healthcare Providers (HCPs) on challenges associated with CHW-delivered COPD screening and referral. In-depth interviews were conducted with eight CHWs and ten HCPs, along with six focus group discussions including 34 Community Members. Research assistants recorded and transcripted interviews verbatim. The thematic analysis was guided by the conceptual framework for implementation outcomes research. The acceptability of the implementation was hindered a lack of awareness about COPD, skepticism regarding the usefulness of COPD screening, and the presence of stigma surrounding the diagnostic process. Additionally, limited adoption was attributed to difficulties in accessibility and the willingness of Community Members to participate in the COPD referral process. The high patient volume, coupled with the complexity and time-consuming nature of the diagnostic and referral procedures, posed significant barriers to successful implementation. To ensure program sustainability, participants recommended increased support for CHWs, the decentralization of COPD care, and the expansion of follow-up services provided by CHWs. CHW-led interventions have great potential to deliver health care services that overcome barriers to treatment and self-management, particularly in settings with limited access to healthcare. However, prior to implementation, baseline assessments are needed to identify potential implementation obstacles and strategies that consider evidence-based approaches tailored to local contexts. Key messages • CHW-led interventions are a useful tool to alleviate barriers to COPD treatment and self-management in rural areas of LMICs where access to care is limited. • Formative assessments of the potential challenges prior to an intervention are required to address and minimize barriers to implementation and sustainability.

An exploratory study on albinism killings in Umhlabuyalingana settlements of Kwazulu-Natal Province, South Africa

People with Albinism are often terrified as the nature and extent of this crime continue increasing. Africa is mainly dealing with this issue, and South Africa appears to be one of the countries grappling with this horrific crime. Thus, this study’s main objective was to explore the Albnism killings of Umhlabuyalingana of KwaZulu-Natal (KZN) Province, South Africa, focusing on the nature of this practice and the perceptions of community members on this scourge. This qualitative study adopted the case study research design, aided by an exploratory research objective. About Twenty (20) participants were selected in Umhlabauyalingana area, using the convenience sampling technique; they were all subjected to one-on-one interviews. The collected data were analysed using the inductive Thematic Content Analysis (TCA) method. This study establishes that albinism genocide has an adverse effect on the livelihood of people living with albinism in the community. This scourge do affects their daily lives, hugely affecting performance of their duties without fear of being abducted. Moreover, individuals closer to the potential victims also fear for the lives of their loved ones. Therefore, albinism killings affects the entire community and people closer to the potential vitims/victim. For recommendation:visible and responsive programmes must be established across South Africa

Student-led exercise testing and prescription has benefits for both students and their community volunteers.

Service-learning opportunities allow students to apply their knowledge and skills through engagement with their community. Previous studies have suggested that student-led exercise testing and health screening can benefit both students and their community participants. In a third year Kinesiology course "Physiological Assessment and Training", students at the University of Prince Edward Island are provided with an introduction to health-focused personal training and develop and manage personalized training programs for community volunteers. The purpose of this study was to investigate the impact of student-led training programs on student learning. A secondary purpose was to investigate the perceptions of community members participating in the program. Community participants included 13 men and 43 women with stable health (mean age: 52.3 ± 10.0 years). Students led participants through aerobic and musculoskeletal fitness tests before and after completing a 4-week student-designed training program based on participants' fitness and interests. Students reported that the program was enjoyable and improved understanding of fitness concepts and confidence in personal training. Community participants rated the programs as enjoyable and appropriate, and viewed students as professional and knowledgeable. These results suggest that student-led personal training programs provide meaningful benefits to students and their community volunteers.

Perceptions of homelessness and housing solutions: a web-based survey methodology to inform local housing policy

ABSTRACT Discrepancies between homelessness perception and reality, as well as policymakers’ assumptions about their constituents’ perceptions, may contribute to policies that exacerbate homelessness and its negative outcomes. To counter these discrepancies, this manuscript introduces a mixed-methods, cross-sectional research protocol that is designed to assess local community member perceptions of and attitudes towards homelessness and potential housing solutions. The results of research modeled after this protocol can be used to inform local housing policy and community awareness campaigns. In this manuscript, we describe the protocol and its accompanying survey instrument, and the lessons our research team learned through the implementation of the protocol during the COVID-19 pandemic. Researchers elsewhere can adapt this protocol to capture localized and nuanced data related to local perceptions of homelessness and housing policy. With commitment to representative resident sampling, this protocol and the data it captures can help advocates craft more responsive and individualized community housing policies than would be possible without localized data collection and analysis.

Children's lived experience and perceptions of community members' influence on their schooling: a study in Uganda.

Global and national initiatives have successfully increased access to public education in low- and middle-income countries. However, many students in rural regions in these countries have high rates of absenteeism and drop-out, and low levels of academic engagement. Together, these significantly limit children's academic performance and achievement. One strategy that addresses these barriers seeks to engage members of the wider local community in schools. Most previous research focuses on adults' perspectives even though the potential benefit of community engagement is greatest when learners perceive it to be positive. Past research has also focused on community members structured engagement in activities within schools. This research provides a wider exploration of children's lived experience and perceptions concerning community members' influence on their schooling and learning. The aim was to gain a rich picture of how primary school students in rural Uganda perceive that community members' behavior helps or hinders their education. Qualitative data from students 10 to 13 years of age were collected through individual interviews that used the draw-and-talk technique (n = 20) and four focus group discussions. Seven broad categories of community members' actions were perceived to be positive (conflict resolution; supporting students' physical well-being; encouraging learning and positive behavior; reducing truancy; providing food and financial support; collective community work; and political representation). Four categories of community members' actions were perceived to have a negative influence (creating barriers to attending school; noise and other distractions; insecurity; and theft and vandalism). We conclude that carefully structured community involvement in schooling may improve the emotional and material support that facilitates students' continued school attendance and their motivation for learning. However, we also identify some limits on the role that local communities may be able to play in overcoming the challenges facing education in low- and middle-income countries.

Community perception and acceptability of COVID-19 vaccine in South-West Nigeria: an online cross-sectional study.

The development of COVID-19 vaccines holds great potential for controlling the spread of SARS-CoV-2. Vaccines, irrespective of the disease are generally fraught with hesitancy, and Nigeria has a history of vaccine hesitancy. This study aimed at determining the perception of community members about the COVID-19 vaccine and their readiness to accept the vaccine in South West, Nigeria. A descriptive cross-sectional study design was employed to collect data from consenting adults using a structured online questionnaire for a period of three weeks. Data were subjected to a Chi-square test and logistic regression for bivariate and multivariate analysis, respectively. A total of 807 respondents participated in the survey with 57.7% males and 42.3% females. Forty-five respondents (5.6%) had previously been diagnosed with COVID-19 while 11.5% of the respondents had co-morbidity. The overall perception of COVID-19 vaccines was good. Fifty-nine (59%) percent of the respondents were willing to accept the vaccine and will also encourage their family members to take the vaccine. Vaccine origin and cost were determinants of vaccine acceptability. Nonacceptability of the vaccine (61.6%) was based on possible adverse effects of the vaccine and mistrust of the government. Educational level, skill status, type of employment, and sector of employment were associated (P<0.001) with the acceptability of the COVID-19 vaccine. Citizens were willing to take COVID-19 vaccines, however, a lack of trust in government programs might undermine the vaccine campaign. Hence, the government needs to rebuild trust with the citizens towards achieving a high vaccination rate for COVID-19.

Rapid ethnography and participatory techniques increase onchocerciasis mass drug administration treatment coverage in Benin: a difference-in-differences analysis

BackgroundOnchocerciasis, a neglected tropical disease (NTD) that causes blindness, is controlled via mass drug administration (MDA) where entire endemic communities are targeted with preventative chemotherapeutic treatment. However, in many settings, MDA coverage remains low. The purpose of this project was to determine if engaging communities in the development of implementation strategies improves MDA coverage.MethodsThis study took place in an intervention and a control commune in Benin, West Africa. We conducted rapid ethnography in each commune to learn about community member perceptions of onchocerciasis, MDA, and opportunities to increase MDA coverage. Findings were shared with key stakeholders and a structured nominal group technique was used to derive implementation strategies most likely to increase treatment coverage. The implementation strategies were delivered prior to and during onchocerciasis MDA. We conducted a coverage survey within 2 weeks of MDA to determine treatment coverage in each commune. A difference-in-differences design was used to determine if the implementation package effectively increased coverage. A dissemination meeting was held with the NTD program and partners to share findings and determine the perceived acceptability, appropriateness, and feasibility of implementing rapid ethnography as part of routine program improvement.ResultsDuring rapid ethnography, key barriers to MDA participation included trust in community drug distributors, poor penetration of MDA programs in rural or geographically isolated areas, and low demand for MDA among specific sub-populations driven by religious or socio-cultural beliefs. Stakeholders developed a five-component implementation strategy package, including making drug distributor trainings dynamic, redesigning distributor job aids, tailoring community sensitization messages, formalizing supervision, and preparing local champions. After implementing the strategy package, MDA coverage increased by 13% (95% CI: 11.0–15.9%) in the intervention commune relative to the control commune. Ministry of Health and implementing partners found the approach to be largely acceptable and appropriate; however, there was mixed feedback regarding the feasibility of future implementation of rapid ethnography.ConclusionsImplementation research conducted in Benin, and indeed throughout sub-Saharan Africa, is often implemented in a top-down manner, with both implementation determinants and strategies derived in the global North. This project demonstrates the importance of participatory action research involving community members and implementers to optimize program delivery.

Qualitative Exploration of Cultural Influence on a Rural Health-Promotion Initiative

ObjectiveTo develop a conceptualization of cultural influence on perceptions of a rural food and physical activity policy, systems, and environmental (PSE) change project to inform public health research and practice. DesignBasic qualitative research design, semistructured phone interviews with community health coalition members. SettingFive rural Southern counties (obesity prevalence > 40%). ParticipantsThirty-nine community coalition members. InterventionThe Centers for Disease Control and Prevention High Obesity Program. PSE initiatives to increase access to healthy food and physical activity opportunities through a community coalition model. Phenomenon of InterestSocial norms and cultural influences surrounding community members’ food preferences, physical activity behavior, and future hopes for community development. AnalysisAbductive content analysis. ResultsMajor categories on food social norms (subcategories: physical health, eating habits, and food preference), race relations, generational factors, physical activity social norms, and hopes for the community (subcategories: increased engagement, health, awareness, cohesion, and inspiration) were discussed in relation to the progress of PSE initiatives. Conclusions and ImplicationsBecause of community member perceptions, PSE initiatives became associated with factors beyond food and fitness, such as race relations, generational differences, and community cohesion. A focus on increased youth and church involvement, community values, relationship building, and input from diverse voices can be foundational to culturally-appropriate PSE efforts in rural settings.

Perceptions of the double value coupon program in southern Illinois.

Purchasing produce at farmers markets represents one method by which individuals can purchase and have access to healthful and seasonal fruits. Despite the extension of nutrition assistance programs to local farmers markets, fruit and vegetables consumption has remained below the recommended guidelines, specifically in rural geographical locations. The purpose of the study was to explore the aspects of the Link Up Illinois Double Value SNAP Nutrition Incentives Program (DVCP) and its effects on food selection at rural farmers markets for individuals enrolled in nutrition assistance programs. The current study uses a qualitative methodology in order to uncover barriers local health departments and farmers markets face to implementing the DVCP in their communities and to discover the perspectives of low-income individuals who utilize the DVCP. This paper explores the organizational and community member perceptions of the DVCP and its administration. Semi-structured interviews and one focus group were conducted with health educators from county health departments, DVCP stakeholders, farmers market managers, local farmers, and residents who used the DVCP. A purposeful sampling method was used, intentionally selecting individuals with lived experiences of the research objective. Data were analyzed using a three-cycle coding process, then categorized into overarching themes until thematic saturation was reached. There were a total of 19 individuals who participated in the study. Five themes and four subthemes emerged from data analysis, including organizational capacity, exposure to the DVCP, purchasing power, DVCP advancements, and values. These findings contextualize the facilitators and barriers of multiple stakeholders when implementing nutrition assistance programs at farmers markets. Other similar "double value" programs can utilize these lessons when seeking to increase participation of underrepresented populations at local farmers markets.

Designing a Community Engaged Training Program for African American and Latinx Communities on COVID-19 in South Mississippi: Results from Qualitative Focus Groups Exploring Community Member Perceptions

Designing a Community Engaged Training Program for African American and Latinx Communities on COVID-19 in South Mississippi: Results from Qualitative Focus Groups Exploring Community Member Perceptions

Community voices around COVID-19 vaccine in Chennai, India: A qualitative exploration during early phase of vaccine rollout.

Globally, vaccination is considered as an important public health strategy to mitigate the impact of the COVID-19 pandemic. The purpose of the current study was to conduct an in-depth inquiry to explore perceptions of community members around COVID-19 vaccines in the southern city of Chennai, Tamil Nadu. This was conducted during the early phase of the vaccine rollout programme in India. A qualitative investigation was conducted between January-February 2021 through in-depth interviews. Healthcare workers, religious leaders, community influencers, local administrators and representatives of marginalized communities were included. The key informant interview guides and probes explored five domains; (i) vaccine availability, (ii) trust in COVID-19 vaccines, (iii) vaccine-related concerns, (iv) health/risk balance and (v) vaccine prioritization. Transcripted interviews were coded using a thematic approach and analyzed manually as well as with the help of ATLAS.ti 9 software. Eagerness to receive COVID-19 vaccines amongst some of the respondents was linked with freedom from fear, possible restoration of normalcy, protection of family and ability to travel and work abroad. Concerns around threat of emergence of new variants, damage caused by such viral mutants and trust in policymakers were other facilitatory influencers for vaccine uptake. On the other hand, doubts surrounding safety and fear of side effects of COVID-19 vaccine were the feeders to vaccine hesitancy. Lack of accurate information, sensational media reports and rumours exacerbated this fear and provoked anxiety among people. Apprehensions around COVID-19 vaccine in the wake of its rapid development and approval for use and reluctance to take it during the declining phase of the epidemic were identified as other inhibitory factors. Participants underlined the importance of having responsive communication strategies in place focussing on vaccine safety. Making vaccines available to people free of cost and ensuring wider access were other programmatic suggestions. In conclusion, our study findings suggest that it is essential to remain engaged with communities and execute evidence-based information dissemination strategy about the safety and efficacy of the vaccines. We identified that it is also imperative to sensitize and train media professionals on how to report side effects related to vaccines. Responsive communication strategies will thus have the potential to serve as a key public health approach pertaining to future pandemic preparedness as well as to manage the demands of clinical and public health issues in an ongoing pandemic situation.

Perceptions of community members in Australia about the risk factors, symptoms and impacts of dementia: A cross-sectional questionnaire study.

Ensuring that the Australian public has an accurate understanding of the characteristics of dementia may assist in improving timely detection of dementia. This cross-sectional questionnaire study aimed to examine community members' perceptions of the risk factors, symptoms and impacts of dementia. Participants were recruited from outpatient units at a major regional hospital and were aged at least 18 years, a patient or an accompanying support person, did not have a dementia diagnosis, had sufficient English knowledge and were well enough to complete a survey. Participants completed a web-based survey on a touchscreen computer including items exploring knowledge of dementia risk factors, symptoms and perceived impacts if they or a loved one had dementia. Counts and proportions were calculated and perceived impacts of dementia were compared for self versus loved one using a χ2 test. Of 353 eligible individuals approached, 208 consented and were included in the study. Between 30% and 61% (n=62-127) of participants believed modifiable factors such as high alcohol consumption and high blood pressure were associated with increased risk of dementia. While a majority of participants (87-96%; n=164-181) identified memory-related symptoms, less than one-third recognised behavioural symptoms. Participants were more likely to identify emotional and practical impacts compared to physical or social impacts as most difficult if they or a loved one had dementia. There remains a need for increased community education to address knowledge gaps regarding modifiable risk factors, behavioural symptoms and potential impacts of dementia on the individual diagnosed and their carers.

Effects of Residential Environmental Screening and Perception Surveys on Superfund Environmental Health Risk Perceptions.

Residents at one of the nation’s largest and longest-operating Superfund sites (Butte, Montana) have expressed environmental health risk perceptions that often diverge from those of EPA and other official stakeholders responsible for the investigation and remediation of site contamination aimed at protecting human health and the environment. A random sample of Butte residents participated in a study of how home-based environmental screening influences environmental health perceptions. Participants completed surveys measuring environmental health perceptions before and after a home site screening of soil and drinking water for lead and arsenic conducted by the research team. Local air monitoring for the same contaminants was also completed during the study period. The home-based screening intervention improved the alignment of subjective participant environmental health perceptions with objective environmental screening measures. Key features of the process that helped achieve this effect included (1) co-locating the collection of participant perceptions and individualized screening measurements; (2) sharing environmental screening results in a clear and unbiased manner; and (3) conducting this work independent of agencies and organizations with direct responsibility for Superfund-related cleanup activities. Empowering residents of a Superfund community with knowledge of the specific kinds and levels of environmental contamination in their home environment may help overcome the gap between agency conclusions regarding environmental health risk and the perceptions of community members.

Perceptions of community members on contextual factors driving cardiovascular disease behavioural risk in Ghana: a qualitative study

BackgroundThere is clear evidence that lifestyle interventions are effective towards reducing cardiovascular risk. However, implementing these interventions in real-world setting has been suboptimal, especially in sub-Saharan Africa, thus creating ‘evidence to practice gap.’ We explore perceptions of community members on contextual factors driving cardiovascular disease (CVD) behavioural risk (alcohol consumption, smoking, physical (in)activity and fruits and vegetables consumption) in Ghana.MethodsThis was a cross-sectional study. Thirty (30) focus group discussions (FGDs) were carried out in five communities in Ghana (Ga Mashie, Tafo, Gyegyeano, Chanshegu and Agorve) between October and November 2017, and these were analysed using a thematic approach.ResultsFive main factors were raised by participants as contextual factors driving alcohol consumption and smoking and these include economic (poverty, unemployment, loss of jobs), psycho-social (worries, hardships, anxieties), medical (pain suppression, illness management), sexual (sexual performance boost), and socio-cultural (curse invocation, quest for supernatural powers) factors. Personal/social factors (time constraints, personal dislike, lack of knowledge of the benefits of exercise), economic factors (poverty, economic hardship), and negative health effects (getting tired easily, medical conditions) were cited as reasons why community members did not engage in physical activity. Consumption of fruits and vegetables in the five communities were determined by availability, cost, personal (dis)like, lack of knowledge about benefits, and cultural taboo. Participants’ narratives revealed that the symbolic functions of some of these behavioural risk factors and the built environment were important determining factors that have sustained these behaviours in these communities over the years.ConclusionsThis study showed that successful implementation of CVD interventions in Ghana needs to address the perceptions of community members on factors driving CVD behavioural risk factors. Future policies and interventions should be developed based on these contextual factors taking into consideration the age, sex and ethnic variations especially with interventions seeking to address CVD risk factors at the primary health care level. These findings should urge local policy makers and health managers to incorporate the roles of these contextual factors in new programs targeting cardiovascular health. Closing the ‘evidence to practice’ gap as far as CVD interventions are concerned may be impossible without this.