Prevention Agenda Research Articles

Problematising ‘Fused Principles’ in Discourses of Preventative Social Care: Interpreting the Implementation of National Social Services Legislation in Wales, UK

Abstract Prevention is a core principle in social care legislation across the UK. However, history shows great variability in how a preventative social care agenda is conceptualised and implemented. We report findings from an independent evaluation of the implementation of the ‘2014 Social Services and Well-being (Wales) Act’ incorporating a document analysis of reports and plans from Wales’ twenty-two local authorities (LAs) and eighty-eight qualitative interviews from social services strategic leaders and operational managers within four Welsh LAs. Analysis highlighted multiple interpretations of national policy, with notable overlapping agendas. In Gramscian terms, there is a constant process of negotiating prevention values and agendas, with consequences for whose interests are served. This was apparent through drives towards cost-saving, financial sustainability and reduced service demand operating alongside values-based principles rooted in well-being and mutualism. Following Kenny’s work in community development, we argue a ‘fusing’ of principles whilst espousing benefits for service users, potentially blurs the aims of the legislation, with implications for practice.

Occupational Disease in New York State: An Update

An assessment of occupational disease in New York State was undertaken that partially replicated and expanded earlier work from 1987. Utilizing an expanded conception of occupational disease, the assessment used a variety of data sources and methods to provide estimates of mortality and morbidity of occupational disease; workers exposed to specific workplace hazards; disparities in occupational disease among racial/ethnic groups and gender; costs and distribution of costs of occupational disease; and accessible occupational medical resources. Examples of the pathways work may impact health in some of the major health issues of current import including stress-related health conditions; substance use; and overweight/obesity were included. The report contains recommendations for addressing the problem of occupational disease in New York State and advocates for the convening of a statewide group to develop an occupational disease prevention agenda.

Avaliação das estratégias de promoção da saúde e prevenção ao uso de drogas na rede psicossocial

Abstract Objective to assess health promotion and drug use prevention strategies in the Psychosocial Care Network. Method this is a qualitative study based on empowerment evaluation, developed in 2017 in the Psychosocial Care Network of a municipality in Rio Grande do Sul, Brazil. The interest groups were 42 workers and managers representing the municipal RAPS components. Participant observation techniques, interviews and Open Forum were used. Results it was assessed that health promotion and drug use prevention actions are precarious and require investments, constituting the mission of workers and managers. Primary care was identified as a difficulty due to weaknesses in public policies and lack of support from specialized services. As a potentiality, matrix support in mental health was listed. Investment in Primary Care is suggested through training and support for these teams. Conclusion and implications for practice health promotion and drug abuse prevention agenda are urgent and must be included in the structuring of public policies and practices within the networks.

Prevalence of syphilis and chlamydia trachomatis infection among men who have sex with men in Jiangsu province, China: A cross-sectional survey.

BackgroundEpidemics of sexually transmitted infections (STIs) among men who have sex with men (MSM) are major global public health concerns. This study aimed to examine the prevalence of syphilis and chlamydia trachomatis (CT) infection and associated factors among MSM in Jiangsu province, China, hoping to provide updated data for the formulation of relevant policies.MethodsA cross-sectional survey was conducted among MSM from April to July 2021 in four cities in the province. Socio-demographic characteristics and behavioral information were collected through a face-to-face questionnaire interview. Venous blood specimens were collected for HIV, hepatitis C (HCV), and syphilis testing using serological testing methods. First-void urine specimens were collected for CT and Neisseria gonorrhoeae (NG) testing using nucleic acid amplification testing (NAAT) methods. Chi-square tests were used to compare differences in syphilis and CT infection between subgroups of variables. Multivariate logistic regression analysis was used to identify factors associated with syphilis and CT infection.ResultsA total of 1,087 participants were enrolled. The prevalence of HIV, HCV, syphilis, CT and NG infection were 6.6, 0.4, 6.3, 4.2, and 0.4%, respectively. MSM recruited online [adjusted odds ratio (aOR) = 2.189, P = 0.020], diagnosed with an STI in the past 12 months (aOR = 3.304, P < 0.001), and living with HIV (aOR = 4.721, P < 0.001) were more likely to have syphilis infection. MSM who were younger than 25 years (aOR = 4.286, P = 0.020), had senior high school level education (aOR = 2.521, P = 0.038), and were recruited via VCT clinics (aOR = 3.455, P = 0.001) were more likely to have CT infection.ConclusionsOur study showed a high prevalence of syphilis and chlamydia among MSM in Jiangsu province, China. STI screening, diagnosis, and treatment services promotion should be a top priority on the prevention agenda.

Factors associated with long-term HIV pre-exposure prophylaxis engagement and adherence among transgender women in Brazil, Mexico and Peru: results from the ImPrEP study.

IntroductionThe HIV epidemic continues to disproportionately impact Latin‐American transgender women (TGW). We assessed factors associated with long‐term pre‐exposure prophylaxis (PrEP) engagement and adherence among TGW enrolled in the Implementation of PrEP (ImPrEP) study, the largest PrEP demonstration study in Latin America.MethodsHIV‐negative TGW aged ≥18 years reporting 1+eligibility criteria in the 6 months prior to enrolment (e.g. sex partner known to be living with HIV, condomless anal sex [CAS], transactional sex or having a sexually transmitted infection [STI]) who could safely take PrEP were enrolled. Follow‐up visits were conducted at 4 weeks and then quarterly. We conducted logistic regression to identify factors associated with long‐term PrEP engagement (3+ follow‐up visits in 52 weeks) and complete self‐reported adherence (no missed pills in the past 30 days) during follow‐up. For both outcomes, we constructed multivariable models controlling for country, socio‐demographics, sexual behaviour, substance use, STIs and self‐reported adherence at 4 weeks (long‐term engagement outcome only).ResultsFrom March 2018 to June 2021, ImPrEP screened 519 TGW, enrolled 494 (Brazil: 190, Mexico: 66 and Peru: 238) and followed them for 52 weeks. At baseline, 27.5% of TGW were aged 18–24 years, 67.8% were mixed‐race and 31.6% had >secondary education. Most, 89.9% reported CAS, 61.9% had >10 sex partners and 71.9% reported transactional sex. HIV incidence was 1.82 cases per 100 person‐years (95% confidence interval [CI]: 0.76–4.38). Almost half of TGW (48.6%) had long‐term PrEP engagement, which was positively associated with reporting complete adherence at week 4 (aOR:2.94 [95%CI:1.88–4.63]) and was inversely associated with reporting CAS with unknown‐HIV partner (aOR:0.52 [95%CI:0.34–0.81]), migration (aOR:0.54 [95%CI:0.34–0.84]), and being from Mexico (aOR:0.28 [95%CI:0.14–0.53]). Self‐reported adherence was associated with TGW aged >34 (aOR:1.61 [95%CI:1.10–2.34]) compared to those aged 25–34 and those with >secondary education (aOR:1.55 [95%CI:1.10–2.19]) and was lower among TGW from Peru (aOR:0.29 [95%CI:0.21–0.41]) or reporting PrEP‐related adverse effects (aOR:0.63 [95%CI:0.42–0.92]).ConclusionsAlthough TGW were willing to enrol in ImPrEP, long‐term PrEP engagement and complete self‐reported adherence were limited, and HIV incidence remained relatively high. A successful HIV prevention agenda should include trans‐specific interventions supporting oral PrEP and exploring long‐acting PrEP strategies for TGW.

Maintaining Momentum for Rotavirus Immunization in Africa during the COVID-19 Era: Report of the 13th African Rotavirus Symposium.

The 13th African Rotavirus Symposium was held as a virtual event hosted by the University of Nairobi, Kenya and The Kenya Paediatric Association on 3rd and 4th November 2021. This biennial event organized under the auspices of the African Rotavirus Network shapes the agenda for rotavirus research and prevention on the continent, attracting key international and regional opinion leaders, researchers, and public health scientists. The African Rotavirus Network is a regional network of institutions initially established in 1999, and now encompassing much of the diarrheal disease and rotavirus related research in Africa, in collaboration with the World Health Organization African Regional Office (WHO-AFRO), Ministries of Health, and other partners. Surges in SARS-CoV2 variants and concomitant travel restrictions limited the meeting to a webinar platform with invited scientific presentations and scientific presentations from selected abstracts. The scientific program covered updates on burden of diarrheal diseases including rotavirus, the genomic characterization of rotavirus strains pre- and post-rotavirus vaccine introduction, and data from clinical evaluation of new rotavirus vaccines in Africa. Finally, 42 of the 54 African countries have fully introduced rotavirus vaccination at the time of the meeting, including the two recently WHO pre-qualified vaccines from India. Nonetheless, the full benefit of rotavirus vaccination is yet to be realized in Africa where approximately 80% of the global burden of rotavirus mortality exists.

Setting a Course to Protect Indigenous Cultures and Communities in our National Suicide Prevention Agenda.

Setting a Course to Protect Indigenous Cultures and Communities in our National Suicide Prevention Agenda.

Why is health improvement policy so difficult to secure?

Many governments seek to improve population health, and some seek to reduce health inequalities. Yet, there remains a large gap between their policy statements and actual outcomes. Perennial questions in public health research include: why is this gap so large, why does it endure, and what can be done to close it? This essay uses political science and policy studies insights to address these questions, focusing on the distinctive issues that relate to (1) broad aims like 'prevention', (2) specific strategies for health improvement, or (3) new events. On the one hand, the idea of 'prevention' has widespread appeal, when governments think they can save money or reduce inequalities by preventing problems happening or worsening. While health protection seeks to inoculate populations against communicable diseases, health improvement strategies, including 'Health in All Policies' (HiAP),primarily address non-communicable diseases (NCDs). Further, the coronavirus disease 2019 (COVID-19) pandemic highlights the unequal spread of ill health, showing that preventive health ideas should be at the core of policy. On the other hand, there is a large gap between rhetorical and substantive commitment to prevention, a continuous HiAP implementation gap, and a tendency for COVID-19 health protection to overshadow health improvement. Explaining each problem clearly helps to identify the factors that generally undermine prevention policies and those specific to more detailed strategies like HiAP or events like COVID-19. We do not prioritise leadership or 'political will' as the policymaking problem. Instead, we identify the systemic factors that apply to even the most sincere, competent, and energetic policymakers. Health improvement policy is typically undermined by a lack of: clarity about what prevention means in practice; congruity between the prevention agenda (emphasising the need for major change to policy and policymaking) and routine government business; and, capacity to overcome obstacles to policy change.

Measuring the health impact of Universal Basic Income as an upstream intervention: holistic trial design that captures stress reduction is essential

Background:In the context of the UK Government’s ‘prevention agenda’, Laura Webber and colleagues have called for a ‘health in all policies’ approach. Universal Basic Income (UBI) is a system of cash transfers to citizens. Recent research suggests it could significantly benefit population health, including via reducing stress. However, a Finnish trial of a policy with similarities to UBI has influenced debate. This was reported as a failure due to a policy objective of reducing unemployment, despite demonstrating significant benefits to well-being. Aims and objectives:In this piece, we seek to advance the debate about the cost-benefit of UBI by identifying knowledge gaps and proposing a means of designing effective trials. Methods:We review UBI trial design and findings in comparison with social gradient in health literature and biopsychosocial theory to identify knowledge gaps. Findings:We highlight a need to refocus UBI trials on improved health, including via reduced stress, to provide policy makers the means of producing accurate cost-benefit analysis. Previous trials have either not reflected likely UBI policy or failed to measure impacts that enable accurate analysis. We contend that interdisciplinary work is required to establish trials that observe factors known to drive the social health gradient. Finally, we argue that statistical modelling is needed to extrapolate shorter-term findings to long-term population-level outcomes. Discussion and conclusions:Resource allocation by Government and/or major funders is required to produce evidence that enables accurate analysis of UBI. Such trials would provide a platform for interdisciplinary work resulting in joined-up evidence and policy.

The ECOWAS conflict prevention framework and the critical and emancipatory peacebuilding approach

This paper discusses the ECOWAS Conflict Prevention Framework from the perspective of the critical and emancipatory peacebuilding approach. The paper argues that the ECOWAS conflict prevention framework is largely guided by the principles of the liberal peacebuilding model which ignores the ‘local’ in peacebuilding. The framework represents a complete departure of the sub-regional body, from an emphasis on conflict resolution to transformative conflict prevention with the overarching objective of ensuring human security instead of state security. When subjecting the framework, however, to the philosophies of the critical and emancipatory peacebuilding approach and the social justice frame, one notices that, in its current form, the framework is inadequate to ensure sustainable peace and security within the sub-region. Its over-reliance on the state as the unit of focus together with its adoption of liberal conceptualization of human security, focus on direct violence, top-down approach, low engagement of local communities to ensure local ownership, and the way these have been implemented make it an apparent elite-based policy. For the framework to have an impact in the sub-region, it must be restructured to make it an empowering policy that engages local actors, communities, resources, and knowledge in the transformative conflict prevention agenda of the sub-region. The framework also needs to be anchored on local ownership and agency and must be made to act as an emancipatory and transformative tool aimed at empowering the people of the sub-region as peacemakers, peacebuilders, and transformative leaders.

Preventing Parkinson's Disease: An Environmental Agenda.

Fueled by aging populations and continued environmental contamination, the global burden of Parkinson’s disease (PD) is increasing. The disease, or more appropriately diseases, have multiple environmental and genetic influences but no approved disease modifying therapy. Additionally, efforts to prevent this debilitating disease have been limited. As numerous environmental contaminants (e.g., pesticides, metals, industrial chemicals) are implicated in PD, disease prevention is possible. To reduce the burden of PD, we have compiled preclinical and clinical research priorities that highlight both disease prediction and primary prevention. Though not exhaustive, the “PD prevention agenda” builds upon many years of research by our colleagues and proposes next steps through the lens of modifiable risk factors. The agenda identifies ten specific areas of further inquiry and considers the funding and policy changes that will be necessary to help prevent the world’s fastest growing brain disease.

The mental health of children and young people living in big cities in a revolving postpandemic world.

The world's population is increasingly urban, with most children and young people growing up and living in cities. Evidence suggests that urbanicity is linked to an increased risk for the development of mental health disorders. Rather than an accumulation of risk factors, urbanization is a complex process that profoundly structures living conditions. In this sense, it is timely to discuss what are the social and structural determinants of mental health of children and young people in such settings. Three domains of determinants of mental health were selected for discussion: economics and living conditions, crime and violence, and urban layouts. For each, we debated realities faced by urban children and young people, providing an overview of recent evidence on implications for mental disorders and well being. We also discuss the potential impacts of the covid-19 pandemic on each domain, as well as recommendations for future action. Structural factors are of major relevance for the mental health of children and young people living in cities. The agenda of mental health promotion and prevention must include whole-of-society interventions aimed at improving living conditions, including economic and social capital, violence prevention and urbanistic planning.

Suicide by hanging: A scoping review.

Suicide by hanging is increasing in many countries around the world and whilst efforts are being made to influence the prevention agenda to reduce the incidence, little is known regarding the contributing factors for choosing this method. The purpose of this scoping review is to summate understandings about how the epidemiology and prevention of suicide by hanging is recognised, described, and discussed in the literature, and critically appraise the extent to which the lived-experiences of survivors of suicide attempts are included. A scoping review was conducted implementing the appropriate framework and in accord with the PRIMSA-ScR extension. Three databases (CINAHL, PubMed, and PsycINFO) were searched along with the reference lists of eligible sources in January and February 2021. Thirty-six articles with a primary focus on hanging as a method of suicide and/or its prevention are included in this review, with brief thematic analysis used to summarise the featured studies. Three distinct themes emerging from the literature include: (i) Hanging suicide deaths in the community environment or person's usual place of residence, (ii) Hanging suicide deaths in controlled environments (including police cells, prisons, and inpatient units), and (iii) Medical management of near-lethal hangings. This review highlights the necessity for improving education and policy regarding the controlled environments frequently associated with hanging suicides and the medical management of near-lethal hangings, as well as the ongoing need for policy to guide and govern the responsible media portrayal of known suicides as well as fictional hangings. Finally, this review highlights the necessity for including those with lived-experiences of a suicide attempt by hanging to advance the current prevention agenda.

High prevalence of Chlamydia trachomatis infection among women attending STD and gynecology clinics in Jiangsu province, China: A cross-sectional survey.

Epidemics of Chlamydia trachomatis (CT) infection among women are major global public health concerns. This study examined the prevalence of CT infection and associated factors among women attending sexually transmitted disease (STD) and gynecology clinics in Jiangsu province, China.A cross-sectional survey was conducted among women attending STD and gynecology clinics in the province during 2018 to 2019. Socio-demographic and behavioral information were collected through face-to-face questionnaire survey. Cervical swab specimens were collected to test for CT. Chi square tests were used to compare differences in CT prevalence between subgroups of characteristics. Multivariate logistic regression analysis was used to identify factors associated with CT infection.A total of 2664 participants were enrolled. The prevalence of CT infection was 16.6% (95% confidence interval: 15.0%–18.1%). Of those, CT prevalence among participants from STD clinics (19.4%) and South Jiangsu (18.5%) were higher. Female outpatients who were service personnel (adjusted odds ratio [aOR] = 1.667, P = .004) or farmers (aOR = 1.593, P = .039), lived in South Jiangsu (aOR = 1.796, P = .004), and were from STD clinics (aOR = 1.608, P = .022) were more likely to infect CT.Our study showed a high prevalence of CT infection among women attending STD and gynecology clinics in Jiangsu province, China. CT screening, surveillance and treatment promotion should therefore be of top priority on the CT prevention agenda.

Moderatism Paradigm of COVID-19 Prevention: Religion-Science Integration Perspective

One of phenomena in the handle of Covid pandemic is the polarization of religionists and scientists. This polarization occurs because the difference of paradigms from them in understanding about COVID-19. The religionists, who leans towards orthodoxy and conservatism, emphasize literal dogmatic approach, whereas the scientists emphasize on scientific approach with the principle of positivistic-materialism. This study discusses the paradigm of moderatism in COVID-19 prevention from integration of science and religion perspective. By using qualitive research and in-depth analysis based on John F. Haugt’s integration theory, this study found the idea of integration between science and religion as a paradigm of moderatism in COVID-19 prevention. This is an epistemological effort in order to create dialogical relationship between science and religion. It means that both fulfill and reinforce each other thereby augmenting the agenda of COVID-19 prevention. There is a need for epistemological transformation that both sides need to undergo to achieve the agenda. Religion, which has been embodied by a literal dogmatic perspective, needs to display dynamic and contextual. So, it can compromise with the reality especially in scientific approach. In the other hands, science which has followed positivistic-materialism principles. It should not be conducted free from all values but it should contain many values, especially spiritual and theistic. In contemporary religious discourse, the integration of science and religion in the context of COVID-19 prevention is a form of moderatism in responding the COVID-19 pandemic situation in terms of thinking, attitude, or behavior.

Suicide prevention in the context of COVID-19: An Indian perspective.

The ongoing COVID-19 pandemic has impacted the health and wellbeing of communities worldwide. Measures to limit transmission, have enhanced vulnerability of individuals to well identified risk factors associated with mental illness and suicide. These include a sense of loneliness, anxiety, depression, insomnia, PTSD, harmful alcohol and drug use. Given that the potential for increased rates of suicide persist, the suicide prevention agenda remains urgent and essential. The same is one of the cornerstones of resilience in a society that is facing an array of challenges due to the pandemic. In this article, we recommend few possible strategies for attenuating suicide risk amidst the COVID-19 pandemic with particular relevance to the Indian context.

Delivering clinical evidence-based child-parent interventions for emotional development through a digital platform: A feasibility trial.

As the prevalence of mental health conditions in childhood increases, there are growing concerns around the accessibility and scale of evidence-based support. However, barriers to referral, time commitment and engagement rates means recommended traditional group-based parenting programmes are unable to provide population level support at scale. The aim of this feasibility study was to establish whether a suite of purposively constructed animated films and digital resources could positively impact on parent and child outcomes in the early years. Families from a range of backgrounds (n = 129) participated in a mixed method evaluation of the digital programme. After completing online surveys and interviews, the test group was given access to the Embers the Dragon platform for 8 weeks whilst the control group continued as usual. 98% of test group parents showed an improvement in parental response in relation to effective parenting styles. During qualitative interviews, child participants verbally recalled an increased range of emotions and coping strategies highlighted in the programme. Digital interventions can be used to support children’s emotional development independent of clinicians and may provide a solution to sustainable family psychoeducation, thereby fulfilling a preventative agenda and potentially lessening the future impact on Child and Adolescent Mental Health Services.

Conceptualizing the Transnational Regulation of Plastics: Moving Towards a Preventative and Just Agenda for Plastics

AbstractThis article categorizes and evaluates how regulatory regimes conceptualize plastics, and how such conceptualizations affect the production, consumption, and disposal of plastics. Taking a doctrinal and policy-oriented approach, it identifies four ‘frames’ – that is, four distinct and coherent sets of meanings attributed to plastics within transnational regulation – namely, plastics as waste to be managed; a material to be prevented; a good (or waste) to be traded freely; and inputs or outputs in production-consumption systems. Based on this analysis, three significant deficiencies in the transnational regulation of plastics are identified: the failure to frame plastics in terms of environmental justice and human rights issues; insufficient focus on plastics prevention (rather than management); and the role of law in reinforcing its production and consumption.

Advancing the Agenda of the Confederation of Trade Unions on the Prevention of Sexual Violence in the World of Work in Indonesia

&lt;p&gt;This article was formulated based on interviews with 5 (five) trade union confederations from a number of confederations in Indonesia, namely: Konfederasi Serikat Pekerja Nasional (KSPN), Konfederasi Sarikat Buruh Muslimin Indonesia (KSarbumusi), Konfederasi Serikat Buruh Seluruh Indonesia (KSBSI), Konfederasi Serikat Pekerja Indonesia (KSPI), and Konfederasi Kongres Aliansi Serikat Buruh Indonesia (KKASBI). This article seeks to explore the efforts made by the trade union confederation in promoting gender equality - specifically in advancing the agenda for the prevention and elimination of sexual violence in the world of work. This article was compiled based on research with a qualitative approach, with data collection methods through interviews and literature studies. The results of this study found that the confederations interviewed had already set up internal structures that have specific functions on issues related to gender equality, gender-based violence, and women’s empowerment; although still limited and on ad-hoc basis. This research also finds that the role of the trade union confederation is particularly prominent in advocating policies related to sexual violence and gender-based violence in the world of work, such as advocating the Bill on the Elimination of Sexual Violence, and the ratification of the ILO Convention No. 190 on Violence and Harassment.&lt;/p&gt;

Local Media Editorial Policy in Yogyakarta in News of Covid-19 (Case Study Editorial Policy in Harian Jogja and Tribun Jogja in News Of Covid-19)

Local mass media play a role in disseminating information about Covid-19. The news of Covid-19 is included in the editorial policy of the media because it contains important news value (significance). Editorial policies are important to research because the Covid-19 problem affects all aspects of life in society from politics, economy, social and culture. This study will look at the editorial policies of local media in Yogyakarta, Jogja Daily and Tribun Jogja in reporting on Covid-19. Researchers want to see how local media play an active role as a source of information that educates and improves the welfare of the community through its editorial policies. The editorial policy will be seen through the Gans story selection approach. The method in this research is a case study by conducting in-depth interviews with the editor. The editorial policy is seen from the period March 2021 to April 2021. The results show that the two local media prioritize the Covid-19 prevention agenda. Daily Jogja and Tribun Jogja saw that the local government did not have readiness in mitigating the pandemic, thus making the two local media editors have different sharpening in each aspect of choosing Gans stories, namely (1) source considerations, (2) substantive considerations, (3) product considerations, (4) value considerations, (5) commercial considerations, (6) audience considerations, and (7) political considerations.