Community Programs Research Articles

Usability and Feasibility of the Antipsychotic Medication Decision Aid in a Community Program for First-Episode Psychosis.

Although antipsychotic medications are considered first-line treatment for psychosis, rates of discontinuation and nonadherence are high, and debate persists about their use. This pilot study aimed to explore the usability, feasibility, and potential impact of a shared decision making (SDM) intervention, the Antipsychotic Medication Decision Aid (APM-DA), for decisions about use of antipsychotic medications. A pilot randomized controlled trial was conducted with 17 participants in a first-episode psychosis program. Nine participants received the APM-DA, and eight received usual care. After their appointments, intervention group participants had less decisional conflict and greater satisfaction with decisions than control group participants had. Use of the APM-DA did not increase appointment length. Comparison of the intervention outcomes with the control outcomes was limited because of the small sample. The results support the feasibility and usability of an SDM process via the use of the APM-DA in routine community psychosis care.

University-community Partnership Contribution Towards Rural Sustainability: Participatory Action Research in the Rice Farming Community of Paipayales, Ecuador

Abstract Rice cultivation is the main economic livelihood for many families around the world. This activity represents several challenges for farmers and community members for rural sustainability, a cross-cutting element of the Sustainable Development Goals (SDGs) of the United Nations (UN). In response, the Polytechnic University (ESPOL), fulfilling its mission of linking with society, implemented a community program where students and professors interact and collaborate with rice farmers in the rural community of Paipayales, located in the Santa Lucia canton, Guayas province. This article explores the impact of university-community projects through the Participatory Action Research (PAR) approach in order to evaluate them as a tool for contributing towards rural sustainability in communities. As a result, it was determined that the main problems faced by most of the farmers of the “Dios con Nosotros” Association are the availability of water in the wells and the commercialization of paddy rice. Considering these problems, the wells were geolocated and a board was designed for proper water management; at the same time, water quality was studied and recommendations were presented according to the problems encountered. Two proposals were also presented to create a rice husker and a rice separator to increase their profit margin by selling rice directly to retailers and wholesalers. As relevant conclusions, the importance of implementing links and relationships between the university community and society was highlighted, guaranteeing the value of working in transdisciplinary teams and achieving a comprehensive intervention that would lead to significant improvements in the community.

The Stroll Safe Outdoor Falls Prevention Program: Participant Experiences in Naturally Occurring Retirement Community Program Sites

Abstract Date Presented 03/21/24 The qualitative findings from an efficacy trial for the Stroll Safe outdoor falls prevention program will be presented. Results reveal a number of program benefits, including increased safe community mobility strategy use. Primary Author and Speaker: Tracy Chippendale Contributing Authors: Szu-Wei Chen

Incorporating a One Health Approach Into the Study of Environmental Crimes and Harms: Towards a ‘One Health Green Criminology’

Abstract Amid increasingly intense and frequent Emerging Infectious Disease events, such as COVID-19, it is evident that the current global ecological crisis poses a threat to the health and well-being of humans, non-human animals and ecosystems. This paper aims to expand existing green criminological scholarship by arguing for the incorporation of a ‘One Health’ perspective. This would (1) enable the integration of scientific knowledge to better address threats, harms and crimes to health and well-being; and (2) contribute to the advance of Eco-justice. The study identifies four areas where a One Health perspective within green criminology may reveal overlooked harms and threats to health and well-being. Conversely, integrating green criminology would benefit the One Health scientific community and specific programs.

Health and well-being of refugee women in sex work: A systematic literature review

Introduction: Refugees face many barriers when arriving in a new country, and these barriers are especially felt by women, who often travel alone or with children. These barriers create a situation where some women turn to sex work, either voluntarily or involuntarily. Both refugees and sex workers face adversities related to their mental health and well-being, however little research has examined the intersections between both identities outside of STI incidence and violence. Objective: This systematic literature review aimed to explore mental health and overall well-being of women refugees who engage in sex work. Themes were extracted to better understand experiences to inform clinical and community practice. Methods: A systematic literature review was conducted using PsycInfo, CINAHL, Scopus, Web of Science, PubMed, Google Scholar, ProQuest, and Medline, as well as grey literature for articles published between 2013 and 2023. The JBI Critical Appraisal Checklist for Qualitative Research was used to evaluate the quality of the primary research articles. 11 articles were included in the final synthesis. Results: The five themes included Fear, Mental/Psychological Health, Social Well-being, Economic/Financial Well-being, and Spiritual Struggles. These themes were interconnected to shape the experiences of these women within their circumstances. Engaging in sex work as a refugee, particularly in instances of sex trafficking, created significant challenges in all aspects of well-being, and the circumstances related to being a refugee often increased vulnerabilities to become involved in sex work for survival. Conclusion: These results suggest the need for policies, community programs, and clinical practice protocols to address the unique needs of women refugees to mitigate factors drawing them to sex work, and better support those who are currently involved in it.

INFLUENCE OF DIETARY HABITS ON BODY COMPOSITION IN LEBANESE ACTIVE UNIVERSITY STUDENTS: A GENDER SPECIFIC ANALYSIS

Problem Statement: The unhealthy lifestyle behaviors that university students face comprising sedentary behaviors are associated with weight gain and obesity in this critical life age. Purpose: The purpose of the study is to explore the effect of dietary habits on body composition parameters in Lebanese Active University Students according to gender. Methods: A sample of 200 students from the Lebanese University, faculty of education, physical Education department were studied. The standardized Dietary questionnaire (Turconi et al., 2003) was used to assess the dietary habits of the participants. Body Composition was assessed using the method of multifrequency bioelectrical analysis. Five body composition parameters were assessed: Body Height, Body Mass, Body mass index, Percentage Body Fat mass, and percentage of Skeletal Muscle mass. Results: Lebanese Physical Education students showed satisfactory results and scored above average in the four sections of the nutrition survey. Regarding gender-based classification, males showed better scores in sections of dietary habits and nutrition knowledge, while females showed better scores in physical activity rated level, and nutrition beliefs. Regarding Body Composition, Lebanese students were found in normal body weight. The multiple regression analysis technique showed that the dietary habits factor has mild to moderate influence on body composition specifically on its three tested dependent variables: BM, BFM, and SMM. Conclusion: Findings support the need from educational and health authorities to develop and evaluate health-promotion and obesity-prevention programs for university communities especially for female gender with regular healthy lifestyle monitoring and standardized assessments.

Leveraging Patient Education to Amplify Colorectal Cancer Screening in the United States: Strategies and Implications.

Despite several available screening modalities, colorectal cancer (CRC) remains a leading cause of cancer deaths, especially among populations with lower screening rates. Barriers to screening include cost, access, awareness, and education disparities, with interventions such as patient education programs and mailed screening kits showing promise in increasing participation rates. The current review elucidates the correlation between patient awareness/knowledge and screening rates in the United States, highlighting the pivotal role of education in mitigating these deficiencies. Different educational models, including online resources, mailed information, community programs, direct provider-based interventions, and narratives, are explored in terms of their effectiveness and limitations. We also offer a blueprint for primary care providers (PCPs) that highlights the importance of tailored education, barrier identification, and utilization of available resources to enhance CRC screening uptake. Large-scale adoption of educational strategies has the potential to significantly increase CRC screening rates and consequently reduce mortality associated with this preventable malignancy.

25-Year Evaluation of an In-Person Therapeutic Community Program in the Southwest United States between 1994 and 2019

This study investigated the effect of therapeutic community programming and aftercare treatment completion on rearrest rates in the Southwest United States across 25 years. The asymptote of rearrest trajectories did not occur until 10 years post-release, although this varied by risk classification. Treatment receipt was not related to 25-year rearrest trajectories. However, people classified as higher risk were more likely to be rearrested than those classified a low risk while controlling for treatment receipt. Aftercare completion extended the time to arrest; individuals completing an aftercare program were less likely to be arrested, and high-risk participants that completed aftercare showed a similar rearrest trajectory as low-risk participants.

Reaching out to fathers in Afro-Caribbean contexts: a case study review of best practices from the Fatherhood is Sacred program in native communities.

Historical trauma has played a significant role in the difficulties of fathers to fulfill their coparenting roles in Native American communities. This pattern is also true for men in Afro-Caribbean communities. Fatherhood programs developed by the Native American Fatherhood and Family Association (NAFFA) have shown effectiveness in supporting fathers, enhancing their confidence and coparenting skills, and overcoming trauma in Native communities. This paper seeks to identify the opportunities and best practices for cross-cultural adaptation of the Fatherhood is Sacred program to Afro-Caribbean families and contexts.

Natural Health Community Program and Well-Being: An Uncontrolled Study of Women Survivors of Domestic Violence.

The purpose of this study was to evaluate a local natural healing service program and to explore how engagement in natural healing services related to the well-being of survivors of domestic violence. Using longitudinal secondary data, we conducted t-tests, regression, and correlation analysis on three measures (hope, distress, and empowerment) that were completed by the participants (N = 31). We provided evidence of the positive impact of a community-based natural healing services program on the well-being of survivors of domestic violence, specifically their sense of hope. This research represents the potential for natural healing services provided at the community level.

Willingness and capacity of publicly-funded vector control programs in the USA to engage in tick management

BackgroundThe vast majority of vector-borne diseases in the USA are associated with mosquitoes or ticks. Mosquito control is often conducted as part of community programs run by publicly-funded entities. By contrast, tick control focuses primarily on individual residential properties and is implemented predominantly by homeowners and the private pest control firms they contract. We surveyed publicly-funded vector control programs (VCPs), presumed to focus mainly on mosquitoes, to determine what tick-related services they currently offer, and their interest in and capacity to expand existing services or provide new ones.MethodsWe distributed a survey to VCPs in the Northeast, Upper Midwest and Pacific Coast states of the USA, where humans are at risk for bites by tick vectors (Ixodes scapularis or Ixodes pacificus) of agents causing Lyme disease and other tick-borne diseases. The data we report are based on responses from 118 VCPs engaged in vector control and with at least some activities focused on ticks.ResultsDespite our survey targeting geographic regions where ticks and tick-borne diseases are persistent and increasing public health concerns, only 11% (12/114) of VCPs reported they took direct action to suppress ticks questing in the environment. The most common tick-related activities conducted by the VCPs were tick bite prevention education for the public (70%; 75/107 VCPs) and tick surveillance (48%; 56/116). When asked which services they would most likely include as part of a comprehensive tick management program, tick bite prevention education (90%; 96/107), tick surveillance (89%; 95/107) and tick suppression guidance for the public (74%; 79/107) were the most common services selected. Most VCPs were also willing to consider engaging in activities to suppress ticks on public lands (68%; 73/107), but few were willing to consider suppressing ticks on privately owned land such as residential properties (15%; 16/107). Across all potential tick-related services, funding was reported as the biggest obstacle to program expansion or development, followed by personnel.ConclusionsConsidering the hesitancy of VCPs to provide tick suppression services on private properties and the high risk for tick bites in peridomestic settings, suppression of ticks on residential properties by private pest control operators will likely play an important role in the tick suppression landscape in the USA for the foreseeable future. Nevertheless, VCPs can assist in this effort by providing locally relevant guidelines to homeowners and private pest control firms regarding best practices for residential tick suppression efforts and associated efficacy evaluations. Publicly-funded VCPs are also well positioned to educate the public on personal tick bite prevention measures and to collect tick surveillance data that provide information on the risk of human encounters with ticks within their jurisdictions.Graphical

The supervision gap in peer support workforce: implications for developing effective peer support programs in Native American communities

The article addresses the critical role of peer support programs in the delivery of behavioral health services. Peer support is instrumental in fostering mental health and overall wellness. Its efficacy is widely recognized in the broader population, including minority groups and communities. Peer support programs also offer distinct benefits for the health of Native American communities. When specifically tailored to these communities' needs, they address individuals' unique cultural, historical, and social challenges during their recovery journey. However, the persistent supervision gap in the peer support workforce poses a significant challenge to implementing these programs. This gap not only hampers the effectiveness of the programs but also limits their potential benefits. The paper conducts a comprehensive exploration of the causes and consequences of this supervision gap, underscoring the urgent need to address it and its implications for the mental health of Native American communities. The urgency of addressing this supervision gap is paramount, as it directly impacts the mental health and wellness of Native American communities. Also, it identifies and advocates for best practices in supervising peer support workers, explicitly focusing on Native American individuals and communities. In this vein, it raises awareness for more culturally sensitive, effective, and impactful peer support programs for Native American communities. The main objective is to improve Native communities' mental health and wellness by harnessing the power of peer support and ensuring its effective implementation through adequate supervision.

Self-efficacy of physical education teachers: how does it contribute to achieving the overarching objectives of national sport?

Self-efficacy is the conviction that one can perform the tasks required to accomplish specific goals. Teachers' self-efficacy is crucial in the physical education environment to promote active engagement in achieving the objectives of the Great Design of National Sport (DBON). This study aims to examine physical education teachers' self-efficacy and how it affects their participation in DBON implementation. The research method used was a descriptive survey with a quantitative approach. The research sample consisted of 40 physical education teachers in Cilacap district at the elementary school level selected by random sampling. Data were collected through questionnaires measuring the level of self-efficacy and teachers' participation in DBON programs. Data were analyzed using descriptive and inferential statistical techniques. This study revealed that the average self-efficacy of sports teachers in contributing to achieving the goals of the National Sports Grand Design (DBON) related to increasing sports culture in the community was 90.78%. In addition, the average self-efficacy of sports teachers in terms of capacity, synergy, and productivity of national achievement sports is 88.12%. The average self-efficacy of sports teachers related to improving the sports-based economy is 87.08%. These results indicate that the level of self-efficacy of physical education teachers is in the moderate to high category. There is a significant positive correlation between teachers' self-efficacy and their level of participation in DBON activities, where teachers with high self-efficacy are more likely to be actively involved in sports development programs in schools and communities. The conclusion of this study is that increasing physical education teachers' self-efficacy can significantly contribute to the successful implementation of the National Sport Grand Design. Recommendations include training and workshops to improve teachers' self-efficacy as well as support from the school and government to facilitate teachers' active participation in DBON programs. Keywords: Self-efficacy, Physical Education, Teachers, National Sport Grand Design

Care in the Community: A COVID-19 initiative to reduce hospital re-presentations among community-dwelling people.

The COVID-19 pandemic has had a substantial impact on the utilisation of hospital and emergency department (ED) services. We examined the effect of a rapid response service on hospital re-presentations among people discharged from the ED and short-stay wards at a tertiary referral hospital. This retrospective cohort study compared 112 patients who completed the Care in the Community program with 112 randomly selected controls. Both cases and controls were discharged from hospital between September 2020 and June 2021. Intervention patients were evaluated by a multidisciplinary team, who implemented a goal-directed program of up to 4-weeks duration. Logistic regression, negative binomial regression and Cox proportional hazards regression were used to evaluate outcomes at 28 days and at 6 months. The median time between referral and the first home visit was 3.9 days. In adjusted analyses, the intervention reduced hospital re-presentations at 28 days (odds ratio: .40, 95% confidence interval (CI): .17-.94) and lengthened the time to the first hospital re-presentation (hazard ratio: .59, 95% CI: .38-.92). Although the intervention did not reduce the total number of hospital re-presentations at 6 months (adjusted incidence rate ratio: .73, 95% CI: .49-1.08), it reduced total time spent in hospital by 303 days (582 vs. 885). This study is among the first to investigate the effect of a community-based intervention on hospital re-presentations during the COVID-19 pandemic. It provides evidence that a sustainable 4-week intervention is associated with reduced hospital re-presentations and time spent in hospital.

학습공동체 프로그램 참여가 대학생들의 학업적 자기효능감, 회복탄력성, 대학몰입, 학업 성취도에 미치는 영향

Objectives This study investigated the effects of university students’ participation in learning communities as extracurricular programs on their academic self-efficacy, resilience, institutional commitment, and academic achievement. Methods A total of 72 undergraduate students attending a 4-year university in Korea participated in the study. They all have participated in learning community programs for one semester and were tested for their academic self-efficacy, resilience, institutional commitment, and academic achievement before and after their learning community experiences. Pre- and post-test data for these dependent variables were analyzed using SPSS 28.0 through paired sample t-tests. Results The analysis found that the participating students’ overall academic self-efficacy and all of its three sub-factors showed a statistically significant increase. Similarly, the resilience area also showed a significant increase in pre-post comparison, and significant increases were confirmed in the control and sociability sub-factors. The participating students’ level of university engagement in total and in two of the three sub-factors showed a significant increase. No significant difference was found in academic achievement between pre-test and post-test results. Conclusions The results of this study confirm that learning community programs in universities can have a positive impact on important areas for university students such as academic self-efficacy, resilience, and university engagement. This suggests that various learning community programs be facilitated in many universities to promote improvement in these areas.

The Role of Virtue Ethics in Modern Moral Dilemmas

Purpose: The study sought to investigate how virtue ethics can be applied to contemporary ethical issues and comparing its implementation across different cultural contexts. Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library. Findings: The findings reveal that there exists a contextual and methodological gap relating to the role of virtue ethics in modern moral dilemmas. Preliminary empirical review revealed that virtue ethics provided a robust framework for addressing modern moral dilemmas by focusing on the development of moral character and the habitual practice of virtues like honesty, courage, and compassion. It emphasized that virtues guide not only actions but also motivations, enabling consistent ethical behavior. The study highlighted the importance of community and social context in nurturing virtues, suggesting that supportive environments are crucial for ethical decision-making in various settings, such as healthcare and corporate governance. Ultimately, virtue ethics was found to promote ethical resilience and adaptability, making it a valuable approach for resolving contemporary ethical challenges and fostering a more just and sustainable world. Unique Contribution to Theory, Practice and Policy: Aristotle's Virtue Ethics, Alasdair MacIntyre's Neo-Aristotelian Virtue Ethics and Philippa Foot's Natural Goodness may be used to anchor future studies on virtue ethics and modern moral dilemmas. The study recommended expanding the theoretical foundations of virtue ethics to include contemporary issues, integrating virtue ethics into professional and personal domains, and incorporating it into public policy frameworks. It emphasized the need for educational institutions to promote character development and suggested community programs to nurture virtues. Additionally, the study highlighted the importance of continuous research and interdisciplinary dialogue to keep virtue ethics relevant in addressing modern moral dilemmas. These recommendations aimed to enhance theoretical insights, improve practical applications, and create policies that foster an ethically conscious society.

Survey of Pesticide Use between Mango Farmers Practicing Area-Wide Integrated Pest Management and Conventional Farming in West Java, Indonesia

Mango farmers in Indonesia rely heavily on pesticides to control a variety of pests and diseases, with tephritid fruit flies being a major pest of the crop. To reduce pesticide use, Area-Wide Integrated Pest Management (AW-IPM) to control fruit flies was trialed and introduced in 2015 and has now been successfully implemented in several districts in West Java, Indonesia. This study surveyed pesticide use in mango farms adopting AW-IPM and those practicing conventional pest control methods. Purposive and Snowball sampling methods were used to select and interview 83 mango farmers to assess farmers knowledge and practices of pesticide use between the two groups. The farmers surveyed consisted of those that have adopted AW-IPM of fruit flies and conventional farmers, meaning those that did not adopt AW-IPM. The results of the survey revealed that compared to conventional farmers, the AW-IPM farmers had a high level of knowledge of pesticides and most of them were aware of pesticide-related environmental risks and adopted better and safer practices. Overall, storage of pesticides within living areas was reported by 10% of respondents, and most respondents (75%) adopted unsafe practices when disposing of used pesticide containers, such as selling them to plastic waste collectors. Half of all the respondents reported and experienced at least one symptom of a pesticide-related health problems. This study contributes to a better understanding of potential pesticide exposure and risks to mango farmers in Indonesia. A pesticide management training program for the mango farming community is badly needed.

Community-engaged flood mitigation and ecological restoration on a university campus

Abstract Urban flooding is a major climate change risk that can be mitigated with green infrastructure such as tree plantings and restored naturalised buffers along watercourses. The creation and maintenance of green infrastructure projects for climate change adaptation provides opportunities for community partnerships and programming with co-benefits for human well-being and biodiversity. Here we present findings of action research on a flooding adaptation and education that was implemented on an urban higher education institution’s campus in partnerships within the university and with local Indigenous peoples, the regional conservation authority, the municipal government, and the public library. Through participatory workshops, we applied bioengineering and mixed planting methods to restore a creek bank. Using a combination of oral storytelling, digital media, and visual art that integrated perspectives across disciplines and knowledge systems, we situated our creek restoration project within a framework of environmental justice, emphasising specific acts of stewardship to improve watershed health and advance reconciliation. We produced digital resources and outreach materials to disseminate lessons from the project into the community and to support similar flooding adaptation efforts at local and global scales. Our project demonstrates how incorporating partnerships into the design and implementation of nature-based solutions can build cross-cultural ecological knowledge, forge important on and off-campus relationships, and create place-based opportunities for students to take direct and measurable action on climate change.

Implementing Policy and Practice Changes to Support Breastfeeding Duration in New York State Communities.

The health benefits of breastfeeding are well-documented, but rates of breastfeeding duration in the US fall below national targets - especially when mothers have less education, have lower incomes, are non-Hispanic Black, or live in nonmetropolitan areas. The Creating Breastfeeding Friendly Communities program was designed to promote breastfeeding and reduce disparities by implementing policy and practice changes in worksites from 2017 through 2023. The purpose of this evaluation was to determine whether the program was effective in increasing breastfeeding supports and addressing disparities. We used a 14-item tool to assess breastfeeding policies and practices at baseline and follow-up at each worksite. We used number of employees to determine worksite size, and we used worksite address to calculate social vulnerability of the community where each site was located and to classify rurality of the county where sites were located. We found significant improvements in the number and quality of breastfeeding supports available at participating worksites (N = 292 at baseline and follow-up). The program successfully reached worksites in socially vulnerable communities. Supports for breastfeeding increased in all worksite subgroups, but they increased less at worksites that were small or rural. The evaluation supports the effectiveness of worksite lactation programs and protective labor laws. Findings suggest that special attention must be given to worksites that are small, located in socially vulnerable communities, or rural counties, to support implementation and reduce disparities.

Latine immigrant youths’ attitudes toward mental health and mental health services and the role of culturally-responsive programming

Latine immigrant youth, in general, report logistical barriers that contribute to utilizing fewer healthcare services and not knowing how to navigate the healthcare system. In addition to underutilizing healthcare services, Latine immigrant youth also report higher levels of negative attitudes toward mental health when compared to non-Latine immigrant youth. However, little is still known regarding factors that impact these attitudes toward Latine immigrant youth, as well as the community support efforts that are available to this specific group. Using a semi-structured interview with 12 Latine immigrant youth, this study explored (1) the attitudes towards mental health, (2) attitudes towards mental health services, (3) and the experiences of participating in a local community-based program for Latine immigrant youth. Results found that most participants held positive attitudes toward mental health, and all participants described positive attitudes toward mental health services. In addition, all participants reported having positive experiences with a culturally sensitive youth program that promotes psychological well-being while integrating into the United States. They noted that it had benefited them socially, culturally, and psychologically. Given the rise of Latine immigrant youth in the U.S. and the stigma surrounding mental health attitudes, it is crucial to continue to explore this area to serve Latine immigrant youth better and connect them to the mental health services they may need. Also, it is important to have community programs, such as this one, that support and meet Latine immigrant youth’s needs.