Search

The 3Es – Environment, Experience, and Education – each contribute to women's participation in weightlifting. When in alignment with a woman's unique goals and abilities, they can increase confidence and enjoyment. Fitness professionals working independently or within an organization can refer to the 3Es as reminders of how to empower more women to not only begin lifting weights, but also to be more confident within fitness settings. Learn more in this important feature. Apply It!: After reading this article, the reader should be able to: • Recognize how fitness environments and experiences with fitness professionals may contribute to women's perceived barriers to weightlifting. • Understand commonly reported barriers to weightlifting among women. • Apply the 3E framework in practice to decrease women's reported barriers to weightlifting. [ABSTRACT FROM AUTHOR]

Purpose/objectives: Little is understood about dental student perspectives providing care to people with serious mental illness (SMI), a population with significant oral health disparities. This study explored student perceptions, questions and beliefs about people with SMI using the Social Ecological Model as a framework to better understand perspectives and identify potential educational needs in dental medicine curricula for providing care to this population. Methods: Survey data was collected in spring of 2021 from predoctoral dental students (n = 126) enrolled in a required course at a mid‐Atlantic university. Ninety‐nine percent of the students completed the survey. The IRB approved qualitative study examined student responses to a six question survey using content analysis. An iterative coding process was used and included reflexivity memos, data dictionaries and consensus building among the four coding researchers to identify recurring concepts and ultimately identify themes. Results: Four primary themes were identified: Concerns and Stereotypes; Uncertainties; Professional Role and Responsibilities; and Learning Preferences. Participants expressed fear and discomfort in working with people with SMI. They also noted multiple questions about providing clinical care, referrals and the interaction of oral health and mental health. Lastly, they offered ideas about educational strategies to improve learning on the topic. Conclusion(s): Pre‐doctoral dental students have concerns about providing care to people with SMI and limited understanding of dental professional role and responsibilities about care for this vulnerable population. Predoctoral dental curriculum should be expanded to address professional roles when working with this population to improve student competency and comfort, and ultimately improve care to people with SMI. [ABSTRACT FROM AUTHOR]

Background: Implicit bias permeates beliefs and actions both personally and professionally and results in negative health outcomes for people of color—even in the neonatal intensive care unit (NICU). NICU clinicians may naïvely and incorrectly assume that NICU families receive unbiased care. Existing evidence establishing associations between sex, race, and neonatal outcomes may perpetuate the tendency to deny racial bias in NICU practice. Evidence Acquisition: Using the socioecological model as a framework, this article outlines evidence for racial health disparities in the NICU on multiple levels—societal, community, institutional, interpersonal, and individual. Using current evidence and recommendations from the National Association of Neonatal Nurses Position Statement on "Racial Bias in the NICU," appropriate interventions and equitable responses of the NICU clinician are explored. Results: Based on current evidence, clinicians should reject the notion that the social construct of race is the root cause for certain neonatal morbidities. Instead, clinicians should focus on the confluence of medical and social factors contributing to each individual infant's progress. This critical distinction is not only important for clinicians employing life-saving interventions, but also for those who provide routine care, developmental care, and family education—as these biases can and do shape clinical interactions. Implications for Practice and Research: Healthcare practitioners have an ethical and moral responsibility to maintain up-to-date knowledge of new evidence that impacts our clinical practice. The evidence demonstrates the importance of recognizing the enduring role of racism in the health and well-being of people of color and the need to adjust care accordingly. [ABSTRACT FROM AUTHOR]

The purpose of this article is to explore factors that influence pediatric patients and their parents during provider-led goals-of-care conversations. Our framework can help providers enhance holistic communication by approaching difficult topics (ie, quality of life, end of life) with an understanding of the multilayered external influences that affect patient/parent decision making. A 5-layer model is presented that describes facilitators to conversations about quality goals of care and advance directives. Each year, complex health conditions (a) affect approximately 500 000 children in the United States, 8600 of whom meet current palliative care criteria, and (b) account for over 7 million child deaths globally. Nurses can use knowledge of the unique values and culture of families with children who have complex health conditions to support them by providing high quality, ongoing goals-of-care conversations, especially if their access to pediatric palliative care is limited. [ABSTRACT FROM AUTHOR]

Rural women and their babies experience poorer perinatal outcomes than their urban counterparts and this inequity has existed for decades. This study explored the barriers and enablers that exist for rural women in Australia in accessing perinatal care. A qualitative descriptive design, using reflexive thematic analysis, was employed. Semi-structured interviews were conducted in 2023 with women who had recently given birth in rural Victoria, Australia (n=19). A purposive sampling strategy was used, recruiting women via social media platforms from rural communities across the state. The Socioecological Model (SEM) was used as a framework to organise the findings. Study participants reported multilevel barriers and enablers to accessing perinatal care in their own communities. Intrapersonal factors included financial resources, transportation, self-advocacy, health literacy, rural stoicism, personal agency, and cost of care. Interpersonal factors included factors such as ineffective relationships, poor communication, and care provider accessibility. Organisational factors included inequitable distribution of services, under-resourcing of perinatal services in rural areas, technology-enabled care models and access to continuity of care. Community factors included effective or ineffective interprofessional or interorganisational collaboration. Policy factors included centralisation of perinatal care, lack of funded homebirth and midwifery care pathways and access to free perinatal care. Participants in this study articulated several key barriers influencing access to perinatal care in rural areas. These factors impede help-seeking behaviour and engagement with care providers, compounding the impact of rurality and isolation on perinatal outcomes and experience of care. Key enablers to accessing perinatal care in rural communities were also identified and included personal agency, health literacy, social capital, effective collaboration and communication between clinicians and services, technology enabled care and free perinatal care. [ABSTRACT FROM AUTHOR]

Purpose The purpose of the study was to examine mean differences between intrapersonal and institutional variables and the overall perception of radiation safety (OPRS) among U.S. radiologic technologists. The study also sought to demonstrate the applicability of the socioecological model for radiation safety decision-making. Methods A quantitative, cross-sectional design with the Radiation Actions and Dimensions of Radiation Safety survey instrument was used to collect data and guide hypotheses testing. The 425 research participants included radiologic technologists working in radiography, mammography, computed tomography, and radiology management. Categorical and descriptive data were calculated, and 1-way analysis of variance tests were used to analyze hypotheses. Results Seven main effects demonstrated mean differences between groups for the OPRS, including age (F5,419 = 2.55, P = .03), years of experience (F5,419 = 4. 27, P = .001), primary employed imaging modality (F2,422 = 9.04, P = .001), primary role (F2,422 = 4.58, P = .01), shift length (F3,421 = 10.33, P = .001), primary practice facility (F4,404 = 5.00, P = .001), and work shift (F3,405 = 4.14, P = .007), with shift length having the largest effect. Level of education, employment status, number of imaging credentials, gender, patient population, and practice location were not significant at the level of P = .05. Discussion Radiation safety culture is a multidimensional topic that requires consideration of several intervening influences, making the socioecological model well aligned when considering radiation safety culture and radiation safety perception in medical imaging. Previous research on radiation safety perception among radiologic technologists demonstrated that leadership actions, teamwork across imaging stakeholders, organizational learning, and questioning behavior are drivers of OPRS. However, this study's findings demonstrate that radiologic technologist scheduling practices and primary employed imaging modalities also should be considered when seeking to improve OPRS. Conclusion This study presents an extensive examination of intrapersonal and institutional variables on OPRS among U.S.-based radiologic technologists and provides findings to support radiation safety culture decision-making in medical imaging, particularly for shift length considerations. [ABSTRACT FROM AUTHOR]

Using a socioecological model as a theoretical framework, we aimed to explore the barriers to retain in competitive sport 463 senior athletes (aged 61.4 ± 5.5 years) actively engaged in sports disciplines from 4 European countries. Participants answered an open-ended question regarding perceived barriers to continued engagement in sports, and their answers were subject to content analysis. The results highlighted physical determinants as the main reasons for potential disengagement from competitive sports. Our data suggest the need to minimize these potential barriers by implementing programs that are designed to keep senior athletes competing in sports for as long as possible. [ABSTRACT FROM AUTHOR]

The United States benefits economically and socially from the diverse skill-set and innovative contributions of immigrants. By applying a socioecological framework with an equity lens, we aim to provide an overview of the health of children in immigrant families (CIF) in the United States, identify gaps in related research, and suggest future areas of focus to advance health equity. The literature review consisted of identifying academic and gray literature using a MeSH Database, Clinical Queries, and relevant keywords in 3 electronic databases (PubMed, Web of Science, and BrowZine). Search terms were selected with goals of: 1) conceptualizing a model of key drivers of health for CIF; 2) describing and classifying key drivers of health for CIF; and 3) identifying knowledge gaps. The initial search produced 1120 results which were screened for relevance using a meta-narrative approach. Of these, 224 papers were selected, categorized by topic, and reviewed in collaboration with the authors. Key topic areas included patient and family outcomes, institutional and community environments, the impact of public policy, and opportunities for research. Key inequities were identified in health outcomes; access to quality health care, housing, education, employment opportunities; immigration policies; and inclusion in and funding for research. Important resiliency factors for CIF included strong family connections and social networks. Broad structural inequities contribute to poor health outcomes among immigrant families. While resiliency factors exist, research on the impact of certain important drivers of health, such as structural and cultural racism, is missing regarding this population. More work is needed to inform the development and optimization of programs and policies aimed at improving outcomes for CIF. However, research should incorporate expertise from within immigrant communities. Finally, interventions to improve outcomes for CIF should be considered in the context of the socioecological model which informs the upstream and downstream drivers of health outcomes. [ABSTRACT FROM AUTHOR]

Black women experience disparities in HIV incidence. Pre-exposure prophylaxis (PrEP) is a once-daily pill that can prevent HIV transmission. To enhance PrEP uptake among Black women, it is essential to examine their perceptions of PrEP. In 2018, 33 Black women in New York City completed interviews about their attitudes, knowledge, and perceived barriers and facilitators to PrEP use. Emergent themes were organized using a socioecological model. Participants identified barriers at the sociocultural level, including stigma, medical mistrust, and health care avoidance. At the community level, health care access issues and limited community knowledge were reported. Partner-level barriers included trust in partners and meaning attributed to PrEP use within the context of monogamy. Individual-level barriers included lowperceived risk and concerns aboutPrEP's safety and efficacy. Our findings can inform future PrEP research with Black women, as well as PrEP implementation efforts aimed at increasing uptake among this population. [ABSTRACT FROM AUTHOR]

The socio-ecological model (SEM) is a widely used framework that can be applied to heat-related illness (HRI) in the context of multiple influencing factors that exist in society. Leaders and policymakers must intervene to mitigate the deleterious effects of climate change on those at risk. The purpose is to introduce the SEM as a framework to address the complex factors contributing to the impact of excess heat. Conceived through the SEM, the compounding and cumulative impact of excess heat resulting in HRI is operationalized. The SEM provides a structure for understanding the complex nature of climate change and HRI and proposed interventions. The prevention of HRI is dependent on actions, related to practice, education, research, and advocacy across multiple levels of the SEM. The SEM has the potential to target HRI at all levels of society to reduce the harm of excess heat. • The socio-ecological model can be applied to climate change and heat-related illnesses. • The socio-ecological model highlights the cumulative impacts of excess heat. • Heat-related illnesses can be mitigated by intervening at various levels in society. • Clinicians can decrease the harm of excess heat by intervening at all levels. • Addressing impacts at the policy level requires compliance from organizations. [ABSTRACT FROM AUTHOR]

Black women experience disparities in HIV incidence. Pre-exposure prophylaxis (PrEP) is a once-daily pill that can prevent HIV transmission. To enhance PrEP uptake among Black women, it is essential to examine their perceptions of PrEP. In 2018, 33 Black women in New York City completed interviews about their attitudes, knowledge, and perceived barriers and facilitators to PrEP use. Emergent themes were organized using a socioecological model. Participants identified barriers at the sociocultural level, including stigma, medical mistrust, and health care avoidance. At the community level, health care access issues and limited community knowledge were reported. Partner-level barriers included trust in partners and meaning attributed to PrEP use within the context of monogamy. Individual-level barriers included lowperceived risk and concerns aboutPrEP's safety and efficacy. Our findings can inform future PrEP research with Black women, as well as PrEP implementation efforts aimed at increasing uptake among this population. [ABSTRACT FROM AUTHOR]

Identifying risk factors of incomplete immunization among children is crucial to developing relevant policies to improve immunization coverage. In this study, we investigated factors associated with incomplete immunization among children in Indonesia and elucidated differences in risk factors between urban and rural areas. The data came from a national-wide survey, the 2017 Indonesia Demographic Health Surveys. In total, 3264 children aged 12–23 months were included in the study. An incomplete immunization status was defined as a child who did not complete the ten doses of basic vaccinations, consisting of one dose of bacille Calmette-Guérin, one dose of hepatitis B, three doses of pentavalent vaccine (diphtheria, pertussis, tetanus, hemophilus influenza type B, and hepatitis B vaccine), four doses of polio vaccine, and one dose of measles vaccine. Generalized linear mixed models were constructed to examine the effects of different levels of risk factors on the incomplete immunization status. We further conducted stratified analyses by urban and rural areas. About 40% of the 3264 children were incompletely immunized, among whom 45.3% were in urban areas and 54.7% were in rural areas. Eight of the 34 provinces had incomplete immunization rates exceeding 50%, and the Papua and Maluku regions had the highest rates of incomplete child immunization. The multivariate analyses showed that when women attended fewer than four antenatal care sessions and resided outside the Nusa Tenggara region, their children were more likely to have incomplete immunization in both urban and rural areas. On the other hand, having no health insurance was positively associated with incomplete immunization in urban areas, whereas having received a tetanus vaccination during pregnancy was negatively associated with incomplete immunization in rural areas. Results of this study suggest that tailored interventions should be developed to address significant risk factors in rural and urban areas. [ABSTRACT FROM AUTHOR]

Patients with diabetes regularly carry out multiple disease-management behaviors--taking prescribed medications, following diet and exercise regimens, self-monitoring their blood glucose concentrations, and coping emotionally with the condition--that may require ongoing support from community and clinical resources. Diabetes self-management education (DSME) is an ongoing, patient-centered process that helps provide the knowledge, skills, and ability for self-care. Evidence suggests that DSME is most effective when reinforced by community resources, through what are called community-clinical resources. We conducted a series of qualitative key-informant interviews with DSME coordinators/managers from all counties in Hawai'i to document the landscape of DSME services in the state, focusing specifically on challenges and recommendations. We analysed the results using the socioecological model in order to chart these factors by levels of influence on health care providers, in terms of service provision, and on patients, in terms of DSME utilization. Many interviewees highlighted concerns about low utilization of DSME services, as well as practical implementation challenges (eg, group versus 1-on-1 sessions). Nonetheless, DSME coordinators/managers offered numerous recommendations to improve DSME across Hawai'i, highlighting opportunities for improved community-clinical linkages. Finally, emergent from the interviews were anxieties about increasing numbers of youth with diabetes and insufficient resources for them in DSME or other community-clinical resources. This paper offers suggestions to expand community-clinical linkages and to adapt services provided by DSME to meet patient and community needs. It is particularly timely as Hawai'i is rapidly increasing the number and diversity of DSME programs available. [ABSTRACT FROM AUTHOR]

Informed by a socioecological framework, this qualitative study contributes to the fields of allied health and aging by identifying the factors that influence older women's participation in competitive softball. Focus groups were conducted with 6 teams of women (N = 64) ranging in age from 55 to 79 years. Data were audio-recorded, transcribed verbatim, and analyzed thematically. Results revealed issues of recruitment, access to resources, and breaking age-related cultural stereotypes. Knowledge from this study can offer insight into how allied health professionals might mitigate these issues to promote competitive sports alternatives for future cohorts of aging women. [ABSTRACT FROM AUTHOR]

Objectives: Identify perceived barriers to leisure-time physical activity during pregnancy to inform future interventions aimed at improving physical activity levels in pregnancy.Design: PubMed/Medline and Web of Science databases were systematically searched using a reference period between 1986 and January/2016.Methods: A comprehensive search strategy was developed combining the following keywords: (barriers OR constraints OR perceptions OR attitudes) AND (physical activity OR exercise OR motor activity) AND (pregnancy OR pregnant women OR antenatal OR prenatal). Thematic synthesis was conducted to analyze the data. A socioecological model was used to categorize the reported barriers.Results: Twelve quantitative studies and 14 qualitative studies were included. Barriers belonging to the intrapersonal level of the socioecological model were the most reported in the studies and were categorized in five themes as follows: (1) Pregnancy-related symptoms and limitations; (2) Time constraints; (3) Perceptions of already being active, (4) Lack of motivation and (5) Mother-child safety concerns. At the interpersonal level, barriers were coded into two descriptive themes: (1) Lack of advice and information and (2) Lack of social support. Two other themes were used to summarize Environmental, Organizational and Policy barriers: (1) Adverse weather and (2) Lack of resources.Conclusions: A range of relevant barriers to leisure-time physical-activity engagement during pregnancy were identified in this literature review. Pregnancy-related symptoms and limitations barriers were the most reported in studies, regardless of study design. Mother-child safety concerns, lack of advice/information and lack of social support were also important emphasized pregnancy-related barriers to be targeted in future interventions. [ABSTRACT FROM AUTHOR]

In this study we explore the relationship between the benefits of greenspace and fear of crime in New Zealand neighbourhoods. To ensure that the full benefits of investment in greenspace are realised, it is important to understand the complex interactions that occur within natural environments and the effect of these interactions on individual wellbeing within different populations (in this case New Zealand). Employing an ordered logit model, this study uses data on self-reported life satisfaction, fear of crime and access to greenspace from the New Zealand General Social Survey. In line with existing evidence, results suggest that greater access to greenspace is associated with higher levels of life satisfaction. The strength of this association, however, is strongly dependent on fear of crime. That is, when residents report that they feel ‘unsafe’ or ‘very unsafe’ in their neighbourhood, the psychological benefits of access to greenspace disappear almost entirely. This relationship is conditioned further by age and gender, with residents between 50 and 59 years of age and males being less likely to report being very satisfied with their lives. Given the considerable level of public investment in providing and maintaining greenspace, there is a clear need to address fear of crime in the neighbourhood in order to ensure that the full benefits of policies directed at promoting the use of neighbourhood greenspace for health and well-being can be realised. [ABSTRACT FROM AUTHOR]

Abstract: Increasing the use of urban green space has appeared on the political agenda, primarily because increased use is expected to improve the health and well-being of the urban population. Green space is contributing to restoring mental fatigue, serving as a resource for physical activity, reducing mortality and reducing the level of stress. However, knowledge and experience on how to implement this agenda are scarce. In this paper, we use a socio-ecological model as framework when studying influences on the use of respondents’ nearest urban green space in the Danish city of Odense. Data were obtained from a survey sent to 2500 randomly selected adult residents within the central part of the city. We tested the relative importance of different factors on the frequency of use of the nearest urban green space by using a multivariate logistic regression model. The results show that almost half of the respondents did not use their nearest green space the most. Whether or not respondent used their nearest green space most depends primarily on area size, distance to the area and factors that are likely to express a reduced mobility; old age, young children and poor health. If the nearest urban green space also is the most used green space, having a dog is the only factor that significantly increases the frequency of use. Further research is needed to determine what it is that makes people use an area more, if the basic conditions of a reasonable size (>5ha) within a reasonable distance (<600m) are fulfilled. [Copyright &y& Elsevier]