Search

A family-skills program for Latino fathers and youth was implemented to prevent youth obesity. Lessons learned focused on practices to address barriers to engagement and retention among fathers and youth within the Latino community. Program development issues included selection of organizations, facilitators, language, and delivery methods. Implementation issues included timing and location. Cultural issues regarding learner needs, and teaching and implementation methods need to be considered. Using the lessons learned, Extension professionals can create impactful programs that engage and retain Latino fathers and youth.

Utilizing Yosso's community cultural wealth framework as a theoretical lens, we sought to examine how nontraditional, community-based family engagement programs impacted adult family members' thoughts and actions about engagement with their children's schools. The study drew primarily from the interviews, observations, and document analysis of two nontraditional family engagement programs in urban communities. Findings indicate that program approaches built upon and extended families' social and navigational capitals. Educational leaders can more meaningfully engage urban families by learning from and incorporating practices implemented by the programs we examine and discuss in this article.

Utilizing Yosso's community cultural wealth framework as a theoretical lens, we sought to examine how nontraditional, community-based family engagement programs impacted adult family members' thoughts and actions about engagement with their children's schools. The study drew primarily from the interviews, observations, and document analysis of two nontraditional family engagement programs in urban communities. Findings indicate that program approaches built upon and extended families' social and navigational capitals. Educational leaders can more meaningfully engage urban families by learning from and incorporating practices implemented by the programs we examine and discuss in this article. [ABSTRACT FROM AUTHOR]

Contextual and social realities must be built into any educational program for activism to take place. This case study examines an education and environment program which has adapted to the social distancing measures of COVID-19, resulting in an even more community-reliant and community-driven program than the program designers initially intended. The Eco Ambassador Program uses environmental activism within a space that supports mental health during COVID-19 social isolation. While community engagement and action have been elements of the program, the program has transformed to utilize new levels of social capital in the program's network, to overcome the obstacles presented in regular programming. Many aspects of the critical pedagogy of space are utilized to conceptualize this educational program during the pandemic. The limitations of in-person interactions in defined learning spaces led to more technology-reliant programming, hence broadening the space of place-based learning, while enabling personal spaces and personal environments to become new learning spaces.

While the gold standard for intervention science is the randomized controlled trial (RCT), there is growing emphasis on the practical implementation and evaluation of evidence-based programs into community agencies. Assessment of program efficacy by community-based organizations can confirm planned delivery of services, implementation fidelity, and demonstrate positive outcomes, which can provide justification for funding. Methods and measures used in an RCT, however, often cannot be implemented in non-research settings and different approaches are needed. This manuscript reviews the emerging literature on program evaluation work and draws upon the authors' experiences conducting evaluations with three community-based organizations funded by Administration for Community Living to implement programs for individuals with dementia and their family care partners. This manuscript argues for an examination of the expectations of evaluation efforts for translation of research-based trials to practice and emphasizes three main strategies for assessment: (1) Development of brief tailored assessments; (2) Measuring fidelity of implementation of the program; and (3) Measuring acceptability of the program to clients., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Adolescent aggressive behavior has increasingly become a central issue affecting the safety of both school campuses and the broader society. Despite the existence of numerous community interventions targeting this issue, there has been a paucity of efforts to consolidate the findings on the effectiveness of community-based programs in preventing aggressive behavior. This meta-analysis sought to address this gap by reviewing and assessing the impact of community-based initiatives on reducing adolescent aggression. A thorough search was carried out on 12 electronic databases: EBSCO, ERIC, PubMed, PsycINFO, MEDLINE, EMBASE, Scopus, Web of Science, ProQuest Dissertations and Theses, the China National Knowledge, Wanfang Databases, and China Science and Technology Journal Database. Sixteen studies were finalized, and meta-analyses were performed using a random effect model on RevMan v5.4 software developed by Cochrane. The analysis encompassed 16 published studies, involving a total of 2,585 participants. The key components of existing programs for aggression reduction included providing behavioral skills and training for adolescents, employing a problem-solving approach to address behavioral issues, offering psychological treatment, and emphasizing community supervision. The results indicate a significant positive effect of community-based interventions on aggression reduction (standardized mean difference = -0.26, 95% confidence intervals [-0.39, -0.13], Z  = 3.84, p  < .001). The subgroup analyses revealed that the intervention's effectiveness was moderated by the duration of the intervention, its theoretical foundation, and the sample size. This study furnishes empirical evidence supporting the enhancement of policies and practices to foster community engagement in mitigating aggressive behavior., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

BackgroundLow-and middle-income countries mostly have ageing populations with many unmet economic, social, or health-related needs, Vietnam being an example. Community-based support in Vietnam, organized as Intergenerational Self-Help Clubs (ISHCs) based on the Older People Associations (OPA) model, can help to meet these needs by the provision of services for various aspects of life. This study aims to assess the implementation of the ISHCs and whether successful implementation is associated with more member-reported positive health.MethodsWe used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the implementation using multiple data sources: ISHC board surveys (n = 97), ISHC member surveys (n = 5,080 in 2019 and n = 5,555 in 2020), focus group discussions (6; n = 44), and interviews with members and board leaders (n = 4).ResultsReach ranged between 46 and 83% of ISHCs reaching target groups, with a majority of women and older people participating. Regarding Effectiveness, members indicated high satisfaction with the ISHCs. Adoption scores were high, with 74%–99% for healthcare and community support activities, and in 2019, higher adoption scores were associated with more members reporting good positive health. In 2020, reported positive health slightly decreased, probably due to the influence of the COVID-19 pandemic. A total of 61 ISHCs had consistent or improving Implementation from 2019 to 2020, and confidence in Maintenance was high.ConclusionThe implementation of the OPA model in Vietnam is promising regarding its promotion of health and may help to tackle the needs of an ageing population. This study further shows that the RE-AIM framework helps to assess community health promotion approaches.

This forum paper dialogues with Crystal Morton and Demetrice Smith-Mutegi's "Making it matter: Developing African American girls and young women's mathematics and science identities through informal STEM learning." Their article unveils the experiences of participants in Girls STEM Institute, and how they challenged beliefs about their ability to perform in science and mathematics. I extend the discussion to explore the importance of access through community-based initiatives and stand on the premise that we will continue to oxygenate master narratives and perpetuate inequities if the structure and function of our programs fail to challenge the status quo. Therefore, this paper serves as a call to action to: (1) recognize and address spirit murdering from teachers and authority figures who dismiss the abilities of Black girls to perform in STEM; (2) create humanizing spaces within schools and the larger community for Black girls to access STEM with authenticity; and (3) leverage the multidimensional identities of Black girls in ways that validate their cultural resources and brilliance. When we commit ourselves to creating more equitable learning spaces in STEM, then our actions will align with our responsibility to make Black girls matter. [For "Making It Matter: Developing African-American Girls and Young Women's Mathematics and Science Identities through Informal STEM Learning," see EJ1332932.]

This study, centered around a survey of library directors (N = 83), examines community health programming (CHP) in Michigan's public libraries within the broader context of national CHP initiatives. Reponses indicate that while physical activity classes and food skills programs are popular, there are still challenges to overcome. These findings led us to recommendations for cultivating partnerships that can help CHP grow and flourish. [ABSTRACT FROM AUTHOR]

BackgroundApproximately 14% of all adolescents globally cope with mental health conditions. However, community-based psychosocial services for adolescents with mental health conditions are scarce and under-researched. Scant scholarly attention has been paid to leisure and/or social activities in community-based rehabilitation services for adolescents with mental health conditions.ObjectivesTo begin to fill this gap, we chose a bottom-up framework to probe the following questions: Which community-based programs for adolescents with mental health conditions exist worldwide? What common characteristics do they present? What is their range of services?MethodWe systematically searched three leading academic databases, reference lists, and worldwide websites in English.Eligibility criteriaPrograms with information in English that provide services in a community setting, service content that includes leisure and/or social activities, cater to users aged 10–18, and content explicitly targets adolescents with mental health conditions.ResultsTwenty-seven psychosocial programs that provide leisure and/or social activities and encourage the promotion of adolescent mental health in the community were identified. We mapped and categorized the programs into three groups: integrated recovery, leisure recovery, and advocacy recovery.ConclusionPractical implications for implementation are suggested based on the findings. Specifically, service providers should attend to the psychological needs of adolescents by prioritizing peer interaction and offering suitable social and leisure activities. These activities can also boost adolescent participation in community-based rehabilitation programs and address the treatment gap. Comprehensive studies and uniform terminology in the field are needed.

A family-skills program for Latino fathers and youth was implemented to prevent youth obesity. Lessons learned focused on practices to address barriers to engagement and retention among fathers and youth within the Latino community. Program development issues included selection of organizations, facilitators, language, and delivery methods. Implementation issues included timing and location. Cultural issues regarding learner needs, and teaching and implementation methods need to be considered. Using the lessons learned, Extension professionals can create impactful programs that engage and retain Latino fathers and youth. [ABSTRACT FROM AUTHOR]

Community-based educational programs coordinated and run by local residents, Inuit organizations, and nonprofit organizations are periodically offered in communities in Nunavut. This article presents examples of these programs from the communities of Kangiqłiniq (Rankin Inlet) and Igluligaarjuk (Chesterfield Inlet) as well as programs connecting Inuit with belongings in museum collections held outside of Nunavut. The research involved anthropological methods of participant observation, interviews, and ethnographic insights from experiences of organizing and participating in programs. Indigenous research methodologies also guide the research. We elaborate how community-based programs provide opportunities for Inuit knowledge generation and transmission while contributing to well-being and community cohesion. These programs can (re)connect and engage Inuit with knowledge of the land, traditional and contemporary cultural practices, and Inuit belongings that have been disconnected from communities and individuals through colonial processes. [ABSTRACT FROM AUTHOR]

Child- and family-serving programs in community-based settings wield tremendous power for improving the lives of infants and toddlers. In this article, three authors, from Ohio, Montana, and Sierra Leone, describe the principles of adaptive leadership and will share their real-world applications. Their stories explore critical questions for leading communitybased organizations: How do leaders of community-based efforts build leadership among families and other program participants? How do they incorporate equity, diversity, and social justice into both their programs and their process? How do they extend their influence and impact beyond the local? And, perhaps most important, how do they sustain themselves amid competing pressures and priorities?

Background: The current literature supports the effectiveness of exercise, education, and self-management interventions for the long-term management of persistent low back pain. However, there is significant uncertainty about the implementation of interventions related to barriers, facilitators, and patient's preferences. This study will evaluate the Back to Living Well program implementation from a participant and organizational perspective. More specifically we address the following objectives: 1) identify program barriers and facilitators from participants' perspectives, 2) identify factors related to program, personal and contextual factors that contribute to negative and positive outcomes, and outcome trajectories, 3) identify factors influencing participants' selection of an in-person or e-health program, and 4) evaluate program specific barriers and facilitators from the organization and care delivery perspectives. Methods: This study will utilize a mixed-method convergent design including a longitudinal cohort strand and a longitudinal qualitative interview strand. The RE-AIM framework will be used to assess program implementation. Participants (n = 90, 1:1: in person or virtual) who choose to register in the program as well as staff (n = 10 to 15) involved in the delivery of the program will be invited to participate. Participants will participate in a 12-week physical activity, education, and self-management program. Implementation outcomes will be measured at 3-, 6-, 12-months, and six months after the end of the follow-ups. Interview scripts and directed content analysis will be constructed based on the Theoretical Domains Framework and the Neuromatrix Model of Pain, Theoretical Domains Framework. Staff interviews will be constructed and analyzed using the Consolidated Framework for Implementation Research. Participants will also complete pain, disability, quality of life and psychological questionnaires, wear an activity tracker at all time points, and complete weekly pain and activity limitation questions using a mobile application. Discussion: The study results will provide evidence to inform potential future implementation of the program. An effective, appropriately targeted, and well implemented exercise program for the long-term management (i.e., tertiary prevention) of LBP could minimize the burden of the condition on patients, the health care system and society. Trial registration: ClinicalTrials.gov NCT05929846. This (Registration Date: July 3 2023) study has been approved by the Hamilton Integrated Research Ethics Board Project ID#15,354. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a significant risk factor for cardiovascular disease, with a higher prevalence among African Americans (AA) than other racial groups. The impact of community-based interventions on managing blood pressure (BP) in AA communities is not fully understood. The purpose of this review was to synthesize literature on community-based physical activity (PA) programs designed to manage BP in AA populations. Methods: We conducted a scoping review by searching 4 databases (PubMed, CINAHL, MEDLINE, and APA PsycInfo) and reference lists of studies. Search terms included community PA, community-based, hypertension, high BP, AA, Black Americans, PA, and exercise. Inclusion criteria were studies (1) conducted in the United States and (2) published in English language from January 2013 to September 2023, with community-based interventions that included PA for BP management among AA aged ≥18 years. Results: Search results yielded 260 studies, of which 11 met the inclusion criteria. BP decreased over time in studies that incorporated PA, faith-based therapeutic lifestyle changes with nutritional education. The duration of the PA interventions varied, with moderate to vigorous PAs implemented for 12 weeks or longer having a greater impact on BP management. Conclusions: Evidence suggests that community-based PA programs can potentially reduce BP among AA. PA programs incorporating faith-based therapeutic lifestyle change with nutritional education appear to reduce BP. Practitioners should consider multicomponent community-based PA initiatives to improve BP outcomes in AA communities. [ABSTRACT FROM AUTHOR]

Objectives: Human aging is a multidirectional, multidimensional, and multicausal process that reflects biological, psychological, and sociocultural influences, which act in distinct combinations throughout the life-span. Proactivity towards avoiding the usual aging process is needed. This study analyses the long-term effects of participation in Community-Based Programs on psychological well-being. Method: A sample of 150 community-dwelling participants enrolled in Community-Based Programs, aged 55 to 84 years and living in three Portuguese localities were matched by age (55–64, 65–74, 75–84 years), gender, and locality with a comparison group of non-participants. We administered a multidimensional gerontological protocol which included socio-demographic information, measures of health/disease, functional ability, social network, cognitive performance and psychological well-being. Hierarchical regression models were used to test the effects of Community-Based Programs on psychological well-being adjusting for remaining variables. Results: Overall, psychological well-being is positively associated with household income and satisfaction with health. Nevertheless, in participants, psychological well-being builds predominantly upon social network and is not associated with a moderate inability or cognitive deficits, contrasting with psychological well-being in non-participants. After adjusting for background variables, psychological well-being was positively associated with health satisfaction and social network and negatively related to moderate inability. Further, a significant interaction of participation in Community-Based Programs with age, points out higher levels of psychological well-being in participants contrasting with a downward trend in non-participants. After stratification by age, psychological well-being increases with time attending Community-Based Programs in the oldest (75–84 years) contrasting with the remainder. Conclusions: Participation in Community-Based Programs may improve the negative effects of the aging process on psychological well-being. This positive effect as age increases may be linked to a reinforcement of social network, valued more by participants in Community-Based Programs. Furthermore, the programs may act as a healing/maintenance strategy in persons with moderate inability and/or cognitive deficits. [ABSTRACT FROM AUTHOR]

ObjectivesHuman aging is a multidirectional, multidimensional, and multicausal process that reflects biological, psychological, and sociocultural influences, which act in distinct combinations throughout the life-span. Proactivity towards avoiding the usual aging process is needed. This study analyses the long-term effects of participation in Community-Based Programs on psychological well-being.MethodA sample of 150 community-dwelling participants enrolled in Community-Based Programs, aged 55 to 84 years and living in three Portuguese localities were matched by age (55-64, 65-74, 75-84 years), gender, and locality with a comparison group of non-participants. We administered a multidimensional gerontological protocol which included socio-demographic information, measures of health/disease, functional ability, social network, cognitive performance and psychological well-being. Hierarchical regression models were used to test the effects of Community-Based Programs on psychological well-being adjusting for remaining variables.ResultsOverall, psychological well-being is positively associated with household income and satisfaction with health. Nevertheless, in participants, psychological well-being builds predominantly upon social network and is not associated with a moderate inability or cognitive deficits, contrasting with psychological well-being in non-participants. After adjusting for background variables, psychological well-being was positively associated with health satisfaction and social network and negatively related to moderate inability. Further, a significant interaction of participation in Community-Based Programs with age, points out higher levels of psychological well-being in participants contrasting with a downward trend in non-participants. After stratification by age, psychological well-being increases with time attending Community-Based Programs in the oldest (75-84 years) contrasting with the remainder.ConclusionsParticipation in Community-Based Programs may improve the negative effects of the aging process on psychological well-being. This positive effect as age increases may be linked to a reinforcement of social network, valued more by participants in Community-Based Programs. Furthermore, the programs may act as a healing/maintenance strategy in persons with moderate inability and/or cognitive deficits.

Introduction: Globally, over half of the estimated new HIV infections now occur among key populations, including men who have sex with men, sex workers, people who inject drugs, transgender individuals, and people in prisons and other closed settings, and their sexual partners. Reaching epidemic control will, for many countries, increasingly require intensified programming and targeted resource allocation to meet the needs of key populations and their sexual partners. However, insufficient funding, both in terms of overall amounts and the way the funding is spent, contributes to the systematic marginalization of key populations from needed HIV services. Discussion: The Joint United Nations Programme on HIV/AIDS (UNAIDS) has recently highlighted the urgent need to take action to end inequalities, including those faced by key populations, which have only been exacerbated by the COVID‐19 pandemic. To address these inequalities and improve health outcomes, key population programs must expand the use of a trusted access platform, scale up differentiated service delivery models tailored to the needs of key populations, rollout structural interventions and ensure service integration. These critical program elements are often considered "extras," not necessities, and consequently costing studies of key population programs systematically underestimate the total and unitary costs of services for key populations. Findings from a recent costing study from the LINKAGES project suggest that adequate funding for these four program elements can yield benefits in program performance. Despite this and other evidence, the lack of data on the true costs of these elements and the costs of failing to provide them prevents sufficient investment in these critical elements. Conclusions: As nations strive to reach the 2030 UNAIDS goals, donors, governments and implementers should reconsider the true, but often hidden costs in future healthcare dollars and in lives if they fail to invest in the community‐based and community‐driven key population programs that address structural inequities. Supporting these efforts contributes to closing the remaining gaps in the 95‐95‐95 goals. The financial and opportunity cost of perpetuating inequities and missing those who must be reached in the last mile of HIV epidemic control must be considered. [ABSTRACT FROM AUTHOR]

Background: Population surveys are necessary to measure a community's eye care needs. We conducted simultaneous surveys in two regions in Malaysia in 2023 to estimate the prevalence of blindness and/or visual impairment (VI), identify its main causes, and compare the results with the survey in 2014. Methods: The surveys were simultaneously done in Eastern and Sarawak administrative regions using the Rapid Assessment of Avoidable Blindness (RAAB) technique. It involved a multistage cluster sampling method, each cluster comprising 50 residents aged 50 years and older. The prevalence of blindness and/or visual impairment (blindness, severe, moderate, and early) and its primary cause were determined through a visual acuity test and eye examination with a hand-held ophthalmoscope. Results were compared with the previous survey in 2014. Results: A total of 10,184 subjects were enumerated, and 9,709 were examined (94.5% and 96.2% responses for Eastern and Sarawak, respectively). The prevalence of blindness and severe VI appeared lower than the previous survey. For blindness: Eastern 1.4%, 95%CI (0.9, 1.9) to 0.8%, 95%CI (0.5, 1.1) and Sarawak: 1.6% 95%CI (1.0, 2.1) to 0.6%, 95%CI (0.3, 0.9). For severe VI: Eastern 1.2%, 95%CI (0.8, 1.7) to 0.9%, 95%CI (0.6, 1.1) and Sarawak 1.1% 95%CI (0.6, 1.6) to 0.9%, 95% CI(0.6, 1.2). The main cause of blindness was untreated cataracts: 77.3% (Eastern) and 75.0% (Sarawak). Diabetic retinopathy was the 2nd main cause of blindness for Eastern at 9.1%, but it only caused early to severe VI in Sarawak. Conclusion: The prevalence of blindness and severe VI were lower than in the previous survey. It could have been attributed to a community cataract program implemented soon after the survey in 2014. However, more efforts are needed to address the high percentage of avoidable blindness within both regions. [ABSTRACT FROM AUTHOR]

Background: Dance is a promising health resource for older adults, but empirical evidence remains inconsistent. The lack of synthesised evidence regarding program design, dose, and delivery limits understanding of factors influencing participation and health outcomes. This scoping review aimed to map the scope, range, and effectiveness of dance programs for older people, and identify gaps and opportunities for future research and practice. Methods: Searches across five databases (September 2023) identified 148 studies evaluating 116 dance programs (≥4 weeks) for older adults (≥55 years, N = 8060), Dance interventions delivered to clinical groups were excluded. Intervention design and delivery were charted against the TIDieR reporting checklist. Program outcomes including adherence, safety, and positive tests were charted into established taxonomies. Results: Demographic information, program details, and implementation were often insufficiently reported. Participant groups differed by age range, with underserved communities underrepresented. Programs varied extensively in key factors including dose, prospective 'active ingredients', delivery approach, facilitator expertise, and class size. While dance was physically safe, adherence rates in older adults are comparable to other community exercise programs. Less than 40% of health assessments showed positive change, with more consistent benefits to physical endurance, strength, and function, moderate impacts on psychosocial health, and limited benefits to cognitive and brain health, and falls and falls risk. Conclusion: Dance is a meaningful, safe, adaptable, and low-cost health resource for older adults. Key opportunities for advancing research include improved access for underserved groups, program suitability assessments, strategies to support adherence and engagement including theory-informed approaches, and incorporation of participant and practitioner insights. Identification of key 'active ingredients' and dance program factors may improve understanding of causal pathways and mechanisms to optimise engagement and health impacts. Stronger reporting practices will facilitate comparisons across studies and more robust evidence synthesis. This review provides a critical knowledge foundation to guide future approaches in dance for health and offers reporting recommendations. [ABSTRACT FROM AUTHOR]

Background: In Ghana, the use of illegal drugs and alcohol has been classified as endemic. To manage this menace, the Therapeutic Community model for Substance Use Disorders (SUD) was introduced in Ghana about a decade ago as an alternative to other existing strategies. However, the effectiveness of this treatment modality for substance use disorders in Pantang Mental Hospital and Accra Psychiatric Hospital has not been scientifically studied. Objective: This study, therefore, sought to explore the experiences of substance users or residents enrolled in the Therapeutic Community programme toward recovery from substance use disorders. Method: This research employed an explorative-descriptive design. Participants (N = 20) were enrolled purposively sampled and recruited into the study. Face-to-face interviews were conducted using a semi-structured guide and data were analyzed using Colaizzi's descriptive phenomenology data analysis process. Results: Two main themes emerged from the data: "Why I stayed" (Motivation), and "All things are new" (Life transformation). The study pointed out that residents or participants mainly expressed positive experiences in the programme, including experiencing a sense of belongingness, enhanced self-esteem/self-worth, and most importantly, developing hope of a life free of addiction. Conclusion: In conclusion, the study found that participants in the Therapeutic Community (TC) program generally had positive experiences and believed in its effectiveness for recovery. Factors such as a relaxed environment, supportive staff, and interactions with other residents contributed to their positive experience. The study discovered that motivation, a conducive environment for care, structured program activities, and relationships among residents were key factors that motivated participants to stay and actively participate in the therapeutic community program. These factors fostered hope and a sense of belonging, ultimately contributing to their recovery journey. However, participants expressed the need for self-actualization, which they hoped to achieve after completing the program and reintegrating into the community. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Community‐dwelling older adults are at high risk for unmet social service needs. We describe a novel partnership embedding county services case managers in the Emergency Department (ED) to connect older adults to community services alongside their medical care.Setting: A medium‐sized urban ED with 55,000 patient visits a year. Intervention: Case managers from the Franklin County, Ohio Office on Aging (OA) were embedded within the ED. The OA team worked with the ED social work team to identify community‐dwelling older patients, perform an in‐person intake assessment, and initiate needed community services (including home‐delivered meals, emergency response systems, house repairs, and transportation). Program logic model and development are reported in detail.From June to December 2023, there were 7284 ED visits for adults ≥60 years old. Referrals to the OA case manager ranged from 1 to 13 per day. The OA case managers performed 252 full intake assessments on unique patients. The population was 51% men. Only 11% (n = 28) were currently connected to OA services, and of those already connected 29% (n = 8) needed increased services. Of the remaining unconnected patients (n = 224), 8% (n = 20) were not county residents and the OA team connected them with other county OAs. Half 53% (n = 120) were accepting of services and had services from the OA or other community health programs initiated during the ED visit. The OA team made three new Adult Protective Services referrals and one referral to the long‐term care ombudsman. The program did not increase ED length of stay or hospital admission rates.Embedding county service enrollment within a community ED is a cost neutral intervention that reached a population without previous services. Future plans include expansion of the program and evaluation of the program's ability to detect elder mistreatment and self‐neglect. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Discussion Community doulas are perinatal health workers who provide peer education, resource navigation, and support during pregnancy, childbirth, and the postpartum period. Evidence suggests that doulas improve the experience of care, reduce cesarean birth, and improve breastfeeding outcomes. However, people with low incomes cannot access affordable community doula support in most states due to lack of insurance reimbursement. To determine the affordability of Medicaid reimbursement for doula services, there is a need to fill a gap in research that employs real‐world data and a return‐on‐investment (ROI) analysis approach.We conducted a ROI analysis from the healthcare perspective of an enhanced community doula intervention, Best Beginnings for Babies (BBB). Healthcare and program cost data were collected alongside clinical outcomes from a randomized controlled trial of routine maternity care at Boston Medical Center with and without BBB. ROI was calculated as the net healthcare savings divided by the investment costs. Post‐COVID‐19 program costing estimates were also performed.Average healthcare costs per patient were $18,969 for the BBB group compared with $20,121 for routine care, a savings of $1,152. BBB program costs were an average of $971 per person. There was an 18% ROI. Lower costs for the birth hospitalization and NICU stays accounted for the largest areas of savings. Per‐person program costs using proposed MassHealth fees produced a positive return on investment, although 2023 hospital doula program wages and salaries did not.The BBB‐enhanced community doula program was cost‐saving to payers and increased access to doula support for low‐income people. Even with post‐COVID‐19 increases in program costs, analysis demonstrated doula support was still financially feasible. This study should reassure budget‐conscious Medicaid payers that doula services are affordable. [ABSTRACT FROM AUTHOR]

Aims: Many older persons do not think of themselves as "patients" but as persons wishing to live as actively as possible for as long as possible. However, most health-related quality of life (HRQL) measures were developed for use with clinical populations. The aim of this project was to fill that gap and to develop, for international use, a measure of what matters to older persons as they age and seek to remain as active as possible, Older Persons for Active Living (OPAL). Methods: For content development, interviews about active living were conducted with older persons from Canada, USA, UK, and the Netherlands in English, French, Spanish and Dutch, respectively with subsequent thematic analysis and harmonization. Results: Analyses of transcripts from 148 older persons revealed that active living was a "way of being" and not merely doing activities. Saturation was reached and a total of 59 content areas were identified. After grouping similar "ways" together and after conducting a consensus rating of importance, 19 unique and important "ways" remained. In some languages, formulating was challenging for three of the 19, resulting in changes to two English words and dropping two other words, yielding a final list of 17 "ways of being" with harmonized wording in 4 languages. Conclusion: This study underscores the significance of listening to older adults and highlights the importance of considering linguistic and cultural nuances in measure development. [ABSTRACT FROM AUTHOR]

Traumatic injury remains a significant public health problem, with the burden highest in low-middle income countries (LMICs) and rural areas.1,2 The far-western region of Nepal, which has the lowest human development index in the country, has a high burden of traumatic injuries.3-5 One hospital in the far-western district of Achham, Bayalpata Hospital, cares for the majority of patients with traumatic injuries – most of whom arrive without any pre-hospital care. The absence of a professionalized pre-hospital program, such as an established Emergency Medical Services (EMS) system, necessitates creative strategies to address this gap.6,7 In this context, implementing a trauma-training program for community health responders (CHRs) offers a promising solution, leveraging local resources to improve early-stage trauma care. [ABSTRACT FROM AUTHOR]

Background: An October, 2021 review of Public Health Ontario's COVID-19 guidance for congregate settings such as shelters and long-term care homes demonstrated that this guidance did not include references to ventilation or filtration. In April 2022, an interdisciplinary team with expertise in indoor air quality (IAQ), engineering, epidemiology, community programming and knowledge translation launched a virtual ventilation and filtration consultation program for community spaces in Toronto, Ontario. The program gives people working in community spaces direct access to IAQ experts through 25-min online appointments. The program aims to help reduce the risk of COVID-19 transmission in community spaces, and was designed to help compensate for gaps in public health guidance and action. Methods: Representatives from participating organizations (n. 27) received a link to an online survey via email in April 2023. Survey questions explored the impacts of the program on topics such as: purchase and use of portable air filters; maintenance and use of bathroom fans; and, maintenance and modification of HVAC systems. Survey participation was anonymous, and no demographic information was collected from participants. Results: Representatives from 11 organizations completed the survey (40%). Of those who responded, nine (82%) made changes as a result of the program, with eight (73%) making two or more changes such as purchasing portable air filters and increasing routine maintenance of HVAC systems. Conclusions: When presented with brief access to expert support and tailored plain language guidance, people working in community spaces increased their use of ventilation and filtration strategies for COVID-19 infection prevention and control. [ABSTRACT FROM AUTHOR]

Interventionists are critical components of community-based gang programs. One practice they employ is diffusing or interrupting situations that lead to homicide. How they accomplish this is unclear. This paper contextualizes retaliatory gang homicide interruptions performed by one interventionist within black communities in South Los Angeles over a 24-month period between 2016–2018. Data indicates the interventionist conducted 19 interruptions involving 24 gangs utilizing nine different techniques. Gang dynamics and the triggering events that spurred retaliation shaped the techniques utilized. At least one homicide was prevented as a result of each interruption, though the likelihood is that several were given the tit-for-tat nature of gang homicide. Methodological, theoretical, and practical applications of these and other study findings are provided. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionsClinical ImplicationsThe present study is a cross-validation of the Financial Exploitation Vulnerability Scale (FEVS), a measure of contextual risk for financial exploitation.The sample was drawn from both the community and the SAFE program, a service for older adults who have been financially scammed. FEVS was administered within a larger assessment battery. The total score ability to differentiate exploitation groups and its correlates were examined. ROC analysis and logistic regression evaluated the clinical utility of the FEVS to detect exploitation. Results were compared to the initial validation study.FEVS score was significantly higher for those who were exploited and correlated with age. ROC analysis revealed adequate detection of financial exploitation. FEVS total score remained a strong predictor of exploitation when compared to demographic factors and several measures of cognitive functioning.Cross-validation demonstrates strong evidence that the FEVS detects financial exploitation in older adults, beyond the ability of many known risk factors.FEVS is an evidence-based tool for identifying exploitation and is accessible to many professionals working with older adults. Items query contextual factors that allow professionals to support clients with the appropriate standard of care. [ABSTRACT FROM AUTHOR]

Background: Bottle feeding should be avoided since it interferes with optimal breastfeeding and it causes diarrheal-related morbidity and mortality. Despite the WHO's recommendation that children to avoid bottle feeding, it is still widely practiced in developing countries including our country, Ethiopia. Therefore, this study aimed to assess the spatial variations, and determinants of bottle feeding among children aged 0–23 months using the recent demographic and health survey data for Ethiopia. Methods: A secondary data analysis was conducted using the 2019 Ethiopian mini demographic and health survey data. The total weighted sample of 2067 children aged 0–23 months was included in this study. Spatial analysis was done to identify the hotspot areas of bottle feeding among children in Ethiopia. Multivariable multilevel logistic regression was used to identify predictors of bottle feeding. The spatial analysis was done using ArcGIS 10.7 and Sat Scan 9.6 software. Result: The prevalence of bottle feeding among children aged 0–23 months was 21.52% with 95% CI(19.80%, 23.34%). Age of the child from 6–11 months, and 12–23 months age, having secondary and above education [AOR = 2.09; 95%CI; 1.31, 3.32], being from middle and rich household [AOR = 2.14; 95%CI; 1.37, 3.34] and [AOR = 2.30; 95%CI; 1.46, 3.63], and twin birth [AOR = 8.06; 95%CI; 2.87, 22.58] were significant predictors of bottle feeding. Hotspot areas of bottle feeding were observed in Addis Ababa, Dire Dawa, Harari, and Afar regions of Ethiopia. Conclusion: Bottle feeding practice was found to be spatially clustered in Ethiopia. Education, wealth index, parity, and child's age were significant predictors of bottle feeding. Hotspot areas of bottle feeding were observed in Addis Ababa, Dire Dawa, Harari, and Afar regions. Special attention should be directed towards mothers residing in hotspot areas, educated mothers, mothers of multiple births, and mothers from rich households through community education programs focused on child feeding practices to reduce the practice of bottle-feeding in Ethiopia. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONManual wheelchair skills training programs are novel developments, particularly in the United States. As perceived by the caregivers of participants, this study aimed to examine the long-term impact of the Skills on Wheels program on participants’ occupational engagement and quality of life at home, at school, and in the community. Secondly, this study investigated the caregivers’ perspectives of the program design of Skills on Wheels. This was a qualitative inquiry based upon thematic analyses of semi-structured interviews after participation in a pediatric wheelchair skills training program. The study participants were 9 caregivers whose children participated in this program over the 2021 and 2022 implementation years. Caregivers were given a 10-question semi-structured interview. The five overarching topics included program impact: (i) occupational engagement, (ii) program impact: quality of life factors, (iii) program resources/design, (iv) novelty/importance of program/wheelchair skills training, and (v) desired continued wheelchair skills practice in the future. Results provided tangible feedback to integrate into program design and supported the Skills on Wheels program’s positive value as it relates to impact on quality of life and occupational engagement for participants.Wheelchair skills training programs are important for children with disabilities to fill in service gaps related to community mobility.When developing community programs in general, it is necessary to gain the understanding of the impact on caregivers of children with disabilities.This paper provides insight into how a pediatric wheelchair skills training program is viewed by the caregivers of participating children.Therapists and researchers can see the caregiver impact of programs or training such as that described in this study.Wheelchair skills training programs are important for children with disabilities to fill in service gaps related to community mobility.When developing community programs in general, it is necessary to gain the understanding of the impact on caregivers of children with disabilities.This paper provides insight into how a pediatric wheelchair skills training program is viewed by the caregivers of participating children.Therapists and researchers can see the caregiver impact of programs or training such as that described in this study. [ABSTRACT FROM AUTHOR]

AbstractThe United States is battling an opioid overdose epidemic, and Veterans are at almost double the risk compared to the general population. Veterans Health Administration (VHA) recognizes the critical role naloxone plays as a risk mitigation strategy in opioid prescribing; however, there was not a standardized process within the Kansas City VA Medical Center’s (KCVAMC) community care program. This quality improvement project included Veterans that received opioids through community care from 2022 to 2023. The Stratification Tool for Opioid Risk Mitigation and chart review were used along with descriptive statistics. Results found 11% (22 of 206) of Veterans were dispensed naloxone within one year prior to receiving their opioid prescription. This data indicated the importance of expanding access to naloxone in Veterans receiving opioids from community care providers. As a result of this data, the KCVAMC implemented an outpatient pharmacy protocol to dispense naloxone to appropriate Veterans that receive an opioid through the community care program. The protocol was initiated on March 29, 2023. From the end of March through 2023, naloxone dispensing for these Veterans increased from 11% to 67%. [ABSTRACT FROM AUTHOR]

Background: Data are needed on differences in community-dwelling populations with bipolar disorder (BP) regarding trust in research and access to care. We characterized community members by lifetime history of bipolar disorder. We hypothesized that those with BP would have less trust in research, visit a health provider less, and participate less in research than those without BP. We also hypothesized that those with BP would be more likely to have a history of marijuana (MJ) use. Methods: A cross-sectional design was used for this analysis. The study population consisted of 12,489 members (78.0%) from the HealthStreet community engagement program who were interviewed by a Community Health Worker about health history and demographics. Results: Among the sample, the rate of BP was 10.6% (n = 1326). Those reporting BP were more likely than those who did not (n = 11,163), to report muscle, bone, and mental health problems, to be younger, female, to have visited the doctor in the past 12 months, to be interested in participating in research, and be current MJ users. Trust did not differ between BP groups. Conclusions: Our analysis found that persons with BP had higher access to care and more interest in research, thus our primary hypothesis was rejected. Our secondary hypothesis, that persons with BP were more likely to have a history of MJ use was upheld. These findings are important because they address a crucial gap in the literature surrounding BP and lay the groundwork for future community-level research. [ABSTRACT FROM AUTHOR]

Stunting, a consequence of chronic malnutrition, particularly affects children aged 0-24 months, impacting child mortality and development. This review aims to explore stunting prevention interventions in this age group, focusing on caregiving during the first 1000 days of life. A systematic search yielded 18 relevant studies published between 2019 and 2023, diverse in location and intervention approaches. Interventions varied from supplementation to community and healthcare programs. Integrating nutrition education with maternal support proved crucial. The review stresses the need for sustainable, context-specific approaches tailored to local contexts. Recommendations include integrating nutrition education into healthcare and community interventions. Continuous evaluation is vital. This review offers insights into stunting prevention, aiding evidence-based strategies globally. Future research should explore caregiving complexities and intervention sustainability. Nursing practitioners are key in implementing holistic approaches to stunting prevention and improving child health outcomes. [ABSTRACT FROM AUTHOR]

The notions of indigenous knowledge and cultural philosophies are becoming ubiquitous in many social inquiries, and evaluation is no exception. Nonetheless, the pursuit to embed relevant indigenous philosophies in contemporary evaluation has yet to succeed. In this article, we discuss indigenous relational philosophies, approaches, and practices as they relate to evaluation. Using qualitative research approaches, we interviewed 43 Indigenous development leaders and other local representatives in three local government areas in Ghana. Utilizing evidence synthesis approaches through a triangulation process, we conclude that indigenous knowledge and other cultural ethos were distinct in community-based development evaluation processes. There was an elusive intersection between indigenous and contemporary evaluation paradigms. Indigenous evaluation has principles such as community spirit, mutual trust, self-organization, relational patterns or networks, "ubuntu" ideals, consensus building, and collective action that can complement contemporary evaluation for the effective and efficient evaluation of community development programs and social policies. We identify key indigenous elements and other indigenous relational assessment patterns to aid in the design of an indigenously driven relational evaluation framework. The evaluative competencies embedded in indigenous philosophies are vast, thus, a call for future research is proposed. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]