Search

Lifestyle interventions regularly rely on study staff to implement the intervention and collect outcomes data directly from study participants. This study describes the experiences of project staff in two randomized controlled trials of a postpartum lifestyle intervention to reduce risk factors for type 2 diabetes in Latinas. Latinas are the fastest growing minority group in the U.S. and have the highest rates of type 2 diabetes after a diagnosis of gestational diabetes mellitus. The challenges of implementing lifestyle interventions for postpartum women have been poorly documented. A qualitative focus group was conducted with eight staff members (five health educators and three health interviewers) involved in Proyecto Mama and Estudio Parto. The discussion was audio recorded, transcribed, and coded in NVivo. Focus group topics included: 1) participant recruitment, 2) participant retention, 3) implementation of the lifestyle intervention, 4) assessment of behavior change, 5) overall challenges and rewarding aspects of the trial, and 6) recommended changes for future trials. Key themes emerged regarding enabling factors and barriers to implementing a lifestyle intervention in postpartum Latinas. Enabling factors included: a) the staff’s belief in the importance of the intervention, b) opportunities associated with the longitudinal nature of the trial, c) belief that the staff could empower participants to make behavior change, d) benefits of flexible intervention sessions, and e) connection with participants due to shared cultural backgrounds. Barriers included: a) participant stressors: home, food, and financial insecurity, b) low health literacy, c) issues related to recent immigration to the continental U.S., d) handling participant resistance to behavior change, e) involvement of family members in assessment visits, f) limitations of the assessment tools, and g) time limitations. Findings highlight the challenging contexts that many study participants face, and shed light on the potentially influential role of health educators and interviewers in intervention implementation and data collection. Specific recommendations are made for strategies to improve adherence to diabetes prevention programs in postpartum underserved and minority populations in this challenging, transitional period of life. NCT01679210 . Registered 5 September 2012; NCT01868230 . Registered 4 June 2013.

Low/no-income, African American men are disproportionally burdened by chronic disease resulting from a complex interplay of systemic, sociocultural, and individual factors. These disparities are related to poverty, racism, gender role strain, high levels of stress, low levels of physical activity, and malnutritious diet. Men of Color Health Awareness (MOCHA) is a community-driven movement to address the physical, mental, social, and spiritual needs of men of color. As part of ongoing programming, the MOCHA Standard intervention consists of a 10-week program including: (1) small group discussions of issues particularly relevant to men of color, (2) classes on health topics focusing on chronic disease control, such as nutrition, obesity, high blood pressure, fitness, and the social determinants of health; and (3) 60-min of moderately intensive aerobic exercise twice a week. While the MOCHA Standard intervention has yielded positive results, feedback from previous participants warranted an in-depth sociocultural tailoring of the curriculum to improve community receptiveness, in particular, revising the sessions to "narrativize" the materials to strengthen their potential effectiveness. This manuscript describes the novel recruitment strategies; the development of an enhanced MOCHA+ Stories Matter program that uses narrative communication strategies; and the methodology used to assess the comparative effectiveness of the MOCHA Standard relative to MOCHA+ Stories Matter program in lowering stress and risk of chronic diseases in a randomized controlled trial. The results of this research will contribute to the identification of effective interventions to address health disparities in low-income African-American men and the dissemination of effective chronic disease prevention programming.

This article focuses on findings of a two-year pilot research study focused on addressing sexual and reproductive health inequities faced by adolescent women of Puerto Rican descent living on the mainland United States. Working with three groups of young women, in the pilot study we gathered ethnographic data in and around a group-based digital storytelling process to inform the development of a larger intervention. Digital stories are short (1–3 minute), participant produced videos that synthesize still and moving image, a voiceover recording of the participant telling her story, and background music and text to document personal experiences. Based on narrative analysis of digital stories and field notes written in and around the digital storytelling workshop process, as well as follow-up individual interviews with workshop participants, our findings center on the ways that trauma has specifically shaped participants’ sexual and reproductive health experiences. We argue that digital storytelling serves as a critical narrative intervention, whereby participants’ engagement in the storytelling process enables them to collaboratively interrogate and potentially address prior trauma, bolster a sense of social support and solidarity, and potentially recalibrate stigmatizing conversations about them. We introduce our project methodology, and then present key findings on trauma as it informs sexual and reproductive health practices, with digital storytelling showcased as a modality for critical narrative intervention. We conclude by discussing implications for critical public health research and practice.

Substance use disorder (SUD) is a growing issue nationally, and SUD in pregnancy has significant consequences for mothers and their children. This article describes findings from a pilot project that used digital storytelling as a mechanism for understanding substance use and recovery from the perspective of women in recovery from SUD in pregnancy who worked as peer mentors with pregnant women currently experiencing SUD. Research on peer mentorship has primarily focused on outcomes for mentees but not the experience of the peer mentors themselves. In this qualitative study, a 3-day digital storytelling workshop was conducted with five women in recovery serving as peer mentors in their community. Each mentor also participated in an individual, in-depth interview. The digital storytelling workshop process helped peer mentors make linkages between their past substance use experiences to their present work of recovery, and fostered deep social connections between mentors through the shared experience. The workshop process also elicited a sense of hope among participants, which served as groundwork for developing advocacy-based efforts. Digital storytelling may be therapeutic for women in recovery and has the potential to be integrated into recovery programs to bolster hope and social support among participants.

We currently see an interdisciplinary shift toward a "participatory turn" in health research and promotion under which community engagement, shared decision making and planning, and the use of visual and digital methods have become paramount. Digital storytelling (DST) is one such innovative and engaging method increasingly used in applied health interventions, with a growing body of research identifying its value. Despite its increasing use, a standard approach to empirically assess the impacts on individuals participating in DST interventions does not currently exist. In this article, we define DST as a distinct narrative intervention, illustrate key elements that inform the methodology, and present a conceptual model to examine how DST may contribute to increased socioemotional well-being and bolster positive health outcomes. Our proposed model is informed by elements of narrative theory, Freirian conscientization, multimodality, and social cognitive theory and can serve as a guide for public health practitioners and researchers interested in assessing the potential benefits of DST as an applied health intervention. Recommendations for practice call for a rigorous methodological approach to apply and test this model across a range of health contexts and populations.

Since the 2003 call by the Institute of Medicine to educate undergraduates in public health, various models have emerged for incorporating public health into the liberal arts and sciences. One model is a professionalized public health major that uses core public health competencies to prepare a workforce of health professionals. A second model offers a broad-based public health major rooted in liberal arts principles, resisting the utilitarian trend toward human capital formation. A third model resists even the label of “public health,” preferring instead to introduce undergraduates to many ways of analyzing human health and healing. The multidisciplinary Culture, Health, and Science Program, based on six key commitments for preparing liberal arts students to analyze health and respond to global health challenges, is offered as an alternative to the public health major.

Digital storytelling workshops are increasingly being used to capture lived experiences and develop/disseminate health promotion messages for vulnerable and marginalized populations. Thirty female Latina teens of varied sexual/parity status produced digital stories of significant life experiences in a group context and then viewed and evaluated them using the Narrative Quality Assessment Tool. This tool was used to examine participants' experience of emotional engagement and identification with each story as well as a single-item indicator of desire to "do something in my community" related to the story. Emotional engagement was moderately strong; identification scores were neutral relative to the stories. Emotional engagement was strongly, significantly related to "desire to act in my community," while identification was not related. Emotional engagement should be considered an important factor to incorporate in the production of digital stories for purposes of developing interest in social action beyond the digital storytelling workshop.

The University of Massachusetts Amherst is part of Five-Colleges Inc, a consortium that includes the university and four liberal arts colleges. Consortium faculty from the School of Public Health and Health Sciences at the university and from the colleges are working to bridge liberal arts with public health graduate education. We outline four key themes guiding this effort and exemplary curricular tools for innovative community-based and multidisciplinary academic and research programs. The structure of the consortium has created a novel trajectory for student learning and engagement, with important ramifications for pedagogy and professional practice in public health. We show how graduate public health education and liberal arts can, and must, work in tandem to transform public health practice in the 21st century.

The field of public health frequently issues calls for social justice, but it is not clear that everyone agrees on what this means or how to achieve it. To assess lay citizens' views on the relationship between justice and health, we conducted individual interviews with 19 young parenting women to hear and discuss their thoughts about the causes of health disparities, ways to reduce them, and the nature of the just society. A salient theme to emerge in these interviews was the topic of “caring.” This article reports on four categories identified under the theme of caring: 1) observations of apathy and indifference; 2) the effects of not caring; 3) models of caring; and 4) the pull of caring. Based on these results, the article outlines a grounded theory on the role of caring in conceptualizing health motivation.

This chapter discusses a digital storytelling project that combined aims to gain fine-grained understanding of, and address, sexual health inequities among Puerto Rican Latinas in the project community. The authors begin by introducing digital storytelling as a culture-centered approach for use in public health research and intervention. They then trace two emerging ethical issues in research using digital storytelling, both related to key project findings of current and historical trauma among participants: (1) conflicting aims in the project and (2) the ethical standard to minimize harm. The authors conclude that these issues can be resolved if projects are guided by a sensitive ethical protocol, and that digital storytelling and other participatory, visual, and arts-based methods can be harnessed for the design of effective sexual health interventions.

In a recent Editors Choice column in the American Journal of Public Health Northridge and Coupey1 advocate the increased use of long-acting reversible contraception (LARC) specifically the intrauterine device and the implant as a means to achieve reproductive health equity. They reference the American Academy of Pediatrics recommendation which states that these methods should be considered "first-line contraceptive choices" for adolescents and young adults.2 (Am J Public Health. Published online ahead of print November 12 2015: e1-e2. doi:10.2105/AJPH.2015.302900).

Influenced by Cooke and Kothari's (2001) suggestion that participation "remains a way of talking about rather than doing things" (p. 32), we question to what extent this is true in the public health funding process. Thus, the aim of this article was to investigate the ways in which recent National Institutes of Health (NIH)-funded community-based participatory research (CBPR) projects discursively positioned CBPR in their grant applications. We collected 17 NIH-funded CBPR proposals, analyzed them using a grounded theory approach, and subjected the findings to critical analysis focusing on the definition of community, the type of community "participation" promoted, and the nature of the research proposed. We conclude that certain types of CBPR projects are privileged in the funding review process and discuss the implications of these findings for future CBPR praxis.

Using a positive youth development framework, this article describes how a 3-year digital storytelling project and the 566 digital stories produced from it in Northwest Alaska promote protective factors in the lives of Alaska Native youth and serve as digital “hope kits,” a suicide prevention approach that emphasizes young people’s reasons for living. Digital stories are short, participant-produced videos that combine photos, music, and voice. We present process data that indicate the ways that digital stories serve as a platform for youth to reflect on and represent their lives, important relationships and achievements. In so doing, youth use the digital storytelling process to identify and highlight encouraging aspects of their lives, and develop more certain and positive identity formations. These processes are correlated with positive youth health outcomes. In addition, the digital stories themselves serve as reminders of the young people’s personal assets—their reasons for living—after the workshop ends. Young people in this project often showed their digital stories to those who were featured positively within as a way to strengthen these interpersonal relationships. Evaluation data from the project show that digital storytelling workshops and outputs are a promising positive youth development approach. The project and the qualitative data demonstrate the need for further studies focusing on outcomes related to suicide prevention.