“You Live Where?!” Lesbian Mothers' Attachment to Nonmetropolitan Communities

A positive attachment to one's residential community has been linked to better mental health ( McLaren, 2009 ), stronger social support ( Young, Russell, & Powers, 2004 ), and a higher quality of life ( Mak, Cheung, & Law, 2009 ). Attachment to residential community has been understudied in research on lesbian, gay, bisexual, and transgender (LGBT) families. The current study attempts to fill this gap by using family and minority stress theories to examine the predictors of residential community attachment among 77 lesbian mothers living in nonmetropolitan communities. Our findings indicate that stronger residential community attachment is predicted by more frequent contact with family of origin, low religiosity, and an interaction between close LGBT friendships and the presence of at least one local LGBT organization. Contrary to expectations, anti‐LGBT victimization perpetrated by community members did not have an effect on residential community attachment.     

Driving forces for home‐based reablement; a qualitative study of older adults’ experiences

As a result of the ageing population worldwide, there has been a growing international interest in a new intervention termed ‘reablement’. Reablement is an early and time‐limited home‐based intervention with emphasis on intensive, goal‐oriented and interdisciplinary rehabilitation for older adults in need of rehabilitation or at risk of functional decline. The aim of this qualitative study was to describe how older adults experienced participation in reablement. Eight older adults participated in semi‐structured interviews. A qualitative content analysis was used as the analysis strategy. Four main themes emerged from the participants’ experiences of participating in reablement: ‘My willpower is needed’, ‘Being with my stuff and my people’, ‘The home‐trainers are essential’, and ‘Training is physical exercises, not everyday activities’. The first three themes in particular reflected the participants’ driving forces in the reablement process. Driving forces are intrinsic motivation in interaction with extrinsic motivation. Intrinsic motivation was based on the person's willpower and responsibility, and extrinsic motivation was expressed to be strengthened by being in one's home environment with ‘own’ people, as well as by the co‐operation with the reablement team. The reablement team encouraged and supported the older adults to regain confidence in performing everyday activities as well as participating in the society. Our findings have practical significance for politicians, healthcare providers and healthcare professionals by contributing to an understanding of how intrinsic and extrinsic motivation influence reablement. Some persons need apparently more extrinsic motivational support also after the time‐limited reablement period is completed. The municipal health and care services need to consider individualised follow‐up programmes after the intensive reablement period in order to maintain the achieved skills to perform everyday activities and participate in society.     

Empowering senior citizens for healthy nutrition in Germany: A pilot study

Main goal of this study was to analyse how empowerment processes and bottom‐up activities aimed at healthier food choices and food environment could be initiated among a group of senior citizens (between 60 and 75 years old). The intervention was set up as a pilot study in a rural community (15,000 inhabitants) in the federal state of Bavaria, South Eastern Germany. A process evaluation documented how group formation and empowerment processes developed during the course of the intervention. Extensive field notes were taken in 27 meetings, interviews (n = 13) and focus groups (n = 4) were conducted with participants and key persons at different points of the intervention. Data were analysed using content analysis. The intervention succeeded in motivating senior citizens to participate in regular meetings over 11 months. During the intervention, the group members’ awareness of factors influencing their eating behaviour increased. Furthermore, they developed ideas to improve the community's food environment and accomplished duties needed to implement these ideas. However, initiating empowerment processes, especially in terms of fostering leadership and transferring responsibility, took longer than expected and could be realised only partially. The findings support a further use and evaluation of the empowerment approach for addressing nutritional aspects among senior citizens.     

Preventive home visits to older home‐dwelling people in Denmark: are invitational procedures of importance?

Since 1998 all municipalities in Denmark have been required by law to offer two annual preventive home visits to all home‐dwelling citizens aged 75 or over. The influence of invitational procedures on acceptance rates has not been investigated. The aim of this study was to describe and investigate whether different invitational procedures were associated with first preventive home visit acceptance rates. The study was based on secondary analyses of data from the Danish Intervention Study on Preventive Home Visits. Data were collected from 1998 to 2002. Of the 4060 participants in the main study, 3245 reported receiving an offer for an identifiable preventive home visit, of whom 2399 (73.9%) provided complete data for the main analyses in the present study. Invitational procedures were categorised as: (1) a letter with a proposed date and time for the visit, (2) a visitor telephone call, and (3) a letter with encouragement to phone the visitor for appointment (letter without a proposed date). Covariates included sex, age, experience with preventive interventions, functional ability, self rated health, social relations and psychosocial characteristics. Statistical analyses included chi‐square tests, and bi‐ and multivariable logistic regression analyses. Different invitational procedures were associated with first preventive home visit acceptance rates. Significantly more men (75.1%) than women (62.8%) declined the first preventive home visit regardless of the invitational procedure. Compared to ‘letter with a proposed date’, men had an odds ratio of 1.78 (95% CI: 1.16–2.74) for declining visits when ‘telephone call’ was used and an odds ratio 2.81 (95% CI: 1.79–4.40) when ‘letter without a proposed date’ was used as the invitational procedure. In women the odds ratios were 1.23 (95% CI: 0.91–1.68) and 1.87 (95% CI: 1.37–2.55), respectively.     

Why immunization coverage fails to catch up in India? A community‐based analysis

Background An effort has been made in this paper to examine the impact of community and household vis‐à‐vis individual‐level variables on immunization coverage among Indian children. Methods National Family Health Survey‐2 data set has been used for the analysis. Multilevel regression analyses have been used to explore the relative effects of community‐, household‐ and individual‐level factors on immunization coverage. Three community‐level variables, i.e. availability of health facilities, availability of all‐weather roads and information, education and communication (IEC) activities conducted during last year, are included in this analysis. Results Availability of health facility and information, education and communication activities plays a significant role in determining the level of immunization coverage among children. Even with community‐level variables in the model, individual‐level variables, i.e. parent's education, birth order of child and number of antenatal care visits, retain their predictive role for the potential immunization coverage. Conclusions Universal immunization can be achieved by providing services at community level and information about the available services and their benefits to the community. There is a considerable, unexplained variation in the immunization coverage between different communities, even in the most complex model used in this study, which could explain the entire heterogeneity of immunization coverage among Indian states.     

A qualitative exploration of responses to self‐compassion in a non‐clinical sample

Research suggests that being self‐compassionate can have myriad benefits, including life satisfaction, health‐promoting behaviours and improved mental health. Given the possible advantages of being self‐compassionate, it seems critical to explore how to promote this in the general population. This qualitative study aimed to understand responses to the idea of being compassionate to oneself within the general population. Semi‐structured interviews were conducted in the North East of England between October 2014 and February 2015, they were analysed using thematic analysis. As part of an intervention study, non‐clinical volunteers watched a psychoeducation video about the concept of self‐compassion and then participated in one of four meditation exercises. Following this, participants were interviewed about their responses to the idea of being self‐compassionate. Three themes were identified: Benefits of Self‐Compassion; Being Self‐Compassionate and Barriers to Self‐Compassion. Participants believed that being self‐compassionate would be beneficial, for both themselves and the world, but they believed that self‐compassion would make them vulnerable and that others would judge them. Thus, participants were afraid to be the first ones to be self‐compassionate and stated that, in order for self‐compassion to be acceptable, we need to change the perspective of western culture. These findings underscore the importance of understanding society's role in a person's ability to be self‐compassionate. In order to reap the benefits of self‐compassion, we need to create a culture that accepts and encourages this. As practitioners, we are in a position to lead in self‐compassion and to encourage other leaders to promote this as a preventative mental health strategy.     

A systematic review of components of community‐based organisation engagement

Community‐based organisations (CBOs) are important for eliminating health disparities globally and translating research findings to inform interventions. Engagement is an integral part of partnerships between CBOs and community health researchers and impacts the quality and quantity of any desired outcome. Despite the acknowledged benefits of community‐based organisation engagement (CBOE), there are variations in its operationalisation and paucity in the understanding of its use in community‐scientific partnerships. To further understand CBOE, the aim of this study was to synthesise published literature relevant to the definitions and applications of CBOE and identify its key components. A systematic search was conducted in March 2017, and updated in June 2017. Keywords were varied to account for international differences in spelling and word usage. Five major databases, MEDLINE, PubMed, CINAHL, PsycINFO and Google Scholar, were used to identify potential research studies. A total of 32 studies were included in this review. Following the analysis of the literature, four salient themes emerged as components of CBOE: (1) Need (a consensus between all the parties in a partnership on the importance of a specified project and its proposed benefits to a target community); (2) Partnership Dynamics (the workings of a relationship between a CBO and a scientific/academic stakeholder); (3) Resources (include but are not limited to: personnel, money, work space, expertise and equipment); and (4) Outcomes (products of the partnership). This review provides a foundation for future research in applying CBOE to translational research and interventions. This analysis will assist community health researchers in planning partnerships with CBOs, and make necessary adjustments to improve study outcomes. Appropriate application of the components of CBOE in partnerships will assist researchers in addressing health disparities.     

Impediments to community‐based care for people ageing with intellectual disability in rural New South Wales

The emerging phenomenon of ageing with an intellectual disability has become subject to an increasing research focus in recent years. However, there remains little knowledge regarding the specific impediments that community workers face in supporting this cohort. The aims of the current study were to identify the major factors that, direct care staff believe, have most impact upon individuals ageing with an intellectual disability in the community. A three‐round Delphi project was conducted across rural areas of New South Wales in Australia with 31 disability support workers to gain their perspectives on the main impediments facing a person ageing with intellectual disability. The 2010 study identified that the issue of ageing with an intellectual disability was presenting significant problems for community‐based service delivery to this group of people. The panel identified 25 different impediments to the provision of support. A thematic analysis of the items indicated three main themes of ‘funding’, ‘training’ and ‘access to services’. By identifying these impediments to supporting people ageing with an intellectual disability in the community, both services and government funding bodies have the ability to plan to overcome both current and future problem areas. This identification of impediments may facilitate individuals to receive more appropriate assistance, which in turn may lead to an improved quality of life and maintenance of a community‐based placement rather than premature admission to the congregate‐care system. This study is particularly timely, given that Australia is in the midst of implementing a National Disability Insurance Scheme, and is an opportunity for all levels of government to agree on the mechanisms to appropriately assist individuals with an intellectual disability to continue to be supported in the community as they age.     

‘What works here doesn’t work there’: The significance of local context for a sustainable and replicable asset‐based community intervention aimed at promoting social interaction in later life

Interventions that harness local assets to benefit a community are increasingly being promoted to improve health and well‐being. In practice, we know little about how local contexts or reliance on local resources affect the sustainability and scalability of asset‐based community developments. This qualitative case study documents the development and implementation of a novel asset‐based community development project. Based in a large mainly rural county in North East England with relatively high levels of socioeconomic deprivation, the project aimed to prevent social isolation among older people, using a range of food‐related activities. Twenty‐one semi‐structured interviews were conducted with service users, volunteers, project partners, project development workers and senior staff. Interviews explored the project's design and implementation process, outcomes for participants and the wider community, and project sustainability and scalability. Thematic analysis of the data identified four factors likely to be important for creating sustainable and replicable asset‐based community projects. These factors are (a) recognising and harnessing assets among local people who may be otherwise marginalised due to age, geographical isolation and/or socioeconomic deprivation; (b) identifying assets that can be provided by local businesses; (c) genuine project co‐production to develop activities that meet local needs and inspire enthusiasm among all stakeholders; and (d) ongoing organisational support to meet the challenges to sustainability that exist in socioeconomically deprived areas. We conclude that successful asset‐based community projects require extensive community input and learning captured from existing programmes can facilitate the replicability of programmes in other community contexts.     

Young people’s perceptions of substance use norms and attitudes in the LGBT community

Objectives : Sexual minority young people (SMYP) show higher levels of substance use than their heterosexual counterparts. This study aims to test potential LGBT community‐specific reasons assumed to affect substance use and their relationships to LGBT community participation/connectedness and substance use behaviour. Methods : Eight LGBT community‐specific reasons for substance use were tested in an online survey with 1,556 SMYP. Results : Respondents agreed that the LGBT community had liberal attitudes towards substance use (80.5%, n=1,079) and that the media portrayed substance use as a part of the community culture (66.5%, n=904). Participants disagreed that excessive partying is a part of the community (34.7%, n=470). Significant but weak correlations between reasons and community participation/connectedness or personal substance use behaviour were found. Subgroup analyses indicated male and gay/lesbian participants showed differential agreement levels to some of the reasons. Conclusion : Young people’s perceptions of substance use within the LGBT community are not associated with community participation/connectedness or personal substance use. Implications for public health : Further research is needed to better understand what factors lead to elevated levels of substance use in SMYP. This may assist in the development of adequate public health responses. Targeting problematic beliefs may have little impact on substance use in SMYP.     

A new approach to community participation assessment

It is important to investigate the processes which influenceparticipation in a community-wide intervenlion programme, tosee if the programme actually evolved from an idea to reality.A method for assessing community participation in health programmeshas been developed and so far niainly applied in developingcountries. The method uses five indicators that strongly influencethe community participation process. These are: needs assessment,leadership, organization, resource mobilization and management.This method was used to analyse the community development processin a community intervention programme aimed at preventing accidents,in Sollentuna municipality, Stockholm County. An asses.snrentof the participation process was made for years 2 and 4, indicatingthat participation had expanded. The method was of value fordescribing and understanding the participation process and wasalso found to be relevant in an accident prevention programmein an industrialized country. The method was also found robea valuable educational tool when used as a process indicatorfor the programme, and important for understanding change.