Healthy by Association: The relationship between social participation and self-rated physical and psychological health

This paper investigates the relationship between social participation and subjective health. Using individual-level data from the British Household Panel Survey, we show that being an active member of a social or sport organisation increases self-rated physical and psychological health. For men, the benefits of social interaction work primarily via physical pathways, while women report a more psychosocial channel. We separate the main results by occupation and document some heterogeneity. Manual workers find more physical and psychological relief via social involvement, whereas non-manual workers are more likely to take relief from sport participation. Interestingly, as the number of associations in which the individual is active increases, the incremental increase in social benefits diminishes. Our findings point to the importance of promoting social and sport activities in health communication and policy making.     

社区老年人久坐行为、社会参与度与抑郁的关系研究

目的 调查社区老年人久坐行为、社会参与度与老年抑郁之间关系。方法 在2020年6月至8月间选择安徽省合肥市4个社区的632名60岁及以上的人群为调查对象,使用一般资料调查表、久坐行为自评问卷、社会活动参与频率问卷及病人健康问卷抑郁量表对目标人群进行问卷调查,使用Pearson相关分析和logistic回归分析探讨社区老年人久坐行为、社会参与度与抑郁的关系。结果 社区老年人每天久坐行为时间为（6.88±1.98）h,社会参与度得分为（15.53±3.79）分,抑郁的检出率为11.6%;社区老年人抑郁与久坐行为呈现正相关,与社会参与度呈现负相关（P<0.05）;logistic回归分析显示,在校正社会人口学等变量后,久坐行为是抑郁的危险性因素［OR=2.029,95%CI（1.689~2.439）;P<0.001］;社会参与度是社区老年人抑郁的保护性因素［OR=0.795,95%CI（0.721~0.877）;P<0.001］。结论 社区老年人久坐行为水平普遍较高,久坐行为及社会参与度是老年人抑郁患病风险的重要影响因素,社区卫生保健人员可通过干预老年人群的久坐时长,鼓励老年人群多参与社会交往频率从而减少抑郁的患病风险。     

Interactive technology applications for behavioral counseling: issues and opportunities for health care settings

CONTENT: This article discusses the rationale for, and the potential benefits and limitations of, computer-based interactive health communication (IHC) programs for health behavior counseling. We describe common barriers to health behavior counseling in medical settings and show how IHCs can address these issues. Following an overview of current and likely near-future IHCs, the potential impact of IHCs on the patient-provider relationship is considered. Results from evaluations of IHCs are summarized and important and unique issues in evaluating IHCs are discussed. We conclude with recommendations for clinical applications, including recommendations for consumers considering purchase or adoption of IHCs and recommendations for future research.     

Improving the quality of child health services: participatory action by providers.

OBJECTIVE: To test a quality improvement approach called COPE (Client-Oriented, Provider-Efficient services), for use in strengthening health systems and supporting Integrated Management of Child Health (IMCI) efforts. DESIGN: Pre- and post-intervention observations of client/provider interactions, facility audits, staff and client surveys, and focus groups to evaluate differences between eight COPE intervention and eight matched non-intervention facilities after a 15-month intervention in 2001. SETTING: Primary care clinics in Guinea and Kenya. STUDY PARTICIPANTS: Health care providers and child caregivers. INTERVENTIONS: Over 15 months, the intervention supported four COPE exercises at each intervention site, supported supervisor training in quality management, and organized minimal training in topics selected by site staff as areas where training was needed. MAIN OUTCOME MEASURES: Differences in staff's and child caregiver's knowledge, attitudes, and practices; differences in the quality of services provided. RESULTS: On almost every quality indicator (over 65 indicators), whether reported by staff, observed by evaluators, or reported by clients, the intervention sites performed statistically significantly better than control sites. INTERVENTION: sites were cleaner and more pleasant, with more respect and information for clients, and more privacy. Staff had better personal communication skills, better diagnostic skills, and prescribing practices and gave better home care instructions to carers. Clients in intervention sites were more informed and more satisfied, and their children had better immunization coverage than those in control sites. CONCLUSION: COPE is a simple process, yet our study confirms that it can have a very dramatic effect on the quality of services. This study demonstrated how all areas of quality can be addressed by empowering health care providers to take action by using COPE. We suggest that COPE can complement Integrated Management of Childhood Illness (IMCI) training and can help to achieve better health for children.     

Exploring the decision-making preferences of people with colorectal cancer

OBJECTIVES: To explore patient views on participation in treatment, physical care and psychological care decisions and factors that facilitate and hinder patients from making decisions. DESIGN: Qualitative study using semi-structured interviews with patients. SETTING AND PARTICIPANTS: Three NHS Trusts in the north-west of England. Theoretical sampling including 41 patients who had been treated for colorectal cancer. RESULTS: For patients, participation in the decision-making process was about being informed and feeling involved in the consultation process, whether patients actually made decisions or not. The perceived availability of treatment choices (surgery, radiotherapy, chemotherapy) was related to type of treatment. Factors that impacted on whether patients wanted to make decisions included a lack of information, a lack of medical knowledge and trust in medical expertise. Patients perceived that they could have a more participatory role in decisions related to physical and psychological care. CONCLUSION: This study has implications for health professionals aiming to implement policy guidelines that promote patient participation and shared partnerships. Patients in this study wanted to be well informed and involved in the consultation process but did not necessarily want to use the information they received to make decisions. The presentation of choices and preferences for participation may be context specific and it cannot be assumed that patients who do not want to make decisions about one aspect of their care and treatment do not want to make decisions about other aspects of their care and treatment.     

Community organization factors affecting veteran participation in adaptive sports

Objective: This study aims to describe United States military veteran participation in adaptive sports and to assess the demographic make-up and organizational characteristics of existing adaptive sports programs.Design: Prospective, cross-sectional survey.Setting: Community organizations with adaptive sports programs.Participants: 85 adaptive sports programs.Interventions: Nine question survey.Outcome Measures: Demographic data and sports offered by adaptive sports programs in the United States.Results: The survey response rate was 70%. The median number of total participants in an organization was 75 and the median number of veterans was 50. 76% of organizations had some degree of affiliation with a VAMC. Organizations affiliated with a VAMC are more likely to be rehabilitation centers, whereas community organizations with no VAMC affiliation are most commonly independent organizations with no rehabilitation component. Individuals of all ages participate in adaptive sports, with increasing participation associated with increasing age. Golf was the sport offered most commonly by adaptive sports programs in this survey. Low-contact sports were offered more often than high-contact sports, and the majority of programs offered adaptive sports year-round.Conclusions: Our results suggest that U.S. Military veterans represent a large proportion of the individuals participating in adaptive sports. Further research specifically focusing on factors veterans find desirable when considering participating in adaptive sports is indicated to identify programs that should be promoted, developed, and funded to increase veteran participation in adaptive sports.     

Recommendations for Better Civic Learning: Building and Rebuilding Democracy

This is the concluding essay for a special report from The Hastings Center entitled Democracy in Crisis: Civic Learning and the Reconstruction of Common Purpose, which grew out of a project supported by the John S. and James L. Knight Foundation. This essay provides an integrative discussion of various theoretical and practical reform perspectives offered by other essays in the report. It also offers a number of recommendations. It notes that the aim of the special report is not to propose specific reform measures but, rather, to consider larger, more theoretic concerns related to political and economic questions, which are personal and structural—psychological, cultural, and institutional—at the same time. In response, this essay argues that the best relationship between the citizenry and government in a democracy is not one of deference, nor one of contestation, but one that is critically constructive, which in turn is linked to practices of civic learning. To be constructive, citizens need scientific literacy, an understanding of how government and other institutions work, critical thinking abilities, and many open and diverse forums for civic learning to offset the increasingly isolating media “bubbles” that are the only source of information for many. The essay then formulates five recommendations designed to facilitate critically constructive citizenship and civic learning. These are creating a basis for civic participation, acquiring information, talking to each other, designing institutional change, and achieving deliberation.     

Participatory Systems Mapping for Municipal Prioritization and Planning

Rapidly growing cities face new and compounding health challenges, leading governments and donors to seek innovative ways to support healthier, more resilient urban growth. One such approach is the systems mapping process developed by Engaging Inquiry (EI) for the USAID-funded Building Healthy Cities project (BHC) in four cities in Asia. This paper provides details on the theory and methods of the process. While systems mapping is not new, the approach detailed in this paper has been uniquely adapted to the purpose of municipal planning. Strategic stakeholder engagement, including participatory workshops with a diverse group of stakeholders, is at the core of this approach and led to deeper insights, greater buy-in, and shared understanding of the city’s unique opportunities and challenges. This innovative mapping process is a powerful tool for defining municipal priorities within growing cities across the globe, where the situation is rapidly evolving. It can be used to provide evidence-based information on where to invest to gain the biggest impact on specific goals. This paper is part of a collection in this issue providing a detailed accounting of BHC’s systems mapping approach across four project cities.     

Promoting Inclusive Recruitment: a Qualitative Study of Black Adults’ Decision to Participate in Genetic Research

Underrepresentation of Black individuals in genetic research is a longstanding issue. There are well-documented strategies to improve the enrollment of Black participants; however, few studies explore these strategies—as well as the barriers and facilitators for participation—by sampling Black people who have previously participated in genetic research. This study explores the decision-making process of Black adults who have participated in genetic research to identify best practices in the recruitment of Black subjects in genetic research. We conducted 18 semi-structured interviews with Black adults with prior research participation in genetic studies housed at an urban academic medical center in the United States of America (USA). An online survey was conducted with the participants to gather demographic data and information on prior research participation. Trust in research was ascertained with the Corbie-Smith Distrust in Clinical Research Index. Two participants scored high levels of distrust using the validated index. Using thematic content analysis, 4 themes emerged from the interviews: (1) Participants are active players in health system, (2) information is power, and transparency is key, (3) therapeutic alliances and study characteristics facilitate participation, and (4) race pervades the research process. The decision to participate in genetic research for the participants in our study was prompted by participants’ internal motivations and facilitated by trust in their doctor, trust in the institution, and ease of participation. Most participants viewed their enrollment in genetic research in the context of their own racial identity and the history of medical racism in the USA.     

家属参与式全方位护理干预在动脉瘤性蛛网膜下腔出血患者中的应用价值

目的 探究家属参与式全方位护理干预在动脉瘤性蛛网膜下腔出血患者中的应用价值.方法 由本院2012年2月至2015年收治的动脉瘤性蛛网膜下腔出血患者中选取90例进行本次实验研究,采取随机双盲法将患者分为观察组(45例)和对照组(45例),对照组患者实施临床常规护理,观察组患者实施家属参与式全方位护理干预,对比两组患者再出血率、并发症情况、护理满意度、住院时间,并采取汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)评估患者的心理状况.结果 观察组患者再出血率为0.00％,总并发症率为4.44％,总满意率为95.56％,对照组分别为11.11％、17.78％、77.78％,观察组再出血率及总并发症率显著低于对照组,总满意率高于对照组,住院时间明显短于对照组[(41.24±3.45)d vs.(49.56±4.34)d],两组比较差异有统计学意义(P＜ 0.05);护理干预前两组患者均存在一定焦虑、抑郁情绪,HAMA、HAMD评分相近;护理干预后各组评分均改善,观察组改善程度优于对照组,差异有统计学意义(P＜0.05).结论 家属参与式全方位护理干预在动脉瘤性蛛网膜下腔出血患者中效果极好,患者再出血率及并发症率显著降低,心理状况改善,患者恢复快,满意度高,具有极高临床应用及推广价值.