Reweighting UK Biobank corrects for pervasive selection bias due to volunteering.

BACKGROUND: Biobanks typically rely on volunteer-based sampling. This results in large samples (power) at the cost of representativeness (bias). The problem of volunteer bias is debated. Here, we (i) show that volunteering biases associations in UK Biobank (UKB) and (ii) estimate inverse probability (IP) weights that correct for volunteer bias in UKB. METHODS: Drawing on UK Census data, we constructed a subsample representative of UKB's target population, which consists of all individuals invited to participate. Based on demographic variables shared between the UK Census and UKB, we estimated IP weights (IPWs) for each UKB participant. We compared 21 weighted and unweighted bivariate associations between these demographic variables to assess volunteer bias. RESULTS: Volunteer bias in all associations, as naively estimated in UKB, was substantial-in some cases so severe that unweighted estimates had the opposite sign of the association in the target population. For example, older individuals in UKB reported being in better health, in contrast to evidence from the UK Census. Using IPWs in weighted regressions reduced 87% of volunteer bias on average. Volunteer-based sampling reduced the effective sample size of UKB substantially, to 32% of its original size. CONCLUSIONS: Estimates from large-scale biobanks may be misleading due to volunteer bias. We recommend IP weighting to correct for such bias. To aid in the construction of the next generation of biobanks, we provide suggestions on how to best ensure representativeness in a volunteer-based design. For UKB, IPWs have been made available.

Examining the effectiveness of a training program on improving knowledge, functional skills, and attitude in natural disaster volunteers.

Introduction: Disaster relief volunteers must have certain psychological and cognitive characteristics. Therefore, the present study aimed to investigate the effectiveness of the training program on improving knowledge, functional skills, and attitude among disaster volunteers. Methods: A quasi-experimental study was conducted in 2023 in Iran, including an intervention and control group and follow-ups. Ninety health volunteers were randomly selected and divided into two groups of 45. The experimental group received the training program for an hour a week for three months. The control group received no intervention. The participants of both groups completed the disaster preparedness questionnaire at the pre-test, post-test, and one and three months after the intervention. Data was analyzed using SPSS "version 26" software in the methods section. Results: The intervention effect were significant in increasing the volunteers' functional skills (F = 3.75), knowledge (F = 166.50), and attitude (F = 1.74), all in (p = 0.001). According to the results, this effect was stable over time for functional skills (F = 1.83) and knowledge (F = 18.04) all in (p < 0.05). Conclusion: Training programs can help improve skills, attitudes and knowledge in natural disaster volunteers. Researchers interested in the field of natural disaster relief, particularly health researchers, could consider further examining the aforementioned topics in their studies.

Supporting each other: Older adults' experiences empowering food security and social inclusion in rural and food desert communities.

Older adults vulnerable to food insecurity are at risk of poor psychological and physical health. Poor public infrastructure or proximity to food sources can exacerbate risk of food insecurity. Reduced statutory services for social care has heightened the responsibility on third sector organisations and community-led volunteering, essential to supporting healthy ageing in place and reducing the inequalities of ageing. The aim of this qualitative study was to explore how older adults' volunteering with a third sector organisation focused on food access supports food security and builds social capital for socially or economically marginalised older adults within rural and food desert communities. The study aims to bridge the knowledge gap of how volunteering in vulnerable geographies affects food insecurity and community. Semi-structured interviews were conducted with seven older (55+) volunteer 'meal makers' working with the third sector organisation Food Train and its 'Meal Makers' project. Interview recordings were transcribed and thematically analysed. Ecomap methodology was used to illustrate the lived experiences of older adult volunteers as told through the interviews. Two themes were identified by Thematic Analysis: (1) Networks, connectedness, and exposure to social capital, and (2) Supplementary support. This study finds that older adult volunteers are well placed within community interventions supporting food insecure older adults in rural or food desert communities. Ecomaps demonstrated that high social capital volunteers can mediate food access barriers and highlighted points of local knowledge and social connection. Volunteer engagement provides opportunities for food secure older adults to share local knowledge and build networks of food support and social inclusion for food insecure older adults. Older age volunteering should be advocated as a multi-faceted intervention promoting mutual health and wellbeing in volunteer and beneficiary.

An anthropological history of Nepal's Female Community Health Volunteer program: gender, policy, and social change.

BACKGROUND: Community health workers (CHWs) are central to Primary Health Care globally. Amidst the current flourishing of work on CHWs, there often is a lack of reference to history-even in studies of programs that have been around for decades. This study examines the 35-year trajectory of Nepal's Female Community Health Volunteers (FCHVs). METHODS: We conducted a content analysis of an archive of primary and secondary research materials, grey literature and government reports collected during 1977-2019 across several regions in Nepal. Documents were coded in MAXQDA using principles of inductive coding. As questions arose from the materials, data were triangulated with published sources. RESULTS: Looking across four decades of the program's history illuminates that issues of gender, workload, and pay-hotly debated in the CHW literature now-have been topics of discussion for observers and FCHVs alike since the inception of the program. Following experiments with predominantly male community volunteers during the 1970s, Nepal scaled up the all-female FCHV program in the late 1980s and early 1990s, in part because of programmatic goals focused on maternal and child health. FCHVs gained legitimacy as health workers in part through participation in donor-funded vertical campaigns. FCHVs received a stable yet modest regular stipend during the early years, but since it was stopped in the 1990s, incentives have been a mix of activity-based payments and in-kind support. With increasing outmigration of men from villages and growing work responsibilities for women, the opportunity cost of health volunteering increased. FCHVs started voicing their dissatisfaction with remuneration, which gave rise to labor movements starting in the 2010s. Government officials have not comprehensively responded to demands by FCHVs for decent work, instead questioning the relevance of FCHVs in a modern, medicalized Nepali health system. CONCLUSIONS: Across public health, an awareness of history is useful in understanding the present and avoiding past mistakes. These histories are often not well-archived, and risk getting lost. Lessons from the history of Nepal's FCHV program have much to offer present-day debates around CHW policies, particularly around gender, workload and payment.

Impact of training on knowledge, confidence and attitude amongst community health volunteers in the provision of community-based palliative care in rural Kenya.

OBJECTIVES: Existing literature suggests multiple potential roles for community health volunteers (CHVs) in the provision of palliative care (PC) in low- and middle-income countries. In Kenya the role of CHV in the provision of PC has not been reported. The objective of this study was to assess knowledge, confidence, attitude, and clinical practice of community health volunteers after attending a novel palliative care (PC) training program. METHODS: A total of 105 CHVs participated in a 3-day in person training followed by a 1-month in person and telephone observation period of the palliative care activities in the community. Structured questionnaires were used pre- and post-training to assess knowledge acquisition, impact on practice, and content delivery. A mixed method study design was conducted 12-month post training to assess impact on clinical practice. RESULTS: Immediately after training, CHV provided positive ratings on relevance and content delivery. In the month following training, CHVs evaluated 1,443 patients, referred 154, and conducted 110 and 129 tele consults with the patients and PC providers respectively. The follow up survey at 12 months revealed improved knowledge and confidence in various domains of palliative care including symptom and spiritual assessment and provision of basic nursing and bereavement care. Focus group discussions revealed the CHVs ability to interpret symptoms, make referrals, improved communication/ interpersonal relationships, spiritual intervention, patient comfort measures and health care practices as newly learned and practiced skills. CONCLUSIONS: We noted improved knowledge, new skills and change in practice after CHVs participation in a novel training curriculum. CHVs can make important contributions to the PC work force and be first line PC providers in the community as part of larger hub and spoke care model.

Willingness of WHO staff to work in health emergencies in the African Region: opportunity for phased deployment of staff and ensure continuity of health services.

A human resource base that ensures appropriate deployment of staff to emergencies, addressing different shock events in emergencies, without disrupting continuity of service is germane to a successful response. Consequently, the WHO Health Emergencies programme in the African Region, in collaboration with Africa Centre for Disease Control (ACDC) launched the African Volunteer Health Corps (AVoHC) and Strengthening and Utilization of Response Group for Emergencies (SURGE), an initiative aimed at ensuring a pool of timely responders. We explored the willingness of WHO staff to work in emergencies. A call for expression of interest to be part of the Elite Emergency Experts (Triple E) was published on 5th July 2022 via email and was open for 5 weeks. The responses were analyzed using simple descriptive statistics and presented with graphic illustrations. A total of 1253 WHO staff, from all the six WHO regions, cutting across all cadre, applied to the call. The applicants had various trainings and experiences in emergency and have responded to mostly disease outbreaks. Two-third of the applicants were males. This paper did not explore reasons for the willingness to work in emergencies. However, contrary to fears expressed in literature that health workers would not want to work in emergencies with potential for infections, the applicants have worked mostly in infectious emergencies. Literature identified some themes on factors that could impact on willingness of health workers to work in emergencies. These include concerns for the safety of the responders and impact of partners, child and elderly care, as well as other family obligations, which emergency planners must consider in planning emergency response.

Global Rate of Willingness to Volunteer Among Medical and Health Students During Pandemic: Systemic Review and Meta-Analysis.

BACKGROUND: During health crises such as the COVID-19 pandemic, shortages of health care workers often occur. Recruiting students as volunteers could be an option, but it is uncertain whether the idea is well-accepted. OBJECTIVE: This study aims to estimate the global rate of willingness to volunteer among medical and health students in response to the COVID-19 pandemic. METHODS: A systematic search was conducted on PubMed, Embase, Scopus, and Google Scholar for studies reporting the number of health students willing to volunteer during COVID-19 from 2019 to November 17, 2023. The meta-analysis was performed using a restricted maximum-likelihood model with logit transformation. RESULTS: A total of 21 studies involving 26,056 health students were included in the meta-analysis. The pooled estimate of the willingness-to-volunteer rate among health students across multiple countries was 66.13%, with an I2 of 98.99% and P value of heterogeneity (P-Het)<.001. Removing a study with the highest influence led to the rate being 64.34%. Our stratified analyses indicated that those with older age, being first-year students, and being female were more willing to volunteer (P<.001). From highest to lowest, the rates were 77.38%, 77.03%, 65.48%, 64.11%, 62.71%, and 55.23% in Africa, Western Europe, East and Southeast Asia, Middle East, and Eastern Europe, respectively. Because of the high heterogeneity, the evidence from this study has moderate strength. CONCLUSIONS: The majority of students are willing to volunteer during COVID-19, suggesting that volunteer recruitment is well-accepted.

The impact of volunteer service on moral education performance and mental health of college students.

BACKGROUND: Moral education in colleges and universities is an important part of the talent training system, including moral education curriculum, moral education practice, mental health education. Volunteer service is a public welfare act in which volunteers volunteer their time, knowledge, property, technology, with the ultimate goal of helping others and serving the society without personal compensation. As an innovative form of moral education practice in colleges and universities, college students' voluntary service is of great significance in promoting the reform and innovation of moral education, enhancing the affinity, appeal and influence of moral education, and building a positive psychology for college students. SUBJECTS AND METHODS: As an effective carrier of moral education practice in colleges and universities, voluntary service is helpful to enhance the effectiveness of moral education practice and construct the positive psychology of college students. This project is based on the actual situation of college students participating in volunteer services, and collected the volunteer services of 4545 college students in Zhejiang Province. Through model construction and data modeling, the correlation between college students' participation in volunteer service and their moral education performance and mental health was analyzed, and the basic path and guarantee measures to promote the role of volunteer service in moral education and positive psychological construction were deeply explored. RESULTS: From the correlation analysis of students' voluntary service participation, moral education performance and voluntary service motivation, students' attributes are determined according to their voluntary service participation, so as to predict their moral education performance and mental health level. CONCLUSION: College students' voluntary service is partially positively related to their moral education performance and mental health. In order to improve students' moral education performance and mental health, we can optimize the participation frequency, participation duration, participation ways and type structure of voluntary service, constantly increase the participation frequency of voluntary service, increase the duration of voluntary service, broaden the participation ways of voluntary activities, and enrich the types of voluntary service activities.

Evaluation of Incoming Messages to WhatsApp Communication Network Created by Volunteers in Major Disasters: The Case of Turkey Earthquake.

OBJECTIVE: This research was conducted in order to assess the 1-week aid needs determined by the health professional who voluntarily served in the WhatsApp communication network during the earthquakes in Kahramanmaras, Turkey. METHODS: This descriptive retrospective epidemiological study focuses on the 1-week messaging activities of the WhatsApp group created by volunteers after the earthquake in Turkey. During the 7-day period included in the research, a total of 5813 messages were sent. 3472 of these messages were not included in the research for various reasons, and a total of 2341 messages were used for the research. RESULTS: In all 7 days, it was seen that most of the messages were sent via text message and that voice messages were very few. When the distribution of the needs demanded by the earthquake victims for 7 days was examined, it was seen that there was a significant increase in the needs on the fourth day after the earthquake, and that the highest increase was the need for tents. CONCLUSION: While the demands for rescue services increased in the first 2 days, it was determined that the demands for water especially, dry food, and tents increased from the third day onwards. It is suggested that a professional online infrastructure system should be created to enable the transfer of instant scene and need information that can be activated in such disasters.

Facilitators and barriers of implementing end-of-life care volunteering in a hospital in five European countries: the iLIVE study.

BACKGROUND: End-of-life (EoL) care volunteers in hospitals are a novel approach to support patients and their close ones. The iLIVE Volunteer Study supported hospital volunteer coordinators from five European countries to design and implement an EoL care volunteer service on general wards in their hospitals. This study aimed to identify and explore barriers and facilitators to the implementation of EoL care volunteer services in the five hospitals. METHODS: Volunteer coordinators (VCs) from the Netherlands (NL), Norway (NO), Slovenia (SI), Spain (ES) and United Kingdom (UK) participated in a focus group interview and subsequent in-depth one-to-one interviews. A theory-inspired framework based on the five domains of the Consolidated Framework for Implementation Research (CFIR) was used for data collection and analysis. Results from the focus group were depicted in radar charts per hospital. RESULTS: Barriers across all hospitals were the COVID-19 pandemic delaying the implementation process, and the lack of recognition of the added value of EoL care volunteers by hospital staff. Site-specific barriers were struggles with promoting the service in a highly structured setting with many stakeholders (NL), negative views among nurses on hospital volunteering (NL, NO), a lack of support from healthcare professionals and the management (SI, ES), and uncertainty about their role in implementation among VCs (ES). Site-specific facilitators were training of volunteers (NO, SI, NL), involving volunteers in promoting the service (NO), and education and awareness for healthcare professionals about the role and boundaries of volunteers (UK). CONCLUSION: Establishing a comprehensive EoL care volunteer service for patients in non-specialist palliative care wards involves multiple considerations including training, creating awareness and ensuring management support. Implementation requires involvement of stakeholders in a way that enables medical EoL care and volunteering to co-exist. Further research is needed to explore how trust and equal partnerships between volunteers and professional staff can be built and sustained. TRIAL REGISTRATION: NCT04678310. Registered 21/12/2020.

Community Transport's Dual Role as a Transport and a Social Scheme: Implications for Policy.

Community transport comprises diverse local, not-for-profit, and primarily volunteer-run transport schemes that operate across the United Kingdom. These schemes support the travel needs of thousands of people, most of whom are older, live in rural areas, and have few other transport options. Further, this transport sector is unique in that most schemes are designed, created, and run by older people themselves. And yet, community transport has thus far received relatively little attention in both policy and research. Using semi-structured interviews with community transport providers in Oxfordshire, this paper proposes community transport as a practice guided by phronesis and argues that it has been made to hold a dual role as both a transport and a social scheme. The transport it provides is unique in being made low-cost, flexible, and functionally accessible. It has also been made into a social scheme as it helps those with few other options, provides benefits that extend beyond the transport realm, and fosters community. Though this dual role means that community transport has many cross-sectoral benefits, this type of service provision is found to be overlooked in both national and local policy, which has enabled the constitutive role of phronesis in community transport. Given this, there are challenges ahead for the sector in both ensuring its sustainability and maintaining its ability to respond closely to users' needs.

The effect of an anti-malarial herbal remedy, Maytenus senegalensis, on electrocardiograms of healthy Tanzanian volunteers.

BACKGROUND: The emergence of resistance to artemisinin-based combination therapy necessitates the search for new, more potent antiplasmodial compounds, including herbal remedies. The whole extract of Maytenus senegalensis has been scientifically investigated for potential biological activities both in vitro and in vivo, demonstrating strong antimalarial activity. However, there is a lack of data on the electrocardiographic effects of M. senegalensis in humans, which is a crucial aspect in the investigation of malaria treatment. Assessing the electrocardiographic effects of M. senegalensis is essential, as many anti-malarial drugs can inadvertently prolong the QT interval on electrocardiograms. Therefore, the study's objective was to evaluate the electrocardiographic effects of M. senegalensis in healthy adult volunteers. METHODS: This study is a secondary analysis of an open-label single-arm dose escalation. Twelve healthy eligible Tanzanian males, aged 18 to 45, were enrolled in four study dose groups. A single 12-lead electrocardiogram (ECG) was performed at baseline and on days 3, 7, 14, 28, and 56. RESULTS: No QTcF adverse events occurred with any drug dose. Only one volunteer who received the highest dose (800 mg) of M. senegalensis experienced a moderate transient change (△QTcF > 30 ms; specifically, the value was 37 ms) from baseline on day 28. There was no difference in maximum QTcF and maximum △QTcF between volunteers in all four study dose groups. CONCLUSIONS: A four-day regimen of 800 mg every 8 h of M. senegalensis did not impact the electrocardiographic parameters in healthy volunteers. This study suggests that M. senegalensis could be a valuable addition to malaria treatment, providing a safer alternative and potentially aiding in the battle against artemisinin-resistant malaria. The results of this study support both the traditional use and the modern therapeutic potential of M. senegalensis. They also set the stage for future research involving larger and more diverse populations to explore the safety profile of M. senegalensis in different demographic groups. This is especially important considering the potential use of M. senegalensis as a therapeutic agent and its widespread utilization as traditional medicine. Trial registration ClinicalTrials.gov, NCT04944966. Registered 30 June 2021-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04944966?term=kamaka&draw=2&rank=1.

Knowledge, Attitudes, and Practices Regarding Dengue Prevention Among Health Volunteers in an Urban Area - Malang, Indonesia.

OBJECTIVES: The dengue prevention program known as "One House One Mosquito Larva Inspector" involves health volunteers who play a crucial role in the surveillance of mosquito larvae and reporting their findings to local public health officials. This study aimed to identify factors related to the knowledge, attitudes, and practices (KAP) of dengue prevention behavior among these health volunteers. METHODS: A study was conducted in 5 sub-districts in Malang, an urban area in Indonesia. We employed a cross-sectional design and utilized a semi-structured questionnaire to assess the KAP of 400 health volunteers. Data were collected through face-to-face interviews. RESULTS: Multiple logistic regression analysis revealed that individuals with a more positive attitude (odds ratio [OR], 1.69; p<0.05) and those with family sizes greater than five persons (OR, 1.90; p<0.05) were more likely to engage in effective dengue prevention practices. Additionally, possesing good knowledge was significantly assocated with more positive attitude (OR, 2.24; p<0.001). Furthermore, 40% reduction in positive attitude was observed in those over 45 years (OR, 0.60; p<0.05). The best practices most frequently reported by the majority of respondents included always reporting their surveillance activities (75.8%) and cleaning the water container in the bathroom at least once a week (65.2%). However, only 52.2% of respondents regularly checked for mosquito larvae in their neighborhood. CONCLUSIONS: Sustainable promotion and training for the "One House One Mosquito Larva Inspector" initiative are necessary, particularly among young health volunteers, to improve dengue prevention behaviors both within their own homes and in the surrounding environment.

Nurses Honoring Fallen Nurses.

ABSTRACT: Nurse honor guards are groups of volunteer nurses that attend fellow nurses' funerals or memorial services and conduct a brief ceremony to recognize the nurse's dedication to the profession. These ceremonies incorporate elements of nursing's history, including the wearing of traditional nursing uniforms. Nurse honor guards highlight that nurses not only tend to the well-being of their patients but also share a collective responsibility to support and care for one another. This article describes what nurse honor guards do and discusses the authors' experiences participating in them.

The experiences and needs of older adults receiving voluntary services in Chinese nursing home organizations: a qualitative study.

BACKGROUND: Older adults living in nursing home organizations are eager to get voluntary help, however, their past experiences with voluntary services are not satisfactory enough. To better carry out voluntary services and improve the effectiveness of services, it is necessary to have a deeper understanding of the experiences and needs of older adults for voluntary services. METHODS: The purposive sampling method was used to select 14 older adults from two nursing home organizations in Hangzhou and conduct semi-structured interviews, Collaizzi's seven-step method was used to analyze the data. RESULTS: Older adults in nursing home organizations have both beneficial experiences and unpleasant service experiences in the process of receiving voluntary services; Beneficial experiences include solving problems meeting needs and feeling warmth and care, while unpleasant service experiences include the formality that makes it difficult to benefit truly, lack of organization, regularity, sustainability, and the mismatch between service provision and actual demands. The needs for voluntary services mainly focuses on emotional comfort, Cultural and recreational, and knowledge acquisition. CONCLUSION: Older adults in nursing home organizations have varied voluntary experiences, and their voluntary service needs are diversified. Voluntary service needs of older adults should be accurately assessed, and voluntary service activities should be focused upon.

Miracle friends and miracle money in California: a mixed-methods experiment of social support and guaranteed income for people experiencing homelessness.

BACKGROUND: This paper describes the protocols for a randomized controlled trial using a parallel-group trial design that includes an intervention designed to address social isolation and loneliness among people experiencing homelessness known as Miracle Friends and an intervention that combines Miracles Friends with an economic poverty-reduction intervention known as Miracle Money. Miracle Friends pairs an unhoused person with a volunteer "phone buddy." Miracle Money provides guaranteed basic income of $750 per month for 1 year to Miracle Friends participants. The study will examine whether either intervention reduces social isolation or homelessness compared to a waitlist control group. METHODS: Unhoused individuals who expressed interest in the Miracle Friends program were randomized to either receive the intervention or be placed on a waitlist for Miracle Friends. Among those randomized to receive the Miracle Friends intervention, randomization also determined whether they would be offered Miracle Money. The possibility of receiving basic income was only disclosed to study participants if they were randomly selected and participated in the Miracle Friends program. All study participants, regardless of assignment, were surveyed every 3 months for 15 months. RESULTS: Of 760 unhoused individuals enrolled in the study, 256 were randomized to receive Miracle Friends, 267 were randomized to receive Miracle Money, and 237 were randomized to the waitlist control group. In the two intervention groups, 360 of 523 unhoused individuals were initially matched to a phone buddy. Of the 191 study participants in the Miracle Money group who had been initially matched to a volunteer phone buddy, 103 were deemed to be participating in the program and began receiving monthly income. DISCUSSION: This randomized controlled trial will determine whether innovative interventions involving volunteer phone support and basic income reduce social isolation and improve housing outcomes for people experiencing homelessness. Although we enrolled unhoused individuals who initially expressed interest in the Miracle Friends program, the study team could not reach approximately 30% of individuals referred to the study. This may reflect the general lack of stability in the lives of people who are unhoused or limitations in the appeal of such a program to some portion of the unhoused population. TRIAL REGISTRATION: ClinicalTrials.gov NCT05408884 (first submitted on May 26, 2022).

"Don't fuss at our staff": A moral economy of volunteerism in South Carolina safety net clinics.

In South Carolina, a state that has foregone Medicaid expansion, working poor residents often rely on safety net clinics for medical care. This care often occurs far from major hospitals, in different, inferior, spaces where limited services are provided in lesser circumstances. The temporary and conditional aid provided in these clinics is meant as a last resort, but often serves as the only source of care for many working poor patients, who must manage the effects of sustained precarity and protracted immiseration with conditional aid provided by volunteers. Here I explore the function that volunteering plays in regulating patients' utilization, and ability to contest, the quality of safety net care. Using ethnographic examples and interview data I show how the needs of patients-referred to in the clinics as "clients"-are managed and contained by a moral economy of volunteer care. These reciprocal obligations of debt and duty preclude working poor patients from making demands of, or lodging complaints against, the free clinics' staff, due to their capacity as volunteers, and leaves the state's safety net effectively unassailable to accusations of inefficacy or neglect. Consequently, patients must defer care, ignore episodes of maltreatment, and ration and share prescription medications, lest they be considered recusant or deemed not sufficiently appreciative of the volunteer staff dedicating their time to them. As a result of this moral economy, the plight of the state's uninsured working poor residents goes under-recognized as the safety net absorbs their cases, hiding the attritional nature of the ostensibly free care they receive and ration.