RESUMEN
The transition from pediatric to adult care for patients with chronic disease is a vulnerable period, with risks of disengagement from care and subsequent complications of inadequately managed disease. This period comes at a time when there are many other transitions occurring in the young person's life, including changes to vocation, social supports, and to their physiology. The aim of the TRACER study is to assess the feasibility of conducting a multi-center, randomized-controlled trial of a virtual Transition Coach Intervention in youth transferring from pediatric to adult rheumatology care. Patients are being recruited at their last pediatric rheumatology visit from McMaster Children's Hospital and Children's Hospital, London Health Sciences Centre in Ontario, Canada. Participants are then randomized to standard of care or to eight transition coaching sessions, covering topics around health management, future planning, and self-advocacy. The primary outcomes of the study are to demonstrate protocol feasibility, including optimal recruitment and consent rates, ≥ 90% coaching session completion, and complete data collection with ≤ 5% missing data. Baseline demographics, transition readiness, global functional assessment, disease activity, and self-efficacy will be collected to characterize the study population. Recruitment has begun and is estimated to last 19 months. This study will inform the design of a robust, multi-centered, randomized-controlled study to investigate the impact of a virtual transition coaching program in supporting the physical, mental, and social well-being of youth with rheumatic disease transitioning into adult care. Clinical trial registration: ClinicalTrials.Gov protocol ID: 14499.
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Estudios de Factibilidad , Tutoría , Reumatología , Transición a la Atención de Adultos , Humanos , Reumatología/métodos , Tutoría/métodos , Adolescente , Adulto , Adulto Joven , Masculino , Empoderamiento , Femenino , Enfermedades Reumáticas/terapia , Enfermedades Reumáticas/psicología , NiñoRESUMEN
BACKGROUND: Establishing healthy behaviors during a child's first 5 years is essential for healthy growth. Parents are targeted as agents of change because they serve as primary models of behavior during this period. Although parent-focused interventions often target empowerment as a driver of change, our understanding of how parents experience the process of empowerment in the context of child health promotion remains limited. OBJECTIVE: This qualitative study explored the process by which parents gain empowerment through participation in a health promotion intervention. METHODS: Semi-structured interviews were conducted with 37 low-income parents who participated in Parents Connect for Healthy Living (PConnect), a 10-week empowerment-centered obesity prevention intervention. Data were analyzed using inductive-deductive thematic analysis and guided by empowerment theories. RESULTS: Most parents were Hispanic/Latino (41%) and female (97%). Five themes emerged that correspond to the process by which parents gained empowerment: (1) friendships formed and relationships strengthened during PConnect, (2) parents strengthened relationships with their children and believed in their ability to parent successfully, (3) the experience of knowledge led to behavior change, (4) parents used new resources to improve family health, and (5) parents took action. CONCLUSION: Empowerment theory should be a component of health promotion programs.
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Empoderamiento , Promoción de la Salud , Padres , Investigación Cualitativa , Humanos , Femenino , Promoción de la Salud/métodos , Masculino , Padres/psicología , Adulto , Pobreza , Relaciones Padres-Hijo , Entrevistas como Asunto , Preescolar , Salud Infantil , Niño , Conductas Relacionadas con la Salud , Poder Psicológico , Hispánicos o Latinos/psicologíaRESUMEN
BACKGROUND: Social media, including online health communities (OHCs), are widely used among both healthy people and those with health conditions. Platforms like Twitter (recently renamed X) have become powerful tools for online mental health communities (OMHCs), enabling users to exchange information, express feelings, and socialize. Recognized as empowering processes, these activities could empower mental health consumers, their families and friends, and society. However, it remains unclear how OMHCs empower diverse population levels and groups. OBJECTIVE: This study aimed to develop an understanding of how empowerment processes are conducted within OMHCs on Twitter by identifying members who shape these communities, detecting the types of empowerment processes aligned with the population levels and groups outlined in Strategy 1 of the Integrated People-Centred Health Services (IPCHS) framework by the World Health Organization (WHO), and clarifying members' involvement tendencies in these processes. METHODS: We conducted our analysis on a Twitter OMHC called #bipolarclub. We captured 2068 original tweets using its hashtag #bipolarclub between December 19, 2022, and January 15, 2023. After screening, 547 eligible tweets by 182 authors were analyzed. Using qualitative content analysis, community members were classified by examining the 182 authors' Twitter profiles, and empowerment processes were identified by analyzing the 547 tweets and categorized according to the WHO's Strategy 1. Members' tendencies of involvement were examined through their contributions to the identified processes. RESULTS: The analysis of #bipolarclub community members unveiled 5 main classifications among the 182 members, with the majority classified as individual members (n=138, 75.8%), followed by health care-related members (n=39, 21.4%). All members declared that they experience mental health conditions, including mental health and general practitioner members, who used the community as consumers and peers rather than for professional services. The analysis of 547 tweets for empowerment processes revealed 3 categories: individual-level processes (6 processes and 2 subprocesses), informal carer processes (1 process for families and 1 process for friends), and society-level processes (1 process and 2 subprocesses). The analysis also demonstrated distinct involvement tendencies among members, influenced by their identities, with individual members engaging in self-expression and family awareness support and health care-related members supporting societal awareness. CONCLUSIONS: The examination of the #bipolarclub community highlights the capability of Twitter-based OMHCs to empower mental health consumers (including those from underserved and marginalized populations), their families and friends, and society, aligning with the WHO's empowerment agenda. This underscores the potential benefits of leveraging Twitter for such objectives. This pioneering study is the very first to analyze how a single OMHC can empower diverse populations, offering various health care stakeholders valuable guidance and aiding them in developing consumer-oriented empowerment programs using such OMHCs. We also propose a structured framework that classifies empowerment processes in OMHCs, inspired by the WHO's Strategy 1 (IPCHS framework).
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Empoderamiento , Salud Mental , Medios de Comunicación Sociales , Humanos , Medios de Comunicación Sociales/estadística & datos numéricos , Investigación Cualitativa , Servicios de Salud MentalRESUMEN
BACKGROUND: Patients with severe mental health issues who live in isolated rural areas are difficult to reach and treat. Providing effective treatment is difficult because mental health problems are complex and require specialized knowledge from a range of professionals. Task-sharing with lay mental health workers (LMHWs) has potential but requires proper training and supervision to be effective. This article reports on the challenges and facilitators experienced in empowering LMHWs in their role, with the help of a technology supported supervision group. The study sought to understand the functioning of the Empowering Supervisory Group (ESG) in the context of junior psychologists and LMHWs in rural India, and investigate how they experienced it by exploring challenges, lessons and empowerment. METHODS: Qualitative analysis of interviews with the 22 ESG participants and their supervisors. RESULTS: A total of three discrete phases of supervision were identified where supervisors responded to the changing needs of the group. This began with building trust at a baseline level, tackling issues with competence and autonomy and finally experiencing meaning and impact through self-determination. The experience of empowerment even in an online setting was very beneficial given the challenges of working in rural areas. CONCLUSION: Empowerment based supervision of LMHWs and junior psychologists online enables a level of engagement that positions them to engage in community mental health practices with greater independence and confidence.
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Empoderamiento , Humanos , India , Femenino , Población Rural , Agentes Comunitarios de Salud/psicología , Agentes Comunitarios de Salud/organización & administración , Agentes Comunitarios de Salud/educación , Psicología , Masculino , Servicios de Salud Rural/organización & administración , Investigación Cualitativa , Adulto , Servicios de Salud Mental/organización & administración , Poder PsicológicoRESUMEN
BACKGROUND: Providing relevant knowledge to empower all pregnant women diagnosed and nondiagnosed with tuberculosis (TB) is essential worldwide. Proper dissemination of health information for pregnant women could assist in preventing TB complications amongst women and babies. The study aimed to describe the sources of knowledge that empower pregnant women diagnosed with TB and improve their quality of life in Limpopo Province, South Africa. METHODOLOGY: The study followed a qualitative, exploratory and descriptive research design. The study was conducted in 12 selected primary healthcare facilities in three crisis districts. Thirty-five pregnant women with TB disease were purposively selected, and face-to-face interviews were conducted to generate data, which were analysed using the thematic approach. Measures to ensure trustworthiness and ethical standards were adhered to. RESULTS: The findings of this study revealed that healthcare workers, community stakeholders, and TB ambassadors are the primary sources of knowledge dissemination for capacitating women diagnosed with TB. CONCLUSION: Most pregnant women lacked knowledge regarding TB ambassadors as sources of information for empowering women, community awareness campaigns, and Google searches as sources of information sharing. All stakeholders need to work together, considering the patients' charter for TB care that sets out the right for respect and information sharing. The emphasis of this study was on developing a comprehensive educational intervention that could assist in improving the quality of TB services offered to pregnant women.
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Conocimientos, Actitudes y Práctica en Salud , Mujeres Embarazadas , Investigación Cualitativa , Tuberculosis , Humanos , Femenino , Sudáfrica , Embarazo , Adulto , Mujeres Embarazadas/psicología , Empoderamiento , Entrevistas como Asunto , Calidad de Vida , Adulto JovenRESUMEN
Climate change can evoke intergenerational conflict. Structural inequalities and their unequal impact on generations can increase perceptions of collective victimhood among the younger generation (< 30 years) and bear the risk of social tensions between the young and the elderly. An experimental study (N = 434) showed that younger people perceived an increased risk of future victimhood. In line with a needs-based approach, the young reported an increased desire to pursue agentic intergroup goals, indicating a heightened need for agency. However, when the young received empowering messages that affirmed their ingroup agency, their willingness to reconcile with the old generation increased, whereas informing them about non-agentic ingroup behavior did not affect reconciliation (between-subjects manipulation). While empowering messages from the outgroup ("Grannies for Future") that directly affirmed the young generations' agency for climate change mitigation as well as empowering messages from the ingroup that indirectly affirmed ingroup agency in domains unrelated to climate change both addressed the need for agency, only outgroup empowerment promoted intergenerational reconciliation. However, empowerment did not affect support for collective climate action. We discuss empowerment as an avenue for resolving intergroup conflict in the context of climate change and possible consequences for climate action and social change.
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Cambio Climático , Relaciones Intergeneracionales , Humanos , Masculino , Femenino , Adulto , Adulto Joven , Empoderamiento , Poder Psicológico , Persona de Mediana Edad , AncianoRESUMEN
Women's empowerment has been promoted by researchers and development practitioners as one of the most promising strategies to address widespread hunger and malnutrition. However, the relationship between women's empowerment and dietary diversity and child nutrition has rarely been studied among vulnerable populations or individuals at greater risk of poor physical and social health status. Moreover, the effects of different domains of women's empowerment on nutritional outcomes, including dietary diversity and child anthropometry, have rarely been examined, especially with panel data. Using two rounds of panel data from 1900 households and fixed effects regression models, we analyze the effect of women's empowerment on household dietary diversity score (HDDS) and child anthropometry among the particularly vulnerable tribal groups in Odisha, India. We also estimate the effects of various decision-making domains of women's empowerment on HDDS and child anthropometry to understand which empowerment domains matter for nutrition. Results show that women's empowerment is positively associated with HDDS (coef. 0.41 food groups; p < 0.1) and reduces the prevalence of underweight (coef. 39%; p < 0.05) and wasting (coef. 56%; p < 0.1) in children but has no effect on the prevalence of child stunting. Women's empowerment in agricultural input use; output sales; income; food purchases; and credit, group membership, and employment contribute to improved dietary diversity and child nutrition. We conclude that women's empowerment contributes to improved dietary diversity and child nutrition and is a promising strategy to improve farm household diets and child nutrition among vulnerable populations. Strengthening women's empowerment through the promotion of women's access to land and other agricultural inputs, market participation, access to information, capital, and credit is important.
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Antropometría , Dieta , Empoderamiento , Composición Familiar , Poblaciones Vulnerables , Humanos , India/epidemiología , Femenino , Poblaciones Vulnerables/psicología , Poblaciones Vulnerables/estadística & datos numéricos , Adulto , Niño , Masculino , Estado Nutricional , PreescolarRESUMEN
BACKGROUND: Being diagnosed with Breast Cancer (BC) is a crisis that throws the patient's life out of balance. Cancer-related fatigue is a debilitating sign experienced by women during and after BC treatment. Regular physical exercise may help mitigate patients' fatigue, enhance coping abilities, improve their quality of life, and overall well-being. In parallel, psychological interventions are geared toward normalizing the lived painful experiences among oncology patients. OBJECTIVE: to examine the effect of bundling seated exercises and psychoeducational rehabilitation using the teach-back approach on fatigue and coping of women postmastectomy. METHODS: A quasi-experimental study was conducted in the Oncology Surgical Department and chemotherapy unit at the Alexandria Main University Hospital, Egypt. A total of 60 women were randomly allocated to either to the study or the control groups. Women in the study group practiced seated exercises and psychological rehabilitation interventions, including mindfulness breathing, problem-solving training, cognitive reframing technique, and thought stopping while the control group received the routine care. RESULTS: The study revealed a significant decline in the fatigue mean scores among participants in the intervention group from 136.10 ± 27.76 to 98.43 ± 25.99 (p < 0.001). Similarly, there was a significant decrease in the patients' mean scores of maladaptive coping, helplessness/ hopelessness (p = 0.014), and anxious preoccupation (p = 0.008). In contrast, there is a noticeable increment in the scores of adaptive coping, such as fighting spirit (p = 0.012), cognitive avoidance (p = 0.002), and fatalism (p = 0.009). CONCLUSION: Bundling seated exercises and psychological rehabilitation interventions using the teach-back approach have been proven to be simple and inexpensive non-pharmacological methods of reducing cancer-related fatigue and improving coping skills among women post-mastectomy. TRIAL REGISTRATION NUMBER: NCT06360276, ClinicalTrails.gov, Retrospectively registered (April 8th, 2024), URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT06360276 .
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Adaptación Psicológica , Neoplasias de la Mama , Terapia por Ejercicio , Fatiga , Mastectomía , Humanos , Femenino , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/psicología , Mastectomía/psicología , Persona de Mediana Edad , Fatiga/psicología , Adulto , Terapia por Ejercicio/métodos , Terapia por Ejercicio/psicología , Calidad de Vida/psicología , Atención Plena/métodos , Egipto , Educación del Paciente como Asunto/métodos , Empoderamiento , Terapias Mente-Cuerpo/métodos , Ejercicio Físico/psicologíaRESUMEN
Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF-LPF frameworks and suggestions to increase the transformative power of future studies.
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Investigación Participativa Basada en la Comunidad , Vivienda Popular , Investigación Cualitativa , Humanos , Quebec , Colaboración Intersectorial , Disparidades en el Estado de Salud , Empoderamiento , Poder Psicológico , Entrevistas como AsuntoRESUMEN
Biology education research provides important guidance for educators aiming to ensure access for disabled students. However, there is still work to be done in developing similar guidelines for research settings. By using critical frameworks that amplify the voices of people facing multiple forms of marginalization, there is potential to transform current biology education research practices. Many biology education researchers are still in the early stages of understanding critical disability frameworks, such as Disability Critical Race Studies (DisCrit), which consists of seven tenets designed to explore the intersecting experiences of ableism and racism. Our Research Methods Essay uses DisCrit as a model framework and pulls from other related critical disability frameworks to empower disabled voices in biology education research. Drawing from existing scholarship, we discuss how biology education researchers can design, conduct, and share research findings. Additionally, we highlight strategies that biology education scholars can use in their research to support access for participants. We propose the creation and sharing of Access and Equity Maps to help plan-and make public-the steps researchers take to foster access in their research. We close by discussing frequently asked questions researchers may encounter in taking on critical frameworks, such as DisCrit.
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Biología , Personas con Discapacidad , Humanos , Biología/educación , Investigación , Estudiantes , Empoderamiento , Proyectos de Investigación , RacismoRESUMEN
In the realm of modern healthcare, digital health solutions are poised to transform patient care, particularly in surgical interventions such as Total Hip Arthroplasty. Through a scoping review of 40 studies, this paper identifies six categories of digital interventions tailored for pre- and post-operative care in THA, spanning (Tele-)Rehabilitation, (Tele-)Monitoring and -Communication, Mobile Applications and Patient Portals, Digital Patient Assessment and Outcome Measurement, as well as Biomechanics and Robotics. These solutions, ranging from AI-driven communication tools to weight-shifting robot control systems, promise a more patient-centered, efficient, and accessible healthcare model. The paper concludes by advocating for continued exploration and development of digital health solutions to improve surgical outcomes and patient experiences across various medical contexts.
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Artroplastia de Reemplazo de Cadera , Telemedicina , Artroplastia de Reemplazo de Cadera/rehabilitación , Humanos , Empoderamiento , Aplicaciones Móviles , Salud DigitalRESUMEN
This paper introduces a mobile framework designed to enhance citizen access to and sharing of health data, aiming to empower individuals with greater control over their personal health information. Accessing and sharing health-related data is essential in everyday scenarios, from routine doctor visits or viewing your health on your own to emergencies where swift access can save lives. It addresses the challenges posed by the fragmented nature of healthcare services and the barriers of language differences in patient records. The framework utilizes the EU eHealth Digital Service Infrastructure (eHDSI) OpenNCP for translating patient summaries and the FHIR Smart Health Links Protocol for secure sharing. A pilot study with 40 participants was conducted to assess the usability and effectiveness of the app, revealing a strong demand among citizens for such innovative health services.
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Aplicaciones Móviles , Humanos , Proyectos Piloto , Difusión de la Información , Telemedicina , Registros Electrónicos de Salud , Registros de Salud Personal , Empoderamiento , Salud DigitalRESUMEN
Health literacy empowers people to access, understand and apply health information to effectively manage their own health and to be an active participant in healthcare decisions. In this paper we propose a conceptual model for cognitive factors affecting health literacy and related socioeconomic aspects. Then we develop the HEALIE Knowledge Graph to represent the model, drawing from various medical ontologies, resources, and insights from domain experts. Finally, we combine the Knowledge Graph with a Large Language Model to generate personalised medical content and showcase the results through an example.
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Alfabetización en Salud , Humanos , Participación del Paciente , Medicina de Precisión , Procesamiento de Lenguaje Natural , EmpoderamientoRESUMEN
Global health photography has historically been commissioned and, therefore, dominated by the gaze of Western photographers on assignments in the Global South. This is changing as part of international calls to decolonise global health and stimulate 'empowerment', spawning a growing initiative to hire local photographers. This article, based on interviews with global health photographers, reflects on this paradigm shift. It highlights how behind the laudable aim of 'empowerment' of local global health photography there is a simultaneous exploitation of precarious photographer labour and the emergence of 'glocal' photography elites. The paper argues that empowerment of local photographers can become a euphemism for reducing image production costs and maintaining control over the image content, while extending the scope of mainstream global health visual culture without challenging it. Finally, the article amplifies the growing concern that uncritical engagement with institutionalised empowerment becomes a warrant for the reproduction of local inequalities behind the fashionable façade of cooperation and care.
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Empoderamiento , Salud Global , Fotograbar , Humanos , Entrevistas como Asunto , ColonialismoRESUMEN
Objective: To explore the causal complexity between individual digital literacy and innovative behaviors by focusing on medical students, and to provide scientific references for empowering their innovative behaviors. Methods: A questionnaire survey was conducted to collect relevant data from students currently enrolled in a medical school in Anhui Province. Fuzzy-set qualitative comparative analysis (fsQCA) was performed to examine the different combination paths for empowering innovative behaviors in medical students. Results: A total of 922 valid questionnaires were collected. Based on six conditional variables of digital literacy, namely information and data literacy, communication and collaboration literacy, digital content creation literacy, security literacy, problem solving literacy, and career-related literacy, there were five configurations for high-level innovation behaviors of medical students, with the overall consistency being 0.816 and the overall coverage being 0.664. On the other hand, there were three configurations for their low-level innovation behaviors, with the overall consistency being 0.901 and the total coverage being 0.585. Conclusion: There is a causal complexity between medical students' digital literacy and their innovative behaviors. Different dimensions of digital literacy act synergistically to produce multiple paths to empower medical students' innovative behaviors. Among them, a high level of competence in digital content creation is the core condition that empowers innovative behaviors in medical students, while a low level of problem-solving competence is the key barrier to their innovative behaviors.
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Estudiantes de Medicina , Estudiantes de Medicina/psicología , Humanos , Encuestas y Cuestionarios , Empoderamiento , Alfabetización Digital , Lógica Difusa , Femenino , Solución de ProblemasRESUMEN
The five-year rule must die. Despite an extensive literature search, the origins of the five-year rule remain unknown. In an era when the nursing profession is so focused on evidence-based practice, any approach that arbitrarily limits literature searches to articles published in the previous five years lacks scientific basis. We explore some reasons for the pervasiveness of the practice and suggest that librarians need to engage with nursing faculty, who are well-positioned to be change agents in this practice.
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Docentes de Enfermería , Humanos , Empoderamiento , Bibliotecólogos , Innovación Organizacional , Bibliotecas Médicas/organización & administraciónRESUMEN
Neonatal mortality remains a critical public health issue, with Sub-Saharan Africa (SSA) experiencing disproportionately high rates compared to other global regions. Notably, SSA and South Asia are the regions most lagging behind the Sustainable Development Goal (SDG) 3.2, aiming for <12 neonatal deaths per 1,000 live births by 2030. Within SSA, Nigeria, the most populous country, records the highest number of neonatal deaths annually. Given the structural similarities among SSA nations, this narrative review, focusing on Nigeria, explores effective strategies to reduce the neonatal mortality gap. Information about trends, risk factors, and prevalent lapses was obtained from literature from renowned databases like PubMed, Scopus, and Google Scholar, and grey literature consisting of reports from relevant governmental and non-governmental organizations. Critical risk factors commonly identified include inadequate antenatal care (less than three visits), lack of access to skilled and clean birth practices, limited healthcare accessibility, financial barriers, substandard environmental conditions, and nutritional shortfalls. This review highlights women's empowerment as an additional critical factor, often overlooked, in the efforts to decrease neonatal mortality rates. Improving women's empowerment indices, such as the Gender Inequality Index (GII), employment, and literacy, offers a promising avenue to curtail neonatal mortality rates in Nigeria and across SSA sustainably. While this is potentially a long-term solution, short and medium-term recommendations were also proffered. By integrating women's empowerment within a broader strategy to improve maternal and newborn health, Nigeria can advance towards securing a healthier future for its youngest population.
Main findings: Neonatal mortality remains a major public health crisis in SSA, even with sustained local and global efforts.Added knowledge: Sustainably resolving this crisis requires a holistic approach that includes women's empowerment, a factor that is often overlooked in current interventions to curb neonatal mortality.Global health impact for policy and action: Prioritizing women's empowerment will contribute to sustainably reducing neonatal mortality rates and will also help address other prevalent public health and economic challenges facing developing countries.
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Empoderamiento , Mortalidad Infantil , Humanos , Femenino , Nigeria/epidemiología , Recién Nacido , Lactante , Factores de Riesgo , África del Sur del Sahara/epidemiología , Embarazo , Accesibilidad a los Servicios de Salud , Factores Socioeconómicos , Atención Prenatal/organización & administraciónRESUMEN
Institutions training future healthcare professionals in healthcare and community engagement play a crucial role beyond traditional classroom settings. Recognizing their potential to support under-represented groups and minorities, institutions increasingly encourage engagement with schools and community organizations. However, work remains to advance meaningful and impactful educational outreach and service-learning programs. This manuscript synthesizes the perspectives of a group of medical school educators to discuss developing sustainable programs to engage youth in Science, Technology, Engineering, Math, and Medicine (STEMM) education with a focus on biomedical science. Through near-peer education and service-learning, healthcare students can impart knowledge, provide mentorship, promote enthusiasm for STEMM fields, and nurture health-related self-efficacy within individuals and communities. Collaborative efforts through student-as-teacher approaches bridge health-related disparities and cultivate healthier, more empowered futures for all. We advocate for community outreach strategies that target future health professionals early in their education and support the scholarship of teaching and learning and program evaluation. Successful long-term programs must ensure that results are systematically assessed, measured, and perpetuated. This perspective aims to highlight the role of service learning and community outreach in increasing individual health literacy and fostering an enduring interest in STEMM careers, thereby empowering the next generation of elementary and secondary school students.
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Relaciones Comunidad-Institución , Alfabetización en Salud , Humanos , EmpoderamientoRESUMEN
INTRODUCTION: Sexual and reproductive health and rights (SRHR) are vital for both individual well-being and development. Bangladesh has made long strides in improving SRHR over the last few decades. However, the progress has been uneven across various groups of reproductive-aged females, with the married adolescent girls (MAGs) often being more vulnerable to denial of SRHR than other women. This study intends to develop Balika Bodhu, a combined empowerment and social norm intervention for promoting SRHR among the MAGs and assess its impact. METHODS: The evaluation will employ a mixed-method two-arm Cluster Randomized Controlled Trial (CRCT) design, where Arm 1 receives the intervention, and Arm 2 serves as the control. The trial will cover 32 clusters (villages) in Rajbari Sadar sub-district, randomized into two equally distributed study arms. A total of 1,120 MAGs aged 15-19 years will be randomly selected from the clusters (35 per cluster) to form a cohort. The MAGs, their husbands, selected elderly women (26 per village) and influential community members (26 per village) will receive group sessions in the intervention clusters. The MAGs and their husbands will be interviewed at baseline and endline. A randomly selected cross-sectional sample of community members aged 35-59 years at baseline and endline will also be surveyed to measure attitudes and social norm regarding SRHR of MAGs. Qualitative data will be collected using 32 In-depth Interviews, six Key Informant Interviews, and eight Focus Group Discussions from two intervention villages. Intention-to-treat (ITT) analysis will be performed to assess the impact of the intervention. Narrative analysis and the Grounded Theory approach will be used to analyze the qualitative data. CONCLUSION: Rigorous evaluation of Balika Bodhu should contribute to the literature on what works and what does not in addressing denial of SRHR to MAGs using empowerment and social norm intervention and inform policies and programs. TRIAL REGISTRATION: Clinicaltrials.gov: identifier: NCT06126770; Date: Oct 7, 2023. Version 1.
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Empoderamiento , Salud Reproductiva , Población Rural , Salud Sexual , Normas Sociales , Adolescente , Adulto , Femenino , Humanos , Adulto Joven , Bangladesh , Matrimonio/psicología , Ensayos Clínicos Controlados Aleatorios como Asunto , Conducta Sexual/psicologíaRESUMEN
Parkinson's disease (PD) poses a number of challenges for individuals, affecting them physically, mentally, emotionally, and socially. The complex nature of PD necessitates empowering patients to address their unique needs and challenges, fostering improved health outcomes and a better quality of life. Patient empowerment is a multifaceted concept crucial to enhancing healthcare outcomes, particularly in chronic conditions such as PD. However, defining patient empowerment presents challenges due to its varied interpretations across disciplines and individuals. Essential components include access to information, development of self-care skills, and fostering a supportive environment. Strategies for patient empowerment encompass health literacy, education, and shared decision-making within a trusted healthcare provider-patient relationship. In PD, patient empowerment is crucial due to the disease's phenotypic variability and subjective impact on quality of life. Patients must navigate individualized treatment plans and advocate for their needs, given the absence of objective markers of disease progression. Empowerment facilitates shared decision-making and enables patients to communicate their unique experiences and management goals effectively. This paper provides a comprehensive overview of the dimensions and strategies associated with patient empowerment, its definition and the facilitators that are necessary, emphasizing its critical importance and relevance in Parkinson's management. At the end of this review is a personal perspective as one of the authors is a person with lived experience.