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Health Education and Behavior

The Impact of the Castle Doctrine on Crime Rates in Texas: Policy Recommendations and Public Health Implications
2 days 7 hours ago
Health Education & Behavior, Ahead of Print.
An amendment to the Castle Doctrine was implemented in Texas in 2007. The amendment allows the residents of Texas no obligation to retreat prior to using a weapon for protecting oneself, one’s belongings, and/or one’s property. The objective of the study is to examine whether the Castle Doctrine had an impact on individual crime rates, consolidated violent and consolidated property crime rates, and the overall combined crime rate as the dependent variables. The econometric method of analysis employed in this study is an interrupted time series regression with the line of interruption separating pre-/postimplementation periods marked in the year 2007 for time frames 1998-2006 (preimplementation years) and 2007-2016 (postimplementation years). The independent variables were time, the implementation of the Castle Doctrine—the intervention, and time after the intervention—the postimplementation intervention. Findings of the study indicated an increase in the individual crime rates of murders and rapes and a simultaneous decrease in individual rates of property crimes. Moreover, the analysis detected a decrease in the consolidated violent crime rate of 0.03% (95% confidence interval [CI: −0.012, 0.010]; p = .285) and a decrease in the consolidated property crime rate of 1.81% (95% CI [−0.104, 0.118]; p = .391). Conclusively, a decrease in the overall combined crime rate of 2.31% (95% CI [−0.116, 0.207]; p = .362) was detected over the analyzed time frame. The findings of the study denoted a decrease in the property crime rate that prospectively connects to the likelihood of the deterrence effect, which may imply that perpetrators may have been discouraged to invade properties due to notion of encountering armed homeowners.
Amrita G. Shenoy
The Indirect Influence of Organizational Safety Climate on Football Players’ Concussion Reporting Intentions
1 week ago
Health Education & Behavior, Ahead of Print.
Most of the health interventions designed to increase athletes’ reporting of potential concussion symptoms have focused only on the individual athlete. Unfortunately, interventions targeted at athletes’ knowledge and understanding of concussion risk has not reliably increased their reporting behavior, leading to increased calls for “changing the culture of concussion reporting.” To date, no studies have examined the role of organizational safety climate has on concussion-symptom reporting behavior. We hypothesized that players’ perception of organizational safety climate would be indirectly related to their concussion symptom reporting intentions, via the influence of safety culture on supportive social norms and self-efficacy, two well-known predictors of concussion reporting intentions. We used structural equation modeling techniques to create robust latent measures of our model variables and then examined the indirect influence of football program safety climate on football players’ symptom reporting intentions. Surveys were completed by NCAA Division I football players (N = 223) before and after the 2017 football season. We tested a confirmatory factor analysis and hypothesized latent variable model with preseason data, made small adjustments to our model (adding correlated error terms), and then confirmed using postseason data. We also examined a competing, alternative model. Results support the indirect and influence of perceived safety climate on concussion reporting intentions primarily via the relationship between safety climate and social norms, and to a lesser extent between safety climate and self-efficacy. Discussion focuses on the importance of considering the addition of interventions aimed at systems-level influences to facilitate supportive social norms and athlete self-efficacy regarding concussion symptom reporting.
Heidi A. Wayment
The Role of Dispensing Device and Label Warnings on Dosing for Sunscreen Application: A Randomized Trial
1 week 1 day ago
Health Education & Behavior, Ahead of Print.
Drug manufacturers are expected to provide labeling information needed to yield safe and effective product use. However, it is not clear that consumers dose sunscreen, an over-the-counter drug, appropriately; in fact, existing evidence suggests underdosing as a common phenomenon. The objective of this study was to evaluate the effect of dispensing device and labeling on self-administered doses of sunscreen in young adults. To investigate those effects, a 2 × 2 factorial laboratory experiment crossing dispensing device (two levels) with labeling treatment (two levels) was conducted. Participants applied sunscreen from each of the four treatments; dosing concentration, measured in mg/cm2, served as the response variable. Participants (n = 94) were recruited on the campuses of Michigan State University (East Lansing, MI) and California Polytechnic State University (San Luis Obispo, CA). Each participant applied sunscreen from each unique treatment to sites on their arms and legs (four applications). Postapplication, a survey was completed to characterize demographics, risk perception, and sunscreen use patterns. Results indicate participants applied approximately 30% less sunscreen from the pump bottles than the squeeze bottles (difference estimate of 0.3059 mg/cm2, standard error = 0.0607, p < .0001); there was no evidence of a difference based on label treatments. Post hoc recognition tests indicated only 55% of participants were able to recognize the two experimental labels they had viewed immediately following sunscreen application. Sunscreen application density was directly related to level of worry regarding skin cancer and frequency of sunscreen use (α = .05). Our results suggest the dispensing device used to deliver sunscreen impacts the dosage amount consumers apply.
Alyssa Harben
Barriers and Motivators of Bicycling by Gender Among Older Adult Bicyclists in the Midwest
1 week 1 day ago
Health Education & Behavior, Ahead of Print.
Introduction. Physical activity (PA), particularly low-impact activities like bicycling, can improve health in older adults. However, bicycling rates are lower in the Midwest than other regions in the United States. Therefore, it is important to identify unique social, personal, and environmental factors that inhibit or promote bicycling, and how these are associated with PA. The influences of these factors were explored using the social ecological model. Method. A cross-sectional online survey was developed using previously validated local and national bicycling questionnaires, then distributed to Midwestern bicyclists 50 years and older. Exploratory factor analysis was conducted to understand the influences of social, personal, and environmental barriers and promoters on bicycling patterns. All models were conducted separately by gender, and accounted for age, race, education, marital status, income, and employment. Results. Social promoters (B = 0.386, p = .002), such as having friends/family that bicycle were associated with greater PA. Personal promoters (B = −0.311, p = .006) such as needing to lose weight were associated with reduced PA. Environmental factors had no associations with PA. However, individual environmental components, such as number of vehicles on the roads, were significantly associated with PA for both males and females. Females reported more barriers than males. The overall model accounted for 16.1% of the total variance in PA levels. Conclusion. Interventions to promote PA via bicycling in older adults should focus on social factors, while also reducing personal-level factors for males. Interventions for females could focus on reducing specific personal, social, and environmental barriers.
Amanda Grimes
Development of a Survey to Assess Latino Fathers’ Parenting Practices Regarding Energy Balance–Related Behaviors of Early Adolescents
1 week 1 day ago
Health Education & Behavior, Ahead of Print.
Latino adolescents face challenges to performing energy balance–related behaviors (EBRBs) to prevent childhood obesity, including healthy dietary intake, adequate physical activity, and limited screen time. Fathers are underrepresented in family-based obesity interventions but could be influential in shaping the EBRBs of Latino children. Three types of parenting practices (setting expectations/limits, role modeling, managing availability and accessibility) have shown relatively consistent positive relationships with children’s EBRBs in studies that have mostly involved mothers. The purpose of this study was to develop measures to assess Latino fathers’ parenting practices based on existing measurement instruments, focus groups and cognitive testing. Criterion validity of the measures (40 items) was examined with Latino fathers and their early adolescents (10-14 years old, n = 96 dyads) who were predominantly from low-income, two-parent households. Criterion validity was indicated by significantly higher intakes of fruit and vegetables; lower intakes of sugar-sweetened beverages, sweets/salty snacks and fast foods; more weekly physical activity hours; and fewer daily screen time hours among adolescents who reported high versus low levels/frequencies of supportive parenting practices. In addition, nearly all scales of adolescent-reported paternal behavioral modeling and availability/accessibility practices were significantly correlated with adolescents’ corresponding EBRBs (r = 0.22 to 0.54). However, poor validity and agreement with early adolescents’ reports were found for most father-reported parenting practices. Overall, this study indicated that the measures were acceptable for assessing adolescents’ report of Latino fathers’ parenting practices around EBRBs. The findings also indicate the importance of including early adolescents’ reports in measuring paternal parenting practices.
Youjie Zhang
Hookah and Electronic Inhalant Device Use and Perceptions Among African American Youth and Young Adults: Are We Asking the Right Questions?
1 week 2 days ago
Health Education & Behavior, Ahead of Print.
Objectives. Survey items used in surveillance systems to assess the use of emerging products like hookah and electronic inhalant devices (EIDs) may not match definitions used by high-risk populations. This qualitative study explored how African American youth and young adults (YYAs) (1) use hookah and EIDs and (2) identify patterns in the ways they describe and organize these products. Design. Individual in-person interviews were conducted among a sample of continuation high school and vocational school students in southern California. Participation was limited to those who had ever tried at least one tobacco product, self-identified as African American, and were between the ages of 14 and 26 years (n = 28). We conducted a content analysis to identify patterns in perceptions and use of these products. Results. African American YYAs recognized and described traditional hookah based on physical attributes, but for EIDs, including e-cigarettes, e-hookah, and vape pens, YYAs focused on reasons for using the product. Three primary categories emerged for reasons YYA used specific products: nicotine content and quitting, social facilitation, and use with marijuana. E-cigarettes were identified as quitting aids and as having nicotine but were not considered addictive. The term hookah recalled both the traditional and electronic pen-type products for YYAs. The terms vapes, hookah, wax pens, and others are used in the context of describing product use with marijuana. Conclusions. A better understanding of why African American YYAs use these products is needed to develop better measures for accurate rates of use, uncover differences in use between product types, and to develop effective prevention messaging.
Kari-Lyn K. Sakuma
Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?
1 week 3 days ago
Health Education & Behavior, Ahead of Print.
Background. Health insurance access and health literacy are critical components of “enabling resources” to encourage uptake of services. We sought to test whether health literacy boosts health services utilization in the context of expanded access to health insurance stemming from the Affordable Care Act. Method. We used individual-level data from 11 states included in the Behavioral Risk Factor Surveillance System 2016. We conducted a two-stage least squares instrumental variables analysis. We instrumented improved access to health insurance stemming from Affordable Care Act Medicaid expansion. As outcome variables, we examined cost as a barrier to needed care, having a personal doctor and receipt of routine health checkups, flu shots, Pap tests, mammograms, sigmoidoscopy/colonoscopy, and dental visits in the past year. We then tested whether the relation between improved health insurance access and health services utilization was moderated by health literacy. Health literacy was measured by a dichotomized scale comprising three items: difficulties obtaining advice or information about health, difficulties understating information from health professionals, and difficulties understanding written health information. Results. We found that improving health insurance access increased the likelihood of reporting a personal doctor while reducing the likelihood of reporting cost as a barrier to care. We also found an interaction effect between health insurance and health literacy on dental visits. However, there was no significant interaction effect between insurance access and health literacy for preventive services utilization. Conclusion. Health literacy did not explain why people fail to access preventive services even when they obtain access to insurance, with the sole possible exception of dental visits among individuals with high literacy.
Shiho Kino
An Examination of John Henryism, Trust, and Medication Adherence Among African Americans With Hypertension
1 week 3 days ago
Health Education & Behavior, Ahead of Print.
Background. John Henryism is defined as a measure of active coping in response to stressful experiences. John Henryism has been linked with health conditions such as diabetes, prostate cancer, and hypertension, but rarely with health behaviors. Aims. We hypothesized that reporting higher scores on the John Henryism Scale may be associated with poorer medication adherence, and trust in providers may mediate this relationship. Method. We tested this hypothesis using data from the TRUST study. The TRUST study included 787 African Americans with hypertension receiving care at a safety-net hospital. Ordinal logistic regression was used to examine the relationship between John Henryism and medication adherence. Results. Within our sample of African Americans with hypertension, lower John Henryism scores was associated with poorer self-reported adherence (low, 20.62; moderate, 19.19; high, 18.12; p < .001). Higher John Henryism scores were associated with lower trust scores (low John Henryism: 40.1; high John Henryism: 37.9; p < .001). In the adjusted model, each 1-point increase in the John Henryism score decreased the odds of being in a better cumulative medication adherence category by a factor of 4% (odds ratio = 0.96, p = .014, 95% confidence interval = 0.93-0.99). Twenty percent of the association between medication adherence and John Henryism was mediated by trust (standard deviation = 0.205, 95% confidence interval = 0.074-0.335). Discussion. This study provides important insights into the complex relationship between psychological responses and health behaviors. It also contributes to the body of literature examining the construct of John Henryism among African Americans with hypertension. Conclusion. The findings of this study support the need for interventions that promote healthful coping strategies and patient–provider trust.
Yendelela L. Cuffee
Randomized Evaluation of the National Collegiate Athletic Association’s Concussion Education Fact Sheet for Coaches
2 weeks 4 days ago
Health Education & Behavior, Ahead of Print.
Background. Concussion education for coaches is being increasingly recommended by leading sports organizations, yet the effectiveness of available materials has not often been assessed. This study evaluated the impact of the National Collegiate Athletic Association’s (2017) publication: “Concussion safety: What coaches need to know” (the “NCAA Fact Sheet for Coaches”) on participants’ concussion knowledge and safety supportive intentions. Method. NCAA head coaches (n = 779) were randomized to view the NCAA Fact Sheet for Coaches either before (intervention condition) or after (control condition) responding to questions assessing concussion knowledge and intentions to engage in three behaviors (talk to team about concussion safety; allow symptomatic athlete to continue play; encourage medical staff to return athlete as quickly as possible). Results. Knowledge scores were significantly higher among coaches in the intervention condition as compared to the control condition, largely driven by differences in knowledge about the consequences of continued play postconcussion (injury, reaction time, possible death). Fewer coaches in the intervention condition expected that they would allow an athlete with a suspected concussion continue to participate in a game or practice or that they would encourage medical staff to return athletes to play as quickly as possible. Discussion. The present study provides evidence that educational content, like that contained in the NCAA Fact Sheet for Coaches, may have a positive short-term impact on concussion knowledge and behavioral intentions of coaches. In light of these findings, sports organizations should consider providing similar educational materials to coaches, evaluating whether the information is impactful in their population.
Emily Kroshus
Learning From Coalitions’ Efforts to Promote Equity and Justice
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 110S-114S, October 2019.
Coalitions and collaboratives are working to address many of the most pressing contemporary health and social issues. The articles in this special issue provide numerous insights into these complex collaborative processes across different contexts and focal issues. All emphasize and scrutinize the strategies that groups are using in their work. These strategies seek to navigate not only conventional notions of effectiveness but also the challenges of pursuing greater equity and justice. In this concluding article, we distill some of the key insights from these articles as a collective. This special issue on collaborating for equity and justice can serve as a launching point for new efforts by coalitions and researchers pursuing policy, systems, and structural changes, particularly those intent on addressing root causes of health and social disparities.
Brian D. Christens
Language, Culture, and Collectivism: Uniting Coalition Partners and Promoting Holistic Health in the Menominee Nation
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 81S-87S, October 2019.
Recent perspectives on Indigenous health have recognized language, culture, and values as central to well-being and recovery from historical trauma. Health coalitions, which identify community health concerns and mobilize members to implement strategies for change, have begun to shift their focus from programs to policy, systems, and environmental change but have been slower to recognize the possibilities of centering Indigenous ways of being in their work. This article details a case study of the Menominee Wellness Initiative, an Indigenous health coalition that has increasingly made language, culture, and collective values the focus of their health promotion work, and often due to the participation and influence of community organizers in the coalition. The study is presented as a collaborative writing effort between coalition members and academic partners. Qualitative data were gathered through observations of coalition meetings; in-depth, semistructured interviews with coalition members; and interactive data analysis discussions within the collaborative writing team. In the results, we describe how the shift in the coalition’s framework came to be and the influence this shift has had on the coalition, its activities, and its community impacts. These findings illustrate and extend understanding of several principles of Collaborating for Equity and Justice and supports literature and practice related to health promotion through the centering of Indigenous ways.
Amy Hilgendorf
A Collaborative Approach to Assess Legacy Pollution in Communities Near a Lead–Acid Battery Smelter: The “Truth Fairy” Project
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 71S-80S, October 2019.
Advocates for civil rights, environmental justice, and movements promoting social justice require data and may lack trust in public authorities, turning instead to academic scientists to help address their questions. Assessing historical exposure to toxic chemicals, especially in situations of a specific industrial source of pollution affecting a community, is critical for informing appropriate public health and policy responses. We describe a community-driven approach to integrate retrospective environmental hazard exposure assessment with community organizing to address concerns about the extent of exposure to toxic metals in a predominantly working-class, Latinx community living near a now-closed lead–acid battery smelter facility. Named the “Truth Fairy Project” by leaders of the community organization East Yard Communities for Environmental Justice, this community–university partnership aimed to assess prenatal and early-life exposures to toxic metals through biomarkers of exposure in baby/deciduous teeth. This partnership integrated community mobilization with empirical research, informing residents about toxic metal exposures and improving the community’s capacity to respond to a public health crisis.
Jill E. Johnston
Growing Equity and Health Equity in Perilous Times: Lessons From Community Organizers
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 9S-18S, October 2019.
Although a growing body of evidence underscores the contributions of community-based participatory research, community coalitions and other community engagement approaches to addressing health equity, one of the most potent forms of engagement—community organizing—has attracted far less attention in our field. Yet, organizing by and for communities, to build power, select issues, develop and use strategies, and take action to address the goals they collectively have set, may offer important lessons for public health professionals in these fraught times. We share, largely in their own words, the experiences and reflections of ~140 grassroots organizers across the United States who attended regional convenings of organizers in 2017, planned and run by four leading community capacity and base-building organizations, and where diverse organizers shared strategies that work, challenges faced, and the deep concerns among their already often disenfranchised communities in the contemporary sociopolitical and cultural context. After briefly reviewing some of community organizing’s core tenets and complexities, we share our qualitative research methods and key findings about the primary cross-regional concerns raised (mass incarceration, voter suppression, and immigrant rights), the themes that emerged (e.g., centering leadership by women of color and of using a health lens to frame community issues), as well as the challenges faced (e.g., the retraumatization often experienced by organizers and the difficulties in building alliances between groups “that have been taught to distrust each other”). We conclude by discussing how many of the promising practices and lessons shared by the community organizers might enhance our own field’s health equity-focused efforts, particularly if we take seriously one of their most bedrock messages: that there can be no health equity without racial equity and social justice, and that to get to health equity, we must first address equity writ large, particularly in troubling times.
Meredith Minkler
From Roots to Results: A Qualitative Case Study of the Evolution of a Public Health Leadership Institute Building Capacity in Collaborating for Equity and Justice
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 33S-43S, October 2019.
Policy, systems, and environmental change are now widely accepted as critical to sustaining improvements in community health. Evidence suggests that such systems-level change is most effective when driven by community-based partnerships. Yet, after more than three decades of building community-based partnership work, health inequities have continued to deepen. To address health inequities, current and historical distributions of power are increasingly recognized as important considerations in efforts to ensure all individuals have the opportunity to attain their full health potential (i.e., achieving health equity). Building on social determinants of health literature, social injustice and powerlessness are put forth as fundamental causes of health inequities. Focusing on power as a root cause of health and health equity through application of Wolff and colleagues’ six principles requires substantial changes in contemporary public health practice. This case study uses document analysis of a single case, the Community Teams Program, to assess the evolution of a statewide public health leadership program’s efforts to build the capacity of coalition-based teams to catalyze community change in line with Wolff and colleagues’ principles. Deductive, selective coding of the materials surface four themes in the program adaptations: (1) the need to focus on power as a root cause, (2) shifting power through relationship building, (3) storytelling as a way to shift narrative, and (4) building mechanisms into the curriculum that hold coalitions accountable for applying and sustaining learned skills. The themes demonstrate philosophical, pedagogical, and organizational changes to center power building approaches in health promotion. Findings are triangulated by reflections from the program director and recorded reflections of participants captured in existing evaluation data.
Lesley Wolf
The Washtenaw ID Project: A Government-Issued ID Coalition Working Toward Social, Economic, and Racial Justice and Health Equity
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 53S-61S, October 2019.
Introduction. The policing of identities through policies that restrict access to IDs issued by U.S. governmental entities disparately affects communities of color; communities who identify as low-income, immigrant, older, and/or transgender; and community members who experience chronic mental illness, housing instability, or incarceration. Yet government-issued IDs are increasingly needed to access health-promoting resources such as housing, banking, social services, and health care, and in interactions with law enforcement. Methods. Since 2012, the Washtenaw ID Project’s coalition-building process has involved communities affected by restrictive ID policies, advocates, and institutional stakeholders to enact community and systems change regarding inequities in government-issued IDs. We discuss the coalition-building process that culminated in the implementation of a photo ID issued by Washtenaw County government as a policy change strategy. We also highlight the community-academic research partnership evaluating the effectiveness of the Washtenaw ID in order to ensure equity in Washtenaw ID access and acceptance. Results. In 2015, 77% of Washtenaw ID holders reported having no other locally accepted ID. At follow-up, Washtenaw ID holders reported favorable Washtenaw ID acceptance rates in several domains (e.g., health care, school), but not when accessing banking services and housing. Additionally, community discussions suggested racial inequities in carding and ID acceptance. We discuss next steps for policy improvement to ensure equitable impact of the ID. Conclusions. Without national policy reform instating access to government-issued IDs for all, the social movement to establish local IDs may improve access to health-related resources contingent on having an ID. Careful attention must be paid to community organizing processes, policy implementation, and evaluation to ensure equity.
Alana M. W. LeBrón
Strengthening Our Collaborative Approaches for Advancing Equity and Justice
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 5S-8S, October 2019.
The Principles for Collaborating for Equity and Justice are explicit about addressing social and economic injustice, structural racism, and community organizing to facilitate resident power and ownership. They also focus on structural change, an acknowledgment of complexity, and the need to thoughtfully build on decades of practice and scholarship on collaborating for community change. This special theme issue of Health Education & Behavior includes 10 articles that highlight these principles and provide insight into the complexities, challenges, and rewards of collaborating in ways that are intentional about advancing health equity through inclusive processes and shared goals to address social determinants of health. We provide a brief overview of the articles and identify community organizing and building resident power as possible strategies that should be combined with, complement, or in some cases replace, our more commonplace multisectoral coalitions if we hope to reduce health inequities through community collaboration.
Michelle C. Kegler
Justice System Reform for Health Equity: A Mixed Methods Examination of Collaborating for Equity and Justice Principles in a Grassroots Organizing Coalition
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 62S-70S, October 2019.
Recent critiques of collective impact have provided a conceptual alternative that emphasizes the necessity of community organizing, and more explicit emphasis on advancing equitable systems and policy changes. This article reports results from a study of a citywide coalition in Chicago, IL that espoused many of these same principles. The coalition focused on justice system reform—systems and policy change that would dismantle punitive policies disproportionately affecting people of color—but also sought to connect these efforts with broader social determinants of health. The organizations that comprised the coalition were a pairing of those traditionally involved in restorative justice practice, and those traditionally involved in grassroots organizing. An action research partnership provided an opportunity to investigate processes and outcomes of a coalition created to advance equitable systems and policy changes. This analysis of the coalition’s functioning employs a mixed methods approach. We utilize two waves of interorganizational social network data and qualitative data including participant observation, in-depth interviews, and archival document review to examine the coalition’s successes and challenges related to each of the six core principles of Collaborating for Equity and Justice. This analysis provides practical insights into the benefits and challenges of implementing deeply participatory processes to address policy and systemic drivers of social determinants of health. Findings show that fully integrating all six principles is challenging, especially when a coalition represents broad constituencies across race, geography, and organizational philosophy. In such diverse settings, considerable time must be spent to build relationships and a strong foundation for sustainable processes.
Daniel G. Cooper
Creating Spaces for Young People to Collaborate to Create Community Change: Ohio’s Youth-Led Initiative
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 44S-52S, October 2019.
Scholars and researchers are increasingly calling attention to the need for community-based coalitions to become more inclusive of local residents and engage those most directly affected by the issues. One population, however, often remains the recipient of services as opposed to partners or leaders in community change initiatives: youth. Over the past several years in Ohio, adults convening and facilitating youth-led programs have been transforming their work by utilizing the Youth Empowerment Conceptual Framework and the Substance Abuse and Mental Health Services Administration’s Strategic Prevention Framework to empower young people and ensure their equitable participation in community change efforts. This article provides an overview of Ohio’s statewide youth-led initiative, highlighting how adult allies engaged young people in a data-driven strategic planning process and intentionally selected and implemented strategies designed to affect the health of their local communities. This initiative provides key insights into the Collaborating for Equity and Justice Principles 4, 5, and 6.
Jessica J. Collura
Toward Sexual Health Equity for Gay, Bisexual, and Transgender Youth: An Intergenerational, Collaborative, Multisector Partnerships Approach to Structural Change
3 weeks 3 days ago
Health Education & Behavior, Volume 46, Issue 1_suppl, Page 88S-99S, October 2019.
Background. Gay, bisexual, and transgender youth (GBTY) experience sexual health inequities and contend with intersectional oppression. The Michigan Forward in Enhancing Research and Community Equity (MFierce) Coalition formed as an intergenerational, collaborative, multisector partnership with a focus on implementing community-identified policy, systems, and environmental (PSE) change strategies to address inequities and injustices. Aims. We describe MFierce coalition development and structural change activities organized within Collaborating for Equity and Justice (CEJ) principles and provide empirical data supporting the utility of such principles. Method. We prioritized leadership by GBTY and created personal and professional capacity-building activities to support GBTY in being change agents. Our work was grounded in community-engaged scholarship and used a shared-power community development process. Our PSE change intervention, the Health Access Initiative (HAI), was a structural change program for health facilities aimed at improving the quality of and access to sexual health care for GBTY. Results. We evaluated coalition functioning and activities through multimethod assessments and evaluated PSE changes through HAI participant surveys. Data demonstrated positive and steady coalition dynamics, multiple benefits of participation for GBTY, and strategies for collaborative multigenerational community work. HAI outcome data revealed significant increases in PSE changes. Discussion. Centering life experiences of GBTY in collaborative partnerships and building opportunities for professional and personal development can support sustainable community change. We offer recommendations for developing future intergenerational, collaborative, multisector partnerships that prioritize youth leadership. Conclusion. Collaborative methods and careful consideration of adult–youth dynamics can inform future transformative efforts focused on health equity and justice for GBTY.
Triana Kazaleh Sirdenis
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20 hours 27 minutes ago
Table of Contents for Health Education & Behavior. List of articles from both the latest and ahead of print issues.
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