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Because of the increase in community-engaged research, several human research ethics trainings for laypeople have been developed. We aim to (1) describe the pedagogical tailoring of a research ethics training for laypeople for a research study where promotores —community health workers—delivered an intervention to increase health care access and promote healthy behaviors among Latinos and (2) present results of the application of the training after 4 months in the field. We tailored a previously developed training to Latino community members implementing a research study. Key modifications included (1) translation (2) use of pedagogical tools, such as cooperative learning, role-plays, and inclusion of cultural preferences. One novel addition was to use dialogues that the trainees enacted and then discussed. We evaluated the training with a posttraining survey with eight community liaisons and 13 promotores implementing the intervention, and a focus group with eight promotores, 4 months after working in the field. Trainees said they felt confident obtaining informed consent, felt the dialogues were realistic and helped them remember what they learned, and wanted more feedback from trainers on their performance. Promotores demonstrated the application of ethical principles beyond the training by discussing the possibility of advertising broadly in social media (justice), the risks and benefits of providing community resources to participants (beneficence), and the university's role in legitimizing their position as promotores (respect). We conclude that a pedagogically tailored ethics research training for laypeople can be successful and that dialogues to be enacted need to be explored further. [ABSTRACT FROM AUTHOR]

Background: Latin America and the Caribbean (LAC) has experienced an unprecedented mining boom since the mid-2000s with unknown effects on sexual and reproductive health (SRH). This study takes the essential first steps of summarizing the available literature regarding SRH in mining contexts in LAC, identifying critical gaps in knowledge, and discussing main implications for future research. Methods: We conducted a scoping review with a systematic search of health literature in four databases, reference lists of selected papers, and citations in Google Scholar. Results: The systematic search yielded 592 primary references and 16 articles from LAC. The 11 papers finally selected were conducted in gold-mining contexts in Brazil, Venezuela, Guyana, Peru, and Colombia, between 1995 and 2016. Ten studies centered on measuring HIV/STD prevalence among mineworkers and other populations; few examined associated risk factors. Eight studies reported high HIV/STD prevalence in the study population. None of the studies explored broader SRH issues. Conclusions: Available research is scarce and provides limited evidence on SRH in LAC mining contexts. Critical gaps include little knowledge on (1) broader SRH impacts besides HIV/STDs, (2) SRH in settings different from gold-mining contexts in Amazon countries, (3) mechanisms shaping SRH in LAC mining contexts, and (4) effective interventions in these scenarios. Future research must consider the distinctive demographic, environmental, socioeconomic, and gender dynamics triggered by the mining economy in the analysis of the relationship between mining and SRH, particularly in a period of extractive boom. [ABSTRACT FROM AUTHOR]

Background. Lay health advisor (LHA) interventions with Latino men are rare, especially in emerging Latino communities. We present a process evaluation of a male LHA network aiming at connecting Latino men to various kinds of services and to the Latino community. It assesses the feasibility of (1) maintaining a steering coalition; (2) hiring, training, and retaining male LHA; and (3) recruiting and assisting underserved participants. Methods. Project management data and LHA debriefings were analyzed qualitatively and compared to a logic model and evaluation table prepared before the project started. Results. The community coalition steered the project during its implementation. Eleven men attended the initial LHA training. Two thirds of them reflected the community in educational level. One third did not and required extra mentoring from the other LHA to recruit participants. LHA requested topics for monthly trainings according to their needs in the field, including housing, sexual health, and immigration. LHA enrolled 182 participants. Participants’ needs went beyond health issues. Therefore, LHA needed to forge new collaborations with local social service organizations. Conclusions. Recruiting male LHA is feasible. LHA and the community coalition can suggest adaptations to fit the local context. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To explore (a) how women who were diagnosed with breast cancer (BC) defined themselves as survivors and when this occurred, and (b) the types of benefits they derived from their experiences.Research Approach: An exploratory, qualitative approach.Participants: 112 women who had BC (response rate = 70%).Setting: Participants were recruited from two cancer survivor organizations in a northeastern U.S. city.Methodologic Approach: Responses to open-ended questions in telephone interviews were examined by age at diagnosis using thematic analysis. Chi squares were used to conduct analyses by age (younger than 51 years; aged 51 years or older).Main Research Variables: Meaning of survivorship, defining moment, benefits derived from surviving from breast cancer.Findings: Participants' perceptions of survivorship included two main components, a defining moment and the meaning attached to being a survivor. Becoming a survivor is an active process, except in the case of those participants who realized they were survivors when informed by a third party. Meanings differed by age at diagnosis. Most participants listed at least one benefit from surviving cancer.Conclusions: The definitions of survivorship and benefits outlined here suggest that many positive aspects of the survivorship experience exist that may inform future interventions' designs.Implications for Practice: Providers should acknowledge the strength survivors show in the process of meaning-making and finding benefits in their adverse experiences. The use of expressive and supportive interventions may hold promise for women facing difficulties in coping with their diagnosis. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To explore (a) how women who were diagnosed with breast cancer (BC) defined themselves as survivors and when this occurred, and (b) the types of benefits they derived from their experiences.Research Approach: An exploratory, qualitative approach.Participants: 112 women who had BC (response rate = 70%).Setting: Participants were recruited from two cancer survivor organizations in a northeastern U.S. city.Methodologic Approach: Responses to open-ended questions in telephone interviews were examined by age at diagnosis using thematic analysis. Chi squares were used to conduct analyses by age (younger than 51 years; aged 51 years or older).Main Research Variables: Meaning of survivorship, defining moment, benefits derived from surviving from breast cancer.Findings: Participants' perceptions of survivorship included two main components, a defining moment and the meaning attached to being a survivor. Becoming a survivor is an active process, except in the case of those participants who realized they were survivors when informed by a third party. Meanings differed by age at diagnosis. Most participants listed at least one benefit from surviving cancer.Conclusions: The definitions of survivorship and benefits outlined here suggest that many positive aspects of the survivorship experience exist that may inform future interventions' designs.Implications for Practice: Providers should acknowledge the strength survivors show in the process of meaning-making and finding benefits in their adverse experiences. The use of expressive and supportive interventions may hold promise for women facing difficulties in coping with their diagnosis. [ABSTRACT FROM AUTHOR]

PURPOSE. Raices was a community health worker (promotores)-delivered intervention to improve physical activity (PA) and diet among Latinx living in an emerging community, an area with a small yet growing Latinx population. The purpose of this study was to examine change from baseline to follow-up in PA and diet in participants who completed the 6-month intervention, in comparison to those in a control group. METHODS. N=164 participants (n = 78 intervention; n= 86 control) were drawn from Allegheny County, Pennsylvania. Promotores used an intervention tool offering non-directive social support to assist participants in developing SMART goals to address their life concerns in 8 domains of life (e.g., social, diet, exercise/recreation); the control group received printed materials. Participants completed a survey in Spanish at baseline and follow-up to assess demographics and lifestyle outcomes (i.e., the International Physical Activity Questionnaire [IPAQ]-short form; Starting the Conversation (STC) 8-item simplified food frequency instrument). We ran linear mixed effects models adjusted for covariates (i.e., age, gender, education, total years living in the U.S and body mass index) to compare change in outcomes over time. RESULTS. We recruited Latinx adults with origins from South America (47%), Mexico (28%) Central America (16%) and other countries (3%). Fifty-eight percent of the sample was female ( median age 38 years), and half had a college degree and were living in the U.S for 5 or fewer years. There was a significant intervention by time interaction in total MET min/week with an increase of 2215.82 min/week (618.23, 3813.41; p = 0.007) from baseline to follow-up. There was also a marginally significant intervention by time interaction for total diet score (-0.77, [- 1.55,0.02]; p = 0.054), indicating healthier dietary practices at follow-up. CONCLUSION. This study demonstrates the potential effectiveness of a promotores network in assisting individuals living in an emerging Latinx community to address their own life concerns and improve health behaviors. Future studies should include objective and more rigorous measures of health behaviors with a larger sample to replicate these results. [ABSTRACT FROM AUTHOR]

An editorial is presented which addresses the authors' views about the American Emergency Law Inventory (ELI) and direct engagements with stakeholders in the emergency management volunteer workforce. According to the article, stakeholder engagement is expected to promote innovation and sustainability in disaster planning. Public health readiness-based legal principles are assessed, along with U.S. Medical Reserve Corps (MRC) units.

Introduction: Research exploring the mistreatment of birthing people in the United States is emerging rapidly within the context of increasingly poor maternal health outcomes that include unacceptable racial disparities. Previous research has explored overlap between psychological birth trauma and mistreatment using patient descriptions of birth experiences, but no previous studies have explored these issues from the perspectives of clinicians. The aim of this study was to explore whether maternity care providers' descriptions of patient birth trauma overlap with categories of mistreatment from a globally accepted typology. Methods: Content analysis was performed on a qualitative data set of 28 semi-structured interviews about patient birth trauma, completed in 2018–2019 with U.S. maternity care clinicians, including obstetricians, family physicians, midwives and labor/delivery nurses. The interviews were part of a larger study exploring maternity clinician perspectives and experiences of patient birth trauma. For this analysis Krippendorff's method of categoric distinction was used, with categories from a globally recognized typology of maternity patient mistreatment. Results: Clinicians' descriptions of their experiences with patient birth trauma mapped onto all seven mistreatment categories, although no interview questions specifically asked about mistreatment. In more than 30 hours of interviews, transcribed to more than 800 pages, the word mistreatment appears only once, suggesting that some healthcare providers may use the phrase "birth trauma" as a euphemism to describe mistreatment. Eighteen of 28 interviews included at least one description that fit into a mistreatment category. "Failure to meet professional standards of care" was the category with the most mapped clinician statements, followed by "Stigma and discrimination" and "Poor rapport between women and providers." Conclusions: This study contributes new insight into maternity clinicians' conceptualization of patient trauma and how their descriptions of birth trauma overlap with mistreatment. Clinicians implicitly connected mistreatment with some patient experiences of birth trauma, even when they were not specifically asked about mistreatment. Findings point to a need for further research into mistreatment, including routinized "everyday care" that may include mistreatment, particularly for marginalized and historically excluded birthing people. Future research also must explore the potential role of mistreatment in poor and inequitable U.S. birth outcomes. Plain language summary: Many people giving birth in the United States experience poor health outcomes, and there is a wide racial disparity, with people of color more likely to experience poor outcomes. In recent research, birthing people reported that they were mistreated during their labor and delivery, including being shouted at, scolded, or threatened. Mistreatment accounts were more frequent among women of color. Previous research has looked at patient reports about their birth experiences to explore whether their descriptions of psychological trauma include overlap with mistreatment, but no other studies have looked at descriptions of birth trauma from the perspectives of medical clinicians. The objective of this study was to explore whether maternity care providers' descriptions of patient birth trauma overlap with categories of mistreatment from a globally accepted list. This study analyzed the content of 28 semi-structured interviews about patient birth trauma, completed in 2018–2019 with obstetricians, family physicians, midwives and labor/delivery nurses. In the interviews, participant descriptions of patient birth trauma fit into all seven mistreatment categories. Participant descriptions included examples of patients receiving medical procedures or treatments without first giving consent, nurses avoiding the rooms of patients who do not speak English, and other forms of mistreatment. Participants were not asked specifically about mistreatment, but they described birth trauma by giving examples of mistreatment, which suggests that some healthcare providers may use the phrase "birth trauma" when talking about "mistreatment." This study shows a need for further research into mistreatment, including routine "everyday care" that may include mistreatment. [ABSTRACT FROM AUTHOR]

Exclusive breastfeeding is recommended for 6 months; however, many childbearing people wean their infants before 6 months. Psychosocial factors such as stress, social support and race are significant determinants of breastfeeding; however, few studies have longitudinally explored the effect of perceived stress and various forms of social support on exclusive breastfeeding. We used quantitative methodologies to examine exclusive breastfeeding, perceived stress and social support among 251 participants from the Postpartum Mothers Mobile Study. Participants between 18 and 44 years were recruited during pregnancy (irrespective of parity) and completed surveys in real-time via Ecological Momentary Assessment up to 12 months postpartum from December 2017 to August 2021. We measured perceived stress with the adapted Perceived Stress Scale and perceived social support with the Multi-dimensional Social Support Scale. Received social support was measured using a single question on breastfeeding support. We conducted a mixed-effects logistic regression to determine the effect of stress, race and social support on exclusive breastfeeding over 6 months. We examined the moderation effect of perceived social support and breastfeeding support in the relationship between perceived stress and exclusive breastfeeding. Black, compared with White, participants were less likely to breastfeed exclusively for 6 months. Participants who reported higher perceived stress were less likely to breastfeed exclusively for 6 months. Perceived social support moderated the relationship between perceived stress and exclusive breastfeeding (odds ratio: 0.01, 95% confidence interval: 0.001-0.072). However, breastfeeding support directly increased the likelihood of exclusive breastfeeding over 6 months. Perceived stress is negatively associated with exclusive breastfeeding. Birthing people who intend to breastfeed may benefit from perinatal support programs that include components to buffer stress. [ABSTRACT FROM AUTHOR]

Background: Latino preschool children have higher rates of obesity than preschool children from other racial/ethnic groups; however, few effective, culturally appropriate interventions exist targeting this group. The purpose of this study was to test the feasibility of a 10-week, promotora-mediated, home-based intervention to promote a healthy weight in Latino preschool children.Methods: Trained promotoras (community health workers) delivered 10, 90-min weekly interactive and tailored sessions to Latino families living in Allegheny County. Participants were recruited through promotoras' own social networks and community gatherings, flyers, and word of mouth. Primary outcome measures included child body mass index (BMI) z-score and percentile. Secondary outcome measures included child objectively measured physical activity and dietary intake, and the home social and physical environment (e.g., parent health behaviors, parent self-efficacy, parental support, physical activity equipment in the home). The final analysis sample included 49 of 51 participants who completed both baseline and follow-up assessments.Results: Participants included mothers (33.5 ± 6.1 years old) and their preschool-aged children who were primarily 1st generation immigrants from Mexico (65%). The primary analyses of BMI percentile and z-score showed no change post-intervention. However, there was a significant decrease in child BMI percentile for overweight and obese children from baseline to follow-up (p < .05). We also saw significant pre/post increases in child daily fruit and vegetable intake, and parent moderate-to-vigorous physical activity, fruit and vegetable servings per day, and self-efficacy; and significant decreases in child saturated fat and added-sugar intake, and child and parent screen time (p's < .05).Conclusions: Despite the short duration of the intervention and follow-up, this pilot study showed promising effects of a promotora-mediated intervention to promote a healthy weight in Latino preschool children. [ABSTRACT FROM AUTHOR]

Purpose of the Study: In a number of states, physicians are mandated by state law to report at-risk drivers to licensing authorities. Often these patients are older adult drivers who may exhibit unsafe driving behaviors, have functional/cognitive impairments, or are diagnosed with conditions such as Alzheimer's disease and/or seizure disorders. The hypothesis that mandatory physician reporting laws reduce the rate of crash-related hospitalizations among older adult drivers was tested. Design and Methods: Using retrospective data (2004-2009), this study identified 176,066 older driver crash-related hospitalizations, from the State Inpatient Databases. Three age-specific negative binomial generalized estimating equation models were used to estimate the effect of physician reporting laws on state's incidence rate of crash-related hospitalizations among older drivers. Results: No evidence was found for an independent association between mandatory physician reporting laws and a lower crash hospitalization rate among any of the age groups examined. The main predictor of interest, mandatory physician reporting, failed to explain any significant variation in crash hospitalization rates, when adjusting for other state-specific laws and characteristics. Vision testing at in-person license renewal was a significant predictor of lower crash hospitalization rate, ranging from incidence rate ratio of 0.77 (95% confidence interval 0.62-0.94) among 60- to 64-year olds to 0.83 (95% confidence interval 0.67-0.97) among 80- to 84-year olds. Implications: Physician reporting laws and age-based licensing requirements are often at odds with older driver's need to maintain independence. This study examines this balance and finds no evidence of the benefits of mandatory physician reporting requirements on driver crash hospitalizations, suggesting that physician mandates do not yet yield significant older driver safety benefits, possibly to the detriment of older driver's well-being and independence. [ABSTRACT FROM AUTHOR]

Background Unintended pregnancy (UIP) is a persistent public health concern in the United States disproportionately experienced by racial/ethnic minorities and women of low socioeconomic status. UIP often occurs with experiences of reproductive coercion (RC) and intimate partner violence (IPV). The purpose of the study was to qualitatively describe and compare contexts for UIP risk between low-income Black and White women with histories of IPV/RC. Study Design Semistructured interviews were conducted with low-income Black and White women with histories of IPV or RC, ages 18 to 29 years, recruited from family planning clinics in Pittsburgh, Pennsylvania. Results Interviews with 10 non-Hispanic Black women and 34 non-Hispanic White women ( N = 44) were included in the analysis. Differences between White and Black women emerged regarding IPV/RC experiences, gender roles in intimate relationships, and trauma histories, including childhood adversity. Fatal threats and IPV related to childbearing were most influential among White women. Among Black women, pregnancy was greatly influenced by RC related to impending incarceration, subfertility, and condom nonuse, and decisions about contraception were often dependent on the male. Sexual abuse, including childhood sexual assault, in the context of sexual/reproductive health was more prominent among White women. Childhood experiences of neglect impacted pregnancy intention and love-seeking behaviors among Black women. Conclusions Racial differences exist in experiences of IPV/RC with regard to UIP even among women with similar economic resources and health care access. These findings provide much-needed context to the persistent racial/ethnic disparities in UIP and illustrate influences beyond differential access to care and socioeconomic status. [ABSTRACT FROM AUTHOR]

This article summarizes and reviews the cross-discipline literature on violent crime in destination neighborhoods postrelocation in order to build a more comprehensive picture of risk factors for violence, as well as how and why housing policies influence risk of violence. High rates of violent crime continue to be a persistent problem in areas of concentrated poverty and public housing. Modern housing programs such as Moving to Opportunity and Housing Opportunities for People Everywhere are popular interventions for reducing the density of low-income people receiving public housing assistance by relocating residents of distressed housing projects. However, evidence suggests that relocated residents may not experience less violence or improved safety in their new communities. [ABSTRACT FROM AUTHOR]