The importance of systems thinking,context, and inclusion when studying the feasibility of expanding the FoodShare (SNAP) outreach program to rural communities of Northern Wisconsin

Evaluators often neglect to question whether a program has been appropriately designed for a new context prior to a feasibility study’s commencement. In this paper, we document the results of a case study that closely examined context when determining the feasibility of implementing a FoodShare outreach program in rural northern Wisconsin. Using community-based participatory mixed methods, we examine how stakeholder engagement led to both study refinement and a more comprehensive understanding of community food security based on contextual factors and systems thinking. Lessons learned when conducting feasibility studies from this perspective are provided to improve evaluation practice.     

Albinism,spiritual and cultural practices,and implications for health,healthcare, and human rights: a scoping review

Persons with albinism – a disability found worldwide – are particularly at risk for human rights violations in Africa. The purpose of this scoping review was to establish the current state of knowledge on albinism, spiritual and cultural practices, and implications for health and health services. Electronic searches of nine databases were conducted. After screening, 40 articles were reviewed. Four themes emerged: health implications of albinism; health-related cultural and spiritual meanings attached to albinism; health-related experiences of persons with albinism; and human rights and albinism. The findings reveal that African ontologies, including witchcraft beliefs and practices, are implicated by their construction of the person with albinism as an ontologically different entity, although few studies explicated this relationship. How broader social structures influence persons with albinism disproportionately, resulting in health and social inequities, is another under-researched area. This scoping review lays the groundwork for intersectoral, interdisciplinary research.     

Sexual Health Services for Homeless Youth: A Qualitative Analysis of their Experiences

The sexual health problems experienced by homeless youth bring into question their use of available sexual health services. Using a qualitative typological analysis, this study aims to identify sexual health services utilization profiles for homeless youth, and to understand the role of the homeless experience on the utilization of sexual health services. Individual interviews were conducted with 33 homeless youth (17 men, 16 women) between 18 and 25?years of age. Typological analysis identified four profiles: (1) a targeted use of sexual health services to determine one’s serological status following a relational change during the homeless experience; (2) a limited use of sexual health services to manage sexual emergencies that arise during the homeless experience; (3) a regular use of sexual health services to avoid the risks associated with the homeless experience; (4) a frequent use of sexual health services to obtain support when engaging in prostitution during the homeless experience. This study shows that the precarious and unstable conditions within the homeless experience incite youth to utilize sexual health services in different ways. These findings point to the importance of rethinking sexual health services to better adapt them to the different utilization profiles of homeless youth.     

The relationship between Black and gay community involvement and HIV-related risk behaviors among Black men who have sex with men

Black gay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their White male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV-related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of young Black men who have sex with men (YBMSM) on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16 to 29. Cross-sectional measures for this study include Black and gay community closeness, drug use, sexual risk behaviors, HIV testing, and health promotion behaviors. Closeness with the gay community was associated with greater pre-exposure prophylaxis (PrEP) knowledge as well as participating in health promotion programs along with higher rates of transactional sex and having sex under the influence of substances, and increased odds of self-reported HIV seropositivity. Involvement in the Black community was associated with lower odds of reporting being HIV positive. Findings suggest that programs and initiatives are needed to help promote the positive aspects of the Black and gay communities, while minimizing the negative correlates of such involvements.     

Discrimination,mental health,and body image among transgender and gender-non-binary individuals: Constructing a multiple mediational path model

The purpose of the current study was to examine the relationships among discrimination, mental health, and body image in a national sample of transgender adults. Participants (N = 78) identified as transgender, genderqueer, or other gender-non-binary identities and were recruited via a national online survey. Harassment/rejection, work/school, and other discrimination explained 10.4% of the variance in body appreciation, while satisfaction with life, anxiety, self-esteem, and depression explained 60.7%. Within these models, harassment/rejection was inversely associated with body appreciation, while self-esteem and satisfaction with life were positively associated. A series of path models moving from a measurement model to a more parsimonious and excellent-fitting model found that the effect of harassment/rejection on body appreciation was fully mediated by self-esteem and satisfaction with life, resulting in a multiple mediation.     

The sacred and the profane in life science work: The case of assisted reproduction laboratories

Reproductive medicine and assisted reproduction therapies have been developed over the last decades resulting in over five million babies. The handling of human reproductive materials and patients is based on the ability to combine health care work and techno-scientific expertise in both the clinic and the laboratory setting. This study of Swedish assisted reproductive technology clinics demonstrates that the active day-to-day manipulation of human reproductive materials enact both the ‘profane’, through treating the embryos as raw materials in standardized procedures enabling economies of scale, and the ‘sacred’ through enacting a separation, the potential to human life, the patients ordeals, and seriousness. The enactment of the profane and the sacred is mostly balanced but at certain points in the work procedures, their intersecting becomes particularly salient. Such points provide opportunities for the study of the sense making of professionals in organizational grey zones, during techno-scientific activities.     

A Case Study Using Photovoice to Explore Racial and Social Identity Among Young Black Men: Implications for Social Work Research and Practice

This article describes an exploratory qualitative case study using a research method novel to social work known as Photovoice. This case study of the Photovoice process assesses its value as a community-based participatory research (CBPR) method with marginalized communities within social work research. Photovoice was used to engage young Black men as researchers into their own lived experience. Through a photographic and group participatory project, participants discussed how intersections of race, gender, and sexuality affect their lives and health. While this methodology has proliferated within public health literature, little research exists within social work. Photovoice represents a research well-aligned with core social work values of empowerment and social justice. This method offers our profession a participatory, action-oriented tool to inform practice and policy and does so in the voices of communities who often go unheard.     

Gender Roles and Internalized Sexual Stigma in Gay and Lesbian Persons: A Quadratic Relation

Purpose: No previous research has deeply investigated the association between gay men and lesbians’ adherence to gender roles and their internalized sexual stigma. This study suggests a potential non-linear correlation between these factors. Methods: Seventy-five gay men and 70 lesbians responded to self-report questionnaires. Hierarchical multiple regression analyses were conducted to investigate linear, quadratic, and exponential models and to determine which model best explained the correlation. Results: The quadratic model best explained the correlation, showing no gender differences. Conclusion: Adherence to gender roles constitutes a relevant factor in predicting internalized sexual stigma.     

新型城镇化进程中河北省城乡社区医疗卫生配套研究

新型城镇化建设的稳步推进及卫生体制改革的逐步深化,为河北省推进城乡社区医疗卫生发展改革带来了重大机遇,但河北省城乡社区医疗卫生配套状况仍然面临着重视不够、高水平人员短缺等问题。为此,应进一步加大城乡社区医疗卫生配套的宣传力度、建立并完善城乡社区高层次人才的制度机制、积极借鉴国外社区医疗卫生先进经验,以实现河北省城乡社区医疗卫生的可持续发展。     

Maternal Education and Investments in Children's Health

Maternal education differences in children's academic skills have been strongly linked to parental investment behaviors. This study extended this line of research to investigate whether these same maternal education patterns in parenting are observed among a set of parenting behaviors that are linked to young children's health. Drawing on data from the Early Childhood Longitudinal Study, Birth Cohort (n = 5,000) and longitudinal models incorporating random effects, the authors found that higher levels of maternal education were associated with more advantageous health investment behaviors at each phase of early development (9 months, 2 years, 4 years, 5 years). Moreover, these disparities were typically largest at the developmental stage when it was potentially most sensitive for children's long‐term health and development. These findings provide further evidence of a developmental gradient associated with mothers' education and new insight into the salience of mothers' education for the short‐ and long‐term health and well‐being of their children.