In 2013, a cohort of public health students participated in a 'flipped' Environmental and Occupational Health course. Content for the course was delivered through NextGenU.org and active learning ...activities were carried out during in-class time. This paper reports on the design, implementation, and evaluation of this novel approach.
Using mixed-methods, we examined learning experiences and perceptions of the flipped classroom model and assessed changes in students' self-perceived knowledge after participation in the course. We used pre- and post-course surveys to measure changes in self-perceived knowledge. The post-course survey also included items regarding learning experiences and perceptions of the flipped classroom model. We also compared standard course review and examination scores for the 2013 NextGenU/Flipped Classroom students to previous years when the course was taught with a lecture-based model. We conducted a focus group session to gain more in-depth understanding of student learning experiences and perceptions.
Students reported an increase in knowledge and survey and focus group data revealed positive learning experiences and perceptions of the flipped classroom model. Mean examination scores for the 2013 NextGenU/Flipped classroom students were 88.8% compared to 86.4% for traditional students (2011). On a scale of 1-5 (1 = lowest rank, 5 = highest rank), the mean overall rating for the 2013 NextGenU/Flipped classroom students was 4.7/5 compared to prior years' overall ratings of 3.7 (2012), 4.3 (2011), 4.1 (2010), and 3.9 (2009). Two key themes emerged from the focus group data: 1) factors influencing positive learning experience (e.g., interactions with students and instructor); and 2) changes in attitudes towards environmental and occupation health (e.g., deepened interest in the field).
Our results show that integration of the flipped classroom model with online NextGenU courses can be an effective innovation in public health higher education: students achieved similar examination scores, but NextGenU/Flipped classroom students rated their course experience more highly and reported positive learning experiences and an increase in self-perceived knowledge. These results are promising and suggest that this approach warrants further consideration and research.
The focus is on modelling how different behaviours and social structures affect disease spread, thereby resulting in epidemics, disease containment, stuttering transmission, or burnout.6 An important ...finding is that contact networks are characterised by community structure--ie, a tendency for formation of high-connectivity clusters, which can amplify or reduce population transmission.6 Social networks can transmit information that increases community cohesion and ability to prevent infection, and also foster social mobilisation and culture change. ...the social sciences are crucial in creation of appropriate public health responses to risk and emergence of epidemics.
Anthropology and Global Health Janes, Craig R.; Corbett, Kitty K.
Annual review of anthropology,
01/2009, Volume:
38, Issue:
1
Journal Article
Peer reviewed
This article addresses anthropology's engagement with the emerging discipline of global health. We develop a definition for global health and then present four principal contributions of anthropology ...to global health: (a) ethnographic studies of health inequities in political and economic contexts; (b) analysis of the impact on local worlds of the assemblages of science and technology that circulate globally; (c) interrogation, analysis, and critique of international health programs and policies; and (d) analysis of the health consequences of the reconfiguration of the social relations of international health development.
Although the prevalence of depression in Vietnam is on par with global rates, services for depression are limited. The government of Vietnam has prioritized enhancing depression care through primary ...healthcare (PHC) and efforts are currently underway to test and scale-up psychosocial interventions throughout the country. With these initiatives in progress, it is important to understand implementation factors that might influence the successful integration of depression services into PHC. As the implementers of these new interventions, primary care providers (PHPs) are well placed to provide important insight into implementation factors affecting the integration of depression services into PHC. This mixed-methods study examines factors at the individual, organizational and structural levels that may act as barriers and facilitators to the integration of depression services into PHC in Vietnam from the perspective of PHPs.
Data collection took place in Hanoi, Vietnam in 2014. We conducted semi-structured interviews with PHPs (n = 30) at commune health centres and outpatient clinics in one rural and one urban district of Hanoi. Theoretical thematic analysis was used to analyse interview data. We administered an online survey to PHPs at n = 150 randomly selected communes across Hanoi. N = 226 PHPs responded to the survey. We used descriptive statistics to describe the study variables acting as barriers and facilitators and used a chi-square test of independence to indicate statistically significant (p < .05) associations between study variables and the profession, location and gender of PHPs.
Individual-level barriers include low level of knowledge and familiarity with depression among PHPs. Organizational barriers include low resource availability in PHC and low managerial discretion. Barriers at the structural level include limited mental health training among all PHPs and the existing programmatic structure of PHC in Vietnam, which sets mental health apart from general services. Facilitators at the individual level include positive attitudes among PHPs towards people with depression and interest in undergoing enhanced training in depression service delivery.
While facilitating factors at the individual level are encouraging, considerable barriers at the structural level must be addressed to ensure the successful integration of depression services into PHC in Vietnam.
Integrated knowledge translation (IKT) and community-based participatory research (CBPR) are recognized as effective approaches when Indigenous and non-Indigenous partners work together to focus on a ...common goal. The "Learning Circles: Local Healthy Food to School" (LC:LHF2S) study supported the development and implementation of Learning Circles (LC) in 4 Canadian Indigenous communities with the goal of improving local, community-based healthy food systems. Critical to the research process were annual gatherings (AG) where diverse stakeholders (researchers, Indigenous community members, and partners) visited each community to share knowledge, experiences, and provide support in the research process. Using a qualitative, descriptive method, this paper explores how the AG supported IKT across partners. Yearly interviews involving 19 total participants (with some participating multiple times across the 4 gatherings) elicited their AG experiences in supporting local LC:LHF2S. Three themes with multiple sub-themes were identified: (a) setting the stage for IKT (importance of in-person gatherings for building relationships across partners, learning from each other), (b) enabling meaningful engagement (aligning research with Indigenous values, addressing tensions and building trust over time, ensuring flexibility, and Indigenous involvement and leadership), and (c) supporting food system action at the local level (building local community engagement and understanding, and integrating support for implementation and scale-up of LC). This paper provides useful and practical examples of the principles of Indigenous-engaged IKT and CBPR in action in healthy, local, and traditional food initiatives. AG are a valuable IKT strategy to contribute to positive, transformative change and ethical research practice within Indigenous communities. Key words: knowledge translation, community-based participatory research, Indigenous, health promotion, food systems, Learning Circles L'application integree des connaissances (<< IKT >>) et la recherche participative communautaire (<< CBPR >>) sont reconnues comme des approches efficaces lorsque des partenaires autochtones et non autochtones travaillent ensemble en se concentrant sur un objectif commun. L'etude << Learning Circles: Local Healthy Food to School >> (<< LC:LHF2S >>) a soutenu le developpement et la mise en oeuvre de cercles d'apprentissage (<< LC >>) dans quatre communautes autochtones canadiennes dans le but d'ameliorer les systemes locaux et communautaires d'alimentation saine. Les rassemblements annuels (<< AG >>) oU divers intervenants (chercheurs, membres des communautes autochtones et partenaires) ont visite chaque communaute pour partager leurs connaissances, leurs experiences etaient essentiels au processus de recherche. Au moyen d'une methode qualitative et descriptive, cet article explore la maniere dont l'AG a soutenu l'IKT parmi les partenaires. Des entretiens annuels impliquant 19 participants au total (certains participant plusieurs fois au cours des quatre rassemblements) ont renforce leurs experiences d'AG pour le soutien du LC: LHF2S local. Trois themes avec plusieurs sous-themes ont ete identifies : (a) preparer le terrain pour l'IKT (importance des rencontres en personne pour etablir des relations entre les partenaires, apprendre les uns des autres), (b) permettre un engagement significatif (aligner la recherche sur les valeurs autochtones, resoudre les tensions et renforcer la confiance au fil du temps, assurer la flexibilite et la participation et le leadership des Autochtones) et (c) soutenir l'action du systeme alimentaire au niveau local (renforcer l'engagement et la comprehension de la communaute locale et integrer le soutien a la mise en oeuvre et a l'intensification du LC). Ce document fournit des exemples utiles et pratiques des principes de l'IKT et de la CBPR impliquant les Autochtones en action dans des initiatives alimentaires saines, locales et traditionnelles. L'AG est une strategie d'IKT precieuse pour contribuer a un changement positif et transformateur et a une pratique de recherche ethique au sein des communautes autochtones. Traduit par la Redaction Mots-cles : application des connaissances, recherche participative communautaire, autochtone, promotion de la sante, systemes alimentaires, cercles d'apprentissage
•Canada’s sociocultural determinants create communication challenges in primary care.•Patient-centred care fosters communication with vulnerable patient populations.•Communication and decisions aids ...have been developed for primary care.•Research in Canada should focus on marginalized and minority groups.
Patient-provider communication is critical in primary care. Canada’s unique health system, population distribution, and cultural context suggest there is value in addressing the topic in the Canadian context. We conducted a scoping review to synthesize recent Canadian literature to inform practice in primary care settings and identify research agendas for patient-provider communication in Canada.
Using Arksey and O’Malley’s framework we searched four literature databases: Medline, Web of Science, CINAHL and EMBASE. We extracted 21,932 articles published between 2010 and 2017. A total of 108 articles met the inclusion criteria. The articles were analyzed qualitatively using thematic analysis to identify major themes.
Four major themes were identified: information sharing, relationships, health system challenges, and development and use of communication tools.
Our review identified a need for Canadian research regarding: communication in primary care with Aboriginal, immigrant, and rural populations; the impact of medical tourism on primary care; and how to improve communication to facilitate continuity of care.
Challenges providers face in primary care in Canada include: communicating with linguistically and culturally diverse populations; addressing issues that emerge with the rise of medical tourism; a need for decision aids to improve communication with patients.
The presence and influence of nongovernmental organizations (NGOs) in the landscape of global health and development have dramatically increased over the past several decades. The distribution of NGO ...activity and the ways in which contextual factors influence the distribution of NGO activity across geographies merit study. This paper explores the distribution of NGO activity, using Bolivia as a case study, and identifies local factors that are related to the distribution of NGO activity across municipalities in Bolivia.
The research question is addressed using a geographic information system (GIS) and multiple regression analyses of count data. We used count data of the total number of NGO projects across Bolivian municipalities to measure NGO activity both in general and in the health sector specifically and national census data for explanatory variables of interest.
This study provides one of the first empirical analyses exploring factors related to the distribution of NGO activity at the national scale. Our analyses show that NGO activity in Bolivia, both in general and health-sector specific, is distributed unevenly across the country. Results indicate that NGO activity is related to population size, extent of urbanization, size of the indigenous population, and health system coverage. Results for NGO activity in general and health-sector specific NGO activity were similar.
The uneven distribution of NGO activity may suggest a lack of co-ordination among NGOs working in Bolivia as well as a lack of co-ordination among NGO funders. Co-ordination of NGO activity is most needed in regions characterized by high NGO activity in order to avoid duplication of services and programmes and inefficient use of limited resources. Our findings also indicate that neither general nor health specific NGO activity is related to population need, when defined as population health status or education level or poverty levels. Considering these results we discuss broader implications for global health and development and make several recommendations relevant for development and health practice and research.
Aboriginal peoples are among the most food insecure groups in Canada, yet their perspectives and knowledge are often sidelined in mainstream food security debates. In order to create food security ...for all, Aboriginal perspectives must be included in food security research and discourse. This project demonstrates a process in which Aboriginal and non-Aboriginal partners engaged in a culturally appropriate and respectful collaboration, assessing the challenges and barriers to traditional foods access in the urban environment of Vancouver, BC, Canada. The findings highlight local, national, and international actions required to increase access to traditional foods as a means of achieving food security for all people. The paper underscores the interconnectedness of local and global food security issues and highlights challenges as well as solutions with potential to improve food security of both Aboriginal and non-Aboriginal peoples alike.
In their own words: a model of healthy aging Bryant, Lucinda L; Corbett, Kitty K; Kutner, Jean S
Social science & medicine (1982),
10/2001, Volume:
53, Issue:
7
Journal Article
Peer reviewed
Many previous studies have assessed the aging process by measuring clinical and functional variables. To supplement that quantitative understanding, we asked older people what constitutes their ...health and contributes to it. Using grounded theory-type methods, we analyzed semi-structured interviews with 22 study subjects, who were randomly selected from among those whose reported perceived health differed from that predicted by a regression model constructed from data from a randomized trial of a primary care intervention. We focused on disparate cases to identify factors that best discriminate between more and less healthy aging. Interview questions targeted perceptions of health; well-being; valued abilities, activities, and relationships; social support; control; sense of coherence; and personal outlook. A model of healthy aging emerged. To these older people
health meant
going and doing something meaningful, which required four components: something worthwhile to do, balance between abilities and challenges, appropriate external resources, and personal attitudinal characteristics (e.g., positive attitude vs. “poor me”). By reframing healthy aging in older people's own terms, this model encourages interdisciplinary support of their desired goals and outcomes rather than only medical approaches to deficits and challenges.
Summary Worldwide, oral cancer is responsible for 170,000 deaths per year. Intervention to prevent this disease is a long sought after goal. Chemoprevention studies have focused on ...clinicopathological features of potentially malignant lesions (PML) in an effort to prevent their progression to cancer. However, prediction of future behavior for such lesions is difficult and remains a major challenge to such intervention. Different approaches to this problem have been tested in the past 20 years. Early genetic progression models identified critical regions of allelic imbalance at 3p and 9p, and provided the basis for molecular markers to identify progressing PMLs. Subsequently, technological advances, such as genome-wide high-throughput array platforms, computer imaging, visualization technology and next generation sequencing, have broadened the scope for marker development and have the potential of further improving our ability to identify high-risk lesions in the near future either alone or in combination. In this article, we examine the milestones in the development of markers for PML progression. We emphasize the critical importance of networks among scientists, health professionals and community to facilitate the validation and application of putative markers into clinical practice. With a growing number of new agents to validate, it is necessary to coordinate the design and implementation of strategies for patient recruitment, integration of marker assessment, and the final translation of such approaches into clinical use.
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