Are Training and Experience adapting Evidence-Based interventions associated With Self-Efficacy and attitudes? a Cross-Sectional Survey of Students and Practitioners With Varying Levels of adaptation Experience

Increasing use of evidence-based interventions (EBIs) in local settings will help reduce the research-practice gap and improve health equity. Because adaptation to new settings and populations is essential to effective EBI use, frameworks to guide practice are receiving more attention; most, however, only provide broad guidelines without instructions for making adaptations in practice. Therefore, practitioners may need additional training or technical assistance (TA) to implement and adapt EBIs. This study explores whether practitioners\u27 and students\u27 general EBI training or TA and level of adaptation experience are associated with self-efficacy in adapting EBIs and with attitudes toward EBI use. We analyzed baseline survey data of participants in an evaluation of IM-Adapt Online, a newly developed decision support tool. We asked about previous training on EBIs, general and specific adaptation behaviors, and attitudes toward EBIs and found an association between previous training or TA in using EBIs with higher self-efficacy for using and adapting EBIs. Respondents with prior EBI training were significantly more likely to have higher self-efficacy in EBI behaviors across subdomains and in total than those without training. Respondents reported lowest self-efficacy for planning adaptations

Assessment of the Building Collaborative Research Capacity Model: Bridging the community-academic researcher divide

Background: Community–based Participatory Research (CBPR) can be challenging when community leaders and academic researchers have not previously co-led research or worked together with established rules guiding their relationships, roles, and respective functions. The objective of this investigation was to assess the processes and outcomes of the Building Collaborative Research Capacity Grant Program, sponsored by the Community Engagement Research Program of The Atlanta Clinical and Translational Science Institute and designed to foster CBPR. Methods: Four competitively selected community-based organizations (CBOs) participated in capacity-building workshops designed to build research skills and receive technical assistance to plan a pilot study with academic researchers. Pre- and postsurveys were used to assess the impact of the training and technical assistance on the CBOs’ knowledge and skills and abilities to plan, implement, and evaluate research. Key informant interviews were conducted with academic researchers and CBO dyads to identify experiences, perceptions, and recommendations related to the program model, and seven identified domains of collaborative research including research skills, attitudes toward collaboration, shared goals, institutional factors, mutual respect, human and fiscal resources, and partnering skills. Results: Areas of research competency increased from pre- to post-survey, with statistically significant increases in Community Assessment (p= 0.046) and Program Planning (p= 0.046). Each partnership had inherent characteristics related to strengths and barriers affecting the research outcomes. Conclusions: The present results contribute to the literature through assessment of processes, outcomes, and partner insights of a model designed to facilitate collaborative community-engaged research partnerships. Future research should examine the model to expand understanding of the dimensions of effective community and academic research collaboration

Pilot Study Results from a Brief Intervention to Create Smoke-Free Homes

Very few community-based intervention studies have examined how to effectively increase the adoption of smoke-free homes. A pilot study was conducted to test the feasibility, acceptability, and short-term outcomes of a brief, four-component intervention for promoting smoke-free home policies among low-income households. We recruited forty participants (20 smokers and 20 nonsmokers) to receive the intervention at two-week intervals. The design was a pretest-posttest with follow-up at two weeks after intervention. The primary outcome measure was self-reported presence of a total home smoking ban. At follow-up, 78% of participants reported having tried to establish a smoke-free rule in their home, with significantly more nonsmokers attempting a smoke-free home than smokers (P = .03). These attempts led to increased smoking restrictions, that is, going from no ban to a partial or total ban, or from a partial to a total ban, in 43% of the homes. At follow-up, 33% of the participants reported having made their home totally smoke-free. Additionally, smokers reported smoking fewer cigarettes per day. Results suggest that the intervention is promising and warrants a rigorous efficacy trial

Pathways between childhood trauma, intimate partner violence, and harsh parenting: findings from the UN Multi-country Study on Men and Violence in Asia and the Pacific

Background Although childhood trauma and violence against women are global public health issues, few populationbased data from low-income and middle-income countries exist about the links between them. We present data from the UN Multi-country Study on Men and Violence in Asia and the Pacific, exploring the pathways between different forms of childhood trauma and violence against women. Methods In this multicountry study, we interviewed multistage representative samples of men and women, aged 18–49 years, in Asia and the Pacific, using standardised population-based household surveys. Men were interviewed in six countries, and women in four. Respondents were asked questions about their perpetration or experience of intimate partner violence or non-partner sexual violence, childhood trauma, and harsh parenting (smacking their children as a form of discipline). We used maximum likelihood multivariate logit models to explore associations between childhood trauma and violence against women, and fitted path models to explore associations between experience and perpetration of child maltreatment. Findings Between Jan 1, 2011, and Dec 1, 2012, 10 178 men and 3106 women completed interviews in this study, with between 815 and 1812 men per site and 477 and 1103 women per site. The proportion of men who experienced any childhood trauma varied between 59% (n=478, 95% CI 54·0–63·3; Indonesia rural site) and 92% (n=791, 89·4–93·8; Bougainville, Papua New Guinea). For women, the results ranged from 44% (n=272, 37·7–50·8; Sri Lanka) to 84% (n=725, 80·7–86·8; Bougainville, Papua New Guinea). For men, all forms of childhood trauma were associated with all forms of intimate partner violence perpetration. For women, all forms of childhood trauma were associated with physical intimate partner violence, and both physical and sexual intimate partner violence. There were significant, often gendered, pathways between men’s and women’s perpetration and experiences of childhood trauma, physical intimate partner violence, harsh parenting, and other factors. Interpretation The data point to both a co-occurrence and a cycle of abuse, with childhood trauma leading to violence against women and further child maltreatment, which in turn increases the risk of experience or perpetration of violence during adulthood. Efforts to prevent both forms of violence would benefit from a meaningful integrated approach. Interventions should promote positive parenting, address inequality and the normalisation of violence across the life course, and transform men’s power over women and children

The association between women's sanitation experiences and mental health: A cross-sectional study in Rural, Odisha India.

Emerging qualitative research suggests women's sanitation experiences may impact mental health. However, specific associations remain unclear. We aimed to determine if sanitation access and sanitation experiences were associated with mental health among women in rural Odisha, India. Using a cross-sectional design, we evaluated the association between sanitation access and sanitation experiences and selected mental health outcomes. Data were collected from 1347 randomly selected women across four life course stages in 60 rural communities (December 2014-February 2015). Our four primary outcomes included: mental well-being, and symptoms of anxiety, depression, and distress. The primary exposures were (1) access to a functional latrine within the household compound and (2) sanitation insecurity (SI), evaluated using a seven domain measure assessing women's negative sanitation experiences and concerns. We used hierarchical linear modeling to determine associations between the exposures and mental health outcomes, adjusting for covariates (life stage, poverty, current health status, social support). Mean well-being scores were moderate and mean anxiety, depression, and distress scores were above a threshold indicating the potential presence of any of the three conditions. Access to a functional household latrine was associated with higher well-being scores, but not with anxiety, depression or distress. Women's SI domains were associated with all four outcomes: four domains were significantly associated with lower well-being scores, two were significantly associated with higher anxiety scores, three were significantly associated with higher depression scores, and three were significantly associated with higher distress scores, all independent of functional household latrine access. Women in rural Odisha, India may suffer assaults to their well-being and have higher symptoms of anxiety, depression, and distress when urinating and defecating, even if they have an available facility. These findings suggest that sanitation-related interventions should consider how to accommodate women's experiences beyond excreta management to comprehensively impact health

Challenges in Enforcing Home Smoking Rules in a Low-Income Population: Implications for Measurement and Intervention Design

Smoke-free homes reduce exposure to secondhand smoke, contribute to lower levels of consumption, and help smokers to quit. Even when home smoking rules are established however, they may not be consistently enforced

Confidentiality considerations for use of social-spatial data on the social determinants of health: Sexual and reproductive health case study

Understanding whether and how the places where people live, work, and play are associated with health behaviors and health is essential to understanding the social determinants of health. However, social-spatial data which link a person and their attributes to a geographic location (e.g., home address) create potential confidentiality risks. Despite the growing body of literature describing approaches to protect individual confidentiality when utilizing social-spatial data, peer-reviewed manuscripts displaying identifiable individual point data or quasi-identifiers (attributes associated with the individual or disease that narrow identification) in maps persist, suggesting that knowledge has not been effectively translated into public health research practices. Using sexual and reproductive health as a case study, we explore the extent to which maps appearing in recent peer-reviewed publications risk participant confidentiality. Our scoping review of sexual and reproductive health literature published and indexed in PubMed between January 1, 2013 and September 1, 2015 identified 45 manuscripts displaying participant data in maps as points or small-population geographic units, spanning 26 journals and representing studies conducted in 20 countries. Notably, 56% (13/23) of publications presenting point data on maps either did not describe approaches used to mask data or masked data inadequately. Furthermore, 18% (4/22) of publications displaying data using small-population geographic units included at least two quasi-identifiers. These findings highlight the need for heightened education for researchers, reviewers, and editorial teams. We aim to provide readers with a primer on key confidentiality considerations when utilizing linked social-spatial data for visualizing results. Given the widespread availability of place-based data and the ease of creating maps, it is critically important to raise awareness on when social-spatial data constitute protected health information, best practices for masking geographic identifiers, and methods of balancing disclosure risk and scientific utility. We conclude with recommendations to support the preservation of confidentiality when disseminating results

Assessing Women's Negative Sanitation Experiences and Concerns: The Development of a Novel Sanitation Insecurity Measure.

Lack of access to acceptable sanitation facilities can expose individuals, particularly women, to physical, social, and mental health risks. While some of the challenges have been documented, standard metrics are needed to determine the extent to which women have urination- and defecation-related concerns and negative experiences. Such metrics also are needed to assess the effectiveness of interventions to mitigate them. We developed a sanitation insecurity measure to capture the range and frequency of women's sanitation-related concerns and negative experiences. Research was conducted in rural Odisha, India with women across various life course stages to reflect a range of perspectives. This paper documents the mixed data collection methods and the exploratory and confirmatory factor analyses we employed to arrive at a final measure. The final sanitation insecurity measure includes 50 items across seven factors that reflect the physical environment, the social environment, and individual-level constraints. Most factor scores were significantly higher for unmarried women and for women who lacked access to functional latrines, indicating social and environmental influence on experiences. This measure will enable researchers to evaluate how sanitation insecurity affects health and to determine if and how sanitation interventions ameliorate women's concerns and negative experiences associated with sanitation

A Minimal Intervention to Promote Smoke-Free Homes among 2-1-1 Callers: North Carolina Randomized Effectiveness Trial

This study examined the extent to which delivery of the minimal Smoke-Free Homes intervention by trained 2-1-1 information and referral specialists had an effect on the adoption of home smoking bans in low-income households. A randomized controlled trial was conducted among 2-1-1 callers (n = 500) assigned to control or intervention conditions. 2-1-1 information and referral specialists collected baseline data and delivered the intervention consisting of 3 mailings and 1 coaching call; university-based data collectors conducted follow-up interviews at 3 and 6 months post-baseline. Data were collected from June 2013 through July 2014. Participants were mostly female (87.2%), African American (61.4%), and smokers (76.6%). Participants assigned to the intervention condition were more likely than controls to report a full ban on smoking in the home at both 3- (38.1% vs 19.3%, p = < .001) and 6-month follow-up (43.2% vs 33.2%, p = .02). The longitudinal intent-to-treat analysis showed a significant intervention effect over time (OR = 1.31, p = .001), i.e. OR = 1.72 at 6 months. This study replicates prior findings showing the effectiveness of the minimal intervention to promote smoke-free homes in low-income households, and extends those findings by demonstrating they can be achieved when 2-1-1 information and referral specialists deliver the intervention. Findings offer support for this intervention as a generalizable and scalable model for reducing secondhand smoke exposure in homes

Reactions to Cigarette Taxes and Related Messaging: Is the South Different?

Given the lag in tobacco control policies in the southeastern US, we examined differences in reactions to tobacco taxes and related messaging among Southeasterners vs. non-Southeasterners