Health Education and Community Empowerment: Conceptualizing and Measuring Perceptions of Individual, Organizational and Community Control

Also PCMA Working Paper #38.http://deepblue.lib.umich.edu/bitstream/2027.42/51259/1/493.pd

Detroit's East Side Village Health Worker Partnership: Community-Based Lay Health Advisor Intervention in an Urban Area

In recent years, there have been few reports in the literature of interventions using a lay health advisor approach in an urban area. Consequently, little is known about how implementation of this type of community health worker model, which has been used extensively in rural areas, may differ in an urban area. This article describes the implementation of the East Side Village Health Worker Partnership, a lay health advisor intervention, in Detroit, Michigan, and notes how participatory action research methods and principles for community-based partnership research are being used to guide the intervention. Findings are presented on how the urban context is affecting the design and implementation of this intervention. Implications of the findings for health educators are also presented and include the utility of a participatory action research approach, the importance of considering the context and history of a community in designing a health education intervention, and the importance of recognizing and considering the differences between rural and urban settings when designing a health education intervention.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67390/2/10.1177_109019819802500104.pd

Social Networks and Social Support: Implications for Natural Helper and Community Level Interventions

The convincing evidence of the relationship between social support, social networks, and health status has influenced the development of program strategies which are relevant to health education. This article focuses on the linkage between social support and social networks and health education programs which involve interventions at the network and community level. Two broad strategies are addressed: programs enhancing entire networks through natural helpers; and programs strengthening overlapping networks/communities through key opinion and infor mal leaders who are engaged in the process of community wide problem-solving. Following a brief overview of definitions, this article highlights several network characteristics which are often found to be related to physical and mental health status. Suggestions are made for how these network characteristics can be applied to the two program strategies. Principles of practice for the health educator, and some of the limitations of a social network approach are delineated. The article concludes with a recommendation for engaging in action research—a perspective highly consistent with both the strategies discussed and the concepts of social networks and social support. This approach not only recognizes, but also acts to strengthen indigenous skills and resources.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67587/2/10.1177_109019818501200106.pd

Giardia duodenalis: New Research Developments in Pathophysiology, Pathogenesis, and Virulence Factors

Giardia duodenalis is a very common, ubiquitous, intestinal protozoan parasite infecting animals and humans. Of the eight distinct genetic assemblages known to date, assemblages A and B are infectious to humans. Giardia is the most commonly recognized cause of traveller’s diarrhea. Giardiasis impairs weight gain and is responsible for a variety of extra-intestinal and post-infectious complications, including post-infectious irritable bowel syndrome, chronic fatigue, failure to thrive, and cognitive impairment. Giardiasis occurs in the absence of invasion of the intestinal tissues by the trophozoites and in the absence of any overt inflammatory cell infiltration, with the exception of a modest increase in intraepithelial lymphocytes and mast cells. In endemic parts of the World where the infection is often concurrent with bacterial enteritis causing inflammation-driven diarrheal disease, giardiasis appears to be protective against diarrhea. Recent observations have demonstrated that this effect may be due to a direct immuno-modulating effect of the parasite via its cathepsin B cysteine protease which cleaves pro-inflammatory CXCL8. No known toxin has yet been directly implicated in the pathophysiology of giardiasis. Diarrhea in giardiasis is mostly malabsorptive in nature, rather than hypersecretory. Findings from ongoing research indicate that the post-infectious effects of giardiasis may be due to microbiota dysbiosis induced by the parasite during the acute phase of infection.Ye