Planning with PRA: HIV and STD in a Nepalese mountain community.
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The application of Participatory Rural Appraisal methods (PRA) to the topic of sexual health enabled us to explore key factors concerning local people's perceptions regarding HIV/AIDS and STDs and to plan collectively to address the emerging issues. Conducting the process in a gender sensitive way enabled people to feel safe enough to express their own opinions, and having gained confidence in their peer groups, to share ideas later with the whole community in a joint planning exercise. Nevertheless one group was identified as difficult to reach and whose needs could not be met in a group for reasons of confidentiality. While the methodology itself clearly has great potential in planning around specific health issues, there are, nevertheless, limitations. Although the approach and the tools used are simple and accessible, the skills needed to analyze the information are more complex and demanding. The training given did not manage to equip facilitators adequately with these analytical skills and in the future will be more experience based and geared towards developing analysis and the ability to formulate questions. In addition, since the project is not permanently resident in the area, intensive support within the District is necessary to increase the chances of sustainability. (+info)
Risks and benefits of coronary angioplasty: the patients perspective: a preliminary study.
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OBJECTIVES: To describe what cardiac patients in Northern Ireland understand to be the benefits of coronary angioplasty and assess the extent to which they have been able to make informed choices about their treatment. DESIGN: An interview based questionnaire survey completed after the patients had undergone coronary angiography, within hours of treatment counselling. SUBJECTS: 150 patients consecutively recruited from two regional cardiology centres in Belfast, Northern Ireland. MAIN OUTCOME MEASURES: The perceived complication rate and the perceived gain in life expectancy from coronary angioplasty. RESULTS: Although most subjects had asked the consultant questions, 70% (n = 104) thought that they contributed negligibly or not at all to the treatment decision. Although 75% (n = 112) recalled discussing the complication rate from the procedure, only 27% accurately estimated this rate (as between 0.5 and 1.5%). Eighty eight per cent (n = 131) thought that their mortality risks would be substantially or greatly reduced by having the procedure. The patients anticipated a gain in life expectancy of some 10 years (median) and this was significantly in excess of the potential gain in life expectancy which dietary prudence to lower blood cholesterol, not smoking, and taking more exercise might produce (median 5 years respectively; P < 0.0001, Wilcoxon matched pairs signed rank test). CONCLUSIONS: Patients vastly overrate the capacity of angioplasty to control their disease: angioplasty is seen as more effective than risk factor modification. (+info)
Do local inhabitants want to participate in community injury prevention?: a focus on the significance of local identities for community participation.
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During the 1980s the community became the object of new interest and enthusiasm among many health promotion practitioners and researchers, and the principle of community participation was put on the research agenda. However, recent evaluations of major community health promotion programs have questioned the value of community interventions. This paper argues that the community level need not be of less importance in future health promotion initiatives. It is discussed whether the cultural dimension and the significance of local identities, neglected in most community health promotion programs, should receive more attention when local inhabitants are invited to participate in health promotion or disease prevention activities. Results from a study of injury prevention projects in small Norwegian municipalities indicate that the inhabitants' identification with local spatial subarenas might play an important role when they decide to become involved in injury prevention. Contemporary sociological approaches to the community, focusing on developments of local identities in processes of globalization, have formed a theoretical frame of reference in this study. (+info)
Is peer tutoring beneficial in the context of school resuscitation training?
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First year pupils at a Cardiff comprehensive school were trained in cardiopulmonary resuscitation, 106 by the teacher only and 137 by the teacher assisted by older pupils (peer tutoring). Scores in a multiple choice theory test and in practical skill assessment showed no significant difference between instruction methods, but boys taught by the teacher assisted by older pupils expressed less willingness to resuscitate in an emergency than girls instructed by either method (P < 0.01). Girls had higher scores in the multiple choice paper (P < 0.025) and in the skills assessment (P < 0.01). Those pupils who reported some prior knowledge of resuscitation techniques performed better during skill assessment than novice trainees (P < 0.025). (+info)
Parental perceptions of barriers to childhood immunization: results of focus groups conducted in an urban population.
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The current US immunization rates for 2 year olds are approximately half of the goal set for the year 2000. Research studies have focused primarily on the perception of health care providers in the identification of barriers and benefits to childhood immunization. While health care providers are an important part of the immunization delivery process, the perceptions of parents are also important. In this study, qualitative methods were used to explore perceived parental barriers to childhood immunization delivery. Twelve focus groups comprising White, African-American, Hispanic, urban and non-urban people were conducted at a variety of sites, including clinics, churches, schools and work sites. The results indicated that time off from work, access to well-child care and difficulty understanding the complexity of the immunization schedule were seen as barriers to adhering to an immunization schedule. Participants emphasized problems in taking time off from work to get immunizations, sometimes without pay, and expressed fears that doing so would jeopardize promotions and raises. While some of the parental perceptions were similar to those identified in studies of health care providers in the literature, many were not. This study emphasizes the importance of gathering information from parents as well as from health care providers. (+info)
Environment, development and health: ideological metaphors of post-traditional societies?
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Environment and health have become nearly interchangeable concepts in post-traditional societies. We are able to observe almost an obsession with them, as if individual changes in ways of life--important for the individual and significant for the culture though they may be--possessed the power to overthrow a system of economic relations that aims at growth in numerical terms rather than at development, enabling society to sustain its specific modes of private and public interaction. (+info)
Current conceptualizations of mental health and mental health promotion.
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Health promotion is generally agreed to be underpinned by a set of principles which distinguish it from other disciplines and professions. This paper takes these principles as the starting point for a review of the literature of mental health promotion. The aim is to clarify the ways in which mental health and mental health promotion are currently conceptualized, in order to identify areas where health promotion can make a unique contribution to complement that of other interest groups. In the first section, it is suggested that current definitions of mental health are inadequate for health promotion practice in that they either equate health with the absence of illness or present a culturally skewed, individualized and 'expert'-led version of what it means to be mentally healthy. The second section then traces the implications of these definitions as they emerge from the literature relating to mental health promotion practice. The paper concludes with a discussion of some ways in which health promotion specialists might begin to develop a mental health promotion agenda which is more consistent with health promotion principles. (+info)
Protecting paradise: tourism and AIDS in the Dominican Republic.
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This study summarizes results from six data collection instruments administered to tourists, hotel workers, and commercial sex workers (CSWs) in the Dominican Republic (D.R.). The objective of this study was to assess: 1. how HIV/AIDS may affect tourism; 2. how tourists are likely to react to prevention campaigns; and 3. how tourism may affect the spread of HIV/AIDS. It was found that an overwhelming proportion of tourists did not consider the prevalence of HIV to be a factor when making their travel plans, and that most did not consider themselves at greater risk of becoming infected while on holiday than when they were at home. This study determined that the spread of HIV/AIDS was unlikely to affect the demand for tourism services in the D.R. The study also found that most tourists would respond positively to an HIV/AIDS prevention campaign and would not be discouraged from visiting the D.R. because of such campaigns. Those most receptive to prevention efforts were also those who felt they were at highest risk, according to study data. Finally, it was determined that while most tourists probably do not engage in high risk activities, there were some male and female tourists who do engage in sexual encounters with multiple Dominican CSWs and hotel employees. These encounters represent a risk to the health and economic development of the D.R., as well as to tourists and their other sexual partners. Based on these findings, it is recommended that in order to minimize the potential social and economic impact of HIV/AIDS in the D.R., prevention messages need to reach a number of groups which have not yet been adequately targeted. These groups include tourists, with a special emphasis on 'sex tourists', and hotel employees, with a special emphasis on entertainment staff. (+info)