Suchergebnisse

Introduction: The purpose of this study was to assess the perceived barriers and strategies for improvement of timely detection, treatment, and management of cervical cancer among Ghanaian women in a tertiary hospital setting. Methods: Sixty semi-structured interviews, comprised of thirty-five cervical cancer patients and twenty-five healthcare professionals who provide cervical cancer care, were conducted. Two focus groups were conducted, including four healthcare professionals and another with two healthcare professionals—the data were analyzed using NVivo 12. A theoretical thematic analysis was utilized to identify common themes and sub-themes that arose from the participant interviews. The social-ecological model framework was employed to classify themes. Results: Lack of knowledge about the disease, screening, perceived lack of susceptibility and seriousness, cost of diagnostic test, treatment, travel, and accommodations coupled with a low socio-economic status are barriers at the individual level. Lack of financial and social support from family and normative gender relations were the barriers at the interpersonal level. The sociocultural beliefs in the communities associated with the causes of the disease, stigmatization, and alternative healing were barriers at the community level. There are several barriers at the organizational level that effect timely detection, treatment, and management. These barriers are associated with the availability and access to adequate health systems and trained health professional such as lack of diagnostic facilities, high levels of misdiagnosis, delay in release of results, inefficient referral process, poor patient-provider communication, difficult patient navigation, lack of treatment equipment, maintenance and resources, lack of psychosocial support, and lack of palliative care services. Lack of government-sponsored education programs, funding allocated for health facilities and trained healthcare professionals in the rural settings and tertiary health facilities, drug stockpile, inadequate insurance coverage, and timely reimbursement of insurance claims for hospitals pose significant barriers at the policy level. Strategies proposed for improvement were centered around education, community outreach and sensitization, health system improvements, and increased community organization and government support. Discussion: Cervical cancer early detection, treatment, and management outcomes face several barriers at the various level of the SEM. To improve detection time, treatment, and management issues, these barriers at all levels must be addressed simultaneously.

AbstractThe fundamental challenge of a renewed American community is attention to the needs of youth, particularly the large and growing proportion living in disenfranchised, urban circumstances. Fortunately, communities across the nation have acknowledged this face, prompting them to launch innovative programs to prevent and stop youth violence.

BackgroundMental health is a serious public health concern that is uniquely devastating for African American families.ObjectiveThis study systematically critiques the body of work documenting the mediating role of social support and neighborhood context on the psychological well-being of African American families.MethodsThis review used the PRISMA multistate process.FindingsSeveral important findings are drawn from this study: a) social support and neighborhood context shape psychological well-being, b) existing studies are limited in capacity to capture context despite having contextualized frameworks, c) African centered theory is missing.ConclusionsSocial support and neighborhood context matter. Future researchers must employ methods to capture this context and the link to mental health in African American communities where disproportionate risks exist.

First published in 1999, Worlds Apart examined the nature of poverty through the stories of real people in three remote rural areas of the United States: New England, Appalachia, and the Mississippi Delta. In this new edition, Duncan returns to her original research, interviewing some of the same people as well as some new key informants. Duncan provides powerful new insights into the dynamics of poverty, politics, and community change. ";What stories Mil Duncan has to tell! In this new edition of her classic Worlds Apart, she offers sage advice about how to begin to reverse the dangerously growing divide between rich and poor in our country.";—Robert Putnam, author of Bowling Alone and Our Kids: The American Dream in Crisis ";A mosaic of intimate portraits revealing the social, ecenomic, and political isolation of rural poverty, Worlds Apart is a must-read for anyone seeking to understand the root causes of inquality in America.";—Darren Walker, president, Ford Foundation