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Social Determinants and Teen Pregnancy Prevention: Exploring the Role of Nontraditional Partnerships.

ABSTRACT: Addressing the social determinants of health (SDOH) that influence teen pregnancy is paramount to eliminating disparities and achieving health equity. Expanding prevention efforts from purely individual behavior change to improving the social, political, economic, and built environments in which people live, learn, work, and play may better equip vulnerable youth to adopt and sustain healthy decisions. In 2010, the Centers for Disease Control and Prevention in partnership with the Office of Adolescent Health funded state- and community-based organizations to develop and implement the Teen Pregnancy Prevention Community-Wide Initiative. This effort approached teen pregnancy from an SDOH perspective, by identifying contextual factors that influence teen pregnancy and other adverse sexual health outcomes among vulnerable youth. Strategies included, but were not limited to, conducting a root cause analysis and establishing nontraditional partnerships to address determinants identified by community members. This article describes the value of an SDOH approach for achieving health equity, explains the integration of such an approach into community-level teen pregnancy prevention activities, and highlights two project partners' efforts to establish and nurture nontraditional partnerships to address specific SDOH.

SUBMITTER: Fuller TR

PROVIDER: S-EPMC5701861 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Social Determinants and Teen Pregnancy Prevention: Exploring the Role of Nontraditional Partnerships.

Fuller Taleria R TR White Carla P CP Chu Jocelyn J Dean Deborah D Clemmons Naomi N Chaparro Carmen C Thames Jessica L JL Henderson Anitra Belle AB King Pebbles P

Health promotion practice 20161201 1

Addressing the social determinants of health (SDOH) that influence teen pregnancy is paramount to eliminating disparities and achieving health equity. Expanding prevention efforts from purely individual behavior change to improving the social, political, economic, and built environments in which people live, learn, work, and play may better equip vulnerable youth to adopt and sustain healthy decisions. In 2010, the Centers for Disease Control and Prevention in partnership with the Office of Adol ...[more]

PMID: 27913658

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Project description:BackgroundLimited resources make prevention of complex population-level issues such as obesity increasingly challenging. Collaboration and partnerships between organisations operating in the same system can assist, however, there is a paucity of research into how relationships function at a local level. The aim of this study was to audit initiatives, explore networks, and identify potential opportunities for improving the obesity prevention system in a Health Service area of Western Australia (WA).MethodsA mixed-methods study was undertaken in a metropolitan Health Service in Perth, WA in 2019-20. Structured face-to-face interviews (n = 51) were conducted with organisations engaged in obesity prevention, to identify prevention initiatives and their characteristics using a Systems Inventory tool. The Research Team identified the 30 most active organisations during the Systems Inventory, and an online Organisational Network Survey was administered to explore: relationships across six domains; partnership duration; frequency of interaction with other organisations; barriers to implementation; and key contributions to obesity prevention. Descriptive statistics were used to summarise barriers, contributions and Systems Inventory data. Organisational Network Survey data were analysed using social network analysis through UCINET 6 for Windows and Netdraw software. Whole network and cohesion scores were calculated: average degree; density; diameter; and degree centralization. Core-periphery analysis was conducted to identify densely connected core and sparsely connected periphery organisations.ResultsThe Systems Inventory identified 189 unique prevention initiatives, mostly focusing on individual-level behaviour change. Fifty four percent (n = 15) of the Organisational Network Survey respondent organisations and most core organisations (67%, n = 8) were government. The information and knowledge sharing network had a density of 45% indicating a high level of information and knowledge exchange between organisations. The lowest densities were found within the receiving (3.3%), providing (5.5%) and sharing (5.6%) funding networks, suggesting that these formal relationships were the least established.ConclusionApplying a systems thinking lens to local obesity prevention revealed that initiatives conducted focused on individual-level behaviour change and that collaboration and communication between organisations focused on information sharing. Capturing the extent and nature of initiatives and the way partnerships operate to improve obesity prevention can help to identify opportunities to strengthen the networks.

Project description:ObjectiveExisting research on social determinants of health (SDoH) predominantly focuses on physician notes and structured data within electronic medical records. This study posits that social work notes are an untapped, potentially rich source for SDoH information. We hypothesize that clinical notes recorded by social workers, whose role is to ameliorate social and economic factors, might provide a complementary information source of data on SDoH compared to physician notes, which primarily concentrate on medical diagnoses and treatments. We aimed to use word frequency analysis and topic modeling to identify prevalent terms and robust topics of discussion within a large cohort of social work notes including both outpatient and in-patient consultations.Materials and methodsWe retrieved a diverse, deidentified corpus of 0.95 million clinical social work notes from 181 644 patients at the University of California, San Francisco. We conducted word frequency analysis related to ICD-10 chapters to identify prevalent terms within the notes. We then applied Latent Dirichlet Allocation (LDA) topic modeling analysis to characterize this corpus and identify potential topics of discussion, which was further stratified by note types and disease groups.ResultsWord frequency analysis primarily identified medical-related terms associated with specific ICD10 chapters, though it also detected some subtle SDoH terms. In contrast, the LDA topic modeling analysis extracted 11 topics explicitly related to social determinants of health risk factors, such as financial status, abuse history, social support, risk of death, and mental health. The topic modeling approach effectively demonstrated variations between different types of social work notes and across patients with different types of diseases or conditions.DiscussionOur findings highlight LDA topic modeling's effectiveness in extracting SDoH-related themes and capturing variations in social work notes, demonstrating its potential for informing targeted interventions for at-risk populations.ConclusionSocial work notes offer a wealth of unique and valuable information on an individual's SDoH. These notes present consistent and meaningful topics of discussion that can be effectively analyzed and utilized to improve patient care and inform targeted interventions for at-risk populations.

Project description:In Morogoro Region of south-central Tanzania, loss of crops and safety concerns due to elephants compromises livelihoods in many rural communities relying on subsistence agriculture. Using a social-ecological system framework to examine conflict-coexistence between people and elephants, this paper explores drivers that influence human-elephant interaction and subsistence farmer attitudes towards elephants in 10 villages from three different districts. Surveys and interviews document experiences interacting with elephants along with direct and indirect costs incurred in sharing the landscape, revealing different tolerance levels by residents of subject communities towards elephants that have important implications for elephant conservation. Rather than uniformly negative beliefs about elephants, analyses reveal that over the past decade a shift has occurred from largely favorable to unfavorable. The variables influencing attitudes included amounts of crops lost to elephants, perceived benefits from elephants, amounts of crops lost to other causes, perceived trend of human-elephant conflict (HEC) in the past three decades and level of education. Villager tolerance varied by level of income, perception on how the community coexists with elephants, amounts of crops lost to elephants and compensation. The study contributes to understanding how HEC is affecting the relationship between people and elephants, revealing a shift in the conflict-coexistence continuum from positive to broadly negative and identifying characteristics underlying varying tolerance towards elephants in different communities. Rather than a static condition, HEC emerges under specific conditions at particular times and places through varying, uneven interactions between rural villagers and elephants. In communities vulnerable to food insecurity, such conflict exacerbates existing problems of poverty, social inequality, and feelings of oppression. Addressing the causes of HEC, when possible, will be essential to elephant conservation as well as to improving the wellbeing of rural villagers.

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Social Determinants and Teen Pregnancy Prevention: Exploring the Role of Nontraditional Partnerships.

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Social Determinants and Teen Pregnancy Prevention: Exploring the Role of Nontraditional Partnerships.

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