Dataset Information

HIV: A Socioecological Case Study.

ABSTRACT:

Introduction

New strategies are needed to lower health care costs and address the health care needs of communities, especially for marginalized persons and subpopulations. Improved education in health systems, which encompasses population, community, preventive, and public health, is one way to better train the future physician workforce to meet national and local health care needs. This resource was created as part of an 18-month science of health systems and navigation curriculum.

Methods

The purpose of this resource is to use the socioecological model lens to analyze health disparities for marginalized persons and subpopulations. A medically and socially complex patient with HIV is presented as the initial case study that leads to identification of barriers and needs on individual, community, and public policy levels. This is an active-learning resource that includes both small- and large-group discussion driven by self-directed learners using the provided resources.

Results

This resource was successfully implemented as a required session for 150 medical students beginning the second year of medical school. A cohort of 21 students randomly selected to complete a standard online course evaluation for the session, rated their agreement (1 = strong disagreement, 5 = strong agreement) to the statement "Rate the extent to which the lecture supported your mastery of the learning objectives," as 4.4, on average.

Discussion

This curriculum has been implemented and evaluated for medical students, but it is broadly applicable to residents and interprofessional students in health-related fields. It is designed to give learners a practical medical context for the application of principles that may be taught within a health systems or population health course.

SUBMITTER: Sell J

PROVIDER: S-EPMC6440396 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Publications

HIV: A Socioecological Case Study.

Sell Jarrett J George Daniel D Levine Martha P MP

MedEdPORTAL : the journal of teaching and learning resources 20161202

<h4>Introduction</h4>New strategies are needed to lower health care costs and address the health care needs of communities, especially for marginalized persons and subpopulations. Improved education in health systems, which encompasses population, community, preventive, and public health, is one way to better train the future physician workforce to meet national and local health care needs. This resource was created as part of an 18-month science of health systems and navigation curriculum.<h4>M ...[more]

PMID: 30984851

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Project description:BackgroundLate diagnosis of HIV remains a challenge, despite improved testing and treatment. Testing is often targeted at high-risk groups; workplace events might normalise testing and allow access to a wider population. The construction workforce has a number of risk factors for HIV. In the Test@Work study, HIV tests were delivered within general health checks to construction employees, with high uptake and acceptability. This paper reports on the experiences of construction managers and health professionals involved in Test@Work and explores the suitability of construction worksites as a venue for opt-in HIV testing.MethodsQualitative interviews (n = 24) were conducted with construction managers who had facilitated health check/HIV testing (n = 13), and delivery partners (n = 11) including i) healthcare volunteers who had delivered general health checks (n = 7) and, ii) HIV professionals who had conducted HIV testing (n = 4) at 21 Test@Work events held on construction sites. Interviews explored their experiences of these events and views towards HIV testing in the workplace. Exit questionnaires (n = 107) were completed by delivery partners after every event, providing qualitative data identifying facilitators and barriers to effective delivery. Thematic analysis identified themes that were mapped against a socioecological framework.ResultsDelivery partners reported high engagement of construction workers with workplace HIV testing, peer-to-peer encouragement for uptake, and value for accessibility of onsite testing. HIV professionals valued the opportunity to reach an untested population, many of whom had a poor understanding of their exposure to HIV risk. Managers valued the opportunity to offer workplace health checks to employees but some identified challenges with event planning, or provision of private facilities.ConclusionsThe construction sector is complex with a largely male workforce. Providing worksite HIV testing and education to an untested population who have poor knowledge about HIV risk helped to normalise testing, encourage uptake and reduce HIV-related stigma. However, there are practical barriers to testing in the construction environment. Rapid testing may not be the most suitable approach given the challenges of maintaining confidentiality on construction worksites and alternatives should be explored.

Project description:BackgroundAnthropogenic changes in the environment are increasingly threatening the sustainability of socioecological systems on a global scale. As stewards of the natural capital of over a quarter of the world's surface area, Indigenous Peoples (IPs), are at the frontline of these changes. Indigenous socioecological systems (ISES) are particularly exposed and sensitive to exogenous changes because of the intimate bounds of IPs with nature. Traditional food systems (TFS) represent one of the most prominent components of ISES, providing not only diverse and nutritious food but also critical socioeconomic, cultural, and spiritual assets. However, a proper understanding of how future climate change may compromise TFS through alterations of related human-nature interactions is still lacking. Climate change resilience of indigenous socioecological systems (RISE) is a new joint international project that aims to fill this gap in knowledge.Methods and designRISE will use a comparative case study approach coupling on-site socioeconomic, nutritional, and ecological surveys of the target ISES of Sakha (Republic of Sakha, Russian Federation) and Karen (Kanchanaburi, Thailand) people with statistical models projecting future changes in the distribution and composition of traditional food species under contrasting climate change scenarios. The results presented as alternative narratives of future climate change impacts on TFS will be integrated into a risk assessment framework to explore potential vulnerabilities of ISES operating through altered TFS, and possible adaptation options through stakeholder consultation so that lessons learned can be applied in practice.DiscussionBy undertaking a comprehensive analysis of the socioeconomic and nutritional contributions of TFS toward the sustainability of ISES and projecting future changes under alternative climate change scenarios, RISE is strategically designed to deliver novel and robust science that will contribute towards the integration of Indigenous issues within climate change and sustainable agendas while generating a forum for discussion among Indigenous communities and relevant stakeholders. Its goal is to promote positive co-management and regional development through sustainability and climate change adaptation.

Dataset Information

HIV: A Socioecological Case Study.

Introduction

Methods

Results

Discussion

Publications

HIV: A Socioecological Case Study.

Similar Datasets

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