Community Workers’Social Support and Sleep Quality during the Coronavirus Disease 2019(COVID-19):A Moderated Mediation Model

To explore the relationship between social support and sleep quality of community workers in Wuhan during the coronavirus disease 2019(the COVID-19 infection epidemic),this research constructed a mediating effect model to explore the mediating psychological mechanism of social support influencing sleep quality of front-line community workers.A total of 500 front-line community workers in Wuhan were investigated.We used the perceived social support scale(PSSS),the Connor-Davidson Resilience Scale(CD-RISC),the perceived stress scale(PSS),and the Pittsburgh sleep quality index(PSQI)to measure social support,psychological resilience,perceived stress and sleep quality.Specifically,the higher the PSQI,the worse the sleep quality.Pearson correlation structural equation model was used to analyze the relationship between these factors.The results showed that:(1)There was a significant negative correlation between social support,psychological resilience,and perceived stress of community workers and PSQI,that means,the higher the level of social support,psychological resilience,and perceived stress,the higher the sleep quality.(2)Social support positively predicted psychological resilience and perceived stress,and perceived stress negatively predicted PSQI.(3)Social support can affect sleep quality through the mediating role of psychological resilience and perceived stress,and the mediating role includes two paths:the single mediating role of perceived stress and the chain mediating role of psychological resilience-perceived stress.(4)Gender moderates the relation-ship between social support and perceived stress,and the influence of social support on perceived stress of women is higher than that of men.Gender moderates the relationship between psychological resilience and PSQI,and only women’s psychological resilience had a negatively predictive effect on PSQI,while men did not,which means that psychological resilience of female frontline community workers can positively predict sleep quality.This research reveals the relationship between social support and sleep quality and its mechanism and verifies that social support can indirectly affect physical health through psychological resilience and perceived stress.It provides reference suggestions and intervention guidance for improving the sleep quality of community workers.

Community workers contribution for data quality improvement in routine health information system: Live births number estimation by capture recapture method

The lack of reliable vital statistics raises questions about the role of the health information system in acquiring such data, which are essential for planning health services and for the general management of the population’s needs. This study analyzed completeness of the vital data registration system and assessed the potential contribution of a community worker net-work to this system in rural Benin. The capture-recapture method was used in this interventional study to estimate the number of live births from three sources: the Routine Health Information System, the municipality, and community workers in two groups of villages. Log linear modelling was carried out with a Bayesian Information Criterion-weighted estimate of the number of live births. The exhaustiveness of the Routine Health Information System was improved by the contribution of the community workers from 29.3% to 42.5% in the first group, and from 61.7% to 77.5% in the second group. Estimating live births by the capture method in rural settings based on the contribution of community workers could be a more efficient alternative to censuses in acquiring reliable vital statistics.

Effectiveness of Adherence to Standardized Hypertension Management by Primary Health Care Workers in China:a Cross-sectional Survey 3 Years after the Healthcare Reform

The standardized hypertension management provided by primary health care workers is an important part of China＇s recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.

Community-based intervention of chronic disease management program in rural areas of Indonesia

Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.

Community health worker model for health care delivery and environment programs focused on initiatives in USA and India

Community health workers are equipped with the tools and resources necessary to bring about a change in the form of a rapid chain reaction.The community health workers model focuses on the practices,strategies,plans,and implementation techniques needed to organize a community health event based on diverse agendas:health,environment,and minorities.This model encompasses past experiences as a guide with tested strategies to assist future health interns with a ground framework and resources to showcase the importance of adopting healthy and environmentally friendly practices.The basic outline of the model is based on data collected from various community health events in Illinois(United States of America)and New Delhi(India).These events included back to school fairs,cleanliness drives,health camps,and educational events.As community health workers can help in implementing better practices in the masses through one-on-one interactions,this model of community health worker programs would outline event organization tips,predicted outcomes,targeted audience,and required material templates.The next phase of this model highlights utilizing the data and experience from these events to report to the health ministries of different countries for the incorporation of the proposed practices in their health agendas and policies.This model,if implemented unanimously,could bring about a revolution in the arena of health workers.They will be assisted at each step,will establish connections with health workers globally,and share their health and environment-based agendas to collaborate and organize important events.This model envisions a strong established network of community health workers,display of their agenda,and creation of a ripple effect throughout the society by the means of these programs.

Integration of community health workers into health systems in developing countries:Opportunities and challenges

Background:Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health work-ers(CHWs).It is imperative that health care systems focus on improving access to quality continu-ous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness.Objective:To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries.Methods:Six databases were examined for quantitative,qualitative,and mixed-methods stud-ies that included the integration of CHWs,their motivation and supervision,and CHW policy making and implementation in developing countries.Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs.Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized.Results:CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health.Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings.Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work,as well as financial and nonfinancial incentives,motivation,collaborative and supportive supervision,and a manageable workload.Conclusions:For sustainable integration of CHWs into health care systems,high-performing health systems with sound governance,adequate financing,well-organized service delivery,and adequate supplies and equipment are essential.Similarly,competent communities could contrib-ute to better CHW performance through sound governance of community resources,promotion of inclusiveness and cohesion,engagement in participatory decision making,and mobilization of local resources for community welfare.

Vestibular Function Evaluation in Endemic Diseases Combat Agents

Introduction: Simultaneous exposure to certain chemical agents and noise may cause synergistic, additive or potentiating effects on the auditory and vestibular system. However, there is still a lack of studies investigating simultaneous exposure to pesticides and noise in the vestibular system. Purpose: To analyze the findings of the vestibular evaluation of endemic diseases combat agents when simultaneously exposed to pesticides and noise. Method: Thirty-three male pesticide-exposed and noise-fighting endemic diseases combat agents participated in the study. The age range was 48 to 67 years (mean = 56 years). All participants underwent vestibular examinations, such as positional nystagmus research, spontaneous nystagmus with open and closed eyes, semi-spontaneous nystagmus, optokinetic nystagmus, pendular screening, per rotatory, caloric tests and tonal audiometry. Data were analyzed by descriptive statistics. Results: Altered exams were presented in 36.4% of the cases. There was no statistically significant relationship between pesticide handling time and test results (p = 0.2825). The results of pure tone audiometry correlated significantly (p = 0.0494) with the vestibular exams, as participants who presented with worse hearing thresholds at the frequency of 4000 Hz in the right ear also presented altered results in the vestibular exam. Conclusion: The present study concluded that more than 1/3 of the studied population presented with vestibular dysfunction, which was related to anterior and posterior labyrinth alteration (Cochlear-Vestibular Syndrome). No central vestibular alteration was noted in this population.

Women’s Perceptions and Attitudes Related to Family Planning Use among Poor Population in Rural Rwanda

INTRODUCTION: In 2012, Rwandan Government has declared family planning (FP) a national priority for poverty reduction and socioeconomic development. However, rural areas still contribute to higher fertility rates. OBJECTIVE: To explore factors to influence FP uptake in rural families. METHODS: This study used mixed (quantitative and qualitative) methods consisted of two separate surveys. The first survey (quantitative-based cross-sectional design) determined FP use in households while the second survey (qualitative-based design) identified socio-cultural factors which hindered FP uptake in households. In total, 119 households with women in reproductive age (15 - 45) were targeted in rural areas in Western province, Karongi District. The data collected during door-to-door visits using paper-based-questionnaires and administered through interviews. A database mask was designed under OnaCollect, then processed in SPSS software. The results were presented in tables of frequencies, the difference between proportions assessed using Chi-Square-test, the difference between means assessed using t-tests, significance at p = or <0.05, confidence level at 0.95, and a margin error of 0.09. RESULTS: Socio-cultural norms influenced no use of contraception (32.8%) or only promoted natural methods (12.6%). Social norms were religious in origin (38.5%) where Christianity (91.8%) discouraged modern methods (viewed as killing children) but encouraged using natural methods, preferably abstinence (73.3%). Cultural norms (17.9%) influenced families to have many children as resources of wealth, evidence of productivity, and a way to decrease parents’ workloads including assisting mothers in home-based activities such as cooking, and assisting fathers in farming activities such as keeping cows, goats and pigs. Other attitudes included gender-based issues (2.5%) mainly due to spousal disapproval (men dominated in taking FP decisions in families), whereas other non-users of modern methods (28.2%) feared side-effects. This study was registered with IRB: CMHS/IRB/097/2019. CONCLUSION: Religious, social, and cultural norms affect FP in rural areas. In order to accelerate FP uptake, men and religious leaders should be targeted as key partners who influence women’s choices.