Interactive Development of Community Education and Migrant Workers' Continuing Education

Community education is an essential carrier of continuing education and plays a positive role in promoting continuing education of migrant workers. On the one hand,it can raise employment quality and labor skills of migrant workers; on the other hand,it manifests function of serving society of community education. Besides,it is also an important measure for building learning society and lifelong learning system.From the perspective of interactive development,it discusses interactive relationship between community education and migrant workers' continuing education,analyzes their interactive mechanism,and comes up with recommendations for developing community education and migrant workers' continuing education.

Promoting Active Living and Healthy Eating among Inner-City Youth through Community Health Workers: From Clinic to Neighborhood

The promotion of physical activity and healthy eating to prevent obesity among youth is a pressing challenge. The current study examined the feasibility of community health workers (CHWs) conducting a physical activity (PA) and healthy eating intervention strategy with links to community supports and programs. Youth aged 10 - 18 years were recruited from three clinical sites serving inner-city families. Trained CHWs conducted assessment and counseling for PA and healthy eating among youth and their families and provided customized plans and navigation to neighborhood PA and nutrition programs. Measures of daily PA by self-report, weekday and weekend day sedentary behaviors, fruit and vegetable intake, avoidance of fatty foods, and avoidance of sugary drinks were assessed at baseline and follow-up. Twenty-five patients (mean age = 12.9 years) were exposed to ~9 months of intervention from baseline. Pre- and post-assessments revealed significant changes in reported PA, sedentary behaviors on weekdays, sedentary behaviors on weekend days, fruit and vegetable intake, avoidance of fatty foods, and avoidance of sugary drinks. Results demonstrated the feasibility of having CHWs effectively influenced the PA and eating behaviors of inner-city youth. Greater success was evident when assessment and counseling for PA and healthy eating were accompanied by navigation to neighborhood resources. The use of CHWs may be a cost-effective approach impacting the PA, sedentary, and dietary behaviors of youth.

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.

Training Community Health Workers to Scale-Up HIV Care in Rural Lesotho: Implementation Lessons from the Field

Community health workers (CHWs) have long played an important role in the management of complex health problems, especially in resource-poor settings. Although there is a large literature regarding the use of CHWs around the world, there is little detail about how these workers are selected, trained and utilized in the field. Lesotho has one of the highest rates of HIV in the world, with an estimated 25% of the general population infected with the disease;at the same time, there is a significant health human resources shortage in Lesotho with an estimated 60% of health posts left vacant. Community health workers have the potential to play a major role in HIV treatment scale-up in the country, and in 2006, a CWH-based project called 'The Rural Initiative' was started in the remote mountain regions of the country. More than 1000 CHWs were trained and employed through this program between June 2006 and December 2008. This paper will review the CHW program in detail, with a focus on recruitment, training, ongoing supervision and support, and the larger public health implications of the CHW program in Lesotho. It is hoped this program can serve as a practical model for other programs working with or in need of CHWs.

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.

The Community Renewal of Shantytown Transformation in Old Industrial Cities:Evidence from Tiexi Worker Village in Shenyang,China

There are many problems,such as poverty,unemployment,poor infrastructure and how to improve the ecological environment,in the shantytowns of old industrial cities.Shantytowns are the most centralized areas with different contradictions,referred to as the‘problem areas’of urban sustainable development.The shantytown transformation of old industrial cities is a typical process of unit community disintegration,which is reflected not only in the reconstruction of physical space but also in the community renewal of social spatial integration and culture reconstruction.Based on qualitative research,questionnaires and in-depth interviews,taking Tiexi Worker Village in Shenyang as a research case,this paper attempts to analyse the characteristics and driving forces of the community renewal of shantytown transformation in old industrial cities.We found that the physical space of Tiexi Worker Village has changed considerably,which is embodied in its land use structure,living environment and community service facilities,reflecting the development of community function from simple industrial function to comprehensive functions.The residents in this community have experienced a transformation from a period of homogeneity to one of heterogeneity.The social network of the community has been destroyed.Social stratification,social differentiation and higher fluidity have occurred.Community renewal is mainly affected by macro factors such as policy regulation,economic driving,condition constraints,and micro factors such as residents’choice of living space and willingness to renew their communities.The transformation policy of the old industrial zone and the development policy of the new urban area are the fundamental and deep-seated reasons for the renewal of Tiexi Worker Village,which determine the direction of the renewal and development of the community.The paid use of land and the development of the real estate industry are the direct stimulating factors for the renewal of Tiexi Worker Village,which become the direct reasons for the spatial transformation.The changes in the population in urban and rural areas and the promotion of traffic are the driving factors for the renewal of the community,while the choice of residents and their willingness regarding community renewal are the endogenous forces for promoting community renewal.Finally,the author attempts to put forward a model of the interlaced mechanism of the forming of community renewal at the macroscopic and microcosmic levels,which are the urban renewal and reconstruction and social space differentiation of community residents,respectively.

The Perception of Health Workers and Stakeholders Involved in the Process of Selecting Indigent in Burkina Faso

Background: Indigent selected for their health care is complex and poses enormous challenges. The actors involved have an influence on health actions and their perception is decisive for better care for the indigent. Little evidence exists on these perceptions and this paper has captured this. Methods: A case study involved 163 participants with a questionnaire and an interview guide. The quantitative responses were classified according to a measurement scale, proportions and overall indices of perception (Ip) and satisfaction (CSAT) were calculated. The relationship between variables was investigated using chi-square. Thematic analysis was used with qualitative data. The study met ethical requirements. Results: The participants had a positive perception of the selection: Ip = 0.77, but a minority (1/5) were dissatisfied with the selection. The perception of selection did not differ significantly depending on the experience of the actors. For the vast majority, the definition of indigent was satisfactory (CSAT = 91.4). The selection was done in a top down fashion and steps such as setting up committees, informing stakeholders, had shortcomings which negatively impacted the effectiveness of the selection. The needs of the participants included transparency in the indigent select process, matching the tools for selecting the indigent to the context, strengthening of local action, deconstruction of prejudices in terms of the indigent, power of actors to act, and importance for health services to reach out to the indigent. Conclusion: Considering the perception of the actors as well as their needs will improve the selection for effective care of the indigent.

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.

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.

＂Beyond the Dreams of Loveliness＂ --Film, Unionism, and Working Class Community Formation in Detroit, 1933-1939

Ever since Lawrence Goodwyn published The Populist Moment, social historians have been keenly aware of the power culture represents when it comes to resistance. Historically, ＂movement culture＂ has been used to create a collective climate and offered political activists a springboard to discuss with the masses the benefits of joining a social movement. ＂Beyond the Dreams of Loveliness＂ uses the cultural outlet of film and the labor movement in the city of Detroit as analytical tools to examine working class community resistance throughout the 1930s. In the midst of the ＂golden age of film＂ community activists and union organizers--some of whom were well-known radicals and some of whom were mainstream unionists--used the institution of cinema to instill a level of class consciousness in the masses and mobilize the working class community against exploitation of employers, reactionary politicians, and white supremacist organizations. Movie-going had been a very popular form of recreation in Detroit since the 1920s and downtown theatres increasingly became the destination of an eclectic array of workers. Movie theaters themselves were bastions of community activity around the thirties and many were located in the heart of the city＇s working class district. Yet it was the films themselves that offered community activists and unionists a chance to converse with workers regarding the socio-economic matters of the day. Hollywood released a good number of films that dealt with working class issues and provided activists with ample opportunities to ＂instruct＂ the audience and carry on the discussion into the factory or union halls. ＂Beyond the Dreams of Loveliness＂ relies on a combination of oral histories, movie reviews, film clips, and union and/or working class organizational records to illuminate how activists in Detroit＇s working class community used film as an outlet to inspire working class resistance. In sum, film provided an accessible form of entertainment that proved to be effective on two fronts： It promoted increased group cooperation, friendship, and alliances while it also fostered a shared culture, making it easier for activists to organize workers in the coming struggles for unionism.

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.

Immigration to the US: The Insidious Health Risk Factor

US Latinos experience higher rates of obesity than their non-Latino counterparts. Factors associated with immigration, including length of residence in the United States, are associated with an increased risk of obesity. Latino community health workers (CHWs) work closely with communities, and are in an ideal position to provide insight on the underlying mechanisms of the Latino obesity epidemic. Focus groups were conducted with 15 CHWs and thematic analyses were performed to explore elements associated with obesity among Latino immigrants. Emergent themes included: reduction in physical activity due to less walkable spaces, more transportation options, and busier schedules in the United States. Interviewees also identified a sudden increase in access to unhealthy food and an abrupt reduction in access to, and affordability of, healthy food choices upon immigration. Culturally appropriate interventions to increase awareness of these factors and neutralize their effects among early Latino immigrants are recommended.

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.

Global burden, distribution, and interventions for infectious diseases of poverty

Infectious diseases of poverty(IDoP)disproportionately affect the poorest population in the world and contribute to a cycle of poverty as a result of decreased productivity ensuing from long-term illness,disability,and social stigma.In 2010,the global deaths from HIV/AIDS have increased to 1.5 million and malaria mortality rose to 1.17 million.Mortality from neglected tropical diseases rose to 152,000,while tuberculosis killed 1.2 million people that same year.Substantial regional variations exist in the distribution of these diseases as they are primarily concentrated in rural areas of Sub-Saharan Africa,Asia,and Latin America,with geographic overlap and high levels of co-infection.Evidence-based interventions exist to prevent and control these diseases,however,the coverage still remains low with an emerging challenge of antimicrobial resistance.Therefore,community-based delivery platforms are increasingly being advocated to ensure sustainability and combat co-infections.Because of the high morbidity and mortality burden of these diseases,especially in resource-poor settings,it is imperative to conduct a systematic review to identify strategies to prevent and control these diseases.Therefore,we attempted to evaluate the effectiveness of one of these strategies,that is community-based delivery for the prevention and treatment of IDoP.In this paper,we describe the burden,epidemiology,and potential interventions for IDoP.In subsequent papers of this series,we describe the analytical framework and the methodology used to guide the systematic reviews,and report the findings and interpretations of our analyses of the impact of community-based strategies on individual IDoPs.