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1
Hynes, Mary, Nicole Anderson, Monika Kastner, and Arlene Astell. "MODELS OF OLDER ADULT GROUP ENGAGEMENT TO IMPROVE HEALTH MANAGEMENT." Innovation in Aging 6, Supplement_1 (November 1, 2022): 577. http://dx.doi.org/10.1093/geroni/igac059.2171.
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Abstract We are studying the use of peer-to-peer group intervention as a means of promoting older adult health self-efficacy and self-management. To explore how older adults have worked together to improve health behaviors, a scoping review was conducted of older adult peer coaching in health maintenance or health improvement groups. Seventeen studies met all search criteria, including interventions examining the value of peer support in self-management of diabetes, a peer led program for fear of falling, and the effect of self-help groups on quality of life. Two models of peer engagement were identified: peer support and mutually supportive environments. Ten studies trained older adults to be peer mentors or leaders with training periods varying from two days to 30 weeks, although many did not include details of the training. The other seven studies examined mutually supportive environments for peer engagement such as a clinician-led with peer-support model, an app-based program with a social support component, and a prevention focused mutual support group. These studies included research comparing self-care and quality of life results after self-help group therapy and a study that analyzed the impact and role of volunteering at a seniors’ centre on maximizing member self-efficacy. While all studies reported on peer self-health engagement, there were many different goals ranging from evaluating health improvement programs to comparing peer and professional health group leadership. One consistent theme was improved perceived self-efficacy though peer group engagement.
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Ayala, George, Laurel Sprague, L. Leigh-Ann van der Merwe, Ruth Morgan Thomas, Judy Chang, Sonya Arreola, Sara L. M. Davis, et al. "Peer- and community-led responses to HIV: A scoping review." PLOS ONE 16, no. 12 (December 1, 2021): e0260555. http://dx.doi.org/10.1371/journal.pone.0260555.
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Introduction In June 2021, United Nations (UN) Member States committed to ambitious targets for scaling up community-led responses by 2025 toward meeting the goals of ending the AIDS epidemic by 2030. These targets build on UN Member States 2016 commitments to ensure that 30% of HIV testing and treatment programmes are community-led by 2030. At its current pace, the world is not likely to meet these nor other global HIV targets, as evidenced by current epidemiologic trends. The COVID-19 pandemic threatens to further slow momentum made to date. The purpose of this paper is to review available evidence on the comparative advantages of community-led HIV responses that can better inform policy making towards getting the world back on track. Methods We conducted a scoping review to gather available evidence on peer- and community-led HIV responses. Using UNAIDS’ definition of ‘community-led’ and following PRISMA guidelines, we searched peer-reviewed literature published from January 1982 through September 2020. We limited our search to articles reporting findings from randomized controlled trials as well as from quasi-experimental, prospective, pre/post-test evaluation, and cross-sectional study designs. The overall goals of this scoping review were to gather available evidence on community-led responses and their impact on HIV outcomes, and to identify key concepts that can be used to quickly inform policy, practice, and research. Findings Our initial search yielded 279 records. After screening for relevance and conducting cross-validation, 48 articles were selected. Most studies took place in the global south (n = 27) and a third (n = 17) involved youth. Sixty-five percent of articles (n = 31) described the comparative advantage of peer- and community-led direct services, e.g., prevention and education (n = 23) testing, care, and treatment programs (n = 8). We identified more than 40 beneficial outcomes linked to a range of peer- and community-led HIV activities. They include improved HIV-related knowledge, attitudes, intentions, self-efficacy, risk behaviours, risk appraisals, health literacy, adherence, and viral suppression. Ten studies reported improvements in HIV service access, quality, linkage, utilization, and retention resulting from peer- or community-led programs or initiatives. Three studies reported structural level changes, including positive influences on clinic wait times, treatment stockouts, service coverage, and exclusionary practices. Conclusions and recommendations Findings from our scoping review underscore the comparative advantage of peer- and community-led HIV responses. Specifically, the evidence from the published literature leads us to recommend, where possible, that prevention programs, especially those intended for people living with and disproportionately affected by HIV, be peer- and community-led. In addition, treatment services should strive to integrate specific peer- and community-led components informed by differentiated care models. Future research is needed and should focus on generating additional quantitative evidence on cost effectiveness and on the synergistic effects of bundling two or more peer- and community-led interventions.
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Tse, Mimi, Shamay Ng, Xue Bai, Paul Lee, Raymond Lo, Daphne Sze Ki Cheung, Kin Cheung, and Suey Yeung. "Lesson Learned from Peer Volunteers in a Peer-Led Pain Management Program among Nursing Home Residents." International Journal of Environmental Research and Public Health 16, no. 17 (August 26, 2019): 3097. http://dx.doi.org/10.3390/ijerph16173097.
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Background: Chronic pain is common among older adults and is associated with adverse physical and psychological outcomes. Given the burden of pain and limited healthcare resources, devising innovative and cost-effective ways of managing chronic pain is of high priority. The aim of this paper is to explore the experiences and perceptions of peer volunteers (PVs) in a peer-led pain management program among nursing home residents in Hong Kong. Methods: Forty-six PVs were recruited and trained to lead a pain management program (PAP). The PAP consisted of one 1 hour session per week for 12 weeks. It included 20 min of physical exercises performed under the supervision of PVs, followed by 30 min of pain management education, including information on pain situations, the impacts of pain, the use of drugs and non-drug strategies for pain management, demonstrations, and return demonstrations of various non-drug pain management techniques. Quantitative data were collected from questionnaires (demographics, pain situation, and pain knowledge) for all PVs. Qualitative data (PVs’ experiences in leading the PAP, their perceived benefits, barriers encountered, and recommendations for improving the PAP) were collected at week 12 (upon completion of the PAP). Data were analyzed using the Statistical Package for Social Sciences and content analysis for qualitative data. Results: A total of 46 PVs were recruited (34 females, 74%), with a mean ± SD age of 61.0 ± 5.1 years. Thirty-one of them reported having chronic pain. Before the training, their self-rated pain knowledge was 40.0 ± 20.5 (maximum 100 points) while their actual pain knowledge score was 86.1 ± 10.6 (maximum 100 points). The PVs reported an improvement in their knowledge and skills after leading PAPs. No PVs reported having received any negative comments about their role in leading the PAP but mentioned that they had received feedback on how to improve the program. Conclusions: This study provides further evidence that peer-led pain management programs are feasible and can lead to positive experiences for the PVs. Peer support models are coming into wide use because they show promise in helping patients to manage chronic conditions. Peer volunteers will become important resources in elderly care. The barriers that were identified may lead to improvements in the design and planning of future PAPs.
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Tse, Mimi, Yajie Li, Shuk Kwan Tang, Shamay S. M. Ng, Xue Bai, Paul H. Lee, Raymond Lo, and Suey Shuk Yu Yeung. "An Exploration of the Effectiveness of a Peer-Led Pain Management Program (PAP) for Nursing Home Residents with Chronic Pain and an Evaluation of Their Experiences: A Pilot Randomized Controlled Trial." International Journal of Environmental Research and Public Health 17, no. 11 (June 8, 2020): 4090. http://dx.doi.org/10.3390/ijerph17114090.
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Background: 80% of nursing home residents have reported chronic pain, which is often accepted by older adults as part of aging. Peer support models are being used to help individuals manage their chronic conditions and overcome the challenges of limited healthcare resources. The aims of this study were: (i) to examine the effectiveness of a 12 week peer-led pain management program (PAP) for nursing home residents and (ii) to evaluate their experiences. Methods: A cluster randomized controlled trial (RCT) was used. The 12 week pain management program was provided for the experimental group. Outcomes were measured at three time points. The participants’ satisfaction and acceptance were evaluated by a semi-structured interview after the program was completed. Results: Pain self-efficacy, pain intensity, pain interference, pain knowledge, and depression levels improved after the completion of the 12 week peer-led PAP. The pain-intensity level reported at week 12 was significantly lower in the experimental group than in the control group. Semi-structured interviews showed that the nursing home residents were satisfied with the pain education that they received. Conclusions: The 12 week peer-led PAP appeared to improve the pain-related and psychological outcome measures in nursing home residents, and the feedback on the peer-led PAP from the nursing home residents was positive.
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Samuolis, Jessica, Angela J. Harrison, and Karen Flanagan. "Evaluation of a Peer-Led Implementation of a Suicide Prevention Gatekeeper Training Program for College Students." Crisis 41, no. 5 (September 2020): 331–36. http://dx.doi.org/10.1027/0227-5910/a000638.
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Abstract. Background: Research on models of implementation that enable widespread dissemination of suicide prevention to young adults is needed to address the critical public health issue of suicide among young adults. A peer-to-peer implementation approach may increase widespread dissemination of suicide prevention on college campuses. Aims: The current study involved the evaluation of a peer-led implementation of the evidence-based program Question, Persuade, and Refer Gatekeeper Training for Suicide Prevention (QPR). Method: A total of 161 college students attended one of eight QPR implementations conducted by student peer educators certified as QPR trainers. Questionnaires were administered at pretest and posttest to assess knowledge of suicide, likelihood of intervening with someone suicidal, and self-efficacy to intervene with someone suicidal. Results: Results from a series of paired-samples t tests showed significant increases from pretest to posttest on the three outcomes of interest – knowledge of suicide, self-efficacy to intervene with someone suicidal, and likelihood to intervene with someone suicidal. Limitations: The short time frame of the current study is a limitation. Conclusion: Support for a peer-led model of implementation for college students has critical implications in terms of increasing the capacity for widespread dissemination of suicide prevention efforts on college campuses.
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Paterno, Mary T., Maud Low, Aline Gubrium, and Kirk Sanger. "Mothers and Mentors: Exploring Perinatal Addiction and Recovery Through Digital Storytelling." Qualitative Health Research 29, no. 4 (June 6, 2018): 545–56. http://dx.doi.org/10.1177/1049732318777474.
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Substance use disorders (SUDs) are a growing problem for pregnant and parenting women. Woman-to-woman peer support may positively influence perinatal outcomes but little is known about the impact of such support on the women who are providing support. The purpose of this study was to describe experiences of addiction in pregnancy, recovery, and subsequently serving as a peer mentor to other pregnant women with active SUD among women in recovery in a rural setting. We conducted one digital storytelling workshop with five women serving as peer mentors with lived experience of perinatal SUD. The mentors faced significant stigma in pregnancy. They had each done the “inside work” to achieve recovery, and maintained recovery by staying balanced. Peer mentoring supported their own recovery, and story sharing was integral to this process. Peer-led support models may be an effective, self-sustaining method of providing pregnancy-specific peer support for SUD.
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Villanueva-Vilchis, María Del Carmen, Jolanta Aleksejuniené, Benjamín López-Núñez, and Javier De la Fuente-Hernández. "A peer-led dental education program for modifying oral self-care in Mexican children." Salud Pública de México 61, no. 2, Mar-Abr (January 23, 2019): 193. http://dx.doi.org/10.21149/9273.
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Objective. To compare peer-led dental education (PLDE) versus conventional dental instruction (CDI) in modifying children’s oral self-care. Materials and methods. The intervention group (two schools) received PLDE and the control group (two schools) received CDI. The quality of oralself-care practice (OSC-P) and oral self-care skills (OSC-S) were indicated by dental plaque levels (%) and compared before and after the dental education. Results. There were no baseline OSC-P differences between the control (55.8 ± 12.8%) and intervention (55.5 ± 14.6%) groups or OSC-S differences between the intervention (38.5 ± 13.2%) and control (38.1 ± 12.5%) groups. At the three-month follow-up we observed OSC-P deterioration in the control group (63.2 ± 15.0%) and OSC-P improvement in the intervention group (52.2 ± 15.6%). The OSC-P/OSC-S regression models found these predictors: baseline oral self-care, group affiliation, and mother’s education (p<0.05). Conclusion. The hypothesis was confirmed and significant predictors were baseline oral self-care levels, group affiliation, and mother’s education.
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Potter, C. L. "Systematic literature review of the use of lay support models in postnatal depression." European Psychiatry 26, S2 (March 2011): 1105. http://dx.doi.org/10.1016/s0924-9338(11)72810-3.
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AimsGrowing interest has been shown in the use of peers as lay health workers in maternal healthcare. This review aimed to examine published evidence on the effectiveness of lay support models for the management of postnatal depression (PND).MethodsMEDLINE, EMBASE, PsycINFO and the Cochrane Library were searched for randomised controlled trials (RCTs) of interventions conducted by lay health workers in postnatal women, published between 1980 and August 2010. The search revealed seven studies, totaling 16,095 participants, which reported outcomes in PND and mothers’ mental health/self-esteem.ResultsThe value of lay support models depends on the intervention type and the population targeted. Telephone based peer support, for women identified as high-risk for PND, showed a statistically significant reduction in Edinburgh Postnatal Depression Scale (EPDS) scores at 12 weeks. Universal provision of peer mentoring has been shown to significantly improve self-esteem at one year postpartum, but no studies have shown statistical significance on PND or mental health outcomes (measured by EPDS/SF-36). In poor populations, women's groups led by peer facilitators have been shown to reduce moderate depression by 57%, compared to controls. However, another study, which evaluated community group support showed a low uptake (19%) resulting in no statistical significance. Similarly there was no significant improvement in PND with self-help manuals, despite one study reporting favorable feedback.ConclusionsThere is some evidence from RCTs that high-risk groups and specific demographics can benefit from targeted peer support. However, no particular model can be strongly recommended, and further research is required.
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Kunwar, Ramesh Raj. "Airbnb: Understanding the Concept, Recognizing the Values." Journal of Tourism and Hospitality Education 10 (May 4, 2020): 132–69. http://dx.doi.org/10.3126/jthe.v10i0.28764.
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Peer-to-peer (P2P) accommodation into the tourism market through a model of disruptive innovation is going to be very popular in the world. This has been coined as network hospitality led by Airbnb platform which will work as a mediator between the hosts and guests. Trust plays the major role for decision making to buy the shelter. The objective of studying this new area is to understand in better way through the help of secondary sources. Academic research is generally guided by the theories. Therefore, the researcher aimed to know which kind of concepts and models were applied by previous scholars. The study is confined to the Airbnb and Couchsurfing. For this study, the researcher has followed umbrella type of review research which will shed light on the knowledge of peer-to-peer accommodation and sharing economy.
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Stamou, Elina. "Reclaiming user leadership in peer support practice." Journal of Mental Health Training, Education and Practice 9, no. 3 (September 2, 2014): 167–76. http://dx.doi.org/10.1108/jmhtep-02-2014-0003.
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Purpose – The purpose of this paper is to explore user leadership in peer support practice by reviewing existing evidence and models of delivery, investigating the recently developed term of “authentic” peer support and reflecting on challenges and opportunities for the future. Design/methodology/approach – The paper presents and discusses views and evidence on peer support policy and practice, found in the current literature, grass roots peer support experts’ presentations and contributions to conferences, a national peer support network, key policy documents and the work of Together for Mental Wellbeing. Findings – Peer support benefits are widely documented as is its history, rooted in user leadership. More recently, peer support is acknowledged in a number of key mental health policy documents as seen to be key in the response to current quality and cost agendas. There has been a simultaneous increase of “formal” peer support as practiced by large service providers and a gradual shift away from its “user led” origins. Against the background of the current economic climate and implications for mental health services, there seems to be a need to pause and reflect on current peer support practice and rethink the way forward. Originality/value – This paper's emphasis on the authenticity of peer support covers new ground in relation to an important topical debate.
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Struthers, Karen, Clare Tilbury, and Grace Williams. "Young People Leading Change in Domestic Violence Prevention: R4Respect." Children Australia 42, no. 3 (May 25, 2017): 205–16. http://dx.doi.org/10.1017/cha.2017.20.
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Active youth participation models that tackle major social problems can promote positive youth development and wellbeing. Implementation and evaluation of youth participation models to curtail violence in families and other intimate relationships is limited. The present study reports on a process evaluation of a new youth participation model called R4Respect that features a peer-led approach to respectful relationships education, which is aimed at preventing domestic violence. The evaluation uses qualitative methods, based on interviews with youth participants and adult external stakeholders, drawing on the Tiffany–Eckenrode Program Participation Scale. The evaluation demonstrates that R4Respect is successfully engaging young people as decision-makers and peer-educators in strategies aimed at improving the understanding young people have of what constitutes respect in relationships. The R4Respect model shows that young people can fulfil an important role in the prevention of domestic violence.
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Pirrocco, Fiona, Ian Goodman, and Michael B. Pitt. "Leveraging Peer Teaching for Global Health Elective Preparation: Implementation of a Resident-Led Global Health Simulation Curriculum." Global Pediatric Health 6 (January 2019): 2333794X1985110. http://dx.doi.org/10.1177/2333794x19851108.
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Introduction. As more trainees engage in global health electives, the call for best practices in predeparture preparation grows. However, many residency programs may not have the infrastructure or staffing in place to consistently meet these expectations. Objective. To assess the feasibility, benefits, and limitations of having residents trained to facilitate and implement a global health preparatory simulation curriculum. Approach. In 2016, we had 5 residents undergo online Simulation Use for Global Away Rotations (SUGAR) facilitator training. Since then, we have conducted 3 simulation sessions from 2016 to 2018. Feedback was obtained from 75% of our participants, which was found to be similar to feedback obtained from attending-led models. Lessons Learned. A resident-led global health preparatory curriculum provides a sustainable model for residency programs without placing additional burden on attending faculty.
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Frenken, Koen. "Political economies and environmental futures for the sharing economy." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 375, no. 2095 (May 2017): 20160367. http://dx.doi.org/10.1098/rsta.2016.0367.
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The sudden rise of the sharing economy has sparked an intense public debate about its definition, its effects and its future regulation. Here, I attempt to provide analytical guidance by defining the sharing economy as the practice that consumers grant each other temporary access to their under-utilized physical assets. Using this definition, the rise of the sharing economy can be understood as occurring at the intersection of three salient economic trends: peer-to-peer exchange, access over ownership and circular business models. I shortly discuss some of the environmental impacts of online sharing platforms and then articulate three possible futures of the sharing economy: a capitalist future cumulating in monopolistic super-platforms allowing for seamless services, a state-led future that shifts taxation from labour to capital and redistributes the gains of sharing from winners to losers, and a citizen-led future based on cooperatively owned platforms under democratic control. The nature and size of the social and environmental impacts are expected to differ greatly in each of the three scenarios. This article is part of the themed issue ‘Material demand reduction’.
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Mitchell, Julie, and Nathalie Soini. "Student Involvement for Student Success: Student Staff in the Learning Commons." College & Research Libraries 75, no. 4 (July 1, 2014): 590–609. http://dx.doi.org/10.5860/crl.75.4.590.
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How do you effectively train and assess student staff in a learning commons environment? How do you foster a student-led approach while maintaining accurate and high-level service? How do you create an environment where student staff are engaged and motivated to succeed? Peer-to-peer service models are fundamental to many learning commons environments and contribute to student success. Many student-delivered services in learning commons compliment programs traditionally offered exclusively by professional staff such as librarians, IT professionals, learning specialists or student affairs personnel. In such service models, students are the front line contact and the need for knowledgeable assistance and accurate referrals remains paramount. This article presents the findings of a study that investigated how training and assessment is approached with student staff in a learning commons environment. Learning commons coordinators and supervisors from across North American shared how they train students (methods and content), approach ongoing professional development of student staff, and how they monitor or assess the overall quality and accuracy of their student service models. The survey results and tangible examples offer insights and strategies for fostering an engaged student team, driven to deliver a high level of service.
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Bell, Sara F. E., Luke Coffey, Joseph Debattista, Steven G. Badman, Andrew M. Redmond, David M. Whiley, Jime Lemoire, et al. "Peer-delivered point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae within an urban community setting: a cross-sectional analysis." Sexual Health 17, no. 4 (2020): 359. http://dx.doi.org/10.1071/sh19233.
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Abstract Background The advent of fully automated nucleic acid amplification test (NAAT) technology brings new public health opportunities to provide Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) point-of-care testing (POCT) in non-traditional settings. Methods: This pilot study evaluated the integration of the CT/NG Xpert diagnostic assay into an urban peer-led community setting providing HIV and syphilis POCT. A comprehensive protocol of testing, result notification, referral and follow up, managed by peer test facilitators, was undertaken. Results: Over 67 weeks, there were 4523 occasions of CT/NG testing using urine, oropharyngeal and anorectal samples with 25.7% (803) of the 3123 unique participants returning for repeat testing. The prevalence of CT and NG was 9.5% and 5.4% respectively. Where CT and or NG infection was detected, 98.4% (604/614) of participants were successfully notified of detected infection and referred for treatment. Evaluation Survey responses (11.4%, 516/4523) indicated a substantial proportion of respondents (27.1%, 140/516) ‘would not have tested anywhere else’. Of note, 17.8% (92/516) of participants reported no previous CT/NG test and an additional 17.8% (92/516) reported testing more than 12 months ago. A total of 95.9% (495/516) of participants ‘Strongly agreed’ or ‘Agreed’ to being satisfied with the service. Conclusion: The project successfully demonstrated an acceptable and feasible model for a peer-delivered community-led service to provide targeted molecular CT/NG POCT. This model offers capacity to move beyond the traditional pathology and STI testing services and establish community-led models that build trust and increase testing rates for key populations of epidemiological significance.
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Impedovo, Donato, and Giuseppe Pirlo. "Artificial Intelligence Applications to Smart City and Smart Enterprise." Applied Sciences 10, no. 8 (April 24, 2020): 2944. http://dx.doi.org/10.3390/app10082944.
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Smart cities work under a more resource-efficient management and economy than ordinary cities. As such, advanced business models have emerged around smart cities, which have led to the creation of smart enterprises and organizations that depend on advanced technologies. In this Special Issue, 21 selected and peer-reviewed articles contributed in the wide spectrum of artificial intelligence applications to smart cities. Published works refer to the following areas of interest: vehicular traffic prediction; social big data analysis; smart city management; driving and routing; localization; and safety, health, and life quality.
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Houghton, R., V. Knight, B. Clifton, and R. Varma. "Early initiation of antiretroviral therapy (ART): from point-of-care test to ART at a peer-led community-based testing site in Sydney." Sexual Health 16, no. 1 (2019): 94. http://dx.doi.org/10.1071/sh18094.
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The effect of performing baseline HIV investigations (BLHIVI) at the time of a reactive HIV point-of-care test in the pathway to antiretroviral therapy (ART) in a community setting has not been described. In this study, 67 men newly diagnosed with HIV across three service models were analysed. The median time to ART was 30, 29.5 and 38 days (P=0.29) at a peer-led community testing site intervention group, in a historical control group and in an urban publicly funded sexual health service respectively. In a community setting, the inclusion of BLHIVI has the potential to reduce the time to early ART initiation.
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Tedy, Tedy Tedy, Abu Bakar Adni, Aloysius Evan Kristian, Iqbal Asyarf Lufty, and Muhammad Faried Romdolni. "Faktor-Faktor yang Memengaruhi Repurchase Intention pada Network Orchestrator X." Jurnal Manajemen 17, no. 1 (October 30, 2020): 39–56. http://dx.doi.org/10.25170/jm.v17i1.1334.
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Abstract
The development of peer-to-peer lodging begins with the presence of Airbnb in 2008 which is connected in 192 countries and served 60 million travelers worldwide. The presence of Airbnb has led to several similar business models, namely the network orchestrator. In Indonesia, network orchestrator x appeared in 2015 with a business model similar to a hotel, but assets in the form of buildings and their contents are owned by partners/third people. Network orchestrator x provides an application system integrated with a smartphone. In this study the questionnaire was distributed to 401 respondents and the number that could be used was 226 questionnaires. This research was conducted by adding two variables to the existing research model which is tangible and intangible variables. Based on the research, factors that significantly affect customer satisfaction are product performance risk, room and bathroom size, staff's helpfulness, accuracy of service, personal attention, and customer satisfaction also significantly influence repurchase intention.
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Trucco, Elisa M., Craig R. Colder, William F. Wieczorek, Liliana J. Lengua, and Larry W. Hawk. "Early adolescent alcohol use in context: How neighborhoods, parents, and peers impact youth." Development and Psychopathology 26, no. 2 (March 12, 2014): 425–36. http://dx.doi.org/10.1017/s0954579414000042.
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AbstractDevelopmental–ecological models are useful for integrating risk factors across multiple contexts and conceptualizing mediational pathways for adolescent alcohol use, yet these comprehensive models are rarely tested. This study used a developmental–ecological framework to investigate the influence of neighborhood, family, and peer contexts on alcohol use in early adolescence (N = 387). Results from a multi-informant longitudinal cross-lagged mediation path model suggested that high levels of neighborhood disadvantage were associated with high levels of alcohol use 2 years later via an indirect pathway that included exposure to delinquent peers and adolescent delinquency. Results also indicated that adolescent involvement with delinquent peers and alcohol use led to decrements in parenting, rather than being consequences of poor parenting. Overall, the study supported hypothesized relationships among key microsystems thought to influence adolescent alcohol use, and thus findings underscore the utility of developmental–ecological models of alcohol use.
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Junlakarn, Siripha, Phimsupha Kokchang, and Kulyos Audomvongseree. "Drivers and Challenges of Peer-to-Peer Energy Trading Development in Thailand." Energies 15, no. 3 (February 8, 2022): 1229. http://dx.doi.org/10.3390/en15031229.
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Recent developments in disruptive technologies along with the cost reduction of photovoltaics have been transforming business models in the electricity sector worldwide. The rise of prosumers has led to a more decentralized and open local green energy market through the emergence of peer-to-peer (P2P) energy trading, where consumers and prosumers can buy or sell electricity through an online trading platform. P2P energy trading has the potential to make green energy more accessible at the local level, provide a customer choice that aligns with community values, and promote the use of renewable energy (RE) for local consumption. Although P2P energy trading has already been adopted in some countries, its implementation remains challenging in other countries, including Thailand. In this work, we investigated the drivers and challenges of implementing P2P energy trading in Thailand based on the perspectives of P2P energy trading pilot project developers participating in the regulatory sandbox program. A strategic framework was used to identify the respondents’ standpoints on the political, economic, social, technological, legal, and environmental (PESTLE) factors that can influence the implementation of P2P energy trading. This can help businesses, policymakers, and regulators better understand drivers and barriers of P2P energy trading, which is a potential local energy market. This paper also provides policy recommendations for regulatory changes for the future development of P2P energy trading, including opening a third-party access (TPA) regime, enabling a liberalized market in the electricity market, and integrating the role and responsibilities of the prosumer for P2P energy trading into existing law.
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Ilham, Nur Iqtiyani, Mohamad Zhafran Hussin, Nofri Yenita Dahlan, and Eko Adhi Setiawan. "Prospects and Challenges of Malaysia's Distributed Energy Resources in Business Models Towards Zero – Carbon Emission and Energy Security." International Journal of Renewable Energy Development 11, no. 4 (August 1, 2022): 1089–100. http://dx.doi.org/10.14710/ijred.2022.45662.
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For a decade, distributed energy resources in Malaysia have growth as one of the paths in battling with sustainable energy crisis and environmental pollution. Several intriguing initiatives and incentives have been established to encourage the use and sales-side of renewable energy at the distribution consumers. However, Malaysia's distributed energy resources penetration is still at its slow pace, with only 7.6% (excluding large hydropower) shared in energy mix generation. Therefore, innovation in power systems is required to drive the uptake of distributed energy resources. This paper reviews the business model innovation that allows distributed energy resources to participate in national grid services and the wholesale electricity market. Different technical and non-technical challenges with high shares of variable renewable energy in power systems are highlighted, and the current update on compensation scheme, Net-Energy-Metering 3.0 is also discussed. Along with these challenges, stance the prospect of adopting distributed energy resources innovation projects such as peer-to-peer energy trading and virtual power plant in the electricity market. It could further furnish the benefits to a better environmental and power system in terms of carbon dioxide avoidance, grid flexibility and increase revenue for distributed energy resources owners respectively. Through the review, it led to observation that policy and regulatory in Malaysia are the main factors in accelerating the distributed energy resources deployment. Therefore, the abilities and roles of Malaysia Energy Commission and Sustainable Energy Development Authority as a regulator and implementing agencies are crucial in determining the present and future distributed energy resources business model.
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Komakech, Joel, Hasina Rakotomanana, Christine Walters, Margaret Kabahenda, Ki Cole, Sam Emerson, Deana Hildebrand, and Barbara Stoecker. "Maternal Peer Support Through a Caregroup Model Improves Complementary Feeding of Infants by Refugee Mothers in Post-Emergency Settlements in the West-Nile Region in Uganda." Current Developments in Nutrition 6, Supplement_1 (June 2022): 584. http://dx.doi.org/10.1093/cdn/nzac060.042.
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Abstract Objectives Introduction: Infant complementary feeding in refugee settlements remains inadequate, amidst declining humanitarian aid. However, there is limited evidence for interventions to address these nutrition challenges in the refugee settlements. Objective: Examine the effects of peer-led integrated nutrition education on infant feeding by South Sudanese refugee mothers in the West-Nile region in Uganda. Methods A community-based randomized control study enrolled 390 pregnant mothers in the 3rd trimester as baseline for a peer-led nutrition education intervention using the caregroup model. Two groups (moms-only and moms & dads combined) comprised treatments with a control group. Higher scores on the Medical Outcomes Study (MOS) Social Support Index were used as a proxy for better maternal social support. Infant complementary feeding was assessed using the 2021 WHO guidelines. Multivariable logistic regression models determined effects of the interaction of maternal social support by group over time on infant feeding practices. The models were adjusted for maternal and infant confounders. Results Maternal age (mean ± SD) was 27.7 ± 5.1 years while the infant birthweight was 3.1 ± 0.5 kg. Higher maternal social support positively affected timely introduction of solid and semi-solid foods in moms-only (β = 0.11, p = .011) and moms & dads (β = 0.11, p = .001) groups. Positive intervention effects were noted on infant minimum dietary diversity for both the moms-only group (β = 0.06, p = .01) and the moms & dads group (β = 0.03, p = .001), but no effect was observed between maternal social support and infant minimum meal frequency. However, higher maternal social support in both moms-only and moms & dads groups influenced meeting the minimum acceptable diet (β = 0.07, p = .016 and β = 0.04, p = .026 respectively) and consumption of eggs and/or flesh foods (β = 0.11, p < .0001 and β = 0.05, p = .004). Conclusions A maternal peer support integrated nutrition education program improved complementary feeding of infants in post-emergency settlements. Enhanced maternal social support in nutrition-sensitive programs may benefit infants in post-emergency settlements in the West-Nile region in Uganda. Funding Sources A grant from the Nestlé Foundation for the Study of Problems of Nutrition in the World, Switzerland.
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Celis, Hanne, Brian A. Jingwa, Olivier Degomme, Ronan Van Rossem, Marleen Temmerman, and Kristien Michielsen. "Characteristics of participants in an HIV prevention intervention for youth in Rwanda: results from a longitudinal study." Afrika Focus 27, no. 2 (February 25, 2014): 71–86. http://dx.doi.org/10.1163/2031356x-02702005.
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Introduction. This paper studies determinants of participation in a peer-led school-based HIV prevention intervention in Rwanda. Methods. A baseline survey among 1071 students (mean age 17 years) assessed potential determinants of participation, while a follow-up six months in the intervention measured actual participation in the intervention. Statistical models were built using multivariate linear and multinomial regression analysis predicting overall participation, participation in group discussions and individual counseling. Results. Those who recently had sex, had been tested for HIV, feel more susceptible to HIV, have a higher sexual self-concept, a more positive future perspective (only for non-sexually active), and boys, were more likely to participate in group activities. Also students from the same class as the peer educator and boarding school students were more likely to participate in group activities. Older students and those with low external health locus of control participated more in individual counseling. Discussion. Participation could be increased by investing in general well-being of young people, organizing girls-only activities, and diversifying activities.
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Murray-Swank, Aaron B., and Lisa Dixon. "Family Psychoeducation as an Evidence-Based Practice." CNS Spectrums 9, no. 12 (December 2004): 905–12. http://dx.doi.org/10.1017/s109285290000972x.
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AbstractFamily psychoeducation programs have emerged as a strongly supported evidence-based practice in the treatment of schizophrenia and bipolar disorder. Over 30 randomized clinical trials demonstrated that psychoeducation programs reduce relapse, improve symptomatic recovery, and enhance psychosocial and family outcomes. Recent work supports family psychoeducation strategies for other disorders, including major depression, obsessive-compulsive disorder, and borderline personality disorder. This review summarizes the research evidence supporting prominent models of family psychoeducation. Professional and peer-led family education programs are also reviewed and differentiated from family psychoeducation. Directions for future research studies to enhance the evidence base and inform treatment recommendations are proposed. Finally, strategies for implementation of family psychoeducation in routine clinical practice are discussed.
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Pascal, Marie C., and Caroline S. E. Homer. "Models of Postnatal Care for Low-Income Countries: A Review of the Literature Abstract." International Journal of Childbirth 6, no. 2 (2016): 104–32. http://dx.doi.org/10.1891/2156-5287.6.2.104.
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PURPOSE:This review aims to identify the key features of effective models of postnatal care involving midwifery personnel and to determine which models may be appropriate for implementation in low-income countries.STUDY DESIGN:A narrative synthesis of English language, peer-reviewed articles from 2004 to 2014 was undertaken. Four online library databases were searched. Inclusion/exclusion criterion and a quality appraisal were applied.MAJOR FINDINGS:Twenty-two studies were included in the review, but only 4 were from low-income countries. Midwifery-led models of postnatal care are cost-effective to provide high-quality care in every settings for every women in respect of 2 core components of quality care that are woman-centered care and continuity of care. Midwifery postnatal care is provided at hospital, in community settings, and at home, all presenting different strengths and weaknesses. Combinations of models of midwifery postnatal care and collaboration between stakeholders have had positive impacts on the quality of postnatal care. To be completely effective, this requires a better management and support of midwifery personnel though. Women and midwifery personnel’s satisfaction needs to be considered to identify the local means and needs and to plan a suitable model of midwifery postnatal care at each location.MAIN CONCLUSION:Low-income countries could develop a midwifery-led model of postnatal care. This will require identifying women and midwifery personnel’s needs and the available resources and involving the stakeholders collaboratively to provide a suitable model of midwifery postnatal care. Education and practice will need to be addressed as well as promotion to the population. There is a need to conduct more research on midwifery postnatal care in low-income countries to evaluate how to best use them and what aspect of the midwifery postnatal care can be strengthened.
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Widnall, Emily, Lizzy Winstone, Ruth Plackett, Emma A. Adams, Claire M. A. Haworth, Becky Mars, and Judi Kidger. "Impact of School and Peer Connectedness on Adolescent Mental Health and Well-Being Outcomes during the COVID-19 Pandemic: A Longitudinal Panel Survey." International Journal of Environmental Research and Public Health 19, no. 11 (June 1, 2022): 6768. http://dx.doi.org/10.3390/ijerph19116768.
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School closures and social distancing measures during the pandemic have disrupted young people’s daily routines and social relationships. We explored patterns of change in adolescent mental health and tested the relationship between pre-pandemic levels of school and peer connectedness and changes in mental health and well-being between the first lockdown and the return to school. This is a secondary analysis of a longitudinal 3-wave panel survey. The study sample included 603 students (aged 13–14) in 17 secondary schools across south-west England. Students completed a survey pre-pandemic (October 2019), during lockdown (May 2020) and shortly after returning to school (October 2020). Multilevel models, with random effects, were conducted for anxiety, depression and well-being outcomes with school and peer connectedness as predictor variables. Symptoms of anxiety decreased from pre-pandemic to during the first UK lockdown and increased on the return to school; anxious symptoms decreased the most for students reporting feeling least connected to school pre-pandemic. Students reporting low levels of school and peer connectedness pre-pandemic experienced poorer mental health and well-being at all time points. Low school connectedness pre-pandemic was associated with a greater increase in anxious and depressive symptoms between lockdown and the return to school when compared to students with medium levels of school connectedness. No associations were found with high school connectedness or with low/high peer connectedness. For adolescents with poor school connectedness, the enforced time away from school that the pandemic caused led to reduced anxiety. Going forwards, we need to consider ways in which to promote connection with school as a way of supporting mental health and well-being.
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Lalu, Manoj M. "140 Past and Future Changes in Scientific Publishing." Journal of Animal Science 99, Supplement_3 (October 8, 2021): 75. http://dx.doi.org/10.1093/jas/skab235.135.
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Abstract Publication in scientific journals remains the primary method to disseminate research findings; however, the landscape of scientific publication is rapidly changing. For instance, although open access publication has led to unprecedented opportunities to share information with the global scientific community, it has also contributed to the rise of “predatory journals.” These journals accept fees to publish articles without promised quality checks (e.g. peer review). In order to better understand current publication practices and the threat predatory journals pose, this session will: 1) Briefly summarize the history of scientific publication and how the current model of peer-reviewed publication developed. 2) Define predatory journals and review components of the international consensus definition (false or misleading information, deviation from best editorial and publication practices, lack of transparency, aggressive/indiscriminate solicitation; Nature doi.org/10.1038/d41586-019-03759-y). 3) Summarize empirical studies that have assessed the current burden of predatory journals. A broad group of stakeholders are affected by these journals, including researchers and the public. 4) Provide a practical approach for audience members to distinguish between predatory and legitimate journals. 5) Highlight some key developments that will lead to new publication models in the future.
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Xu, Ling, Noelle Fields, Ishan Williams, Joseph Gaugler, and Daisha Cipher. "THE SENIOR COMPANION PROGRAM PLUS: A PROMISING LAY PROVIDER MODEL FOR ADRD FAMILY CAREGIVING." Innovation in Aging 6, Supplement_1 (November 1, 2022): 450. http://dx.doi.org/10.1093/geroni/igac059.1757.
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Abstract Considerable disparities exist in the prevalence of Alzheimer’s Disease and related dementia (ADRD) in older African American (AA) populations compared to older white populations. Given the need for caregiver interventions for family caregivers from racial and ethnic minority groups that hold potential for translation, implementation, and sustainability in their communities, peer-led, lay provider models may offer promise. We developed the Senior Companion Program Plus (SCP Plus), a peer-led psychoeducational program for AA family caregivers (CGs) provided by Senior Companions (SCs). Guided by sociocultural stress and coping model, the study was a randomized controlled trial that assessed the effects of SCP Plus on AA ADRD family caregivers’ stress and burden, coping skills, and social support. Although COVID-19 ended the trial early, study participants included Senior Companion-Caregiver dyads (N=20). Friedman tests for non-normally distributed variables, one-way repeated measures ANOVA for normally distributed variables, and post hoc between group significance tests were conducted. CGs in SCP Plus group reported significantly decreased caregiving burden (F(2,6) = 17.65, p = 0.003) especially between pre- and follow up-tests, as well as increased coping skills, especially at post-test (F(2,6) = 4.93, p = 0.05), satisfaction with social support (χ2(2) = 6.53, p = 0.04), and positive aspect of caregiving (χ2(2) = 6.53, p = 0.04) (especially between pre- and post-tests as well as between pre- and follow up-tests). Implications for future research are offered as well as lessons learned for culturally congruent, lay provider interventions for ADRD family caregivers.
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Stanich, Cynthia A., Michael A. Pelch, Elli J. Theobald, and Scott Freeman. "A new approach to supplementary instruction narrows achievement and affect gaps for underrepresented minorities, first-generation students, and women." Chemistry Education Research and Practice 19, no. 3 (2018): 846–66. http://dx.doi.org/10.1039/c8rp00044a.
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To help students who traditionally underperform in general chemistry, we created a supplementary instruction (SI) course and called it the STEM-Dawgs Workshops. These workshops are an extension of the Peer-led Team Learning (PLTL) SI. In addition to peer-facilitated problem-solving, we incorporated two components inspired by learning sciences: (1) training in research-based study skills, and (2) evidence-based interventions targeting psychological and emotional support. Here we use an explanatory mixed methods approach to measure the impact of the STEM-Dawgs Workshops, with a focus on four sub-populations that are historically underrepresented in Chemistry: underrepresented minorities, females, low-income students, and first-generation students. Specifically, we compared three groups of students in the same General Chemistry course: students in general chemistry and not the workshops (“Gen Chem students”), students in the workshops (“STEM-Dawgs”), and students who volunteered for the workshops but did not get in (“Volunteers”). We tested hypotheses with regression models and conducted a series of focus group interviews with STEM-Dawgs. Compared to the Gen Chem population, the STEM-Dawg and Volunteer populations were enriched with students in all four under-represented sub-populations. Compared to Volunteers, STEM-Dawgs had increased exam scores, sense of belonging, perception of relevance, self-efficacy, and emotional satisfaction about chemistry. URM STEM-Dawgs had lower failure rates, and exam score achievement gaps that impacted first-generation and female Gen Chem students were eliminated in the STEM-Dawg population. Finally, female STEM-Dawgs had an increased sense of belonging and higher emotional satisfaction about chemistry than women Volunteers. Focus groups suggested that successes came in part from the supportive peer-learning environment and the relationships with peer facilitators. Together, our results indicate that this supplementary instruction model can raise achievement and improve affect for students who are underrepresented in chemistry.
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Kudek Mirošević, Jasna, Mirjana Radetić-Paić, and Ivan Prskalo. "STUDENTS’ MENTAL HEALTH RISKS REGARDING SUSCEPTIBILITY TO PEER PRESSURE." Acta kinesiologica, N1 2021 (2021): 60–67. http://dx.doi.org/10.51371/issn.1840-2976.2021.15.1.7.
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Given that adolescents and young people spend most of their time in the educational system, advancements in neurodevelopmental research emphasize the important and complex role of peers’ influence on adolescents’ behaviour, suggesting that supportive programmes led by peers have a strong potential benefit (King, & Fazel, 2019). In many cases peers are the most important source of social support, and are therefore an important target group to investigate the factors of risk, signs of poor mental health and ways to assess their health behaviour and awareness of the care which should be taken regarding their mental health, as well as the resources and prevention models. The wish is to study whether there are differences regarding the mental behaviour in certain characteristics of susceptibility to peer pressure as a risk for the mental health of students of the Faculty of Educational Sciences of the Juraj Dobrila University of Pula and students of the Faculty of Teacher Education of the University of Zagreb, Division of Petrinja (N=440). The set hypothesis states that there is a statistically significant difference among students of the faculty in Pula and those in Petrinja in their assessment of certain features of peer pressure susceptibility as a possible risk for mental health. The results obtained at the x2-test showed a statistically significant difference between certain peer pressure features among students regarding their study environment linked to hanging out with peers who consume drugs and being tempted to try them, getting involved in risky behaviours if their peers ask them to, and betting or gambling because their friends also do that. The results indicate that in smaller communities social control and conformity in the students’ behaviour is more present due to their wish to fit in a peer group as well as possible, suggesting the need for strengthening the positive health behaviour of young people during their whole education in order to secure a healthy and productive adult population.
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Shahzad, Muhammad Farrukh, Kanwal Iqbal Khan, Saima Saleem, and Tayyiba Rashid. "What Factors Affect the Entrepreneurial Intention to Start-Ups? The Role of Entrepreneurial Skills, Propensity to Take Risks, and Innovativeness in Open Business Models." Journal of Open Innovation: Technology, Market, and Complexity 7, no. 3 (July 12, 2021): 173. http://dx.doi.org/10.3390/joitmc7030173.
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Start-ups are launched every day, and most of them will fail at the same pace. Worldwide unemployment has become a major concern due to the geometric increase in the population. However, job opportunities are not created at the same pace as the overall population, and jobless people are becoming a burden on the economy. This situation led to introduce a system that helps people become self-employed and gives dignity to their lives. Prior studies reported that many factors could motivate an individual to pursue entrepreneurial projects. However, there is still a gap in identifying a path that promotes entrepreneurial intention among young graduates. Therefore, the purpose of the current study is to determine the effect of self-motivation, family support, peer influence, and institutional support on entrepreneurial intention through entrepreneurial skills, propensity to take risks, and innovativeness. Data were collected from 416 business students from six public and private sector universities in Pakistan. The results revealed that self-motivation, family support, peer influence, and institutional support positively and significantly affected entrepreneurial intention. The mediating role of entrepreneurial skills, a propensity to take risks, and innovativeness also enhances entrepreneurial intention among young graduates. A categorical analysis was conducted to explain the characteristics of the individuals motivated to launch start-ups. The results revealed a significant difference in the grouping variables of gender and education. The conceptual model provides more pronounced results in the case of male and post-graduate students. These findings may motivate young graduates to start new venture capital start-ups based on open business models. In this way, they can contribute to the complex and evolutionary economics that accelerate efficiency through technological innovation.
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Hussong, Andrea M., Susan T. Ennett, Daniel M. McNeish, Veronica T. Cole, Nisha C. Gottfredson, W. Andrew Rothenberg, and Robert W. Faris. "Social network isolation mediates associations between risky symptoms and substance use in the high school transition." Development and Psychopathology 32, no. 2 (June 24, 2019): 615–30. http://dx.doi.org/10.1017/s095457941900049x.
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AbstractThe current study examined whether social status and social integration, two related but distinct indicators of an adolescent's standing within a peer network, mediate the association between risky symptoms (depressive symptoms and deviant behavior) and substance use across adolescence. The sample of 6,776 adolescents participated in up to seven waves of data collection spanning 6th to 12th grades. Scores indexing social status and integration were derived from a social network analysis of six schools and subsequent psychometric modeling. Results of latent growth models showed that social integration and status mediated the relation between risky symptoms and substance use and that risky symptoms mediated the relation between social standing and substance use during the high school transition. Before this transition, pathways involving deviant behavior led to high social integration and status and in turn to substance use. After this transition, both deviant behavior and depressive symptoms led to low social integration and status and in turn greater substance use. These findings suggest that the high school transition is a risky time for substance use related to the interplay of increases in depressive symptoms and deviant behavior on the one hand and decreases in social status and integration on the other.
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Hart, Ashleigh Chanel, Emalie Rosewarne, Wendy Spencer, Ruth McCausland, Greg Leslie, Janani Shanthosh, Christine Corby, Keziah Bennett-Brook, and Jacqui Webster. "Indigenous Community-Led Programs to Address Food and Water Security: Protocol for a Systematic Review." International Journal of Environmental Research and Public Health 18, no. 12 (June 11, 2021): 6366. http://dx.doi.org/10.3390/ijerph18126366.
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The connection between indigenous peoples and Country (a multidimensional concept including land and water) enabled communities to thrive and survive over millennia. This has been eroded by colonisation, dispossession and increasing food and water insecurity due to climate change and supply constraints. Globally, indigenous peoples experience a disproportionate burden of chronic disease and poor nutrition is a major risk factor. Indigenous leaders have been advocating for community-led solutions. The primary aim of this systematic review is to determine what community-led programs have been undertaken to address food and/or water security globally. A comprehensive search of peer-reviewed literature will be performed in EMBASE, CINAHL, PsycINFO, PubMed, Scopus, LILACs, Informit and Business Source Premier. The grey literature search will include grey literature databases, customised Google search engines, targeted websites, and consultation with experts. The search strategy will consist of four concepts, combined as follows: (1) indigenous peoples AND (2) community program AND (3) food security OR (4) water security. Covidence will be used for study screening and data extraction by two authors. A deductive thematic analysis using indigenous-informed methodologies will be used to synthesise data. This review seeks to provide insight on models and mechanisms to encourage action and metrics for quantifying success of indigenous community-led programs to improve food and water security.
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Kemp, Joanne L., Richard T. R. Johnston, Sally L. Coburn, Denise M. Jones, Anthony G. Schache, Benjamin F. Mentiplay, Matthew G. King, et al. "Physiotherapist-led treatment for femoroacetabular impingement syndrome (the PhysioFIRST study): a protocol for a participant and assessor-blinded randomised controlled trial." BMJ Open 11, no. 4 (April 2021): e041742. http://dx.doi.org/10.1136/bmjopen-2020-041742.
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IntroductionThis double-blind, randomised controlled trial (RCT) aims to estimate the effect of a physiotherapist-led intervention with targeted strengthening compared with a physiotherapist-led intervention with standardised stretching, on hip-related quality of life (QOL) or perceived improvement at 6 months in people with femoroacetabular impingement (FAI) syndrome. We hypothesise that at 6 months, targeted strengthening physiotherapist-led treatment will be associated with greater improvements in hip-related QOL or greater patient-perceived global improvement when compared with standardised stretching physiotherapist-led treatment.Methods and analysisWe will recruit 164 participants with FAI syndrome who will be randomised into one of the two intervention groups, both receiving one-on-one treatment with the physiotherapist over 6 months. The targeted strengthening physiotherapist-led treatment group will receive a personalised exercise therapy and education programme. The standardised stretching physiotherapist-led treatment group will receive standardised stretching and personalised education programme. Primary outcomes are change in hip-related QOL using International Hip Outcome Tool-33 and patient-perceived global improvement. Secondary outcomes include cost-effectiveness, muscle strength, range of motion, functional task performance, biomechanics, hip cartilage structure and physical activity levels. Statistical analyses will make comparisons between both treatment groups by intention to treat, with all randomised participants included in analyses, regardless of protocol adherence. Linear mixed models (with baseline value as a covariate and treatment condition as a fixed factor) will be used to evaluate the treatment effect and 95% CI at primary end-point (6 months).Ethics and disseminationThe study protocol was approved (La Trobe University Human Ethics Committee (HEC17-080)) and prospectively registered with the Australian New Zealand Clinical Trials Registry. The findings of this RCT will be disseminated through peer reviewed scientific journals and conferences. Patients were involved in study development and will receive a short summary following the completion of the RCT.Trial registration numberACTRN12617001350314
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Blomster, Jeffrey P. "COMPLEXITY, INTERACTION, AND EPISTEMOLOGY: MIXTECS, ZAPOTECS, AND OLMECS IN EARLY FORMATIVE MESOAMERICA." Ancient Mesoamerica 21, no. 1 (2010): 135–49. http://dx.doi.org/10.1017/s0956536110000039.
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AbstractInteraction between the Gulf Coast Olmecs and various regions of Early Formative Mesoamerica remains debated and poorly understood. In Oaxaca, models have been dominated by neoevolutionary epistemology; interaction between the Valley of Oaxaca and San Lorenzo has been characterized by emulation or peer polity models. Data from the Valley of Oaxaca, the Nochixtlán Valley, and the Gulf Coast demonstrate that San Lorenzo was at a different level of sociopolitical complexity than its contemporaries. Previous comparisons between Olmec-style pottery in the Gulf Coast and Valley of Oaxaca are found to be problematic, and have led to the impression that Oaxaca villagers produced more of this pottery than did the Olmecs. Neutron activation analysis demonstrates the Gulf Coast Olmecs exported ceramics to Mixtecs and Zapotecs in Oaxaca, while receiving few if any pots in return, suggesting that new models and theoretical perspectives must be applied to understanding the relationships between Oaxacan chiefdoms and the nascent Olmec state at San Lorenzo. An agency perspective explores what Mixtec, Zapotec, and Olmec groups may have taken from these interactions and relationships and acknowledges both local and Gulf Coast understandings of “Olmec.” Such relationships may be characterized more by acquisition between regions, with San Lorenzo as a superordinate center.
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Armour, Richard, Jennie Helmer, and John Tallon. "Paramedic-delivered teleconsultations: a grounded theory study." Canadian Journal of Emergency Medicine 24, no. 2 (December 7, 2021): 167–73. http://dx.doi.org/10.1007/s43678-021-00224-6.
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Abstract Objective Progression in Anglo-American models of out-of-hospital care has resulted in the development of alternative roles for paramedics, including advanced paramedics providing teleconsultations to frontline paramedics. Traditionally provided by physicians, little is known about how paramedics perceive peer-to-peer teleconsultations. This research aimed to explore paramedic perceptions of paramedic-delivered teleconsultations. Methods This investigation employed a constructivist grounded theory methodology. Six focus groups were conducted with purposive and theoretical sampling and data analyzed using open coding and continual comparative analysis. Results 33 paramedics from across British Columbia, Canada, participated in the focus groups. Seven key themes emerged during the focus groups; the perceived roles and status of paramedic specialists and physicians in healthcare, the influence of relationships and culture on clinical consultations, practicalities of out-of-hospital care and the importance of lived experience, provision of appropriate clinical advice, professional trust and respect, mentorship in out-of-hospital care and clinical governance and education requirements. This led to the development of the grounded theory paramedics increasing ownership of their profession. Conclusion Paramedics reported a number of areas in which paramedic-delivered teleconsultations provided benefits not seen with traditional physician-delivered teleconsultation model. Emergency health systems delivering an Anglo-American model of care should consider the possible benefits of paramedic-delivered teleconsultations.
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Vezzali, Loris, Sofia Stathi, Richard J. Crisp, Dino Giovannini, Dora Capozza, and Samuel L. Gaertner. "Imagined Intergroup Contact and Common Ingroup Identity." Social Psychology 46, no. 5 (October 2015): 265–76. http://dx.doi.org/10.1027/1864-9335/a000242.
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Abstract. We conducted two studies involving two different age groups (elementary school children and adults) aimed at integrating imagined contact and common ingroup identity models. In the first study, Italian elementary school children were asked to imagine interacting with an unknown immigrant peer as members of a common group. Results revealed that common ingroup imagined contact, relative to a control condition, improved outgroup helping intentions assessed 1 week and 2 weeks after the intervention. In the second study, common ingroup imagined contact led Italian university students to display higher intentions to have contact with immigrants compared to control conditions. In conclusion, results from both studies demonstrate that imagining an intergroup interaction as members of the same group strengthens the effects of imagined contact. These findings point to the importance of combining the common ingroup identity model and the imagined contact theory in order to increase the potentiality of prejudice reduction interventions.
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Halilaj, Iva, Avishek Chatterjee, Yvonka van Wijk, Guangyao Wu, Brice van Eeckhout, Cary Oberije, and Philippe Lambin. "Covid19Risk.ai: An Open Source Repository and Online Calculator of Prediction Models for Early Diagnosis and Prognosis of Covid-19." BioMed 1, no. 1 (August 20, 2021): 41–49. http://dx.doi.org/10.3390/biomed1010003.
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Background: The current pandemic has led to a proliferation of predictive models being developed to address various aspects of COVID-19 patient care. We aimed to develop an online platform that would serve as an open source repository for a curated subset of such models, and provide a simple interface for included models to allow for online calculation. This platform would support doctors during decision-making regarding diagnoses, prognoses, and follow-up of COVID-19 patients, expediting the models’ transition from research to clinical practice. Methods: In this pilot study, we performed a literature search in the PubMed and WHO databases to find suitable models for implementation on our platform. All selected models were publicly available (peer reviewed publications or open source repository) and had been validated (TRIPOD type 3 or 2b). We created a method for obtaining the regression coefficients if only the nomogram was available in the original publication. All predictive models were transcribed on a practical graphical user interface using PHP 8.0.0, and were published online together with supporting documentation and links to the associated articles. Results: The open source website currently incorporates nine models from six different research groups, evaluated on datasets from different countries. The website will continue to be populated with other models related to COVID-19 prediction as these become available. This dynamic platform allows COVID-19 researchers to contact us to have their model curated and included on our website, thereby increasing the reach and real-world impact of their work. Conclusion: We have successfully demonstrated in this pilot study that our website provides an inclusive platform for predictive models related to COVID-19. It enables doctors to supplement their judgment with patient-specific predictions from externally validated models in a user-friendly format. Additionally, this platform supports researchers in showcasing their work, which will increase the visibility and use of their models.
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Domarecka, Ewa, Mahmut Tayyar Kalcioglu, Ahmet Mutlu, Abdulkadir Özgür, Jasper Smit, Heidi Olze, and Agnieszka J. Szczepek. "Reporting Data on Auditory Brainstem Responses (ABR) in Rats: Recommendations Based on Review of Experimental Protocols and Literature." Brain Sciences 11, no. 12 (November 30, 2021): 1596. http://dx.doi.org/10.3390/brainsci11121596.
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Research in hearing science is accelerating, and a wealth of data concerning auditory brainstem responses (ABR) in various animal models is published in peer-reviewed journals every year. Recently, we reviewed studies using ABR measurements in tinnitus rat models. We found significant discrepancies in the outcomes of these studies, some due to different research approaches and others due to different methodologies. Thus, the present work aimed to collect comprehensive information on all factors influencing ABR recordings in rats and compile recommendations on ABR data reporting. A questionnaire with queries about animal husbandry, transfer, handling, and the exact test conditions before, during, and after ABR recordings was sent to 125 researchers who published the relevant studies between 2015 and 2021. Eighteen researchers provided detailed answers on factors related to ABR measurements. Based on the analysis of the returned questionnaires, we identified three domains reflecting animal-, equipment-, and experiment-dependent factors that might influence the ABR outcome, thus requiring reporting in published research. The analysis of survey results led to the compilation of recommendations for reporting ABR outcomes supported by a literature review. Following these recommendations should facilitate comparative and meta-analyses of ABR results provided by various research groups.
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Trude, Angela C. B., Elizabeth Anderson Steeves, Cara Shipley, Pamela J. Surkan, Priscila de Morais Sato, Tracey Estep, Stella Clanton, Lisa Lachenmayr, and Joel Gittelsohn. "A Youth-Leader Program in Baltimore City Recreation Centers: Lessons Learned and Applications." Health Promotion Practice 19, no. 1 (September 12, 2017): 75–85. http://dx.doi.org/10.1177/1524839917728048.
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Peer-led interventions may be an effective means of addressing the childhood obesity epidemic; however, few studies have looked at the long-term sustainability of such programs. As part of a multilevel obesity prevention intervention, B’More Healthy Communities for Kids, 16 Baltimore college students were trained as youth-leaders (YLs) to deliver a skill-based nutrition curriculum to low-income African American children (10-14 years old). In April 2015, formative research was used to inform sustainability of the YL program in recreation centers. In-depth interviews were conducted with recreation center directors ( n = 4) and the YLs ( n = 16). Two focus groups were conducted with YLs ( n = 7) and community youth-advocates ( n = 10). Barriers to this program included difficulties with transportation, time constraints, and recruiting youth. Lessons learned indicated that improving trainings and incentives to youth were identified as essential strategies to foster continuity of the youth-led program and capacity building. High school students living close to the centers were identified as potential candidates to lead the program. Based on our findings, the initial intervention will be expanded into a sustainable model for implementation, using a train-the-trainer approach to empower community youth to be change agents of the food environment and role models.
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Hashim, Ahmed, Margaret O’Sullivan, Hugh Williams, and Sumita Verma. "Developing a community HCV service: project ITTREAT (integrated community-based test – stage – TREAT) service for people who inject drugs." Primary Health Care Research & Development 19, no. 02 (December 4, 2017): 110–20. http://dx.doi.org/10.1017/s1463423617000731.
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Background and aims Majority of the individuals with hepatitis C virus (HCV) infection in England are people who inject drugs, a vulnerable and disenfranchised cohort with poor engagement with secondary care. Our aim is to describe our experiences in setting up a successful nurse led HCV service at a substance misuse service (SMS). Methods We justify the need for a community HCV service and review the different community based models. Our experiences in engaging with stakeholders, obtaining funding, service set up, challenges faced and key recommendations are discussed. Finally, a summary of interim clinical outcomes is presented. Results A successful community based “one-stop” nurse led HCV service was set up in Dec 2013 at a large SMS. It provides all aspects of care (blood borne virus screening, non-invasive assessment of hepatic fibrosis, Hepatology input, HCV treatment, peer mentor, social and psychiatrist support, and opiod substitution) at one site. Interim clinical data indicate high service uptake with HCV treatment outcomes comparable to secondary care. Conclusions The advent of direct acting antivirals provides a unique opportunity for HCV elimination in England by 2030. Our “one-stop” integrated and multidisciplinary community HCV model suggests that HCV care can be successfully delivered outside of a hospital setting and warrants national adoption.
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Ratan, Bani M., Grace J. Johnson, Amanda C. Williams, Jocelyn T. Greely, and Charlie C. Kilpatrick. "Enhancing the Teaching Environment: 3-Year Follow-Up of a Resident-Led Residents-as-Teachers Program." Journal of Graduate Medical Education 13, no. 4 (August 1, 2021): 569–75. http://dx.doi.org/10.4300/jgme-d-20-01167.1.
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ABSTRACT Background Previous faculty-driven residents-as-teachers (RAT) models have had limited efficacy and sustainability. Objective To evaluate the acceptability and effects of a resident-led RAT program on resident teaching. Methods In October 2016, obstetrics and gynecology (OB/GYN) residents at a large academic institution implemented a resident-led RAT program, consisting of a steering committee of peer-selected residents with 2 faculty mentors who planned education-focused resident didactics and journal clubs, organized resident involvement in clerkship activities, and recognized residents who excelled in teaching as Distinguished Educators (DEs). From July 2016 through June 2019, using the Kirkpatrick Model, we evaluated the program with annual resident surveys assessing self-perception of 13 teaching skills (5-point Likert scale) and value of RAT program, institutional end-of-clerkship student evaluations of resident teaching, and resident participation in DE award. Results Annual resident survey response rates ranged from 63% to 88%. Residents' self-reported teaching skills improved significantly in 11 of 13 domains from 2016 to 2018 (improvements ranging from 0.87–1.42; 5-point Likert scale; P < .05). Of the 2018 respondents, 80% agreed that the resident-led RAT program added value to the residency. For 2017–2018 and 2018–2019 academic years, 47% and 48% of medical students (100% response rate) strongly agreed that residents provided effective teaching compared to 30% in 2016–2017 (P < .05). Ten residents have graduated as DEs during this time period. Conclusions A resident-led RAT program increased residents' self-reported teaching skills, improved medical student perceptions of teaching quality, and was sustainable and acceptable over a 3-year period.
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Hamel, Candyce, Chantelle Garritty, Mona Hersi, Claire Butler, Leila Esmaeilisaraji, Danielle Rice, Sharon Straus, Becky Skidmore, and Brian Hutton. "Models of provider care in long-term care: A rapid scoping review." PLOS ONE 16, no. 7 (July 16, 2021): e0254527. http://dx.doi.org/10.1371/journal.pone.0254527.
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Introduction One of the current challenges in long-term care homes (LTCH) is to identify the optimal model of care, which may include specialty physicians, nursing staff, person support workers, among others. There is currently no consensus on the complement or scope of care delivered by these providers, nor is there a repository of studies that evaluate the various models of care. We conducted a rapid scoping review to identify and map what care provider models and interventions in LTCH have been evaluated to improve quality of life, quality of care, and health outcomes of residents. Methods We conducted this review over 10-weeks of English language, peer-reviewed studies published from 2010 onward. Search strategies for databases (e.g., MEDLINE) were run on July 9, 2020. Studies that evaluated models of provider care (e.g., direct patient care), or interventions delivered to facility, staff, and residents of LTCH were included. Study selection was performed independently, in duplicate. Mapping was performed by two reviewers, and data were extracted by one reviewer, with partial verification by a second reviewer. Results A total of 7,574 citations were screened based on the title/abstract, 836 were reviewed at full text, and 366 studies were included. Studies were classified according to two main categories: healthcare service delivery (n = 92) and implementation strategies (n = 274). The condition/ focus of the intervention was used to further classify the interventions into subcategories. The complex nature of the interventions may have led to a study being classified in more than one category/subcategory. Conclusion Many healthcare service interventions have been evaluated in the literature in the last decade. Well represented interventions (e.g., dementia care, exercise/mobility, optimal/appropriate medication) may present opportunities for future systematic reviews. Areas with less research (e.g., hearing care, vision care, foot care) have the potential to have an impact on balance, falls, subsequent acute care hospitalization.
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Anagnostopoulos, Christos, Tahani Aladwani, Ibrahim Alghamdi, and Konstantinos Kolomvatsos. "Data-Driven Analytics Task Management Reasoning Mechanism in Edge Computing." Smart Cities 5, no. 2 (April 24, 2022): 562–82. http://dx.doi.org/10.3390/smartcities5020030.
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Internet of Things (IoT) applications have led to exploding contextual data for predictive analytics and exploration tasks. Consequently, computationally data-driven tasks at the network edge, such as machine learning models’ training and inference, have become more prevalent. Such tasks require data and resources to be executed at the network edge, while transferring data to Cloud servers negatively affects expected response times and quality of service (QoS). In this paper, we study certain computational offloading techniques in autonomous computing nodes (ANs) at the edge. ANs are distinguished by limited resources that are subject to a variety of constraints that can be violated when executing analytical tasks. In this context, we contribute a task-management mechanism based on approximate fuzzy inference over the popularity of tasks and the percentage of overlapping between the data required by a data-driven task and data available at each AN. Data-driven tasks’ popularity and data availability are fed into a novel two-stages Fuzzy Logic (FL) inference system that determines the probability of either executing tasks locally, offloading them to peer ANs or offloading to Cloud. We showcase that our mechanism efficiently derives such probability per each task, which consequently leads to efficient uncertainty management and optimal actions compared to benchmark models.
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Anagnostopoulos, Christos, Tahani Aladwani, Ibrahim Alghamdi, and Konstantinos Kolomvatsos. "Data-Driven Analytics Task Management Reasoning Mechanism in Edge Computing." Smart Cities 5, no. 2 (April 24, 2022): 562–82. http://dx.doi.org/10.3390/smartcities5020030.
Full textAbstract:
Internet of Things (IoT) applications have led to exploding contextual data for predictive analytics and exploration tasks. Consequently, computationally data-driven tasks at the network edge, such as machine learning models’ training and inference, have become more prevalent. Such tasks require data and resources to be executed at the network edge, while transferring data to Cloud servers negatively affects expected response times and quality of service (QoS). In this paper, we study certain computational offloading techniques in autonomous computing nodes (ANs) at the edge. ANs are distinguished by limited resources that are subject to a variety of constraints that can be violated when executing analytical tasks. In this context, we contribute a task-management mechanism based on approximate fuzzy inference over the popularity of tasks and the percentage of overlapping between the data required by a data-driven task and data available at each AN. Data-driven tasks’ popularity and data availability are fed into a novel two-stages Fuzzy Logic (FL) inference system that determines the probability of either executing tasks locally, offloading them to peer ANs or offloading to Cloud. We showcase that our mechanism efficiently derives such probability per each task, which consequently leads to efficient uncertainty management and optimal actions compared to benchmark models.
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Anagnostopoulos, Christos, Tahani Aladwani, Ibrahim Alghamdi, and Konstantinos Kolomvatsos. "Data-Driven Analytics Task Management Reasoning Mechanism in Edge Computing." Smart Cities 5, no. 2 (April 24, 2022): 562–82. http://dx.doi.org/10.3390/smartcities5020030.
Full textAbstract:
Internet of Things (IoT) applications have led to exploding contextual data for predictive analytics and exploration tasks. Consequently, computationally data-driven tasks at the network edge, such as machine learning models’ training and inference, have become more prevalent. Such tasks require data and resources to be executed at the network edge, while transferring data to Cloud servers negatively affects expected response times and quality of service (QoS). In this paper, we study certain computational offloading techniques in autonomous computing nodes (ANs) at the edge. ANs are distinguished by limited resources that are subject to a variety of constraints that can be violated when executing analytical tasks. In this context, we contribute a task-management mechanism based on approximate fuzzy inference over the popularity of tasks and the percentage of overlapping between the data required by a data-driven task and data available at each AN. Data-driven tasks’ popularity and data availability are fed into a novel two-stages Fuzzy Logic (FL) inference system that determines the probability of either executing tasks locally, offloading them to peer ANs or offloading to Cloud. We showcase that our mechanism efficiently derives such probability per each task, which consequently leads to efficient uncertainty management and optimal actions compared to benchmark models.
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Costa, Daniela, Eduardo B. Cruz, Ana M. Rodrigues, Daniela Gonçalves-Bradley, Luís A. Gomes, Helena Donato, and Carla Nunes. "Models of care for patients with knee osteoarthritis in primary healthcare: a scoping review protocol." BMJ Open 11, no. 6 (June 2021): e045358. http://dx.doi.org/10.1136/bmjopen-2020-045358.
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IntroductionKnee osteoarthritis (OA) is a prevalent condition with associated high disability and healthcare costs. Evidence of major gaps in the implementation of evidence-based interventions in people with knee OA led several healthcare systems to implement models of care (MoCs) in order to improve knowledge translation and guaranty their economic sustainability. Nevertheless, there are few studies that analyse the existing body of evidence of MoCs for patients with knee OA in primary healthcare settings. Therefore, we aim to identify MoCs developed for patients with knee OA implemented in primary healthcare and, analyse their core components and outcomes. This scoping review will create knowledge about the components and outcomes of these MoCs which, in the future, will facilitate their transferability to practice.Methods and analysisWe will include studies that developed and implemented an MoC for people with knee OA in primary healthcare. We will use the PCC mnemonic, being ‘Population’—people with Knee OA, ‘Concept’—the MoCs and ‘Context’—the primary healthcare setting. We will conduct the search on PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, Web of Science Core Collection, as well as grey literature databases and relevant institutions and organisations websites, for articles published after 2000. Two independent reviewers will screen titles and abstracts followed by a full-text review to assess papers regarding their eligibility. We will evaluate the methodological quality of the included studies with the Mixed Methods Appraisal tool and apply a data abstraction form to describe and interpret the evidence.Ethics and disseminationAs a secondary analysis, this scoping review does not require ethical approval. Findings will be published in peer-review journal, presented in scientific conferences and as a summary through primary healthcare units.
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Sao, Saumya, Brandon A Knettel, Godfrey A Kisigo, Elizabeth T Knippler, Haika Osaki, Rimel N Mwamba, Jane Rogathi, James S Ngocho, Blandina T Mmbaga, and Melissa H Watt. "HIV Community-Level Stigmatizing Attitudes in Tanzania: Perspectives from Antenatal Care." East African Health Research Journal 4, no. 2 (November 26, 2020): 118–27. http://dx.doi.org/10.24248/eahrj.v4i2.635.
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Introduction: Stigma significantly impacts retention in HIV care and quality of life among people living with HIV. This study explored community-level HIV stigma from the perspective of patients and healthcare workers in antenatal care (ANC) in Moshi, Tanzania. Methods: We conducted in-depth interviews with 32 women (20 living with HIV), key-informant interviews with 7 ANC clinic employees, and two focus group discussions with 13 community health workers. Results: Themes emerged related to drivers and manifestations of stigma, resilience to stigmatizing attitudes, and opportunities to address stigma in ANC. Drivers of stigma included a fear of infection through social contact and associations of HIV with physical weakness (e.g., death, sickness) and immoral behaviour (e.g., sexual promiscuity). Manifestations included gossip, physical and social isolation, and changes in intimate relationships. At the same time, participants identified people who were resilient to stigmatizing attitudes, most notably individuals who worked in healthcare, family members with relevant life experiences, and some supportive male partners. Conclusion/Recommendations: Supportive family members, partners, and healthcare workers can serve as role models for stigma-resilient behaviour through communication platforms and peer programs in ANC. Manifestations of HIV stigma show clear links to constructs of sexuality, gender, and masculinity, which may be particularly impactful during pregnancy care. The persistence of stigma emphasizes the need for innovation in addressing stigmatizing attitudes in the community. Campaigns and policies should go beyond dispelling myths about HIV transmission and immorality to innovate peer-led and couples-based stigma reduction programming in the ANC space
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Mehta, Meeti. "Promoting Virtual Engagement: Addressing the Social and Mental Health Needs of Students with Intellectual Disabilities in a Remote Postsecondary Environment." Undergraduate Journal of Service Learning & Community-Based Research 11 (April 4, 2021): 15–19. http://dx.doi.org/10.56421/ujslcbr.v11i0.339.
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Students with intellectual disabilities (IDs) benefit most from an inclusive curriculum facilitating engagement with peers without IDs. While such curricula exist in primary and secondary education, inclusive postsecondary education (IPSE) is still new. Integrated IPSE allows students with and without IDs to take classes together, with further inclusion in residential life and extracurricular activities. In addition to fostering growth in students with IDs, this creates a diverse college experience for those without IDs, cultivating an informed and inclusive student body.
Knights Exemplar (KE) is a student-led peer mentorship program supporting students with IDs enrolled in Inclusive Education Services (IES), an integrated IPSE program at the University of Central Florida (UCF). KE educates students to ensure peer mentors of the highest quality, serving as role models and bridging the gap between IES students and university resources.
However, six months after KE was founded, UCF shut down due to safety concerns related to the COVID-19 pandemic. This sudden disruption to the organization’s functioning created an array of challenges that needed to be addressed in order to resume operation in a virtual capacity. In dealing with these struggles while prioritizing the social and emotional needs of the students in IES, we learned to adapt to new challenges and make the most of the circumstances of the COVID-19 pandemic. Ultimately, our experiences can serve as a lesson for other university-based IPSE programs seeking to provide more significant support to students with IDs in a virtual environment.
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Bell, Stephen, James Ward, Peter Aggleton, Walbira Murray, Bronwyn Silver, Andrew Lockyer, Tellisa Ferguson, et al. "Young Aboriginal people's sexual health risk reduction strategies: a qualitative study in remote Australia." Sexual Health 17, no. 4 (2020): 303. http://dx.doi.org/10.1071/sh19204.
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Background Surveillance data indicate that Aboriginal and Torres Strait Islander young people are more likely than their non-Indigenous counterparts to experience sexually transmissible infections (STIs) and teenage pregnancy. Despite increasing emphasis on the need for strengths-based approaches to Aboriginal sexual health, limited published data document how young Aboriginal people reduce sexual health risks encountered in their everyday lives. Methods: In-depth interviews with 35 young Aboriginal women and men aged 16–21 years in two remote Australian settings were conducted; inductive thematic analysis examining sexual health risk reduction practices was also conducted. Results: Participants reported individual and collective STI and pregnancy risk reduction strategies. Individual practices included accessing and carrying condoms; having a regular casual sexual partner; being in a long-term trusting relationship; using long-acting reversible contraception; having fewer sexual partners; abstaining from sex; accessing STI testing. More collective strategies included: refusing sex without a condom; accompanied health clinic visits with a trusted individual; encouraging friends to use condoms and go for STI testing; providing friends with condoms. Conclusion: Findings broaden understanding of young Aboriginal people’s sexual health risk reduction strategies in remote Aboriginal communities. Findings signal the need for multisectoral STI prevention and sexual health programs driven by young people’s existing harm minimisation strategies and cultural models of collective support. Specific strategies to enhance young people’s sexual health include: peer condom distribution; accompanied health service visits; peer-led health promotion; continued community-based condom distribution; enhanced access to a fuller range of available contraception in primary care settings; engaging health service-experienced young people as ‘youth health workers’.