Although the tobacco plant has been employed as a medicinal and sacred herb by Indigenous cultures across the Americas, its usage drastically changed after the 15th-century colonial arrival; its large-scale commodification and global marketing once brought to Europe lead to hedonic and addictive uses harmful to health. As a consequence, tobacco smoking is now one of the largest public health problems worldwide. However, in the Peruvian Amazon, a region of origin of tobacco species, Indigenous healers still know how to use the plant for therapeutic purposes. Due to a general disregard of Indigenous knowledge and stigma, these uses have however not so far been clinically investigated. We hence conducted for the first time a clinical field study assessing a sample of patients treated by a traditional healer specialized in tobacco in the Peruvian Amazon (observational design, pilot study, = 27). The study was conducted within a transdisciplinary and multi-epistemic medical frame, in close partnership with an Amazonian healer. We used validated self-report scales to quantitatively assess mental health variables before and after the weeklong treatment, and mixed-methods to report experienced effects. Paired-samples t-tests comparing pre- and post-treatment scores revealed significant reductions in anxiety, depression, perceived stress, and general symptom indicators. Experienced effects included initial physical discomfort, followed by psychologically or existentially/spiritually significant insights. Our findings point to a sophisticated therapeutic approach based on Indigenous knowledge of tobacco applications, which should be further investigated. The study also contributes to the burgeoning scientific field on therapeutic uses of contentious psychoactive plants.

In the context of international migration, many migrant women face an overload of care work for other people, corroborating a lack of adequate care and protection for them, which places them in vulnerable situations and at risk of suffering psychosocial harm. emotional and physical to your health. This is aggravated in the scenario of the COVID-19 pandemic, considering the structural social inequalities that have deepened to unsustainable limits for the subaltern sectors of societies, where Latin American migrant women who work in the field of domestic care of Spain and Germany. In this way, this work seeks to analyze the problem of psychosocial suffering related to care work in migrant Latin American women in Germany and Spain during the COVID-19 pandemic. For this, the integrative review was used as a qualitative synthesis procedure of previous related studies. The importance of this study lies in the fact that there are few studies on the psychosocial health of Latin American migrant women who perform domestic and care work. Some results show that, in this labor niche in Germany and Spain, the identity of women, migrants and Latin Americans, can contribute to unleash psychological and emotional suffering, due to the precarious working conditions to which many submit out of necessity and because of the field. of care to be the first "option", derived mainly from the limited perspectives of labor and social insertion in the country of destination, than from a freely and consciously chosen task.

A partir de entrevistas y conversaciones a profundidad con cinco enfermeros técnicos de los pueblos Yine y Shipibo-Konibo que laboran en establecimientos de salud en la Amazonía de Ucayali en Perú, este estudio muestra que las prácticas desplegadas para atender a los enfermos con síntomas de Covid-19 hicieron uso de terapias y nociones biomédicas e indígenas. Dichas prácticas reflejaron su formación en salud intercultural y su capacidad para adecuar las normas establecidas por el Ministerio de Salud. En función de los síntomas observados en los pacientes, los enfermeros indígenas usaron una variedad de prácticas: vaporaciones, masajes, baños, infusiones y remedios. Las nociones de salud y enfermedad que los enfermeros técnicos indígenas comparten con sus pacientes fueron la base para interpretar el Covid-19 y estuvieron presentes en las atenciones brindadas. Esto se nutrió de la existencia de un sistema de cuidado familiar bastante articulado que fue tejiéndose y siendo negociado en función de los síntomas y las terapias aplicadas. Sus prácticas demuestran la creatividad en los pueblos indígenas. En ese sentido, el sector salud necesita repensar su mirada sobre la medicina indígena, a la que denomina "tradicional" y nos muestra la necesidad de repensar las ideas sobre adecuación de los servicios para la población indígena para colocar en el centro del debate el significado de interculturalidad en salud desde la perspectiva indígena.

This article discusses Earth's Rights as an environmental justice mechanism of reparation, protection, and justice for indigenous communities, environmental defenders, and other populations in Latin America. We argue that Earth's rights encompass and include the right to health and can be integrated into international human rights frameworks to protect all forms of life, responding to colonial legacies of discrimination and violence. We respond to the scarcity of literature discussing Earth's rights in relation to situations where human rights and Earth's rights are violated. We ground our argument in the theoretical conceptualization of Latin American proposals of Earth's rights and its potential for actionable policy approaches that include human health as inevitably interconnected to our planet's well-being. We address the environmental injustices that affect the right to health and argue that an Earth's rights framework can support reparations for historically marginalized communities.

Growing research highlights the role of local community contexts in health and well-being. Communities function as central arenas for health promotion as individuals and community spaces interact in daily life. To better communicate the linkages between community and health, we demonstrate the use of a set of geosocial tools for community diagnosis and health promotion, conceptually grounded in the framework of geosocial embeddedness, using data from community surveys and participatory research conducted with local inhabitants to engage their competency. Through a web-based interactive map generated using a geographic information system, we identified public territories in the municipality where greater policy attention is needed to enhance health. Through an intersectional matrix produced using multilevel analysis, we identified precise social groups by intersectional categories that are most at risk of loneliness for targeted intervention. A health radar chart on multidomain indicators illustrated information on group dynamics and longitudinal comparisons for health promotion. Overall, these tools offered not only diagnoses of the most vulnerable social groups for tailored interventions but also insight for policymakers to improve infrastructure and material resources to promote health. We conclude that geosocial tools offer a promising approach toward sharpening health communication and improving health in the community.

Alzheimer's disease (AD)-focused recruitment research registries can help identify eligible participants for AD studies, but registry participation is limited among racial and ethnic groups most at risk for AD. Using the Reasoned Action Approach (RAA), this study is part of a larger project to design theory-based persuasive recruitment messages that would encourage registry enrollment among underrepresented racial and ethnic groups. National survey data were collected in May/June 2021 from adults aged 50-80 years old living in the United States ( = 1,501) with oversamples of non-Hispanic Black ( = 334) and Hispanic ( = 309) adults for group comparisons. Regression analysis was used to estimate the relationship of the attitudes, norms, and perceived behavioral control on intention to sign up for an AD-focused research registry for each racial/ethnic and sex group (i.e., Black women, Black men, Hispanic female, Hispanic men, non-Hispanic White women, and non-Hispanic White men), followed by an audience segmentation analysis based on intender status. Across almost all target groups, attitudes were an important determinant of intention, and norms and capacity were secondary determinants for Black and Hispanic adults, respectively. There was considerable overlap in attitudinal beliefs most salient to the behavior which focused on benefits to society in some way, either generally (i.e., "helping others in the future"; "advancing science") or more specifically (i.e., "helping others like you"). Differences between groups were more apparent regarding norms and capacity. Targeted recruitment messages based on beliefs that were common across the groups could be an efficient way of recruiting people of color into AD research registries.

First-generation Latinx immigrant youth from the Northern Triangle (NT; El Salvador, Guatemala, and Honduras) face unique risks for experiencing stressors across the phases of migration, which could exacerbate their mental health. This study aimed to (a) identify and characterize unique latent profile groups based on response patterns to immigrant minority stress and psychosocial protective factor items and (b) examine the associations of latent profile membership with depression and anxiety symptoms among NT immigrant youth, controlling for study covariates (i.e., postmigration victimization and forced immigration-related family separation). Primary surveys assessing immigrant minority stress and psychosocial protective factors (i.e., ethnic identity importance, and family, peer, and school support) were administered ( = 172, age range = 14-21, 63% female). Latent profile analysis (Aim 1) and multiple linear regression (Aim 2) were conducted to examine the study aims. A three latent profile model was identified: (a) moderate immigrant minority stress and low psychosocial protection (), (b) moderate immigrant minority stress and moderate psychosocial protection (), and (c) low immigrant minority stress and high psychosocial protection () during postmigration. Multiple linear regression demonstrated that latent profile membership was significantly associated with mental health. Protective associations with mental health were consistently present among the strong resources group. Detrimental associations with mental health were consistently present among the weak resources group. The average resources group demonstrated both protective and detrimental associations with mental health. Postmigration victimization and forced immigration-related family separation covariates were significantly associated with mental health. Findings provide a foundation for further mental health prevention research with NT immigrant youth.

Engagement in preventive health behaviors (PHBs; i.e., healthy eating, sleep, and physical activity) during adolescence is associated with reduced risks for chronic conditions, such as diabetes, in adulthood. Although several interventions seek to improve adolescents' engagement in health promoting behaviors, racial- and income-based disparities across PHBs persist and may be even more pronounced for adolescents with multiple minoritized identities (e.g., Black adolescents in low-income communities). Therefore, targeted interventions that better meet the needs of minoritized adolescents are critical. The design of such interventions should include: (1) adolescent involvement, (2) cultural tailoring, (3) developmental theory, and (4) consideration of the social determinants of health. This article describes how these elements have been successfully incorporated into adolescent preventive health interventions and used to design #DoubleTap4Health, a community-based social media health intervention for Black adolescents from a low-income community. The results of a feasibility pilot of #DoubleTap4Health suggest that (1) attention to these elements in the intervention design process is feasible and advantageous to ensuring that the intervention components are appropriate and well received by adolescents, and (2) the intervention demonstrated promise as adolescents showed improved engagement in PHBs and media literacy skills. Lessons learned and next steps for intervention development are discussed. Including the above four elements in the design of preventive health interventions for adolescents from minoritized communities is critical to promoting health equity.

While 10% of the U.S. population are afflicted with a rare disease, patients with a rare disease can have a difficult time finding a provider or useful information. Patients with rare diseases are often frustrated by lack of knowledge from their provider, lack of satisfaction with their provider, and lack of available time with their provider. Social connections and networks can be a useful tool for patients with rare diseases to seek and maintain support and information. For this study, a specific rare disease's (Ehlers-Danlos syndrome) support groups in a moderately sized metropolitan area were surveyed about their social interactions with others around their rare disease. The survey was distributed through online support groups on Facebook and was open over a 3-month period. For the 102 respondents that completed the social networking portion of the survey, there were 448 connections. The main modality of networking was in-person, with discussions about their rare disease occurring daily. Providers can utilize these social networks, after engaging with patients, to disseminate educational information and request feedback from patients. The social networks patients create can help them feel a sense of connectedness they might not otherwise feel due to their rare disease.

This study aimed to describe barriers athletic trainers (ATs) face to implementing expert recommendations for improving athletes' concussion care-seeking behavior. We distributed an electronic survey through the National Athletic Trainers' Association to 9,997 ATs working in secondary schools or collegiate institutions and received 365 complete responses. We quantitatively measured their barriers using a validated survey based on the Capability, Opportunity, Motivation, Behavior (COM-B) behavior system containing six Likert-type items with a scale of 0 to 10 (labeled ). We performed three analyses: (a) descriptive analysis of COM-B responses, (b) separate ordinal regression analyses to determine if gender, years certified, percent of employment hours spent at their school, or setting (e.g., secondary school or college/university) predict COM-B responses, and (c) group comparisons within types of secondary schools and collegiate institutions. Athletic trainers reported the highest barriers in the opportunity-related constructs followed by capability-related and motivation-related constructs. Practicing in a secondary school, rather than college/university, setting predicted stronger barriers in psychological capability, social opportunity, physical opportunity, and automatic motivation. Athletic trainers at National Collegiate Athletic Association (NCAA) affiliated colleges/universities had higher physical and psychological capability, compared to ATs at non-NCAA-affiliated colleges/universities. Athletic trainers feel motivated and capable of employing practices to improve athlete care-seeking after a concussion, but they face barriers. Organizations should support ATs by providing opportunities to deliver concussion education. Secondary schools and non-NCAA institutions may benefit from resources to reduce barriers to providing concussion education, like toolkits to help deliver concussion education and protected time to providing this education.

Third- and fourth-year U.S. medical students applying to residency were surveyed between August 6 and October 22, 2022, to assess the impact of on medical student residency application location choices. Across all medical specialties, most respondents were unlikely or very unlikely to apply to one or more residency programs located in a state with abortion restrictions (57.9%) and were considering changes in state abortion access when choosing the location of residencies to apply to (77.0%). Respondents in states with no abortion restrictions were less likely to apply to a program in a state with abortion restrictions (2 [1, 3] < .001). The decision significantly impacts residency application decisions for medical students in all specialties. Students are choosing to avoid or target states with restrictive abortion legislation based on their personal views.

Little is known about how distance learning impacts delivery of the National Diabetes Prevention Program (DPP) despite a rapid shift to this platform during the coronavirus disease 2019 (COVID-19) public health emergency. We explored how a workplace DPP, delivered via distance learning, impacted knowledge, motivation, and behavioral skills of participants throughout the program. We conducted repeated qualitative interviews with distance learning participants at baseline, 6 months, and 12 months from September 2020 to July 2022. Three study team members coded interview data using individual responses as the unit of analysis. We used a thematic approach, using the information-motivation-behavioral skills framework, to analyze responses and generate understanding of the program's impact. The 27 individuals who participated in the interviews (89% women, mean age 56 years) reported the distance learning platform was effective in changing their behavior. The program's focus on food logging and setting limits on specific types of caloric intake was perceived as essential. Education on ideal levels of fat and sugar consumption, lessons on how to read food labels, and dissemination of recipes with healthy food substitutions allowed participants to initiate and sustain healthy decision-making. Strategies to increase physical activity, including breaking up exercise throughout the day, made reaching their goals more feasible. Participants reported food logging and weight reporting, as well as group support during sessions, either sustained or increased their motivation to adhere to the program over time. A workplace DPP delivered via distance learning successfully prompted improvements in the knowledge, motivation, and behavioral skills necessary to increase healthy eating and physical activity among participants.

The COVID-19 pandemic disproportionately impacted ethnic minority and other underserved communities, prompting the federal government to fund community-led health literacy initiatives. This evaluation shares challenges and lessons learned, and identifies best practices from community-based organizations (CBOs) partnering with academia and local government to support health literacy programming.

Adapting interventions to new contexts requires consideration of the needs, norms, and delivery structures of the new setting. We describe how we followed the ORBIT model of intervention development to create Health Insurance Navigation Tools (HINT), a health insurance patient navigation intervention for childhood cancer survivors. By engaging stakeholders and leveraging institutional resources, we identified and preemptively addressed real-world barriers, which may improve the feasibility and efficacy of the intervention. Using evidence-based implementation science models to adapt and refine interventions enhances rigor and reproducibility, implements checks and balances, and surmounts challenges of intervention rollout to accelerate the delivery of health insurance education to childhood cancer survivors.

Growing up in socioeconomic disadvantage increases risk of peer bullying at school. Both socioeconomic status and involvement in bullying are predictive of a range of adverse developmental outcomes. However, neither (a) the mechanisms whereby disadvantage increases bullying risk nor (b) the developmental outcomes for which bullying may mediate disadvantage are clear. This review scoped the literature on the relationships between socioeconomic disadvantage, bullying, and health and developmental outcomes for school-aged children and adolescents. Four databases were searched up to June 3, 2023 with 565 studies retrieved, of which 17 met criteria. Most studies were cross-sectional, and studies varied greatly in their definition and measurement of both bullying involvement and disadvantage. No intervention studies were found. Mediators of the disadvantage-bullying association ranged from individual level (e.g., depression) to the national level (e.g., homicide rate); only two studies examined bully-victim status. Of studies where bullying was a mediator, none examined bullying perpetration; the range of outcomes examined was narrowly focused on mental health, failing to capture the full range of developmental outcomes associated with either socioeconomic disadvantage or bullying involvement. This review highlights that future research is needed on identifying and understanding the mediators of the association between disadvantage and bullying victimization, and on the developmental outcomes mediated by bullying perpetration for disadvantaged children. These insights are critical to increase the effectiveness of community- and school-based bullying prevention, particularly in communities with high proportions of socioeconomically disadvantaged families.

To unpack the process of how health information seeking influences health behaviors, we examined the mediating roles of interpersonal discussion and online information sharing in the associations between health information seeking and healthy lifestyle behaviors and the moderating role of health literacy in the associations among health information seeking, interpersonal discussion, online information sharing, and healthy lifestyle behaviors. Data from a large-scale, representative survey ( = 916) revealed that interpersonal discussion and online information sharing mediated the associations between health information seeking and healthy lifestyle behaviors. The associations between health information seeking and interpersonal discussion and between health information seeking and online information sharing were stronger for individuals with high health literacy than those with low health literacy. Findings advance the understanding of the influence of health information seeking and provide practical guidance for promoting a healthy lifestyle.

The far-reaching impact of the COVID-19 pandemic on Latinx communities is well-documented. This population has higher rates of COVID-19 infection and death compared with non-Latinx White Americans mainly due to long-standing problems related to Social Determinants of Health. Communication about issues such as health threats and safety measures are a vital part of public health, and need to be appropriate to the population of focus. To understand the effectiveness of public health communication to Latinx communities in Michigan during the COVID-19 pandemic, semi-structured interviews ( = 16) and three focus groups ( = 24 participants) were conducted virtually in 2021 across counties in Michigan deeply impacted by COVID-19: Washtenaw, Kent, Genesee, and Wayne. Participants shared some facilitating factors that supported effective health communication during the pandemic for their communities. For instance, in their experiences, religious and community leaders were especially effective in communicating information about the pandemic. They also expressed issues with English often being the only language of official communication; the need for bilingual options; and, the need for multiple channels of communication to reach as many people as possible. Participants also highlighted their concerns about inconsistent government communication and politicizing messages as a hindering factor that impacted effective health communication within their communities. Lessons from successes and failures experienced during the COVID-19 pandemic are vital to improving health outcomes for marginalized communities during public health crises. Future responses must ensure that public health communication is appropriate and effective for Latinx communities to better protect them.

The predominant method for treating obesity has been suggesting and providing information on a controlled diet and, to a lesser extent, increased exercise. That approach has largely failed beyond the short term for many decades as obesity rates continue to rise. Therefore, leveraging improvements in psychosocial correlates of weight-loss behaviors has sometimes been suggested instead. The aim of this study was evaluation of targeted improvements in self-regulation and self-efficacy within a theoretically derived weight-loss program. Women with obesity ( = 103) participated in a year-long community-based program emphasizing self-regulatory skills development to counter lifestyle barriers/challenges to first exercise, then controlled eating. Within a structured treatment protocol administered by community facility employees-and based on tenets of social cognitive theory, self-regulation theory, self-efficacy theory, and coaction theory-self-regulatory skills were initially developed to foster adherence to exercise. Those skills were then adapted to promote eating-behavior changes, emphasizing fruit and vegetable intake. Improvements in measures of exercise self-regulation, eating self-regulation, and self-efficacy for controlling eating, their corresponding behaviors, and weight and waist circumference were significant. Greater within-participant carry-over of changes in exercise self-regulation to eating self-regulation was significantly associated with more weight and waist circumference reductions over both 6 and 12 months. Change in eating-related self-efficacy significantly mediated those relationships. The mean weight reduction of approximately 6% indicated positive effects on obesity-related health risks. The community-based setting indicated potentials for large-scale dissemination of theory- and evidence-driven behavioral obesity treatments focused primarily on self-regulatory skills development.

The U.S. Food and Drug Administration (FDA) developed a public education campaign, , that reduced youth susceptibility to tobacco product use. We sought to identify the mechanisms that may underlie the impact of ads on susceptibility to vaping to inform youth tobacco prevention campaigns. Our online randomized controlled trial (clinicaltrials.gov, identifier NCT04836455) examined a large sample of U.S. adolescents ( = 1,348) who had multiple exposures to ads or control videos over a 3-week period in 2021. To examine potential mediating pathways between t ads and susceptibility to vaping, we examined theory-based psychosocial and message-related variables. The largest impact of ads on susceptibility was via more negative attitudes toward vaping (β*β -0.16; 95% confidence interval [CI] = [-0.25, -0.06]). Other mediation paths were via improved health harm risk beliefs (β*β = -0.08; 95% CI = [-0.13, -0.04]), addiction risk beliefs (β*β = -0.04; 95% CI = [-0.06, -0.01]), injunctive norms against vaping (β*β = -0.05; 95% CI = [-0.09, -0.02]), negative affect (β*β = -0.05; 95% CI = [-0.08, -0.02]), and cognitive elaboration (β*β = -0.03; 95% CI = [-0.05, -0.003]). Our findings suggest that ads that target negative attitudes may decrease susceptibility to vaping among youth. Our findings also introduce normative pressure as a novel factor that may be important for vaping prevention messages.

Even though multiple states have approved legal recreational use of cannabis, the expansion of recreational cannabis legalization has led to public health concerns in the United States. Young adults (18-25 years old) have the highest percentage of cannabis use disorder compared to all other age groups. The purpose of this study is to compare cognitive and emotional responses of young adults who use cannabis and non-users to two anti-cannabis media campaigns that employed different message strategies. In total, 50 people (25 people who use cannabis and 25 non-users) participated in the study-a 2 (cannabis use status: people who currently use cannabis/non-users) × 2 (Public Service Advertising [PSA] campaign: Don't be a Lab Rat-Informational/Stoner Sloth-Narrative) × 3 (message replication) experiment. Participants viewed six messages based on the combinations of each of the three message replications within two campaigns. Participants' facial emotional responses were recorded during message exposure. Self-report questions were asked after viewing each message. Self-report indices showed no differences between the two campaigns for participants who use cannabis and non-users. However, after controlling for individual differences, participants who use cannabis displayed more negative emotional responses to the Don't be a Lab Rat messages than to the Stoner Sloth messages. Conversely, cannabis users experienced more positive emotional responses to the Stoner Sloth messages than to the Don't be a Lab Rat messages. The study provides insights for message design in public health campaigns addressing cannabis use, suggesting that psychophysiological measures can be helpful in providing insights into responses not detected by traditional self-report measures.