جستجوی مقالات مرتبط با کلیدواژه "vulnerable populations" در نشریات گروه "پزشکی"

A growing literature has documented how the secondary effects of the COVID-19 pandemic have compounded socioeconomic vulnerabilities already present in society, particularly across social categories such as gender, race, class, and socioeconomic status. Such effects demonstrate how pandemic response policies act as structural determinants of health to influence not only direct health outcomes but also intermediary outcomes, such as access to education or income. 

This review aims to scope research that analyzes pandemic response policies in Canada from an equity perspective, to identify common themes, recommendations, and gaps. 

Fourteen studies were thematically analyzed, the majority being qualitative policy document analysis, applying critical frameworks and focused on effects on select priority populations. Analysis of economic and labour policies indicates a lack of consideration for the specific needs of priority populations, and those engaged in precarious, informal, and essential labour. Analysis of social policies illustrate the wide-ranging effects of school and service closures, particularly on women and children. Furthermore, these policies lacked consideration of populations marginalized during the pandemic, include older adults and their caregivers, as well as lack of consideration of the diversity of Indigenous communities. Recommendations proposed in this review call for developing policy responses that address persistent social and economic inequities, pandemic response policies tailored to the needs of priority populations and more meaningful consultation during policy development.

  The limited number of studies suggests there is still much scope for research recognizing policies as structural determinants of health inequities, including research which takes an intersectional approach.

Disadvantaged subjects are considered a high-risk group due to limited access, insufficient awareness regarding the importance of oral health, and lack of preventive behavior. This study explores oral health literacy (OHL), oral health behaviors (OHB), and factors associated with OHL among women living in Zahedan's slum areas in Iran.

In 2020, a cross-sectional study was carried out on 216 disadvantaged women in the slums of Zahedan City in Iran. The women's OHL and OHB data were collected using the Persian version of the previously validated Oral Health Literacy-Adult Questionnaire. Statistical analysis, including descriptive and analytical statistics, such as multi-variable linear regression analysis, was conducted using the STATA software version 14.2.

All 216 female subjects residing in the slum areas of Zahedan City completed the questionnaire (response rate: 100%). The mean age of participants was 26.7(±5.03) years old. The respondents' mean score of OHL was 7.6 (±2.47) out of 17. 18.98% reported brushing their teeth twice or more daily, 83.3% used fluoride toothpaste, 37.96% had visited a dentist within the past year, 50.93% consumed sugary snacks less than twice per day, and 87.96% did not smoke. In the regression analysis, there was a significant positive relationship between OHL with age (P<0.001), occupation (P=0.03), and educational level (P<0.001).

The level of oral health literacy among women in the slum area was insufficient. The significant positive associations between OHL and factors such as age, occupation, and education level suggest that targeted educational interventions and community-based programs may be needed to improve oral health knowledge and behaviors in this population.

This letter describes the results of the authors' investigations and conclusions regarding the onset of the COVID-19 pandemic and its impact on the multidimensional poverty of vulnerable populations.

Corresponding author:  Nader Aghakhani, Email: nader1453@umsu.ac.ir
You can also search for this author in:  PubMed, Google Scholar

The COVID-19 disease has worse outcomes in individuals with underlying diseases and elderly individuals. Therefore, identifying COVID-19 risk perception and its related factors and outcomes in vulnerable groups is essential for the health system.

This study aimed to determine COVID-19 risk perception, its related factors, and outcomes in vulnerable groups (individuals with underlying diseases, smokers, opioid addicts, the elderly, and pregnant women).

This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was carried out using the keywords “Risk perception” and “COVID-19” in PubMed, Scopus, Science Direct, SID, Proquest, and Magiran databases in the period from 2019 to July 3, 2021. The quality of selected studies was checked by two authors independently according to Newcastle-Ottawa Scale adapted for cross-sectional.

In the initial search, 640 articles were found, of which 56 remained in the screening phase. Then, the full text of 56 articles was studied. Eventually, based on the inclusion and exclusion criteria of the articles, 8 articles were reviewed. This systematic review showed that suffering from an underlying disease, more anxiety, younger age, and female gender are associated with higher COVID-19 risk perception. The outcomes of COVID-19 risk perception were higher COVID-19 risk perception, delayed treatment sessions, increased anxiety and fear, increased ineffective safety behaviors, and greater compliance with health protocols.

Creating sensitivity and proper COVID-19 risk perception is necessary to follow health protocols, but high COVID-19 risk perception can endanger vulnerable groups’ mental and physical health. Besides, reducing the sensitivity of vulnerable groups toward COVID-19 can expose them to the disease

Health information-seeking behavior (HISB) of college students is of importance due to health information inconsistencies at a time when personal independence and concurrent personal health decision making may be increased. Currently, there is a dearth of research about the HISB of college students, especially from diverse backgrounds. Therefore, the purpose of this study was to identify and describe the sources college students use when engaging in HISB; and to explore associations between HISB and demographic factors.

 This cross-sectional study was conducted with undergraduate students at a diverse, public institution in New York City. The sample was drawn from an institutional social science research pool and asked to complete a survey on HISB. A total of 226 respondents completed the survey.

 The believed accuracy of the information found online was positively correlated with related behaviors and beliefs. The number of followers on Instagram proved to be an important mediator of HISB of college students. The number of followers a health information provider has was fittingly positively correlated with the belief that social media is a helpful resource for health information r(233)=0.18, P=0.01. Students from families with two or more generations living in the United States accessed health professionals more frequently than students from one or less generation (χ2=8.107(2), P=0.017).

 Targeted educational programs designed to increase health information seeking skills, including discernment of information quality should be a priority for college students.

This narrative review aims to identify psycho-social issues related to the COVID-19 pandemic, especially among vulnerable populations. Through understanding the psychosocial meanings underneath, the suffering from the pandemic and the transformative experiences toward better society could be substantiated. Searching relevant studies and literature on psycho-social impacts in relation to COVID-19 was conducted from psycho-social points of view. Vulnerable populations such as the mentally ill, the poor, refugees, immigrants, the elderly, and other stigmatized groups were focused on. Reflections and plans on the worsened health disparities and increased stresses among vulnerable groups will help our society to be healthier and safer.

Multiple Sclerosis (MS) patients experience a variety of disease caused disabilities that makes them more vulnerable to the effects of disasters. This study aimed to review all existed studies about disasters and related disaster management planning about MS patients.

The PubMed, Google Scholar, Scopus, and Web of Science, ProQuest, science direct , and grey literature databases were searched up to the mid of 2021. All obtained titles were assessed by the inclusion criteria. Abstracts of the relevant titles were reviewed and eligible articles/documents were included for full text review and data abstraction.

From 24616 Articles/documents, finally 15 documents (13 articles, and 2 books) were selected. In 8 articles (53%) specifically, focused on MS patients and, in the rest focused on them as a member of people with disabilities. Most studies (10, 71.4%), emphasized on the disaster induced stress effect on MS patients. In two books/book sections, the disaster preparedness plan for all types of disabilities was presented in general, and MS patients were mentioned as a member of the group of patients with disabilities.

Despite the importance of planning in response to disasters to address specific problems of MS patients, there is a lack of proper planning. This is very important and there is an urgent need to develop appropriate planning protocols for addressing the special conditions of MS patients in response to disasters.

The impact of the COVID-19 pandemic on human life has led to profound consequences in almost all societies worldwide, and this includes its significant impact on all aspects of health. Health equity has been among the main challenges in any healthcare system. However, with the COVID-19 crisis worsening health inequalities, the need to prioritize health equity in upstream national and international plans must receive scholarly attention. Therefore, this paper reports the findings of a review of the current synthesized evidence about the impact of the COVID-19 pandemic on health equity.

This is a comprehensive review in which we retrieved relevant studies during the period starting from 12/01/2019 to 01/15/2021 are retrieved from various databases. The PRISMA flow diagram and a narrative approach are used for synthesizing the evidence.

We initially retrieved 1173 studies, and after a primary quality appraisal process, 40 studies entered the final phase of analysis. The included studies were categorized into five main outcome variables: Accessibility (95%), Utilization (65.8%), Financial protection: 15 (36.5%), Poverty (31.7%), and Racism (21.9%)

COVID-19 pandemic has been the most devastating global challenge in recent history. While the COVID-19 crisis is still unfolding, its multidimensional adverse effects are yet to be revealed. Nevertheless, some people, e.g., the elderly, minorities, as well as marginalized and poor persons, have suffered the COVID-19 consequences more than others. In line with the whole government/whole society approach, we advocate that governments need to strengthen their special efforts to reduce the extra burden of the pandemic on the most vulnerable populations.

Decentralization of healthcare decision-making in Uganda led to the promotion of public participation. To facilitate this, participatory structures have been developed at sub-national levels. However, the degree to which the participation structures have contributed to improving the participation of vulnerable populations, specifically vulnerable women, remains unclear. We aim to understand whether and how vulnerable women participate in health-system priority setting; identify any barriers to vulnerable women’s participation; and to establish how the barriers to vulnerable women’s participation can be addressed.

We used a qualitative description study design involving interviews with district decision-makers (n = 12), subcounty leaders (n = 10), and vulnerable women (n = 35) living in Tororo District, Uganda. Data was collected between May and June 2017. The analysis was conducting using an editing analysis style.

The vulnerable women expressed interest in participating in priority setting, believing they would make valuable contributions. However, both decision-makers and vulnerable women reported that vulnerable women did not consistently participate in decision-making, despite participatory structures that were instituted through decentralization. There are financial (transportation and lack of incentives), biomedical (illness/disability and menstruation), knowledge-based (lack of knowledge and/or information about participation), motivational (perceived disinterest, lack of feedback, and competing needs), socio-cultural (lack of decision-making power), and structural (hunger and poverty) barriers which hamper vulnerable women’s participation.

The identified barriers hinder vulnerable women’s participation in health- system priority setting. Some of the barriers could be addressed through the existing decentralization participatory structures. Respondents made both short-term, feasible recommendations and more systemic, ideational recommendations to improve vulnerable women’s participation. Integrating the vulnerable women’s creative and feasible ideas to enhance their participation in health-system decision-making should be prioritized.

The rapid development of coronavirus disease 2019 (COVID-19) vaccines has not been met with the assurance of an effective and equitable global distribution mechanism. Low-income countries are especially at-risk, with the price of the vaccines and supply shortages limiting their ability to procure and distribute the vaccines. While the COVAX initiative is one of the solutions to these challenges, vaccine nationalism has resulted in the hoarding of vaccines and the signing of parallel bilateral deals, undermining this formerly promising initiative. Moreover, inequity in local distribution also remains a problem, with clear discrimination of minorities and lack of logistical preparation in some countries. As we continue to distribute the COVID-19 vaccines, pharmaceutical companies should share their technology to increase supply and reduce prices, governments should prioritize equitable distribution to the most at- risk in all nations and low-income countries should bolster their logistical capacity in preparation for mass vaccination campaigns.

Numerous studies have been conducted to seek a better understanding of disparities in adverse pregnancy outcomes. The present study aimed to explore racial differences in influential socio-demographic, economic, and environmental factors in women who have had a low birth weight (LBW) infant (outcome variable). Study Design: A cross-sectional study.

This study used data from the Fragile Families and Child Wellbeing Study (FFCWS). Univariate and multivariate analyses were performed.

The obtained results pointed to statistical racial differences between Non-Hispanic (NH) Black and NH White women in the socio-demographic variable of marital status (P<0.001).  Regarding the assessed economic stability variables, employment status (P=0.032), poverty level (P<0.001), earnings (P=0.038), and federal government assistance paying for rent (P=0.007) were statistically significant across the two racial groups.  The environmental factors that were statistically significant across racial groups were living in public housing projects (P=0.018), car ownership (P<0.001), and neighborhood safety (P=0.010).  The results of the multivariate models revealed that NH Black race and government assistance to pay rent were associated with an increased likelihood of LBW, while being married, having health care coverage, and living in public housing were associated with a decreased likelihood.

As evidenced by the obtained results, there were statistically significant racial differences in sociodemographic, economic, and environmental/physical characteristics associated with adverse pregnancy outcomes.

Acquired immune deficiency syndrome (AIDS) is a pervasive disease, and its epidemic is spreading around the world. The only way to effectively fight against human immunodeficiency virus (HIV)/AIDS is good-quality health. The present study aimed to investigate the effect of an educational intervention program on HIV/AIDS preventive behaviors based on the Health Belief Model (HBM) in vulnerable women residing in peripheral neighborhoods.

This study was a quasi-experimental research conducted among 200 vulnerable women, randomly selected from four community health centers in peripheral neighborhoods in 2019 in Zahedan, Iran. The data were collected using a researcher-made questionnaire, containing demographic information, HIV knowledge, and the HBM constructs. Besides, the data were collected before, immediately after, and 1 month after the intervention in both groups. Data analysis was performed in SPSS (version 24) using descriptive statistics, Chi-square test, independent t-test, repeated-measures analysis of variance, and multivariate linear regression.

The findings revealed no significant difference in the mean scores of knowledge and the HBM constructs before the educational intervention (P > 0.05). However, after the intervention, this difference was significant in three time intervals (P < 0.05). Despite the effectiveness of the educational intervention in the mean scores of knowledge and the HBM constructs in the intervention group compared with the controls, the largest effect size was observed, respectively, in knowledge (d = 0.762) and perceived barriers (d = 0.612), and the smallest effect size was reported in cues to action (d = 0.421). As well, the F-statistic ratio (0.847) demonstrated that the selected demographic variables had failed to explain variations in knowledge mean scores (P = 0.497).

HBM-based training interventions were positive for HIV/AIDS prevention behaviors. However, training alone does not seem to have enough effect on behavior persistence. Therefore, further research is recommended to investigate the role of predictive factors, especially social determinants of health and their relationship to different parts of the model, to take more effective measures for behavioral stability at the same time as training.

Elderly people are among the most vulnerable groups in natural disaster events. Although old age is responsible for them becoming unequally vulnerable, understanding the different aspects of vulnerability can help health care providers, especially nurses, to manage disaster risk for this increasing number of people. This study intended to explore disaster‑related vulnerability and its contributing factors based on older adults’ perceptions and experiences.
This qualitative content analysis study was performed in Iran in 2016. The study was conducted by semi‑structured interviews of 24 participants, and purposeful sampling with maximum variation continued until data saturation.
By analyzing primary codes two main themes were extracted through content analysis, namely personal factors and social factors, from experiences of two experts in the field of health in emergencies and disaster management among 22 Iranian elderly participants.
This study indicated that age is not the only criteria that makes an elderly person vulnerable, but their lifetime achievements and experiences can determine their level of vulnerability. The results of this study will help health service providers as well as disaster nurses to identify and moderate the factors affecting the vulnerability of the elderly, and by using their rich experience, enhance senior citizens’ resilience to disasters.

Vulnerable women are prone to sexually transmitted diseases due to their high-risk behaviors. The present study aimed to investigate the effect of self-care training program based on Orem’s model on the behaviors leading to sexually transmitted diseases in vulnerable women.
This field trial was initially conducted on 100 women covered under health services and welfare organization in Isfahan city, who were selected by rationing sampling. For needs assessment, they filled the self‑care needs assessment questionnaire in three domains of knowledge, attitude, and practice. Then, at the stage of intervention (self-care training), 64 subjects were selected through convenient sampling and were assigned to experimental and control groups by random allocation. Data were analyzed by descriptive and analytical statistical tests through SPSS 18.
Results showed that mean scores of knowledge (P With regard to these results, it can be concluded that if the educational programs are planned based on clients’ real needs assessment, the learners follow the educational materials, related to their problems, more seriously and it results in a notable behavior change in them.

One much needed tool to assist with the monitoring and evaluation of Human Immunodeficiency Virus (HIV) prevention programs is to provide a valid instrument to measure protective sexual behavior and related factors. The current study aimed to design a valid and reliable instrument to predict the protective sexual behaviors of women at risk of HIV in Iran. Patients and The current study was a sequential mixed cross-sectional and methodological research. Initially, via a qualitative research, constructs and factors associated with sexual protective behavior of women at risk were identified through 25 in-depth interviews. The questionnaire on predictors of protective sexual behaviors in women at risk of HIV (PSPB) was designed based on a qualitative study, and then its qualitative validity, content, and construct validity were evaluated. Exploratory factor analysis was performed and 200 women at risk participated. Seven concepts emerged after exploratory factor analysis of the 48 items. The content validity ratio (CVR) of the questionnaire constructs were 0.55 to 0.76, and content validity index (CVI) structure was 0.86 to 0.95. Cronbach's alpha coefficient for the entire questionnaire was 0.78, and correlation coefficient of the test-retest reliability for the constructs was from 0.73 to 0.89. The current study proved the capability of the predictors of sexual protective behavior in women at risk for HIV questionnaire as a valid and reliable instrument for the Iranian community.