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Systems-Level Community-Based Chronic Disease Prevention Interventions, Policies, and Research

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 9407

Special Issue Editors


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Guest Editor
Department of Community Health & Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
Interests: place-based initiatives; community contextual indicators; community-led prevention planning; community-based participatory research approaches

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Guest Editor Assistant
Community Alliance for Research and Engagement (CARE), Yale School of Public Health and Southern Connecticut State University, New Haven, CT 06510, USA
Interests: community engagement; community-based participatory research and intervention approaches; health equity; policy change addressing social determinants of health

Special Issue Information

Dear Colleagues,

Despite many large-scale efforts spanning the socioecological model, the public health field has not seen success from chronic disease prevention interventions. While life expectancy continues to increase in most developing countries, years living with a disability has not decreased. This may be due to inherent challenges in sustaining behavioral change interventions, as well as persistent—or worsening—racial and socioeconomic inequities. According to growing literature in systems thinking, it may also be due to governmental, social, and healthcare systems that create health inequities, which will continue to be perpetuated unless these systems are transformed. This is particularly promising if the communities most impacted by inequitable systems—those shaped by colonialism, systemic racism, and social stratification—are meaningfully leading the transformation process. While there is much literature on the need for this level of social change, there is a gap in empirical evidence that explores the process and outcomes of systems that fund, deliver, and evaluate community-based chronic disease prevention efforts. Papers addressing this topic are invited for this Special Issue. We are interested in case studies and outcome studies of innovative, community-led systems-level approaches to chronic disease prevention including cross-sector, place-based interventions; community-prioritized chronic disease programs and policies; policies that affect social change efforts; building community capacity and infrastructure for systems change; strategies that overcome biases and privilege in traditional funding; participatory or empowerment approaches to intervention evaluation. Lastly, we are interested in studies of the impacts of COVID on chronic disease prevention and innovative COVID response and recovery interventions.

Dr. Amy Carroll-Scott
Guest Editor

Alycia Santilli
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic disease prevention
  • community-led public health planning
  • community capacity building
  • social and policy change impacting health
  • systems thinking
  • community-based participatory research

Published Papers (4 papers)

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Research

17 pages, 2051 KiB  
Article
The Reentry Health Care Hub: Creating a California-Based Referral System to Link Chronically Ill People Leaving Prison to Primary Care
by Bethany Divakaran, Natania Bloch, Mahima Sinha, Anna Steiner and Shira Shavit
Int. J. Environ. Res. Public Health 2023, 20(10), 5806; https://doi.org/10.3390/ijerph20105806 - 12 May 2023
Viewed by 1922
Abstract
People released from prison experience high health needs and face barriers to health care in the community. During the COVID-19 pandemic, people released early from California state prisons to under-resourced communities. Historically, there has been minimal care coordination between prisons and community primary [...] Read more.
People released from prison experience high health needs and face barriers to health care in the community. During the COVID-19 pandemic, people released early from California state prisons to under-resourced communities. Historically, there has been minimal care coordination between prisons and community primary care. The Transitions Clinic Network (TCN), a community-based non-profit organization, supports a network of California primary care clinics in adopting an evidence-based model of care for returning community members. In 2020, TCN linked the California Department of Corrections and Rehabilitation (CDCR) and 21 TCN-affiliated clinics to create the Reentry Health Care Hub, supporting patient linkages to care post-release. From April 2020–August 2022, the Hub received 8420 referrals from CDCR to facilitate linkages to clinics offering medical, behavioral health, and substance use disorder services, as well as community health workers with histories of incarceration. This program description identifies care continuity components critical for reentry, including data sharing between carceral and community health systems, time and patient access for pre-release care planning, and investments in primary care resources. This collaboration is a model for other states, especially after the Medicaid Reentry Act and amid initiatives to improve care continuity for returning community members, like California‘s Medicaid waiver (CalAIM). Full article
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17 pages, 1282 KiB  
Article
Research and Evaluation in a Child-Focused Place-Based Initiative: West Philly Promise Neighborhood
by Félice Lê-Scherban, Irene Headen, Adena M. Klem, Kelley Traister, Erikka Gilliam, Maggie Beverly, Matthew Jannetti, Joanne Ferroni and Amy Carroll-Scott
Int. J. Environ. Res. Public Health 2023, 20(9), 5716; https://doi.org/10.3390/ijerph20095716 - 4 May 2023
Viewed by 1659
Abstract
Place-based initiatives attempt to reduce persistent health inequities through multisectoral, cross-system collaborations incorporating multiple interventions targeted at varying levels from individuals to systems. Evaluations of these initiatives may be thought of as part of the community change process itself with a focus on [...] Read more.
Place-based initiatives attempt to reduce persistent health inequities through multisectoral, cross-system collaborations incorporating multiple interventions targeted at varying levels from individuals to systems. Evaluations of these initiatives may be thought of as part of the community change process itself with a focus on real-time learning and accountability. We described the design, implementation, challenges, and initial results of an evaluation of the West Philly Promise Neighborhood, which is a comprehensive, child-focused place-based initiative in Philadelphia, Pennsylvania. Priorities for the evaluation were to build processes for and a culture of ongoing data collection, monitoring, and communication, with a focus on transparency, accountability, and data democratization; establish systems to collect data at multiple levels, with a focus on multiple uses of the data and future sustainability; and adhere to grant requirements on data collection and reporting. Data collection activities included the compilation of neighborhood-level indicators; the implementation of a program-tracking system; administrative data linkage; and neighborhood, school, and organizational surveys. Baseline results pointed to existing strengths in the neighborhood, such as the overwhelming majority of caregivers reporting that they read to their young children (86.9%), while other indicators showed areas of need for additional supports and were programmatic focuses for the initiative (e.g., about one-quarter of young children were not engaged in an early childhood education setting). Results were communicated in multiple formats. Challenges included aligning timelines, the measurement of relationship-building and other process-focused outcomes, data and technology limitations, and administrative and legal barriers. Evaluation approaches and funding models that acknowledge the importance of capacity-building processes and allow the development and measurement of population-level outcomes in a realistic timeframe are critical for measuring the success of place-based approaches. Full article
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14 pages, 310 KiB  
Article
Coalition Building and Food Insecurity: How an Equity and Justice Framework Guided a Viable Food Assistance Network
by Alycia Santilli, Anna Lin-Schweitzer, Sofia I. Morales, Steve Werlin, Kim Hart, James Cramer, Jason A. Martinez and Kathleen O’Connor Duffany
Int. J. Environ. Res. Public Health 2022, 19(18), 11666; https://doi.org/10.3390/ijerph191811666 - 16 Sep 2022
Cited by 4 | Viewed by 2707
Abstract
Food insecurity is widespread in the United States. The COVID-19 pandemic intensified the need for food assistance and created opportunities for collaboration among historically-siloed organizations. Research has demonstrated the importance of coalition building and community organizing in Policy, Systems, and Environmental (PSE) change [...] Read more.
Food insecurity is widespread in the United States. The COVID-19 pandemic intensified the need for food assistance and created opportunities for collaboration among historically-siloed organizations. Research has demonstrated the importance of coalition building and community organizing in Policy, Systems, and Environmental (PSE) change and its potential to address equitable access to food, ultimately improving population health outcomes. In New Haven, community partners formed a coalition to address systems-level issues in the local food assistance system through the Greater New Haven Coordinated Food Assistance Network (CFAN). Organizing the development of CFAN within the framework of Collaborating for Equity and Justice (CEJ) reveals a new way of collaborating with communities for social change with an explicit focus on equity and justice. A document review exploring the initiation and growth of the network found that 165 individuals, representing 63 organizations, participated in CFAN since its inception and collaborated on 50 actions that promote food access and overall health. Eighty-one percent of these actions advanced equitable resource distribution across the food system, with forty-five percent focused on coordinating food programs to meet the needs of underserved communities. With the goal of improving access to food while addressing overall equity within the system, the authors describe CFAN as a potential community organizing model in food assistance systems. Full article
18 pages, 546 KiB  
Article
Moving from Policy to Practice for Early Childhood Obesity Prevention: A Nationwide Evaluation of State Implementation Strategies in Childcare
by Erica L. Kenney, Rebecca S. Mozaffarian, Wendy Ji, Kyla Tucker, Mary Kathryn Poole, Julia DeAngelo, Zinzi D. Bailey, Angie L. Cradock, Rebekka M. Lee and Natasha Frost
Int. J. Environ. Res. Public Health 2022, 19(16), 10304; https://doi.org/10.3390/ijerph191610304 - 18 Aug 2022
Cited by 4 | Viewed by 2102
Abstract
Policies requiring childcare settings to promote healthy eating, physical activity, and limited screentime have the potential to improve young children’s health. However, policies may have limited impact without effective implementation strategies to promote policy adoption. In this mixed-methods study, we evaluated the type, [...] Read more.
Policies requiring childcare settings to promote healthy eating, physical activity, and limited screentime have the potential to improve young children’s health. However, policies may have limited impact without effective implementation strategies to promote policy adoption. In this mixed-methods study, we evaluated the type, quality, and dose of implementation strategies for state-level childcare licensing regulations focused on healthy eating, physical activity, or screentime using: (1) a survey of state licensing staff and technical assistance providers (n = 89) in 32 states; (2) a structured review of each state’s childcare licensing and training websites for childcare providers; and (3) in-depth, semi-structured interviews with 31 childcare licensing administrators and technical assistance providers across 17 states. Implementation strategies for supporting childcare providers in adopting healthy eating, physical activity, and screentime regulations vary substantially by state, in quantity and structure. Childcare programs’ financial challenges, staff turnover, and lack of adequate facilities were identified as key barriers to adoption. Access to federal food programs was seen as critical to implementing nutrition regulations. Implementation resources such as training and informational materials were rarely available in multiple languages or targeted to providers serving low-income or racially/ethnically diverse families. There is a substantial need for implementation supports for ensuring policies are successfully and equitably implemented in childcare. Full article
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