Barriers to and Facilitators of Accessing HIV Services for Street-Involved Youth in Canada and Kenya

Introduction: UNICEF estimates that there are as many as 100 million street-involved youth (SIY) globally. Marginalized conditions put SIY at higher risk of HIV and adverse outcomes once HIV-positive. The objective of this analysis was to describe barriers and facilitators of accessing HIV prevention, testing, and treatment services as Phase I of an implementation study evaluating the use of Peer Navigators to increase access to HIV services.Methods: Semi-structured interviews, focus group discussions (FGD), and Theatre Testing were conducted with individuals who identify as SIY, health care providers, and community stakeholders living in Canada (Toronto, Montreal, London) and Kenya (Eldoret, Huruma, Kitale). Data were analyzed using a directed content approach, guided by the socio-ecological model (SEM).Results: Across the six sites were 195 participants: 64 SIY, 42 healthcare providers, and 97 community-based stakeholders. Barriers were identified at the societal (e.g. intersectional stigma and discrimination), public policy (e.g., inadequate access to basic needs, legal documentation, lack of health insurance, and limited community-based funding), institutional (e.g. lack of inclusive education and training, inadequate HIV educational outreach, and restrictive service provision), interpersonal (e.g., ineffective communication from healthcare providers), and intrapersonal levels (e.g. lack of trust and associated fear, low perception for healthcare, and lack of self-esteem). These contributed to limited HIV services utilization among SIY. Conversely, numerous facilitators were also identified at the public policy (e.g. affordable HIV services and treatment), institutional (e.g. available and accessible HIV prevention tools, HIV education and awareness programs, and holistic models of care), interpersonal level (e.g., systems navigation support, peer support, and personal relationships), and intrapersonal levels (e.g. self-efficacy) as positively supporting SIY access to HIV services.Conclusions: Intersectional stigma was a critical barrier in all sites, and policies and programs that foster welcoming environments for youth from diverse backgrounds and living circumstances may be better able to respond to the HIV service needs of this high risk population. Social support and navigation services were reported to facilitate access to HIV services in all sites.

Young People as Transformative Citizens Fighting Climate Change

The government of Indonesia has launched environmental policies to address the risks of climate change at the national to local levels and involves all elements of development: economy and business, education, environment and forestry, and transportation. In fact, behavioral change is seen as unsustainable, particularly in people's everyday lives. As this problem emerges, Indonesian young people through youth-led environmental organizations hold environmental activities to alternatively introduce and educate communities and schools to recognize and identity climate change impacts. The author then presents two successful youth organizations: Greenpeace Youth Indonesia (GYI) and the Indonesian Students Climate Forum (ICSF). GYI's actions are more stirred with Greenpeace's ideology, which focuses on direct campaigns, protest, and young activist mobilization, while ICSF's repertoires for mitigating climate changes are more community schools-based educational outreach. Although both of them are distinct in nature, their works have been transformative and applicable.

Extending the Reach of the STARs (Students Tackling Advanced Research)

Background Participating in research opportunities during undergraduate education is met with myriad benefits. Students learn the scientific research process, how to think critically, develop transferable skills, refine public speaking, build a professional network, and gain confidence. Despite the numerous benefits of undergraduate research participation, underrepresented and minority (URM) students (e.g., first-generation, low-income, and historically underrepresented students) often do not engage in these valuable undergraduate research opportunities. Objective To begin breaking down some of these historical barriers to participation, we developed the Students Tackling Advanced Research (STAR) Scholars Program. Method A holistic educational outreach program was designed to facilitate underrepresented undergraduate students’ involvement in research and help them understand why research is important in a greater context. Conclusion Students who participated in STAR Scholars self-report positive impacts on understanding what research is, ways to seek out research opportunities, and what steps to take toward future educational and professional goals. Teaching Implications It is imperative to explicitly target barriers that underrepresented students face to allow for equity and inclusion in research and academia. Workshops and activities designed to demystify research, build networking and professional skills, and provide mentorship to students are successful in breaking down these barriers and increase student confidence and competence.

Earth Science Education #6. Lessons Learned: Organizing a Geoscience Outreach Program at the University of Saskatchewan

Geology Outreach at the University of Saskatchewan was initiated during the 2018/19 academic year as a free and informal education opportunity for K–12 educators and their students in Saskatchewan. The program was 100% volunteer-run by undergraduate and graduate students in the Department of Geological Sciences at the University of Saskatchewan. We estimate reaching more than 1000 students in Saskatoon and surrounding areas following two years of outreach offerings. Hands-on activities offered included ‘Rocks and Minerals’, ‘Fossils’, ‘Meteorite Impacts’ and ‘Volcanoes’ and also involved a tour of the Museum of Natural Sciences when completed on campus. The overall intent of these activities was to foster excitement about the Earth Sciences. Typically, Educators who booked our program taught grades 4–7, where the Earth Sciences are strongly represented in Saskatchewan’s science curriculum. Most outreach offerings occurred on the University of Saskatchewan campus, but some were offered remotely at elementary schools and various Girl Guides of Canada events. During the 2019/20 academic year, we booked every outreach event planned for that year within two days and had a waiting list of more than 30 teachers across the province. The demand for geoscience outreach in Saskatchewan is high, and we hope to continue providing engaging, relevant, and fun educational outreach opportunities. University departments across Canada should allocate funds for community and school outreach initiatives and hire science communicators to oversee programs such as this.

Implementation strategies and outcomes for occupational therapy in adult stroke rehabilitation: a scoping review

Background Stroke survivors often encounter occupational therapy practitioners in rehabilitation practice settings. Occupational therapy researchers have recently begun to examine the implementation strategies that promote the use of evidence-based occupational therapy practices in stroke rehabilitation; however, the heterogeneity in how occupational therapy research is reported has led to confusion about the types of implementation strategies used in occupational therapy and their association with implementation outcomes. This review presents these strategies and corresponding outcomes using uniform language and identifies the extent to which strategy selection has been guided by theories, models, and frameworks (TMFs). Methods A scoping review protocol was developed to assess the breadth and depth of occupational therapy literature examining implementation strategies, outcomes, and TMFs in the stroke rehabilitation field. Five electronic databases and two peer-reviewed implementation science journals were searched to identify studies meeting the inclusion criteria. Two reviewers applied the inclusion parameters and consulted with a third reviewer to achieve consensus. The 73-item Expert Recommendations for Implementing Change (ERIC) implementation strategy taxonomy guided the synthesis of implementation strategies. The Implementation Outcomes Framework guided the analysis of measured outcomes. Results The initial search yielded 1219 studies, and 26 were included in the final review. A total of 48 out of 73 discrete implementation strategies were described in the included studies. The most used implementation strategies were “distribute educational materials” (n = 11), “assess for readiness and identify barriers and facilitators” (n = 11), and “conduct educational outreach visits” (n = 10). “Adoption” was the most frequently measured implementation outcome, while “cost” was not measured in any included studies. Eleven studies reported findings supporting the effectiveness of their implementation strategy or strategies; eleven reported inconclusive findings, and four found that their strategies did not lead to improved implementation outcomes. In twelve studies, at least partially beneficial outcomes were reported, corresponding with researchers using TMFs to guide implementation strategies. Conclusions This scoping review synthesized implementation strategies and outcomes that have been examined in occupational therapy and stroke rehabilitation. With the growth of the stroke survivor population, the occupational therapy profession must identify effective strategies that promote the use of evidence-based practices in routine stroke care and describe those strategies, as well as associated outcomes, using uniform nomenclature. Doing so could advance the occupational therapy field’s ability to draw conclusions about effective implementation strategies across diverse practice settings.

Palliative care provider attitudes toward existential distress and treatment with psychedelic-assisted therapies

Background Existential distress is a significant source of suffering for patients facing life-threatening illness. Psychedelic-Assisted Therapies (PAT) are novel treatments that have shown promise in treating existential distress, but openness to providing PAT may be limited by stigma surrounding psychedelics and the paucity of education regarding their medical use. How PAT might be integrated into existing treatments for existential distress within palliative care remains underexplored. Methods The present study aimed to elucidate the attitudes of palliative care clinicians regarding treatments for existential distress, including PAT. We recruited palliative care physicians, advanced practice nurses, and spiritual and psychological care providers from multiple US sites using purposive and snowball sampling methods. Attitudes toward PAT were unknown prior to study involvement. Semi-structured interviews targeted at current approaches to existential distress and attitudes toward PAT were analyzed for thematic content. Results Nineteen respondents (seven physicians, four advanced practice nurses, four chaplains, three social workers, and one psychologist) were interviewed. Identified themes were 1) Existential distress is a common experience that is frequently insufficiently treated within the current treatment framework; 2) Palliative care providers ultimately see existential distress as a psychosocial-spiritual problem that evades medicalized approaches; 3) Palliative care providers believe PAT hold promise for treating existential distress but that a stronger evidence base is needed; 4) Because PAT do not currently fit existing models of existential distress treatment, barriers remain. Conclusions PAT is seen as a potentially powerful tool to treat refractory existential distress. Larger clinical trials and educational outreach are needed to clarify treatment targets and address safety concerns. Further work to adapt PAT to palliative care settings should emphasize collaboration with spiritual care as well as mental health providers and seek to address unresolved concerns about equitable access.

Knowledge translation strategies for sharing evidence-based health information with older adults and their caregivers: findings from a persona-scenario method

Background By understanding the information seeking behaviors of older adults, we can better develop or iterate effective information technologies, such as the McMaster Optimal Aging Portal, that provide evidence-based health information to the public. This paper reports health-related information seeking and searching behaviours and provides strategies for effective knowledge translation (KT) to increase awareness and use of reliable health information. Methods We conducted a qualitative study with eighteen older adults using the persona-scenario method, whereby participants created personas and scenarios describing older adults seeking health information. Scenarios were analyzed using a two-phase inductive qualitative approach, with the personas as context. From the findings related to pathways of engaging with health information, we identified targeted KT strategies to raise awareness and uptake of evidence-based information resources. Results Twelve women and six men, 60 to 81 years of age, participated. In pairs, they created twelve personas that captured rural and urban, male and female, and immigrant perspectives. Some scenarios described older adults who did not engage directly with technology, but rather accessed information indirectly through other sources or preferred nondigital modes of delivery. Two major themes regarding KT considerations were identified: connecting to information via other people and personal venues (people included healthcare professionals, librarians, and personal networks; personal venues included clinics, libraries, pharmacies, and community gatherings); and health information delivery formats, (e.g., printed and multimedia formats for web-based resources). For each theme, and any identified subthemes, corresponding sets of suggested KT strategies are presented. Conclusions Our findings underline the importance of people, venues, and formats in the actions of older adults seeking trusted health information and highlight the need for enhanced KT strategies to share information across personal and professional networks of older adults. KT strategies that could be employed by organizations or communities sharing evidence-based, reliable health information include combinations of educational outreach and materials, decision support tools, small group sessions, publicity campaigns, champions/opinion leaders, and conferences.

PENINGKATAN PENGETAHUAN KESEHATAN MELALUI EDUKASI RESUSITASI JANTUNG PARU

Knowledge of proper CPR among the community, especially students, is still low. Improving CPR skills as the first step in handling cardiac arrest so that cardiac arrest deaths can be prevented. Basic knowledge related to correct CPR becomes the basic insight that participants must have, namely regarding techniques in providing cardiopulmonary resuscitation. Based on the above conditions, we conducted CPR education and training. The purpose of this service activity is to increase knowledge and transfer insight to training participants related to CPR according to the right rules. Service activities began with a coordination meeting with the service implementation team, the results of the meeting determined that CPR knowledge and skills education activities were carried out online on September 25, 2021 and before and after education a pretest and post-test were carried out with a Google form containing questions about the respondent's characteristics and basic knowledge. regarding cardiopulmonary resuscitation. The CPR educational outreach activity was held on September 25, 2021 at 8.00-12.00 with a total of 287 participants, consisting of 63 males and 224 females, which could take place as planned and well-organized. The counseling participants followed the counseling well even though the CPR counseling activities were online. Education about CPR is a form of knowledge transfer related to conditions that require CPR handling to extension participants. The result of the average pretest score is 39.56 and the posttest average value is 50.81, so there is an increase in the knowledge of participants who take part in CPR training by 28.43%. Cardiopulmonary resuscitation educational activities are a form of service in the health sector, it is hoped that this activity will be carried out continuously and can be carried out offline and directly practiced on CPR dolls. Education about CPR is a form of knowledge transfer related to conditions that require CPR handling.Pengetahuan RJP dengan tepat dikalangan masyarakat khususnya mahasiswa masih rendah. Peningkatan ketrampilan RJP sebagai langkah awal penanganan henti jantung sehingga kematian henti jantung dapat dicegah. Pengetahuan dasar terkait RJP yang benar menjadi wawasan dasar yang harus dimiliki peserta yaitu mengenai teknik dalam memberikan resusitasi jantung paru. Berdasarkan kondisi diatas maka kami melakukan edukasi serta pelatihan RJP. Tujuan kegiatan pengabdian ini menambah pengetahuan serta mentransfer wawasan ke peserta pelatihan terkait RJP sesuai aturan yang tepat. Kegiatan pengabdian dimulai dengan rapat koordinasi dengan tim pelaksana pengabgdian, hasil rapat ditetapkan kegiatan edukasi pengetahuan dan ketrampilan RJP dilakukan secara daring pada tanggal 25 September 2021 dan sebelum dan sesudah edukasi dilakukan pretest dan post-test dengan Googe form yang berisi pertanyaan karekteristik responden dan pengetahuan dasar mengenai resusitasi jantung paru. Kegiatan penyuluhan edukasi RJP dilaksanakan tanggal 25 September 2021 pukul 8.00-12.00 dengan total peserta kegiatan sebanyak 287 peserta, terdiri dari 63 laki-laki dan 224 perempuan dapat berlangsung sesuai rencana dan diselenggarakan dengan baik. Peserta penyluhan mengikuti penyuluhan dengan baik walaupun kegiatan penyluhan RJP secara daring. Edukasi tentang RJP merupakan salah satu bentuk transfer pengetahuan terkait kondisi yang memerlukan penanganan RJP ke peserta penyuluhan. Hasil nilai rata-rata prestest sebesar 39.56 dan nilai rata-rata posttest adalah 50.81, maka terjadi peningkatan pengetahuan peserta yang mengikuti pelatihan RJP sebesar 28,43%. Kegiatan edukasi Resusitasi Jantung Paru merupakan bentuk pengabdian di bidang kesehatan diharapkan kegiatan ini dilakukan berkelanjutan serta dapat dilakukan secara luring dan langsung dipraktekkan ke boneka RJP. Edukasi tentang RJP merupakan salah satu bentuk transfer pengetahuan terkait kondisi yang memerlukan penanganan RJP.