Conference Program: APHA, Chicago, November 2015

Annual Meeting of the American Public Health Association, Chicago, 2015

Papers related to Israel:

 

Daoud, Nihaya. “Challenges for Maternal and Child Health Research in The Bedouin Indigenous Minority In Israel.” November 2, 2015, 8:50am.

This presentation focuses on the challenges and opportunities of maternal and child health research among Indigenous Arab Bedouin mothers in Israel.

Bedouins are Israeli citizens who have been living in the south for many decades. They are Israel’s most economically deprived minority and have poor health status. Bedouin infants have higher morbidity and mortality rates compared to their counterparts.

We conducted this study in 2007-2008 to better understand maternal experiences of infant care while drawing on social-ecological approaches to raise Bedouin mothers’ voices and inform policy and interventions.

Multiple factors embedded in Bedouins’ political and historical context complicate research, mainly land disputes with Israeli governments, changes in societal socioeconomic structure from monadic to semi-urban, and socio-cultural transitions including family structure and gender relations. Israeli governments do not recognize Bedouins as an indigenous minority, 40% of them live in legally unrecognized villages with houses that are continually threatened with demolition. These villages lack basic infrastructure including water, electricity, primary care clinics and social services. Conducting research among Bedouins requires building trust and recognizing their health and human rights while understanding their complex political, historical, and social contexts. Building on local knowledge is crucial and requires outstanding research methods. Other issues include attaining ethics approval, maintaining confidentiality, and overcoming language barriers as mothers lack basic reading and writing skills. Funding opportunities and scholarly publication requires additional effort and time. Recognizing these challenges might provide an opportunity for more advanced research among Bedouins and other indigenous populations.

 

Shapiro, Ephraim and Irit Elroy. “Mental Health Care Utilization Among the Most Traditionally Religious Jews and Muslims in Israel in an Era of Reform.” November 3, 2015, 2:30pm.

Background: Israel recently implemented mental healthcare system policy reform, with uncertain impact on utilization among subgroups. The most traditionally religious segments of Israeli society, including both Jews and Muslims,  have distinctive attitudes, behaviors and demographics, all of which can impact mental healthcare usage and the reform’s success. Prior research found some underutilization among the most religious Israelis despite universal health insurance ,  for reasons such as stigma,   yet the topic has been understudied.

Research Questions: 1) To what extent do Haredi/ultraorthodox Jews and traditional Arab Muslims in Israel seek and/or receive mental healthcare 2) Do results vary by key subgroups including religion and socioeconomic status?  3)What interventions can potentially be developed to increase use of needed mental health services among religious groups?

Methodology/Results: A random-sample survey of health utilization among all Israelis conducted in 2013 was analyzed. Outcomes included Mental healthcare utilization measures and attitudinal measures related to potential barriers. Religious group was categorized by self-report. Univariate and bivariate analyses were performed using health, religious, and socioeconomic factors. Chi-square statistics were produced. Over 2000 Israelis were surveyed including 275 Haredi/ultraorthodox  Jews and 225 traditional Muslims.  Variations were found by some but not all religious and socioeconomic subgroups. In addition, key informant interviews with religious, community and medical leaders were conducted and faith-based intervention opportunities identified

Conclusions:  Culturally-sensitive interventions can potentially be developed to increase appropriate mental health care utilization for religious Israelis. This issue is particularly timely after mental health reform when opportunities to change relevant attitudes and behaviors exist.

 

Shapira, Stav, Limor Aharonson-Daniel,Yaron Bar-Dayan, Deanna Sykes, and Bruria Adini. “Is Earthquake Preparedness a Generic Achievement? Similarities and Differences between Preparedness of Canadian and Israeli Hospital Personnel.” November 3, 2015, 4:30pm.

Background: Healthcare workers (HCW) willingness to report to work (WTR) during a disaster is essential to implementing an efficient response. A better understanding of the mechanisms underlying this matter may contribute to reduced absenteeism in future disasters. Assessing preparedness and WTR in an earthquake scenario, in different social contexts and preparedness approaches (Canada and Israel) may shed light on the complexity of these issues.

Objectives: 1) To assess knowledge, perceptions, attitudes and WTR of HCW in Canada and Israel concerning earthquakes and 2) To evaluate the relationship between these factors and WTR.

Methods: A validated questionnaire including questions about demographic characteristics, knowledge, perceptions, attitudes and WTR in an earthquake scenario was distributed in two tertiary care hospitals located in risk regions, to a random sample of 131 Israeli and 381 Canadian HCW.

Results: Knowledge, perceptions of efficacy, as well as WTR were generally higher among Israeli HCWs. ‘Concern for family’s well-being’ and ‘professional commitment to care’ were reported by the largest proportion of HCW as factors that might influence WTR. Significant predictors of WTR amongst both Israeli and Canadian HCW were the belief that ‘colleagues will also report to work’ and ‘professional commitment’.

Conclusions: Significant differences were found in levels of knowledge, perceptions, attitudes and WTR in an earthquake scenario between Israeli and Canadian HCW. Social and professional solidarity seems to be cross-cultural factors that mitigate other potential barriers to WTR. This may help formulate new methods of improving hospital personnel preparedness to future events.

 

Shapiro, Ephraim and Rachel Nisanholtz. “Community Nurses and Chronic Disease in Israel, the United States, and the United Kingdom: A Comparative Analysis.” November 4, 2015, 11:00am.

Background: The growing worldwide trend of chronic disease harms not only the public’s health but increases costs. Public health and other community nurses can play important roles in its prevention and control. These nurses can play vital roles in advancing national health system objectives. However, despite this there has been inadequate comparative study of community nurses’ role in preventing and controlling chronic disease.

Objectives: 1)What roles do public health and other community nurses play for  chronic disease prevention and control? 2)What trends and related challenges exist for these nurses in terms of chronic disease prevention and control? 3)How do these nurses’ roles, trends and challenges vary across Israel, the U.S., and the U.K and what lessons can be learned?

Methodology:  Key informant interviews and a comprehensive literature review were performed and themes related to the objectives analyzed. An average of 10 interviews was performed among nursing leaders and/or academic experts in each of the three countries.

Key Findings/Conclusions: The role of nurses in non-hospital settings has grown rapidly; further growth is expected to occur, with variations by type of nurse. They have a multiplicity of roles and can reach a wide variety of groups. There are important implications for reducing health disparities as nurses can play important roles in monitoring social determinants. While there is much overlap, important differences exist between community nurses in different settings; countries can learn from each other’s successes and challenges although contextual differences such as cultural, institutional, and policy and differences need to be understood.

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