A Social Ecological Model of Syndemic Risk affecting Women with and At-Risk for HIV in Impoverished Urban Communities.

A Social Ecological Model of Syndemic Risk affecting Women with and At-Risk for HIV in Impoverished Urban Communities.
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在贫困的城市社区中影响艾滋病毒和艾滋病毒的妇女的联合风险的社会生态模型。

DOI:
10.1007/s10464-015-9750-y
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发表时间:
2015-12
影响因子:
3.1
通讯作者:
Lounsbury DW
Lounsbury DW
中科院分区:
心理学2区
文献类型:
--
作者:
Batchelder AW;Gonzalez JS;Palma A;Schoenbaum E;Lounsbury DW

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综合性流行病风险是一种生态结构,由共同发生的相互依存的社会环境、人际和个人内部决定因素定义。我们假设,在贫困的城市社区中,艾滋病毒感染者和高危妇女的综合风险是暴力、物质使用、经济困难、情绪困扰和自我价值的函数。为了更好地了解这些相互关系,我们开发并验证了一个系统动力学(SD)模型的基础上同行评议的文献;二次数据分析的队列数据集,包括妇女的艾滋病毒感染者和风险在纽约州布朗克斯(N = 620);和输入从布朗克斯为基础的社区咨询委员会。模拟模型的输出结果显示,随着时间的推移,不同的样本配置文件的不同水平和模式的综合风险。产出产生了新的见解,如何有效地探索多成分多层次的方案,以战略发展更有效的服务,这一人口。具体而言,该模型表明,有效的多层次干预措施可以通过提高自我价值来增强妇女的复原力,从而减少人们认为的经济困难和暴力风险。总的来说,我们的知情模型描述了自我价值如何成为脆弱性的主要驱动力,以及对影响这一人群的流行病学理论的有意义的补充。
Syndemic risk is an ecological construct, defined by co-occurring interdependent socio-environmental, interpersonal and intrapersonal determinants. We posited syndemic risk to be a function of violence, substance use, perceived financial hardship, emotional distress and self-worth among women with and at-risk for HIV in an impoverished urban community. In order to better understand these interrelationships, we developed and validated a system dynamics (SD) model based upon peer-reviewed literature; secondary data analyses of a cohort dataset including women living with and at-risk of HIV in Bronx, NY (N = 620); and input from a Bronx-based community advisory board. Simulated model output revealed divergent levels and patterns of syndemic risk over time across different sample profiles. Outputs generated new insights about how to effectively explore multicomponent multi-level programs in order to strategically develop more effective services for this population. Specifically, the model indicated that effective multi-level interventions might bolster women’s resilience by increasing self-worth, which may result in decreased perceived financial hardship and risk of violence. Overall, our stakeholder-informed model depicts how self-worth may be a major driver of vulnerability and a meaningful addition to syndemic theory affecting this population.
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