Dr. Daudet Ilunga Tshiswaka

The influx of African immigrants and their offspring to United States has increased the heterogeneity of the Black communities. While COVID-19 has lay bare the disproportionate impact of the virus on Black communities, the perceptions and reactions of African immigrants’ offspring to the pandemic is yet to be explored. As part of an ongoing project on COVID-19 and African Immigrants and Refugees (AIR), interviews were conducted with participants that identified as African immigrant offspring and young adults who migrated to the US. Interview questions were guided by the Social Ecological Model, and data was analyzed using thematic analysis approach. Key findings highlight the prevalence of misinformation and key information sources, crystallized into four themes: (1) knowledge of COVID-19; (2) sources of information about COVID-19; (3) cultural self-identity and US healthcare system: and (4) spirituality, healing and COVID-19. Participants had adequate knowledge, and preventive measures about COVID-19, though earlier interviews among them during the early stage of the pandemic showed confusion about the nature of the virus. The value of family networks as sources of information and misinformation, especially through social media was salient in participants’ discussion, while the overload of news media was a source of concern leading to disengagement. Participants’ cultural self-identity served as lens in interpreting their interactions with the US healthcare system, while the value of spirituality and traditional remedies to healing were discussed as tools for coping with the pandemic. Efforts to increase COVID-19 vaccine should consider the multicultural values of this population.

Excerpt - Since the mid-1990s, attention has increasingly shifted toward investigating and promoting men's involvement in maternal and child health (1). Numerous studies have highlighted the positive impact of male partner's involvement on maternal health care services. Specifically, male partner involvement in maternal care reduces risk of HIV transmission to infants of HIV-positive mothers (2), improves adherence to recommended infant feeding practices (3), and increases uptake of maternal health services such as antenatal care (4). This involvement is also linked to reduce risks of preterm births, low birth weight, fetal growth restrictions, and infant mortality (5–7). Conversely, extensive research has shown that IPV negatively influences maternal health outcomes, with affected women facing higher rates of physical trauma, suicidal ideation, and increased visits to emergency rooms (8–13).

INTRODUCTION
Community Health Workers (CHW), increase access and help navigate the complex healthcare system
Florida ranks in the bottom 20% in social, economic, physical environment, behavioral, and health outcomes (1).
Public health and medical advances have not reached the health goals in all parts of society (2)
Shortage of health professionals (including CHWs) (1,4), and social determinants of health (3) exacerbated health disparities (US, Florida)
Being familiar and trusted members (5), mobilizing CHWs to marginalized communities increases health access (IOM, 2003)
The rising CHW cadre (US, 41% between 2000 to 2005) (6), their critical roles, and responsibilities warrant effective training for CHWs
CHWs as certified, skilled, experienced cadre via effective and cost-effective training (7), could retool the health system and improve health outcomes
LHWs served in health and social services (1960s). Today, CHWs in community organizations, health departments, churches, schools, and hospitals promote health education and various health interventions
AIMS
Summarize evidence of training program development, implementation, and evaluation to explore Gaps in CHWs’ knowledge, skills, competencies, and training needs
Explore areas for additional training to enhance CHWs’ effectiveness.
Enhance healthcare delivery through appropriate training interventions

This study aims to assess relationships between previous stroke diagnosis and demographic or disability status variables, stratified by U.S. citizenship status. The 2019 and 2021 National Health Interview Survey data were analyzed for both descriptive statistics and logistic regression models. Age, sex, income level, race/ethnicity, health insurance status, and indicators of disability common after stroke were predictor variables of interest. For each disability predictor variable, higher odds of having stroke were seen regardless of citizenship status, except for the 'difficulty remembering' variable. For U.S. citizens, increasing age corresponded with higher odds of stroke diagnosis. For noncitizens, odds ratios decreased from 40.3 (95% CI 38.88-41.82) for the 40-65 age group to 29.6 (95% CI 28.38-30.77) in the 80 + group, when compared with the 18-39 age reference group. Female noncitizens had higher odds of stroke, while male citizens had higher odds. Non-Hispanic Black citizens had higher odds of stroke, while the other racial/ethnic groups had higher odds for noncitizens. The results indicated the existence of several socio-demographic disparities in stroke. Notably, noncitizens experienced stroke at a younger age and reported more severe disability outcomes after stroke diagnosis than citizens.

Introduction: Over the past two years, public health practitioners in African countries have worked actively to combat the Coronavirus Disease 2019 (COVID-19) pandemic with relatively low fatality rates. This pandemic has forced healthcare professionals to re-think and redesign the healthcare system within their own country.
Methods: Using the Afrocentric PEN-3 framework and a letter style, the purpose of this commentary was to describe the positive, existential, and negative socio-cultural values associated with African healthcare systems. The commentary also highlights socio-cultural factors affecting public trust in African healthcare systems and their health agencies and how systematically decolonizing them may decrease foreign reliance and empower efficient locally based solutions.
Results: We, as African public health practitioners, make three key points in this commentary. First, African public health practitioners have developed resilience within under-resourced healthcare systems. Secondly, oral tradition in African societies and its byproduct (social media) is the means through which people connect and share what they know about any topics (COVID-19). Thirdly, African leaders have particularly contributed to the high level of distrust in their countries' healthcare systems in favor of the healthcare systems of industrialized countries.
Conclusion: This commentary concludes with implications for encouraging African public health practitioners to cultivate the resilience that has led to contributing to the wellness of millions of Africans during this COVID-19 pandemic.

[...]the Mann-Whitney U test was used to determine whether the number of primary stroke centers differed in urban and rural counties. Constraints to the use of telestroke, however, include the availability and affordability of technology, the need for ongoing technological support, logistical challenges related to the potential need for examination assistance by a participating bedside clinician or nurse, and several legal and ethical questions about provider credentials and patient safety and privacy (15,16).

The purpose of this study was to investigate the relationship between the transnational connections of West African women immigrants and stress factors. From our extensive research, there is a scarcity of studies investigating this matter concerning transnational immigrant health. We conducted three focus group interviews with 7 transnational West African immigrants living in Chicago, Illinois. The PEN-3 model, as a cultural framework, was applied to guide the thematic analysis to explore the phenomenon of stress in West African immigrant women who maintain transnational ties between their home countries and the United States. Participants noted that a primary factor around increased stress involved trying to maintain strong ties to their native customs while acculturating to a foreign land. In particular, these women face challenges around employment and domestic responsibilities while also attempting to manage transnational responsibilities such as sending remittances back to their native land. The West African immigrant women of this study face several challenges in maintaining their home, work and social life. However, when they are resettling in a new land, these challenges affect them multidimensionally, including cultural identity, relationships and expectations, and cultural empowerment, which are elements of the PEN-3 framework. For these reasons, health researchers and intervention planners would benefit from further research into the links between the transnational connections that female African immigrants experience and their stress related coping behaviors.

Background: Because early recognition of symptoms and timely treatment of stroke can reduce mortality and the long-term effects of such events, efforts to make many people both aware of these symptoms and knowledgeable about what to do when recognising them are critical for reducing impacts from stroke.
Objectives: To assess the impact of a stroke preparedness film (intervention) and stroke preparedness pamphlets (usual care) on self-efficacy for stroke recognition and action.
Design: Two-arm cluster randomised trial conducted between July 2013 and August 2018.
Setting: A total of 13 church sites located in economically disadvantaged urban neighbourhoods in New York. Of the 883 churchgoers approached, 503 expressed interest, 375 completed eligibility screening and 312 were randomised. Participant inclusion criteria were Black or Hispanic churchgoers, aged 34 years or older, without stroke history, but at a high risk for stroke. The intervention consisted of two 12-minute stroke films: Gospel of Stroke, in English for Black participants, and Derrame Cerebral, in Spanish for Hispanic participants.
Method: Participants were pre–post-tested (at baseline, 6-month follow-up and 12-month follow-up) for self-efficacy. Descriptive analysis, a linear mixed model and t tests were used to assess the effects of a stroke preparedness film and stroke preparedness pamphlets on self-efficacy.
Results: Findings are based on intention-to-treat analysis. A total of 310 participants completed the study (99% retention rate). About half (53.8%) of participants were Black and 46.2% Hispanic in the intervention group; 48.3% were Black and 51.7% were Hispanic in the usual care group. Overall, both groups evidenced higher self-efficacy (i.e. lower predicted means) over time (p < .0001), although a significant benefit was not observed for the intervention relative to usual care.
Conclusion: Both stroke preparedness films and stroke preparedness pamphlets improved self-efficacy with respect to stroke recognition and action among minority churchgoers.

Background: The incidence of stroke in Nigeria is unknown, but stroke literacy, defined here as awareness of stroke warning symptoms and risk factors may be poor in high-risk communities. Although there is growing recognition of the use of music as a conduit to promote health literacy, African music is often overlooked as a source of health information. We sought to understand community-level perspectives on using African music to promote acute stroke literacy.
Methods: A purposive sample of education, health and music professionals, high school and university students were recruited to participate in the qualitative study. Study participants completed a brainstorming exercise that elicited their perceptions of potential barriers and facilitators to the use of music to promote acute stroke literacy in Nigeria. Content analysis was used to identify key themes emerging from the brainstorming exercise.
Results: A total of 44 individuals, comprising of 25 students with a mean age of 15.9 ± 1.6 years (52% females) and 19 professionals with a mean age of39 ± 7.7 years (57.9% males) participated in the brainstorming exercise. Facilitators to the use of music to promote acute stroke literacy in Nigeria include the cultural relevance of music, the ubiquity of music, and government involvement. Key barriers include religious beliefs that discourage the use of “secular” music, cost-related barriers, and limited government support.
Conclusions: Findings from this study provide guidance aimed at improving acute stroke literacy in Nigeria, particularly the importance of government involvement in the development and implementation of stroke literacy interventions guided by African music. Future work should consider implementing interventions that leverage the cultural elements of African music and further assess the extent to which these identified facilitators and/or bar-riers may influence stroke literacy.

Over the past half century, the Democratic Republic of the Congo (DRC), a low-income and post-conflict country, has experienced several Ebola Virus Disease outbreaks, with different fatality rates. The DRC is currently experiencing the Coronavirus Disease 2019 (COVID-19) pandemic. Using the PEN-3 cultural model, we assessed the socio-cultural factors affecting public trust in the government and its health agencies. Results of this analysis revealed the perceptions, enablers, and nurturers that impacted public trust in the government and its health agencies among the Congolese population. Future interventions designed to address the COVID-19 in the DRC should account for these socio-cultural factors.