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The overall objective of this research was to elucidate the ecosystem of women’s health social enterprises (WHSEs) based in the United States. The Aim I was to conduct a secondary data analysis of a random national sample of non-profit WHSEs based in the United States regarding their characteristics and areas of intervention. Aim II was to conduct a qualitative assessment of a sample of WHSEs based in the United States regarding their perspectives on the ecosystem of WHSEs. Aim I utilized the GuideStar database and assessed enterprise size, geographic location, financial distress, health intervention area, and health activity category using descriptive statistics, statistical tests, and multivariable regression analysis via SPSS. Aim II utilized in-depth interviewing and grounded theory analysis via MAXQDA 2018 to identify novel themes and core categories while using an established framework for mapping social enterprise ecosystems as a scaffold.

Aim I findings suggest that WHSE activity is more predominant in the south region of the United States but not geographically concentrated around cities previously identified as social enterprise hubs. WHSEs take a comprehensive approach to women’s health, often simultaneously focusing on multiple areas of health interventions. Although most WHSEs demonstrate a risk for financial distress, very few exhibited severe risk. Risk for financial distress was not significantly associated with any of the measured enterprise characteristics. Aim II generated four core categories of findings that describe the ecosystem of WHSE: (1) comprehensive, community-based, and culturally adaptive care; (2) interdependent innovation in systems, finances, and communication; (3) interdisciplinary, cross-enterprise collaboration; and (4) women’s health as the foundation for family and population health. These findings are consistent with the three-failures theory for non-profit organizations, particularly that WHSEs address government failure by focusing on the unmet women’s health needs of the underserved populations (in contrast to the supply of services supported by the median voter) and address the market failure of over exclusion through strategies such as cross-subsidization and price discrimination. While WHSEs operate with levels of financial risk and are subject to the voluntary sector failure of philanthropic insufficiency, the data also show that they act to remediate other threats of voluntary failure.

Aim I findings highlight the importance of understanding financial performance of WHSEs. Also, lack of significant associations between our assessed enterprise characteristics and their financial risk suggests need for additional research to identify factors that influence financial performance of WHSE. Aim II findings show that WHSEs are currently engaged in complex care coordination and comprehensive biopsychosocial care for women and their families, suggesting that these enterprises may serve as a model for improving women’s health and health care. The community-oriented and interdisciplinary nature of WHSE as highlighted by our study may also serve as a unique approach for research and education purposes. Additional research on the ecosystem of WHSE is needed in order to better inform generalizability of our findings and to elucidate how WHSE interventions may be integrated into policies and practices to improve women’s health.

The purpose of this chapter is to review how well walking interventions have increased and sustained walking, and to provide suggestions for improving future walking interventions. A scoping review was conducted of walking interventions for adults that emphasised walking as a primary intervention strategy and/or included a walking outcome measure. Interventions conducted at the individual, community, and policy levels between 1990 and 2015 were included, with greater emphasis on recent interventions. Walking tends to increase early in interventions and then gradually declines. Results suggest that increased walking, and environmental-change activities to support walking are more likely to be sustained when they are immediately followed by greater economic benefits/time-savings, social approval, and/or physical/emotional well-being. Adaptive interventions that adjust intervention procedures to match dynamically changing environmental circumstances also hold promise for sustaining increased walking. Interventions that incorporate automated technology, durable built environment changes, and civic engagement, may increase cost-efficiency. Variations in outcome measures, study duration, seasons, participant characteristics, and possible measurement reactivity preclude causal inferences about the differential effectiveness of specific intervention procedures for increasing and sustaining walking. This review synthesises the effects of diverse walking interventions on increasing and sustaining walking over a 25-year period. Suggestions are provided to guide future development of more effective, sustainable walking interventions at the population level.

Global evidence indicates that multiple structural, biological, and behavioural mechanisms link gender-based violence (GBV), HIV/HCV, and substance misuse among women and adolescent girls. The aim of this chapter is to briefly summarise and synthesise recent literature that examines the complex and bi-directional relationships among these epidemics in different populations of adolescent girls and women around the world. To inform this chapter, a selective search strategy was conducted, prioritising use of meta-analytic epidemiological studies and research on interventions and policies that address different aspects of the syndemic among women and girls who use drugs worldwide. The search targeted publications from 2015 to 2019 using PubMed, MEDLINE, and Google Scholar. The chapter highlights methodological and geographic gaps in existing policy, intervention, and implementation research and makes recommendations for strategies to tackle these gaps. It also identifies a continuum of multilevel evidence-based interventions that target the risk environments and key syndemic mechanisms linking these intersecting epidemics that have been found to be effective in reducing intimate partner violence and other forms of GBV, substance use, and HIV/HCV risks. This chapter also assesses inclusiveness of existing research and interventions for underserved and disproportionately affected populations, affecting adolescent girls, sexual minority women, and racial/ethnic minority women and identifies strategies to target gaps or disparities for these key affected populations. Finally, this chapter describes the gaps and opportunities that harm reduction programmes, medical settings, and other community organisations experience in implementing gender-responsive programmes and policies to redress these intersecting epidemics.

This chapter is dedicated to the exploration of attitudes toward family planning within marginalized communities in Bangladesh. It begins by elucidating the concept of attitudes and underscoring their significance in the context of family planning. This chapter investigates the intricate relationship between attitudes and family planning decisions, revealing the diverse attitudes prevalent within these marginalized communities. It proposes targeted interventions aimed at breaking down attitudinal barriers that hinder effective family planning practices, with the goal of empowering these communities through a transformative process of attitude change. This comprehensive examination of attitudes toward family planning among marginalized populations contributes valuable insights to the fields of public health and social development.

Proponents of community engagement to promote social change advocate bringing together researchers, practitioners, politicians, business leaders, advocates and other relevant stakeholders to identify and solve community problems and issues. This chapter will describe the need for academic and community partnerships, how academic institutions can develop priorities, governance and financial structures that facilitate stronger, more effective community relationships and make contributions to the resolution of social ills. The current literature on community engagement, community-based participatory research, community action research, community-engaged scholarship and service-learning are reviewed. The principles and tenets of engaged scholarship are reviewed, barriers to implementation are discussed and examples provided. Academic institutions can play an important role in social change if they are willing to embrace community engagement. A key to success is building trust, sharing power, fostering co-learning, enhancing strengths and resources, building capacity, and addressing community-identified needs. Academic participation requires institutional and faculty commitment to engagement principles, flexible and inclusive governance structures and strategies to educate community members. The development of the relationships and structures required for successful community engagement can be inhibited by imbalances in power and knowledge that often exist among practitioners, researchers, and community members. This review may assist academic institutions to examine implementation of tenure and promotion policies, oversight strategies and structures that assure community development and benefit, as well as opportunities for faculty, staff and student training on principles and best practices of community-engaged research.

The chapter presents a critical analysis of the reception system for non-asylum seeking unaccompanied migrant children in Calabria, a region of South Italy. It focuses on the main features of local welfare for migrants’ children emerging from a qualitative research carried out by mixing different sources: analysis of literature and semi-structured interviews to different stakeholders (politician, local administrators, juvenile judges, social workers, management of foster-care communities, and educators). Shortages in individualized planning, lack of resources for qualifying the educational staff, economic difficulties of local administrators, frequent absence of a cultural and linguistic mediator, lengthy delays in appointing tutelary judge, weakness of social territorial services to support communities, difficulties in organizing training and creating job opportunities, lack of verification and monitoring of inclusion interventions, organizational isolation of reception communities, fragility of networking and sporadic collaboration among different stakeholders involved in protection system, and inadequate collection of data and information about migrant children hosted in foster-care communities are salient limits of the local policies and interventions for non-asylum seeking migrants’ children. The chapter also includes a brief presentation of latest innovation in this policies filed, highlighting some of the best practices in education, training, and employment conducted in the Protection System for Refugees and Asylum Seekers, better organized, more specialized, and supported by the national government.

The chapter situates the role of narrative power in shifting media policy amidst calls for police abolition, defunding, and media reparations following the documentation of media harm. Community-based narrative intervention is not only focused on those aspects of reporting and media that deal with harms perpetuated by discourses on public safety, but also about developing what I refer to as “collective narrative self-determination” to reflect the needs and desires of communities. The chapter documents how grassroots media efforts attempt to reconfigure the space of media policy and shift narratives toward the community power needed to reckon with the consequences of vital public resources being systematically defunded for budgets and policies that entail greater police powers. The chapter concludes this is an important moment for community-based initiatives and interventions that can shift media narratives around policing and urban violence and also shift who is served by those narratives, contributing to the long-term process of building narrative power and racial justice across a wide range of community and media organizations.

School-going young people in South Africa engage in HIV risk behaviour despite high levels of HIV knowledge and a variety of interventions focusing on HIV prevention. The lack of empirical evidence on the effectiveness of current interventions leaves programme implementers with little consensus about how best to prevent HIV infection among young people. This research was done to explore factors underlying HIV risk of young people with the aim of developing HIV prevention in the third decade of the epidemic. Focus group discussions were conducted with young people, educators and parents in eight schools in four provinces of the country. A thematic analysis revealed risk factors especially on the interpersonal and community level. Peer pressure, gender norms and culture, poverty and financial gain and a culture of alcohol use were prominent themes. Negative family relationships, lack of role models and lack of sexual education from home contributed to risk behaviour. Community processes such as exposure to media, lack of recreational facilities, and an erosion of supportive culture and community structures created an environment which did not support healthy behaviour. Factors that prevented risk behaviour were identified as self-respect, open communication with parents, implementation of school programmes, positive peer pressure and a focus on young people's future. Prevention programmes should therefore not only focus on individual factors but should be multi-layered interventions involving various community structures aimed at changing the social ecology in communities to support an alternative lifestyle for young people.