Positive deviance control-case life history: a method to develop grounded hypotheses about successful long-term avoidance of infection

Friedman, Samuel R.; Mateu‐Gelabert, Pedro; Sandoval, Milagros; Hagan, Holly; Jarlais, Don C. Des

doi:10.1186/1471-2458-8-94

Cited by 55 publications

(50 citation statements)

References 44 publications

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“…Drawing on a positive deviance control-case design (Friedman, Mateu-Gelabert, Sandoval, Hagan, & Des Jarlais, 2008), we undertook qualitative life history interviews with PWID in order to explore the social conditions of long term hepatitis C avoidance.…”

Section: Methodsmentioning

confidence: 99%

Opioid pharmacotherapy: Treatment, regimes, constructions and control

Neale¹

2013

International Journal of Drug Policy

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Section: Methodsmentioning

confidence: 99%

Opioid pharmacotherapy: Treatment, regimes, constructions and control

Neale¹

2013

International Journal of Drug Policy

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“…Nonetheless, findings have highlighted ways to support positive deviants in becoming leaders to affect social network norms, including condom use uptake among Rwandan youth with high rates of HIV seroprevalence and early sexual debut, increased responsibility for condom and contraceptive use among gang-affiliated youth in Rio de Janeiro, and strategies to stay HIV-negative among injection drug users in New York. [55][56][57] Intervention designs that consider novel approaches, including participatory methods, to address structural and place-based inequities can impact a range of factors affecting the health and well-being of adolescents. To this end, building on positive social network ties that may lead to increased educational aspirations to decrease substance use may also, for instance, protect against unplanned pregnancy among gang-affiliated youth.…”

Section: Discussionmentioning

confidence: 99%

Homies with Aspirations and Positive Peer Network Ties: Associations with Reduced Frequent Substance Use among Gang-Affiliated Latino Youth

Dommelen-Gonzalez

Deardorff²,

Herd³

et al. 2015

J Urban Health

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In marginalized urban neighborhoods across the USA, Latino youth are disproportionately represented among the growing number of youth gangs. Substance use among gang-involved youth poses both immediate and long-term health risks and can threaten educational engagement, future socioeconomic stability, and desistance. Conventional assessments of gang-affiliated youth and their peer network overlook the possibility that positive peer ties may exist and can foster health promoting behavior norms. Drawing on a positive deviance framework, in this study, we examine the relationship between positive peer network characteristics tied to post-secondary educational aspirations and frequent alcohol and marijuana use among Latino, gangaffiliated youth from a neighborhood in San Francisco. Using generalized estimating equations regression models across 72 peer network clusters (162 youth), we found that having close friends who plan to go to a 4-year college was associated with a lower odds of frequent marijuana and alcohol use (OR 0.27, p=0.02; OR 0.29, p=0.14, respectively) and that this association persisted when adjusting for risk characteristics (OR 0.19, pG0.01; OR 0.25, p=0.12). Public health can advance gang intervention efforts by identifying protective and risk factors associated with non-criminal health outcomes to inform participatory research approaches and asset-based interventions that contribute to building healthy communities.

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“…Conversely, recognizing and building on existing assets can help reduce resignation and dependence. 76 Communities often include people who thrive despite adverse environments. Their wisdom and strategies for leveraging local resources can sometimes be turned into larger programs.…”

Section: Clinical Applicationmentioning

confidence: 99%

Capability and Clinical Success

Ferrer¹,

Carrasco²

2010

The Annals of Family Medicine

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Better outcomes for chronic diseases remain elusive because success depends on events outside the control of the health care system: patients' ability to mange their health behaviors and chronic diseases. Among the most powerful infl uences on self-management are the social and environmental constraints on healthy living, yet the clinical response to these environmental determinants is poorly developed. A potential approach for addressing social determinants in practice, as well as planning and evaluating community responses, is the capability framework. Defi ned as the real opportunity to achieve a desired lifestyle, capability focuses attention on the material conditions that constrain real opportunity and how opportunity emerges from the interaction between personal resources and the social environment. Using examples relevant to chronic disease and behavior change, we discuss the clinical application of the capability framework. CASE HISTORYM rs R. is a 48-year-old Latina who suffers from type 2 diabetes mellitus, hypertension, dyslipidemia, and obesity. She has been regularly attending appointments at the practice for 3 years. Despite ongoing adjustment of her medications, her glycosylated hemoglobin level has never been less than 8.5%. Her history and refi ll intervals suggest that she takes her medications regularly. She has attended nutrition and diabetes education programs. Her physician, Dr M., initially believed that she was motivated to manage her illnesses but is growing increasingly frustrated by the lack of clinical progress. THE EPIDEMIOLOGICAL CONTEXTUnhealthy behaviors and the chronic diseases associated with them account for much of the morbidity and mortality in modern societies. Developing effective solutions is complicated by the burden of morbidity falling most heavily on those with the fewest resources. [1][2][3] Reducing these health disparities has proved especially diffi cult, with little progress during the past 20 years. 4,5 DISCONNECT BETWEEN PROCESS AND OUTCOME IMPROVEMENTSIn the struggle to manage chronic diseases, a growing number of clinical studies point to a disconnect between process-of-care improvements and clinical outcomes. [6][7][8][9] One reason for this disconnect is that success depends on events outside the control of the health care system: patients' ability to alter unhealthy behaviors and manage their diseases.6 The chronic care model therefore emphasizes the importance of patients as active partners. To promote patient participation, clinical strategies have broadened to include more holistic concerns, such as health literacy, [10][11][12][13] self-effi cacy, 14 16 These approaches represent important advances, and they have improved outcomes.12,17 Yet they are themselves limited in scope. They aim to enhance patients' confi dence, motivation, and problem-solving skills, but place less emphasis on evaluating whether the external environment offers real opportunities for change. 18 For example a review of the current national standards for diabetes self-m...

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Positive deviance control-case life history: a method to develop grounded hypotheses about successful long-term avoidance of infection

Abstract: Background: Prevalence rates for long-term injection drug users in some localities surpass 60% for HIV and 80% for HCV. We describe methods for developing grounded hypotheses about how some injectors avoid infection with either virus.

Cited by 55 publications

References 44 publications

Opioid pharmacotherapy: Treatment, regimes, constructions and control

Opioid pharmacotherapy: Treatment, regimes, constructions and control

Homies with Aspirations and Positive Peer Network Ties: Associations with Reduced Frequent Substance Use among Gang-Affiliated Latino Youth

Capability and Clinical Success

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