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Countless individuals in the United States continue to experience effects related to the coronavirus disease 2019 (COVID-19) pandemic, such as job/business instability, the breaking down of school systems, isolation, and negative health consequences. There are, however, certain populations and communities that continue to be disproportionately affected, resulting in severe health outcomes, decreased quality of life, and alarmingly high death rates. These populations typically live in historically excluded communities and identify as persons of color. To advance health equity in these communities, healthy living (HL) strategies are paramount. In fact HL Medicine - getting sufficient physical activity, practicing good nutrition, maintaining a healthy body weight, and not smoking, can be a viable solution. Applying these concepts, particularly the promotion of physical activity, through community collaboration can advance the goals of social justice action., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Community based participatory research (CBPR) emphasizes democratic knowledge production and joint action between academics and communities to promote health equity through multilevel interventions. While much scholarship has expressed a commitment to collaboration between researchers and communities, effective methods of structural governance between community and academic stakeholders is under explored. We fill this gap by presenting a conceptual and empirical analysis describing multiple dimensions of structural governance in CBPR partnerships. First, we integrate public policy evidence on effective collaborative governance designs with the emerging literature in CBPR to create a conceptual model. Next, we utilize internet surveys of 179 federally funded community engaged research projects to construct and assess a measure of structural governance across multiple dimensions using confirmatory factor analysis. We explore whether antecedent factors such as the stage of the partnership and ethnic composition are associated with these dimensions and we examine associations for each of these components on positive perceptions of community involvement of research and collective empowerment. We develop a robust multidimensional measure of structural governance that is positively associated with perceptions of increased community involvement in research and collective empowerment., (© 2021 Society for Community Research and Action.)

Cultural values influence how people understand illness and dying, and impact their responses to diagnosis and treatment, yet end-of-life care is rooted in white, middle class values. Faith, hope, and belief in God's healing power are central to most African Americans, yet life-preserving care is considered "aggressive" by the healthcare system, and families are pressured to cease it.

Access to healthy and appealing food is essential for individuals to be able to live a healthy and quality life. For decades, food security has been a priority issue for public health professionals. Food sovereignty expands upon the concept of food insecurity (i.e., having access to nutritious and culturally relevant food) by incorporating people's rights to define their own food system. The expanded focus of food sovereignty on food systems prioritizes public health professionals' role in supporting environmental- and systems-level initiatives and evaluating their implications for health, economics, and the natural environment. Food sovereignty is of particular importance for Indigenous peoples (i.e., American Indian, Alaska Native, Native Hawaiian, and Pacific Islander communities). Colonization had demonstrable consequences, with many Indigenous communities being forcibly relocated from traditional lands, alongside the destruction of traditional food sources. Indigenous food sovereignty aligns with the sovereign nation status that American Indian tribes and Alaska Native communities have with the United States. Furthermore, the worldviews that incorporate Indigenous communities' relational responsibilities to care for their food systems, according to their traditional practices and beliefs (Coté, 2016; Morrison, 2011), uniquely positions Indigenous peoples to lead food sovereignty initiatives. In this article, we explore what is currently known regarding food sovereignty and health. We then discuss opportunities to expand the evidence on Indigenous food sovereignty's relationships with (1) health and well being, (2) economics, (3) the natural environment, and (4) programming facilitators and barriers. [ABSTRACT FROM AUTHOR]

Efforts to address adolescent sexual and reproductive health (ASRH) inequities often aim to improve school-based sexuality education and reduce individual risk behaviours. Structural determinants are more rarely the focus of interventions. The youth service providers who formed the community advisory board for this community-based participatory research project identified school-based opportunities to improve ASRH by mitigating the impact of social determinants and structural violence on adolescent health. Semi-structured interviews with board members revealed four areas of potential social support intervention that could mitigate these structural determinants, including mentorship, especially for young people who lack supportive relationships at home; small adult-facilitated groups and clubs at school; staffing and training to meet the needs of historically marginalised students; and school-based counselling. These findings indicate the need for school-based programmes that transcend conventional and short-term didactic forms of sexuality education, to foster social support and address interconnected structural factors affecting ASRH. [ABSTRACT FROM AUTHOR]

This manuscript reports on a youth‐driven health assessment engaging youth of color in identifying community health priorities during the coronavirus disease 2019 (COVID‐19) pandemic. Photovoice, a participatory visual ethnographic health assessment strategy, was used to explore the question: What does health or healthiness mean to you and/or your community? Youth captured images that represented their priorities. The photos were discussed using the SHOWed framework and analyzed thematically. Four themes related to community health were identified. Additionally, youth captured their narrative of COVID‐19 as "a revealing force that highlights systemic inequities, driving individuals and communities to both cultivate their resilience and take healthcare into their own hands in response to government and policy level failures." Youth are acutely aware of the historical and structural inequities that create multi‐level barriers to healthcare access. Health inequities existed long before the pandemic, but the current crisis requires us to examine ways to transform the healthcare landscape moving forward. [ABSTRACT FROM AUTHOR]

American Indian and Alaska Native (AI/AN) communities have experienced a history of systemic racism and still face significant oral health disparities. These disparities extend to the youngest community members in the form of early childhood caries (ECC). Although behavior and biology contribute to ECC, the conditions where people live, grow, and work, and the systems and political and economic forces that shape individual health outcomes, are thought to greatly impact ECC among AI/AN populations. To address ECC in AI/AN communities, we used a community based participatory approach that incorporated social determinants of health. We found that implementing culturally-tailored, culturally-centered, and AI/AN-created materials for ECC interventions is viewed favorably by community members and tribal leaders. Because of the complexity of ECC in AI/AN communities we adopted a bundled approach of best practices to reduce ECC including: (1) incorporating locally, contextually, and culturally relevant strategies to present recommended ECC prevention approaches; (2) employing AI/AN community members as educators; (3) utilizing motivational interviewing with expectant mothers; and (4) providing fluoride varnish. Our work underscores the importance of developing trusting partnerships with each other and with our communities, drawing upon the insights of community advisory board members, and eliciting formative assessment data from tribal members to gain a more holistic understanding of our participants' lived experience to design relevant intervention materials. Incorporating local knowledge and situating Western oral health prevention approaches within culturally aligned frameworks can enhance partnerships and create sustainable materials for community work. [ABSTRACT FROM AUTHOR]

Context: Advance care planning (ACP) is underutilized, especially among Black Americans. Yet, no ACP interventions have been tested at the community level.Objectives: Within an established academic and community partnership, we sought to determine whether ACP is a community-identified need and if so, to conduct a pilot study of an evidence-based ACP program, PREPARE (PrepareForYourCare.org).Methods: We conducted open discussions and in-depth interviews to determine the relevance of ACP to the community. We then conducted a pre- to 3-week postpilot study of a virtual peer facilitated brief session to introduce ACP and encourage participants to engage with PREPARE. We conducted thematic content analysis for qualitative data and used paired t-tests to assess within-participant changes in the validated ACP Engagement Survey measured on a 1-5 scale (5 = greatest engagement).Result: We conducted two discussion groups with community leaders (n = 12) and key informant interviews (n = 6), including leaders in aging, public health, health care and faith. We concluded that ACP is a community priority. In the pilot study, we enrolled 13 Black Americans; 85% were women and the mean age was 59.7 years (SD 15.1). There was a trend toward increased ACP engagement after the peer facilitated PREPARE (mean 3.2 (SD 0.6) pre vs. 3.5 (SD 0.6) post, paired t-test P = 0.06). All participants found the intervention to be acceptable and were satisfied with it.Conclusion: Community members identified ACP as important for their community. Peer facilitated PREPARE program is a promising community-based strategy to increase engagement in ACP and may promote health equity. [ABSTRACT FROM AUTHOR]

Community Based Participatory Research (CBPR), as the most cited Community‐Engaged Research (CEnR) approach in the health fields, mirrors community‐psychology's long‐term interest in participatory action research and community empowerment. This article introduces the Engage for Equity study, a long‐term National Institutes of Health‐funded inquiry to identify best partnering and collaborative practices that contribute to community capacity, empowerment and policy outcomes, and to long‐term improved health and health equity. Four articles present facets of the study: psychometrics of partnering process and outcome measures, measures and outcomes of shared governance, and description of the CBPR Model as a new equity‐ and partnership based implementation framework; and as a tool for organizational learning and quality improvement. Finally a review of CBPR and CEnR in psychology offers recommendations for the field. Though focusing on CBPR and CEnR, Engage for Equity offers lessons for all forms of participatory action research. Highlights: Engage for Equity research contributes a validated CBPR Model and measures for engaged research.Engage for Equity contributes new ways to use collective reflection tools to strengthen partnershipsOur research has contributed learnings in psychometrics of measures of processes and outcomesE2 surveys of over 400 diverse partnerships provides major national evidence of best practices [ABSTRACT FROM AUTHOR]

Background: Bottom-up approaches to disparity reduction present a departure from traditional service models where health services are traditionally delivered top-down. Raphael, a novel bottom-up social incubator, was developed in a disadvantaged region with the aim of 'hatching' innovative health improvement interventions through academia-community partnership.Methods: Community organizations were invited to submit proposals for incubation. Selection was made using the criteria of innovation, population neediness and potential for health impact and sustainability. Raphael partnered with organizations to pilot and evaluate their intervention with $5000 seed-funding. The evaluation was guided by the conceptual framework of technological incubators. Outcomes and sustainability were ascertained through qualitative and quantitative analysis of records and interviews at 12 months and 3-5 years, and the Community Impact of Research Oriented Partnerships (CIROP) questionnaire was administered to community partners.Results: Ninety proposals were submitted between 2013 and 2015 principally from non-governmental organizations (NGOs). Thirteen interventions were selected for 'incubation'. Twelve successfully 'hatched': three demonstrated sustainability with extension locally or nationally through acquiring external competitive funding; six continued to have influence within their organizations; three failed to continue beyond the pilot. Benefits to the organisations included acquisition of skills including advocacy, teaching and health promotion, evaluation skills and ability to utilize acquired knowledge for implementation. CIROP demonstrated that individuals' research skills were reported to improve (mean ± sd) 4.80 ± 2.49 along with confidence in being able to use knowledge acquired in everyday practice (5.50 ± 1.38) and new connections were facilitated (5.33 ± 2.25).Conclusions: Raphael, devised as a 'social incubator', succeeded in nurturing novel ideas engendered by community organizations that aimed to impact on health disparities. Judging by success rates of technological incubators its goals were realized to a considerable degree. [ABSTRACT FROM AUTHOR]

American Indian (AI) communities have high levels of stress and trauma and are disproportionately affected by numerous preventable diseases. Here, we describe an academic–community partnership based on a collaboration between Blackfeet Community College students and faculty in Psychology and Immunology at Montana State University (MSU). The collaboration, which has spanned over 5 years, was sparked by community interest in the relationship between stress and disease on the Blackfeet reservation. Specifically, community members wanted to understand how the experience of psychological stress and trauma may affect disease risk in their community and identify factors that promote resilience. In doing so, they hoped to identify pathways through which health could be improved for individual community members. Here, we discuss all stages of the collaborative process, including development of measures and methods and themes of research projects, challenges for community members and non‐indigenous collaborators, future directions for research, and the lessons learned. Finally, we note the ways in which this partnership and experience has advanced the science of community engagement in tribal communities, with the hope that our experiences will positively affect future collaborations between indigenous community members and non‐indigenous scientists. Highlights: We describe the development of a biomedical program of research in a Tribal Community.We found that experiences varied across generations within the tribal community.Shifting the focus to resilience stimulated more community interest in the program of research. [ABSTRACT FROM AUTHOR]

This report illustrates the importance of capacity-building to advance immunization literacy through a community-based participatory research (CPBR) approach using technology to decrease child health immunization disparities. The research project utilizes culturally-tailored immunization and technology literacy modalities for dissemination in targeted low-income neighborhoods. The results suggest successful outcomes are dependent upon contributions and engagement of community members in all project processes, ensuring community buy-in and cultural relevance. The latter approach is time-intensive due in part to the need to build broad-based community partnerships, which can result in a promising approach to foster broader population impact. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a persistent public health problem in the United States, with an estimated one in three women experiencing rape, physical violence, and/or stalking by an intimate partner within her lifetime. Non-Hispanic Black women disproportionately experience IPV, but there has been limited success in implementing culturally appropriate prevention programs and services for members of this population. Community health workers (CHWs) are trusted members of under-resourced communities who provide reliable health information and improve the cultural appropriateness of service delivery and may be a vital resource for developing new IPV interventions. Guided by the principles of community partnered participatory research, we developed the CHW-led Safe Spaces project, which aimed to establish a strong academic-community partnership to focus on issues related to experiences of IPV and the prevention of IPV in New Orleans. In this article, we describe the development of our partnership including the formation of an advisory board, creation of a broad-based stakeholder coalition, offering a community partnered participatory research training, conducting IPV education and outreach, and establishing a research agenda. Our processes are replicable and lessons learned may be relevant to other groups seeking to address IPV by leveraging the strengths of community-academic collaborations and CHWs. [ABSTRACT FROM AUTHOR]

Background This study estimates job-related risks among common low wage occupations (cleaning, construction, food service, cashier/baggers, and factory workers) held by predominantly Haitian, El Salvadorian, and Brazilian immigrants living or working in Somerville, Massachusetts. Methods A community-based cross-sectional survey on immigrant occupational health was conducted between 2006 and 2009 and logistic regression was used to assess the job-related risks among the most common low wage occupations. Results Construction workers reported significantly higher health risks, and lower access to occupational health services than the other occupations. Compared to cashier/baggers, the reference population in this study, cleaners reported significantly lower access to health and safety and work training and no knowledge of workers' compensation. Factory workers reported significantly lower work training compared to cashier/baggers. Food service workers reported the least access to doctors compared to the other occupations. Conclusion We found significant variability in risks among different low wage immigrant occupations. The type of occupation independently contributed to varying levels of risks among these jobs. We believe our findings to be conservative and recommend additional inquiry aimed at assuring the representativeness of our findings. Am. J. Ind. Med. 57:516-526, 2014. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background Racial disparities in blood pressure control are well established; however the impact of low health literacy (LHL) on blood pressure has garnered less attention. Office based interventions that are created with iterative patient, practice and community stakeholder input and are rolled out incrementally, may help address these disparities in hypertension control. This paper describes our study protocol. Methods/design Using a community Based Participatory Research (CBPR) approach, we designed and implemented a cohort study that includes both a practice level and patient level intervention to enhance the care and support of patients with hypertension in primary care practices in a rural region of eastern North Carolina. The study is divided into a formative phase and an ongoing 2.5 year implementation phase. Our main care enhancement activities include the integration of a community health coach, using home blood pressure monitoring in clinical decision making, standardizing care delivery processes, and working to improve medication adherence. Main outcomes include overall blood pressure change, the differential change in blood pressure by race (African American vs. White) and health literacy level (low vs. higher health literacy). Discussion Using a Community based participatory approach in primary care practice settings has helped to engage patients and practice staff and providers in the research effort and in making practice changes to support hypertension care. Practices have engaged at varying levels, but progress has been made in implementing and iteratively improving upon the interventions to date. [ABSTRACT FROM AUTHOR]

A key tenet of community-based participatory research is that communities be involved in all facets of research, from defining the problem to identifying solutions, to assisting in the research, and to participating in the publication of results. In this study, we instituted a small grants program for community participation. A Request for Applications (RFA) was developed and circulated widely throughout the Valley. The RFA sought proposals to address health disparities in cancer education, prevention, and treatment among Hispanics living in the Valley. Funds available were $2,500.00–3,500.00 for 1 year’s worth of work. To help evaluate the progress of the RFA community projects according to the perspectives of the Community Advisory Board (CAB), an open-ended, semi-structured interview was created and administered by a former staff member to CAB members. In 4 years, ten small grants proposed by community members were funded. Funds allocated totaled approximately $25,000. Interviews with CAB members indicated that the RFA program was perceived positively, but there were concerns about sustainability. Our community grants program resulted in the implementation of several novel cancer prevention programs conducted by a variety of community organizations in the Lower Yakima Valley. [ABSTRACT FROM AUTHOR]

The purpose of this study is to observe Cuba's working healthcare models in an effort to improve ethnic health disparities in south Los Angeles through generating a new level of synergy by mobilizing resources to create academic-community partnerships and apply lessons learned. During a three-year period beginning in 2005, a team of 12-14 Charles R. Drew University and UCLA faculty, south Los Angeles community leaders, and health providers completed three one-week visits to Cuba to survey the country's approach to various health problems and ascertain their potential to improve health conditions in south Los Angeles. Various methods such as opinion surveys, evaluations, and team meetings were used to measure the direction and progress of translating lessons learned into creating a working relationship with community leaders. After two visits, opinion surveys demonstrated an increase in the response to acknowledging that there were lessons learned. However, respondents acknowledged that they encountered difficulty in attempting to make these changes. One outcome from these visits resulted in a community forum at which community leaders and residents from south Los Angeles heard various speakers present on lessons learned in Cuba. In conclusion, after observing Cuba's approach to health problems that are also encountered in south Los Angeles, the team has begun to plan research projects and next steps to incorporate lessons learned into current programs with the community. [ABSTRACT FROM AUTHOR]

Lebanon is one of the most unequal countries in the world, whose economy, social welfare and public health system struggle to meet the needs of the Lebanese and over one million Syrian refugees. Researchers applied Community Based Participatory Research (CBPR) methodology in collaboration with a non-governmental organization (NGO) in an underserved Beirut neighborhood from 2014 through 2016, aiming to address health inequities, build social cohesion among refugees and host populations, and empower community members to develop a community health intervention. We recruited a community advisory board (CAB), conducted six focus groups and sixteen individual interviews, and held several community meetings. In response to the study findings, NGO staff, researchers and community members agreed to work together on a trash collection initiative as a community health intervention. Ultimately, we found the CBPR toolkit to be insufficient to the empirical reality: a series of structural challenges due to entrenched local and national hierarchies, ineffective political processes, and inter- and intra-group conflict driven by competition over privatized social services. Together these resulted in a lack of trust in the collaborative process wherein study participants solicited researchers for aid in return for their involvement, mirroring the Lebanese patronage system. Ultimately, the most expedient path toward change was not through empowerment of oppressed community participants, but through the action of already powerful local individuals. In conclusion, structural inequalities limit the participatory and emancipatory possibilities of CBPR research. Power mapping exercises, which are often used in community organizing, offer an important opportunity to assess viability and lay the groundwork for CBPR projects. Academic and popular media in the Middle East often focus on religious, sectarian conflict; however, in our study conflict both between and among social groups was driven by competition over material resources more than cultural or religious differences. • Participation has been fetishized as a silver bullet for empowering communities. • Participation alone cannot remedy structural inequality. • Power analysis and redistribution are essential to achieve transformative change. • CBPR can reinforce existing hierarches, become entangled in local power struggles. • Global health programs should prioritize continuity in program design. [ABSTRACT FROM AUTHOR]