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The far-reaching impact of the COVID-19 pandemic on Latinx communities is well-documented. This population has higher rates of COVID-19 infection and death compared with non-Latinx White Americans mainly due to long-standing problems related to Social Determinants of Health. Communication about issues such as health threats and safety measures are a vital part of public health, and need to be appropriate to the population of focus. To understand the effectiveness of public health communication to Latinx communities in Michigan during the COVID-19 pandemic, semi-structured interviews (n = 16) and three focus groups (n = 24 participants) were conducted virtually in 2021 across counties in Michigan deeply impacted by COVID-19: Washtenaw, Kent, Genesee, and Wayne. Participants shared some facilitating factors that supported effective health communication during the pandemic for their communities. For instance, in their experiences, religious and community leaders were especially effective in communicating information about the pandemic. They also expressed issues with English often being the only language of official communication; the need for bilingual options; and, the need for multiple channels of communication to reach as many people as possible. Participants also highlighted their concerns about inconsistent government communication and politicizing messages as a hindering factor that impacted effective health communication within their communities. Lessons from successes and failures experienced during the COVID-19 pandemic are vital to improving health outcomes for marginalized communities during public health crises. Future responses must ensure that public health communication is appropriate and effective for Latinx communities to better protect them. [ABSTRACT FROM AUTHOR]

Precarious work is increasingly prevalent in the United States and is associated with adverse health outcomes; however, precarious work and associated working conditions are generally not considered in residency training. Healthcare providers should understand the context and risk factors associated with precarious work to holistically serve worker-patients in clinical settings. Objectives: This cross-sectional survey aimed to examine employment characteristics and their associations with employment precarity in two high socioeconomic hardship Chicago neighborhoods. Methods: We used a community-based participatory approach to develop and administer a survey to residents who perceived their work situations to be precarious. Results: A total of 489 residents were surveyed. Responses were skewed toward the most precarious work situations, with the majority of respondents employed outside of a traditional arrangement. Those in the highest precarity category were most likely to identify as Latinx and born outside of the United States. Unstable, low-quality employment conditions were nearly all significantly associated with highest precarity work situations. Conclusions: Precarious employment is an important predictor of other employment conditions, and characterizing these at a hyperlocal level allows for a nuanced understanding of work as a determinant of health. [ABSTRACT FROM AUTHOR]

Drawing upon a long-term partnership between a university and a Title I middle school, we outline relational principles that guided our justiceoriented approach to collaborative research. We conceptualize relational principles as intentional strategies for equitable relationship cultivation and infrastructure development, grounded in the values and sociocultural backgrounds that each stakeholder brings to the partnership. Five principles emerged from our reflections, represented by the following adages: "don't assume neutrality," "recognize the means create the ends," "move at the speed of trust," "broaden ideas of benefit," and "strive for responsiveness, not perfection." Each principle is presented and described using examples that illustrate how these principles can be enacted within educational research partnerships. We conclude with a discussion of potential implications for fostering coherency among community-engaged research perspectives, with relational principles acting as a potential bridge between value-driven community-based participatory research (CBPR) approaches and practice-oriented tools from the research-practice partnership (RPP) field. [ABSTRACT FROM AUTHOR]

Background: Palliative care is seldom integrated in healthcare in fragile, conflict affected and vulnerable settings with significant refugee populations. Aim: This study aimed to evaluate the integration of palliative care into a fragile, conflict affected and vulnerable community in Northern Uganda. Design: Consecutive Rapid Participatory Appraisals were conducted to evaluate the integration of palliative care in Adjumani District. The first established a baseline and the second, 4 years later, evaluated progress. Data collection included documentary review, key informant interviews and direct observation. Setting/participants: A rural district in Uganda with equal numbers of refugees and host populations living side-by-side. 104 key informants were interviewed, and practice observed in 11 health facilities. Results: At baseline, palliative care was not routinely integrated in the health system. Barriers included health system challenges, cultural beliefs, understanding and trust, mental health issues, gaps in palliative care provision, the role of the community and beliefs about illness impacted care with the village health teams being a trusted part of the health system. Following integration activities including training, mentorship and community sensitisation, the repeat rapid appraisal after 4 years showed a significant increase in palliative care delivery. New themes identified included increased provision of palliative care, the impact of training and community engagement and ownership of palliative care. Conclusion: Community engagement and participation, training interventions and referral pathways enabled the integration of palliative care. Rapid Participatory Appraisal provides a useful framework to evaluate activities aimed at integration of palliative care in a community. [ABSTRACT FROM AUTHOR]

Youth homelessness in Canada impacts a significant number of young people. More specific to our focus, populations of young people who are more likely to experience homelessness (e.g. youth with mental health issues, 2SLGBTQIA+ youth, youth from care, and Indigenous youth) face significant barriers to accessing safe, culturally appropriate, and supportive education, suggesting rights to housing and rights to education are intersecting equity issues. This article presents findings from a participatory research project led by members of Youth Action Research Revolution, carried out in Tio’tiá:ke/Montréal, Québec, Canada. Building from experiences young people shared, this article highlights aspects of the public education system that pose problems for youth who are precariously housed or homeless, namely, the application of one-size-fits-all approaches, barriers for students with mental health or learning disability diagnoses, and the lack of clear or actionable institutional mechanisms for students to access preventative support. Following this, we outline educational discourses, practices, and processes that constitute where something may have been done differently to prevent homelessness. We conclude with possible actions to support youth homelessness prevention in schools, including creating more flexible ways for children and families to access supports, resourcing “champion” teachers, and addressing the insidious biases and discrimination in the organization of school policies.

The Arab American community has faced a history of racialization dating back to the late 19th century. The events of 9/11 and the heightened rhetoric of hate during the Trump presidency encouraged anti-Muslim sentiment and increased racial profiling and harassment. This community-based participatory research (CBPR) project uses Photovoice as a methodology to better understand the lived experiences and narratives of Arab Americans in the post-Trump1 era and as a tool for advocacy. The findings from the photo sharing sessions underscore the continued challenge of identity and representation, (in)visibility, and pushing back against anti-Arab/Muslim racism. The findings also highlight religion as a protective factor against structural and systemic racism. Overall, the participants in this study demonstrated their community resilience and navigational capital as they survived and thrived amid racializing experiences and microaggressions. Implications of this work include the need for increased consciousness raising about the lived experiences of the Arab American community and opportunities for allyship and advocacy.

ObjectiveTo examine women's perceptions of modern menstrual hygiene methods (MMHM), such as tampons and menstrual cups, focusing on socio-demographic variations and special groups in the Coimbatore district of Tamil Nadu.MethodsA qualitative study among women of reproductive age (15–49 years) group was conducted using Focus Group Discussions (FGDs) among twelve women subgroups independently in 2023.ResultsThe present study involved 23 focus group discussions (FGDs) across various groups of women, including those in formal and informal sectors, urban and rural areas, school and college students, healthcare workers, women in sports, tribal women, transgender women, and female sex workers (FSW), with a total of 188 participants. The age range varied across groups, from 15 to 45 years. Over half of the participants were married (51.1%), and 68.7% were literate, though illiteracy was higher in the informal sector, rural, tribal areas, transgender women, and FSW groups. Sanitary pads were the most used menstrual hygiene method (88.3%), followed by cloth (4.8%), and modern methods like menstrual cups or tampons (1.6%). Notably, 70% of FSW and 28.6% of tribal women still used cloths. Menstrual hygiene choices were often influenced by family recommendations, school-based menstrual hygiene sessions, institutional policies, and social media. Regarding satisfaction, 27.1% were content with their menstrual hygiene method, citing accessibility, affordability, and leakage prevention. However, issues with pads included heat, rashes, and discomfort. A significant number (31.4%) shifted from cloth to pads recently, mainly due to leakage and lack of adequate washing facilities. Only 6.1% had tried modern menstrual methods, with tampons and menstrual cups being considered more suitable but less feasible, especially among tribal women. Participant concerns ranged from the potential health risks of sanitary pads to waste disposal challenges. Recommendations included public menstrual hygiene management (MHM) dispensers, better waste collection practices, and increased awareness through advertisements. Some participants advocated for the concept of free menstruation, emphasizing informed choices and accessibility for all.ConclusionThe findings suggest that increasing access to modern menstrual hygiene products, coupled with comprehensive education and support, could improve acceptance and feasibility, especially for marginalized and underrepresented women.

Abstract Background Asians and Asian Americans have the lowest rate of mental health service utilization (25%) in the US compared to other racial/ethnic groups (39 − 52%), despite high rates of depression, anxiety, and suicidal ideation. The lack of culturally-responsive mental health trainings hinders access to mental health services for these populations. We assessed the mental health priorities of Asian communities in Greater Boston and evaluated cultural responsiveness of the Mental Health First Aid (MHFA), a first-responder training teaching participants skills to recognize signs of mental health and substance use challenges, and how to appropriately respond. Methods This is community-based participatory research with the Boston Chinatown Neighborhood Center (BCNC), Asian Women For Health (AWFH), and the Addressing Disparities in Asian Populations through Translational Research (ADAPT) Coalition. We conducted focus groups with community-based organization staff and community members to assess mental health priorities of Asian populations in Boston, MA. We then evaluated the utility and cultural-responsiveness of the English-language MHFA for Asian populations through pre- and post-training questionnaires and focus groups with community participants. Paired t-tests were used to evaluate questionnaire responses. Thematic analysis was used to analyze interviews. Results In total, ten staff and eight community members participated in focus groups, and 24 community members completed the MHFA and pre- and post-training questionnaires. Common mental health challenges in the Asian communities reported by participants were loneliness, high stigma around mental illnesses, academic pressure, and acculturation stress. Compared to pre-training, MHFA participants demonstrated lower personal mental health stigma (p

Background: Birthmark Doula Collective, a cooperative that provides doula and lactation services in the Greater New Orleans area, mounted an emergency response after two Category 4 storms: Hurricane Laura (2020) and Hurricane Ida (2021). The response included activating a no-cost emergency perinatal and infant feeding hotline. Both disasters coincided with a resurgence of COVID-19 infections in Louisiana. Research Aim: The aim of this study is to understand how an emergency perinatal and infant feeding hotline supported infant and young child feeding in emergencies during hurricanes in Louisiana. Method: This study used a cross-sectional, retrospective qualitative design in a population with low breastfeeding rates. We conducted a content analysis of 97 hotline call logs from Hurricanes Laura and Ida, focus groups with lactation support providers who staffed the hotline during either storm (n = 5), and interviews with mothers who called during Hurricane Ida (n = 2). Focus groups and interviews lasted 30 and 60 minutes, respectively. Transcripts were analyzed using thematic analysis techniques. Results: Call logs revealed infant feeding needs (e.g., mastitis, low milk supply, relactation, and infant formula requests) and non-infant feeding needs (e.g., infant supplies, perinatal and infant care referrals, shelter information). Infant formula was the most requested supply during both hurricanes. Maternal participants discussed family vulnerabilities during Hurricane Ida. Staff described training and strategies to provide support while maintaining their own well-being. Conclusion: Providing a free emergency hotline service is one way to support pregnant and postpartum people and their families seeking infant feeding advice, supplies, and support in the immediate aftermath of a disaster. [ABSTRACT FROM AUTHOR]

To understand the perspectives of individuals living within food swamps and how they may perceive their access to healthy vs. unhealthy foods before and during the COVID-19 pandemic. Additionally, we examine how they may navigate their food environment to feed themselves and their families. We recruited women of color living within a food swamp neighborhood to share their perspectives on healthy and unhealthy food access, healthy eating, neighborhood resources, and community support. We employed the Photovoice model to engage participants to take photographs and document their experiences through two surveys. A focus group was completed to identify solutions and priorities to improve healthy food access. Nine themes related to food access including marketing, food quality, and affordability were identified. Participants conveyed the “saddening” or “frustrating” experience of taking images, which allowed them to document what they feel is the unfair experience of purchasing food in their own neighborhood. Participants highlighted goals they believed would improve outcomes for their neighborhood while discussing potential stakeholders who may assist the community. Participants identified several existing community assets such as local markets and schools that should be leveraged and expanded to enhance the overall health-promoting aspects of their neighborhood. Community members are able to identify the prevalence of unhealthy foods in their neighborhoods and work diligently to combat issues of food access. After completion of the Photovoice study, participants felt more confident about their ability to influence community. [ABSTRACT FROM AUTHOR]

Background: Asians and Asian Americans have the lowest rate of mental health service utilization (25%) in the US compared to other racial/ethnic groups (39 − 52%), despite high rates of depression, anxiety, and suicidal ideation. The lack of culturally-responsive mental health trainings hinders access to mental health services for these populations. We assessed the mental health priorities of Asian communities in Greater Boston and evaluated cultural responsiveness of the Mental Health First Aid (MHFA), a first-responder training teaching participants skills to recognize signs of mental health and substance use challenges, and how to appropriately respond. Methods: This is community-based participatory research with the Boston Chinatown Neighborhood Center (BCNC), Asian Women For Health (AWFH), and the Addressing Disparities in Asian Populations through Translational Research (ADAPT) Coalition. We conducted focus groups with community-based organization staff and community members to assess mental health priorities of Asian populations in Boston, MA. We then evaluated the utility and cultural-responsiveness of the English-language MHFA for Asian populations through pre- and post-training questionnaires and focus groups with community participants. Paired t-tests were used to evaluate questionnaire responses. Thematic analysis was used to analyze interviews. Results: In total, ten staff and eight community members participated in focus groups, and 24 community members completed the MHFA and pre- and post-training questionnaires. Common mental health challenges in the Asian communities reported by participants were loneliness, high stigma around mental illnesses, academic pressure, and acculturation stress. Compared to pre-training, MHFA participants demonstrated lower personal mental health stigma (p < 0.001) and higher mental health literacy (p = 0.04) post-training. Participants also noted the lack of data statistics and case studies relevant to Asian populations in the training, and desired the training be offered in languages spoken by Asian ethnic subgroups (e.g., Chinese, Vietnamese). Conclusion: Cultural-responsiveness of the MHFA for Asian populations could be improved with the inclusion of data and case studies that capture common mental health challenges in the Asian communities and with translation of the MHFA to non-English languages predominant in Asian communities. Increasing the cultural relevance and language accessibility of the MHFA could facilitate wider adoption of these trainings across communities and help to reduce mental health stigma and gaps in literacy and service utilization. [ABSTRACT FROM AUTHOR]

Background: The Greater Lawndale Healthy Work project is a sequential mixed methods community based participatory research project that examines work as a structural determinant of health and builds community capacity for healthy work in a predominantly Black and Latinx community in Chicago known as Greater Lawndale (GL). Objectives: We interviewed community leaders in GL as key informants to understand the barriers to healthy work and inform intervention development. Methods: We conducted a directed content analysis of transcripts from 20 key informants and coded the social ecology and type of intervention. Results: Every key informant mentioned at least one asset in GL, showing an opportunity to employ a capacity-oriented approach to intervention development. Key informants suggested a variety of interventions to address precarious work across levels of the social ecology, with individual and community level interventions being the most salient. Conclusion: Through this approach, we were able to navigate tensions and challenges in conducting research for community-wide change. Key informant stakeholder interviews can be leveraged to meaningfully inform intervention development and support the development of multi-level, sustainable, and culturally acceptable interventions that advance health equity. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a ten-week research project exploring the intricacies of a co-located intergenerational program in Southeast Queensland. The research involved an early learning centre, North Early Learning, operated by a large not-for-profit organisation, Queensland Child Learning, and an aged care residence, Aged Care Living (pseudonyms). The research question underpinning this paper focused on identifying the views of educators, children, and families currently attending the early childhood education and care centre who will participate in the co-located intergenerational program. Employing a community-based participatory research approach, the study explores the perspectives of educators, children, and families participating in the program through visual children's surveys, facilitated interviews, and online surveys. The findings highlight positive attitudes from educators and families toward intergenerational programs, leading to the development of an implementation timeline aligned with the needs of educators, children, and families that are reflective of the unique context of the centre. [ABSTRACT FROM AUTHOR]

This protocol lays the groundwork for a community-centered investigation into the intersection between climate change and violence against women and girls. Providing a standardized framework, this paper will enable researchers to collect and analyze data on severe weather patterns and their potential impact on violence within communities. The interlinkage between violence and climate is an emerging field of research. There is a need for a comprehensive understanding of the intersection of these two issues focusing on the manifestations of violence, specific vulnerabilities, and coping strategies. This protocol outlines a qualitative research approach employed in Kilifi County, Kenya. The study will include key informant interviews with community leaders and policymakers, along with focus group discussions with women, adolescent girls, and men. Community engagement is a crucial component of this work as it will ensure that the research is conducted ethically and respectfully and ensure that the findings are relevant and applicable to the community being studied. This study will contribute to a deeper understanding of the complex dynamics between violence against women and girls and climate change, informing policies, interventions, and advocacy efforts and elevating the voices of women and girls to promote gender equity in the face of climate change challenges. [ABSTRACT FROM AUTHOR]

Cultural beliefs, personal experiences, and historic abuses within the healthcare system—rooted in structural racism—all contribute to community distrust in science and medicine. This lack of trust, particularly within underserved communities, contributes to decreased participation in clinical trials and a lack of representation in the data. Open dialogue about community concerns and experiences related to research participation and medical care processes can help build trust and change attitudes and behaviors that affect community health. This protocol outlines an approach to increase trust in science and clinical trials among communities in the Bronx, New York that are typically underrepresented in research data. Bridging Research, Accurate Information and Dialogue (BRAID) is a two-phased, evidence-based community engagement model that creates safe spaces for bilateral dialogues between trusted community messengers, and clinicians and scientists. The team will conduct a series of BRAID Conversation Circles on the topic of clinical trials with local trusted community messengers. Participants will be members of the community who are perceived as “trusted messengers” and can represent the community’s voice because they have insight into “what matters” locally. Conversation Circles will be audiotaped, transcribed, and analyzed to identify emergent challenges and opportunities surrounding clinical trial participation. These key themes will subsequently inform the codesign and co-creation of tailored messages and outreach efforts that community participants can disseminate downstream to their social networks. Surveys will be administered to all participants before and after each Conversation Circle to understand participants experience and evaluate changes in knowledge and attitudes about clinical trials, including protections for research participants the advantages of having diverse representation. Changes in motivation and readiness to share accurate clinical trial information downstream will also be assessed. Lastly, we will measure participants dissemination of codesigned science messages through their social networks by tracking participant specific resource URLs of materials and videos posted on a BRAID website. This protocol will assess the effectiveness and adoptability of an innovative CBPR model that can be applied to a wide range of public health issues and has the potential to navigate the ever-changing needs of the communities that surround health systems.

BackgroundPopulation mobility is prevalent and complex in sub-Saharan Africa, and can disrupt HIV care and fuel onward transmission. While differentiated care models show promise for meeting the needs of mobile populations by addressing care cascade gaps, the voices of mobile populations need to be included when designing care delivery models. We assessed the unmet needs of mobile populations and engaged mobile stakeholders in the design and implementation of service delivery to improve care outcomes for mobile people living with HIV (PLHIV).MethodsCBPR was conducted in 12 rural communities in Kenya and Uganda participating in a mobility study within the Sustainable East Africa Research in Community Health (SEARCH) test-and-treat trial (NCT# 01864603) from 2016 to 2019. Annual gender-balanced meetings with between 17 and 33 mobile community stakeholders per meeting were conducted in local languages to gather information on mobility and its influence on HIV-related outcomes. Discussions were audio-recorded, transcribed and translated into English. Findings were shared at subsequent meetings to engage mobile stakeholders in interpretation. At year three, intervention ideas to address mobile populations' needs were elicited. After refinement, these intervention options were presented to the same communities for prioritization the following year, using a participatory ranking approach.ResultsTransit hubs, trading centers, and beach sites were identified as desirable service locations. Communities prioritized mobile health 'cards' with electronic medical records and peer-delivered home-based services. Mobile health clinics, longer antiretroviral refills, and 24/7 (after service) were less desirable options. Care challenges included: lack of transfer letters to other clinics; inability to adhere to scheduled appointments, medication regimens, and monitoring of treatment outcomes while mobile amongst others.ConclusionsIterative discussions with mobile community stakeholders elicited communities' health priorities and identified challenges to achieving HIV care cascade outcomes. Understanding the mobility patterns and unique needs of mobile populations through responsive community engagement is critical.

Abstract Background Despite the effectiveness of colorectal cancer (CRC) screening, American Indians (AIs) have low screening rates in the US. Many AIs receive care at Indian Health Services, Tribal, and Urban Indian (I/T/U) healthcare facilities, where published evidence regarding the implementation of CRC screening interventions is lacking. To address this gap, the University of New Mexico Comprehensive Cancer Center and the Albuquerque Area Southwest Tribal Epidemiology Center collaborated with two tribally-operated healthcare facilities in New Mexico with the goal of improving CRC screening rates among New Mexico’s AI communities. Methods Guided by the principles of Community Based Participatory Research, we engaged providers from the two tribal healthcare facilities and tribal community members through focus group (two focus groups with providers (n = 15) and four focus group and listening sessions with community members (n = 65)), to elicit perspectives on the feasibility and appropriateness of implementing The Guide to Community Preventive Services (The Community Guide) recommended evidence-based interventions (EBIs) and strategies for increasing CRC screening. Within each tribal healthcare facility, we engaged a Multisector Action Team (MAT) that participated in an implementation survey to document the extent to which their healthcare facilities were implementing EBIs and strategies, and an organizational readiness survey that queried whether their healthcare facilities could implement additional strategies to improve uptake of CRC screening. Results The Community Guide recommended EBIs and strategies that received the most support as feasible and appropriate from community members included: one-on-one education from providers, reminders, small media, and interventions that reduced structural barriers. From the providers’ perspective, feasible and acceptable strategies included one-on-one education, patient and provider reminders, and provider assessment and feedback. Universally, providers mentioned the need for patient navigators who could provide culturally appropriate education about CRC and assist with transportation, and improved support for coordinating clinical follow-up after screening. The readiness survey highlighted overall readiness of the tribal facility, while the implementation survey highlighted that few strategies were being implemented. Conclusions Findings from this study contribute to the limited literature around implementation research at tribal healthcare facilities and informed the selection of specific implementation strategies to promote the uptake of CRC screening in AI communities.

Abstract Background Engaging patients and community members in healthcare implementation, research and evaluation has become more popular over the past two decades. Despite the growing interest in patient engagement, there is scant evidence of its impact and importance. Boot Camp Translation (BCT) is one evidence-based method of engaging communities in research. The purpose of this report is to describe the uptake by primary care practices of cardiovascular disease prevention materials produced through four different local community engagement efforts using BCT. Methods EvidenceNOW Southwest (ENSW) was a randomized trial to increase cardiovascular disease (CVD) prevention in primary care practices. Because of its study design, Four BCTs were conducted, and the materials created were made available to participating practices in the “enhanced” study arm. As a result, ENSW offered one of the first opportunities to explore the impact of the BCT method by describing the uptake by primary care practices of health messages and materials created locally using the BCT process. Analysis compared uptake of locally translated BCT products vs. all other products among practices based on geography, type of practice, and local BCT. Results Within the enhanced arm of the study that included BCT, 69 urban and 13 rural practices participated with 9 being federally qualified community health centers, 14 hospital owned and 59 clinician owned. Sixty-three practices had 5 or fewer clinicians. Two hundred and ten separate orders for materials were placed by 43 of the 82 practices. While practices ordered a wide variety of BCT products, they were more likely to order materials developed by their local BCT. Conclusions In this study, patients and community members generated common and unique messages and materials for cardiovascular disease prevention relevant to their regional and community culture. Primary care practices preferred the materials created in their region. The greater uptake of locally created materials over non-local materials supports the use of patient engagement methods such as BCT to increase the implementation and delivery of guideline-based care. Yes, patient and community engagement matters. Trial registration and IRB Trial registration was prospectively registered on July 31, 2015 at ClinicalTrials.gov (NCT02515578, protocol identifier 15–0403). The project was approved by the Colorado Multiple Institutional Review Board and the University of New Mexico Human Research Protections Office.

Background: This paper describes a UK-based study, SPICES-Sussex, which aimed to co-produce and implement a community-based cardiovascular disease (CVD) risk assessment and reduction intervention to support underserved populations at moderate risk of CVD. The objectives were to enhance stakeholder engagement; to implement the intervention in four research sites and to evaluate the use of Voluntary and Community and Social Enterprises (VCSE) and Community Health Worker (CHW) partnerships in health interventions. Methods: A type three hybrid implementation study design was used with mixed methods data. This paper represents the process evaluation of the implementation of the SPICES-Sussex Project. The evaluation was conducted using the RE-AIM framework. Results: Reach: 381 individuals took part in the risk profiling questionnaire and forty-one women, and five men participated in the coaching intervention. Effectiveness: quantitative results from intervention participants showed significant improvements in CVD behavioural risk factors across several measures. Qualitative data indicated high acceptability, with the holistic, personalised, and person-centred approach being valued by participants. Adoption: 50% of VCSEs approached took part in the SPICES programme, The CHWs felt empowered to deliver high-quality and mutually beneficial coaching within a strong project infrastructure that made use of VCSE partnerships. Implementation: Co-design meetings resulted in local adaptations being made to the intervention. 29 (63%) of participants completed the intervention. Practical issues concerned how to embed CHWs in a health service context, how to keep engaging participants, and tensions between research integrity and the needs and expectations of those in the voluntary sector. Maintenance: Several VCSEs expressed an interest in continuing the intervention after the end of the SPICES programme. Conclusion: Community-engagement approaches have the potential to have positively impact the health and wellbeing of certain groups. Furthermore, VCSEs and CHWs represent a significant untapped resource in the UK. However, more work needs to be done to understand how links between the sectors can be bridged to deliver evidence-based effective alternative preventative healthcare. Reaching vulnerable populations remains a challenge despite partnerships with VCSEs which are embedded in the community. By showing what went well and what did not, this project can guide future work in community engagement for health. [ABSTRACT FROM AUTHOR]

Background: Despite the effectiveness of colorectal cancer (CRC) screening, American Indians (AIs) have low screening rates in the US. Many AIs receive care at Indian Health Services, Tribal, and Urban Indian (I/T/U) healthcare facilities, where published evidence regarding the implementation of CRC screening interventions is lacking. To address this gap, the University of New Mexico Comprehensive Cancer Center and the Albuquerque Area Southwest Tribal Epidemiology Center collaborated with two tribally-operated healthcare facilities in New Mexico with the goal of improving CRC screening rates among New Mexico's AI communities. Methods: Guided by the principles of Community Based Participatory Research, we engaged providers from the two tribal healthcare facilities and tribal community members through focus group (two focus groups with providers (n = 15) and four focus group and listening sessions with community members (n = 65)), to elicit perspectives on the feasibility and appropriateness of implementing The Guide to Community Preventive Services (The Community Guide) recommended evidence-based interventions (EBIs) and strategies for increasing CRC screening. Within each tribal healthcare facility, we engaged a Multisector Action Team (MAT) that participated in an implementation survey to document the extent to which their healthcare facilities were implementing EBIs and strategies, and an organizational readiness survey that queried whether their healthcare facilities could implement additional strategies to improve uptake of CRC screening. Results: The Community Guide recommended EBIs and strategies that received the most support as feasible and appropriate from community members included: one-on-one education from providers, reminders, small media, and interventions that reduced structural barriers. From the providers' perspective, feasible and acceptable strategies included one-on-one education, patient and provider reminders, and provider assessment and feedback. Universally, providers mentioned the need for patient navigators who could provide culturally appropriate education about CRC and assist with transportation, and improved support for coordinating clinical follow-up after screening. The readiness survey highlighted overall readiness of the tribal facility, while the implementation survey highlighted that few strategies were being implemented. Conclusions: Findings from this study contribute to the limited literature around implementation research at tribal healthcare facilities and informed the selection of specific implementation strategies to promote the uptake of CRC screening in AI communities. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore a food-insecure, low income, predominantly African American community's experiences with a produce prescription program (PPP). Design: Researchers conducted 3 focus groups and 4 individual interviews with Maywood Veggie Rx (VRxM) participants asking questions about the logistics of the program while also exploring ideas around health, food, and community. Setting: This produce prescription program took place in Maywood, Illinois which is an urban underserved community with 23.5 K people, most of whom are Black/African American (61%) and Hispanic (32%). Participants: The 24 participants interviewed through focus groups and individual interviews were enrolled in the 2021-2022 VRxM program. Participants were mainly female, with only three participants being males. Ages ranged between 34 and 74 years of age with a mean age of 56.3. Method: Qualitative data from transcripts were then coded via a grounded theory approach to identify common themes. Results: A research team of seven including the two Co-PIs, three medical students and two dietetic interns identified 278 codes which were then condensed into 117 codes and then placed into 9 categories. Researchers identified three recurrent themes among the experiences of VRxM participants: (1) trust building, (2) culturally relevant and adaptive nutrition education, and (3) bidirectional feedback. These three themes mirror many of the principles of Community Based Participatory Research (CBPR). Conclusion: The study findings identify common themes among the experiences of VRxM which are in line with the collaborative approach of CBPR principles. Produce Prescription Programs should utilize CBPR principles in the creation and implementation of programming to improve the participant experience. Future research should include additional focus groups on new iterations of VRxM and should also include those people who chose not to participate in VRxM to explore barriers to participation. [ABSTRACT FROM AUTHOR]

Background: Engaging patients and community members in healthcare implementation, research and evaluation has become more popular over the past two decades. Despite the growing interest in patient engagement, there is scant evidence of its impact and importance. Boot Camp Translation (BCT) is one evidence-based method of engaging communities in research. The purpose of this report is to describe the uptake by primary care practices of cardiovascular disease prevention materials produced through four different local community engagement efforts using BCT. Methods: EvidenceNOW Southwest (ENSW) was a randomized trial to increase cardiovascular disease (CVD) prevention in primary care practices. Because of its study design, Four BCTs were conducted, and the materials created were made available to participating practices in the "enhanced" study arm. As a result, ENSW offered one of the first opportunities to explore the impact of the BCT method by describing the uptake by primary care practices of health messages and materials created locally using the BCT process. Analysis compared uptake of locally translated BCT products vs. all other products among practices based on geography, type of practice, and local BCT. Results: Within the enhanced arm of the study that included BCT, 69 urban and 13 rural practices participated with 9 being federally qualified community health centers, 14 hospital owned and 59 clinician owned. Sixty-three practices had 5 or fewer clinicians. Two hundred and ten separate orders for materials were placed by 43 of the 82 practices. While practices ordered a wide variety of BCT products, they were more likely to order materials developed by their local BCT. Conclusions: In this study, patients and community members generated common and unique messages and materials for cardiovascular disease prevention relevant to their regional and community culture. Primary care practices preferred the materials created in their region. The greater uptake of locally created materials over non-local materials supports the use of patient engagement methods such as BCT to increase the implementation and delivery of guideline-based care. Yes, patient and community engagement matters. Trial registration and IRB: Trial registration was prospectively registered on July 31, 2015 at ClinicalTrials.gov (NCT02515578, protocol identifier 15–0403). The project was approved by the Colorado Multiple Institutional Review Board and the University of New Mexico Human Research Protections Office. [ABSTRACT FROM AUTHOR]

In the transition to a less protectionist research ethics paradigm—in which vulnerable groups are no longer excluded from participating in research—academic researchers need to think differently about vulnerability. By means of a collective autoethnographic investigation of professional and co-researcher's experiences in a community-based participatory research (CBPR) project, this article explores how vulnerability is experienced and perceived in the work process and how to respond to vulnerability. It finds that vulnerability manifests in two main ways—that of feeling "emotional hurt" and "epistemic self-doubt"—and that it comes from two main layers: the lived life and from working within CBPR. The main argument in the article is that vulnerability is inevitable in qualitative research like CBPR, when involving persons in vulnerable life situations. We propose four key recommendations for future research: (a) accept vulnerability as an inevitable part of CBPR, (b) balance protection with participant autonomy in situ and together as a team, (c) use a processual approach because ethical risks in the research context might alter over time, and (d) accept that placing co-researchers at the center of interpretative authority can increase professional researcher's vulnerability. The article expands existing understandings of ethical issues and risk in inclusive research through a combined and innovative focus on both professional and co-researcher's lived experiences. [ABSTRACT FROM AUTHOR]

BackgroundThis paper describes a UK-based study, SPICES-Sussex, which aimed to co-produce and implement a community-based cardiovascular disease (CVD) risk assessment and reduction intervention to support under-served populations at moderate risk of CVD. The objectives were to enhance stakeholder engagement; to implement the intervention in four research sites and to evaluate the use of Voluntary and Community and Social Enterprises (VCSE) and Community Health Worker (CHW) partnerships in health interventions.MethodsA type three hybrid implementation study design was used with mixed methods data. This paper represents the process evaluation of the implementation of the SPICES-Sussex Project. The evaluation was conducted using the RE-AIM framework.ResultsReach: 381 individuals took part in the risk profiling questionnaire and forty-one women, and five men participated in the coaching intervention. Effectiveness: quantitative results from intervention participants showed significant improvements in CVD behavioural risk factors across several measures. Qualitative data indicated high acceptability, with the holistic, personalised, and person-centred approach being valued by participants. Adoption: 50% of VCSEs approached took part in the SPICES programme, The CHWs felt empowered to deliver high-quality and mutually beneficial coaching within a strong project infrastructure that made use of VCSE partnerships. Implementation: Co-design meetings resulted in local adaptations being made to the intervention. 29 (63%) of participants completed the intervention. Practical issues concerned how to embed CHWs in a health service context, how to keep engaging participants, and tensions between research integrity and the needs and expectations of those in the voluntary sector. Maintenance: Several VCSEs expressed an interest in continuing the intervention after the end of the SPICES programme.ConclusionCommunity-engagement approaches have the potential to have positively impact the health and wellbeing of certain groups. Furthermore, VCSEs and CHWs represent a significant untapped resource in the UK. However, more work needs to be done to understand how links between the sectors can be bridged to deliver evidence-based effective alternative preventative healthcare. Reaching vulnerable populations remains a challenge despite partnerships with VCSEs which are embedded in the community. By showing what went well and what did not, this project can guide future work in community engagement for health.

This article focuses on a collaboration between educators at higher education institutions in the UK, reflecting on fashion education in Northeast England and how it is evolving to support and diversify aspirations for the arts outside London. The project is supported by research backed by the British Fashion Council, aiming to explore regional initiatives to enable young creatives to have stable careers in fashion and the arts across the UK. This paper demonstrates how examples of this have been implemented through the work of the community education group This is Creative Enterprise, UAL, Teesside and Northumbria universities, through building pathways from schools to universities and encouraging dialogue between schools, industry, higher education and community groups. Case studies demonstrate participatory research projects that encourage responsible engagement with fashion, supporting regional growth, community engagement and a decentralised vision.

Youth experiencing homelessness (YEH) are infrequently included in the development, organization, and provision of homelessness-related services. This lack of youth voice and services tailored for their expressed needs can lead to underutilization of services, dissatisfaction, and poor outcomes. Photovoice, a participatory research method, has been used to empower persons from marginalized populations and to provide a platform for them to share their voices. This photovoice project partnered with six YEH (18-20 years old). Participants worked together, with the support of two group facilitators, to take photographs, identify themes, write narratives that best represented their lived experience, and share their concerns and ideas for the community. Photos and narratives were shared with decisionmakers at community-based showings. Attendees of the showings anecdotally reported having an increased awareness of YEH issues. The showings served as a catalyst in the community to address the challenges of YEH. Recommendations for research and practice are provided. [ABSTRACT FROM AUTHOR]

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This paper reflects on a music therapy community engagement project that incorporates clinical training, service learning, and community music therapy. Two faculty members and a practicum student in a Midwestern university engaged community members connected to Parkinson's disease to create a music-based program. We offer a conceptual framework that connects approaches situated within community music therapy (CoMT) qualities and community-based participatory research (CBPR) principles. We share project processes, findings, and recommendations, emphasizing all as equal stakeholders. [ABSTRACT FROM AUTHOR]

Background: Concern was voiced by Elders, teachers, and parents that and playtime activities of the Head Start preschool programme were not aligned with the local Alaska Native culture in their communities. Methods: The Alaska Native Tribal Health Consortium partnered with 12 Head Start preschool programmes, administered by Rural Alaska Community Action Program in rural Alaska, to explore with community members Alaska Native value-based solutions to the concerns they raised. Local input was gathered via focus groups, interviews, and surveys. Results: We worked together with communities to create a physical activity guide specific to preschool-age children in the region. The guide includes activity descriptions, lesson plans, flash cards, and photos of traditional Alaska Native physical activities and games specific to the region. This manuscript details the community engagement process foundational to the physical activity guide's adoption and implementation. Conclusions: The processes by which the guide was developed were strength-based and participatory. Widespread community engagement and participation led to a guide that was readily adopted because the community had taken ownership of the content. The lessons learned have been invaluable in developing long-term community-based partnerships and in setting the precedent to further incorporate local/regional culture into rural Alaska Head Start programmes. [ABSTRACT FROM AUTHOR]

ContextAdvance care planning (ACP) is underutilized, especially among Black Americans. Yet, no ACP interventions have been tested at the community level.ObjectivesWithin 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).MethodsWe 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).ResultWe 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.ConclusionCommunity 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.

BACKGROUND: A novel coronavirus, SARS-CoV-2 (known as COVID-19), spread rapidly around the world, affecting all and creating an ongoing global pandemic. In the United States, Latinx, African American, and Indigenous populations across the country have been disproportionately affected by COVID-19 cases and death rates. An examination of the perceptions and beliefs about the spread of the virus, COVID-19 testing, and vaccination amongst racial/ethnic minority groups is needed in order to alleviate the widespread disparity in new cases and deaths. METHODS: From November to December 2020 the research team conducted focus groups with members of Latinx farm-working communities in the Eastern Coachella Valley, located in the inland southern California desert region. A total of seven focus groups, six in Spanish and one in Purepecha, with a total of 55 participants were conducted. Topics covered include knowledge of the coronavirus, COVID-19 testing and vaccination. RESULTS: Using theme identification techniques, the findings identify structural factors that underly perceptions held by immigrant, migrant, and indigenous Latinx community members about COVID-19, which, in turn, shape attitudes and behaviors related to COVID-19 testing and vaccination. Common themes that emerged across focus groups include misinformation, lack of trust in institutions, and insecurity around employment and residency. CONCLUSIONS: This racial/ethnic minority population is structurally vulnerable to historical and present-day inequalities that put them at increased risk of COVID-19 exposure, morbidity, and mortality. Findings from the focus groups indicate a significant need for interventions that decrease structural vulnerabilities by addressing issues of (dis)trust in government and public health among this population.

The perspectives of Alaska Native (AN) peoples are rarely represented in quality of life (QOL) research. AN representation and voice is imperative to mitigating health disparities and in health promotion for AN peoples. To address these gaps, a sample of 15 AN people (six male, nine female) was recruited to participate in stakeholder QOL research. Five focus groups participated in activities that led participants to identify 28 themes; qualitative data analyses led researchers to identify seven additional themes. All 35 themes were integrated and reduced to the following nine culturally-grounded QOL themes: family, subsistence, access to resources, health and happiness, traditional knowledge and values, acts of self, providing, sobriety, and healing. These themes reflect the values of the participants and are exemplars of a culturally relevant, community based participatory research approach. Future research and health service implications - such as future development of a measure of AN QOL to improve wellness in healthcare settings and beyond - are discussed.

Abstract Background Co-production is an umbrella term used to describe the process of generating knowledge through partnerships between researchers and those who will use or benefit from research. Multiple advantages of research co-production have been hypothesized, and in some cases documented, in both the academic and practice record. However, there are significant gaps in understanding how to evaluate the quality of co-production. This gap in rigorous evaluation undermines the potential of both co-production and co-producers. Methods This research tests the relevance and utility of a novel evaluation framework: Research Quality Plus for Co-Production (RQ + 4 Co-Pro). Following a co-production approach ourselves, our team collaborated to develop study objectives, questions, analysis, and results sharing strategies. We used a dyadic field-test design to execute RQ + 4 Co-Pro evaluations amongst 18 independently recruited subject matter experts. We used standardized reporting templates and qualitative interviews to collect data from field-test participants, and thematic assessment and deliberative dialogue for analysis. Main limitations include that field-test participation included only health research projects and health researchers and this will limit perspective included in the study, and, that our own co-production team does not include all potential perspectives that may add value to this work. Results The field test surfaced strong support for the relevance and utility of RQ + 4 Co-Pro as an evaluation approach and framework. Research participants shared opportunities for fine-tuning language and criteria within the prototype version, but also, for alternative uses and users of RQ + 4 Co-Pro. All research participants suggested RQ + 4 Co-Pro offered an opportunity for improving how co-production is evaluated and advanced. This facilitated our revision and publication herein of a field-tested RQ + 4 Co-Pro Framework and Assessment Instrument. Conclusion Evaluation is necessary for understanding and improving co-production, and, for ensuring co-production delivers on its promise of better health.. RQ + 4 Co-Pro provides a practical evaluation approach and framework that we invite co-producers and stewards of co-production—including the funders, publishers, and universities who increasingly encourage socially relevant research—to study, adapt, and apply.

Abstract Background The Sohkitehew (Strong Heart) Research Group, which included an Elders Advisory Committee of seven Nehiyawak (Cree) women, set out to bring Maskwacîs community members together to understand Nehiyawak women’s experiences of “aging well”. The goals of this research were to generate information honouring Indigenous ways of knowing, and gather strengths-based knowledge about aging well, to help Maskwacîs, women maintain wellness as they age. Methods We facilitated qualitative Sharing Circles in three different settings in Maskwacîs. Discussions were prompted using the four aspects of the self, guided by Medicine Wheel teachings: Physical, Mental, Emotional, Spiritual. Detailed notes were recorded on flip charts during the discussions of each Sharing Circle. Data were analysed using descriptive content analysis to identify practical strategies for aging well. Results Thirty-six community members attended one or more Sharing Circle. Strategies included: Physical—keeping active to remain well; Mental—learning new skills to nourish your mind; Emotional—laughing, crying, and being happy; Spiritual—practicing Nehiyawak traditional ways. Participants commented that balancing these four aspects of the self is necessary to achieve wellness. Following the analysis of the Sharing Circle comments, three community feedback sessions were held to discuss the results in the wider community. These strategies were formatted into a draft booklet which incorporated Cree language, and archive photographs of Maskwacîs women and families. Conclusions The Nehiyawak Sharing Circles identified practical strategies that help women to remain well as they age. This positive approach to aging could be adopted in other Indigenous and non-Indigenous communities.

Resumen: Se describe la experiencia del Proyecto Alifara, un proceso participativo cuyo objetivo es impulsar acciones de promoción de la salud comunitaria. En 2020 se creó un grupo motor en la comarca rural de Els Ports, en la Comunidad Valenciana, España, donde participaron 39 personas, entre profesionales y miembros de la ciudadanía. Este grupo diseñó la primera encuesta de análisis de salud, según los determinantes de la salud que consideraron relevantes en su entorno, y se recopilaron 1180 respuestas. Los resultados se presentaron en cada pueblo mediante grupos focales o World Café, para recopilar sugerencias de mejoras y posibles acciones a implementar. Finalmente, el proceso sentó las bases para crear un consejo de salud comarcal e implementar la Estrategia de Atención Comunitaria de la Comunidad Valenciana. La participación y el trabajo en red fueron clave en el proceso, y la escasez de recursos y de formación en análisis de datos fueron las principales dificultades. Abstract: A description of the Alifara Project is provided a participatory process to promote community health. In 2020, a core working group was created in the rural region of Els Ports, in the north of the Valencian Community, Spain, with the participation of 39 people, including professionals and community members. The core group itself designed the first health needs assessment survey, based on the health determinants they considered relevant in their context, and 1180 responses were collected. The results were presented in each town through focus groups or world café to gather suggestions for health promoting activities to implement locally. Finally, the process set the basis for the creation of a local health council, to implement the new Community Health Care Plan of the Valencian Community. Community engagement and partnerships were the key to the success of the process, while the limited resources and lack of training in data analysis were the main challenges.

ABSTRACTBackground: Concern was voiced by Elders, teachers, and parents that and playtime activities of the Head Start preschool programme were not aligned with the local Alaska Native culture in their communities.Methods: The Alaska Native Tribal Health Consortium partnered with 12 Head Start preschool programmes, administered by Rural Alaska Community Action Program in rural Alaska, to explore with community members Alaska Native value-based solutions to the concerns they raised. Local input was gathered via focus groups, interviews, and surveys.Results: We worked together with communities to create a physical activity guide specific to preschool-age children in the region. The guide includes activity descriptions, lesson plans, flash cards, and photos of traditional Alaska Native physical activities and games specific to the region. This manuscript details the community engagement process foundational to the physical activity guide’s adoption and implementation.Conclusions: The processes by which the guide was developed were strength-based and participatory. Widespread community engagement and participation led to a guide that was readily adopted because the community had taken ownership of the content. The lessons learned have been invaluable in developing long-term community-based partnerships and in setting the precedent to further incorporate local/regional culture into rural Alaska Head Start programmes.

Background: The alarming increase in annual deforestation rates has had devastating consequences in climate change, and it is affecting Indigenous people, who depend entirely on the land for survival and has also weakened the rainforest's crucial role in stabilizing the global climate. Recognizing and respecting Indigenous people's needs and social, economic, and historical conditions influence health and healthcare. This study aimed to conduct online concept mapping workshops with university students to identify perceived important and feasible actions for improving the mental health of Indigenous people living in their territory in association with climate change. Methods: Concept mapping, a participatory mixed methodology, was conducted virtually with 20 Indigenous students at two universities in Brazil. A focus prompt was developed from consultations with Indigenous stakeholders and read--"To improve the mental health of Indigenous peoples in their territory during climate change crises, it is necessary to....". Results: University students organized 42 unique statements in 6 clusters that cover a wide range of topics: family support, 0.68 (SD 0.19); respect and understanding, 0.37 (SD 0.08); improvement actions, 0.52 (SD 0.07); public policies in favor of Indigenous people's mental health, 0.24 (0.09); health actions, 0.15 (SD 0.08); Indigenous training in health and its importance in improving mental health 0.32 (SD 0.07). Conclusion: These clusters range from community initiatives, public policies, health actions, and strengthening professional services in Indigenous communities. These all provide numerous concrete ideas for developing interventions designed to address mental health challenges associated with climate change. [ABSTRACT FROM AUTHOR]

Veteran community engagement is an evolving discipline informed by traditional community-based participatory research, veteran studies, and veterans themselves. This Special Issue suggests that research collaborations including military veterans, soldiers, and their families as co-researchers is a critical next step toward a design thinking perspective in social and healthcare systems for this population. This Special Issue was conceptualized through a veteran community-academic partnership formed over a decade ago. This partnership hosted several Warrior Summit conferences from 2013 to present, with the last of this series calling for academic contributions. The resulting papers drawn from the conference and other authors form this issue, and include a wide range of topics: veteran microdosing and psychedelic self-medication; a historical view of the impact of education exchange between U.S. and South Korean military nurses; strategies for engaging veterans in research of a theater-based intervention for PTSD; interprofessional approaches to addressing veteran identity considerations through collaborations between chaplain service and psychologists in the VA Healthcare System; an international perspective exploring a community collaborative with veterans in Montréal, Canada; efforts to build long-term and sustainable models for veteran engagement in health services research; community-engaged strategies to address veteran homelessness within broader housing stability efforts; and examining the role of veteran peer mentorship programs in alcohol recovery. These projects represent an emerging movement and offer a multidisciplinary roadmap toward honoring veterans voices in research, clinical services, and program development. [ABSTRACT FROM AUTHOR]

Agricultural labor is extremely hazardous, yet young children are legally permitted to work on farms. This paper contextualizes and describes Latinx hired child farmworkers' stated reasons for working. We conducted a mixed-methods study using in-depth interviews (n = 30) and survey interviews (n = 202) with Latinx child farmworkers aged 10 to 17 in North Carolina. Our qualitative thematic analysis identified children's salient reasons for working, including supporting family, contextual factors that lead to farm work, and occupying summer time. Statistical analysis showed that children's primary reasons for working included buying clothes (91.1%) and school supplies (64.7%), with few differences by gender, age, or other characteristics. The findings demonstrate that most Latinx children view farm work as a necessary but temporary experience that financially supports their families. We discuss the implications for protecting Latinx child workers by reducing their structural vulnerability in order to facilitate healthy development. [ABSTRACT FROM AUTHOR]

Objectives: There is a huge treatment gap for late‐life depression in sub‐Saharan Africa. Building on prior work to scale‐up mental healthcare with the aid of the WHO Mental Health Gap Action Programme Intervention Guide electronic version (emhGAP‐IG), this study aims to involve older people in the iterative development of innovations to overcome challenges in the detection and clinical management of late‐life depression by frontline non‐specialist primary healthcare workers (PHCW) in Nigeria. Methods: There were 43 participants in the study. We conducted formative qualitative research using 15 in‐depth key informant interviews with persons who were 60 years or older and had a recent experience of depression. We also conducted two focus group discussions comprising 13 of their caregivers. Through a full day stakeholders workshop comprising 15 participants, we drew on the results of our qualitative explorations to identify the pathway to impact of an intervention package (emhGAP‐Age) appropriate for the specific needs of persons with late‐life depression in Nigeria. Results: A Theory of Change (ToC) map was produced. It highlights the expected long‐term outcomes of emhGAP‐Age to include the potential for improvement of the mental health and wellbeing of older people living in Nigeria and the generation of interest among governmental agencies concerned with policy and planning for mental healthcare. Key resources that serve as preconditions were identified to consist of the availability of PHCW who are skilled in the identification and treatment of depression and have interest in and commitment to providing care to older people. Required community resources include support from immediate family, neighbours, and informal groups. Interventions that are appropriate for depression in old age need to incorporate these community resources and address not only the symptoms of the condition but also comorbid physical health problems. Conclusions: A participatory ToC process led to the identification of the key components of an age‐appropriate version of the emhGAP‐IG for delivering care to older persons with depression by PHCW in Nigeria. Key points: There is a large treatment gap for late‐life depression in sub‐Saharan Africa.We used participatory methodology to design an age‐appropriate depression intervention in Nigeria.We identified key resources that may serve as preconditions for depression intervention to drive change.A late life depression intervention has the potential to attract policy interest. [ABSTRACT FROM AUTHOR]

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]

To explore perceptions of community dwelling caregivers of preschool-aged children regarding the influence of social determinants of health (SDOH) on children's school readiness. Parents' perspectives regarding solutions to enhance school readiness in preschool-aged children are also explored. This study employed a qualitative, descriptive design and a community based participatory research (CBPR) approach. An academic institution collaborated with parents, teachers, and administrators at a community-based preschool learning center. Ten young-adult to middle-aged mothers and caregivers attended two separate focus groups and completed open-ended questionnaires. Inductive and deductive thematic analysis of text were employed. Three themes emerged 1) Families described the vast lack of appropriate community resources and inability to access those resources that are available to prepare their children for school 2). Family members need help processing information about social resources 3) Community, individual and systemic level solutions to enhance school readiness. Academic-Community partnerships provide an opportunity to (1) identify solutions to remove systemic barriers that impede children's readiness for school, and (2) design interventions to support families through that process. Interventions to enhance school readiness should be family-focused and can be informed by understanding the influence of SDOH during the planning stages. SDOH create barriers and prevent parents from prioritizing their children's school, health-care, and developmental needs. Interventions to enhance school readiness should be family-based and can be informed by understanding the influence of SDOH during the planning stages. Social advocacy is also needed to enhance the ability of parents to enhance their children's school readiness. • Social determinants inhibit caregiver's ability to prioritize school readiness in their children • Lack of informational, social, and economic resources can impair the ability of families to prepare their children for school • Community and systemic solutions can be identified via Academic-Community Collaborations [ABSTRACT FROM AUTHOR]

The inclusion of minorities in educational contexts requires further reflection on how to manage the processes that determine policies, investments, and best practices. The participation of minorities at all levels of the decision-making processes is crucial to achieving effective inclusion, in order to emancipate them from the reductive view of integration or mere access. In the present-day scenario, it is important and necessary to focus on who holds a key power role in transforming and changing the outcomes of participation in decision-making processes: policy-makers and decision-makers. They are the ones who have the power to decide at various levels. The aim of this paper is to reflect on some key aspects that can pave the way to the participation of minorities in decision-making processes. In the first part of the paper, the concept of participation and its applications in decision-making processes will be discussed to outline rigorous theoretical frameworks. In the second part, the focus will shift onto how scientific research can support policy-makers and decision-makers in meeting the challenge of building participatory decision-making processes.