Can we Build on Social Movement Theories to Develop and Improve Community-Based Participatory Research? A Framework Synthesis Review

Equitable community-based participatory research engagement with communities of color drives All of Us Wisconsin genomic research priorities

OBJECTIVE

The NIH All of Us Research Program aims to advance personalized medicine by not only linking patient records, surveys, and genomic data but also engaging with participants, particularly from groups traditionally underrepresented in biomedical research (UBR). This study details how the dialogue between scientists and community members, including many from communities of color, shaped local research priorities.

MATERIALS AND METHODS

We recruited area quantitative, basic, and clinical scientists as well as community members from our Community and Participant Advisory Boards with a predetermined interest in All of Us research as members of a Special Interest Group (SIG). An expert community engagement scientist facilitated 6 SIG meetings over the year, explicitly fostering openness and flexibility during conversations. We qualitatively analyzed discussions using a social movement framework tailored for community-based participatory research (CBPR) mobilization.

RESULTS

The SIG evolved through CBPR stages of emergence, coalescence, momentum, and maintenance/integration. Researchers prioritized community needs above personal academic interests while community members kept discussions focused on tangible return of value to communities. One key outcome includes SIG-driven shifts in programmatic and research priorities of the All of Us Research Program in Southeastern Wisconsin. One major challenge was building equitable conversations that balanced scientific rigor and community understanding.

DISCUSSION

Our approach allowed for a rich dialogue to emerge. Points of connection and disconnection between community members and scientists offered important guidance for emerging areas of genomic inquiry.

CONCLUSION

Our study presents a robust foundation for future efforts to engage diverse communities in CBPR, particularly on healthcare concerns affecting UBR communities.

Adopting, implementing and assimilating coproduced health and social care innovations involving structurally vulnerable populations: findings from a longitudinal, multiple case study design in Canada, Scotland and Sweden

BACKGROUND

Innovations in coproduction are shaping public service reform in diverse contexts around the world. Although many innovations are local, others have expanded and evolved over time. We know very little, however, about the process of implementation and evolution of coproduction. The purpose of this study was to explore the adoption, implementation and assimilation of three approaches to the coproduction of public services with structurally vulnerable groups.

METHODS

We conducted a 4 year longitudinal multiple case study (2019-2023) of three coproduced public service innovations involving vulnerable populations: ESTHER in Jönköping Region, Sweden involving people with multiple complex needs (Case 1); Making Recovery Real in Dundee, Scotland with people who have serious mental illness (Case 2); and Learning Centres in Manitoba, Canada (Case 3), also involving people with serious mental illness. Data sources included 14 interviews with strategic decision-makers and a document analysis to understand the history and contextual factors relating to each case. Three frameworks informed the case study protocol, semi-structured interview guides, data extraction, deductive coding and analysis: the Consolidated Framework for Implementation Research, the Diffusion of Innovation model and Lozeau's Compatibility Gaps to understand assimilation.

RESULTS

The adoption of coproduction involving structurally vulnerable populations was a notable evolution of existing improvement efforts in Cases 1 and 3, while impetus by an external change agency, existing collaborative efforts among community organizations, and the opportunity to inform a new municipal mental health policy sparked adoption in Case 2. In all cases, coproduced innovation centred around a central philosophy that valued lived experience on an equal basis with professional knowledge in coproduction processes. This philosophical orientation offered flexibility and adaptability to local contexts, thereby facilitating implementation when compared with more defined programming. According to the informants, efforts to avoid co-optation risks were successful, resulting in the assimilation of new mindsets and coproduction processes, with examples of how this had led to transformative change.

CONCLUSIONS

In exploring innovations in coproduction with structurally vulnerable groups, our findings suggest several additional considerations when applying existing theoretical frameworks. These include the philosophical nature of the innovation, the need to study the evolution of the innovation itself as it emerges over time, greater attention to partnered processes as disruptors to existing power structures and an emphasis on driving transformational change in organizational cultures.

Nourishing the Mind: How Food Security Influences Mental Wellbeing

Food insecurity is a significant public health problem worldwide and critical to mental health. There is a complex relationship between food security and mental health. We carried out a narrative review study aiming to address how food insecurity impacts mental wellbeing by focusing on the mental health repercussions of food insecurity, recognizing its pivotal role in attaining Sustainable Development Goals 2 (on hunger) and 3 (on enhancing global wellbeing). A comprehensive search was conducted on PubMed and Google Scholar, incorporating Google searches for pertinent reports and policy documents. To address these questions, we emphasized and elucidated the interconnectedness between food security and mental health. The review shows that food security and mental health share a profound relationship influenced by multifaceted factors like socioeconomic conditions, access to nutritious food, and societal inequalities. We then provide recommendations for integrating food security into mental health strategies based on the insights and conclusions drawn. Strategies ranging from sustainable farming practices to urban agriculture initiatives and digital mental health services demonstrate avenues for enhancing food safety and mental wellbeing. This highlights the need for collaborative interdisciplinary efforts and systemic reforms to address these interconnected challenges.

Social movements and collective behavior: an integration of meta-analysis and systematic review of social psychology studies

Background

The impact of social movements (SMs) and collective behavior (CB) supports the relevance of approaching this phenomenon from social psychology. Several systematic reviews (10) and meta-analyses (6) have been carried out in the 21st century, but there is a lack of integration.

Aim

This study seeks to review the patterns of CB and corroborate the psychosocial factors that explain participation in CB and SMs, as well as the long-term psychological effects of participating in them.

Method

A systematic search was carried out in the databases Web of Science, Scopus, ProQuest, ScienceDirect, Willey Online Library, EBSCO, and JSTOR for articles dated between 1969 and 2022. We searched for meta-analyses and systematic reviews that empirically evaluated social movements and collective behavior. Of the 494 initial records, after scanning and eligibility phases, 16 meta-analyses and systematic reviews were analyzed in the present work.

Results

The evidence reviewed shows that participation in collective gatherings and CB are common. A cross-cultural survey suggests that collective gatherings are mostly of a leisure type, to a lesser extent religious and sporting, and to an even lesser extent, demonstrations and large religious rites. World Value surveys found that one to three persons out of 10 participate in protests or CB related to SMs and four out of 10 movements achieved some kind of success. Studies challenged that CBs were characterized by unanimity of beliefs, identification and behavior, generalized excitement, as well as mass panic and riot after catastrophes. Only two out of 10 CB are violent. Meta-analysis and systematic reviews confirm that participation in CB and SMs was associated with (a) intergroup conflict and realistic threat (r = 0.30); (b) positive attitudes, expectations, or agreement with goals or collective motive (r = 0.44); (c) cognitive fraternal relative deprivation (r = 0.25); (d) collective efficacy (r = 0.36); (e) collective identity (r = 0.34); (f) emotions and affective relative deprivation (r = 0.35); (g) moral conviction and threat to moral (r = 0.29); and (h) disagreement with system justification belief (r = -0.26). Participation in successful CB and SMs provokes positive changes in emotions, social identity and social relationships, values and beliefs, and empowerment, as well as negative effects such as depression, stress, burnout, and disempowerment related to the failures of SMs.

Conclusion

Studies confirm the importance of explanatory factors for SMs, with data from various cultural regions. There is a lack of systematic studies of CB as well as meta-analyses and more culturally diverse studies of the effects of participation in them.

Community-based participatory interventions to improve food security: A systematic review

Introduction

This systematic review aimed to evaluate community-based participatory (CBP) interventions to improve food security and/or its dimensions to highlight the scope and characteristics of interventions and extract the characteristics of effective interventions.

Methods

The electronic databases, including PubMed/MEDLINE, SCOPUS, EMBASE, Web of Science, and Google Scholar, were searched from 1980 to 30 August 2022 for relevant studies. We included randomized controlled trials (RCTs), cluster randomized controlled trials (cRCTs), controlled before and after studies (CBAs), non-randomized controlled trials (nRCT), and interrupted time series (ITS) studies to identify the community-based participatory interventions. The indicators of food and nutrition security into four dimensions, as well as food insecurity measured as score and/or prevalence of food insecurity based on validated perception-based measures were considered outcome. Two reviewers independently evaluated the studies for eligibility, extracted data, and evaluated the risk of bias in the included studies using the Effective Public Health Practice Project (EPHPP). The quality of included reports was categorized as strong (when there were no weak ratings), moderate (when one factor was rated as weak), or weak (when two or more factors were rated as weak). A descriptive analysis of the findings was performed.

Results

A total of twelve studies were included. The quality of all eligible studies (n = 12) was rated as moderate/weak. Most CBP interventions were guided by formative research (n = 9, 75%). Two main groups for utilized strategies were identified: agricultural and nutrition strategies. Agricultural strategies included agricultural education, preparing and improving soil and seeds, promoting and supporting gardening/harvesting utilizing traditional skills based on the local culture, and agroecological practices. Nutrition strategies included store and shopping programs, farmers' markets, fresh fruit and vegetable programs, nutrition education programs for mothers, and food vouchers. The main outcomes improved in the CBP interventions were food security (n = 2) and its dimensions, including availability (n = 3), access (n = 5), and utilization (n = 2). All agroecological practices achieved statistically significant outcomes in the intended food security target(s). However, nutritional interventions were not effective for some access components such as mean adequacy ratio, fruit and vegetable intake, and nutrition environment of the stores. No studies evaluated stability outcome components of food security.

Discussion

CBP interventions guided by formative research data and agroecological practices were promising strategies to improve food security and its dimensions. Insufficient data on the stability components of food security and weak design studies were the considerable gaps in the research evidence reviewed. More research employing randomized experimental designs with adequate sample size and high retention rates is required.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/], identifier [CRD42020189477].

Reflecting and rejuvenating our work, together: One team's consideration of AJCP publications on gender-based violence

Community psychology has long valued reflexive praxis as a critical part advancing our research and action. In this Virtual Special Issue (VSI), we, a group of community psychologists and gender-based violence (GBV) researchers at many different points in our careers, reflected on GBV publications that have appeared in AJCP. We examine the ways in which community psychology broadly and articles in AJCP more specifically have conceptualized GBV as a sociocultural issue, how GBV intersects with other oppressions and forms of violence, the tension when systems that aspire to support survivors are inequitable and focused on ameliorative change, and the importance of interventions being locally informed and locally driven. By highlighting selected GBV-focused articles published in AJCP, this VSI discusses (a) understanding and transforming culture via robust research and local partnerships, (b) targeting effective interventions for survivors, (c) invoking systems and targeting change in institutional environments, and (d) making connections between local efforts and broader social movements. To continue to move forward, we conclude we must reflect, embrace methodological plurality, partner, and push for structural change. Reflective questions regarding research and action are offered, to address gender-based violence.

Development of a multidimensional culturally and socially inclusive measure of factors that support resilience: Child Resilience Questionnaire-Child report (CRQ-C)-a community-based participatory research and psychometric testing study in Australia

OBJECTIVE

Development and testing of a comprehensive and social and culturally inclusive child-report measure of resilience factors supporting positive outcomes in the face of adversity.

DESIGN

The measure is based on a socioecological model of resilience and was developed and revised using community-based participatory research methods with Aboriginal and refugee background communities. Pilot testing and validation of the child-report version (Child Resilience Questionnaire-Child report (CRQ- C)) is described in this paper.

SETTING

Australia.

PARTICIPANTS

Children aged 7-12 years from culturally and socially diverse backgrounds completed the CRQ- C in the pilot (n=387) and validation study (n=775). Families recruited via hospital clinics, Aboriginal and refugee background communities and nested follow-up of participants in an existing cohort study.

ANALYSIS

The factor structure and construct validity of CRQ-C scales were assessed using exploratory and confirmatory factor analyses. Preliminary assessment of criterion validity was conducted usinghe Strengths and Difficulties Questionnaire (SDQ). Internal consistency of final scales was assessed using Cronbach's alpha.

RESULTS

Conceptually developed CRQ-C was over inclusive of resilience factors and items. Exploratory factor analyses and confirmatory factor analyses supported 10 subscales reflecting personal resilience factors (positive self/future, managing emotions) and connectedness to family, school and culture. Excellent scale reliability (α=0.7-0.9) for all but one scale (Friends, α=0.6). Significant negative correlation between CRQ-C and SDQ total difficulty score supporting criterion validity (r_s=-0.317, p<0.001).

CONCLUSION

The CRQ-C is a new culturally and socially inclusive self-report measure of resilience factors in childhood, with demonstrated content, construct and scale reliability. Further testing of criterion validity required. Availability of child and parent report CRQ supports broad applications in clinical, research and intervention work. Socially inclusive and culturally appropriate tools are fundamental to create the evidence needed to assess and guide intervention efforts.

Development and validation of a multidimensional, culturally and socially inclusive Child Resilience Questionnaire (parent/caregiver report) to measure factors that support resilience: a community-based participatory research and psychometric testing study in Australia

OBJECTIVE

Develop a comprehensive socially inclusive measure to assess child resilience factors.

DESIGN

A socioecological model of resilience, community-based participatory research methods and two rounds of psychometric testing created the Child Resilience Questionnaire (parent/caregiver report, child report, school report). The parent/caregiver report (CRQ-P/C) is the focus of this paper.

SETTING

Australia.

PARTICIPANTS

Culturally and socially diverse parents/caregivers of children aged 5-12 years completed the CRQ-P/C in the pilot (n=489) and validation study (n=1114). Recruitment via a large tertiary hospital's outpatient clinics, Aboriginal and refugee background communities (Aboriginal and bicultural researchers networks) and nested follow-up of mothers in a pregnancy cohort and a cohort of Aboriginal families.

ANALYSIS

Exploratory and confirmatory factor analyses conducted to assess the structure and construct validity of CRQ-P/C subscales. Cronbach's alpha used to assess internal consistency of subscales. Criterion validity assessed with the Strengths and Difficulties Questionnaire (SDQ) parent report.

RESULTS

Conceptually developed CRQ comprised 169 items in 19 subscales across five socioecological domains (self, family, friends, school and community). Two rounds of psychometric revision and community consultations created a CRQ-P/C with 43 items in 11 scales: self (positive self, positive future, managing emotions), family (connectedness, guidance, basic needs), school (teacher support, engagement, friends) and culture (connectedness, language). Excellent scale reliability (α=0.7-0.9), except basic needs scale (α=0.61) (where a highly endorsed item was retained for conceptual integrity). Criterion validity was supported: scales had low to moderate negative correlations with SDQ total difficulty score (R_s= -0.2/-0.5. p<0.001); children with emotion/behavioural difficulties had lower CRQ-P/C scores (β=-14.5, 95% CI -17.5 to -11.6, adjusted for gender).

CONCLUSION

The CRQ-P/C is a new multidomain measure of factors supporting resilience in children. It has good psychometric properties and will have broad applications in clinical, educational and research settings. The tool also adds to the few culturally competent measures relevant to Aboriginal and refugee background communities.

Stakeholder Engagement In a Comparative Effectiveness/Implementation Study to Prevent Staphylococcus Aureus Infection Recurrence: CA-MRSA Project (CAMP2)

BACKGROUND

Methicillin-resistant or methicillin-sensitive Staphylococcus aureus skin and soft tissue infections pose serious clinical and public health challenges. Few protocols exist for outpatient education, decolonization and decontamination.

OBJECTIVES

This trial implemented infection prevention protocols in homes via community health workers/Promotoras.

METHODS

We engaged clinicians, patient stakeholders, clinical and laboratory researchers, New York-based federally qualified health centers and community hospital emergency departments. The Clinician and Patient Stakeholder Advisory Committee (CPSAC) convened in person and remotely for shared decision-making and trial oversight.

RESULTS

The intervention trial consented participants with skin and soft tissue infections from Methicillin-resistant Staphylococcus aureus or methicillin-sensitive Staphylococcus aureus, completed home visits, obtained surveillance cultures from index patients and household members and sampled household environmental surfaces at baseline and three months.

LESSONS LEARNED

The retention of the CPSAC during the trial demonstrated high levels of engagement.

CONCLUSIONS

CPSAC was highly effective throughout design and execution by troubleshooting recruitment and home visit challenges.

Identifying evidence of effectiveness in the co-creation of research: a systematic review and meta-analysis of the international healthcare literature

Background

To investigate and address the evidence gap on the effectiveness of co-creation/production in international health research.

Methods

An initial systematic search of previous reviews published by 22 July 2017 in Medline, Embase, PsycINFO, Scopus and Web of Science. We extracted reported aims, elements and outcomes of co-creation/production from 50 reviews; however, reviews rarely tested effectiveness against intended outcomes. We therefore checked the reference lists in 13 included systematic reviews that cited quantitative studies involving the public/patients in the design and/or implementation of research projects to conduct meta-analyses on their effectiveness using standardized mean difference (SMD).

Results

Twenty-six primary studies were included, showing moderate positive effects for community functions (SMD = 0.56, 95%CI = 0.29–0.84, n = 11) and small positive effects for physical health (SMD = 0.25, 95%CI = 0.07–0.42, n = 9), health-promoting behaviour (SMD = 0.14, 95%CI = 0.03–0.26, n = 11), self-efficacy (SMD = 0.34, 95%CI = 0.01–0.67, n = 3) and health service access/receipt (SMD = 0.36, 95%CI = 0.21–0.52, n = 12). Non-academic stakeholders that co-created more than one research stage showed significantly favourable mental health outcomes. However, co-creation was rarely extended to later stages (evaluation/dissemination), with few studies specifically with ethnic minority groups.

Conclusions

The co-creation of research may improve several health-related outcomes and public health more broadly, but research is lacking on its longer term effects.

Structural Community Governance: Importance for Community-Academic Research Partnerships

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.

Cultural Sources of Strength and Resilience: A Case Study of Holistic Wellness Boxes for COVID-19 Response in Indigenous Communities

The COVID-19 pandemic has had disproportionately severe impacts on Indigenous peoples in the United States compared to non-Indigenous populations. In addition to the threat of viral infection, COVID-19 poses increased risk for psychosocial stress that may widen already existing physical, mental, and behavioral health inequities experienced by Indigenous communities. In recognition of the impact of COVID-19 related psychosocial stressors on our tribal community partners, the Johns Hopkins Center for American Indian Health Great Lakes Hub began sending holistic wellness boxes to our community partners in 11 tribal communities in the Midwestern United States and Canada in summer of 2020. Designed specifically to draw on culturally relevant sources of strength and resilience, these boxes contained a variety of items to support mental, emotional, cultural, and physical wellbeing. Feedback from recipients suggest that these wellness boxes provided a unique form of COVID-19 relief. Additional Johns Hopkins Center for American Indian Health offices have begun to adapt wellness boxes for the cultural context of their regions. This case study describes the conceptualization, creation, and contents of these wellness boxes and orients this intervention within a reflection on foundations of community-based participatory research, holistic relief, and drawing on cultural strengths in responding to COVID-19.

Co-creating a social science research agenda for clean sport: An international Delphi study

BACKGROUND

Doping in sport is a significant issue. To date, research informing doping prevention has lacked a framework guiding research priorities. To ensure research is coordinated, sustainable and focused on end-user priorities, this study co-created the first research agenda for doping prevention.

METHODS

The Delphi method was used to develop this agenda. Based upon two substantive reviews of the doping literature and 12 focus groups across five countries, a questionnaire was developed assessing the importance of 15 research topics and identifying research questions.  Eighty-two anti-doping stakeholders with relevant expertise were invited to be panel members. In Round 1, an expert panel (n = 57; 70% response rate) completed this questionnaire. In Round 2, panel members (n = 33; 58% response rate) ranked for relative importance the eight topic areas rated highest in Round 1, before doing the same for research questions within each topic. Based on these rankings, a draft agenda was created. In Round 3, panel members (n = 26; 79% response rate) rated the degree to which they accepted this agenda, the feasibility of its delivery and identified possible barriers and facilitators to implementation.

RESULTS

The results of Round 1 and Round 2 were used to create a draft agenda consisting of 18 research questions stratified across eight topic areas. This agenda was either fully (n = 16) or mostly (n = 9) accepted by the panel in Round 3 (96.2%). Research topics included the effectiveness of interventions/education programmes, environmental influences, long-term development of protective and risk factors in athletes and their entourage, athletes' experiences of anti-doping procedures and athletes' place in the anti-doping system.

CONCLUSIONS

A rigorous exercise created an agenda for doping prevention research. Adoption and application of this agenda should lead to better coordination, more efficient use of funding, enhanced uptake of research findings and more effective doping prevention education.

Development and Evaluation of an Online Education-Entertainment Intervention to Increase Knowledge of HIV and Uptake of HIV Testing among Colombian Men Who Have Sex with Men (MSM)

Using a community-based participatory approach, we developed a film to promote HIV testing among young men who have sex with men (MSM) in Bogotá. Using a 5-step process to develop the intervention, we conducted 11 focus groups with MSM (n = 141) to receive community feedback at each step. To evaluate the intervention we recruited 300 young MSM to complete a baseline survey in December 2017. Between February–June 2018, 63 participants watched the film and completed a post-viewing survey, which showed the intervention was acceptable for the target population. Between August–December 2018, 48 MSM who watched the film and 47 who did not (control group) completed a follow-up survey. To obtain preliminary evidence of the efficacy of the intervention, we assessed the main effect of time (baseline vs. follow-up) and the interaction between time and group (intervention vs. control) on HIV testing uptake and intentions, and knowledge of HIV transmission dynamics and HIV-related rights. Knowledge of HIV rights increased from baseline to follow-up in the intervention group only. HIV Knowledge increased for both groups. HIV testing intentions increased significantly more for non-gay-identified men in the intervention group, but the overall effect of the intervention was not significant. Testing uptake did not change.

Best Practices for Community-Engaged Research with Pacific Islander Communities in the US and USAPI: A Scoping Review

This scoping review identifies the best practices of community-based participatory research with Pacific Islanders in the United States and United States Affiliated Pacific Islands. Eighty-four articles from January 2000 to December 2017 were included in the review. Best practices included the importance of engaging Pacific Islander community leaders as research staff, community co-investigators, and community advisory board members. Best practices also focused on removing barriers to research by using participants' native languages, conducting research within the geographic community, and spending significant time to build trust. Novel best practices included honoring Pacific Islanders' cultural practices such as protocols for engagement, reciprocity, and social and spiritual inclusiveness and honoring Pacific Islanders' collectivist cultural structure. The goal of this scoping review is to aid community-academic partnerships working to improve the health of Pacific Islanders.

A review of reviews on principles, strategies, outcomes and impacts of research partnerships approaches: a first step in synthesising the research partnership literature

Background

Conducting research in partnership with stakeholders (e.g. policy-makers, practitioners, organisations, patients) is a promising and popular approach to improving the implementation of research findings in policy and practice. This study aimed to identify the principles, strategies, outcomes and impacts reported in different types of reviews of research partnerships in order to obtain a better understanding of the scope of the research partnership literature.

Methods

This review of reviews is part of a Coordinated Multicenter Team approach to synthesise the research partnership literature with five conceptually linked literature reviews. The main research question was ‘What principles, strategies, outcomes and impacts are reported in different types of research partnership approaches?’. We included articles describing a literature review of research partnerships using a systematic search strategy. We used an adapted version of the Revised Assessment of Multiple Systematic Reviews tool to assess quality. Nine electronic databases were searched from inception to April 2018. Principles, strategies, outcomes and impacts were extracted from the included reviews and analysed using direct content analysis.

Results

We included 86 reviews using terms describing several research partnership approaches (e.g. community-based participatory research, participatory research, integrated knowledge translation). After the analyses, we synthesised 17 overarching principles and 11 overarching strategies and grouped them into one of the following subcategories: relationship between partners; co-production of knowledge; meaningful stakeholder engagement; capacity-building, support and resources; communication process; and ethical issues related to the collaborative research activities. Similarly, we synthesised 20 overarching outcomes and impacts on researchers, stakeholders, the community or society, and the research process.

Conclusions

This review of reviews is the first that presents overarching principles, strategies, outcomes and impacts of research partnerships. This review is unique in scope as we synthesised literature across multiple research areas, involving different stakeholder groups. Our findings can be used as a first step to guide the initiation and maintenance of research partnerships and to create a classification system of the key domains of research partnerships, which may improve reporting consistency in the research partnership literature.

Trial registration

This study is registered via Open Science Framework: 10.17605/OSF.IO/GVR7Y.

At the Margins: Comparing School Experiences of Nonbinary and Binary-Identified Transgender Youth

BACKGROUND

Transgender, nonbinary, and gender nonconforming (TNG) young people are a diverse group, including young people with gender identities beyond the gender binary. Whereas nonbinary youth experience disparities in victimization and mental health, school belonging, support, and resources have not been well described.

METHODS

We conducted an online survey of TNG young people (ages 12-22) in Wisconsin to assess school belonging, safety, support, and resources. We compared responses among participants with nonbinary versus binary identities using mulvariate analysis of variance, multivariate analysis of covariance, chi-square and logistic regression analysis.

RESULTS

A total of 287 TNG young people met inclusion criteria (average age 18.2 ± 2.5 years). More than 40% of participants identified as nonbinary. Nonbinary participants were less likely to be out to teachers, but more likely to utilize supportive staff as a resource compared to binary-identified TNG peers. There were no significant differences in school safety and belonging.

CONCLUSIONS

Most school experiences do not vary significantly between TNG young people with binary versus nonbinary gender identities, though nonbinary young people are less likely to be out at school. Future research should examine factors that impact whether nonbinary young people share their gender identity and access school support services.

From victims to citizens: Emerging activist identities in the anti-fracking movement in Bulgaria

AIMS

The anti-fracking movement in Bulgaria, 2011-2013, was a successful grassroots effort to influence national environmental policy. The study draws on social movements and community psychology scholarship to investigate the emergence, development, and implications of activist identities as an important force for the movement's success.

METHODS

Within a qualitative design, data were collected from interviews with activists, observations of organizing events, movement documents, and media publications. Structured and open coding followed by qualitative analyses produced descriptions and explanations of the construction and use of identities in the movement.

RESULTS

Four major identities emerged in social and discursive interactions among activists and between activists and contextual forces: Victims, Bulgarians, Nature-protectors, and Citizens. The four identities were used interchangeably and afforded differential empowerment and opportunities for participation in policy-making.

CONCLUSION

The emerging activist identities were processes and products of the complex relationships between agency and context. The study contributes in illuminating the links between policy context, empowerment, participation, and political action.

Tell it to Me Straight: The Benefits (and Struggles) of a Consumer-driven Assessment Process

Community-based Participatory Research (CBPR), where consumers participate in the design and execution of an evaluation, holds promise for increasing the validity and usefulness of evaluations of services. However, there is no literature comparing methods and outcomes of studies conducted by professional evaluators with those conducted through a consumer-driven evaluation process. We attempt to fill this gap by presenting the methods and results from a qualitative evaluation conducted by professional evaluators along with one conducted by a team of consumer researchers who engaged in a CBPR process. This paper includes: (a) methods, and findings that emerged from these evaluations each tasked with examining similar issues within the same community; (b) description of the process used to train the team of consumer researchers whose economic and educational backgrounds are different than most evaluators; and (c) lessons learned about how to prepare for and work with common barriers to implementing a CBPR evaluation.

Conceptualising the initiation of researcher and research user partnerships: a meta-narrative review

Background

Integrated knowledge translation refers to researcher and research user partnerships to co-generate and implement knowledge. This type of partnership may be critical to success in increasing knowledge use and impact, but the conceptualisation of its initiation has not been fully developed. Initiating this type of partnership has proven to be challenging but crucial to its success. The purpose of this study was to conduct a meta-narrative review of partnership initiation concepts, processes, enablers, barriers and outcomes in the disciplines of healthcare and social sciences where examples of researcher and research user partnerships were found.

Methods

Seven research traditions were identified. Three were in the discipline of social sciences (including psychology, education and business) and five were in the discipline of healthcare (including medicine, nursing, public health, health services research). Searches were conducted in MEDLINE, EMBASE, CINAHL, ABI Inform, ERIC, PsychInfo and the Cochrane Library on June 9, 2017. Fifty titles and abstracts were screened in triplicate; data were extracted from three records in duplicate. Narratives comprised of study characteristics and conceptual and empirical findings across traditions were tabulated, summarised and compared.

Results

A total of 7779 unique results were identified and 17 reviews published from 1998 to 2017 were eligible. All reviews identified a partnership initiation phase referred to as ‘early’ or ‘developmental’, or more vaguely as ‘fuzzy’, across six traditions – integrated knowledge translation, action research, stakeholder engagement, knowledge transfer, team initiation and shared mental models. The partnership initiation processes, enablers, barriers and outcomes were common to multiple narratives and summarised in a Partnership Initiation Conceptual Framework. Our review revealed limited use or generation of theory in most included reviews, and little empirical evidence testing the links between partnership initiation processes, enablers or barriers, and outcomes for the purpose of describing successful researcher and research user partnership initiation.

Conclusions

Narratives across multiple research traditions revealed similar integrated knowledge translation initiation processes, enablers, barriers and outcomes, which were captured in a conceptual framework that can be employed by researchers and research users to study and launch partnerships. While partnership initiation was recognised, it remains vaguely conceptualised despite lengthy research in several fields of study. Ongoing research of partnership initiation is needed to identify or generate relevant theory, and to empirically establish outcomes and the determinants of those outcomes.

The influence of social media on child feeding practices and beliefs among Hispanic mothers: A mixed methods study

OBJECTIVES

(1) To identify factors that influence child feeding practices and beliefs among Hispanic mothers in a low-income community; (2) to describe the use of social media, other internet websites, and text messaging among Hispanic mothers; and (3) to explore mothers' perceptions of social media and/or text messaging interventions to prevent childhood obesity.

METHODS

Mixed methods descriptive study with a sequential explanatory design. Hispanic mothers (N = 66) from Detroit, Michigan with children between 6 and 36 months of age completed surveys regarding their child feeding practices, the source (s) influencing these practices, and their use of social media, internet, and text messaging. During qualitative interviews (N = 19), we explored mothers' use of social media and internet websites to find child health information as well as mothers' perspectives on social media/internet/text messaging interventions to promote child health.

RESULTS

Most survey respondents were between the ages of 20 and 39 years. One-third of mothers breastfed their child for >6 months; 68% did not introduce solids until their child was older than 6 months. The majority (96%) owned a cellphone; 75% used social media at least once daily. Few mothers indicated that social media and other internet websites influenced their child feeding decisions. During qualitative interviews (N = 19), almost all mothers expressed interest in social media and/or text messaging as a tool to communicate information regarding child health and feeding.

CONCLUSIONS

Hispanic mothers had high rates of social media use and most desired social media/internet/text messaging interventions to promote child health.

With a Spirit that Understands: Reflections on a Long-term Community Science Initiative to End Suicide in Alaska

This retrospective analysis of a long-term community-based participatory research (CBPR) process spans over two decades of work with Alaska Native communities. A call to action from Alaska Native leadership to create more effective strategies to prevent and treat youth suicide and alcohol misuse risk initiated a response from university researchers. This CBPR process transformed into a collaborative effort to indigenously drive and develop solutions through research. The People Awakening project started our team on this translational and transformational pathway through community intervention science in the Central Yup'ik region of Alaska. We examine more deeply the major episodes and their successes and struggles in maintaining a long-term research relationship between university researchers and members of Yup'ik Alaska Native communities. We explore ways that our CBPR relationship has involved negotiation and engagement with power and praxis, to deepen and focus attention to knowledge systems and relational elements. This paper examines these deeper, transformative elements of our CBPR relationship that spans histories, cultures, and systems. Our discussion shares vignettes from academic and community perspectives to describe process in a unique collaboration, reaching to sometimes touch upon rare ground in emotions, tensions, and triumphs over the course of a dozen grants and twice as many years. We conclude by noting how there are points where, in a long-term CBPR relationship, transition out of emergence into coalescing and transformation can occur.

Prioritizing the health education needs based on community participation: AHP method

INTRODUCTION

The identification of health education needs through the community results in targeted services and health promotion. Prioritizing these needs, in addition to identifying the desired health system based on the needs of the community, is required for the optimal allocation of resources. Therefore, this study was conducted with the aim prioritizing the health educational needs of Sabzevar-Iran community.

MATERIALS AND METHODS

This study was a two-step mix study. In the first stage, the qualitative method of the main themes of health educational needs of Sabzevar society was determined. Then, the questionnaire was prepared by a paired scale (36 questions) and quantitative method was used to prioritize the main themes with Analytic Hierarchy Process (AHP) software. The random sampling method was used in this study and data analysis was performed using Expert Choice software using AHP method.

RESULTS

Social problems with 0.206, contagious diseases with 0.205, nutrition with 0.161, and public health with 0.132 were in the first to fourth grades of health educational needs in Sabzevar city and environmental health, health management, noncontagion diseases, elderly, and occupational health were in the fifth to ninth grades. The consistency index in this study was 0.08, although the adjustment index is <0.1 good and acceptable.

CONCLUSION

Social problems are the first priority of Sabzevar society, which require appropriate training.

Shifting Implementation Science Theory to Empower Primary Care Practices

Observers of the past 10 to 15 years have witnessed the simultaneous growth of dramatic changes in the practice of primary care and the emergence of a new field of dissemination and implementation science (D&I). Most current implementation science research in primary care assumes practices are not meeting externally derived standards and need external support to meet these demands. After a decade of initiatives, many stakeholders now question the return on their investments. Overall improvements in quality metrics, utilization cost savings, and patient experience have been less than anticipated. While recently conducting a research project in primary care practices, we unexpectedly discovered 3 practices that profoundly shifted our thinking about the sources and directionality of practice change and the underlying assumptions of D&I. Inspired by these practices-along with systems thinking, complexity theory, action research, and the collaborative approaches of community-based participatory research-we propose a reimagining of D&I theory to empower practices. We shift the emphasis regarding the source and direction of change from outside-in to inside-out Such a shift has the potential to open a new frontier in the science of dissemination and implementation and inform better health policy.

Understanding community-based participatory research through a social movement framework: a case study of the Kahnawake Schools Diabetes Prevention Project

BACKGROUND

A longstanding challenge of community-based participatory research (CBPR) has been to anchor evaluation and practice in a relevant theoretical framework of community change, which articulates specific and concrete evaluative benchmarks. Social movement theories provide a broad range of theoretical tools to understand and facilitate social change processes, such as those involved in CBPR. Social movement theories have the potential to provide a coherent representation of how mobilization and collective action is gradually developed and leads to systemic change in the context of CBPR. The current study builds on a social movement perspective to assess the processes and intermediate outcomes of a longstanding health promotion CBPR project with an Indigenous community, the Kahnawake Schools Diabetes Prevention Project (KDSPP).

METHODS

This research uses a case study design layered on a movement-building evaluation framework, which allows progress to be tracked over time. Data collection strategies included document (scientific and organizational) review (n = 51) and talking circles with four important community stakeholder groups (n = 24).

RESULTS

Findings provide an innovative and chronological perspective of the evolution of KSDPP as seen through a social movement lens, and identify intermediate outcomes associated with different dimensions of movement building achieved by the project over time (mobilization, leadership, vision and frames, alliance and partnerships, as well as advocacy and action strategies). It also points to areas of improvement for KSDPP in building its potential for action.

CONCLUSION

While this study's results are directly relevant and applicable to the local context of KSDPP, they also highlight useful lessons and conclusions for the planning and evaluation of other long-standing and sustainable CBPR initiatives. The conceptual framework provides meaningful benchmarks to track evidence of progress in the context of CBPR. Findings from the study offer new ways of thinking about the evaluation of CBPR projects and their progress by drawing on frameworks that guide other forms of collective action.