Community-based participatory research to promote healthy lifestyles among Latino immigrant families with youth with disabilities

Participatory Research with Persons who Experience Mental Illness in Occupational Therapy: A Scoping Review

Background. Persons who experience mental illness also face stigma and discrimination that frequently lead to a loss of ability to exercise autonomy and agency in their lives. Purpose. The range and breadth of literature exploring participatory research with persons living with mental illness are unknown in occupational therapy and occupation science. We initiated this study to fill this gap in the existing occupational therapy and occupational science literature. Method. Using the method of Arksey and O'Malley, we have conducted a scoping review to identify the range and breadth of literature. A qualitative content analysis was performed. Findings. A total of 34 articles were included in the narrative synthesis. The content analysis led to three related themes from the included studies: (1) coming together; (2) unique potential of participatory research; and (3) challenges in conducting participatory research. Conclusions. This review highlights that participatory research is well suited to research conducted with persons living with mental illness to support meaningful engagement and minimize stigma throughout the research process. This review can guide future participatory research and practice in occupational therapy and occupational science with persons living with mental illness.

Community-Partnered Research appraisal tool for conducting, reporting and assessing community-based research

Objective The aim of this study was to develop an appraisal tool to support and promote clear, accurate and transparent standards and consistency when conducting, reporting and assessing community-based research. Design Current recommendations for developing reporting guidelines was used with three key differences: (1) an analysis of existing guides, principles and published literature about community engagement, involvement and participation in research using situational and relational maps; (2) feedback and pilot-testing by a community-based research team; and (3) testing the utility and usability of the appraisal tool. Results After a series of iterative revisions, the resulting Community-Partnered Research (CPR) appraisal tool emerged into three products: an elaborate prospective format, a basic retrospective format, and a supplemental checklist format. All three versions of the CPR appraisal tool consist of 11 main question items with corresponding prompts aimed to facilitate awareness, accountability, and transparency about processes and practices employed by professional researchers and community co-researchers throughout four phases of research: (1) partnership and planning, (2) methods, (3) results and (4) sustainment. Conclusion We hope that introducing this tool will contribute to shifting individual and systematic processes and practices towards equitable partnerships, mutual trustworthiness and empowerment among professional researchers and community co-researchers and, in turn, improving the quality of co-created knowledge that benefits communities and creates social change.

Perceived barriers and facilitators to healthy eating among Pakistani women participating in the PakCat program in Catalonia: A qualitative approach

Immigrant women of Pakistani origin are among the most at-risk groups for type 2 diabetes, obesity, and heart failure in Catalonia. As the incidence of these diseases is associated with lifestyle factors, we approached this community with participatory research and conducted six focus groups (N = 36) among Pakistani women participating in the PakCat Program. The research process of this paper adhered to the COREQ checklist. Through the thematic analysis, we identified six main themes: social beliefs and attitudes, family environment, personal factors, dietary acculturation, traditional dietary patterns, and economic factors. We discovered both facilitators and barriers associated with each theme, but the findings indicated that Pakistani women encounter more inhibitors than enablers to following a healthy diet. The determination of these factors can facilitate the reinforcement of the aspects that help Pakistani women to follow a healthy diet and provide adequate tools to overcome the barriers.

A Study of Immigrant Latinas Perspectives of Caring for their Diabetes

Hispanic-Americans are disproportionately affected by type 2 diabetes compared to non-Hispanic Whites. Five million adult Hispanic Americans are estimated to have been diagnosed with T2D. Among US Hispanics, Mexicans have the highest rate (14.4%) of diabetes. Further, Hispanics are also twice as likely as non-Hispanics Whites to die from diabetes, making it the fifth leading cause of their death and a serious health problem in Hispanic communities. Yet, little is understood of what rural immigrant Latinas do to care for their diabetes health. In-depth interviews (3 focus groups) and thematic analysis found 16 Latinas had T2D on average for 9 years; all emigrated to the USA from Mexico, lived in the USA for an average of 27 years, and worked (60%). Within the domain of "What do you do to take care of your health?" Latinas desired to adhere to exercise, controlled diet, and medications, but perceived a powerful barrier to a healthy life was the American lifestyle that included long work days, more money to purchase unhealthy foods and a desire for them, and a lack of time for other forms of exercise. Despite the Latina participants' years of experience about living with T2D in the US, they still struggled to adhere to healthy behaviors. Future research should address the longer time Hispanic immigrants live in the US with the more at-risk they become for diminished health.

Partnering with immigrant families to promote language justice and equity in education

Despite US federal legislation mandates institutions to provide meaningful access and participation to students and families in educational settings, culturally and linguistically diverse (CLD) families and caregivers of children in special education experience cultural and linguistic barriers. A Community Advisory Team (CAT) of parents, advocates, community interpreters and translators, researchers, and teachers explored CLD families' experiences and advocacy efforts. Critical bifocality and circuits of dispossession, privilege, and resistance informed the documentation of inequities and resistance to understand the linkages of structural arrangements of power. Focus groups with families (n = 21) speakers of Spanish, Portuguese, and Cantonese were conducted. Findings indicate perceived discrimination, poor and inadequate interpretation and translation services impact children's access to special education services, hinder family's communication with schools and reduce the perceptions of schools as trustworthy institutions. Families advocate relentlessly for their children and recommend schools listen to families and hire culturally and linguistically competent interpreters and translators. Community psychologists can make significant contributions to promote language justice in education settings through participatory approaches to inquiry that value CLD families' knowledge and expertise.

Community-engaged asset mapping with Latinx immigrant families of youth with disabilities

Asset mapping is a participatory methodology that engages community members in identifying services and settings that promote health and well-being. This study aimed to identify community assets from the perspective of Latinx immigrant families with youth with disabilities. Latinx immigrant families (n = 21) participated in the mapping, followed by a reflection session and an open forum (n = 30). The findings revealed that families identified faith-based organizations and social service agencies as some of the main assets in their communities, while they identified mental health services as the most needed. The results also showed that participants preferred to utilize services and resources that are within walking distance of their homes, provide safe spaces, treat them well, offer bilingual services, do not require documentation, and are affordable. This study has important implications for community scholars and practitioners interested in implementing asset-based methodologies that focus on participants as experts of their own realities and agents of change and that promote advocacy and empowerment actions.

Interventions for Health Promotion and Obesity Prevention for Children and Adolescents with Developmental Disabilities: a Systematic Review

This systematic review evaluated interventions and relevant outcomes for health promotion and obesity prevention among children and adolescents with developmental disabilities (DD). Twenty-one studies including randomized control trials (n= 9) and quasi-experimental studies (n=12) published between 2010 and 2021 met inclusion criteria related to participant characteristics, intervention type, and child obesity-related outcomes. Five types of intervention programs were identified: aerobic and strength training, sport-based physical activity, aquatic exercise, active video gaming, and diet and lifestyle. Whereas analysis of intervention outcomes, efficacy, and study rigor showed mixed results and weak evidence of effective interventions, this review identified gaps in the literature, promising strategies for addressing obesity in children with DD, and implications for practice and future research.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40489-022-00335-5.

Goal Setting with Latinx Families of Children with Intellectual and Developmental Disabilities: Case Studies

Behavioral community psychology focuses on studying issues that matter to communities, unpacking contextual factors that impact people's behaviors, and identifying strategies to address such issues. Goal setting is one such strategy often used by behavioral psychologists. Grounded in the values of behavioral community psychology and a behavior analysis paradigm, this study illustrated two case studies of Latinx parents of children with disabilities where goal-setting strategies were implemented to promote behavior change. The first case study focused on the promotion of healthy lifestyle behaviors and routines among Latinx families of children with disabilities in the United States. The second case study examined goal setting related to youth development by parents of adolescents with disabilities in Colombia. In both cases, participants received training on goal setting and had opportunities to discuss progress toward achieving their goals, share action steps taken, and discuss the contextual challenges or barriers that they experienced. The results indicate that behavioral goal-setting procedures can be effective in helping parents attain their goals and brainstorm strategies for addressing behavioral and contextual challenges. Implications for future research advancing behavioral community psychology are discussed.

Participatory approaches in the development of health interventions for migrants: a systematic review

OBJECTIVE

Analysis of participatory approaches to developing health interventions for migrants and how approaches embody core participatory principles of inclusivity and democracy.

DESIGN

A systematic review of original articles. Electronic searches within the databases MEDLINE, Embase, Global Health and PsychINFO (from inception-November 2020).

ELIGIBILITY CRITERIA FOR STUDY SELECTION

Original peer-reviewed articles reporting research to develop and implement a health intervention for migrants, incorporating participatory approaches. We defined migrants as foreign-born individuals. Only articles reporting the full research cycle (inception, design, implementation, analysis, evaluation, dissemination) were included.

DATA EXTRACTION

We extracted information related to who was involved in research (migrants or other non-academic stakeholders), the research stage at which they were involved (inception, design, implementation, analysis, evaluation, dissemination), the method of their involvement and how this aligned with the core principles of participatory research-categorising studies as exhibiting active or pseudo (including proxy and indirect) participation.

RESULTS

1793 publications were screened, of which 28 were included in our analysis. We found substantial variation in the application of participatory approaches in designing health interventions targeting migrants: across 168 individual research stages analysed across the 28 studies, we recorded 46 instances of active participation of migrants, 30 instances of proxy participation and 24 instances of indirect participation. All studies involved non-academic stakeholders in at least one stage of the research, only two studies exhibited evidence of active participation of migrants across all research stages. Evidence is limited due to the variability of terms and approaches used.

CONCLUSIONS

Important shortfalls in the meaningful inclusion of migrants in developing health interventions exist, suggesting a more rigorous and standardised approach is warranted to better define and deliver participatory research and improve quality.

REGISTRATION

This review followed Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and is registered on the Open Science Framework (osf.io/2bnz5).

Latinx Parents' Perceptions of Neighborhood Walking Safety for Their Youth With Intellectual Disabilities: A Mixed-Methods Investigation

Increased walking distance and frequency has been linked to positive health outcomes. Neighborhood walkability disproportionately impacts youth with intellectual and developmental disabilities (IDD). We investigated concerns of Latinx parents of youth with IDD about walkability and their impact on families' walking behavior. We surveyed Latinx parents of youth with IDD (n = 21) and compared results with the general population. Results were triangulated with a focus group (n = 5). Survey data were analyzed using a Mann-Whitney U test, and focus group data via thematic analysis. We found a significant difference (P < .05) between parents of youth with IDD and the general population on perceived aesthetics, opportunity to participate, and satisfaction. Latinx parents and their youth with IDD experience disparities in the safety and pleasantness of their communities for walking, which may contribute to decreased community participation, poorer health outcomes, and lower levels of neighborhood satisfaction among this already vulnerable population.

Parental experiences of adopting healthy lifestyles for children with disabilities living with overweight and obesity

BACKGROUND

Children with disabilities present with high obesity rates.

OBJECTIVE

This study explored the parental experience of adopting healthy lifestyle choices, for children with disabilities, who received dietetic weight management advice.

METHODS

Semi-structured qualitative interviews were carried out with eight parents/carers in their own homes or healthcare setting in an inner London locality, or by telephone. Data was analyzed using an interpretative phenomenological analysis (IPA) approach.

RESULTS

Five superordinate themes emerged: 1. Strategies to promote healthy lifestyles: encouraging physical activity, limiting access to food and taking a gradual approach to making lifestyle changes. 2. Challenges to adopting healthy lifestyles: selective eating patterns, the high cost of healthy foods and parental/carer lack of time. 3. The role of healthcare professionals (HCPs): revealed that not all parents/carers received advice or support, prior to dietetic referral, when managing their child's weight. Feeling reassured by HCPs was valued. Parents/carers reported a positive experience of seeing the dietitian, as they appreciated receiving practical and individualized advice. 4. Support needs: family support and support from families with children with disabilities was explored. 5. Parent/carer wellbeing: such as stress was found to have a detrimental impact on parents making healthy lifestyle changes.

CONCLUSIONS

Adopting a healthy lifestyle involved a variety of strategies and challenges, some of which are specific to this population group and should be considered by HCPs, when having weight-related discussions and offering advice. Parental/carer support needs and wellbeing should also be taken into consideration when planning weight management services for this population group.

Using a community-based participatory research approach to meaningfully engage those with lived experience of diabetes and homelessness

INTRODUCTION

Participatory research is a study method that engages patients in research programs, ideally from study design through to dissemination. It is not commonly used in diabetes health services research. Our objectives were to describe the process and challenges of conducting a participatory research project and to highlight the experiences of both patient co-researchers and academic researchers.

RESEARCH DESIGN AND METHODS

We recruited people with lived experience of homelessness (PWLEH) and diabetes in Toronto, Canada to become patient co-researchers. They were asked to commit to attending biweekly meetings. We undertook two major research projects: concept mapping to choose a research focus; and photovoice to explore accessing healthy food while homeless. We used a convergent mixed-methods design to evaluate their experience.

RESULTS

A diverse group of eight PWLEH had an average attendance of 82% over 21 meetings-despite this success, we encountered a number of challenges of conducting this research: funding, ethics approval and recruitment were particularly difficult. Group members reported that participation improved their ability to self-advocate in their diabetes care and provided them with tangible skills and social benefits. Group members stated that they valued being involved in all aspects of the research, in particular knowledge translation activities, including advocating for nutritious food at shelters; presenting to stakeholders; and meeting with policymakers.

CONCLUSIONS

The use of participatory research methods enables academic researchers to support community members in pursuing research that is pertinent to them and which has a positive impact. In our study, co-researchers contributed in meaningful ways and also valued the experience.

Impact of COVID-19 on the Mental Health and Well-Being of Latinx Caregivers of Children with Intellectual and Developmental Disabilities

The COVID-19 pandemic has impacted the entire world in unprecedented ways. However, populations that have had a history of marginalization have experienced a more profound impact. One such group is Latinx families of children with intellectual and developmental disabilities (IDD) in the Unites States. In this study, we used a mixed methods approach to explore the impact of the pandemic on the mental health and well-being of Latinx caregivers of children with IDD. Specifically, we (1) identified which social determinants of health are correlated with maternal caregivers perceived general health, mental health, and well-being; (2) explored the impact of the pandemic on families' overall eating and physical activity routines; and (3) identified emergent themes from caregivers' experiences during the pandemic. Thirty-seven Latinx caregivers participated in three interviews in which several validated instruments were administered. The results indicated that perceived social support, annual family income, food security, and receipt of financial benefits were correlated with fewer depressive symptoms. Annual family income was also significantly correlated with perceived general health. Most caregivers reported that the pandemic had placed a strain on their economic situation; increased their isolation; and disrupted their child's therapeutic supports, online education, eating routines, and engagement in physical activity. Meanwhile, some caregivers reported positive changes as a result of the pandemic. Implications for future research and practice are discussed.

The Occupational Participation of Latinx Cancer Survivors and Their Family Caregivers Living in Survivorship: A Qualitative Exploration Informed by Multiple Stakeholders

The purpose of this study was to examine the lived experiences of Latinx cancer survivors and their family caregivers during survivorship. Eighteen semi-structured interviews were conducted with a variety of stakeholders including Latinx cancer survivors (n = 8), their family caregivers (n = 5), and cancer care providers (n = 5). Data were analyzed thematically to describe occupational participation. Latinx families lived in political, economic, language, and social contexts that facilitated and hindered their well-being. Survivors simultaneously experienced occupational deprivation and posttraumatic growth. To promote occupational justice, occupational therapy practitioners and researchers are called to partner with Latinx survivors and their families to facilitate skills needed for everyday participation.

Evaluation of Public Health Messages Promoting Early Detection of Dementia Among Adult Latinos With a Living Older Adult Parental Figure

INTRODUCTION

We aimed to evaluate the resonance of public health messages promoting early detection of dementia in adult Latinos with a living older adult loved one.

METHOD

We conducted a mixed-methods study with focus groups and surveys to evaluate eight messages encouraging Latino adults to accompany their older loved one for cognitive assessment. Qualitative data were transcribed and coded, and thematic analysis was conducted. We used descriptive statistics for quantitative data.

RESULTS

Participants suggested that messages need to be translated into Spanish and images need to be more natural, present balance between positive and serious facial expressions, show more ethnic/racial diversity, and show family members other than the parents. Five major sociocultural themes affected how the messages were received: stigma, gender roles, the importance of the mother figure, guilt, and family togetherness.

CONCLUSION

Public health messages targeting cultural values are needed to effectively encourage early dementia detection in Latinos. Findings can be used to adapt culturally appropriate public health messages encouraging early dementia detection in Latinos.

Meaningful Engagement in Research: Community Residents as Co-creators of Knowledge

Community psychologists have contributed significantly to the body of literature on community-based participatory research (CBPR) and its application in understanding and addressing health and community participation disparities. At the core of CBPR are mutually beneficial partnerships with communities, whereby community members' voices are heard and they become co-researchers, helping guide the research process. In this article, I argue that for community psychologists to change the landscape of community participation, health, and well-being disparities experienced by many vulnerable populations who often face multiple forms of oppression, CBPR needs to be transformative and emancipatory. Stakeholders must be meaningfully involved as co-creators of knowledge and promoters of social justice embracing a human rights agenda. Drawing from work conducted with Latinx immigrant families with youth who have disabilities, I propose the following strategies moving forward: promoting meaningful participation of community members as co-creators of knowledge; promoting meaningful conversations that matter to communities; promoting civic engagement, activism, and advocacy; promoting an assets- and strengths-based approach to research; and promoting culturally relevant interventions. Community psychologists have the opportunity to make significant contributions to addressing disparities when community residents' knowledge is valued and recognized.

A Community-Based Participatory Action Research for Roma Health Justice in a Deprived District in Spain

Addressing health disparities and promoting health equity for Roma has been a challenge. The Roma are the largest disadvantaged ethnic minority population in Europe and have been the victims of deep social and economic injustices, institutional discrimination, and structural antigypsyism over many centuries. This has resulted in a much worse health status than their non-Roma counterparts. Current strategies based on ameliorative and top-down approaches to service delivery have resulted in paradoxical effects that solidify health disparities, since they do not effectively address the problems of vulnerable Roma groups. Following a health justice approach, we present a community-based participatory action research case study generated by a community and university partnership intended to address power imbalances and build collaboration among local stakeholders. This case study involved a group of health providers, Roma residents, researchers, Roma community organizations, and other stakeholders in the Poligono Sur, a neighborhood of Seville, Spain. The case study comprises four phases: (1) identifying Roma health assets, (2) empowering Roma community through sociopolitical awareness, (3) promoting alliances between Roma and community resources/institutions, and (4) building a common agenda for promoting Roma health justice. We highlighted best practices for developing processes to influence Roma health equity in local health policy agendas.