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Thomson LJM, Waterson H, Chatterjee HJ. Successes and challenges of partnership working to tackle health inequalities using collaborative approaches to community-based research: mixed methods analysis of focus group evidence. Int J Equity Health 2024; 23:135. [PMID: 38965627 PMCID: PMC11223342 DOI: 10.1186/s12939-024-02216-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/20/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND The concept of collaborative approaches involves community residents in joint decision-making processes to maintain or enhance their material and social conditions. During COVID-19, public services saw the benefits of actively collaborating with communities and involving residents in decision-making processes. As communities have resources and assets, they are well-placed to contribute to developing local health and wellbeing initiatives. An interdisciplinary and nationally funded three-phase research programme, "Mobilising community assets to tackle health inequalities", was established with the objective of utilising local, cultural, and natural assets to support health and wellbeing. The current study aimed to synthesise evidence collected by research teams awarded funding in phase one of the programme, comprising academic and non-academic, health and social care, voluntary and community partners. METHODS Ten online focus groups were conducted with research teams from across the UK exploring the successes and challenges of partnership working to tackle health inequalities using collaborative approaches to community-based research. Eight focus group questions were split between partnership working and health inequalities. RESULTS Thematic and content analysis produced 185 subthemes from which 12 themes were identified. Major themes representing an above average number of coded responses were research evidence; funding; relationships with partners; health inequalities and deprivation; community involvement; and health service and integrated care systems. Minor themes were link workers and social prescribing; training and support; place-based factors; longevity of programmes; setting up and scaling up programmes; and mental health. CONCLUSIONS Successes included employing practice-based and arts-based methods, being part of a research project for those not normally involved in research, sharing funding democratically, building on established relationships, and the vital role that local assets play in involving communities. Challenges involved a lack of sustainable financial support, the short-term nature of funding, inconsistencies in reaching the poorest people, obtaining the right sort of research evidence, making sufficient research progress, building relationships with already over-burdened health care staff, and redressing the balance of power in favour of communities. Despite the challenges, participants were mainly optimistic that collective approaches and meaningful co-production would create opportunities for future research partnerships with communities.
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Affiliation(s)
- L J M Thomson
- UCL Arts and Sciences, University College London, London, UK.
- UCL Division of Biosciences, University College London, London, UK.
| | - H Waterson
- UCL Arts and Sciences, University College London, London, UK
- National Centre for Creative Health, Oxford, UK
| | - H J Chatterjee
- UCL Arts and Sciences, University College London, London, UK.
- UCL Division of Biosciences, University College London, London, UK.
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Kvalsvik F, Larsen BH, Eilertsen G, Falkenberg HK, Dalen I, Haaland S, Storm M. Health Needs Assessment in Home-Living Older Adults: Protocol for a Pre-Post Study. JMIR Res Protoc 2024; 13:e55192. [PMID: 38635319 PMCID: PMC11066750 DOI: 10.2196/55192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Conducting a health needs assessment for older adults is important, particularly for early detection and management of frailty. Such assessments can help to improve health outcomes, maintain overall well-being, and support older adults in retaining their independence as they age at home. OBJECTIVE In this study, a systematic approach to health needs assessment is adopted in order to reflect real-world practices in municipal health care and capture the nuances of frailty. The aim is to assess changes in frailty levels in home-living older adults over 5 months and to examine the observable functional changes from a prestudy baseline (t1) to a poststudy period (t2). Additionally, the study explores the feasibility of conducting the health needs assessment from the perspective of home-living older adults and their informal caregivers. METHODS Interprofessional teams of registered nurses, physiotherapists, and occupational therapists will conduct 2 health needs assessments covering physical, cognitive, psychological, social, and behavioral domains. The study includes 40 home-living older adults of 75 years of age or older, who have applied for municipal health and care services in Norway. A quantitative approach will be applied to assess changes in frailty levels in home-living older adults over 5 months. In addition, we will examine the observable functional changes from t1 to t2 and how these changes correlate to frailty levels. Following this, a qualitative approach will be used to examine the perspectives of participants and their informal caregivers regarding the health needs assessment and its feasibility. The final sample size for the qualitative phase will be determined based on the participant's willingness to be interviewed. The quantitative data consist of descriptive statistics, simple tests, and present plots and correlation coefficients. For the qualitative analysis, we will apply thematic analysis. RESULTS The initial baseline assessments were completed in July 2023, and the second health needs assessments are ongoing. We expect the results to be available for analysis in the spring of 2024. CONCLUSIONS This study has potential benefits for not only older adults and their informal caregivers but also health care professionals. Moreover, it can be used to inform future studies focused on health needs assessments of this specific demographic group. The study also provides meaningful insights for local policy makers, with potential future implications at the national level. TRIAL REGISTRATION ClinicalTrials.gov NCT05837728; https://clinicaltrials.gov/study/NCT05837728. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55192.
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Affiliation(s)
- Fifi Kvalsvik
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Bente Hamre Larsen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Grethe Eilertsen
- Research Group of Older Peoples' Health, University of South-Eastern Norway, Drammen, Norway
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Helle K Falkenberg
- Research Group of Older Peoples' Health, University of South-Eastern Norway, Drammen, Norway
- National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Ingvild Dalen
- Section of Biostatistics, Research Department, Stavanger University Hospital, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Stine Haaland
- Department of Health and Welfare services, Stavanger kommune, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway
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Nogueira González P, Gil González D, Álvarez-Dardet Díaz C. [Lights and shadows in the implementation of community action for health]. GACETA SANITARIA 2024; 38:102387. [PMID: 38608387 DOI: 10.1016/j.gaceta.2024.102387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To explore the experiences of individuals who develop projects and interventions where community participation-action constitutes a strategic tool for reducing health inequalities. METHOD Qualitative study based on semi-structured, in-depth online interviews with individuals considered experts in the development of health promotion strategies involving community participation. A total of 12 individuals from the healthcare, social healthcare, academic, and associative backgrounds were selected. The texts were analyzed following the thematic content analysis approach. RESULTS The prominent strength of the processes involving the interviewed individuals is their participatory approach. However, there is no genuine commitment to promoting community participation from primary healthcare, and precarity has been identified as a significant weakness in the development of participatory health promotion projects. The sustainability of participatory processes relies on the transfer of knowledge to the community and their empowerment. CONCLUSIONS Participatory processes have demonstrated their ability to reposition the community as an essential part of the healthcare system. It would be interesting to use a measurement tool for participation in all community health actions, both to guide their design and planning and to assess the depth of participation and its impact on the process. Enhancing community action expectations for health in the near future involves promoting a community-oriented approach in primary care and intersectoral collaboration, which requires a significant institutional and policy commitment.
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Affiliation(s)
| | - Diana Gil González
- Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España; Departamento de Enfermería Comunitaria, Medicina Preventiva, Salud Pública e Historia de la Ciencia, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Carlos Álvarez-Dardet Díaz
- Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
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Polson B, Crozier AJ, Dollman J, Gunn KM. 'If you want something to happen, you have to do it yourself': Understanding rural Australian's perspectives of health volunteering. Health Promot J Austr 2024; 35:311-320. [PMID: 37227095 DOI: 10.1002/hpja.752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/03/2023] [Accepted: 05/10/2023] [Indexed: 05/26/2023] Open
Abstract
ISSUE ADDRESSED Rurality is associated with poorer health outcomes and access to health services, yet a strength of rural living includes community cohesion indicated by high rates of volunteering. While volunteerism is an effective means to target health needs in resource-restricted contexts, research on volunteerism to address rural Australian health needs is limited. This research aimed to explore rural adults' perspectives of volunteerism in local activities and programs that had a direct health related benefit (health volunteering). METHODS Eight people from the Murray Mallee region of South Australia participated during April 2021, ranging in age from 32 to 75 years. Participants were invited to one-on-one interviews that occurred via a phone call or teleconference meeting, which were audio-recorded and transcribed verbatim to facilitate thematic analysis. RESULTS Seven main themes emerged. Participants identified that (1) health volunteering takes many forms, (2) health volunteering affords local ownership and accessibility, (3) health volunteers have particular skills and values, but also (4) gain social benefits and learn new skills. Rural health volunteering was also associated with (5) a variety of personal costs, and (6) there are several environmental barriers and (7) facilitators to rural health volunteering that should be considered when designing health programs. CONCLUSION Results provide insight into how rural communities can enhance the development and application of volunteering roles to support health volunteering. SO WHAT?: Including local champions, reducing the financial burden and developing support networks for volunteers are practical suggestions to enhance levels of volunteering for health in rural settings.
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Affiliation(s)
- Bianca Polson
- Allied Health and Human Performance Unit, University of South Australia, Adelaide, South Australia, Australia
| | - Alyson J Crozier
- Allied Health and Human Performance Unit, University of South Australia, Adelaide, South Australia, Australia
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Jim Dollman
- Allied Health and Human Performance Unit, University of South Australia, Adelaide, South Australia, Australia
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Kate M Gunn
- Department for Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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South J, Woodall J, Stansfield J, Mapplethorpe T, Passey A, Bagnall AM. A qualitative synthesis of practice-based learning from case studies on COVID community champion programmes in England, UK. BMC Public Health 2024; 24:7. [PMID: 38166766 PMCID: PMC10759547 DOI: 10.1186/s12889-023-17470-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Community-based volunteering supports outbreak management by extending reach into at-risk communities. This paper examines the application of a 'community champions' model in England, UK, during the COVID-19 pandemic. Evidence pre-pandemic shows that community champion interventions tap into social networks to strengthen connections with disadvantaged communities. During the pandemic, the UK government set up a COVID community champions funding award scheme for local authorities to develop local programmes that addressed emerging inequalities. The study aim was to identify transferable learning on community engagement in the pandemic by undertaking a secondary qualitative synthesis of practice-based case studies of local COVID community champion programmes. METHODS A systematic staged approach for synthesis of practice-based case studies was used. In total, 16 COVID community champion case studies, which were written by practitioners involved in local programme implementation and published by the Local Government Association, were included. Case studies covered aims, programme development and delivery, examples of activities and a discussion of learning. Framework qualitative analysis methods were used to code and organise data prior to cross case analysis. The final stage produced an overarching thematic framework that best represented descriptive and interpretive themes. RESULTS The results provide an overview of common features of COVID community champion programmes and emergent learning. All local programmes aimed to reduce health inequalities by involving at-risk communities in local prevention efforts, adapting the approach to local priorities. Two levels of community engagement were volunteer mobilisation and subsequent community-based outreach activities. Elements of capacity building, such as training and creation of networks, were common. The synthesis of practice-based learning found that stronger relationships with communities were regarded as a key mechanism to support more equitable prevention strategies. Other learning themes related to champion roles, community engagement strategies and programme implementation. CONCLUSIONS By focusing on how community champion approaches were applied by local authorities in England during the COVID-19 pandemic, this study contributes to knowledge on volunteer mobilisation as a mechanism to improve public health communication and outreach. Notwithstanding the limitations of experiential evidence, the synthesis of practice-based learning highlights potentially transferable community engagement strategies for health protection and health improvement.
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Affiliation(s)
- Jane South
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK.
| | - James Woodall
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK
| | - Jude Stansfield
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK
| | - Tom Mapplethorpe
- Corporate Strategy, Commissioning and Public Health, Kirklees Council, Huddersfield, HD1 9EL, UK
| | - Andrew Passey
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK
| | - Anne-Marie Bagnall
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK
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Southby K, Bidey T, Grimes D, Khor Z, South J, Bagnall AM. Together through tough times: a qualitative study of community resilience to protect against mental health issues in the UK. JOURNAL OF PUBLIC MENTAL HEALTH 2022. [DOI: 10.1108/jpmh-03-2022-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Purpose
Living in an area experiencing economic and social disadvantage is a known risk factor to poor mental health and well-being. This paper aims to understand how some communities experiencing disadvantage appear to be more resilient to the enduring challenges they face and display better mental health outcomes.
Design/methodology/approach
A qualitative case study approach was used. Semi-structured interviews (total = 74) were undertaken remotely with residents (n = 39) and voluntary, community and social enterprise groups, community leaders and other local stakeholders (n = 35) in four case study areas. Data analysis was cross-case, thematic analysis. Community analysis workshops (n = 4) and resilience mapping workshops (n = 4) in each site corroborated emerging insights.
Findings
Four overlapping and interacting themes support community resilience: community hubs and local voluntary, community and social enterprise (VCSE) networks; opportunities to participate and make connections within communities; open and supportive environments to talk about mental health and well-being; and community identities and collective narratives. Differences in access to these resources was a cross-cutting theme.
Originality/value
Community resilience can be understood in terms of the amount of resources – articulated in terms of capital – that communities can draw on in response to challenges, and how well these resources are mobilised. A thriving VCSE sector is important for community resilience in communities experiencing disadvantage as a mechanism for both sustainably building and mobilising community resources in the face of daily and enduring challenges.
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Westlake D, Elston J, Gude A, Gradinger F, Husk K, Asthana S. Impact of COVID-19 on social prescribing across an Integrated Care System: A Researcher in Residence study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4086-e4094. [PMID: 35355347 PMCID: PMC9111657 DOI: 10.1111/hsc.13802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/25/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Emerging evidence suggests that connecting people to non-medical activities in the community (social prescribing) may relieve pressure on services by promoting autonomy and resilience, thereby improving well-being and self-management of health. This way of working has a long history in the voluntary and community sector but has only recently been widely funded by the National Health Service (NHS) in England and implemented in Primary Care Networks (PCNs). The COVID-19 global pandemic coincided with this new service. There is wide variation in how social prescribing is implemented and scant evidence comparing different delivery models. As embedded researchers within an Integrated Care System in the Southwest of England, we examined the impact of COVID on the implementation of social prescribing in different employing organisations during the period March 2020 to April 2021. Data were collected from observations and field notes recorded during virtual interactions with over 80 social prescribing practitioners and an online survey of 52 social prescribing practitioners and middle managers. We conceptualise social prescribing as a pathway comprising access, engagement and activities, facilitated by workforce and community assets and strategic partnerships. We found that these elements were all impacted by the pandemic, but to different degrees according to the way the service was contracted, whether referrals (access) and approach (engagement) were universal ('open') or targeted ('boundaried') and the extent to which practitioners' roles were protected or shifted towards immediate COVID-specific work. Social prescribers contracted in PCNs were more likely to operate an 'open' model, although boundaries were developing over time. We suggest the presence of an explicit, agreed delivery model (whether 'open' or 'boundaried') might create a more coherent approach less likely to result in practitioner role drift, whilst allowing flexibility to adjust to the pandemic and enhancing practitioner satisfaction and well-being. The potential consequences of different models are examined.
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Affiliation(s)
- Debra Westlake
- Community and Primary Care Research GroupFaculty of Health, Medicine, Dentistry and Human SciencesUniversity of PlymouthPlymouthUK
- Centre for Evidence‐Based MedicineNuffield Department of Primary Care Health SciencesUniversity of OxfordRadcliffe Observatory QuarterOxfordUK
- Present address:
Centre for Evidence‐Based MedicineNuffield Department of Primary Care Health SciencesUniversity of OxfordRadcliffe Observatory QuarterOxfordUK
| | - Julian Elston
- Community and Primary Care Research GroupFaculty of Health, Medicine, Dentistry and Human SciencesUniversity of PlymouthPlymouthUK
| | - Alex Gude
- Community and Primary Care Research GroupFaculty of Health, Medicine, Dentistry and Human SciencesUniversity of PlymouthPlymouthUK
| | - Felix Gradinger
- Community and Primary Care Research GroupFaculty of Health, Medicine, Dentistry and Human SciencesUniversity of PlymouthPlymouthUK
| | - Kerryn Husk
- Applied Research Collaboration South West Peninsula (PenARC)Faculty of Health, MedicineDentistry and Human SciencesUniversity of PlymouthNational Institute for Health ResearchPlymouthUK
| | - Sheena Asthana
- Plymouth Institute of Health and Care ResearchPlymouthUK
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South J, Mapplethorpe T, Gledhill R, Marsh W, Stansfield J, Evans S, Mancini M, Outhwaite H. Learning from public health practice: the development of a library of community-centered practice examples. J Public Health (Oxf) 2022:6623459. [PMID: 35774035 DOI: 10.1093/pubmed/fdac065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/28/2022] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Valuable learning derived from public health practice can be captured through practice-based case studies, also known as practice examples. Practice examples of participatory interventions supplement the evidence base by providing information on the complexities of implementation in communities. This paper reports on a Public Health England project to build a bank of community-centered practice examples based on robust processes of collection and curation. METHODS The multidisciplinary project had three phases: (i) development and piloting a process to collect practice examples, (ii) refining review processes and gathering further examples via national and regional teams (iii) maintenance of an accessible collection on the library platform. RESULTS The project resulted in a searchable collection of 55 practice examples illustrating participatory approaches in public health practice. The collection shows diversity in terms of settings, population, focus and type of approach used to work with communities. A secondary outcome was the development of generic guidance and templates for further collections on public health topics. CONCLUSIONS This project illustrates how information on the implementation of community-centered approaches in real-life contexts can be gathered and disseminated through a transferable process. Having collections of practice examples supports knowledge exchange in public health as learning is shared.
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Affiliation(s)
- Jane South
- School of Health, Leeds Beckett University, Leeds LS1 3HE, UK.,Office for Health Improvement and Disparities, Department of Health and Social Care, London SW1H 0EU, UK
| | - Tom Mapplethorpe
- Office for Health Improvement and Disparities, Department of Health and Social Care, London SW1H 0EU, UK
| | - Rachel Gledhill
- UK Health Security Agency Knowledge and Library Services, UK Health Security Agency, London SW1H 0EU, UK
| | - Wendy Marsh
- UK Health Security Agency Knowledge and Library Services, UK Health Security Agency, London SW1H 0EU, UK
| | - Jude Stansfield
- School of Health, Leeds Beckett University, Leeds LS1 3HE, UK.,Office for Health Improvement and Disparities, Department of Health and Social Care, London SW1H 0EU, UK
| | - Sian Evans
- Local Knowledge and Intelligence Service (LKIS) East, Office for Health Improvement and Disparities, Department of Health and Social Care, Cambridge CB21 5XA, UK
| | - Michelle Mancini
- Office for Health Improvement and Disparities, North East and Yorkshire, Department of Health and Social Care, Newcastle NE15 8NY, UK
| | - Helen Outhwaite
- Improvement Directorate, NHS England and NHS Improvement, Leeds LS2 7UE, UK
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Christie-de Jong F, Kotzur M, Amiri R, Ling J, Mooney JD, Robb KA. Qualitative evaluation of a codesigned faith-based intervention for Muslim women in Scotland to encourage uptake of breast, colorectal and cervical cancer screening. BMJ Open 2022; 12:e058739. [PMID: 35568495 PMCID: PMC9109091 DOI: 10.1136/bmjopen-2021-058739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES This pilot study aimed to evaluate the acceptability of a codesigned, culturally tailored, faith-based online intervention to increase uptake of breast, colorectal and cervical screening in Scottish Muslim women. The intervention was codesigned with Scottish Muslim women (n=10) and underpinned by the reframe, reprioritise and reform model and the behaviour change wheel. SETTING The study was conducted online, using Zoom, due to the COVID-19 pandemic. PARTICIPANTS Participants (n=18) taking part in the intervention and subsequently in its evaluation, were Muslim women residing in Scotland, recruited through purposive and snowball sampling from a mosque and community organisations. Participants were aged between 25 years and 54 years and of Asian and Arab ethnicity. DESIGN The study's codesigned intervention included (1) a peer-led discussion of barriers to screening, (2) a health education session led by a healthcare provider, (3) videos of Muslim women's experiences of cancer or screening, and (4) a religious perspective on cancer screening delivered by a female religious scholar (alimah). The intervention was delivered twice online in March 2021, followed 1 week later by two focus groups, consisting of the same participants, respectively, to discuss participants' experiences of the intervention. Focus group transcripts were analysed thematically. RESULTS Participants accepted the content and delivery of the intervention and were positive about their experience of the intervention. Participants reported their knowledge of screening had increased and shared positive views towards cancer screening. They valued the multidimensional delivery of the intervention, appreciated the faith-based perspective, and in particular liked the personal stories and input from a healthcare provider. CONCLUSION Participatory and community-centred approaches can play an important role in tackling health inequalities in cancer and its screening. Despite limitations, the intervention showed potential and was positively received by participants. Feasibility testing is needed to investigate effectiveness on a larger scale in a full trial.
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Affiliation(s)
| | - Marie Kotzur
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Rana Amiri
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | | | - Kathryn A Robb
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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Widyarini N, Retnowati S, Setiyawati D. An explorative study of beliefs in two groups of community health promoters of adolescent reproductive health in Indonesia: informed by theory of planned behavior. ETHNICITY & HEALTH 2022; 27:894-908. [PMID: 33153288 DOI: 10.1080/13557858.2020.1838453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To explore beliefs in specific social context and potential individual-level behavioral strategies used by two groups of community health promoters to foster their participation of promoting ARH. DESIGN Two phases of formative studies based on the Theory of Planned Behavior (TPB) was conducted with community health promoters in the integrated service center (pos pelayanan terpadu/posyandu), posyandu cadres and peer educators of three villages in Tengger, East Java, Indonesia. RESULT The phase one, conducted with posyandu cadres (n = 20) and peer educators (n = 21). A survey using open-ended questions and focus group discussion was carry out to elicit accessible behavioral (advantages and disadvantages), normative (references of who have significant roles for promoters) and control (personal or situational factors) beliefs related to ARH promotion. The content analysis, elicited 15 salient beliefs for posyandu cadre and 21 for the peer educators. In phase two, the participants who previously participated in phase 1 (posyandu cadres (n = 14 and peer educators (n = 21))), completed two questionnaires to measure the belief strength and evaluation of the beliefs. CONCLUSIONS The result showed that each group has different characteristic in the strength of their beliefs in promoting reproductive health. The findings highlight the social context underlying beliefs associated with ARH promotion and opportunities to enhance engagement with the different groups of community health promoters.
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Affiliation(s)
- Nurlaela Widyarini
- Faculty of Psychology, University of Muhammadiyah Jember, Indonesia
- Faculty of Psychology , Universitas Gadjah Mada, Indonesia
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Crisan C, Van Dijk PA, Oxley J, De Silva A. Worker and manager perceptions of the utility of work-related mental health literacy programmes delivered by community organisations: a qualitative study based on the theory of planned behaviour. BMJ Open 2022; 12:e056472. [PMID: 35351719 PMCID: PMC8961141 DOI: 10.1136/bmjopen-2021-056472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Reluctance to seek help is a leading contributor to escalating mental injury rates in Australian workplaces. We explored the benefit of using community organisations to deliver mental health literacy programmes to overcome workplace barriers to help-seeking behaviours. DESIGN This study used a qualitative application of the theory of planned behaviour to examine underlying beliefs that may influence worker's intentions to participate in mental health literacy programmes delivered by community organisations and manager support for them. SETTING This study took place within three large white-collar organisations in the Australian state of Victoria. PARTICIPANTS Eighteen workers and 11 managers (n=29) were interviewed to explore perspectives of the benefits of such an approach. RESULTS Community organisations have six attributes that make them suitable as an alternative mental health literacy programme provider including empathy, safety, relatability, trustworthiness, social support and inclusivity. Behavioural beliefs included accessibility, understanding and objectivity. The lack of suitability and legitimacy due to poor governance and leadership was disadvantages. Normative beliefs were that family and friends would most likely approve, while line managers and colleagues were viewed as most likely to disapprove. Control beliefs indicated that endorsements from relevant bodies were facilitators of participation. Distance/time constraints and the lack of skills, training and lived experiences of coordinators/facilitators were seen as barriers. CONCLUSIONS Identifying workers' beliefs and perceptions of community organisations has significant implication for the development of effective community-based strategies to improve worker mental health literacy and help seeking. Organisations with formal governance structures, allied with government, peak bodies and work-related mental health organisations would be most suitable. Approaches should focus on lived experience and be delivered by qualified facilitators. Promoting supervisor and colleague support could improve participation. Models to guide cross-sector collaborations to equip community organisations to deliver work-related mental health literacy programmes need to be explored.
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Affiliation(s)
- Corina Crisan
- Monash Sustainable Development Institute, BehaviourWorks Australia, Monash University, Melbourne, Victoria, Australia
| | | | - Jennie Oxley
- Monash University Accident Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Andrea De Silva
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Lee C, Bassam ERW, Kuhn I. Community-oriented actions by food retailers to support community well-being: a systematic scoping review. Public Health 2021; 201:115-124. [PMID: 34861630 DOI: 10.1016/j.puhe.2021.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Growing inequalities, austerity public funding, and the COVID-19 pandemic have contributed to heightened interest in mobilising the assets and resources within communities to support health and well-being. We aimed to identify the type of actions or initiatives by food retail stores intended to support local communities and contribute to well-being. STUDY DESIGN A Scoping Review. METHOD A scoping review was conducted in Scopus, Web of Science, and of grey literature to identify the extent of study of food retail stores in supporting community well-being, types and outcomes recorded from community-oriented actions. Data extraction included: population targeted, the content of initiative/action, outcomes recorded and key insights. Studies were grouped into broad categories relating to their actions and objectives. RESULTS Actions were associated with either strengthening communities or public health prevention or promotion. Few studies reported clearly on impact, and most accounts of impact on well-being and broader community outcomes were narrative accounts rather than objectively measured. Although rigorous capture of outcomes was absent, there were consistent themes around partnership and community insights that are relevant to the development and implementation of future actions in communities. CONCLUSIONS This is an under-researched area that may nevertheless hold potential to support the broader public health effort in communities. To provide clear recommendations for specific investments, there is merit in identifying a subset of health and well-being outcomes most likely to be associated with food retailer community actions in order to assess and capture impact in future. We propose that the theoretical underpinning associated with asset-based approaches, which take account of context and community conditions, would be a useful framework for future study.
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Affiliation(s)
- C Lee
- Cambridge Institute for Sustainability Leadership and Cambridge Public Health. 1 Trumpington Street, Cambridge, CB2 1QA, UK; Cambridge Public Health, Interdisciplinary Research Centre, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
| | - E R W Bassam
- Cambridge Institute for Sustainability Leadership and Cambridge Public Health. 1 Trumpington Street, Cambridge, CB2 1QA, UK
| | - I Kuhn
- University of Cambridge Medical Library, University of Cambridge School of Clinical Medicine, Box 111 Cambridge Biomedical Campus, Cambridge, CB2 0SP, UK
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13
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Crosse AM, Barry MM, Lavelle MJ, Sixsmith J. Bridging Knowledge Systems: A Community-Participatory Approach to EcoHealth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312437. [PMID: 34886163 PMCID: PMC8657114 DOI: 10.3390/ijerph182312437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 11/17/2022]
Abstract
Earth’s life-supporting ecosystems are integral to human and planetary health. Ecosystem services connect ecosystem functions to human wellbeing. The complex, multifaceted socio-ecological challenges of ecosystem decline necessitate a transdisciplinary approach, including the active and meaningful engagement and participation of local communities. Communities uniquely possess expert local knowledge, which, when integrated into policy development and community planning, has the potential to enhance and sustain ecosystem benefits for health and wellbeing. Community-informed mapping tools provide an opportunity for integrating science, policy, and public participation in data collection. However, there is a dearth of community-informed mapping tools demonstrating the interconnection of the ecological and social determinants of health at a place-based level. This paper presents a study that employs a community-based participatory research approach to mapping local knowledge systems on EcoHealth. The study seeks to develop a community mapping tool for shared dialogue and decision-making on EcoHealth between local communities and policymakers. The participatory research methods used to explore community awareness and knowledge regarding ecosystem services, health, and sustainability in the local area are described. The process of co-producing a Community EcoHealth Toolkit, based on the integration of different knowledge systems into local policy and planning, is discussed.
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14
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Stathi A, Withall J, Agyapong-Badu S, Barrett E, Kritz M, Wills D, Thogersen-Ntoumani C, Fox KR. Mobilising people as assets for active ageing promotion: a multi-stakeholder perspective on peer volunteering initiatives. BMC Public Health 2021; 21:150. [PMID: 33461519 PMCID: PMC7812118 DOI: 10.1186/s12889-020-10136-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/27/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Successful peer volunteering is central to many community-based, active ageing initiatives. This study synthesises the perspectives of a range of stakeholders involved in peer volunteering initiatives and provides recommendations as to how peer volunteers can be effectively mobilised as community assets. METHODS An evidence synthesis of qualitative data from (a) the evaluation of ACE (Active, Connected, Engaged), a feasibility trial of a peer volunteering active ageing intervention, and (b) interviews with volunteers and managers of third sector organisations providing peer volunteering programmes. Data were analysed using directed content analysis. RESULTS Ten managers, 22 volunteers and 20 ACE participants were interviewed. The analysis identified six main themes, 33 higher and 22 sub themes. Main themes were: (i) Motives, (ii) Benefits, (iii) Skills and Characteristics, (iv) Challenges, (v) Training Needs, (vi) Recruitment and Retention. Altruism, changes in life circumstances, opportunities to reconnect with the community and personal fulfilment were the main reasons for volunteering. Volunteering was described as being personally rewarding, an avenue to acquire new skills and knowledge, and an opportunity for increased social connections and physical activity. Good peer volunteers are committed, reliable, have a good sense of humour, good interpersonal skills and are able to relate to participants. When pairing volunteers with participants, shared interests and geographical proximity are important to consider. Clarity of role, level of time commitment, regular feedback, recognition of effort and strong networks for on-going support are important strategies to facilitate volunteer retention. CONCLUSIONS The findings of this study support the value of peer volunteering as a strategy for mobilising community assets in promoting active ageing. To ensure success and longevity, these schemes require appropriate funding and efficient administrative support.
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Affiliation(s)
- Afroditi Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Department for Health, University of Bath, Bath, UK
| | | | - Sandra Agyapong-Badu
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Eva Barrett
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Marlene Kritz
- School of Psychology, Curtin University, Perth, Australia
| | | | | | - Kenneth R. Fox
- School of Policy Studies, University of Bristol, Bristol, UK
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Hutchinson SL, Lauckner H. Recreation and collaboration within the Expanded Chronic Care Model: working towards social transformation. Health Promot Int 2020; 35:1531-1542. [PMID: 31990349 DOI: 10.1093/heapro/daz134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Assisting people to live well with a chronic physical or mental health condition requires the creation of intersectoral community-based supports for chronic condition self-management. One important but underutilized resource for supporting chronic condition self-management in the community is recreation, which refers to relatively self-determined and enjoyable physical, social or expressive everyday activities. The Expanded Chronic Care Model (ECCM) provides a framework for identifying systems-level strategies to support self-management through increased access to community recreation opportunities. In this article, an occupation-based social transformation approach, which involves examining assumptions, considering contexts of daily activities and partnering to create meaningful social change, is used to examine the ECCM. Recommendations related to strengthening social change with a specific focus on collaborations and networks through recreation are provided. Through such collaborations, self-management of chronic conditions in community recreation contexts is advanced. Health providers and community-based recreation services providers are invited to be part of these intersectoral changes that will promote health amongst those living with chronic conditions.
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Affiliation(s)
- Susan L Hutchinson
- School of Health and Human Performance, Dalhousie University, 6230 South Street, Halifax, Nova Scotia, Canada
| | - Heidi Lauckner
- School of Occupational Therapy, 5869 University Avenue, Halifax, Nova Scotia, Canada
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16
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Stansfield J, South J, Mapplethorpe T. What are the elements of a whole system approach to community-centred public health? A qualitative study with public health leaders in England's local authority areas. BMJ Open 2020; 10:e036044. [PMID: 32847905 PMCID: PMC7451485 DOI: 10.1136/bmjopen-2019-036044] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 07/16/2020] [Accepted: 07/22/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The aim of the study was to identify key elements of whole system approaches to building healthy communities and putting communities at the heart of public health with a focus on public health practice to reduce health inequalities. DESIGN A mixed-method qualitative study was undertaken. The primary method was semi-structured interviews with 17 public health leaders from 12 local areas. This was supplemented by a rapid review of literature, a survey of 342 members of the public via Public Health England's (PHE) People's Panel and a round-table discussion with 23 stakeholders. SETTING Local government in England. RESULTS Eleven elements of community-centred public health practice that constitute taking a whole system approach were identified. These were grouped into the headings of involving, strengthening, scaling and sustaining. The elements were underpinned by a set of values and principles. CONCLUSION Local public health leaders are in a strong position to develop a whole system approach to reducing health inequalities that puts communities at its heart. The elements, values and principles summarise what a supportive infrastructure looks like and this could be further tested with other localities and communities as a framework for scaling community-centred public health.
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Affiliation(s)
- Jude Stansfield
- Health Improvement Division, Public Health England, London, UK
- School of Health and Community Studies, Leeds Beckett University, Leeds, West Yorkshire, UK
| | - Jane South
- Health Improvement Division, Public Health England, London, UK
- School of Health and Community Studies, Leeds Beckett University, Leeds, West Yorkshire, UK
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Turin TC, Abedin T, Chowdhury N, Ferdous M, Vaska M, Rumana N, Urrutia R, Chowdhury MZI. Community engagement with immigrant communities involving health and wellness research: a systematic review protocol towards developing a taxonomy of community engagement definitions, frameworks, and methods. BMJ Open 2020; 10:e035649. [PMID: 32265248 PMCID: PMC7245376 DOI: 10.1136/bmjopen-2019-035649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/17/2020] [Accepted: 03/13/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The importance of community engagement has been established globally in health and wellness research. A certain degree of ambiguity remains, however, regarding the meaning of community engagement, which term has been used for various purposes and implemented in various forms. In this study, we aimed to explore the different definitions of community engagement, discuss the various objectives that have been proposed and uncover the diverse ways this concept has been implemented among researchers working for the betterment of the health and wellness of immigrant communities in host countries. METHODS AND ANALYSIS Taxonomy is a process for classifying complex and multifaceted matters using logical conceptual domains and dimensions for clearer way of contextualising. We will develop a taxonomy to organise the available literature on community engagement in immigrant health and wellness research in a way that captures user knowledge and understanding of its various meanings and processes. Specific methodological and analytical frameworks for systematic review and taxonomy development will guide each step. We will conduct a comprehensive systematic search in relevant databases, from inception to December 2019, using appropriate keywords followed by snowball search (single-citation tracking, reference lists). Papers will be included if they fall within predefined inclusion criteria (seen as most likely informative on elements pertaining to community engagement) and are written in English, regardless of design (conceptual, qualitative and quantitative). Two reviewers will independently employ two-stage screening (title-abstract screening followed by screening of the full text to determine inclusion). Finally, information that helps to develop taxonomy of the concept and practice of community engagement will be abstracted and used towards taxonomy development, where different levels of stakeholder research team members will be involved. ETHICS AND DISSEMINATION Ethical approval is not required for this systematic review. We have opted for an integrated knowledge translation or a community-engaged knowledge mobilisation approach where we are engaged with community-based citizen researchers from the inception of our programme. We plan to disseminate the results of our review through meetings with key stakeholders, followed by journal publications and presentations at applicable platforms.
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Affiliation(s)
- Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tasnima Abedin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nashit Chowdhury
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mahzabin Ferdous
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Marcus Vaska
- Knowledge Resource Service, Alberta Health Services, Calgary, Alberta, Canada
| | - Nahid Rumana
- Foothills Medical Center, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rossana Urrutia
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mohammad Ziaul Islam Chowdhury
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Pelletier CA, Pousette A, Ward K, Fox G. Exploring the perspectives of community members as research partners in rural and remote areas. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:3. [PMID: 32015898 PMCID: PMC6990467 DOI: 10.1186/s40900-020-0179-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Community engagement in research has the potential to support the development of meaningful health promotion interventions to address health inequities. People living in rural and remote areas face increased barriers to participation in health research and may be unjustly excluded from participation. It is necessary to understand the process of patient and public engagement from the perspective of community members to support partnered research in underserved areas. The aim of this project was to increase understanding on how to include community members from rural and remote areas as partners on research teams. METHODS Using purposive sampling, we completed semi-structured interviews with a representative sample of 12 community members in rural and remote areas of northern British Columbia, Canada. Interviews were audio recorded and transcribed verbatim. Following an integrated knowledge translation approach, an inductive thematic analysis was completed to incorporate researcher and knowledge user perspectives. RESULTS The factors important to community members for becoming involved in research include: 1) relevance; 2) communication; and 3) empowering participation. The analysis suggests projects must be relevant to both communities and individuals. Most participants stated that they would not be interested in becoming partners on research projects that did not have a direct benefit or value for their communities. Participants expressed the need for clear expectations and clarification of preferred communication mechanisms. Communication must be regular, appropriate in length and content, and written in a language that is accessible. It is essential to ensure that community members are recognized as subject matter experts, to provide appropriate training on the research process, and to use research outcomes to support decision making. CONCLUSIONS To engage research partners in rural and remote communities, research questions and outcomes should be co-produced with community members. In-person relationships can help establish trust and bidirectional communication mechanisms are prudent throughout the research process, including the appropriate sharing of research findings. Although this project did not include community members as research team members or in the co-production of this research article, we present guidelines for research teams interested in adding a patient or public perspective to their integrated knowledge translation teams.
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Affiliation(s)
- Chelsea A. Pelletier
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada
| | - Anne Pousette
- Promotion of Wellness in Northern BC (WINBC), Clinical Faculty, Northern Medical Program, University of British Columbia, Medical Staff, University Hospital of Northern BC, Northern Health, Prince George, Canada
| | - Kirsten Ward
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada
- Present address: Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Gloria Fox
- Population and Preventive Public Health, Northern Health, Prince George, Canada
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Complexity and Community Context: Learning from the Evaluation Design of a National Community Empowerment Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010091. [PMID: 31877710 PMCID: PMC6981559 DOI: 10.3390/ijerph17010091] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/11/2019] [Accepted: 12/17/2019] [Indexed: 12/03/2022]
Abstract
Community empowerment interventions, which aim to build greater individual and community control over health, are shaped by the community systems in which they are implemented. Drawing on complex systems thinking in public health research, this paper discusses the evaluation approach used for a UK community empowerment programme focused on disadvantaged neighbourhoods. It explores design choices and the tension between the overall enquiry questions, which were based on a programme theory of change, and the varied dynamic socio-cultural contexts in intervention communities. The paper concludes that the complexity of community systems needs to be accounted for through in-depth case studies that incorporate community perspectives.
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