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Coulston F, Spittle A, McDonald C, Toovey R, Cameron KL, Attard K, Binstock L, Fletcher I, Delaney A, Murphy T, Keating C, Sellick K. Development and Evaluation of a Framework for Authentic Online Co-Design: Partnership-Focussed Principles-Driven Online Co-Design. Health Expect 2024; 27:e14138. [PMID: 38982761 PMCID: PMC11233779 DOI: 10.1111/hex.14138] [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: 03/15/2024] [Revised: 05/20/2024] [Accepted: 06/19/2024] [Indexed: 07/11/2024] Open
Abstract
INTRODUCTION Co-design in health research involves patient and public involvement and engagement (PPIE) in intervention or service design. Traditionally, co-design is undertaken in-person; however, exploring online delivery is warranted. PPIE in co-design must be considered carefully, and assumptions that in-person approaches will transition automatically to an online environment should be avoided. Currently, there are a lack of evidence-informed approaches to facilitating co-design online. This study aimed to develop and evaluate a framework for authentically adapting health research co-design into an online environment. MATERIALS AND METHODS The initial framework was developed through a literature review, synthesis of in-person co-design principles, and alignment of online strategies. The framework was then applied to a co-design project with 10 participants across relevant PPIE groups (end-users [n = 4], clinicians [n = 2], coaches [n = 2] and clinician-researchers [n = 2]). Participants' experiences of the online co-design process were evaluated via a mixed-methods design using surveys and semi-structured interviews. Evaluation data were analysed using descriptive statistics and reflexive thematic analysis to inform a revised framework. RESULTS The developed framework, Partnership-focussed Principles-driven Online co-Design (P-POD) was used to design eight 90 min online co-design workshops. Evaluation data involved 46 survey responses, and eight participants were interviewed on project completion. Survey data indicated that the process was satisfying, engaging and adhered to the P-POD framework. Themes derived from interview data describe a respectful and collaborative online culture, valuing of diverse perspectives and space for healthy debate, how power was perceived as being shared but not equal and multiple definitions of success within and beyond the process. A final, refined P-POD framework is presented. CONCLUSION With evaluation of the initial P-POD framework showing evidence of adherence to co-design principles, positive participant experiences and goal achievement for both the project and the participants, the refined P-POD framework may be used and evaluated within future intervention or service design. PATIENT OR PUBLIC CONTRIBUTION This study involved the participants (end-users, clinicians and service providers) in the co-design process described, interpretation of the results through member-checking interview responses, assisting in development of the final framework and as co-authors for this manuscript.
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Affiliation(s)
- Free Coulston
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Clinical SciencesMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Alicia Spittle
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Clinical SciencesMurdoch Children's Research InstituteParkvilleVictoriaAustralia
- Newborn ServicesThe Royal Women's HospitalParkvilleVictoriaAustralia
| | - Cassie McDonald
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Allied HealthAlfred HealthMelbourneVictoriaAustralia
| | - Rachel Toovey
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Clinical SciencesMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Kate L. Cameron
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Clinical SciencesMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Kimberley Attard
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Loni Binstock
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Consumer Advisory Group, Centre for Research Excellence in Newborn MedicineMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Isaac Fletcher
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Adie Delaney
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Tayla Murphy
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Caroline Keating
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Kath Sellick
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
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Carr C, King LM, Maizel J, Scaglione NM, Stetten NE, Varnes JR, Tomko C. Strategies and Interventions Used to Prevent Violence Against Sex Workers in the United States: A Scoping Review Using the Social-Ecological Model. TRAUMA, VIOLENCE & ABUSE 2024; 25:2436-2451. [PMID: 38054440 DOI: 10.1177/15248380231214786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Structural factors in the United States, such as criminalization, contribute to disproportionate rates of violence against sex workers and subsequent risk of adverse health outcomes. There is a clear need for systemic interventions and risk reduction strategies to reduce violence in this population. To inform next steps in prevention, this scoping review provides an overview of the literature on violence prevention efforts targeting sex workers in the United States, mapped out according to the social-ecological model (SEM). A comprehensive search of peer-reviewed literature across five databases with no limit on publication date yielded 2,372 documents. Studies were eligible for inclusion if they focused on the U.S. population of sex workers and had a clearly defined aim or purpose of exploring, describing, or evaluating sex work violence prevention interventions or risk reduction strategies. Twelve studies met all eligibility criteria and were selected. Only two of the studies evaluated sexual violence prevention interventions, while the remaining 10 explored strategies sex workers use to minimize the risk of violence. Most research focused on female sex workers, violence from paying clients, and prevention at the individual level of the SEM. Our findings suggest a need for additional violence prevention interventions tailored for diverse groups of sex workers and cognizant of the overlapping forms of violence they face. This scoping review contributes to the limited body of research on the prevention of violence against sex workers in the United States by providing future directions for research and program development that span across the SEM.
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Affiliation(s)
- Cary Carr
- University of Florida, Gainesville, USA
| | | | - Jennifer Maizel
- University of Florida, Gainesville, USA
- Nova Southeastern University, Fort Lauderdale, FL, USA
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Merner B, Schonfeld L, Virgona A, Lowe D, Walsh L, Wardrope C, Graham-Wisener L, Xafis V, Colombo C, Refahi N, Bryden P, Chmielewski R, Martin F, Messino NM, Mussared A, Smith L, Biggar S, Gill M, Menzies D, Gaulden CM, Earnshaw L, Arnott L, Poole N, Ryan RE, Hill S. Consumers' and health providers' views and perceptions of partnering to improve health services design, delivery and evaluation: a co-produced qualitative evidence synthesis. Cochrane Database Syst Rev 2023; 3:CD013274. [PMID: 36917094 PMCID: PMC10065807 DOI: 10.1002/14651858.cd013274.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Partnering with consumers in the planning, delivery and evaluation of health services is an essential component of person-centred care. There are many ways to partner with consumers to improve health services, including formal group partnerships (such as committees, boards or steering groups). However, consumers' and health providers' views and experiences of formal group partnerships remain unclear. In this qualitative evidence synthesis (QES), we focus specifically on formal group partnerships where health providers and consumers share decision-making about planning, delivering and/or evaluating health services. Formal group partnerships were selected because they are widely used throughout the world to improve person-centred care. For the purposes of this QES, the term 'consumer' refers to a person who is a patient, carer or community member who brings their perspective to health service partnerships. 'Health provider' refers to a person with a health policy, management, administrative or clinical role who participates in formal partnerships in an advisory or representative capacity. This QES was co-produced with a Stakeholder Panel of consumers and health providers. The QES was undertaken concurrently with a Cochrane intervention review entitled Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. OBJECTIVES 1. To synthesise the views and experiences of consumers and health providers of formal partnership approaches that aimed to improve planning, delivery or evaluation of health services. 2. To identify best practice principles for formal partnership approaches in health services by understanding consumers' and health providers' views and experiences. SEARCH METHODS We searched MEDLINE, Embase, PsycINFO and CINAHL for studies published between January 2000 and October 2018. We also searched grey literature sources including websites of relevant research and policy organisations involved in promoting person-centred care. SELECTION CRITERIA We included qualitative studies that explored consumers' and health providers' perceptions and experiences of partnering in formal group formats to improve the planning, delivery or evaluation of health services. DATA COLLECTION AND ANALYSIS Following completion of abstract and full-text screening, we used purposive sampling to select a sample of eligible studies that covered a range of pre-defined criteria, including rich data, range of countries and country income level, settings, participants, and types of partnership activities. A Framework Synthesis approach was used to synthesise the findings of the sample. We appraised the quality of each study using the CASP (Critical Appraisal Skill Program) tool. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. The Stakeholder Panel was involved in each stage of the review from development of the protocol to development of the best practice principles. MAIN RESULTS We found 182 studies that were eligible for inclusion. From this group, we selected 33 studies to include in the final synthesis. These studies came from a wide range of countries including 28 from high-income countries and five from low- or middle-income countries (LMICs). Each of the studies included the experiences and views of consumers and/or health providers of partnering in formal group formats. The results were divided into the following categories. Contextual factors influencing partnerships: government policy, policy implementation processes and funding, as well as the organisational context of the health service, could facilitate or impede partnering (moderate level of confidence). Consumer recruitment: consumer recruitment occurred in different ways and consumers managed the recruitment process in a minority of studies only (high level of confidence). Recruiting a range of consumers who were reflective of the clinic's demographic population was considered desirable, particularly by health providers (high level of confidence). Some health providers perceived that individual consumers' experiences were not generalisable to the broader population whereas consumers perceived it could be problematic to aim to represent a broad range of community views (high level of confidence). Partnership dynamics and processes: positive interpersonal dynamics between health providers and consumers facilitated partnerships (high level of confidence). However, formal meeting formats and lack of clarity about the consumer role could constrain consumers' involvement (high level of confidence). Health providers' professional status, technical knowledge and use of jargon were intimidating for some consumers (high level of confidence) and consumers could feel their experiential knowledge was not valued (moderate level of confidence). Consumers could also become frustrated when health providers dominated the meeting agenda (moderate level of confidence) and when they experienced token involvement, such as a lack of decision-making power (high level of confidence) Perceived impacts on partnership participants: partnering could affect health provider and consumer participants in both positive and negative ways (high level of confidence). Perceived impacts on health service planning, delivery and evaluation: partnering was perceived to improve the person-centredness of health service culture (high level of confidence), improve the built environment of the health service (high level of confidence), improve health service design and delivery e.g. facilitate 'out of hours' services or treatment closer to home (high level of confidence), enhance community ownership of health services, particularly in LMICs (moderate level of confidence), and improve consumer involvement in strategic decision-making, under certain conditions (moderate level of confidence). There was limited evidence suggesting partnering may improve health service evaluation (very low level of confidence). Best practice principles for formal partnering to promote person-centred care were developed from these findings. The principles were developed collaboratively with the Stakeholder Panel and included leadership and health service culture; diversity; equity; mutual respect; shared vision and regular communication; shared agendas and decision-making; influence and sustainability. AUTHORS' CONCLUSIONS Successful formal group partnerships with consumers require health providers to continually reflect and address power imbalances that may constrain consumers' participation. Such imbalances may be particularly acute in recruitment procedures, meeting structure and content and decision-making processes. Formal group partnerships were perceived to improve the physical environment of health services, the person-centredness of health service culture and health service design and delivery. Implementing the best practice principles may help to address power imbalances, strengthen formal partnering, improve the experiences of consumers and health providers and positively affect partnership outcomes.
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Affiliation(s)
- Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Ariane Virgona
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- Child and Family Evidence, Australian Institute of Family Studies, Melbourne, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Cheryl Wardrope
- Clinical Governance, Metro South Hospital and Health Service, Eight Mile Plains, Australia
| | | | - Vicki Xafis
- The Sydney Children's Hospitals Network, Sydney, Australia
| | - Cinzia Colombo
- Laboratory for medical research and consumer involvement, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Nora Refahi
- Consumer Representative, Melbourne, Australia
| | - Paul Bryden
- Consumer Representative, Caboolture, Australia
| | - Renee Chmielewski
- Planning and Patient Experience, The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | | | | | | | - Lorraine Smith
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Susan Biggar
- Consumer Representative, Melbourne, Australia
- Australian Health Practitioner Regulation Agency (AHPRA), Melbourne, Australia
| | - Marie Gill
- Gill and Wilcox Consultancy, Melbourne, Australia
| | - David Menzies
- Chronic Disease Programs, South Eastern Melbourne Primary Health Network, Heatherton, Australia
| | - Carolyn M Gaulden
- Detroit Wayne County Authority Health Residency Program, Michigan State University, Providence Hospital, Southfield, Michigan, USA
| | | | | | - Naomi Poole
- Strategy and Innovation, Australian Commission on Safety and Quality in Health Care, Sydney, Australia
| | - Rebecca E Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Brothers S, Palayew A, Simon C, Coulter A, Strichartz K, Voyles N, Vincent L. Patient experiences of methadone treatment changes during the first wave of COVID-19: a national community-driven survey. Harm Reduct J 2023; 20:31. [PMID: 36894968 PMCID: PMC9996563 DOI: 10.1186/s12954-023-00756-3] [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: 12/14/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND During COVID-19, the Substance Abuse and Mental Health Services Administration (SAMHSA) allowed Methadone Maintenance Treatment (MMT) programs to relax in-person MMT requirements to reduce COVID-19 exposure. This study examines patient-reported changes to in-person methadone clinic attendance requirements during COVID-19. METHODS From June 7, 2020, to July 15, 2020, a convenience sample of methadone patients (N = 392) were recruited in collaboration with National Survivors Union (NSU) in 43 states and Washington D.C. through social media (Facebook, Reddit, Twitter, and Web site pop-ups). The community-driven research (CDR) online survey collected information on how patient take-home methadone dosing and in-person drug testing, counseling, and clinic visit frequency changed prior to COVID-19 (before March 2020) to during COVID-19 (June and July 2020). RESULTS During the study time period, the percentage of respondents receiving at least 14 days of take-home doses increased from 22 to 53%, while the percentage receiving one or no take-home doses decreased from 22.4% before COVID-19 to 10.2% during COVID-19. In-person counseling attendance decreased from 82.9% to 19.4%. While only 3.3% of respondents accessed counseling through telehealth before COVID-19, this percentage increased to 61.7% during COVID-19. Many respondents (41.3%) reported visiting their clinics in person once a week or more during COVID-19. CONCLUSIONS During the first wave of COVID-19, methadone patients report decreased in-person clinic attendance and increased take-home doses and use of telehealth for counseling services. However, respondents reported considerable variations, and many were still required to make frequent in-person clinic visits, which put patients at risk of COVID-19 exposure. Relaxations of MMT in-person requirements during COVID-19 should be consistently implemented and made permanent, and patient experiences of these changes should be explored further.
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Affiliation(s)
- Sarah Brothers
- Department of Sociology, Pennsylvania State University, University Park, USA.
| | - Adam Palayew
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Caty Simon
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA.,NC Survivors Union, Greensboro, NC, USA.,Whose Corner Is It Anyway, Holyoke, MA, USA
| | - Abby Coulter
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA
| | - Knina Strichartz
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA
| | - Nick Voyles
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA
| | - Louise Vincent
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA.,NC Survivors Union, Greensboro, NC, USA
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Gilgoff JN, Park E, Price J, Scott T, Moyd T, Rouse K, Knighton G, Frey J, Mattocks N, Shook E, Tuten M, Unick J, Wagner FA. Building Equitable Community-Academic Partnerships for Opioid Recovery Research: Lessons Learned from Stakeholder Engagement With Peer and Provider Organizations. JOURNAL OF COMMUNITY ENGAGEMENT AND SCHOLARSHIP 2022; 15:479. [PMID: 36540657 PMCID: PMC9762856 DOI: 10.54656/jces.v15i1.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Forming equity-based community-academic partnerships focused on recovery research is a time- consuming and challenging endeavor, but one well worth the care and effort required. Through building trusting relationships, vital research collaborations emerge, which are driven by expressed community needs and supported with university resources. This article describes the stakeholder engagement process utilized by a university-based and opioid-focused initiative entitled Innovations in Recovery through Infrastructure Support (IRIS). IRIS developed a diverse and representative network of clinical providers, peer recovery workers, academics, and other behavioral health leaders. The process was informed by community-based participatory research (CBPR) practices and principles aimed at creating equitable partnerships. Lessons learned include the need to reshape the relationship between research and the community through an acknowledgment of harms committed by academia, as well as the importance of maintaining an approach of humility, accountability, and patience with the partnership process. Concrete benefits that go beyond the long-term promise of change, including compensating partners financially for their time, help ensure equity. A commitment to always asking "Who's missing?" and then filling those gaps builds a broad network inclusive of the various constituencies that make up the recovery support system. As IRIS builds on these lessons learned and plans next steps, we share our experience to support others engaged in forming community-academic partnerships through deep stakeholder engagement and use of participatory approaches within and outside of recovery research.
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Livingston LJ. Partnerships in pandemics: tracing power relations in community engaged scholarship in food systems during COVID-19. AGRICULTURE AND HUMAN VALUES 2022; 40:217-229. [PMID: 36035965 PMCID: PMC9397152 DOI: 10.1007/s10460-022-10349-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic dramatically disrupted food and educational systems, laying bare institutional inadequacies and structural inequalities. While there has been ample discussion on impacts to the food system and higher education institutions separately, there has been little written through the perspective of people who navigate both. Farmers, researchers, graduate students, chefs, and many stakeholders contribute to community engaged scholarship (CES) in food systems, facing novel obstacles and opportunities with the spread of the pandemic. In this article, I utilize institutional ethnography to center the experiences of the people who participated in or led CES projects during the spring and summer of 2020. The goal of this study is to understand how discourse and texts in the academic institution constrain the reality of CES partnerships and identify areas for change. My findings show that tenure and promotion guidelines and funding opportunities constrain CES partnerships, reducing opportunities for relationship building and discouraging innovative models of participation. Quantified evaluation metrics on grant rubrics and tenure and promotion guidelines privilege individual academic researchers growing large programs, writing lucrative grants for the university, and publishing profusely. However, community-led and decentralized projects were able to adapt to community priorities and sustain research projects during the pandemic. COVID-19 created obstacles to community engagement and allowed for creative approaches to community participation. By restructuring academic evaluation and funding processes to support problem-solving models of CES led by community partners, CES projects can support both academic and community priorities in times of disruption and relative stability.
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Gollust SE, Call KT, Moon JR, Cluxton B, Bailey Z. Designing and Implementing a Curriculum to Support Health Equity Research Leaders: The Interdisciplinary Research Leaders Experience. Front Public Health 2022; 10:876847. [PMID: 35646764 PMCID: PMC9136100 DOI: 10.3389/fpubh.2022.876847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/13/2022] [Indexed: 12/05/2022] Open
Abstract
Health inequities in the United States are well-documented. However, research that is focused on solutions, rather than just describing the problem, and research that is designed explicitly to inform needed policy and practice change, is still too rare. The Robert Wood Johnson Foundation Interdisciplinary Research Leaders (IRL) program launched in 2016 with the goal of filling this gap: to generate community-engaged research to catalyze policy action in communities, while promoting leadership among researchers and community partners. In this paper, we describe the creation and implementation of a curriculum for IRL program participants over the first 5 years of the program. The curriculum—spanning domains of leadership, policy, communication, community engagement, and research methodologies—was designed to cultivate leaders who use research evidence in their efforts to promote change to advance health equity in their communities. The curriculum components implemented by IRL might be applied to other educational programs or fellowships to amplify and accelerate the growth of leaders nationwide who can use research and action to respond to grave and ongoing threats to community health.
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Affiliation(s)
- Sarah E. Gollust
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, United States
- *Correspondence: Sarah E. Gollust
| | - Kathleen T. Call
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - J. Robin Moon
- Department of Health Policy and Management, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | | | - Zinzi Bailey
- Divisions of Medical Oncology and Epidemiology, Department of Medicine, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
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Netherland J, Kral AH, Ompad DC, Davis CS, Bluthenthal RN, Dasgupta N, Gilbert M, Morgan R, Wheelock H. Principles and Metrics for Evaluating Oregon's Innovative Drug Decriminalization Measure. J Urban Health 2022; 99:328-331. [PMID: 35107693 PMCID: PMC8809225 DOI: 10.1007/s11524-022-00606-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Jules Netherland
- Department of Research and Academic Engagement, Drug Policy Alliance, New York, NY, USA
| | | | - Danielle C Ompad
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, USA.
- Center for Drug Use and HIV|HCV Research, New York University School of Global Public Health, New York, NY, USA.
| | - Corey S Davis
- Network for Public Health Law, Harm Reduction Legal Project, Los Angeles, CA, USA
| | - Ricky N Bluthenthal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Nabarun Dasgupta
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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We are the researched, the researchers, and the discounted: The experiences of drug user activists as researchers. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103364. [PMID: 34294521 DOI: 10.1016/j.drugpo.2021.103364] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 06/13/2021] [Accepted: 06/23/2021] [Indexed: 11/20/2022]
Abstract
In this commentary, activists from Urban Survivors Union, the United States national drug users union, discuss our experiences conducting research on methadone clinic adoption of relaxed SAMHSA guidelines during the COVID-19 epidemic. In particular, we focus on our interactions with academic researchers as a grassroots organization of criminalized people designing our own research. We describe the challenges we navigated to retain decision making powers over the research question, data analysis and interpretation, and dissemination. We find that our collaborations with academic researchers are often complicated by power imbalances and structural issues. In our experience as directly impacted people, even community based participatory research (CBPR) often sidelines us. Our eventual research approach demonstrates how our process transcends CBPR by becoming community driven research (CDR). We suggest several changes to the research process in order to propagate this model.
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Not missing the opportunity: Strategies to promote cultural humility among future nursing faculty. J Prof Nurs 2019; 36:28-33. [PMID: 32044049 DOI: 10.1016/j.profnurs.2019.06.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 05/13/2019] [Accepted: 06/03/2019] [Indexed: 12/19/2022]
Abstract
As the demographics in the United States continue to change, nurses must deliver care to patients from diverse cultural backgrounds. Cultural humility is a lifelong process of self-reflection which is also defined by that individual. It allows an individual to be open to other people's identities, which is core to the nursing standard of providing holistic care. Embracing and incorporating cultural humility is essential for creating a comprehensive and individualized plan of care. One of the ways to achieve cultural humility in nursing is to train future faculty to become agents of cultural humility. This also helps to create a pipeline of nurses who have respect and empathy for the patients they serve. The aims of this paper include: 1) define cultural humility and its importance to healthcare professionals; 2) explore the intrapersonal, interpersonal, and system levels of cultural humility; 3) provide insight on how to promote cultural humility; 4) reflect on best practices across a variety of healthcare disciplines; and 5) provide suggestions for practice.
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Switzer S, Chan Carusone S, Guta A, Strike C. A Seat at the Table: Designing an Activity-Based Community Advisory Committee With People Living With HIV Who Use Drugs. QUALITATIVE HEALTH RESEARCH 2019; 29:1029-1042. [PMID: 30499367 DOI: 10.1177/1049732318812773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recently, scholars have begun to critically interrogate the way community participation functions discursively within community-based participatory research (CBPR) and raise questions about its function and limits. Community advisory committees (CACs) are often used within CBPR as one way to involve community members in research from design to dissemination. However, CACs may not always be designed in ways that are accessible for communities experiencing the intersections of complex health issues and marginalization. This article draws on our experience designing and facilitating Research Rec'-a flexible, and activity-based CAC for a project about the acute-care hospital stays of people living with HIV who use drugs. Using Research Rec' as a case study, we reflect on ethical, methodological, and pedagogical considerations for designing and facilitating CACs for this community. We discuss how to critically reflect on the design and facilitation of advisory committees, and community engagement processes in CBPR more broadly.
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Affiliation(s)
| | - Soo Chan Carusone
- 2 Casey House Hospital, Toronto, Ontario, Canada
- 3 McMaster University, Hamilton, Ontario, Canada
| | - Adrian Guta
- 4 University of Windsor, Windsor, Ontario, Canada
| | - Carol Strike
- 5 University of Toronto, Toronto, Ontario, Canada
- 6 Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Bernays S, Paparini S, Namukwaya S, Seeley J. A Failed Method? Reflections on Using Audio Diaries in Uganda With Young People Growing Up With HIV in the BREATHER Trial. QUALITATIVE HEALTH RESEARCH 2019; 29:719-730. [PMID: 30499374 DOI: 10.1177/1049732318813534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this article, we present a case study in which we consider our use of the audio diary method with young people (aged 10-24) living with HIV in Uganda in a longitudinal qualitative study conducted in a clinical randomized control trial. Despite initial enthusiasm for the method among participants to capture accounts of participants' experiences outside of the confines of the HIV clinic, the constraints the young people encountered in accessing sufficient privacy to confidently make recordings meant that no one elected to use them again in the study. Despite the insights the use of the method generated, the lack of acceptability led to its relative failure. This demonstrates that despite the call for innovation, there is an unwavering necessity when selecting methods that they align with the needs and preferences of our participants and with an attentive assessment of the local context in which illness narratives are produced.
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Affiliation(s)
- Sarah Bernays
- 1 University of Sydney, Sydney, New South Wales, Australia
| | - Sara Paparini
- 2 Graduate Institute of International and Development Studies, Geneva, Switzerland
| | | | - Janet Seeley
- 3 Uganda Virus Research Institute, Entebbe, Uganda
- 4 London School of Hygiene & Tropical Medicine, London, United Kingdom
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14
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Shaver J, Freeland R, Goldenberg T, Stephenson R. Gay and Bisexual Men's Perceptions of HIV Risk in Various Relationships. Am J Mens Health 2018; 12:655-665. [PMID: 29355071 PMCID: PMC6131437 DOI: 10.1177/1557988317745759] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/25/2017] [Accepted: 11/02/2017] [Indexed: 11/24/2022] Open
Abstract
Men who have sex with men (MSM) bear a disproportionate burden of HIV incidence in the United States. Previous study of sexual decision-making and HIV risk among MSM has not accounted for relationship dynamics. Further research must examine this connection between relationship dynamics and sexual decision-making, especially regarding condomless anal intercourse. This study analyzes data gathered from gay and bisexual men regarding their sexual partners and sexual decision-making over a 10-week period through personal relationship diaries (PRDs) and a follow-up in-depth interview (IDI). Through coding and extraction of relationship dynamics, key patterns of participants' sexual decision-making processes were examined based on relationship type, which was categorized by commitment, formality, and sexual agreement. Participants' sexual relationships can be divided into five categories: (a) Uncommitted, one time, (b) Uncommitted, ongoing, (c) Transitioning or unknown commitment, (d) Committed, nonmonogamous, and (e) Committed, monogamous. These five categories correspond to patterns in sexual decision making and consequent sexual risk-taking behaviors. Each of these influence HIV risk within male-male sexual encounters in a particular manner, and understanding these is important for appropriately tailored HIV prevention interventions for MSM. Recommendations are included for interventions seeking to address HIV risk across a wide variety of MSM sexual relationships.
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Affiliation(s)
- John Shaver
- Center for Sexuality and Health
Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Ryan Freeland
- Center for Sexuality and Health
Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Tamar Goldenberg
- Center for Sexuality and Health
Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
- Health Behavior and Health Education,
University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rob Stephenson
- Center for Sexuality and Health
Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
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15
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George AS, LeFevre AE, Schleiff M, Mancuso A, Sacks E, Sarriot E. Hubris, humility and humanity: expanding evidence approaches for improving and sustaining community health programmes. BMJ Glob Health 2018; 3:e000811. [PMID: 29946489 PMCID: PMC6014224 DOI: 10.1136/bmjgh-2018-000811] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/03/2018] [Accepted: 05/03/2018] [Indexed: 11/16/2022] Open
Abstract
Community-based approaches are a critical foundation for many health outcomes, including reproductive, maternal, newborn and child health (RMNCH). Evidence is a vital part of strengthening that foundation, but largely focuses on the technical content of what must be done, rather than on how disparate community actors continuously interpret, implement and adapt interventions in dynamic and varied community health systems. We argue that efforts to strengthen evidence for community programmes must guard against the hubris of relying on a single approach or hierarchy of evidence for the range of research questions that arise when sustaining community programmes at scale. Moving forward we need a broader evidence agenda that better addresses the implementation realities influencing the scale and sustainability of community programmes and the partnerships underpinning them if future gains in community RMNCH are to be realised. This will require humility in understanding communities as social systems, the complexity of the interventions they engage with and the heterogeneity of evidence needs that address the implementation challenges faced. It also entails building common ground across epistemological word views to strengthen the robustness of implementation research by improving the use of conceptual frameworks, addressing uncertainty and fostering collaboration. Given the complexity of scaling up and sustaining community RMNCH, ensuring that evidence translates into action will require the ongoing brokering of relationships to support the human creativity, scepticism and scaffolding that together build layers of evidence, critical thinking and collaborative learning to effect change.
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Affiliation(s)
- Asha S George
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Amnesty E LeFevre
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | - Emma Sacks
- Johns Hopkins University, Baltimore, Maryland, USA.,Maternal and Child Survival Program, USAID, Washington, District of Columbia, USA
| | - Eric Sarriot
- Maternal and Child Survival Program, USAID, Washington, District of Columbia, USA.,Save the Children, Washington, District of Columbia, USA
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16
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Kyoon-Achan G, Lavoie J, Avery Kinew K, Phillips-Beck W, Ibrahim N, Sinclair S, Katz A. Innovating for Transformation in First Nations Health Using Community-Based Participatory Research. QUALITATIVE HEALTH RESEARCH 2018; 28:1036-1049. [PMID: 29484964 DOI: 10.1177/1049732318756056] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Community-based participatory research (CBPR) provides the opportunity to engage communities for sustainable change. We share a journey to transformation in our work with eight Manitoba First Nations seeking to improve the health of their communities and discuss lessons learned. The study used community-based participatory research approach for the conceptualization of the study, data collection, analysis, and knowledge translation. It was accomplished through a variety of methods, including qualitative interviews, administrative health data analyses, surveys, and case studies. Research relationships built on strong ethics and protocols to enhance mutual commitment to support community-driven transformation. Collaborative and respectful relationships are platforms for defining and strengthening community health care priorities. We further discuss how partnerships were forged to own and sustain innovations. This article contributes a blueprint for respectful CBPR. The outcome is a community-owned, widely recognized process that is sustainable while fulfilling researcher and funding obligations.
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Affiliation(s)
- Grace Kyoon-Achan
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Josée Lavoie
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathi Avery Kinew
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Wanda Phillips-Beck
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Naser Ibrahim
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stephanie Sinclair
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Alan Katz
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
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17
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Hebert-Beirne J, Hernandez SG, Felner J, Schwiesow J, Mayer A, Rak K, Chávez N, Castañeda Y, Kennelly J. Using Community-Driven, Participatory Qualitative Inquiry to Discern Nuanced Community Health Needs and Assets of Chicago's La Villita, a Mexican Immigrant Neighborhood. J Community Health 2018. [PMID: 29520556 DOI: 10.1007/s10900-018-0484-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In predominately immigrant neighborhoods, the nuances of immigrant life in the ethnic enclave have important, yet underappreciated impact on community health. The complexities of immigrant experiences are essential to unpacking and addressing the impact of acculturative processes on observed racial, ethnic, and class-based health disparities in the United States. These insights because they are largely unexplored are best captured qualitatively through academic-community research partnership. We established the participatory mixed method Little Village participatory community health assessment (CHA) to explore community health in an ethnic enclave. In this paper, we share findings from our qualitative component exploring: how do Residents in a Predominately Immigrant Neighborhood Perceive Community Health Needs and Assets in Little Village. Three major themes emerged: rich, health promoting community assets inherent in the ethnic enclave; cumulative chronic stress impacting the mental health of families and intra-familial strain; and, work and occupation as important but underappreciated community health determinants in an immigrant neighborhood. These nuanced findings enhanced our community health assessment and contributed to the development of two additional tailored CHA methods, a community member-administered Community Health Survey, and an oral history component that provided deeper insight on the community's health needs and assets, and a focus for action on work as a social determinant of health at the community level. Conducting trusted community-driven health assessments that are adaptive and flexible to capture authentic needs and assets are critical, given health consequences of the new anti-immigrant rhetoric and growing socio-political tensions and fear in immigrant neighborhoods in the United States.
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Affiliation(s)
- Jennifer Hebert-Beirne
- Community Health Sciences, University of Illinois at Chicago, School of Public Health, 1603 W Taylor St, Chicago, IL, 60612, USA.
| | - Sarah Gabriella Hernandez
- Department of Psychology, Community and Prevention Research, University of Illinois at Chicago, 1007 W Harrison St, Chicago, IL, 60607, USA
| | - Jennifer Felner
- Division of Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA.,Center for Research on Sexuality and Sexual Health (SASH), Institute for Behavioral and Community Health (IBACH), San Diego State University, 9245 Sky Park Court, Suite 100, San Diego, CA, 92123, USA
| | | | - Anna Mayer
- Taller de José, 2831 W 24th Blvd, Chicago, IL, 60623, USA
| | - Kevin Rak
- Recruitment, Retention, and Community Engagement Program, Center for Clinical and Translational Science, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Noel Chávez
- Community Health Sciences, University of Illinois at Chicago, School of Public Health, 1603 W Taylor St, Chicago, IL, 60612, USA
| | - Yvette Castañeda
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, George Huff Hall, 1206 S 4th St, Champaign, IL, 61820, USA
| | - Joan Kennelly
- Community Health Sciences, University of Illinois at Chicago, School of Public Health, 1603 W Taylor St, Chicago, IL, 60612, USA
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18
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Brave Heart MYH, Chase J, Elkins J, Martin J, Nanez J, Mootz J. Women finding the way: American Indian women leading intervention research in Native communities. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2017; 23:24-47. [PMID: 27383085 DOI: 10.5820/aian.2303.2016.24] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although there is literature concentrating on cross-cultural approaches to academic and community partnerships with Native communities, few address the process and experiences of American Indian women leading federally funded and culturally grounded behavioral health intervention research in Native communities. This paper summarizes relevant literature on community-engaged research with Native communities, examines traditional roles and modern challenges for American Indian women, describes the culturally grounded collaborative process for the authors' behavioral health intervention development with Native communities, and considers emergent themes from our own research experiences navigating competing demands from mainstream and Native communities. It concludes with recommendations for supporting and enhancing resilience.
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19
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Hernandez SG, Genkova A, Castañeda Y, Alexander S, Hebert-Beirne J. Oral Histories as Critical Qualitative Inquiry in Community Health Assessment. HEALTH EDUCATION & BEHAVIOR 2017; 44:705-715. [PMID: 28892652 DOI: 10.1177/1090198117728546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Qualitative methods such as focus groups and interviews are common methodologies employed in participatory approaches to community health assessment to develop effective community health improvement plans. Oral histories are a rarely used form of qualitative inquiry that can enhance community health assessment in multiple ways. Oral histories center residents' lived experiences, which often reveal more complex social and health phenomena than conventional qualitative inquiry. This article examines an oral history research component of the Little Village Community Health Assessment, a collaborative research effort to promote health equity in an urban, Mexican ethnic enclave. We collected of 32 oral histories from residents to provide deeper, more grounded insight on community needs and assets. We initially used thematic data analysis. After analytic peer debriefings with the analysis team, we found the process inadvertently reductionist and instead opted for community listening events for participatory data analysis, knowledge translation, and dissemination of findings. Oral histories were most meaningful in their original audio form, adding to a holistic understanding of health by giving voice to complex problems while also naming and describing concepts that were culturally unique. Moreover, the oral histories collectively articulated a counternarrative that celebrated community cultural wealth and opposed the mainstream narrative of the community as deprived. We argue for the recognition and practice of oral histories as a more routine form of qualitative inquiry in community health assessment. In the pursuit of health equity and collaboratively working toward social justice, oral histories can push the boundaries of community health assessment research and practice.
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Affiliation(s)
| | - Ana Genkova
- 1 University of Illinois at Chicago, IL, USA
| | - Yvette Castañeda
- 2 University of Illinois at Urbana-Champaign, Champaign, IL, USA
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20
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Goodman MS, Sanders Thompson VL. The science of stakeholder engagement in research: classification, implementation, and evaluation. Transl Behav Med 2017; 7:486-491. [PMID: 28397159 PMCID: PMC5645283 DOI: 10.1007/s13142-017-0495-z] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
In this commentary, we discuss the science of stakeholder engagement in research. We propose a classification system with definitions to determine where projects lie on the stakeholder engagement continuum. We discuss the key elements of implementation and evaluation of stakeholder engagement in research posing key questions to consider when doing this work. We commend and critique the work of Hamilton et al. in their multilevel stakeholder engagement in a VA implementation trial of evidence-based quality improvement in women's health primary care. We also discuss the need for more work in this area to enhance the science of stakeholder engagement in research.
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Affiliation(s)
- Melody S Goodman
- College of Global Public Health, New York University, 715-719 Broadway, 10th Floor, New York, NY, 10003, USA.
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21
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Mootz JJ, Stabb SD, Mollen D. Gender-Based Violence and Armed Conflict: A Community-Informed Socioecological Conceptual Model From Northeastern Uganda. PSYCHOLOGY OF WOMEN QUARTERLY 2017; 41:368-388. [PMID: 29563663 PMCID: PMC5858720 DOI: 10.1177/0361684317705086] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The high prevalence of gender-based violence (GBV) in armed conflict has been documented in various national contexts, but less is known about the complex pathways that constitute the relation between the two. Employing a community-based collaborative approach, we constructed a community-informed socioecological conceptual model from a feminist perspective, detailing how armed conflict relates to GBV in a conflict-affected rural community in Northeastern Uganda. The research questions were as follows: (1) How does the community conceptualize GBV? and (2) How does armed conflict relate to GBV? Nine focus group discussions divided by gender, age, and profession and six key informant interviews were conducted. Participants' ages ranged from 9 to 80 years (n =34 girls/women, n = 43 boys/men). Grounded theory was used in analysis. Participants conceptualized eight forms of and 22 interactive variables that contributed to GBV. Armed conflict affected physical violence/quarreling, sexual violence, early marriage, and land grabbing via a direct pathway and four indirect pathways initiated through looting of resources, militarization of the community, death of a parent(s) or husband, and sexual violence. The findings suggest that community, organizational, and policy-level interventions, which include attention to intersecting vulnerabilities for exposure to GBV in conflict-affected settings, should be prioritized. While tertiary psychological interventions with women and girls affected by GBV in these areas should not be eliminated, we suggest that policy makers and members of community and organizational efforts make systemic and structural changes. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index.
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Affiliation(s)
- Jennifer J. Mootz
- Department of Psychology and Philosophy, Texas Woman’s University, Denton, TX, USA
- Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA
| | - Sally D. Stabb
- Department of Psychology and Philosophy, Texas Woman’s University, Denton, TX, USA
| | - Debra Mollen
- Department of Psychology and Philosophy, Texas Woman’s University, Denton, TX, USA
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22
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Blanchard AK, Sangha CATM, Nair SG, Thalinja R, Srikantamurthy HS, Ramanaik S, Javalkar P, Pillai P, Isac S, Collumbien M, Heise L, Bhattacharjee P, Bruce SG. Pursuing Authenticity From Process to Outcome in a Community-Based Participatory Research Study of Intimate Partner Violence and HIV Vulnerability in North Karnataka, India. QUALITATIVE HEALTH RESEARCH 2017; 27:204-214. [PMID: 27378133 PMCID: PMC5167108 DOI: 10.1177/1049732316654871] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Community-based participatory research has been seen to hold great promise by researchers aiming to bridge research and action in global health programs and practice. However, there is still much debate around whether achieving authenticity in terms of in-depth collaboration between community and academic partners is possible while pursuing academic expectations for quality. This article describes the community-based methodology for a qualitative study to explore intimate partner violence and HIV/AIDS among women in sex work, or female sex workers, and their male partners in Karnataka, South India. Developed through collaborative processes, the study methodology followed an interpretive approach to qualitative inquiry, with three key components including long-term partnerships, knowledge exchange, and orientation toward action. We then discuss lessons learned on how to pursue authenticity in terms of truly collaborative processes with inherent value that also contribute to, rather than hinder, the instrumental goal of enhancing the quality and relevance of the research outcomes.
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Affiliation(s)
| | | | - Sapna G Nair
- Karnataka Health Promotion Trust, Bengaluru, Karnataka, India
| | | | | | | | | | - Priya Pillai
- Karnataka Health Promotion Trust, Bengaluru, Karnataka, India
| | - Shajy Isac
- University of Manitoba, Winnipeg, Manitoba, Canada
- Karnataka Health Promotion Trust, Bengaluru, Karnataka, India
| | | | - Lori Heise
- London School of Hygiene & Tropical Medicine, London, UK
| | - Parinita Bhattacharjee
- University of Manitoba, Winnipeg, Manitoba, Canada
- Karnataka Health Promotion Trust, Bengaluru, Karnataka, India
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23
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Goldenberg T, Finneran C, Andes KL, Stephenson R. Using participant-empowered visual relationship timelines in a qualitative study of sexual behaviour. Glob Public Health 2016; 11:699-718. [PMID: 27092985 DOI: 10.1080/17441692.2016.1170869] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examines how the use of participant-empowered visual relationship timelines adds to the quality of an ongoing qualitative data collection in a case study examining the influence of emotions on sexual risk-taking and perceptions of HIV risk among men who have sex with men. Gay and bisexual men (n = 25) participated in a 10-week, three-phase study. During a baseline in-depth interview, participants created a visual timeline using labelled stickers to retrospectively examine their dating/sexual histories. Participants then completed three web-based quantitative personal relationship diaries, tracking sexual experiences during follow-up. These data were extracted and discussed in a timeline-based debrief interview. The visual cues assisted with data collection by prompting discussion through the immediate identification of patterns, opportunities for self-reflection, and rapport-building. The use of flexible data collection tools also allowed for a participant-empowered approach in which the participant controlled the interview process. Through this process, we learned strategies for improving a participant-empowered approach to qualitative research, including: allowing visual activities to drive the interview, using flexible guidelines to prompt activities, and using discrete imagery to increase participant comfort. It is important that qualitative data collection utilise more participatory approaches for gains in data quality and participant comfort.
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Affiliation(s)
- Tamar Goldenberg
- a Department of Behavior and Biological Sciences , University of Michigan School of Nursing , Ann Arbor , MI , USA.,b Center for Sexuality and Health Disparities , University of Michigan , Ann Arbor , MI , USA
| | - Catherine Finneran
- c Hubert Department of Global Health , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Karen L Andes
- c Hubert Department of Global Health , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Rob Stephenson
- a Department of Behavior and Biological Sciences , University of Michigan School of Nursing , Ann Arbor , MI , USA.,b Center for Sexuality and Health Disparities , University of Michigan , Ann Arbor , MI , USA
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24
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Abstract
In this article, I introduce the concept of the space-in-between. This space-in-between is born of the realization that, between the expression of any two polarities (across dimensions such as emotion, thought, geography, and ideology), there exists a philosophical construct useful for framing thinking about practice, research, and managerial relationships in the health professions. Out of this construct emerge practical considerations useful for structuring the conduct of meaningful interpersonal and intercultural interactions. I describe how the idea of a space-in-between developed out of my medical practice, grew as a result of my experiences in international environments. and has found fulfillment in my ongoing work. I explore the application of a space-in-between in public health, medical anthropology, medical ethics, and global health. I review how, as a result of incorporating this space in their daily work, clinicians, educators, researchers, and managers can grow as leaders by sharing the presence that arises from the space-in-between them and the people in the communities they serve.
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Affiliation(s)
- William B Ventres
- University of El Salvador, San Salvador, El Salvador Oregon Health & Science University, Portland, Oregon, USA
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25
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Lea E, Andrews S, Haines T, Nitz J, Haralambous B, Moore K, Hill K, Robinson A. Developing networks between residential aged care facilities as a result of engagement in a falls prevention project: an action research study. Contemp Nurse 2016; 52:163-75. [DOI: 10.1080/10376178.2015.1129911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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26
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Kenny A, Farmer J, Dickson‐Swift V, Hyett N. Community participation for rural health: a review of challenges. Health Expect 2015; 18:1906-17. [PMID: 25470231 PMCID: PMC5810730 DOI: 10.1111/hex.12314] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2014] [Indexed: 11/29/2022] Open
Abstract
CONTEXT Internationally, community participation is highlighted in health policy reform as good for rural communities. Implicit in this policy is the message that the complexities of the rural environment are too difficult for easy solutions and that community participation will somehow build resilient, self-determining communities capable of dealing with complex rural access and equity issues and poorer health outcomes. The underpinning proposition is that by giving decision-making powers to community members, health care will be locally responsive, costs will be contained, and health outcomes will improve. What happens in the practice of enacting community participation in health-care decision making is less clear. OBJECTIVE Despite the growing body of work that documents different levels and models of community participation, significant gaps that outline the practical challenges inherent in rural community participation remain. In this article, we draw on a body of literature to outline the practical considerations in implementing community participation policy in health settings in rural areas. Through a critical review, we aim to stimulate debate, progress ideas and provide a conceptual representation of the somewhat 'messy' nature of rural community participation at a grass-roots organizational level. DISCUSSION AND CONCLUSION Based on our analysis of the current literature, we provide a summary of challenges and practical strategies that might mitigate some of these challenges. Our review highlights that despite policymakers suggesting that community participation is good for rural communities, policy enactment must move beyond mandated tokenism for there to be a recognition that meaningful participation is neither easy nor linear.
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Affiliation(s)
- Amanda Kenny
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVic.Australia
| | - Jane Farmer
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVic.Australia
| | | | - Nerida Hyett
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVic.Australia
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27
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Larson KL, Ballard SM, Nuncio BJ, Swanson M. Testing the feasibility of ¡Cuídate! With Mexican and Central American youth in a rural region of a southern state. Res Nurs Health 2014; 37:409-22. [PMID: 25185453 DOI: 10.1002/nur.21621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2014] [Indexed: 11/07/2022]
Abstract
Regions of the US with growing Latino populations are in need of culturally sensitive sexual risk reduction programs. A Latino community, a public school district, and a university in eastern North Carolina collaborated to test the feasibility of ¡Cuídate!, a culturally tailored, evidence-based sexual risk reduction program, with Mexican and Central American youth. Ten male and 10 female adolescents, ages 13-17 years, participated in the ¡Cuídate! program and post-program focus groups. Early adolescent boys and girls (ages 13-15) gained the most from this program. A safe environment facilitated healthy sexual communication, and condom skills-building provided a context for shared partner responsibility. Grade-level and gender differences were significant. Analysis of the focus group data identified three important messages: Everybody needs sex education, We like this program better because it is hands-on, and I'm going to make better decisions about sex. The findings of this study support the need for community-based interventions that ensure cultural respect, trust, and a safe environment in which to discuss sexual issues.
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Affiliation(s)
- Kim L Larson
- Associate Professor, East Carolina University, College of Nursing, 3135 Health Science Building, Greenville, NC, 27858-4353
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28
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Lea E, Marlow A, Bramble M, Andrews S, Crisp E, Eccleston C, Mason R, Robinson A. Learning Opportunities in a Residential Aged Care Facility: The Role of Supported Placements for First-Year Nursing Students. J Nurs Educ 2014; 53:410-4. [DOI: 10.3928/01484834-20140620-02] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 03/12/2014] [Indexed: 11/20/2022]
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29
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Adams V, Burke NJ, Whitmarsh I. Slow Research: Thoughts for a Movement in Global Health. Med Anthropol 2014; 33:179-97. [DOI: 10.1080/01459740.2013.858335] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Todorova ILG, Tejada S, Castaneda-Sceppa C. Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program. AMERICAN JOURNAL OF HEALTH EDUCATION 2014; 45:76-85. [PMID: 26161165 DOI: 10.1080/19325037.2013.875961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Puerto Ricans are the second largest Hispanic group in the U.S. and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. PURPOSE To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being developed. To develop it as a participatory program, the community members were asked about their perspectives. METHODS Five focus groups with 28 participants, aged 45-60, were conducted, transcribed and analyzed using Thematic Analysis. In-depth analysis of meanings of health promoting behaviors, in the context of cultural beliefs and values was carried out. RESULTS The following themes were identified: Health as balance and integration; Health as connection of self, connection with others; Cultural meanings of lifestyle choices; Stresses and struggles. Participants suggested that the program should have significant variety and a holistic perspective, be sensitive to different needs and motivations, stimulate mutual understanding and shared cultural meanings. DISCUSSION The program needs to support lifestyle changes which maximally preserve traditions and to introduce multi-level changes. TRANSLATION TO HEALTH EDUCATION PRACTICE The identified cultural meanings of diet, physical activity and relationships were taken into account to develop the educational curriculum.
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Affiliation(s)
- Irina L G Todorova
- Northeastern University, 360 Huntington Avenue, Boston, Massachusetts, 02115, US
| | - Shirley Tejada
- Northeastern University, 360 Huntington Avenue, Boston, Massachusetts, 02115, US
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Rod MH, Ingholt L, Bang Sørensen B, Tjørnhøj-Thomsen T. The spirit of the intervention: reflections on social effectiveness in public health intervention research. CRITICAL PUBLIC HEALTH 2013. [DOI: 10.1080/09581596.2013.841313] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Davison CM, Kahwa E, Atkinson U, Hepburn-Brown C, Aiken J, Dawkins P, Rae T, Edwards N, Roelofs S, MacFarlane D. Ethical challenges and opportunities for nurses in HIV and AIDS community-based participatory research in Jamaica. J Empir Res Hum Res Ethics 2013; 8:55-67. [PMID: 23485671 DOI: 10.1525/jer.2013.8.1.55] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As part of a multinational program of research, we undertook a community-based participatory research project in Jamaica to strengthen nurses' engagement in HIV and AIDS policy. Three leadership hubs were purposefully convened and included small groups of people (6-10) from diverse HIV and AIDS stakeholder groups in Jamaica: frontline nurses and nurse managers in primary and secondary care settings; researchers; health care decision makers; and other community members. People living with HIV or AIDS were among the hub members. Using a relational public health ethics framework, we outline some of the ethical challenges and opportunities experienced by the research team and the leadership hubs. Data included research assistant field notes and hub progress reports. Emerging ethical concerns were associated with relational personhood, social justice, relational autonomy, relational solidarity, and sustainability of the hub activities.
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Cohen AK, Schuchter JW. Revitalizing communities together: the shared values, goals, and work of education, urban planning, and public health. J Urban Health 2013; 90:187-96. [PMID: 22711169 PMCID: PMC3675725 DOI: 10.1007/s11524-012-9733-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Inequities in education, the urban environment, and health co-exist and mutually reinforce each other. Educators, planners, and public health practitioners share commitments to place-based, participatory, youth-focused, and equitable work. They also have shared goals of building community resilience, social capital, and civic engagement. Interdisciplinary programs that embody these shared values and work towards these shared goals are emerging, including school-based health centers, full-service community schools, community health centers, Promise Neighborhoods, and Choice Neighborhoods. The intersection of these three fields represents an opportunity to intervene on social determinants of health. More collaborative research and practice across public health, education, and planning should build from the shared values identified to continue to address these common goals.
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Mendenhall TJ, Seal KL, Greencrow BA, Littlewalker KN, Brownowl SA. The Family Education Diabetes Series: improving health in an urban-dwelling American Indian community. QUALITATIVE HEALTH RESEARCH 2012; 22:1524-1534. [PMID: 22910585 DOI: 10.1177/1049732312457469] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Community-based participatory research has shown great promise as a mutually engaging and respectful way to partner contemporary biomedical knowledge with the lived experience, wisdom, and customs of American Indian people. Designed and implemented through this approach, our Family Education Diabetes Series (FEDS) has evidenced pilot and longitudinal physiological data supporting its effectiveness. However, the multifaceted nature of the program makes it difficult to know which factors are responsible for its success. This difficulty hinders efforts to improve the FEDS and/or inform others' work to advance similar projects. In this study, we conducted a qualitative investigation using talking circles to explore participants' views about what elements of the FEDS are most salient. Our findings suggest that social support and group-oriented sequences hold the most value. We conclude that an emphasis on these processes (instead of program content per se) is most indicated in effecting behavior change and facilitating ongoing disease management.
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Mendenhall TJ, Pratt KJ, Phelps KW, Baird MA. Advancing Medical Family Therapy Through Research: A Consideration of Qualitative, Quantitative, and Mixed-Methods Designs. CONTEMPORARY FAMILY THERAPY 2012. [DOI: 10.1007/s10591-012-9186-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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