Navigating hostility, pursuing hospitality: Conceptualizing community engagement among migrant women entrepreneurs in peripheral areas

From the perspective of academic medical centers (AMCs), community engagement is a collaborative process of working toward mutually defined goals to improve the community’s health, and involves partnerships between AMCs, individuals, and entities representing the surrounding community. AMCs increasingly recognize the importance of community engagement, and recent programs such as Prevention Research Centers and Clinical and Translational Science Awards have highlighted community engagement activities. However, there is no standard or accepted metric for evaluating AMCs’ performance and impact of community engagement activities.In this article, the authors present a framework for evaluating AMCs’ community engagement activities. The framework includes broad goals and specific activities within each goal, wherein goals and activities are evaluated using a health services research framework consisting of structure, process, and outcome criteria. To illustrate how to use this community engagement evaluation framework, the authors present specific community engagement goals and activities of the University of Rochester Medical Center to (1) improve the health of the community served by the AMC; (2) increase the AMC’s capacity for community engagement; and (3) increase generalizable knowledge and practices in community engagement and public health.Using a structure-process-outcomes framework, a multidisciplinary team should regularly evaluate an AMC’s community engagement program with the purpose of measurably improving the performance of the AMC and the health of its surrounding community.

BackgroundTo determine the efficacy of a new typhoid conjugate vaccine in an endemic setting in sub-Saharan Africa, the Typhoid Vaccine Acceleration Consortium is conducting a phase-3 randomized controlled trial in Blantyre, Malawi. This article describes community and stakeholder engagement activities before and during the trial, challenges, and lessons learned.MethodsIn October 2017, Malawi-Liverpool Wellcome Trust (MLW) organized a wide range of community engagement activities, including meetings with Ministry of Health and Education officials at the district and facility level, local community leadership, and parent teacher association groups. We engaged media outlets to include local and international television, radio, and print media. Community members were informed directly through a study jingle played via loudspeaker from a van and by community-based activities.To review engagement activity effectiveness: The MLW team met to discuss progress and challenges; and a focus group discussion (FGD), consisting of trial staff, sought feedback from the community on each engagement modality.ResultsThe school-based vaccine campaign increased community participation exceeding recruitment targets to date (on average, >200 children/day).ConclusionsThe FGD concluded that the van and local activities improved awareness and turnout for the trial, but prior engagement with local government and community leadership is an essential mechanism to provide details of the study, answer questions, communicate the value of the study, and address safety concerns. Effective community engagement is essential in a large intervention trial. Multiple channels of communication are required to reach the community and deliver information needed for participation and provide opportunity for dialogue with the trial team.

The objective of this research is to determine how community-engaged activities, and their resulting impact, are currently being measured by cancer centers. To accomplish this, the various definitions of community engagement as used by cancer center community outreach and engagement programs are identified and analyzed, and the frameworks and metrics employed in assessing community outreach and engagement programming are explored. This work can help to inform how to better determine community engagement impact and its overall return on investment, as well as compare impact across cancer centers. Between August 29 and September 1, 2022, MEDLINE, CINAHL, PsycINFO, EMBASE, and Google Scholar were searched for articles including the "community engagement" and "cancer" search concepts. After removal of duplicate records, a title abstract screen was conducted to identify those articles that (1) were conducted within the USA, (2) focused on cancer, (3) undertaken by a cancer center, (4) pertained to community engagement, and (5) published in the English language. The review excluded conference abstracts, editorials, and book chapters. Analysis of definitions identified within the included literature revealed the following four overarching core components of community engagement specific to cancer centers: defined stakeholders, resource exchange, collaborative relationships, and mutually beneficial outcomes. The most common frameworks/models were community-based research models, followed by social and behavioral focused. Measures to assess all essential aspects of community engagement were infrequently included in community projects. The results of this scoping review and analysis propose a common definition and model of community engagement for cancer-related activities conducted by cancer centers. These are important as common measures can be incorporated into all aspects of community engagement work. This can assist cancer centers in determining collective impact using both project and process outcomes. Common measures can help cancer centers include time and resources needed for community engagement within budgets and impact reporting.

Consumption community commitment: Newbies' and longstanding members' brand engagement and loyalty

A growing number of academic health centers (AHCs) are considering approaches to expand collaboration with their communities in order to address complex and multisystem health concerns. In 2010, internal leaders at the University of Kansas Medical Center undertook a strategic planning process to enhance both community engagement activities and the scholarship resulting from these engagement activities. The authors describe the strategic planning process, recommendations, and actions associated with elevating community engagement within the AHC's mission and priorities. The strategic planning process included conducting an inventory of community engagement activities within the AHC; analyzing strengths, weaknesses, opportunities, and threats for community engagement work; and identifying goals and strategies to improve future community engagement activities and scholarship. The resulting road map for enhancing community engagement at their institution through 2015 consists of four main strategies: emphasize scholarship in community engagement, revise organizational structures to better facilitate community engagement, prioritize current engagement activities to ensure appropriate use of resources, and enhance communication of engagement initiatives to further develop stakeholder relationships.The authors also discuss implementation of the plan to date and highlight lessons learned that may inform other AHCs as they enhance and expand similar endeavors.

BackgroundMeaningful community engagement is instrumental to effective implementation and sustainment of equitable public health interventions. Significant resources are necessary to ensure that community engagement takes place in culturally sensitive, trusted ways that optimize positive public health outcomes. However, the types and costs of resources best suited to enable meaningful community engagement in implementation research are not well-documented. This study's objectives are (1) to describe a pragmatic method for systematically tracking and documenting resources utilized for community engagement activities, (2) report resources across phases of implementation research, and (3) provide recommendations for planning and budgeting for community engagement in health equity implementation research.MethodsCommunity engagement partners completed a tracking log of their person-hours for community engagement activities across three phases of community engagement (startup, early, maintenance) in two implementation research projects to promote equity in COVID-19 testing and vaccination for underserved communities. Both projects completed a six-session Theory of Change (i.e., a facilitated group discussion about current and desired conditions that culminated with a set of priorities for strategic change making) over 4 months with respective Community Advisory Boards (CAB) that included community organizers, promotores, federally qualified health center providers and administrators, and public health researchers. The reported person-hours that facilitated community member engagement were documented and summarized within and across project phases.ResultsFor both projects, the startup phase required the highest number of person-hours (M = 60), followed by the maintenance (M = 53) and early phase (M = 47). Within the startup phase, a total of 5 community engagement activities occurred with identifying and inviting CAB members incurring the greatest number of person-hours (M = 19). Within the early phase, a total of 11 community engagement activities occurred with coordinating and leading live interpretation (Spanish) during CAB sessions incurring the greatest number of person-hours (M = 10). The maintenance phase included 11 community engagement activities with time dedicated to written translation of CAB materials into Spanish incurring the greatest number of person-hours (M = 10).ConclusionsStudy findings indicate that the most significant investment of resources is required in the startup period. Needed resources decreased, albeit with a greater diversity of activities, in later phases of community engagement with Spanish language translation requiring most in the later stage of the study. This study contributes to the community engagement and implementation science literature by providing a pragmatic tracking and measurement approach and recommendations for planning for and assessing costs to facilitate meaningful community engagement in public health implementation research.

Civic and community engagement activities are a necessity in International Non-governmental Organization [INGO] place-based community development efforts. Although civic and community engagement remains needed, more empirical evidence is required to assess the impact of INGOs initiatives on beneficiaries’ civic and community engagement. This exploratory qualitative study examines the impact of Heifer’s Values-Based Holistic Community Development initiatives on participants’ civic and community engagement. Data included semi-structured, in-depth interviews with (n = 102) participants in Central and Northern Uganda, across four time periods of participation: baseline, 6–12 months, 24–36 months, and over 48 months. The interview data were coded and analyzed thematically. We found that participants (a) improved their degree of community and civic engagement, (b) became more active in community development efforts, and (c), over time, saw themselves as agents of social change. The study recommends that INGOs delivering services in constrained contexts should focus on initiatives that facilitate relationship-building among residents and provide support that helps residents realize the positive impact that they can have on their communities. Future research should employ quantitative methods, such as surveys and factor analysis, to examine the impact of VBHCD on various dimensions of civic and community engagement, assessing changes across participants, groups, and timeframes.

BackgroundCommunity-based strategies to promote maternal health can help raise awareness of pregnancy danger signs and preparations for emergencies. The objective of this study was to assess change in birth preparedness and complication readiness (BPCR) and pregnant women’s knowledge about pre-eclampsia as part of community engagement (CE) activities in rural Pakistan during the Community Level Interventions for Pre-eclampsia (CLIP) Trial.MethodsThe CLIP Trial was a cluster randomized controlled trial that aimed to reduce maternal and perinatal morbidity and mortality using CE strategies alongside mobile health-supported care by community health care providers. CE activities engaged pregnant women at their homes and male stakeholders through village meetings in Hyderabad and Matiari in Sindh, Pakistan. These sessions covered pregnancy complications, particularly pre-eclampsia/eclampsia, BPCR and details of the CLIP intervention package. BPCR was assessed using questions related to transport arrangement, permission for care, emergency funds, and choice of facility birth attendant for delivery during quarterly household surveys. Outcomes were assessed via multilevel logistic regression with adjustment for relevant confounders with effects summarized as odds ratios and 95% confidence intervals.ResultsThere were 15 137 home-based CE sessions with pregnant women and families (n = 46 614) and 695 village meetings with male stakeholders (n = 7784) over two years. The composite outcomes for BPCR and pre-eclampsia knowledge did not differ significantly between trial arms. However, CE activities were associated with improved pre-eclampsia knowledge in some areas. Specifically, pregnant women in the intervention clusters were twice as likely to know that seizures could be a complication of pregnancy (odds ratio (OR) = 2.17, 95% confidence interval (CI) = 1.11, 4.23) and 2.5 times more likely to know that high blood pressure is potentially life-threatening during pregnancy (OR = 2.52, 95% CI = 1.31, 4.83) vs control clusters.ConclusionsThe findings suggested that a CE strategy for male and female community stakeholders increased some measures of knowledge regarding complications of pre-eclampsia in low-resource settings. However, the effect of this intervention on long-term health outcomes needs further study.Trial registrationClinical Trials.gov – INCT01911494.

BackgroundWorldwide, more than 40% of the population is at risk from dengue and recent estimates suggest that up to 390 million dengue infections are acquired every year. The Eliminate Dengue (ED) Program is investigating the use of Wolbachia-infected, transmission-compromised, mosquitoes to reduce dengue transmission. Previous introductions of genetically-modified strategies for dengue vector control have generated controversy internationally by inadequately engaging host communities. Community Engagement (CE) was a key component of the ED Program’s initial open release trials in Queensland Australia. Their approach to CE was perceived as effective by the ED team’s senior leadership, members of its CE team, and by its funders, but if and why this was the case was unclear. We conducted a qualitative case study of the ED Program’s approach to CE to identify and critically examine its components, and to explain whether and how these efforts contributed to the support received by stakeholders.Methodology/Principal FindingsIn-depth semi-structured interviews were conducted with 24 participants with a range of experiences and perspectives related to the ED Program’s CE activities. Our analytic approach combined techniques of grounded theory and qualitative description. The ED Program’s approach to CE reflected four foundational features: 1) enabling conditions; 2) leadership; 3) core commitments and guiding values; and 4) formative social science research. These foundations informed five key operational practices: 1) building the CE team; 2) integrating CE into management practices; 3) discerning the community of stakeholders; 4) establishing and maintaining a presence in the community; and 5) socializing the technology and research strategy. We also demonstrate how these practices contributed to stakeholders’ willingness to support the trials.Conclusions/SignificanceOur case study has identified, and explained the functional relationships among, the critical features of the ED Program’s approach to CE. It has also illuminated how these features were meaningful to stakeholders and contributed to garnering support within the host communities for the open-release trials. Our findings reveal how translating ethical intentions into effective action is more socially complex than is currently reflected in the CE literature. Because our case study delineates the critical features of the ED Program’s approach to CE, it can serve as a framework for other programs to follow when designing their own strategies. And because the findings outline a theory of change for CE, it can also serve as a starting point for developing an evaluation framework for CE.

Participatory Health Research (PHR) has the potential to result in more equitable health interventions and impactful research outcomes, and is an increasingly used paradigm in migrant health research. In the context of intersecting systems of social disadvantage imposed on migrant and refugee women, PHR could offer an opportunity for researchers to challenge unequal power dynamics in academic research by co-creating knowledge to improve these women’s healthcare access and use. However, there is limited information about how PHR has been conducted with migrant women, including the extent of their involvement throughout the research process. This scoping review aimed to describe and summarize current evidence on the research approaches and methods that have been used in PHR with women of migrant and refugee backgrounds living in high-income countries, and the extent of community engagement in PHR with this population. We searched MEDLINE Ovid, CINHAL, Scopus, and Web of Science databases from 1 January 2012 to 31 December 2021 to identify qualitative, quantitative, and mixed method studies adopting a PHR approach with migrant women as participants. We included 91 studies from 12 countries. Health topics of included studies included: knowledge, screening and prevention of HPV, cervical and breast cancer, mental health, nutrition and physical activity, gender-based violence, and health promotion and education. The most common PHR approaches were Community-Based Participatory Research and participatory action research. Overall, community engagement was commonly reported in most stages of research; however, participatory engagement with migrant women was more often done by proxy through community organisations or agents, rather than women themselves. We argue that more rigorous reporting of community engagement is necessary to demonstrate PHR conducted with migrant women is following the principles of equity and inclusion in community-academic partnerships.

In 1971, the National Cancer Act created a process to recognize the leadership, facilities, and research efforts at cancer centers throughout the United States. Toward this goal, each NCI-designated cancer center defines and describes a catchment area to which they tailor specific scientific and community engagement activities. The geographically defined catchment areas of 63 NCI-designated comprehensive and clinical cancer centers are collated and presented visually. In addition, the NCI-designated cancer center catchment areas are geographically linked with publicly available data sources to aggregate sociodemographic and epidemiologic characteristics across the NCI Cancer Centers Program. The national map portrays the size, shape, and locations for 63 catchment areas of the 71 NCI-designated cancer centers. The findings illustrate the geographic extent of the NCI Cancer Centers Program during the 50th anniversary of the National Cancer Act. NCI-designated cancer centers occupy a prominent role in the cancer control ecosystem and continue to perform research to address the burden of cancer among their local communities. The strength of the NCI Cancer Centers Program is partly defined by the scope, quality, and impact of community outreach and engagement activities in the catchment areas. The collation and geographic presentation of the distinct, but complementary, NCI-designated cancer center catchment areas are intended to support future research and community outreach activities among NCI-designated cancer centers. See related commentary by Vadaparampil and Tiro, p. 952.

<div>AbstractBackground:<p>In 1971, the National Cancer Act created a process to recognize the leadership, facilities, and research efforts at cancer centers throughout the United States. Toward this goal, each NCI-designated cancer center defines and describes a catchment area to which they tailor specific scientific and community engagement activities.</p>Methods:<p>The geographically defined catchment areas of 63 NCI-designated comprehensive and clinical cancer centers are collated and presented visually. In addition, the NCI-designated cancer center catchment areas are geographically linked with publicly available data sources to aggregate sociodemographic and epidemiologic characteristics across the NCI Cancer Centers Program.</p>Results:<p>The national map portrays the size, shape, and locations for 63 catchment areas of the 71 NCI-designated cancer centers. The findings illustrate the geographic extent of the NCI Cancer Centers Program during the 50th anniversary of the National Cancer Act.</p>Conclusions:<p>NCI-designated cancer centers occupy a prominent role in the cancer control ecosystem and continue to perform research to address the burden of cancer among their local communities. The strength of the NCI Cancer Centers Program is partly defined by the scope, quality, and impact of community outreach and engagement activities in the catchment areas.</p>Impact:<p>The collation and geographic presentation of the distinct, but complementary, NCI-designated cancer center catchment areas are intended to support future research and community outreach activities among NCI-designated cancer centers.</p><p><i>See related commentary by Vadaparampil and Tiro, p. 952</i></p></div>

BackgroundMass anti-malarial administration has been proposed as a key component of the malaria elimination strategy in South East Asia. The success of this approach depends on the local malaria epidemiology, nature of the anti-malarial regimen and population coverage. Community engagement is used to promote population coverage but little research has systematically analysed its impact. This systematic review examines population coverage and community engagement in programmes of mass anti-malarial drug administration.MethodsThis review builds on a previous review that identified 3049 articles describing mass anti-malarial administrations published between 1913 and 2011. Further search and application of a set of criteria conducted in the current review resulted in 51 articles that were retained for analysis. These 51 papers described the population coverage and/or community engagement in mass anti-malarial administrations. Population coverage was quantitatively assessed and a thematic analysis was conducted on the community engagement activities.ResultsThe studies were conducted in 26 countries: in diverse healthcare and social contexts where various anti-malarial regimens under varied study designs were administered. Twenty-eight articles reported only population coverage; 12 described only community engagement activities; and 11 community engagement and population coverage. Average population coverage was 83% but methods of calculating coverage were frequently unclear or inconsistent. Community engagement activities included providing health education and incentives, using community structures (e.g. existing hierarchies or health infrastructure), mobilizing human resources, and collaborating with government at some level (e.g. ministries of health). Community engagement was often a process involving various activities throughout the duration of the intervention.ConclusionThe mean population coverage was over 80% but incomplete reporting of calculation methods limits conclusions and comparisons between studies. Various community engagement activities and approaches were described, but many articles contained limited or no details. Other factors relevant to population coverage, such as the social, cultural and study context were scarcely reported. Further research is needed to understand the factors that influence population coverage and adherence in mass anti-malarial administrations and the role community engagement activities and approaches play in satisfactory participation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1593-y) contains supplementary material, which is available to authorized users.

Community engagement: learning from low-income countries

This paper attempts to build the engaged institution model from faculty perspective. Data was collected from 200 faculty members across disciplines, who were engaged in community engagement and social responsibility activities in one or the other ways. On analysis of the data, it was found that Instruction and Research, Facilitator, Scholarship factors contribute towards community engagement activities in higher educational institutions and that these factors contribute towards Faculty engagement, Student engagement and Community Engagement. All these factors create Engagement institution model. This work has an implications on theory, practice and policy. Service learning, as a pedagogical tool if implemented in HEIs can effectively bring all the influencing factors together and can help in creating an engaged institution.