Pragmatics of Community Organization

BackgroundNigeria has one of the largest Human Immunodeficiency Virus (HIV) epidemics in the world. Addressing the epidemic of HIV in such a high-burden country has necessitated responses of a multidimensional nature. Historically, community-based organizations (CBOs) have played an essential role in targeting key populations (eg. men who have sex with men, sex workers) that are particularly burdened by HIV. CBOs are an essential part of the provision of health services in sub-Saharan Africa, but very little is known about the management practices of CBOs that provide HIV prevention interventions.MethodsWe interviewed 31 CBO staff members and other key stakeholders in January 2017 about management practices in CBOs. Management was conceptualized under the classical management process perspective; these four management phases—planning, organizing, leading, and evaluating—guided the interview process and code development. Data analysis was conducted thematically using Atlas.ti software. The protocol was approved by the ethics committees of the National Institute of Public Health of Mexico (INSP), the National Agency for the Control of AIDS in Nigeria (NACA), and the Nigerian Institute for Medical Research (NIMR).ResultsWe found that CBOs implement variable management practices that can either hinder or facilitate the efficient provision of HIV prevention services. Long-standing CBOs had relatively strong organizational infrastructure and capacity that positively influenced service planning. In contrast, fledgling CBOs were deficient of organizational infrastructure and lacked program planning capacity. The delivery of HIV services can become more efficient if management practices are taken into account.ConclusionsThe delivery of HIV services by CBOs in Nigeria was largely influenced by inherent issues related to skills, organizational structure, talent retention, and sanction application. These, in turn, affected management practices such as planning, organizing, leading, and evaluating. This study shows that KP-led CBOs are evolving and have strong potentials and capacity for growth, and can become more efficient and effective if attention is paid to issues such as hierarchy, staff recruitment, and talent retention.

Intro While researchers are expected to address study participants’ social determinants of health (SDOH), little to no empirical work is dedicated to the science of how to advance partnerships to redress health disparities. The aims of the study are to describe engagement methods to recruit community based organizations (CBOs) in a clinical trial designed to test the navigation of patients through colorectal cancer (CRC) screening while also creating linkages to help address patients’ SDOH. Methods Federally qualified health center (FQHC) staff invited CBO representatives to participate in the trial’s formative assessment components, food box provision, and/or delivery of CRC screening education. This engagement relied on relationships built through the team’s facilitation of a community coalition- a network that already existed in the FQHC. Study records were reviewed to enumerate and tally engagement approaches over the course of the study’s first 2 years. Results Seven CBOs provided a letter with the grant’s submission: 4 CBOs expressed interest in participating in an advisory board; 2 CBOs committed to providing a food box to patients identified with food insecurity; and 1 CBO committed to delivering community CRC screening education. Of the 7 CBOs, 6 completed a key informant interview; 2 provided zip-code level expertise to define study neighborhoods; and 2 developed formal agreements to provide food boxes to intervention participants. There was a change in leadership with 4 of the 7 CBOs, which likely explains the missing interview. Of the 2 partners that committed to food box provision, at the time of implementation- 1 of these no longer had a food pantry function as the CBO had taken this role on during the COVID pandemic’s peak. A neighboring site, however, continues to provide this service and has stepped in to provide food boxes for the study. Similarly, the CBO that had committed to providing community CRC education no longer has capacity to do so and a new partner was engaged to deliver this health education. At the end of grant year 1, to identify additional CBOs that could supply food boxes in other study neighborhoods, staff emailed 2 CBOs that were recommended during interviews, however, we received no response. Half-way through grant year 2, staff reengaged the dedicated CBO engagement team and requested additional e-introduction to new CBO partners that could address patients’ SDOH in these other study neighborhoods. Six CBOs have been approached with 1 interview completed to date. One of these year 2 CBOs provided zip-code level expertise to the study’s analytical team while another CBO is developing a formal agreement to provide food boxes in the other study areas. Conclusions Having a group dedicated to CBO engagement has allowed the research team to conduct outreach and partner with CBOs to co-deliver the intervention to address patients’ SDOH. Additional work is needed to consider the transitions in CBOs which impact initial commitments and timeline in order to anticipate and address these challenges early in a study. Citation Format: Anne Escaron, Joanna Garcia, Adriana Aranda, Jacqueline Macias-Sandoval, Dina Cruz Quintanilla, Crystal Gomez, Elva Arredondo, Gloria Coronado. Enhancing partnerships to address cancer screening disparities: community engagement strategies in a colorectal cancer screening navigation trial [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A127.

OBJECTIVES/SPECIFIC AIMS:.Outline the development and purpose of the partnership brokering database in REDCap. Provide an overview of the tool and how it works. Discuss how this tool facilitates partnership-brokering activities and discuss plans for future use METHODS/STUDY POPULATION: Research Electronic Data Capture (REDCap) is a secure, web-based application developed at Vanderbilt University to assist with systematic data management of small and medium sized projects. CCH utilized REDCap to build a custom data management warehouse entitled the Partnership Brokering Tool. Information compiled in various formats (handwritten notes, spreadsheets, etc.) over the past 10 years by CCH staff, was then systematically organized and entered into the Partnership Brokering Tool. The tool captures information such as individual contact information, organizational affiliation (academic, community, faith, government etc.), research interests (35 categories - asthma, diabetes, heart disease, etc.), communities of foci (children, elderly, LGBTQ, ethnicity, etc.), and target geographic community served (Chicago north, south, suburban, Illinois, etc.). RESULTS/ANTICIPATED RESULTS: Data was compiled on 451 community groups and organizations and 77 partners in academia thus far. Community organizations represent a range of community sectors including advocacy and policy groups, community-based, faith-based organizations, foundations, media, schools, etc. throughout the Chicagoland area. Data analysis activities are underway, however, results will also be shared regarding characteristics of the communities these organizations serve including:. Age range. Special populations (as defined by the CSTI grant). Underrepresented racial and ethnic communities. DISCUSSION/SIGNIFICANCE OF IMPACT: The Partnership Brokering Tool has provided a format for CCH to systematically gather information about the relationships staff have cultivated with community groups and organizations. Unlike an email management system, this REDCap project is highly useful in capturing the parameters of our partner pool, identifying partnership gaps, and matching individuals interested in collaborating with researchers or community organizations that have a particular skill set or research interest. The Partnership Brokering Tool has also facilitated stakeholder engagement dedicated to guiding the centers’ overall goals, objectives, and programming. Finally, utilizing REDCap has streamlined efforts in reporting quantitative and qualitative data about these organizations. In the next phase of this project, CCH will utilize the database to assess the nature of the relationship between CCH and community groups and organizations.

There are four compelling reasons why community psychologists should be directly concerned with community and neighborhood organization: 1 Community organizing, through both the process and product of action, should ordinarily lead to personal empowerment, wellness, and increased competence for those involved; that is, to individual outcomes that are among the primary goals of our discipline 2 Community organization, when successful, should also result in better communities; “better” in terms of the community’s expressed needs. That is, there should bebona fide community accomplishments to point to and tangible improvements in place 3 Scholarly reports (e.g., Berry, Portney, & Thomson, 1993; Fisher, 1985; Homan, 1994; Mattaini & Thyer, 1996; Mattesich & Monsey, 1997; Minkler, 1997; Mondros & Wilson; 1994; Mott, 1997; Wandersman & Florin, Chapter, 11, this volume; Wittig & Bettencourt, 1996) and popular accounts as well (e.g., Alinsky, 1971; Dyson & Dyson, 1989; Kahn, 1982; Medoff & Sklar, 1994) suggest that community organization does, in fact, lead to such positive outcomes, for both individuals and communities. Moreover, psychological research suggests that community organization may have additional personal and social consequences that we view as desirable: greater happiness(Campbell, 1981; Diener, 1984), increased neighboring (Ahlbrandt, 1984), stronger social support networks (Pilisuk & Parks, 1986; Taylor, Repetti, & Seeman, 1997), and lower individual and community pathology (Aneshensel, 1992; Gesten & Jason, 1987; Heller, 1990; House, Umberson, & Landis, 1988; Kretzmann & McKnight, 1993; Naparstek, Biegel, & Spiro, 1982; Rodin, 1985) 4 Finally, in times of economic downturn or worse, community organization can stimulate cooperation and local self-reliance, at little or no cost, thus cushioning and protecting the community from outside adversity

The CDC National DPP lifestyle change program (LCP) is delivered by community and healthcare organizations nationwide to prevent or delay the onset of type 2 diabetes in adults with prediabetes. CDC recognition status assures fidelity and quality in delivering the program but receiving and maintaining it can be challenging. Using a pilot online semi-structured questionnaire, we explored the experiences of community and healthcare organizations delivering the National DPP LCP in receiving and maintaining CDC recognition. Participants were recruited from organizations delivering the National DPP LCP, prioritizing organizations in counties with low socioeconomic status. Participants were asked to discuss the challenges and facilitators their organizations faced in delivering the LCP and in achieving and maintaining CDC recognition. Thematic analysis was used to analyze and report emerging themes. A total of 25 participants completed the questionnaire (all from low SES counties). Our results indicate funding availability was the main facilitator in delivering the program, along with strong partnerships with community organizations and a dedicated team. Barriers to achieving and maintaining CDC recognition to deliver the program included difficulties recruiting and retaining participants, and issues securing funding to cover program costs. Participants reported that easing requirements to achieve/maintain recognition, increasing training opportunities, advocating for better reimbursement, and supporting network development between community organizations can increase the program's sustainability. Our findings highlighted barriers/facilitators related to the success of delivering the National DPP LCP and achieving/maintaining CDC recognition. Strategies to reduce those barriers and promote those facilitators should be considered. Disclosure T.Formagini: None. A.Rezwan: None. D.Rodriguez: None. B.Ng: None. Funding University of Central Florida

How societal expectations, new digital tools, andthe COVID crisis are driving a step-change in human centric remediation.

Supporting home and community gardening is a core activity of many community-based organizations (CBOs) that are leading the food justice movement in the U.S. Using mixed methods across multiple action-research studies with five food justice CBOs, this paper documents myriad layers of benefits that gardening yields.Our participatory methods included conducting extensive case studies with five CBOs over five years; quantifying food harvests with 33 gardeners in Laramie, Wyoming, and surveying them about other gardening outcomes (20 responded); and conducting feasibility studies for assessing health impacts of gardening with two of the five CBOs, both in Wyoming.Analyses of these diverse data yielded four categories of gardening benefits: (1) improving health; (2) producing quality food in nutritionally meaningful quantities; (3) providing cultural services; and (4) fostering healing and transformation.Examining these results together illustrates a breadth of health, food, and cultural ecosystem services, and social change yields of home and community food gardening in these communities. It also points to the need to support CBOs in enabling household food production and to future research questions about what CBO strategies most enhance access to and benefits of gardening, especially in communities most hurt by racism and/or insufficient access to fresh food.

Community-based organizations (CBOs) are critical to delivery of effective HIV prevention because of their reach to key populations. This online survey of a national sample of CBOs assessed their awareness of, interest in, and resources needed to provide nonoccupational postexposure prophylaxis (nPEP), preexposure prophylaxis (PrEP), and HIV treatment as prevention (TasP). One hundred seventy-five CBOs participated: 87 clinical and 88 nonclinical CBOs. For nPEP, PrEP, and TasP, program managers reported that awareness was high (94%, 90%, 85%), meeting current client need was low (20%, 13%, 18%), and the likelihood of increasing their current provision with additional resources was somewhat high (62%, 64%, 62%). Clinical CBOs were more prepared to support expansion of these biomedical interventions than nonclinical CBOs. Meeting the information, training, and resource needs of CBOs is critical for effective collaboration to reduce the number of new HIV infections through expanded delivery of PrEP, nPEP, and TasP.

Sexual violence (SV) is a public health crisis that disproportionately impacts minoritized communities. SV is prominently associated with post-traumatic stress disorder (PTSD) and related health outcomes. Access to early psychosocial intervention may be effective for reducing the long-term health consequences. Community-based organizations (CBOs) are uniquely positioned to address the immediate health and support needs of survivors of SV. However, significant barriers exist to CBO service engagement. Engaging individuals with lived experience offers unique insight to improving access and experiences with CBOs. In this qualitative descriptive study, semi-structured interviews were conducted with survivors of SV (n = 20) to understand their experiences with CBOs to develop recommendations for improving support services. Interviews were analyzed using reflexive thematic analysis methods. Results fell into three themes encompassing prominent and salient ideas shared across and within interviews: Survivor-Centered Services, emphasizing the importance of centering survivor autonomy in services; Expanded Organizational Outreach, discussing how CBOs may meaningfully increase trust and engagement; and Enhanced Organizational Service Offerings, illustrating needs related to finances and housing, among other social determinants. Findings emphasized the importance of CBOs in promoting the health and wellbeing of SV survivors and highlighted opportunities for improvement related to access to, and quality of, support services offered.

To investigate the survival and development conditions of community-based organizations (CBOs) for HIV/AIDS prevention and control among men who have sex with men (MSM) in Chinese cities including Shanghai, Hangzhou, Chongqing. This study employed both qualitative (focus groups) and quantitative (questionnaire survey) methods to obtain information from 15 MSM CBOs in three Chinese cities. The mean work time of the 15 CBOs for HIV/AIDS prevention and control among MSM was 6.7 years (2.1-11.3 years), and the majority of their funds was from international cooperation projects (80 447 000 RMB, 73.0%) from 2006 to 2013. The survival cost of MSM CBOs apart from expenditure of activities was 2 240-435 360 RMB per year. As it was shown in the graph, the survival and development of MSM CBOs was closely related to the development of international cooperation projects. There was a few small size MSM CBOs taking part in the prevention and control of HIV/AIDS and their work content was limited before 2006. From 2006 to 2008, some international cooperation projects were launched in China, such as the China Global Fund AIDS project and the China-Gates Foundation HIV Prevention Cooperation program. As a result, the number of MSM CBOs was increased sharply, and both the scale and 2012, the performance of these programs further promote the establishment of new MSM CBOs and the development of all MSM CBOs with regard to the work places, full-time staffs, work contents, work patterns and the specific targeted population. After 2012, most international cooperation programs were completed and the local department of disease prevention and control continued to cooperate with MSM CBOs. However, the degree of support funds from the local department was different among different regions. Where the funds were below the half of program funds, the development of MSM CBOs ceased and work slowed down. Besides, there were still some constraints for the survival and development of MSM CBOs, such as insufficient funds, no legitimate identity, the outflow of talents and the unsustainable development. The survival and development of MSM CBOs was closely related to the development of international cooperation projects in China. Some departments of disease prevention and control took over the cooperation with MSM CBOs when the international cooperation projects were completed. Given the survival cost of MSM CBOs and the constraints of MSM CBOs development, it needs further investigation on how to ensure the local departments of disease prevention and control to take over the cooperation with MSM CBOs and how to cooperate with MSM CBOs.

BackgroundLong-term conditions pose major challenges for healthcare systems. Optimizing self-management of people with long-term conditions is an important strategy to improve quality of life, health outcomes, patient experiences in healthcare, and the sustainability of healthcare systems. Much research on self-management focuses on individual competencies, while the social systems of support that facilitate self-management are underexplored. The presented study aims to explore the role of social systems of support for self-management and quality of life, focusing on the social networks of people with diabetes and community organisations that serve them.MethodsThe protocol concerns a cross-sectional study in 18 geographic areas in six European countries, involving a total of 1800 individuals with diabetes and 900 representatives of community organisations. In each country, we include a deprived rural area, a deprived urban area, and an affluent urban area. Individuals are recruited through healthcare practices in the targeted areas. A patient questionnaire comprises measures for quality of life, self-management behaviours, social network and social support, as well as individual characteristics. A community organisations’ survey maps out interconnections between community and voluntary organisations that support patients with chronic illness and documents the scope of work of the different types of organisations. We first explore the structure of social networks of individuals and of community organisations. Then linkages between these social networks, self-management and quality of life will be examined, taking deprivation and other factors into account.DiscussionThis study will provide insight into determinants of self-management and quality of life in individuals with diabetes, focusing on the role of social networks and community organisations.

BackgroundDigital health interventions (DHIs) can broaden the reach of HIV prevention interventions and overcome barriers for young cisgender men who have sex with men (YMSM). Community-based organizations (CBOs) have delivered HIV prevention interventions for decades, but few studies have examined how CBOs implement DHIs, including recruitment and retention. Keep It Up! (KIU!) is a Centers for Disease Control and Prevention–designated best-evidence DHI that can promote risk reduction behaviors and reduce sexually transmitted infection incidence.ObjectiveWe sought to descriptively assess CBOs’ approaches to recruitment and retention, elucidate lessons learned, and provide examples of recruitment and retention for future implementers.MethodsTwenty-two CBOs in counties with high HIV rates and large proportions of YMSM were selected through a request for proposal process to implement KIU!. Data were extracted from request for proposal applications and notes from monthly calls with CBO staff. Twenty-five staff members across CBOs were interviewed in the middle of implementation. A descriptive thematic analysis of the lessons learned in recruiting and retaining participants was performed. The research team developed an application dashboard for CBO staff to register participants, track participant progress through the intervention, record and track participant contact, and export usage data. CBO logins to the KIU! dashboard were tracked across the implementation. To descriptively compare approaches to recruitment and retention, the study team divided CBOs according to annual HIV testing volume in the 3 years prior to implementation and years of HIV service provision to YMSM.ResultsThe most frequent modes of recruitment were outreach and community partnerships (21/22, 95%), and the least frequent modes were via hook-up apps (6/22, 27%) and participant referrals (5/22, 23%). CBOs with a low HIV testing volume used online recruitment slightly more frequently, while medium-volume CBOs most frequently used hook-up apps for recruitment. Low-volume CBOs more frequently used phone calls and emails to remind participants to complete intervention modules, while high- and medium-volume CBOs more frequently used text messages. CBOs with more years of HIV service provision to YMSM more frequently had a set reminder schedule for contact with participants. CBO staff identified a need to change how KIU! is pitched to clients by using personalized, recipient-centered language rather than technical jargon. CBOs changed intake forms to ensure that staff remembered to offer KIU! to participants. CBOs had a difficult time retaining participants despite holding in-person events for enrolled participants (eg, raffles and trivia nights) and altering the frequency with which they reminded participants to complete modules.ConclusionsAlthough CBOs had experience in implementing other evidence-based interventions with YMSM, there was no consensus on successful recruitment and retention strategies for this population. We have presented approaches that future CBOs may use in their own implementation of KIU!.

BackgroundTo support the use of research evidence by community-based organizations (CBOs) we have developed 'Synthesized HIV/AIDS Research Evidence' (SHARE), which is an evidence service for those working in the HIV sector. SHARE consists of several components: an online searchable database of HIV-relevant systematic reviews (retrievable based on a taxonomy of topics related to HIV/AIDS and open text search); periodic email updates; access to user-friendly summaries; and peer relevance assessments. Our objective is to evaluate whether this 'full serve' evidence service increases the use of research evidence by CBOs as compared to a 'self-serve' evidence service.Methods/designWe will conduct a two-arm randomized controlled trial (RCT), along with a follow-up qualitative process study to explore the findings in greater depth. All CBOs affiliated with Canadian AIDS Society (n = 120) will be invited to participate and will be randomized to receive either the 'full-serve' version of SHARE or the 'self-serve' version (a listing of relevant systematic reviews with links to records on PubMed and worksheets that help CBOs find and use research evidence) using a simple randomized design. All management and staff from each organization will be provided access to the version of SHARE that their organization is allocated to. The trial duration will be 10 months (two-month baseline period, six-month intervention period, and two month crossover period), the primary outcome measure will be the mean number of logins/month/organization (averaged across the number of users from each organization) between baseline and the end of the intervention period. The secondary outcome will be intention to use research evidence as measured by a survey administered to one key decision maker from each organization. For the qualitative study, one key organizational decision maker from 15 organizations in each trial arm (n = 30) will be purposively sampled. One-on-one semi-structured interviews will be conducted by telephone on their views about and their experiences with the evidence service they received, how helpful it was in their work, why it was helpful (or not helpful), what aspects were most and least helpful and why, and recommendations for next steps.DiscussionTo our knowledge, this will be the first RCT to evaluate the effects of an evidence service specifically designed to support CBOs in finding and using research evidence.Trial registrationClinicalTrials.gov: NCT01257724

Community - based organizations (CBO) have implemented various activities and have contributed to the successful responses to HIV/AIDS epidemic in Vietnam. However, in the context of donor phase-out, little information of current CBO’s activities has been published. This study aims to describe the diversity of CBO’s activities and to assess factors associated with implementing activities. A survey of CBO established before October 2014 and still operated after June 2014 was conducted from November 2014 to June 2015 in Vietnam. Their characteristics and participation in implementing any activities, related or not related to HIV were collected. Majority of 277 CBOs were established 2 to 10 years ago (83%) and were the group of people living with HIV (45%). Ten percent of them had legal status but most of them had leadership and an organization goal. Among 30 activities enlisted, Vietnamese CBOs provided approximately 14 activities on average. Disseminate HIV-related knowledge, outreach most at risk-people and support people to do HIV testing are three most popular activities implemented by Vietnamese CBOs. On the contrary, support for elderly/ homeless people, non-profit activities and other relevant activities are least implemented. A multiple linear regression model found six factors associated with increased activities: Older establishment, having leadership, having legal status, experienced CBO founders, having specific organization goal, and the number of partners. Vietnamese CBOs are implementing diverse activities in terms of types and numbers, remaining the key actor in HIV/AIDS prevention. Future interventions and investment in CBO are necessary to end the epidemic.

Wetlands in Bangladesh represent complex, dynamic natural environments rich in biological diversity and providing a range of ecosystem services to local people. Capture fisheries are a direct link between biodiversity and the poor, but have been declining from overexploitation and wetland degradation. Since 2007 a network of 250 community based organisations (CBOs) across the country has shown a growing interest in managing wetlands for the benefit of poor people, motivated to use their local knowledge and capabilities in collective action to manage wetland resources in ways that conserve biodiversity. Adaptive learning between CBOs has spread good practices to sustain biodiversity and thereby the livelihoods of the poor dependent on fish and other aquatic resources. By now, 59% of CBOs have created small fish sanctuaries, 10% have re-introduced scarce fish, a third of CBOs have banned hunting and a few have added a supplementary income from tourism. By developing and sharing their own knowledge of local ecosystem dynamics and related good practices, tangible ecological and developmental benefits have been derived, increasing the well-being of local people. In 91% of sites local people consider the CBO has improved access of the poor to natural resources. In many cases the main threats faced by CBOs have come from external factors: attempts by the powerful to take control of fisheries away from CBOs; pressure to pay government to lease waterbodies; and uncoordinated and unregulated development that blocks fish movement, drains and pollutes wetlands. As such, these are challenges of governance rather than management. The needs of the poor are represented by the CBOs (64% of members are poor, and almost all CBOs consult with the poor in decision making). By networking together, the CBOs are empowered to actively address these challenges and influence policy and practice to address conservation and poverty issues.