Community-based Approach Research Articles

Household Food Insecurity and Its Association with Nutritional Status of Children 6–59 Months of Age in Kebridehar City

Malnutrition, characterized by an imbalance in the intake of calories, proteins, or other nutrients, includes undernutrition and overnutrition. This study aimed to assess the impact of household food insecurity on the nutritional status of children aged 6 to 59 months in Kebridehar town using a community-based cross-sectional approach. The city of Kebridehar was divided into 12 kebeles and the study targeted families with children in the specified age group. A proportional sample of 344 households was randomly selected from each kebele. Data were collected through surveys and analyzed to determine the prevalence of food insecurity and its effects on children's nutrition.Results: The study revealed significant disparities in food security: 11.6% of households were food secure, while 88.4% were food insecure. Female-headed homes had a lower percentage of impoverished children and the mother's education had a vital influence. Low- and middle-income households had a larger risk of childhood loss than higher-income ones. Smaller families were 15.76 times more likely to suffer food insecurity and homes without health services were 3.27 times higher potential to be food insecure. Children from insecure food families have poorer health outcomes, being 4.95 times more likely to be underweight, 1.30 times more likely to be stunted, and 1.45 times more likely to be wasted.Conclusion: The study highlights an important problem of food insecurity that affects the health of children. Factors such as the woman's family, the mother's education level, low income and family size are crucial. Urgent interventions are necessary to improve food security and nutritional outcomes, especially for families with low income, less education, and poor sanitation.

Place-Based Conservation in Coastal and Marine Ecosystems: The Importance of Engagement with Underrepresented Communities

Through the years, research has described the importance of community-based approaches in the management of coastal and marine ecosystems. Coastal and marine issues are multifaceted and require place-specific approaches developed in partnership with vulnerable communities who are impacted by environmental stressors. Place-based conservation, a management approach that focuses on unique, place-specific characteristics, and other similar methods. It considers the need to integrate human dimensions and location-centered approaches, which are often lacking in typical natural resource management. Meaningful engagement with underrepresented communities can holistically account for socioeconomic factors and cultural knowledge that inform best management practices. As the health of marine and coastal ecosystems is linked with environmental quality and local livelihoods, engaging practitioners with knowledge of these systems can support science and trust in environmental management. This article discusses the importance of community-based research, local insight, various examples of successful management, and culturally relevant knowledge to advance sustainable place-based conservation.

Prosecution in the eyes of the justice-involved: A community-based participatory research approach

Prosecution in the eyes of the justice-involved: A community-based participatory research approach

In This Issue: Mixed Methods Systematic Methodological Reviews, Pillar Integration Applications, Mixed Methods Analysis of Video Interaction Data, Intersectional Mixed Methods Research, Mixed Methods Analysis of Witness Statements, and Combining Community-Based Participatory Approaches to Study Neighborhoods

In This Issue: Mixed Methods Systematic Methodological Reviews, Pillar Integration Applications, Mixed Methods Analysis of Video Interaction Data, Intersectional Mixed Methods Research, Mixed Methods Analysis of Witness Statements, and Combining Community-Based Participatory Approaches to Study Neighborhoods

Using community-based participatory approaches to improve access to mass drug administration for trachoma elimination in a pastoral conflict area of Kenya.

In Baringo County, Kenya, trachoma remains endemic despite repeated mass drug administration (MDA) efforts, with coverage in one of the wards consistently falling short of world health organization (WHO) targets. The disease is endemic in 12 out of the 47 counties in Kenya. Baringo county is a pastoral conflict, hard to reach area where eight rounds of mass drug administration (MDA) for trachoma have been implemented. In Loyamorok ward, treatment coverage has been below 68% against the WHO recommended threshold of 80%. Community engagements that promote participatory approaches are key to MDA success. In this study, we describe community-based participatory approaches qualitatively developed and implemented during the intervention phase of a study that involved a pre-intervention, intervention and post intervention phases and aimed to address barriers of community participation and access to trachoma MDA. Interviews and focus group discussions were used to identify barriers to community participation in MDA, that included power and gender dynamics, rampant insecurity, community myths and misconceptions, migration in search of water and pastures, vastness and terrain and ineffective teams which resulted to unsupervised swallowing of drugs during MDA campaigns. Stakeholders in trachoma were identified through meetings with national, county and sub-county health management teams. The stakeholders, community members and the research team used the identified barriers to formulate MDA strategies including effective stakeholder engagement, enhanced social mobilization, community awareness creation on trachoma, effective planning and execution of MDA and implementation monitoring of the MDA campaign, all aimed at increasing MDA coverage. Overall MDA coverage in the area increased from 67.6% in 2021 to 87% in 2023 thus meeting the WHO threshold of 80%. The use of community-based, participatory approaches in the development and implementation of data driven strategies has the potential to positively influence MDA coverage for trachoma, and other neglected tropical diseases.

Dynamics of prescribing and accessing medications for opioid use disorder: a community-based systems analysis

Background Although medications for opioid use disorder (MOUD) are effective for treating opioid use disorder (OUD), persistent barriers still prevent patients from accessing this life-saving care. Policies to increase MOUD access have produced suboptimal results. This study presents a qualitative system dynamics model that elucidates the complexities of accessing and staying in MOUD treatment. Methods We utilized a community-based system dynamics approach to modeling the MOUD treatment system. We engaged a cohort of system experts/stakeholders, including individuals who had received MOUD, treatment providers, and policymakers, in interviews and group model building to develop and refine a simulation model. We then created a qualitative causal loop diagram based on insights gained while developing the simulation model and a review of interview transcripts. Results The causal loop diagram captures four key factors affecting treatment initiation, retention, and leaving: (1) fraught interactions between patients and healthcare providers; (2) stigma-driven regulation of MOUD creating a culture of fear and defensive medicine; (3) a punitive culture in clinics and opioid treatment programs offering MOUD; and (4) the internalization of the abstinence narrative contributing to premature termination of treatment. Conclusions Our analysis highlights how interdependent and non-linear feedback processes diminish or counteract the effectiveness and sustainability of MOUD policy interventions. Due to system memory and cultural resistance to change, even rolling back reactionary policies may do little to curb established behavioral patterns. In addition, conflicting and competing strategies among various actors within the system contribute to goal misalignment and a lack of standardization of care.

Translating Children’s Environmental Health Science Using Virtual Environments: A Community-Based Participatory Research Approach

Translating Children’s Environmental Health Science Using Virtual Environments: A Community-Based Participatory Research Approach

Citizen-Led Personalization of User Interfaces: Investigating How People Customize Interfaces for Themselves and Others

User interface (UI) personalization can improve usability and user experience. However, current systems offer limited opportunities for customization, and third-party solutions often require significant effort and technical skills beyond the reach of most users, impeding the future adoption of interface personalization. In our research, we explore the concept of UI customization for the self and others. We performed a two-week study where nine participants used a custom-designed tool that allows websites' UI customization for oneself and to create and reply to customization assistance requests from others. Results suggest that people enjoy customizing for others more than for themselves. They see requests as challenges to solve and are motivated by the positive feeling of helping others. To customize for themselves, people need help with the creative process. We discuss challenges and opportunities for future research seeking to democratize access to personalized UIs, particularly through community-based approaches.

Envisioning the Future of Burnout Support: Understanding Frontline Workers' Experiences in Nonprofit Gender-Based Violence Organizations

Frontline workers (FLWs) provide essential services necessary for a functioning society, but the nature of their work contributes to their high rates of burnout. This burnout impacts not only their own health, but also has dire consequences for the people most in need of their services. Digital interventions for burnout may provide scalable, accessible, and cost-effective care. However, such interventions have been designed to intervene at the individual-level and have been inadequate in sustainably alleviating burnout. In addition, these interventions have not considered how we might integrate more effective organizational-level strategies or reflect FLWs' own experiences and the unique contexts of frontline work in their design. One important, yet understudied, domain of frontline work that experiences high rates of burnout is gender-based violence (GBV) service provision in nonprofit organizations. Using a community-based participatory research approach, we ran 8 co-design workshops with FLWs and supervisors from various nonprofit GBV organizations in a large metropolitan city in the United States to understand their experiences, hopes, and perceptions of technology for burnout support within their organizations. We found that participants greatly valued their support systems and supervisory relationships at work. And while there was a desire to use technology as support tools for burnout, participants were wary of how it could conflict with these support systems and important organizational values. We contribute a multilevel framework for digital burnout interventions and argue for a methodological shift to an assets-based approach, reframing the future of research and design of burnout interventions to center and reflect the needs, values, and lived experiences of FLWs.

Exploring harmful traditional practices and its associated factors among puerperal mothers who delivered in public health facilities in southwestern Ethiopia

Harmful traditional practices are deeply ingrained beliefs and behaviors within a society that significantly impact the well-being of mothers and children. In Ethiopia, there is limited awareness and comprehension concerning the prevalence of harmful traditional practices in the puerperal period. The underlying reasons for engaging in harmful cultural practices during this period at the community level remain inadequately studied. The main aim of this research is to investigate the prevalence of harmful traditional practices during the puerperal period and its associated factors in public health facilities of southwestern Ethiopia, 2023. A mixed-methods community-based cross-sectional approach was undertaken from June 1st to July 31st, 2023. The study utilized the 24 kebeles in the Ilubabor and Buno Bedele Zones of Southwest Ethiopia. Three hundred twenty puerperal mothers in selected kebeles found in Ilubabor and Buno Bedele zones met inclusion criteria during the data collection period. We used a pretested semi-structured questionnaire, supplemented by in-depth interviews and focused group discussions with purposively selected 18 mothers. We utilized backward multiple logistic regressions were utilized to evaluate the interplay between various factors, with statistical significance set at a P-value below 0.05. This finding disclosed that the prevalence of harmful traditional practices during the puerperal period was 76.3%. Factors such as educational status (AOR = 3.47, CI = 1.57–9.27), rural residency (AOR = 2, CI = 1.51–4.88), absence of antenatal care in the last pregnancy (AOR = 6.42, CI = 2.33–8.74), and the place of delivery for the most recent child (AOR = 1.7, CI = 1.15–4.07) were significantly associated with these practices. The findings underscore a substantial prevalence of harmful traditional practices among mothers during the puerperal period. It is imperative for the Zonal Health department, in collaboration with relevant stakeholders, to actively combat these practices within rural communities and healthcare facilities.

Reducing the harms of cannabis use in youth post-legalization: insights from Ontario youth, parents, and service providers

BackgroundCanada has one of the highest prevalence of cannabis use globally, particularly among young adults aged 20–24 (50%) and youth aged 16–19 (37%). In 2018, Canada legalized recreational cannabis with the aim of protecting youth by restricting their access and raising public awareness of health risks. However, there has been limited qualitative research on the perceptions of harms associated with youth cannabis use since legalization, which is crucial for developing effective harm reduction strategies. This qualitative study examined perceptions of cannabis use among youth from the perspectives of youth, parents, and service providers. We explored how participants described the perceived risks or harms associated with youth cannabis use, as well as how they described their own and others’ approaches to reducing cannabis-related risks and harms.MethodsThis qualitative study used a community-based participatory research approach in partnership with Families for Addiction Recovery (FAR), a national charity founded by parents of youth and young adults with addiction issues. Virtual semi-structured interviews were conducted, and the data were analyzed using thematic analysis.ResultsThe study included 88 participants from three key groups (n = 31 youth, n = 26 parents, n = 31 service providers). Two main themes emerged regarding perceived risks or harms associated with cannabis use: (1) concerns about cannabis-related risks and harms, including addiction, brain development, impact on family, and various adverse effects on areas such as motivation, concentration, finances, employment, education, physical and mental health; and (2) minimization of risks and harms, featuring conflicting messages, normalization, and perceptions of cannabis being less harmful than other substances. Additionally, two themes related to harm reduction approaches were identified: (1) implementation of harm reduction, and (2) challenges in implementing a harm reduction approach. Specific challenges for each participant group were noted, along with structural barriers such as unavailable and inaccessible services, easy access to cannabis, inadequate public education, and insufficient information on lower-risk cannabis use guidelines.ConclusionsYouth cannabis use is a significant public health concern that requires a multi-pronged approach. Developing youth-centered harm reduction strategies that recognize the developmental needs and vulnerabilities of youth, as well as the important role of families, is imperative.

Building Connections: The Impact of Digital Storytelling on Communication and Leadership Skills Among Disabled Young Adults

Digital storytelling has been applied in research in varied contexts and with varied purposes. Implicit in the process of digital storytelling is the potential to develop and/or enhance a range of individual skills (e.g., multimedia, literacy, communication, etc.). However, further research is needed to gain a deeper understanding of the potential impact of digital storytelling on skill enhancement for disabled youth. This paper provides an overview of Phase 1 of the study “My life. My story: The Youth Digital Storytelling Project” that utilized elements of a community-based participatory action research approach to host a peer-facilitated digital storytelling workshop for young adults with developmental disabilities aimed at capturing and sharing their lived experiences with, knowledge of, and perspectives on significant life-stage transitions in the areas of education, employment, or living. The results from the pre- and post-workshop questionnaires suggest that the participants improved skills in media literacy, communication, and leadership. Additionally, the participants highlighted the importance of considering the delivery format, fostering connections, and enhancing self-confidence in the development of the workshop’s design and delivery. This research adds to the extant literature demonstrating the potential of digital storytelling as a pedagogical tool, offering implications for the design and implementation of online workshops for disabled youth.

Agricultural peer mentors for mental health support

ABSTRACT Stress and mental health challenges are common in the agricultural community, both in the United States and worldwide, especially in rural communities. We recruited farmers, ranchers, and allied agriculturalists across Hawaiʻi to serve as peer mental health mentors (ag mentors). Participation required 14 hours of training including Mental Health First Aid, Question Persuade Refer, internal online resources and webinars with local mental/behavioural health professionals. Thirty-four participants completed all trainings with statistically significant gains (p < .05) in knowledge of what is considered “good” mental health, and increases in confidence in detecting signs and symptoms of mental health challenges in oneself and others. Results also showed greater de-stigmatising attitudes about mental health, and more confidence with respect to providing options for assistance. Qualitative comments also highlighted enthusiastic endorsement of the program. The findings suggest an effective a community-based relational approach to addressing farmer mental health that is consistent with the Hawaiian value of ʻohana (family) and relational ontology.

Community perceptions on socio-economic impacts of uranium exploration in Selous Ecosystem, Tanzania

Large-scale mining has positive and negative effects that impact people differently leading to varying perceptions. This study assessed perceptions of local communities on socio-economic impacts of uranium exploration in Selous Ecosystem, Tanzania. The study was guided by three main research questions (i) Are local communities aware of the impacts of uranium exploration? (ii) What are the socio-economic impacts of uranium exploration? and (iii) What are perceptions of local communities on uranium impacts? A simple random sampling technique was used to select 51 households for questionnaire survey. Additionally, 22 key informants were interviewed and 2 focus group discussions were conducted. Moreover, secondary information such as government policies, legislations, and previous published and unpublished reports were reviewed. The quantitative information was analysed through Statistical Package for Social Science. For the purpose of this study, descriptive statistics was used while qualitative information was analysed using content analysis technique. In terms of awareness, 51% were unaware on negative impacts of uranium mining. The positive socio-economic impacts reported were employment opportunities, improved quality of life, road accessibility and economic opportunities. However, the majority of people interviewed (70 %) claimed that they have not received individual benefits from uranium exploration activities. Perception differed significantly, with 72% of those employed in the mine having positive perceptions, compared to 62% of the unemployed individuals who had negative perceptions. This study recommends a community-based bottom-up approach for awareness raising on uranium impacts. In addition, the mining company should implement effectively its corporate social responsibilities because, the negative perceptions may stand as a hindrance for accomplishment of its goals. The findings of this study provide preliminary baseline for future studies to monitor the impacts of uranium in particular radioactivity pathways associated with uranium mining

Multidimensional Benefits of a Tailored Exercise Program in Preventing Frailty: A Community-Based Approach.

Frailty is a significant health concern in the aging population, particularly in Japan's super-aging society. Community-based interventions show promise in frailty prevention; however, their effectiveness requires further investigation. This study aimed to evaluate the impact of a continuous municipal rehabilitation program on frailty status and physical function in older adults living in suburban Japan. This prospective observational study included 52 participants aged ≥ 65 years (13 males and 39 females) who underwent assessments at baseline and after six months. Participants were divided into Pre-old (65-74 years) and Older (≥75 years) groups. Frailty was assessed using the Kihon checklist (KCL), and physical function was evaluated using the New Physical Fitness Test. Changes in frailty status, physical function, and KCL subcategories were analyzed. Frailty prevalence decreased significantly from baseline to 6 months (21.2% to 7.7%, p = 0.018). In the Pre-old group, significant improvements were observed in the sit-up (p = 0.035) and six-minute walking (p = 0.017) scores. The Older group showed significant improvements in KCL lifestyle (p = 0.023) and physical function (p = 0.018). Seven of ten initially frailty participants transitioned to a non-frailty status after 6 months. The Co-Creative Well-being System was associated with a reduction in frailty prevalence and improvements in physical function, with age-specific benefits observed. This community-based approach presents a promising strategy for addressing frailty in aging populations.

The Nature of Employment in a High Socioeconomic Hardship Community: Data From the Greater Lawndale Healthy Work Survey.

This cross-sectional survey aimed to examine employment characteristics and their associations with employment precarity in two high socioeconomic hardship Chicago neighborhoods. We used a community-based participatory approach to develop and administer a survey to residents who perceived their work situations to be precarious. A total of 489 residents were surveyed. Responses were skewed toward the most precarious work situations, with the majority of respondents employed outside of a traditional arrangement. Those in the highest precarity category were most likely to identify as Latinx and born outside of the United States. Unstable, low-quality employment conditions were nearly all significantly associated with highest precarity work situations. Precarious employment is an important predictor of other employment conditions, and characterizing these at a hyperlocal level allows for a nuanced understanding of work as a determinant of health.

Using artificial intelligence to address mental health inequalities: co-creating machine learning algorithms with key stakeholders and citizen engagement

Purpose Artificial intelligence (AI) is poised to reshape mental health practices, policies and research in the coming decade. Simultaneously, mental health inequalities persist globally, imposing considerable costs on individuals, communities and economies. This study aims to investigate the impact of AI technologies on future citizenship for individuals with mental health challenges (MHCs). Design/methodology/approach This research used a community-based participatory approach, engaging peer researchers to explore the perspectives of adults with MHCs from a peer-led mental health organisation. This study evaluated potential threats and opportunities presented by AI technologies for future citizenship through a co-created film, depicting a news broadcast set in 2042. Data were gathered via semi-structured interviews and focus groups and were analysed using a reflexive thematic approach. Findings The analysis identified four key themes: Who holds the power? The divide, What it means to be human, and Having a voice. The findings indicate that adults with living experiences of MHCs are eager to influence the development of AI technologies that affect their lives. Participants emphasised the importance of activism and co-production while expressing concerns about further marginalisation. Originality/value This study provides new insights into the intersection of AI, technology and citizenship, highlighting the critical need for inclusive practices in technological advancement. By incorporating the perspectives of individuals with living experiences, this study advocates for participatory approaches in shaping AI technologies in mental health. This includes the co-creation of machine learning algorithms and fostering citizen engagement to ensure that advancements are equitable and empowering for people with MHCs.

Women's attitudes towards intimate partner violence in Guyana: a population-based study

Intimate partner violence (IPV) against women is a global health issue and a breach of human rights. However, the literature lacks understanding of how socioeconomic and geographic disparities influence women's attitudes toward IPV in Guyana over time. This study aimed to assess trends in women's attitudes about IPV in Guyana. Data from three nationally representative surveys from 2009, 2014 to 2019 were analysed. The prevalence of women's attitudes about IPV was assessed, specifically in response to going out without telling their partners, neglecting their children, arguing with their partner, refusing sex with their partner, or burning food prepared for family meals. A series of stratified subgroup analyses were also completed. We assessed trends in IPV using the slope index of inequality (SII) and the concentration index of inequality (CIX). We used multilevel mixed-effects logistic regression to assess factors associated with women's attitudes justifying IPV. The prevalence of women's attitudes justifying IPV for any of the five reasons declined from 16.4% (95% CI: 15.1-17.8) in 2009 to 10.8% (95% CI: 9.7-12.0) in 2019. Marked geographic and socioeconomic inequalities were observed among subgroups. The SII for any of the five reasons decreased from-20.02 to-14.28, while the CIX remained constant over time. Key factors associated with women's attitudes about IPV were area of residence, sex of the household head, marital status, respondent's level of education, wealth index quintile, and the frequency of reading newspapers/magazines. From 2009 to 2019, Guyana was able to reduce women's attitudes justifying IPV against women by 34.1% and shortened subgroup inequalities. However, the prevalence remained high in 2019, with persisted inequalities among subgroups. Effective strategies, including the use of media to raise awareness, promotion of community-based approaches, and educational campaigns focusing on geographic and socioeconomic disparities, are essential for continuing to reduce the prevalence of IPV and associated inequalities. The study was funded in part by the National Institutes of Health, Fogarty International Center grant number D43TW012189.

“When you have stress because you don’t have food”: Climate, food security, and mental health during pregnancy among Bakiga and Indigenous Batwa women in rural Uganda

Climate change exerts wide-ranging and significant effects on global mental health via multifactorial pathways, including food insecurity. Indigenous Peoples and pregnant women inequitably experience the harms associated with climate change and food insecurity. This study explores food security and maternal mental health during pregnancy among rural Ugandan Bakiga and Indigenous Batwa women in the context of climate change. Using a community-based research approach, we conducted a series of focus group discussions about climate, food security, and health during pregnancy in four Indigenous Batwa communities and four Bakiga communities in rural Kanungu District, Uganda, as well as longitudinal follow up interviews later in the year. Data were evaluated using a qualitative thematic analysis. Women consistently identified mental health as an important factor affecting maternal-fetal wellbeing during pregnancy. Many women identified that weather and climate extremes, such as prolonged droughts and unpredictable weather events, have made it more difficult for them to obtain sufficient food for themselves and their families during pregnancy, resulting in significant mental distress. More extreme weather conditions have made physical labour difficult or impossible during pregnancy, and resultant hunger further decreased ability to obtain food—a vicious cycle. Women described how anxiety was compounded by worry about future famine, as they anticipated further decreases in crop yields and rising food prices in a changing climate. Indigenous Batwa women experienced additional distress around their lack of access to Indigenous lands and its nutritious food sources. Overall, mothers in rural Uganda described food insecurity and climate extremes as major sources of stress during pregnancy, and they anticipate challenges will worsen. Interventions to enhance adaptive capacity to climate change are needed and should have a focus on the intricate connections with food insecurity and mental health as drivers of overall maternal health.

STRATEGY OF SUSTAINABLE BUSINESS DEVELOPMENT BASED ON COMMUNITY (STUDY OF TODAY'S MODERN COFFEE SHOP BUSINESS ACTORS)

This study explores the sustainable community-based business approach adopted by modern coffee shops in Kendari City to boost community participation and foster customer loyalty. Through qualitative research, including case studies and in-depth interviews with business owners, employees, and community members, the findings indicate that involving the community in innovation and business adaptation strengthens customer relationships and enhances business sustainability. By engaging the community, coffee shops are able to create a sense of ownership, resulting in higher customer retention and greater brand loyalty. The approach also proves effective in addressing operational challenges such as fluctuating demand and supply disruptions by leveraging community-driven solutions. Furthermore, the adoption of sustainable practices, such as sourcing local ingredients, minimizing waste, and utilizing eco-friendly packaging, increases operational resilience and attracts environmentally conscious customers. This business model aligns with local policies promoting the sustainability of MSMEs and offers a replicable framework for other small businesses in similar contexts. Ultimately, the combination of community engagement and sustainable practices not only generates economic benefits but also builds social capital, ensuring long-term business resilience and contributing to local economic growth.