Community-based Collaborative Action Research Research Articles

ALZHEIMER'S DISEASE AND RELATED DEMENTIAS RISK AND PSYCHOSOCIAL HEALTH NEEDS OF OLDER ADULT IMMIGRANTS AND REFUGEES

Abstract To establish priorities for an intervention addressing Alzheimer’s Disease and Related Dementias (ADRD) risk among older adult immigrants and refugees from Afghanistan and the Middle-East and North Africa (MENA). A multi-methods Community-Based Collaborative Action Research design was employed to gather qualitative and quantitative data. Twenty community leaders and stakeholders participated in interviews and community needs survey responses of 124 ethnically diverse adults over age 55 were examined. We analyzed community needs survey data using descriptive statistics. A step-wise Thematic Analysis was used to analyze interview transcripts. A major theme and standout priority was identified: needing culturally-sensitive services and resources addressing social isolation among the elderly. Other psychosocial priorities included: accessibility needs, caregiving support, safety and end-of-life resources, digital literacy, and English language services. This study exemplifies a priority-setting partnership between clinician-researchers and refugee service providers. The priorities highlighted ADRD risk factors and guide the collaborative development of a community-based intervention.

Evidence-Based Review and Discussion Points.

Evidence-Based Review and Discussion Points.

An Integral Approach to the Modeling of Information Support for Local Sustainable Development—Experiences of a Serbian Enabling Leadership Experiment

Collaborative strategic decision making has to be widely informed, communicated and knowledge-based in order to innovate transformations toward local and global sustainability. It is unimaginable that this process could be effective without computer-aided information support, but the research indicates the utilization constraints within human capacities to recognize their usability and usefulness. These constraints seem to be even more challenging within the intensively transitional social contexts, such as Serbia. We argue that understanding the relationships between sustainability, governance, and planning in a specific social context has profound importance to gain usefulness of information support and to ensure its increasing utilization. Identifying the practical path of information support modeling requires an operational framework that encompasses innovative and socially valid initiatives. Therefore, an integral theory framework was chosen to comprehend all social influences on the information support of successful utilization. This article presents the integral framework of the information support’s conceptual setting, which was used to build up community-based collaborative action research (CBCAR) as a transformative social learning process that enables information support utilization, and it was tested in six municipalities of Serbia. The implementation of pilot territorial information support (TIS) initiatives resulted in continuous and proactive local community efforts in information support development and usage.

Trialing the Community-Based Collaborative Action Research Framework: Supporting Rural Health Through a Community Health Needs Assessment.

To describe the application of the Community-Based Collaborative Action Research (CBCAR) framework to uplift rural community voices while conducting a community health needs assessment (CHNA) by formulating a partnership between a critical access hospital, public health agency, school of nursing, and community members to improve societal health of this rural community. This prospective explorative study used the CBCAR framework in the design, collection, and analysis of the data. The framework phases include: Partnership, dialogue, pattern recognition, dialogue on meaning of pattern, insight into action, and reflecting on evolving pattern. Hospital and public health agency leaders learned how to use the CBCAR framework when conducting a CHNA to meet Affordable Care Act federal requirements. Closing the community engagement gap helped ensure all voices were heard, maximized intellectual capital, synergized efforts, improved communication by establishing trust, aligned resources with initiatives, and diminished power struggles regarding rural health. The CBCAR framework facilitated community engagement and promoted critical dialogue where community voices were heard. A sustainable community-based collaborative was formed. The project increased the critical access hospital's capacity to conduct a CHNA. The collaborative's decision-making capacity was challenged and ultimately strengthened as efforts continue to be made to address rural health.

Research Collaboration in a Communication Rights Campaign: Lessons Learned.

In building public support for social change, activists in communities of color routinely approach broader audiences via news media. Communities of color, however, routinely face disparities that limit their access to media including local news media outlets. This lack of access mirrors inequalities in political, social, and economic arenas and can slow public awareness campaigns to address disparities in health, environmental, and other quality-of-life issues. I describe two community-based collaborative action research studies that documented and challenged how local television newscasts underrepresented and misrepresented three communities of color in Boston. The linkage between communication rights and campaigns to address quality-of-life issues is presented, as well as unresolved challenges in the collaborative research process. The study has implications for environmental health campaigns.

Creating a Bridge of Understanding between Two Worlds: Community‐Based Collaborative‐Action Research with Sudanese Refugee Women

To explore the process of partnership between university researchers, students, and South Sudanese refugee women to address the health challenges associated with their resettlement transition to the United States. This qualitative study used a community-based collaborative action research (CBCAR) framework in the design, collection, and analysis of the qualitative data. Twenty refugee women participated in this study. Five health education seminars followed by an audio-recorded focus group were held over 9 months. A final focus group was held to confirm derived themes and develop an action plan. The partnership between the refugee women and researchers resulted in awareness of how power structures and differing expectations affected the process. The dialog in the focus groups provided an opportunity for refugee women to voice challenges to their health in resettlement. A pattern was recognized about how political and sociocultural events affected the process of CBCAR. Dialog and sharing differing worldviews and perspectives led to insights about ways to improve the health of the South Sudanese refugee community. CBCAR is a useful framework to address health concerns of a refugee community. Insights from this study provided a foundation for a future intervention research project with the refugee women.

Academic-Hospital Partnership: Conducting a Community Health Needs Assessment as a Service Learning Project.

The purposes of this service learning project were to trial nursing student application of the Community-Based Collaborative Action Research (CBCAR) framework while conducting a community health needs assessment and to assess the effectiveness of the CBCAR framework in providing real-world learning opportunities for enhancing baccalaureate nursing students' public health knowledge. In this case study analysis, the CBCAR framework linked service learning and community health needs assessment with public health nursing core competencies. Fifteen nursing students partnered with collaborative members. Student observational field notes and narrative reflections were analyzed qualitatively for fidelity to the CBCAR framework and to evaluate student public health knowledge. Students successfully employed the CBCAR framework in collaboration with the critical access hospital and community stakeholders to design and conduct the community health needs assessment. Service learning themes were real-world solutions, professional development, community collaboration, and making a difference. Students developed skills in six of the eight domains of the Quad Council's core competencies for public health nurses. Community-Based Collaborative Action Research facilitates collaborative partnerships and relationships throughout the research process. Students benefited by applying what they have learned from their education to a real community who lacks resources.

Well-Being in Refugee Women Experiencing Cultural Transition

This article presents a situation-specific theory of well-being in refugee women experiencing cultural transition. The theory resulted from 2 studies, an ethnography and a community-based collaborative action research project, with refugee women from South Sudan, who were resettled to the United States. The theory extends the middle-range theory of transition to include cultural transition as a distinct type of transition with a unique set of properties and conditions including 3 phases-separation, liminality, and integration. Community action research is discussed as a culturally relevant intervention for nurses working with immigrants and refugee populations to foster well-being in resettlement.

Patterns in the Lives of African American Women with Diabetes

The experience of African American women with diabetes has not been fully understood to guide meaningful practice. This community-based collaborative action research, based on Newman's nursing theory of health as expanding consciousness, sought to understand the experience of African American women living with diabetes, and to envision new patterns of health by engaging women in dialogue about the meaning of their experiences. Interviews with 7 women revealed the multi-faceted nature of living with diabetes; blood sugars rise and fall with stress, depression, and trauma, as well as spiritual strength, mentors, and sister friends balance energy demands. Findings were woven into a spoken word narrative to engage the wider community in dialogue to gain new insights into how to live and relate in healthier ways. These findings give rise to a different model of community health and guide nurses to focus holistically on what is meaningful in the lives of their patients.

Hmong American Women Living With Diabetes

To understand how to better care for Hmong women with diabetes using nursing theory praxis. Qualitative phenomenologic design, specifically community-based collaborative action research based on Margaret Newman's theory of health as expanding consciousness (HEC). Five Hmong women with Type 2 diabetes and HgbA1c levels over 7.0 were recruited from a community-health clinic. Audiotaped in-home interviews were conducted and data were analyzed to identify common patterns and then developed into a play by the research team with the help of a female Hmong playwright. Community dialogue about the findings generated meaningful actions for health. This study indicates the value of nursing praxis rooted in the theory of health as expanding consciousness and the importance of engaging communities to identify meaningful patterns of health and needed actions. Evidence-based practice is lacking in the care of Hmong women with diabetes. Community-based collaborative action research rooted in the HEC perspective is a new way to envision models of care.