Community-based Implementation Research Articles

Community-Based Tourism Implementation as Mediator on the Relationship between Community Participation and Socio-Economic Sustainability of Tourism

This study explored the mediating effect of community-based tourism implementation on the relationship between community participation and the socio-economic sustainability of tourism in Marilog District. This study employed a quantitative method and stratified random sampling to select the 380 respondents. The survey was distributed to two areas in Marilog District: Barangay Baganihan and Barangay Datu Salumay. The data was evaluated to ascertain whether the variables had a statistical relationship. This study used non-experimental quantitative research, the descriptive-correlation approach, and mediation analysis. The weighted mean, Pearson product-moment correlation coefficient, multiple regression analysis, and path analysis were used to analyze the data. The result revealed that the respondents have high levels of community participation, socio-economic sustainability, and community-based tourism implementation. The relationship between community participation and socio-economic sustainability, community participation and community-based tourism implementation, and socio-economic sustainability and community-based tourism implementation were statistically significant. However, the indirect effect of community participation in socio-economic sustainability through community-based tourism implementation is insignificant and statistically supported by this study, indicating no significant mediation. The study findings’ implications are presented.

Indications of digital literacy during Latino-focused, community-based COVID-19 testing implementation.

We sought to characterize indicators of digital literacy among persons testing for COVID-19 and community health workers (CHWs) providing testing via a digital platform in low-income, majority-Latino communities in California. From March 2021 to March 2022, we trained CHWs to provide community-based COVID-19 testing that relied on a digital platform for registration, recording and reporting of results. Among community members, we examined factors associated with accessing test results digitally and time to results receipt. Among CHWs, we evaluated factors associated with self-reported difficulty using the digital platform and improvement post-training. Overall, 5044 community members were tested for COVID-19. Accessing results digitally vs non-digitally was associated with younger age (Odds Ratio [OR]: 1.02 [95% Confidence Interval [CI], 1.01-1.03], for each year decrease), rural residence (OR:1.61 [95% CI, 1.30-1.99]), and providing an email address at registration (OR: 2.18 [95% CI, 1.80-2.65]). The likelihood of providing an email address at registration was increased among younger, non-Latino, English-speaking, female, and rural testers. Among persons accessing results digitally, median time from testing to result receipt was 41 min, with increased time associated with rural residence and older age. Among 42 CHWs surveyed, 29 (68%) reported technology-related challenges when providing testing: those reporting challenges were more likely to be older and rural CHWs. Rural CHWs were less likely to report technical skill improvement post-training. Email provision may be an indicator of digital literacy among persons testing for COVID-19 in low-income, majority-Latino communities. Rural and older CHWs may need more intensive digital training. Efforts to improve digital literacy in underserved communities are likely needed to realize the full potential of community-based health interventions that utilize digital platforms.

Closing the Dissemination Gap: Accessible Toolkits for the Rapid Replication of Evidence-Informed Interventions to Improve Health Outcomes Among People with HIV.

Despite advances in HIV care and treatment in the U.S., disparities in outcomes along the HIV care continuum persist. The widespread replication of effective and sustainable interventions that prioritize the engagement of underserved populations has been identified as a promising path to ending the HIV epidemic in the U.S. Intervention dissemination products, however, rarely provide the comprehensive and accessible information needed to replicate interventions within community settings. To bridge the divide between research and community-based implementation, the Using Evidence-informed Interventions to Improve Health Outcomes among People Living with HIV (E2i) initiative-grounded in the HIV/AIDS Bureau Implementation Science Framework-created a suite of tools to promote the rapid replication of interventions focused on transgender women, Black men who have sex with men, behavioral health integration, and identifying and addressing trauma. The resulting dissemination products are detailed and digestible multimedia toolkits that follow adult learning theory principles and align with the Template for Intervention Description and Replication criteria for adapting non-pharmacological interventions. Each E2i toolkit consists of five components: implementation guides, narrative videos of site implementation, best practice demonstration videos, interactive learning modules, and recruitment posters and brochures. Over 2 years (2022-2024), the E2i toolkit webpages amassed 7703 unique users and 17,666 pageviews. These toolkits can serve as a blueprint for designing comprehensive and accessible dissemination products for replication of HIV interventions in care settings. Dissemination products that bridge the gap between intervention research and replication in community settings are a crucial missing tool for ending the HIV epidemic.

Participants in a peer-based nutrition and health program in Zimbabwe value dialogue, peer support, and tangible action: A qualitative exploration of peer group experiences.

Peer support groups are implemented globally, and viewed as cost-effective, scalable platforms for delivering health and nutrition programming. Quality is important for participation and achieving social and behavior change goals. Little research has explored the perspectives of peer group participants on quality. This manuscript describes community-based implementation research, and associated findings, which was conducted to learn how participants of a nutrition and health program define quality peer groups and how they suggest improving peer groups. In-depth interviews on experiences, benefits, and challenges were conducted with participants of health and nutrition peer groups, including group members (n = 64) and facilitators (n = 30), in three districts in Zimbabwe. Qualitative data were analyzed thematically and preliminary results were presented in six follow-up focus group discussions with interviewees to provide input on results and interpretation. Peer groups met some of participants' needs for knowledge, social support, and visible improvements in their lives and homes. Participants described generally positive experiences that sustained participation and motivated behavior change. They highlighted group dynamics, interactive facilitation, and community recognition which support the credibility and motivation of group facilitators. Implementation could be improved by strengthening family engagement and more hands-on learning for encouraging participation. Local adaptation of group activities can address influences on behavior change and increase relevance to participants' needs. The perspectives of core stakeholders are essential to understand what aspects of peer groups are most important to implement the approach with quality across contexts. Implementation research and continued monitoring to understand participant perspectives should be an integral part of all programs to ensure the application of adult learning principles and an appropriate balance between fidelity and adaptation for local relevance and engagement.

Exploring the scalability and sustainability of community-based agroforestry to achieve planetary health benefits in Haiti’s Lower Artibonite Valley

Community-based agroforestry, as a planetary health solution, can rebuild fertile soils, minimize climate risk, diversify farmer incomes, and provide a source of food, raw materials, and other vital ecosystem functions. Utilizing focus groups, individual semi-structured interviews, and field observations, we studied how the Haiti Timber Reintroduction Program (HTRIP), an agroforestry program operating in Haiti since 2005, leveraged institutional infrastructures and social networks to facilitate the adoption, scaling, and sustainability of community-based agroforestry as a solution for planetary health. Results show that the adoption and scaling of community-based agroforestry was facilitated by support from institutional and social networks. The results underscore the importance of cross-sector collaboration and coordination in creating the enabling conditions necessary for successful community-based agroforestry implementation. Additionally, strengthened social networks, cultivated through long-term participation in the HTRIP, contributed to the program’s sustainability. While competing socio-political problems in some low-income settings may seem insurmountable—particularly those in fragile states, where our study took place—our research demonstrates that community-based agroforestry solutions are possible. Where culturally relevant, this ecologically and socially based practice could be scaled up to amplify its benefits to more communities. We encourage further research to explore the scaling up of regenerative practices such as agroforestry for climate resilience and planetary health.

Enhanced Oral Pre-exposure Prophylaxis (PrEP) Implementation for Ugandan Fisherfolk: Pilot Intervention Outcomes

Mobile populations such as fisherfolk show high HIV incidence and prevalence. We pilot-tested implementation strategies to enhance pre-exposure prophylaxis (PrEP) uptake and adherence in the context of healthcare outreach events in two mainland fisherfolk communities on Lake Victoria, Uganda from September 2021 to February 2022. The implementation strategies included PrEP adherence supporters (selected from PrEP users’ social networks), community workshops (to address misconceptions and stigma, and empower PrEP advocacy), and check-in calls (including refill reminders). PrEP medical records data were collected from 6-months pre-intervention to 6-months post-intervention. Qualitative interviews with 20 PrEP users (10 who continued, 10 who discontinued), 9 adherence supporters, and 7 key partners (providers, community leaders) explored acceptability. Percentages of PrEP initiators (of those eligible) were significantly higher during the intervention (96.5%) than 6-months before the intervention (84.5%), p < 0.0001; percentages of PrEP users who persisted (i.e., possessed a refill) 6-months post-initiation (47.9% vs. 6.7%) and had at least 80% PrEP coverage (based on their medication possession ratio) from the initiation date to 6-months later (35.9% vs. 0%) were higher during versus pre-intervention, p < 0.0001. A comparison fisherfolk community with better healthcare access had lower uptake (78.3%; p < 0.0001) and persistence at 6-months (34.0%; p < 0.001), but higher coverage during the intervention period (70.4%; p < 0.0001). Qualitative data suggested the strategies promoted PrEP use through reduced stigma and misconceptions. The intervention bundle cost was $223.95, $172.98, and $94.66 for each additional person for PrEP initiation, persistence, and coverage, respectively. Enhanced community-based PrEP implementation that fosters a supportive community environment can improve PrEP use in mobile populations without easy access to healthcare. (NCT05084716).

Patterns of daily oral HIV PrEP adherence among people who inject drugs in Ukraine: an analysis of biomarkers.

Daily oral HIV pre-exposure prophylaxis (PrEP) with tenofovir/emtricitabine (TDF/FTC) is recommended for people who inject drugs (PWID) but coverage is low. The real-life effectiveness of PrEP among PWID is unknown as previous studies were conducted in controlled settings and mainly relied on self-report. Analysis of PrEP metabolites-tenofovir diphosphate (TFVdp) and emtricitabine triphosphate (FTCtp)-offers an objective measure of adherence. To analyse longitudinal patterns of PrEP adherence among PWID in Ukraine, we used data from a community-based implementation trial conducted in Kyiv between July 2020 and March 2021 to test the efficacy of SMS reminders to improve adherence. Among 199 enrolled participants, 156 (78.4%) were retained through 6 months. Based on TFVdp/FTCtp levels assessed at 3 and 6 months, we identified groups with various adherence patterns (adherent at ≥2 doses/week, improved, worsened, non-adherent). Correlates of adherence were analysed using multinomial logistic regression. Most participants (53.8%, n = 84/156) had no detectable metabolites at both assessments; 7.1% (n = 11/156) were consistently taking ≥2 doses/week; 1.3% (n = 2/156) were consistently taking ≥4 doses/week; 13.5% (n = 21/156) exhibited improved and 21.8% (n = 34/156) had worsened adherence at 6 compared to 3 months. "White coat compliance" (increased dosing prior to assessment) was common. Consistent adherence was associated with SMS reminders, younger age, employment, lower income, longer injection drug use duration, recent high-risk injecting (receptive syringe sharing, using pre-filled syringe, back- or front-loading, container sharing), absence of overdose in the past 6 months, perceived HIV risk through sexual intercourse and higher PrEP self-efficacy. Alcohol consumption was associated with inconsistent PrEP use. Groups with improved and worsened adherence did not differ. Daily oral PrEP may not achieve the desired effectiveness among PWID as a standalone intervention, calling for testing of alternative PrEP formulations and innovative integrated risk reduction strategies, especially in the context of HIV epidemics associated with injection drug use in eastern Europe and central Asia and the public health crisis in Ukraine caused by the war with Russia. SMS reminders may be effective among PWID who prioritize PrEP. Our findings offer practical guidance in identifying PWID who are likely to benefit from PrEP and those who need additional support.

Utility of a virtual small group cognitive behaviour program for autistic children during the pandemic: evidence from a community-based implementation study

BackgroundAutistic children often experience socioemotional difficulties relating to emotion regulation and mental health problems. Supports for autistic children involve the use of adapted interventions that target emotion regulation and social skills, alongside mental health symptoms. The Secret Agent Society Small Group (SAS: SG), an adapted cognitive behavioural program, has demonstrated efficacy through lab-delivered randomized control trials. However, research is still needed on its effectiveness when delivered by publicly funded, community-based autism providers under real-world ecologically valid conditions, especially within the context of a pandemic. The COVID-19 pandemic has disrupted access to community-based supports and services for autistic children, and programs have adapted their services to online platforms. However, questions remain about the feasibility and clinical utility of evidence-based interventions and services delivered virtually in community-based settings.MethodsThe 9-week SAS: SG program was delivered virtually by seven community-based autism service providers during 2020–2021. The program included the use of computer-based games, role-playing tasks, and home missions. Caregivers completed surveys at three timepoints: pre-, post-intervention, and after a 3-month follow-up session. Surveys assessed caregivers’ perception of the program’s acceptability and level of satisfaction, as well as their child’s social and emotional regulation skills and related mental health challenges.ResultsA total of 77 caregivers (94% gender identity females; Mean = 42.1 years, SD = 6.5 years) and their children (79% gender identity males; Mean = 9.9 years, SD = 1.3 years) completed the SAS: SG program. Caregivers agreed that the program was acceptable (95%) and were highly satisfied (90%). Caregivers reported significant reduction in their child’s emotion reactivity from pre- to post-intervention (-1.78 (95% CI, -3.20 to -0.29), p = 0.01, d = 0.36), that continued to decrease after the 3-month booster session (-1.75 (95% CI, -3.34 to -0.16), p = 0.02, d = 0.33). Similarly, improvements in anxiety symptoms were observed (3.05 (95% CI, 0.72 to 5.36), p = 0.006, d = 0.39).ConclusionsAs online delivery of interventions for autistic children remains popular past the pandemic, our findings shed light on future considerations for community-based services, including therapists and agency leaders, on how best to tailor and optimally deliver virtually based programming.Trial registrationThis study has been registered with ISRCTN Registry (ISRCTN98068608) on 15/09/2023. The study was retroactively registered.

Methodology for adapting a co-created early childhood development intervention and implementation strategies for use by frontline workers in India and Guatemala: a systematic application of the FRAME-IS framework

ABSTRACT There is little evidence on optimizing the effectiveness and implementation of evidence-based early childhood development (ECD) interventions when task-shifted to frontline workers. In this Methods Forum paper, we describe our adaptation of the International Guide for Monitoring Child Development (GMCD) for task-shifting to frontline workers in Guatemala and India. In 2021–2022, implementers, trainers, frontline workers, caregivers, and international GMCD experts collaborated to adapt the GMCD for a task shifted implementation by frontline workers. We used an eight-step co-creating process: assembling a multidisciplinary team, training on the existing package, working groups to begin modifications, revision of draft modifications, tailoring of visual materials and language, train-the-trainers activities, pilot frontline worker trainings, final review and feedback. Preliminary effectiveness of adaptations was evaluated through narrative notes and group-based qualitative feedback following pilot trainings with 16 frontline workers in India and 6 in Guatemala. Final adaptations included: refining training techniques to match skill levels and learning styles of frontline workers; tailoring all visual materials to local languages and contexts; design of job aids for providing developmental support messages; modification of referral and triage processes for children in need of enhanced support and speciality referral; and creation of post-training support procedures. Feedback from pilot trainings included: (1) group consensus that training improved ECD skills and knowledge across multiple domains; and (2) feedback on ongoing needed adjustments to pacing, use of video-based vs. role-playing materials, and time allocated to small group work. We use the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) framework to document our adaptations. The co-creating approach we use, as well as systematic documentation of adaptation decisions will be of use to other community-based early childhood interventions and implementation strategies.

Barriers and facilitators of communitybased implementation of evidencebased interventions in the UK, for children and young people's mental health promotion, prevention and treatment: rapid scoping review - ERRATUM.

Barriers and facilitators of communitybased implementation of evidencebased interventions in the UK, for children and young people's mental health promotion, prevention and treatment: rapid scoping review - ERRATUM.

IMPLEMENTATION OF COMMUNITY-BASED ENVIRONMENTAL CARE CHARACTER IN ELEMENTARY SCHOOL STUDENTS

The current environmental equilibrium requires global and national solutions. This study aims to evaluate the implementation of community-based environmental character care in Umbulharjo State SD 2, as well as its supportive and inhibitory factors. This research uses a type of descriptive research qualitative approach. The research subjects consisted of the head of the school, parents, CFP accompanying, teachers, and students of class VI A at the Umbulharjo State SD 2. Data collection on the study was done through observations, interviews, and documentation. The validity of the data in this study uses source triangulation and triangulation techniques. The data is then analyzed using a data analysis model according to Miles and Huberman that includes data collection, data reduction, data presentation, and conclusion and verification. The results of this study show that the implementation of community-based environmental caring character in pupils in Umbulharjo State SD 2 was realized through the collaboration of parents and OISCA. Collaboration is carried out through community-based character-enhancing education implementation measures that include: 1) Identification and analysis of school needs; 2) Identifying community participation; 3) building networks and collaboration; 4) designing character enhancement educational activities; 5) Program implementation; 6) Program evaluation; and 7) Maintaining the sustainability of collaboration. Factors supporting the collaboration include the availability of extensive land, the enthusiasm of school citizens, and the presence of support from partners. Implementation of community-based environmental caring character in Umbulharjo State SD 2 through collaboration between parents, OISCA, and schools, highlights the importance of active participation of the community in addressing environmental gaps at the local level.

Cost of start-up activities to implement a community-level opioid overdose reduction intervention in the HEALing Communities Study

BackgroundCommunities That HEAL (CTH) is a novel, data-driven community-engaged intervention designed to reduce opioid overdose deaths by increasing community engagement, adoption of an integrated set of evidence-based practices, and delivering a communications campaign across healthcare, behavioral-health, criminal-legal, and other community-based settings. The implementation of such a complex initiative requires up-front investments of time and other expenditures (i.e., start-up costs). Despite the importance of these start-up costs in investment decisions to stakeholders, they are typically excluded from cost-effectiveness analyses. The objective of this study is to report a detailed analysis of CTH start-up costs pre-intervention implementation and to describe the relevance of these data for stakeholders to determine implementation feasibility.MethodsThis study is guided by the community perspective, reflecting the investments that a real-world community would need to incur to implement the CTH intervention. We adopted an activity-based costing approach, in which resources related to hiring, training, purchasing, and community dashboard creation were identified through macro- and micro-costing techniques from 34 communities with high rates of fatal opioid overdoses, across four states—Kentucky, Massachusetts, New York, and Ohio. Resources were identified and assigned a unit cost using administrative and semi-structured-interview data. All cost estimates were reported in 2019 dollars.ResultsState-level average and median start-up cost (representing 8–10 communities per state) were $268,657 and $175,683, respectively. Hiring and training represented 40%, equipment and infrastructure costs represented 24%, and dashboard creation represented 36% of the total average start-up cost. Comparatively, hiring and training represented 49%, purchasing costs represented 18%, and dashboard creation represented 34% of the total median start-up cost.ConclusionWe identified three distinct CTH hiring models that affected start-up costs: hospital-academic (Massachusetts), university-academic (Kentucky and Ohio), and community-leveraged (New York). Hiring, training, and purchasing start-up costs were lowest in New York due to existing local infrastructure. Community-based implementation similar to the New York model may have lower start-up costs due to leveraging of existing infrastructure, relationships, and support from local health departments.

IJCM_362A: Opportunistic Development of an Educational Intervention to Leverage Community Medicine Residents as Teachers for Community-Based Implementation of Attitudes, Ethics and Communication Module for Medical Students Using Life Skills Education Framework

Background: While undergraduate (UG) medical students often have inadequate opportunities to develop the Attitude, Ethics and Communication (AETCOM) competencies in real-world community settings, the Community Medicine (CM) residents have wider opportunities for community-based activities, but often lack opportunities to independently lead community-based intervention programs. Objective: This descriptive study involves the opportunistic development of a novel educational intervention aimed at integrating the fieldwork and teaching duties of a CM resident, facilitating the administration of the AETCOM module in real-world settings to benefit both UGs and the resident. Methodology: The intervention involved appointing a second-year CM resident as an independent near-peer teacher. This resident conceptualized, developed, and implemented a community-based learning (CBL) experience to administer the AETCOM module in community settings. The CBL included the resident facilitating a life skills education (LSE) session based on the World Health Organization Life Skills framework by engaging 30 third-year medical students with 50 children from the community in the Rural Health Training Centre field area. Kirkpatricks Level One of evaluation was conducted by collecting feedback through informal discussions between the resident, UGs, and faculty. Results: The medical students stated that the program provided an opportunity to learn CM beyond classroom in the community itself, sparking increased interest in the subject; practice teamwork and communication skills in real-world settings; discover their own strengths beyond academics. The resident reported gaining confidence in leadership skills via the opportunity to independently develop and implement a program, and also positively rated the chance to integrate work with teaching responsibilities. The faculty agreed to the benefits but reported apprehension about logistical challenges in routine implementation of such programs. Conclusion: Engaging residents-as-teachers to implement the AETCOM module through a LSE program in community settings is a novel approach to facilitate the development of relevant soft skills among medical students and residents.

Effect of community-based newborn care implementation strategies on access to and effective coverage of possible serious bacterial infection (PSBI) treatment for sick young infants during COVID-19 pandemic.

In Ethiopia, neonatal mortality is persistently high. The country has been implementing community-based treatment of possible serious bacterial infection (PSBI) in young infants when referral to a hospital is not feasible since 2012. However, access to and quality of PSBI services remained low and were worsened by COVID-19. From November 2020 to June 2022, we conducted implementation research to mitigate the impact of COVID-19 and improve PSBI management implementation uptake and delivery in two woredas in Ethiopia. In April-May 2021, guided by implementation research frameworks, we conducted formative research to understand the PSBI management implementation challenges, including those due to the COVID-19 pandemic. Through a participatory process engaging stakeholders, we designed adaptive implementation strategies to bridge identified gaps using mechanism mapping to achieve implementation outcomes. Strategies included training and coaching, supportive supervision and mentorship, technical support units, improved supply of essential commodities, and community awareness creation about PSBI and COVID-19. We conducted cross-sectional household surveys in the two woredas before (April 2021) and after the implementation of strategies (June 2022) to measure changes in targeted outcomes. We interviewed 4,262 and 4,082 women who gave live birth 2-14 months before data collection and identified 374 and 264 PSBI cases in April 2021 and June 2022, respectively. The prevalence of PSBI significantly decreased (p-value = 0.018) from 8.7% in April 2021 to 6.4% while the mothers' care-seeking behavior from medical care for their sick newborns increased significantly from 56% to 91% (p-value <0.01). Effective coverage of severely ill young infants that took appropriate antibiotics significantly improved from 33% [95% CI: 25.5-40.7] to 62% [95% CI: 51.0-71.6]. Despite improvements in the uptake of PSBI treatment, persisting challenges at the facility and systems levels impeded optimal PSBI service delivery and uptake, including perceived low quality of service, lack of community trust, and shortage of supplies. The participatory design and implementation of adaptive COVID-19 strategies effectively improved the uptake and delivery of PSBI treatment. Support systems were critical for frontline health workers to deliver PSBI services and create a resilient community health system to provide quality PSBI care during the pandemic. Additional strategies are needed to address persistent gaps, including improvement in client-provider interactions, supply of essential drugs, and increased social mobilization strategies targeting families and communities to further increase uptake.

Process Evaluation of Community-Based Nutrition Service for Under 2 Years Children in Degadamot District Using Qualitative Approach, Western Ethiopia, 2023.

Malnutrition accounts for 45% of under-5 child morbidities in Ethiopia and is a more common issue in rural communities. In that regard, Ethiopia has implemented a CBN program at the community level to improve the nutrition status of children. Despite this, malnutrition still causes a significant rate of child morbidity and mortality. The implementation status of the CBN program is unknown. Thus, this evaluation aimed to evaluate the children under 2 years in Degadamot district health posts in northwest Ethiopia. A facility-based single-case study design with qualitative-method evaluation was employed from March 28 to April 28, 2023. The evaluation focused on the availability and compliance with multiple data sources. The qualitative data were transcribed, translated, and analyzed using thematic analysis with OPEN CODE version 4.02 software. Finally, the overall program implementation was determined based on predetermined judgmental criteria. According to the predetermined judgment parameter, the overall CBN program implementation level was 62.68%, measured by the availability of resources (71.36%) and compliance of service providers (54.0%). The overall community-based nutrition program implementation in the Degadamot district health post with 2 evaluation dimensions was judged as fair based on the presetting criteria. It is better to improve the service through training HEW and HDA, distributing nutritional supplies, providing regular support, and following up with HEWs for GMP performance in the Degadamot district.

Insights From a Community-Based Strategy to Assess Tobacco and Vape Shop Retailers' Implementation of Tobacco 21 Law in El Paso, Texas.

In 2019, the United States Congress passed Tobacco 21 (T21) legislation that raised the minimum legal sales age for tobacco products from 18 to 21. However, although the federal legislation superseded weaker state laws that were already in place in some states, including Texas, local guidance for retailers was inconsistent. Given that retailers are ultimately responsible for policy implementation, the American Heart Association (AHA) initiated a process of assessing retailers knowledge and perceptions of the law through a survey targeting all tobacco retailers and accompanying ethnography of a subset of vape shops in El Paso, Texas. The process yielded lessons learned for assessment of community-based policy implementation including key considerations for personnel and process that are applicable to other community-based assessment processes. While AHA considered an in-person approach ideal, having an alternate online response option was necessary. In addition, a focused approach and in-depth understanding of the purpose was key to responsiveness of the retailers.

Uptake and Completion of Tuberculosis Preventive Treatment Using 12-Dose, Weekly Isoniazid-Rifapentine Regimen in Bangladesh: A Community-Based Implementation Study.

The United Nations high-level meeting (UNHLM) pledged to enroll 30 million in tuberculosis preventive treatment (TPT) by 2022, necessitating TPT expansion to all at tuberculosis (TB) risk. We assessed the uptake and completion of a 12-dose, weekly isoniazid-rifapentine (3HP) TPT regimen. Between February 2018 and March 2019 in Dhaka, community-based TPT using 3HP targeted household contacts of 883 confirmed drug-sensitive pulmonary TB patients. Adhering to World Health Organization guidelines, contacts underwent active TB screening before TPT initiation. Of 3193 contacts who were advised health facility visits for screening, 67% (n = 2149) complied. Among these, 1804 (84%) received chest X-rays. Active TB was diagnosed in 39 (2%) contacts; they commenced TB treatment. Over 97% of 1216 contacts began TPT, with completion rates higher among females, those with more education and income, non-slum residents, and those without 3HP-related adverse events. Adverse events, mainly mild, occurred in 5% of participants. The 3HP regimen, with its short duration, self-administered option, and minimal side effects, achieved satisfactory completion rates. A community-focused TPT approach is feasible, scalable nationally, and aligns with UNHLM targets.

Implementation of Mother's School to Prevent Stunting "Secanting" among Mothers in Bange Village, Sanggau Ledo District

Background: Mothers have a relatively low level of education, lack of knowledge and understanding about the importance of care during pregnancy to maintain the health of the mother and baby and nutritional needs during pregnancy and for the baby/child, failure to provide exclusive breastfeeding, early marriage, and early pregnancy due to unwanted pregnancies, pregnancies that are too close together, anemia in pregnant women are thought to be triggers for stunting. The Secanting program and health education for teenagers is an alternative action to help minimize the incidence of stunting. Objective: Increase knowledge, attitudes, and behavior of pregnant women and teenagers to prevent stunting by optimizing community empowerment for independence in health. Method: The mapping intervention approach in community-based implementation in program development is packaged in the form of maternal schools to prevent stunting abbreviated as "Secanting" and school-based sexual health education activities for teenagers in high school. Results: Before being given the Secanting program, pregnant women had an average knowledge score of 69.09±11.36, and after being given an average knowledge score of 86.36±8.09. There is a difference in the average score, amounting to 17.27 ± 13.48. The results of observations made regarding the skills of pregnant women in selecting, processing nutritious food ingredients, preparing menus, and serving, showed that before participating in the program, pregnant women had skills with an average score of 58.18 ± 7.5 and after being given the average score skills 81.81±7.5. There is a difference in the average score, amounting to 23.64 ± 8.08. There is an increase in knowledge and skills in pregnant women after being given the Secanting program. The program for adolescents shows that, before being given health education, adolescents know with an average score of 78.67 ± 4.24, and after being given an average knowledge score of 98.44 ± 11.40. There is a difference in the average score, amounting to 19.77 ± 10.33. There is an increase in knowledge in adolescents after being given health education. Conclusion: The Secanting program has proven effective in increasing knowledge in pregnant women and health education has proven effective in increasing knowledge in adolescents.

An Assisted Community Based Implementation of RA 9003 (ACBI RA 9003): The Baranggay Naisud, Experience.

In the Philippines, higher-education institutions like Aklan State University (ASU) are empowered to implement community programs that bring inclusive human and community development. The ASU, College of Hospitality and Rural Resources Management (CHARRM), Bachelor of Science in Environmental Science (BSES) implemented an extension program titled “Enhancement of Community-based Implementation of RA 9003: Ecological solid Waste Management of 2000.” Thus, this study examined the influence of the extension activity to the partner community. Specifically, the study seeks to: describe the perceived influence of the assisted community-based implementation of RA 9003 to the household-based waste management practices; ascertain the perceived influence of the extension activity to the school based waste management practices; identify the perceived influence of the extension activity to the community; and describe the recommendations of the partners to improve the delivery of the activity. Descriptive research design was employed in the study. The respondents of the study were 120 residents, selected through purposive sampling technique. The data were gathered using a validated questionnaire checklist at Naisud, Ibajay Aklan from August to October 2021. The results revealed that majority of the respondents claimed that the activity enabled the household to reduce waste generated and practice recycling. In terms of its influence to the school-based waste management practices, majority of the respondents agreed that school personnel and students were engaged in the implementation of RA 9003. Likewise, the community strictly prohibited the open burning of garbage. The LGU may sustain the good practices by strictly monitoring the compliance of the community to RA 9003. The BSES may duplicate the activity to other barangays that include the recommendations made by the community. Consequently, to better understand the implication of the activity, further study along this line is recommended.

Identification of Community-Based Agricultural Zakat Implementation:

Indonesia is an agricultural country where most of the population works as farmers, the agricultural sector is one of the main sectors of the country's economy. In line with that, statistical data proves that the agricultural sector is still the most important sector in supporting national economic development, especially during the recent pandemic that hit the world where the agricultural sector is at a stable pace compared to other sectors. Temboro Village has a unique culture in terms of the local community that distinguishes it from other villages, namely the concept of Madinah village with a distinctive culture based on certain Islamic ideologies. The research intends to identify the process of agricultural zakat implementation in the village of Temboro and is expected to contribute to the development of agricultural zakat implementation in other areas in Indonesia. The qualitative research method is used with an interpretive approach in a case study where the researcher is involved in sharing experiences with participants in Temboro Village. The results of the study prove that the management of agricultural zakat in Temboro Village is still categorized as traditional. There is no official (amil) zakat institution (LAZ) in Temboro Village. The system of collecting and distributing agricultural zakat is more emphasized on agricultural zakat and infaq which makes the mosque and boarding school the center. The problem in collecting agricultural zakat is not only that individual agricultural land ownership is relatively small but also not all farmers in Temboro village pay their agricultural zakat, so the percentage of agricultural zakat is not optimal and is distributed directly to the village community.