Community-based Model Research Articles

Evaluating the impact of a child sponsorship programme on paediatric health and development in Calauan, Philippines: A retrospective audit.

International child sponsorship programmes comprise a considerable proportion of global aid accessible to the general population. Team Philippines (TP), a health care and welfare initiative run in association with the University of Notre Dame Sydney since 2013, leads a holistic sponsorship programme for 30 children from Calauan, Philippines. To date, empirical research has not been performed into the overall success and impact of the TP child sponsorship programme. As such, this study aims to evaluate its effectiveness in improving paediatric outcomes. Study cohorts comprised 30 sponsored and 29 age- and gender-matched non-sponsored children. Data were extracted from the TP Medical Director database and life-style questionnaires for July-November 2019. Outcome measures included anthropometry, markers of medical health, dental health, exercise, and diet. Statistical analyses were performed in SPSS. Sponsorship resulted in fewer medical diagnoses and prescription medications, superior dental health, and improved diet. Further, sponsored children may show a clinically significant trend towards improved physical health. Sponsorship did not affect growth and development metrics, or levels of physical activity. The TP child sponsorship programme significantly impacts positive paediatric health outcomes in the Calauan community. The strength of the programme lies in its holistic, sustainable, and community-based model, which is enabled by effective international child sponsorship. This study further supports the relationship between supporting early livelihood and improved health in the paediatric population.

THE POTENTIAL FOR COMMUNITY TOURISM DEVELOPMENT IN PHU DINH COMMUNE, DINH HOA DISTRICT, THAI NGUYEN PROVINCE

Research on the potential of community-based tourism development in Phu Dinh Commune, Dinh Hoa District, Thai Nguyen Province, is essential because the commune has started to have community-based tourism households. In this study, we collected data by surveying tourists, authorities, and local people. We analyzed the data and made judgments about the needs of tourists from visitors’ evaluations, local people’s understanding, and difficulties with community-based tourism development activities. The results showed tremendous potential for community-based tourism development in Phu Dinh Commune. The potential for historical-cultural tourism has a significant position now, a prerequisite to attracting tourists to Phu Dinh. Besides, the natural tourism potential is also unique and attractive to tourists. To promote the above tourism potentials for community-based tourism development, it is necessary to have investment support in terms of capital, methods, and fostering knowledge of community-based tourism development for local people to attract tourists to visit historical and cultural sites (basically just a day visit). The tourists can both visit the Dinh Hoa Safety Area National Relic (An Toan Khu - ATK) and combine community-based tourism development (increasing the length of stay of tourists from going to the same day (up to 2-3 days). To achieve these results, it is necessary to converge factors such as policies to support and promote Phu Dinh community-based tourism development of the Department of Tourism, People’s Committees at all levels, the direction and guidance of the local government, and most importantly, the effort of local people learns from the experience of community-based tourism development models.

Oral Health Strategies: Surveying the Present to Plan the Future of Community-Based Learning.

Introduction: Oral health literacy relates to the capacity of individuals to acquire, understand and to act upon oral health information to make appropriate health decisions. This scientific review's main goal is to analyze the strategies that improve oral health literacy within the community, specifically oriented to a community-based learning model focused on the most vulnerable risk groups in society. Materials and Methods: The current review is based on the literature on oral health literacy within community-based learning strategies. The present review selected scientific studies by searching MEDLINE and related databases, such as Web of Science and PUBMED, and by consulting existing bibliographies. Results: Based on the application of the inclusion criteria to the abstracts, 45 publications were retrieved which explicitly dealt with the definitions of oral health literacy, community-based learning, and service learning. Several studies have demonstrated that health consumers with low health literacy fail to understand the available health information. Therefore, innovative oral health literacy strategies should be undertaken. Service learning is an example of an educational approach where the student learns specific soft skills in the classroom and collaborates directly with an agency or institution and engages in reflection activities to deepen their understanding of what is being taught. Conclusions: One of the main strategies used to incorporate the oral health professional in social responsibility and direct contact in the community is through experiencing community-based learning projects. The future graduate must be an educator capable of educating patients in order to themselves acquire high-level skills in oral health literacy.

Implementation of a Community-Based Public Model for the Prevention and Control of Communicable Diseases in Migrant Communities in Catalonia.

In high-income countries, migrant populations have a greater epidemiological vulnerability: increased exposure to infectious diseases, difficulties in diagnosis, case follow-up and contact tracing, and obstacles following preventive measures related to cultural and administrative barriers. This study aims to describe the implementation of a community-based program to address these challenges. The target population is the migrant native population from North Africa, South Asia, Sub-Saharan Africa, Eastern Europe, and Latin America resident in Catalonia during 2023. Implementation phases include the identification of the perceived needs, search, recruitment and capacity building of 16 community health workers, and the development of a computer software. From January to June 2023, 117 community-based interventions have been implemented, reaching 677 people: 73 community case and contacts management interventions, 17 community in-situ screenings (reaching 247 people) and 27 culturally adapted health awareness and education actions (reaching 358 people). The program addresses the following infectious diseases: tuberculosis, Chagas disease, hepatitis C, typhoid, scabies, hepatitis B, mumps and tinea capitis. The implementation of a community-based model may be key to improving surveillance communicable diseases, promoting an equitable and comprehensive epidemiological surveillance system.

Advancing community-academic partnerships to achieve breast health equity: Applying the community-based participatory model to build capacity for sustained impact.

This formative study leveraged a community-academic partnership to identify barriers to care that are potential sources of breast cancer disparities in Black women. Through this partnership and using a community-based participatory research approach, the objective was to develop a community task force to inform future interventions aimed at addressing breast cancer disparities and increasing health equity. The authors assessed gaps in care related to breast cancer in Buffalo, New York, by collecting and analyzing qualitative data from focus groups and interviews with breast cancer survivors and breast navigation groups assessing barriers and facilitators across the cancer care continuum. Then, community-based participatory research approaches were used to build a task force to develop an action plan addressing gaps in care. The authors conducted a thematic analysis of qualitative findings to understand barriers and facilitators to cancer care. Three main domains of themes emerged, including medical mistrust, fear, and stigma; the importance of patient navigation as a form of social support; and the importance of faith and faith-based community. Finally, the findings were presented to a newly formed community task force to validate the data collected and set future priorities to address breast cancer disparities and increase breast health equity in the region. The authors observed that health equity is a critically important issue in cancer care and that developing culturally tailored interventions has the potential to improve care delivery and reduce breast cancer disparities. Learning from and working with community members helps set the future agenda related to health equity. Our overall goal was to assess gaps in breast cancer care in Buffalo, New York, and to use community-based participatory approaches to build a task force to work toward breast health equity. Recent and historical data indicate that the Western New York community is facing a continued wide gap in breast cancer mortality trends between Black and White patients. We collected qualitative data to understand potential sources of inequity related to breast cancer and presented findings to a community task force to set future priorities for addressing breast cancer disparities and increasing breast health equity in our region.

Community-Based Joint Business Model Design for Solutions to Implementing Technology Innovation in Small Farmers

In general, small-scale farmers in rural areas often experience obstacles in implementing technological innovations offered by agricultural extension workers. Obstacles can come from within the individual breeder himself. The theory of small farmers and the theory of collective action is expected to solve the obstacles to implementing these technological innovations. This study aims to analyze and find solutions to the obstacles to implementing technological innovation at the individual level of small farmers in rural areas. Researchers took case study research with a research and development (RD) method approach to find the construction of a joint venture model. Qualitative methods are used in Focus Group Discussion (FGD) activities. At the same time, the quantitative descriptive research method is to evaluate the results of implementing the joint venture model. The population and the evaluation research sample were members of the Ampelsari Makmur Jaya farmer group in Pasuruan Regency and the La Tulip Farmer/Women Group in Lamongan Regency. The number of respondents for the perception evaluation was 68, determined as a total sample. Data was collected through participation techniques, in-depth interviews, FGDs and surveys. The evaluation perception was analyzed using descriptive analysis and Score T. The evaluation of respondents’ perceptions resulted in the farmers accepting the establishment of community-based business units (complete feed and pastured chicken business). The solution is also considered effective in solving the obstacles to applying technological innovation by rural and small-scale farmers in Indonesia.

The Solution for Building and Developing a Community-based Tourism Model in Ly Son Island District – Quang Ngai Province

Community-based tourism (CBT) is one of the forms of tourism that is being formed and developed in rural Vietnam on the basis of exploiting the value of eco-tourism resources, agriculture, and indigenous cultural lifestyles. Ly Son Island District in Quang Ngai Province is home to the Imperial Hoang Sa Navy. On the island, there are unique natural landscapes exploiting tourism services such as Thoi Loi Volcano, Gieng Tien, Hang Pagoda, To Vo Gate, etc. With a long history of development, Ly Son has rich cultural resources, many historical relics, and a rich system of tangible and intangible cultural heritage. However, the development of community tourism here has become uncontrolled and fragmented; at this point, there is no link between community tourism services, and they have not yet formed a complete product to meet visitors’ requirements. With the participatory approach, in-depth interviews, fieldwork, and ABCD method (Assets Based for Community Development), this study analyzes the potential, current situation, and orientation of building and developing a model of CBT at Ly Son Island district, Quang Ngai.

PrEP uptake and early persistence among adolescent girls and young women receiving services via community and hybrid community-clinic models in Namibia.

Adolescent girls and young women (AGYW) face barriers in accessing clinic-based HIV pre-exposure prophylaxis (PrEP) services and community-based models are a proposed alternative. Evidence from such models, however, is limited. We evaluated PrEP service coverage, uptake, and early persistence among AGYW receiving services through community and hybrid models in Namibia. We analyzed routine data for AGYW aged 15-24 who initiated PrEP within HIV prevention programming. PrEP was delivered via three models: community-concierge (fully community-based services with individually-tailored refill locations), community-fixed (community-based initiation and refills delivered by community providers on a set schedule at fixed sites), and hybrid community-clinic (community-based initiation and referral to clinics for refills delivered by clinic providers). We examined proportions of AGYW engaged in services along a programmatic PrEP cascade, overall and by model, and assessed factors associated with PrEP uptake and early persistence (refill within 15-44 days after initiation) using multivariable generalized estimating equations. Over 10-months, 7593 AGYW participated in HIV prevention programming. Of these, 7516 (99.0%) received PrEP education, 6105 (81.2%) received HIV testing services, 6035 (98.9%) tested HIV-negative, and 2225 (36.9%) initiated PrEP. Of the 2047 AGYW expected for PrEP refill during the study period, 254 (12.4%) persisted with PrEP one-month after initiation. Structural and behavioral HIV risk factors including early school dropout, food insecurity, inconsistent condom use, and transactional sex were associated with PrEP uptake. AGYW who delayed starting PrEP were 2.89 times more likely to persist (95% confidence interval (CI): 1.52-5.46) and those receiving services via the community-concierge model were 8.7 times (95% CI: 5.44-13.9) more likely to persist (compared to the hybrid model). Community-based models of PrEP service delivery to AGYW can achieve high PrEP education and HIV testing coverage and moderate PrEP uptake. AGYW-centered approaches to delivering PrEP refills can promote higher persistence.

Tariff setting for the sustainability of communal water points in Mangochi District, Malawi

Abstract The Malawian Government adopted a community-based management model for rural water supply systems, which assumes that users would cover costs related to the operation and maintenance (O&M) of their communal water points through regular cash contributions. These communal water points are mostly boreholes fitted with Afridev hand pumps. However, studies have shown that Afridev hand pumps continue to fail within 3–5 years after installation, despite having a design lifespan of 10–15 years, mostly due to insufficient O&M. Therefore, this study assessed the adequacy of tariffs being used at different water points in Mangochi District in Malawi through a household (HH) survey with a sample size of 288 HHs and a market prices survey. The results showed that 90% of the HHs were making contributions that could not sustainably support the lifecycle O&M costs or the afterlife replacement of the Afridev hand pump. This study suggests a consistent minimum annual water point fund collection of MWK142,050 (US$172.29)1. It is recommended that the study be replicated in other areas. It is also recommended that further studies should focus on HH affordability with respect to the recommended tariff.

What are the evidence bases for developing models of rehabilitation for older people with mental illness in Australia?

This paper updates clinicians and service leaders on evidence bases relevant to rehabilitation for older Australians with mental illness. Narrative review of literature and relevant public domain data supported by reflections on NSW service development. There is a paucity of high-quality evidence regarding mental health rehabilitation in older people. Available evidence supports integrating lessons from physical healthcare with adaptations of 'adult' mental health rehabilitation. Adaptation is required to respond to the specific needs, strengths and service use of older people with mental illness. Challenges for older people include ageism, increased physical and cognitive comorbidities, lower access to mental health services and earlier residential aged care entry. Strengths of older people include an ongoing desire for recovery, ongoing developmental change and often closer connections with carers and GPs. Evidence is consistent with evaluation of relevant NSW service models and initiatives including the Pathways to Community Living Initiative. Integration of recovery-oriented practice and wellness models may provide a framework for future innovative inpatient and community-based models. There is sufficient evidence to guide development of models of rehabilitation with older people, but innovation and evaluation are essential if older people are to have equal opportunities in their recovery journeys.

Categorizing shared photovoltaic business models in renewable markets: An approach based on CANVAS and transaction costs

Shared Photovoltaic (PV) business models enable a broader percentage of consumers to benefit from renewable energy because installation and transaction costs are significantly decreased. Designing these shared and community-based business models can contribute to help countries achieve emission reduction targets, particularly in developing countries. A systematization in different categories of how these business models can improve the awareness of opportunities and barriers to such models, including the identification of potential models is yet to be explored in a specific market. This paper proposes such categorization and discusses different shared PV business models observed in this sector, discussing the main similarities and differences of each one based on the CANVAS business model methodology. Further, this paper analyzes these categories in terms of how the decrease in transaction costs from the consumers’ perspective would help to deliver value. Finally, we demonstrate the proposed categorization to existing models in Brazilian and Indian markets, defining which business model categories are more adherent to this market. Moreover, we discuss possible innovative models yet to be applied to these developing countries and barriers to be overcome. It was identified that major existing business models are feasible for both India and Brazil, however, regulatory hindrances needs to be addressed beforehand.

Overdose education and naloxone distribution program design informed by people who use drugs and naloxone distributors

People who use drugs (PWUD) are the most directly affected by the overdose epidemic. However, they are not often targets of overdose education and naloxone distribution (OEND) programs. Instead, these programs target friends or family members of people prescribed opioids or general community members. This study aimed to understand the perspectives of PWUD and community naloxone distributors on OEND program design. We used a community-based participatory research model to elucidate participant perspectives on what OEND programs should look like in the context of each individual’s specific risk environment. We conducted semi-structured in-depth interviews with PWUD and naloxone distributors (n = 30) in New Brunswick and Newark, New Jersey between February and November of 2022. We analyzed interviews using thematic analysis and identified the following themes: increasing naloxone knowledge, peer-based naloxone access, increasing PWUD-informed OEND program design, and desired broader OEND program scope. All Participants knew what naloxone was and emphasized that naloxone needed to be ubiquitous in the community. Participants prioritized peer-based distribution, integrating distribution into community organizations, and addressing psychosocial issues related to naloxone administration and drug use. In summary, PWUD and community naloxone distributors emphasized peer-led community naloxone distribution that prioritized novel ways for PWUD to access naloxone. OEND program design should prioritize PWUD’s perspectives and direct community naloxone distribution.

Intensive community care services for children and young people in psychiatric crisis: an expert opinion

BackgroundChildren and young people’s (CYP) mental health is worsening, and an increasing number are seeking psychiatric and mental health care. Whilst many CYPs with low-to-medium levels of psychiatric distress can be treated in outpatient services, CYPs in crisis often require inpatient hospital treatment. Although necessary in many cases, inpatient care can be distressing for CYPs and their families. Amongst other things, inpatient stays often isolate CYPs from their support networks and disrupt their education. In response to such limitations, and in order to effectively support CYPs with complex mental health needs, intensive community-based treatment models, which are known in this paper as intensive community care services (ICCS), have been developed. Although ICCS have been developed in a number of settings, there is, at present, little to no consensus of what ICCS entails.MethodsA group of child and adolescent mental health clinicians, researchers and academics convened in London in January 2023. They met to discuss and agree upon the minimum requirements of ICCS. The discussion was semi-structured and used the Dartmouth Assertive Community Treatment Fidelity Scale as a framework. Following the meeting, the agreed features of ICCS, as described in this paper, were written up.ResultsICCS was defined as a service which provides treatment primarily outside of hospital in community settings such as the school or home. Alongside this, ICCS should provide at least some out-of-hours support, and a minimum of 90% of CYPs should be supported at least twice per week. The maximum caseload should be approximately 5 clients per full time equivalent (FTE), and the minimum number of staff for an ICCS team should be 4 FTE. The group also confirmed the importance of supporting CYPs engagement with their communities and the need to remain flexible in treatment provision. Finally, the importance of robust evaluation utilising tools including the Children’s Global Assessment Scale were agreed.ConclusionsThis paper presents the agreed minimum requirements of intensive community-based psychiatric care. Using the parameters laid out herein, clinicians, academics, and related colleagues working in ICCS should seek to further develop the evidence base for this treatment model.

Assessing Brigada Digital de Salud Audience Reach and Engagement: A Digital Community Health Worker Model to Address COVID-19 Misinformation in Spanish on Social Media.

U.S. Spanish-speaking populations experienced gaps in timely COVID-19 information during the pandemic and disproportionate misinformation exposure. Brigada Digital de Salud was established to address these gaps with culturally tailored, Spanish-language COVID-19 information on social media. From 1 May 2021 to 30 April 2023, 495 Twitter, 275 Facebook, and 254 Instagram posts were published and amplified by 10 trained community health workers. A qualitative content analysis was performed to characterize the topics and formats of 251 posts. To assess reach and engagement, page analytics and advertising metrics for 287 posts were examined. Posts predominantly addressed vaccination (49.45%), infection risks (19.12%), and COVID-related scientific concepts (12.84%). Posts were educational (48.14%) and aimed to engage audiences (23.67%), promote resources (12.76%), and debunk misinformation (9.04%). Formats included images/text (55.40%), carousels (27.50%), and videos (17.10%). By 9 June 2023, 394 Facebook, 419 Instagram, and 228 Twitter followers included mainly women ages 24-54. Brigada Digital reached 386,910 people with 552,037 impressions and 96,868 engagements, including 11,292 likes, 15,240 comments/replies, 9718 shares/retweets, and 45,381 video play-throughs. The most engaging posts included videos with audio narration, healthcare providers, influencers, or music artists. This community-based model to engage Spanish-speaking audiences on social media with culturally aligned content to counter misinformation shows promise for addressing public health threats.

Addressing racial inequality and its effects on vaccination rate: A trial comparing a pharmacist and peer educational program (MOTIVATE) in diverse older adults.

BACKGROUND: The mortality, morbidity, health care utilization, and cost attributable to vaccine-preventable diseases are substantial for those aged 50 years and older. Although vaccination is the most cost-effective strategy to prevent common infectious diseases in older adults, vaccination rates remain below US Centers for Disease Control and Prevention benchmarks, especially among racial minorities. Historical mistrust, structural racism within the US medical system, and misinformation contributed to lower immunization rates among minorities, especially Black Americans. To address the critical need to increase knowledge and trust in vaccination, 2 community-based educational interventions were tested: a pharmacist-led didactic session (PHARM) and a peer-led educational workshop (PEER). OBJECTIVE: To determine and compare the effectiveness and costs of PEER and PHARM community-based education models in improving knowledge and trust in vaccinations. METHODS: The Motivating Older adults to Trust Information about Vaccines And Their Effects (MOTIVATE) study was a cluster-randomized trial conducted in the greater Delaware Valley Region sites from 2017 to 2020. The included sites (7 senior centers, 3 housing units, 1 church, and 1 neighborhood family center) predominantly served Black communities. Participants were randomized to either PHARM or PEER sessions covering influenza, pneumococcal disease, herpes zoster, and beliefs related to vaccines. Peer leaders facilitated smaller workshops (5-10 participants), whereas pharmacists conducted larger didactic lectures with 15-43 participants. Outcomes were captured through a self-administered survey at baseline, postprogram, and 1 month after the program. Intervention costs were measured in 2017 US dollars. RESULTS: 287 participants were included. Their mean age was 74.5 years (SD = 8.94), 80.5% were women, 64.2% were Black, and 48.1% completed some college. Knowledge scores within groups for all 3 diseases significantly increased postprogram for both PEER and PHARM and were sustained at 1 month. Between-group knowledge differences were significant only for influenza (PEER participants had significantly larger improvement vs PHARM). Vaccination trust significantly increased in both groups. Total program costs were $11,411 for PEER and $5,104 for PHARM. CONCLUSIONS: Both interventions significantly improved knowledge and trust toward vaccination and retained their effect 1 month after the program. The 2 effective community-based education models should be expanded to ensure timely and trusted information is available to educate older adults about vaccine-preventable diseases. Further research is encouraged to assess the long-term cost-effectiveness of these models' utilization on a larger scale. DISCLOSURES: Dr Schafer is an employee of Merck; however, at the time of the project, he was a professor at Thomas Jefferson University. The other authors have no conflicts of interest to disclose. This study was supported in part by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The opinions expressed in this article are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp. The sponsor played no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the article. Study Registration Number: NCT03239665.

Examining the determinants of health and long-term care for older adults in India through a socio-ecological model - A qualitative assessment.

Ageing is associated with multiple long-term health problems and requires medication management, support with activities of daily living, and attention to psychological needs. This study aimed at exploring the enablers and barriers and psychosocial determinants of long-term care. A qualitative study, using semi-structured interviews and thematic analysis, was carried out from February to June 2018. One-on-one in-depth interviews were carried out with 28 participants, including care recipients (n = 12), caregivers (n = 12), and primary-care physicians (n = 4) at the Community Health Centre in the state of Jammu and Kashmir of India. Attention from family members, leisure activities, faith in the healthcare provider, and a positive attitude towards life were found to be enablers of long-term care. Resource constraints and alienation from the community were barriers. Incorporating the psychosocial needs of care recipients and problems faced by family caregivers is essential in providing good quality care to individuals with chronic illness. The lack of a targeted, nationwide policy has resulted in considerable variability in long-term care services across the country. There is an urgent need to make long-term care an integral part of the Indian health system utilizing a holistic framework to address the health needs of older adults and implementing it through an equitable community-based comprehensive primary health and community-based model.

Community based peer-led TB screening intervention: an innovative approach to increase TB knowledge, presumptive case identification, and referral among sexual minority people in urban Bangladesh

IntroductionOne of the contributors to tuberculosis (TB) burden among vulnerable populations, such as sexual minority people, is the delay in case finding and notification. Given their socially excluded, hard-to-reach nature, community-led approaches need to be introduced to facilitate their screening of TB symptoms and their subsequent referral to TB healthcare providers. This article aimed to explore the existing challenges surrounding TB screening and referral, and the implementation facilitators and barriers of the proposed community-based TB screening model for sexual minority people in Dhaka, Bangladesh.MethodsThis study followed the quasi-experimental design using mixed methods (i.e., qualitative and quantitative) approach. The study participants who were also a part of the community-led TB screening model included sexual minority people enrolled in HIV prevention interventions. In addition to quantitative inquiry, in-depth interviews were conducted on sexual minority people, focus group discussions were also conducted on them and HIV prevention service providers, and key-informant interviews were conducted on service providers, programmatic experts and TB researchers. Data were analyzed using content, contextual and thematic approaches.ResultsThe ‘Six Steps in Quality Intervention Development’ framework was used to guide the development of the community-based TB screening model. In Step 1 (identifying the problem), findings revealed low rates of TB screening among sexual minority people enrolled in the HIV prevention intervention. In Step 2 (identifying contextual factors for change), various individual, and programmatic factors were identified, which included low knowledge, low-risk perception, prioritization of HIV services over TB, and stigma and discrimination towards these populations. In Step 3 (deciding change mechanism), community-based screening approaches were applied, thus leading to Step 4 (delivery of change mechanism) which designed a community-based approach leveraging the peer educators of the HIV intervention. Step 5 (testing intervention) identified some barriers and ways forward for refining the intervention, such as home-based screening and use of social media. Step 6 (collecting evidence of effectiveness) revealed that the main strength was its ability to engage peer educators.ConclusionThis study indicates that a community-based peer-led TB screening approach could enhance TB screening, presumptive TB case finding and referral among these populations. Therefore, this study recommends that this approach should be incorporated to complement the existing TB program.

Thermal energy community-based multi-dimensional business model framework and critical success factors investigation in the mediterranean region of the EU

Rural areas have gained relevance in the EU policy framework as a result of the experienced depopulation trend experienced in these areas. Smart Rural Communities are recognized as effective means to tackle this issue by delivering smart services to local population leading to improved economic competitivity. One of the major challenges, among others, is to deliver renewable energy matching existing demand in opposition of fossil-fuel based solutions. To this end, Energy Communities (EC) potential to deploy Renewable Energies (RE) while improving supplier – consumer engagement and empowering the energy consumer. Despite the advances throughout the EU in the deployment of ECs, the vast majority of them are based on PV systems, leaving a huge path for development of novel business models for thermal energy communities, mainly due to the existing economic and social barriers to thermal energy communities’ deployment.The present work aims at contributing to the closure of this research gap by systematizing community-based business model arrangements for thermal energy communities’ deployment to then identify the relevance of main affecting parameters and identify the critical success factors for business model success. To do so, a novel multi-dimensional business model framework is proposed to promote the deployment of Thermal Energy Communities based on the use of local biomass with a District Heating (DH) network distribution system. The proposed framework analyses business model viability in terms of economic and environmental benefits for different EC layouts according to spatial configuration of the demand –clustered/urban vs. scattered/rural – and to demand profile – industrial/low seasonality vs. residential/high seasonality. Results show that business models are economically viable in terms of payback period below boiler service life and NPV/IRR of the investment needed for all cases, although best results are obtained for clustered and industrial demand as a result of lower investment requirements to deliver the same amount of energy. Critical success factors to ensure business model viability are also investigated, finding the minimum natural gas tariff that makes economically viable the thermal EC business proposition. Last, the business model incorporates the use of digital tools for biomass traceability and low carbon certification enabling local biomass use and supplier – consumer transparency that promotes greater stakeholder engagement. Also, biomass digital traceability is aligned with current regulatory framework in the EU, namely the Renewable Energy Directive (RED II) and the upcoming revision of it (RED III), making the EC business model up-to-date and competitive in terms of services offered to the end-user.

Development of Mental Healthcare Model in Seoul.

To develop an integrated and comprehensive community-based mental healthcare model, opinions were collected on various issues from practitioners in mental health service institutions currently offering mental healthcare services in Seoul through a focus group interview, qualitative research method, and Delphi survey. The focus group interview was conducted with six practitioners from mental health welfare centers and six hospital-based psychiatrists. A questionnaire of opinions on the mental healthcare model was filled by these practitioners and psychiatrists. A Delphi survey was additionally conducted with a panel of 20 experts from a community mental health welfare center and hospital-based psychiatrists. The focus group interview results showed the need for integrated community-based mental healthcare service and the need to establish a system for managing mental and physical health in an integrated manner. Based on the survey results, the current status of community-based mental healthcare services was investigated, and the direction of the revised model was established. The Delphi survey was then conducted to refine the revised model. The present study presents the Seoul-type community-based mental healthcare model with integrated services between a psychiatric hospital with a mental health welfare center as well as combined mental and physical health services. This is ultimately expected to help people with mental illnesses live healthy lives by meeting their needs as community members.

Experiences of Homeless Recipients of Social Model Hospice Care: A Photovoice Exploration.

Homelessness and caregiver insecurity are barriers to accessing hospice for end-of-life care. Some communities have implemented a community-based social model of hospice care, and reports of its characteristics and outcomes are growing in hospice and homeless literature. This case report explored the experiences of social model hospice recipients using photovoice, a community-based participatory method to photograph meaningful aspects of care. Participants (n = 3) took photos (n = 93), journaled, and participated in semistructured interviews as co-analyzers. Through deductive codes from the literature and inductive analysis of data, 6 themes were identified: having a physical location to receive care, involving the community, having spiritual needs attended to, acknowledging family/family of choice, connecting with animals, and feeling cared for. Participants offered few suggestions to improve care. Social model hospice provided a location for care, funding, and social support to address housing and caregiver insecurity. Results corroborated the social model hospice concept (antecedents, attributes, consequences). Findings add to the growing literature with implications for communities and leaders looking to start or improve care. Results suggest that photovoice may be a feasible method for eliciting firsthand experiences of residents. Findings may guide discussions about patient-reported aspects of care for a more accurate understanding of meaningful social model hospice care.