Community-based Participatory Action Research Project Research Articles

Healing the Past by Nurturing the Future: Aboriginal parents' views of what helps support recovery from complex trauma.

We aimed to understand support needs for Aboriginal and Torres Strait Islander parents experiencing complex trauma.Becoming a parent is an exciting yet challenging transition, particularly for parents who have experienced past hurt in their own childhood which can have long lasting effects, including complex trauma. Complex trauma-related distress can make it harder to care for a baby, but the parenting transition offers unique opportunities for recovery.This formative research is part of a community-based participatory action research project which aims to co-design perinatal awareness, recognition, assessment and support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. We used an Indigenist approach and grounded theory methods. Aboriginal and Torres Strait Islander parents who were pregnant and/or have children up to two years old were recruited through perinatal care services and community networks in three Australian sites (Alice Springs, Adelaide and Melbourne). Parents were offered a group discussion or individual interview, facilitated by Aboriginal researchers. Third-person scenarios and visual tools were used to facilitate reflections about the impact of past experiences, what keeps parents strong, hopes and dreams, and what is needed to achieve those dreams. Parents were also shown themes from a previous systematic review of parents' experiences as a prompt to identify any additional key issues.Seventeen Aboriginal and Torres Strait Islander parents participated in August to September 2019. Most were mothers (n = 15). The study's grounded theory methods provided the foundation of a theoretical supposition that positions the transformation of the compounding cycle of trauma, to a reinforcing cycle of nurturing at the intersection of: 1) parents' connectedness; 2) social and emotional wellbeing; and 3) the transition to parenting. Unique opportunities and challenges situated at the interface are bound to the compounding or reinforcing nature of the intersecting factors. Findings reveal complexity, differing experiences by gender and age, as well as within and between communities.

Community Perspectives of Complex Trauma Assessment for Aboriginal Parents: ‘Its Important, but How These Discussions Are Held Is Critical’

Background and PurposeBecoming a parent can be an exciting and also challenging transition, particularly for parents who have experienced significant hurt in their own childhoods, and may be experiencing ‘complex trauma.’ Aboriginal and Torres Strait Islander (Aboriginal) people also experience historical trauma. While the parenting transition is an important time to offer support for parents, it is essential to ensure that the benefits of identifying parents experiencing complex trauma outweigh any risks (e.g., stigmatization). This paper describes views of predominantly Aboriginal stakeholders regarding (1) the relative importance of domains proposed for complex trauma assessment, and (2) how to conduct these sensitive discussions with Aboriginal parents.Setting and MethodsA co-design workshop was held in Alice Springs (Central Australia) as part of an Aboriginal-led community-based participatory action research project. Workshop participants were 57 predominantly Aboriginal stakeholders with expertise in community, clinical, policy and academic settings. Twelve domains of complex trauma-related distress had been identified in existing assessment tools and through community consultation. Using story-telling and strategies to create safety for discussing complex and sensitive issues, and delphi-style methods, stakeholders rated the level of importance of the 12 domains; and discussed why, by whom, where and how experiences of complex trauma should be explored.Main FindingsThe majority of stakeholders supported the importance of assessing each of the proposed complex trauma domains with Aboriginal parents. However, strong concerns were expressed regarding where, by whom and how this should occur. There was greater emphasis and consistency regarding ‘qualities’ (e.g., caring), rather than specific ‘attributes’ (e.g., clinician). Six critical overarching themes emerged: ensuring emotional and cultural safety; establishing relationships and trust; having capacity to respond appropriately and access support; incorporating less direct cultural communication methods (e.g., yarning, dadirri); using strengths-based approaches and offering choices to empower parents; and showing respect, caring and compassion.ConclusionAssessments to identify Aboriginal parents experiencing complex trauma should only be considered when the prerequisites of safety, trusting relationships, respect, compassion, adequate care, and capacity to respond are assured. Offering choices and cultural and strengths-based approaches are also critical. Without this assurance, there are serious concerns that harms may outweigh any benefits for Aboriginal parents.

Differential Experiences of Mental Health among Trans/Gender Diverse Adults in Michigan.

Transgender and gender diverse individuals experience high rates of health disparities, as compared with their cisgender (non-transgender) counterparts. One area in which these disparities is most grave is that of mental health, with some studies indicating transgender and gender diverse individuals as having a 40% rate of lifetime suicide attempts and similarly high rates of depression, anxiety, and suicidal ideation. These rates vary further within this population, with differential rates seen across sociodemographic factors, including race/ethnicity, gender, sexual orientation, disability status, education level, and income. This study explores mental health experiences across different social identities, using data from the 2018 Michigan Trans Health Survey (N = 659), a community-based participatory action research project collected in Michigan, United States, analyzed using chi-square tests of independence and logistic regressions. Findings indicate incredibly high rates of mental health concerns; 72.2% had been diagnosed with depression in their lifetime and 73.0% had been diagnosed with anxiety in their lifetime. In the past year, 49.9% had had non-suicidal self-injury (NSSI) thoughts, 45.4% had suicidal thoughts, 26.3% engaged in NSSI, and 7.7% had attempted suicide. Bivariate regressions showed some nuanced experiences of rates of mental health diagnoses and experiences, such as greater odds of experiencing all mental health disparities among those with disabilities, and differential odds across gender in regard to ever having a depression diagnosis, non-suicidal self-injury thoughts and engaging in non-suicidal self-injury behavior. This indicates a need for social workers, counselors, therapists, and other human services professionals to act more intentionally and with an intersectional lens when it comes to exploring the mental health of transgender and gender diverse persons.

Muxeres en Acción: The Power of Community Cultural Wealth in Latinas Organizing for Health Equity.

Community psychology, despite its commitment to social justice, is prone to engage in deficit-based perspectives that do not appropriately capture the strengths of Latinx communities. Given these limitations, we use a Community Cultural Wealth (CCW) (Yosso, 2005) framework to describe how muxeres, Latina women who identify as promotoras, madres, and mamás, leveraged their political power and culturally informed leadership to improve the health and well-being of their communities. We highlight instances from our fieldwork, witnessing the agency of muxeres en acción for health equity. We offer three case studies to describe how we approached our collaborations with three groups of muxeres situated in different geographic locations in the state of California. The first case study discusses how immigrant muxeres who identify as promotoras (e.g., health workers) in the Central Valley developed their research skills through a promotora model that allowed them to build the capacity to advocate for the well-being of their communities. The second example offers reflections from a Community-Based Participatory Action Research (CBPAR) project with a group of Mexican immigrant madres in a gentrified community in San José. Lastly, the third case study describes how a group of mamás in the East Side of Los Angeles addressed issues of educational inequities. Together, these case studies illustrate muxeres' advocacy for their health and well-being. Because women in general, and muxeres in particular, are considered gatekeepers of culture and tradition within their families, it is crucial that community psychologists ground their work in ethically and culturally appropriate frameworks that highlight the power of muxeres.

Conducting a Community-Based ESOL Programme Needs Analysis

Abstract This article traces a community-based participatory action research (CBPAR) project which engaged local non-profits and the immigrant community in Flint, Michigan, USA, to identify areas for growth in support of local immigrant-background residents. Collaborative data-gathering began in 2015 with the creation of a community asset map which outlined existing services available to immigrants, as well as potential areas for growth. This was followed by a series of linguistically and culturally sensitive focus groups with immigrant-background participants. The use of CBPAR was foundational to this study because it engaged the local community in the needs analysis process and resulted in the development of grassroots ESOL programming. The article outlines steps and recommendations for community-based participatory ESOL needs analysis that can be applied to other geographical regions and ESOL programmes.

Applying a leverage points framework to the United Nations climate negotiations: The (dis)empowerment of youth participants

Young people are both among the generations to be most affected by climate change and critical advocates for climate action. In the face of growing urgency surrounding the climate crisis, the United Nations Framework Convention on Climate Change (UNFCCC) has become an important institutional framework for political progress. We developed a community-based participatory action research project centered on youth involved in the COP climate negotiations. A “leverage points” approach guided our research; this paper is the first time the framework has been applied in an international negotiations context. Our findings point to the structural power, networks, and paradigms that youth might engage with for international climate justice work. We identify actionable leverage points through which youth organizers might increase their social power in the COP process to bring about climate action. Many of these leverage points are rooted in dynamics of power, which we expand upon and connect to broader literature. Moving forward, these findings can benefit and inform the strategies of youth as they participate in the COP process.

Promoting environmental sustainability, equity and health in Victorian Primary Care Partnerships.

Globally and locally, environmental degradation (including climate change) and inequity pose major risks to health. While health promoters recognise the importance of both issues, they may be seen as separate agendas. This study investigated health promotion addressing both issues together. The study was an investigation of health promotion practice addressing environmental sustainability and equity, conducted in 2013, as part of a community-based participatory action research project with three Primary Care Partnerships (PCPs) in Victoria, Australia, during 2009-2016. Thirty-two local health promotion projects addressing both environmental sustainability and equity were identified. Analysis showed clusters of environmental, equity and health themes, particularly around: (a) caring for local environment, food, access to nature and Indigenous participation; (b) sustainability of housing, thermal comfort and reducing energy costs; and (c) sustainable and active transport. The study also found a marked decline in the number of PCPs in Victoria identifying environmental sustainability as a priority in 2013, compared to 2009. Analysis of helpful factors and challenges to practice identified by research participants, suggests interrelated political, organisational and discursive factors contributed to this decline. The study suggests local health promotion can contribute to the development of societies that are more ecologically sustainable and more equitable. However, the challenges suggest broader advocacy is required to support local action. SO WHAT?: Environmental degradation and inequity are major threats to human and ecosystem health. This study shows local health promotion can address both issues concurrently, and provides important information about challenges to this work.

Gaining Insight into Youth Programming and the Inclusivity of Girls

Boys dominate youth recreational programs in ways that control the conversation and the physical space, which impedes the ability for girls to participate. This is distressing, given that youth recreational and social programs, for example, those focusing on personal development or on health and well-being, improve girls’ physical and mental health and serve as a protective buffer against negative health outcomes. We conducted a qualitative community-based Participatory Action Research (PAR) project in which we interviewed programmers responsible for social and recreational programs that cater to youth between the ages of 12 and 18 in a region of Southwestern Ontario, Canada. We examined factors influencing girls’ participation through the lens of a modified Bronfenbrenner Ecological Model. The findings were unpacked with a view toward gender equity, particularly focusing on girls’ health and well-being. Based on the findings, we created a knowledge mobilization gender-based toolkit, which, upon implementing, would make the benefits of recreational programming more accessible to girls.

Healing the Past by Nurturing the Future—co-designing perinatal strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma: framework and protocol for a community-based participatory action research study

IntroductionChild maltreatment and other traumatic events can have serious long-term physical, social and emotional effects, including a cluster of distress symptoms recognised as ‘complex trauma’. Aboriginal and Torres Strait Islander...

The Syrian Canadian Sports Club: A Community-Based Participatory Action Research Project with/for Syrian Youth Refugees

In this paper, we share the rationale, process, and results related to a community-based participatory action research (PAR) project in which we, among other things, aimed to attend to the underrepresentation of newcomer youth in community sport and recreation pursuits. By way of engaging with one rural county’s Syrian youth refugee population while also attending closely to a social ecological framework, we first identified obstacles and opportunities related to multiple systems (i.e., individual, social/interpersonal, organizational/community, public policy). Drawing upon multiple data sources (i.e., photos and photovoice, participants’ drawings and notes, participant-researchers’ field notes, and focus group interviews) to inform our subsequent plan-act-observe-reflect action research cycles, we and our Syrian youth participants co-created and implemented the Syrian Youth Sports Club. In addition to describing the rationale and process related to this Syrian Youth Sports Club, we focus herein upon the results, which primarily relate to participants’ experiences becoming (physically literate) and belonging.

A Method for Making the Just City: Housing, Gentrification, and Health

ABSTRACTA gentrification wave is sweeping across metropolitan America, yet we know very little about the health consequences of this current neighborhood redevelopment trend across different community contexts. This article describes an interdisciplinary, comparative, community-based participatory action (CBPA) research project investigating how housing, community change, and health are connected. We first discuss the linkages among America’s affordable housing crisis, increased rates of gentrification, and health concerns for low-income people in revitalizing neighborhoods. We then lay out our initial hypotheses of how early- and late-stage gentrification processes might affect the health of low-income residents. This is followed by an explanation of how our CBPA approach influenced and altered our gentrification-related research questions and methods. This article contributes to the housing and community development literature by explaining an innovative theoretical and methodological framework for understanding the complex relationships among housing, neighborhood change, and health.

Assessing community (peer) researcher\u2019s experiences with conducting spirometry and being engaged in the \u2018Participatory Research in Ottawa: Management and Point-of-care for Tobacco-dependence\u2019 (PROMPT) project

Plain summaryThis article examines the overall experiences of community researchers in their involvement with the ‘PROMPT’ project for smoking cessation, which targeted community members who were homeless or at-risk for homelessness. More specifically, four community members, representing the study population were involved in the project as researchers. They were asked to complete surveys at both the beginning and end of each research training session to better understand their learning as it related to using a key instrument for this project, a spirometer, to measure project participants’ lung function. Spirometry is typically performed by trained healthcare providers. Community researchers were also interviewed to explore what their experiences were like working as a researcher with their own at-risk community. Although the researchers felt that the training was sufficient, more research is needed to evaluate training effectiveness among community researchers in delivering acceptable quality lung function testing using a spirometer. Upon analyzing the small group discussion and survey results, we found that the community researchers had an overall positive experience with both the project, and the training that was provided to equip them with the knowledge, tools, and resources they needed to successfully work in a research project of this kind. They also faced challenges that are common in such community-based projects, such as the power differential between the researchers with a healthcare background and themselves who have lived experience with the issue at hand.BackgroundThe Ottawa Citizen Engagement and Action Model (OCEAM) used a Community Based Participatory Action Research (CBPAR) approach by involving the most at-risk urban population. Community (peer) researchers participated in every step of the study despite the multiple challenges.ObjectiveTo assess the community researchers’ training and experiences in a CBPAR project, PROMPT: Participatory Research in Ottawa: Management and Point-of-care for Tobacco Dependence.MethodFour community researchers were recruited, representative of the PROMPT project’s target population with current or past poly-substance use; smoking tobacco; and/or being homeless or at-risk for homelessness. The community researchers participated in all phases of PROMPT, including study design, development of questionnaires, participant recruitment, administering consent forms and questionnaires, as well as hand-held spirometry after rigorous training. To assess their knowledge and comfort level with spirometry testing after standardized training, questionnaires were administered pre- and post-training. In turn, to assess their overall experience, interviews were conducted at the end of study completion.ResultsAll community researchers underwent small-group training sessions including presentations, discussions and hands-on practice adapted from standardized training material prepared for health care professionals. Spirometry training was included in all sessions. Self-perceived knowledge and confidence in administering spirometry, as well as skill-testing score averages improved between the pre- and post-training questionnaires. Overall, all the community researchers had a fulfilling experience participating in the project.ConclusionDespite challenges, involving community researchers with lived experience is feasible, satisfying and productive even in the most marginalized populations. Standardized spirometry training of community researchers’ representative of the PROMPT target population, with no healthcare educational background, was feasible and effective in improving knowledge, confidence and readiness to administer spirometry.

Three strikes and you’re out: culture, facilities, and participation among LGBTQ youth in sports

ABSTRACTSchool-based sports and physical education play an important role in the development of youth (Jones, Edwards, et al., 2017), but participation in athletics is unequal for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth compared to their straight/cisgender peers [Greenspan, S. B., Griffith, C., & Murtagh, E. F. (2017). LGBTQ youths’ school athletic experiences: A 40-year content analysis in nine flagship journals. Journal of LGBT Issues in Counseling, 11(3), 190–200]. Sport cultures, generally, recreate dynamics of exclusion for marginalized youth. However, there are opportunities to transform these spaces into more inclusive and positive environments to support positive growth for all young people [Newman, T., Alvarez, A., & Kim, M. (2017). An experiential approach to sport-based positive youth development. Journal of Experiential Education, 40(3), 308–322]. Our study uses a data set of adolescents, collected as part of a community-based participatory action research project led by high school students in southeast Michigan, USA. Respondents reported their sexual and gender identities, as well as experiences in youth sport, as well as safety using sex-segregated facilities (i.e., bathrooms and locker-rooms). Using mediation models based on linear regression, we found evidence that LGBQ high school students play sports at a significantly lower rate compared to straight students, and among those who play sports, LGBTQ respondents felt significantly less safe compared to straight and cisgender students. Opposite to the LGBQ and trans youth in this study, straight/cisgender youth also reported feeling safer using all facilities. The mediation models suggest that these inequalities help to explain disparities in rates of sports participation and feelings of safety while participating. These findings have important implications for policy, practice, and future research.

From “Academic Projectitis” to Partnership: Community Perspectives for Authentic Community Engagement in Health Professional Education

Health professional education (HPE) has taken a problem-based approach to community service-learning with good intentions to sensitize future health care professionals to community needs and serve the underserved. However, a growing emphasis on social responsibility and accountability has educators rethinking community engagement. Many institutions now seek to improve community participation in educational programs. Likewise, many Canadians are enthusiastic about their health care system and patients, who are “experts by lived experience,” value opportunities to “give back” and improve health care by taking an active role in the education of health professionals. We describe a community-based participatory action research project to develop a mechanism for community engagement in HPE at the University of British Columbia (UBC). In-depth interviews and a community dialogue with leaders from 18 community-based organizations working with vulnerable populations revealed the shared common interest of the community and university in the education of health professionals. Patients and community organizations have a range of expertise that can help to prepare health practitioners to work in partnership with patients, communities, and other professionals. Recommendations are presented to enhance the inclusion of community expertise in HPE by changing the way the community and university engage with each other.

Democratic communities: evaluating trialogue for mental health stakeholders

PurposeThe purpose of this paper is to evaluate the usefulness of the first Trialogue Meetings throughout Ireland for individuals from mental health communities by using a participatory action research (PAR) framework.Design/methodology/approachSeven communities participated in monthly Trialogue Meetings as a community-based PAR project. A mixed-methods PAR evaluation was performed on data from 48 participants (service users, service providers, family members/friends and interested community members) who participated in the final Trialogue Meetings.FindingsParticipants identified that Trialogue increased knowledge/awareness of mental health, irrespective of gender, mental health role, age or employment status. Trialogue Meetings provided a supportive environment for many, where men may be comfortable talking and where service providers may benefit from exposure to broader perspectives on mental health. Participants also perceived that Trialogue Meetings deconstructed pre-existing mental health power structures, allowed them to understand mental health from different perspectives and express themselves better.Research limitations/implicationsThe study identifies barriers to Trialogue efficacy such as low service provider engagement and political dynamics extraneous to the meetings themselves.Practical implicationsWhere desirable conditions are present, Trialogue Meetings appear to be sustainable community development initiatives where pre-existing mental health power dynamics may be levelled and knowledge/communication surrounding mental health may be enhanced.Originality/valueThis is the first large-scale evaluation of the innovative Trialogue method among mental health stakeholders using a PAR approach.

Postmigration Living Difficulties, Help-Seeking and Community Resilience in the Initial Stages of Migration: Coproducing Community Practice with Recent Irish Migrants to London

ABSTRACTThis article describes a community-based participatory action research (CBPAR) project that examined the postmigration living difficulties (PMLD), help-seeking and community resilience of recent Irish migrants to London (n = 176). The majority of respondents were young adults, in managerial or professional occupations and in good or very good health. Mixed methods indicate inadequate planning for relocation and poor social support as the main difficulties in the initial stages of migration. Community factors promoting resilience included employment opportunities, local and transnational supports, and cultural familiarity and acceptance. Community participation in the action orientated phase of this CBPAR is discussed.

Management and Point-of-Care for Tobacco Dependence (PROMPT): a feasibility mixed methods community-based participatory action research project in Ottawa, Canada

ObjectiveTo determine the feasibility of a Community-Based Participatory Tobacco Dependence Strategy (PROMPT) in the inner city population of Ottawa (Canada).DesignA feasibility mixed methods prospective cohort study following principles of community-based...

“Stay Strong, Stay Sexy, Stay Native”: Storying Indigenous youth HIV prevention activism

BackgroundTaking Action II is a community-based participatory action research project that adopted a strengths-based approach to thinking about Indigenous youth HIV prevention activism. Eighteen diverse Indigenous youth leaders produced digital stories about Indigenizing HIV prevention during the summer of 2012 at a week-long retreat. Youth were interviewed twice: right after they created their stories and again after community screenings. In the summer of 2013, youth reunited to collaboratively analyze the themes and meanings of their stories. Seven overlapping themes emerged that demonstrated how youth see HIV in the context of their lives' and community. The stories make connections between HIV and structural violence, culture and relationships. In particular, in the context of HIV prevention, they focus on (1) the role of family and elders, (2) traditional sacred notions of sexuality, (3) the importance of education, (4) reclaiming history, (5) focusing on strength, (6) Indigenous cosmology and (7) overcoming addictions. In contrast to conventional public health messaging, youth produced stories rarely focused on individual harm reduction strategies. Instead, ideas of Indigeneity and decolonization were foregrounded as key strategies for health promotion work.

Contextual Factors for Aging Well: Creating Socially Engaging Spaces Through the Use of Deliberative Dialogues

Home and community engagement are key contextual factors for aging well, particularly for older adults in vulnerable social positions. A community-based participatory action research project conducted in Western Canada examined how to best use the shared amenity spaces in a low-income seniors' apartment complex in order to connect services and programs with tenants and to provide opportunities for service providers and local stakeholders to build upon and create new relationships toward collaboration and service delivery. Pre-move deliberative dialogue workshops (n = 4) were conducted with stakeholders (e.g., service providers, developers, and municipal government employees). Workshop participants (n = 24) generated ideas and plans on how physical and social environments can contribute to the social engagement of senior tenants. Shared dialogue led to community investment and asset sharing by integrating the knowledge and experiences of multiple stakeholder groups into the planning process. This article highlights how collaborative planning approaches for the effective use of the social environment (e.g., social programming), within the physical environment (e.g., amenity and community spaces), can generate rich and illuminating data for informing enhancements in the social environment of apartment dwelling low-income seniors. Contextual challenges to service provision are discussed, including the need for communication about and coordination of on-site programming, culturally diverse and responsive programming, and long-term funding. Prolonging independent community living with the assistance of support services should be a goal to both delay premature relocation into institutional care and meet the preferences of older adults.

The challenges of participation in doing community-based participatory action research: Lessons from the Kwithu Project

The Kwithu project started when a volunteer who joined Kwithu, a community-based organization in Mzuzu, Malawi (Africa), to teach English gave a diagnostic test to a random group of forty 7th and 8th graders (20 boys and 20 girls) and discovered that most of them could hardly read or write in English. The test results prompted Maureen, the Kwithu director and co-founder, the teacher and myself to meet with the headteachers of the three schools mostly attended by Kwithu children. The headteachers appreciated our concerns about the English proficiency of the children, but they advised us to focus on more urgent matters if we truly wanted to help, e.g., lack of teaching and learning materials, lack of running water in schools, hunger, teacher qualifications, etc. This advice shifted our initial inquiry goal—from English language teaching—to a community-based participatory action research project designed to address the school conditions in Luwinga. In this paper, I describe the community-based participatory action research inquiry and I reflect on the process of participation.