Community-based Participatory Action Research Articles

Mental Health First Aid for Black Populations: Recommendations From the Neighborhood Healers Project

Community-based participatory action research can facilitate counseling psychologists’ engagement in social justice to benefit Black people’s mental health. One way to improve Black mental health is to equip credible and trustworthy community members with mental health knowledge and skills to support other community members experiencing mental health challenges. This study presents the Neighborhood Healers Project—a community-based participatory action research project that trains Black adults (Neighborhood Healers Fellows) in Mental Health First Aid (MHFA). During the inaugural 12-month fellowship year, we collected longitudinal qualitative data from N = 20 Fellows on the relevance of MHFA to Black people. In this paper, we examined their responses using reflexive thematic analysis. Findings included two themes with affiliated subthemes: (a) Liberatory Paradigm Shift and (b) For Us By Us: Culturally Relevant Curriculum. We conclude with implications for counseling psychologists.

Community-based participatory-research through co-design: supporting collaboration from all sides of disability

BackgroundAs co-design and community-based participatory research gain traction in health and disability, the challenges and benefits of collaboratively conducting research need to be considered. Current literature supports using co-design to improve service quality and create more satisfactory services. However, while the ‘why’ of using co-design is well understood, there is limited literature on ‘how’ to co-design. We aimed to describe the application of co-design from start to finish within a specific case study and to reflect on the challenges and benefits created by specific process design choices.MethodsA telepractice re-design project has been a case study example of co-design. The co-design was co-facilitated by an embedded researcher and a peer researcher with lived experience of disability. Embedded in a Western Australian disability organisation, the co-design process included five workshops and a reflection session with a team of 10 lived experience and staff participants (referred to as co-designers) to produce a prototype telepractice model for testing.ResultsThe findings are divided into two components. The first describes the process design choices made throughout the co-design implementation case study. This is followed by a reflection on the benefits and challenges resulting from specific process design choices. The reflective process describes the co-designers’ perspective and the researcher’s and organisational experiences. Reflections of the co-designers include balancing idealism and realism, the value of small groups, ensuring accessibility and choice, and learning new skills and gaining new insights. The organisational and research-focused reflections included challenges between time for building relationships and the schedules of academic and organisational decision-making, the messiness of co-design juxtaposed with the processes of ethics applications, and the need for inclusive dissemination of findings.ConclusionsThe authors advocate that co-design is a useful and outcome-generating methodology that proactively enables the inclusion of people with disability and service providers through community-based participatory research and action. Through our experiences, we recommend community-based participatory research, specifically co-design, to generate creative thinking and service design.

‘You make the call’: Improving radiology staff scheduling with AI-generated self-rostering in a medical imaging department

IntroductionNew Zealand's shortage of medical imaging technicians has intensified due to factors like illness, the pandemic, and an ageing workforce. Addressing staff retention issues requires attention to intrinsic factors like workplace satisfaction and work-life balance. Self-rostering has proven effective in healthcare by enhancing work-life balance, job satisfaction, and retention, but it has not been implemented widely in radiology. This study aimed to explore the perceptions, benefits, and challenges of implementing AI-generated self-rostering in a radiology department through simulated trials. MethodsThis study simulated an AI-generated roster in a regional New Zealand radiology department, engaging 23 staff members. A mixed-methods approach included surveys and discussion groups. Community-based participatory action methodology guided discussion groups and informed modifications. ResultsThe AI-generated self-rostering method demonstrated success by meeting a high percentage of shift preferences while fulfilling service demands. Participants perceived potential benefits in work-life balance and autonomy, though uncertainties persisted regarding implementation and fairness. Despite staff reservations, we found that an AI-generated self-rostering system may be fairer than manual self-rostering, while saving radiology staff time and cost. ConclusionAI-generated self-rostering offers an innovative solution to an old problem. This self-rostering system provides a fair way for staff to have a say in the shifts they do, which increases feelings of work-life balance and autonomy. In this simulation, AI-generated self-rostering was well received, and most staff were receptive to moving to pilot the programme. Implications for practiceSelf-rostering could be a potential solution to staff retention issues in radiology; we recommend a pilot study is implemented. When switching to self-rostering, departments should consider implementing one-on-one support systems to assist staff with entering preferences. Education is essential to encourage staff understanding and cooperation.

Concevoir un centre alimentaire communautaire pour favoriser la sécurité alimentaire

Objective: The objective of this community-based participatory action research (CBPAR) project was to gain an in-depth understanding of the needs, interest and opportunities that exist within a post-secondary institution with respect to supporting food security among students via a food hub. Methods: The project was undertaken on the campus of the University of British Columbia-Vancouver. The CBPAR approach included 4 phases: 1) information gathering, 2) relationship development, 3) implementation of the community engagement strategy, and 4) shareback of findings to the community. Results: Phase 1 identified key components that formed the research process including campus partners for relationship development (phase 2) and subsequent engagement through their networks (phase 3). Phase 3 included engagement of 62, 111, 156, and 154 students, who participated in facilitated dialogues, community meals, a survey and targeted survey, respectively. Food insecurity related experiences were prevalent, with 37% to 75% indicating they worried about running out of food in the last year. Over 90% of all survey respondents affirmed that they would access a community food hub (CFH). Preferences for the CFH were inclusion of emergency food access, community meals, and financial support and planning, while prioritizing foods that meet cultural needs, and a low cost grocery store within the CFH. Conclusion: There is a demonstrated need and desire among students for innovative approaches to support food security at a post-secondary institution. The process outlined may serve as a road map for other communities who are seeking to move beyond emergency food relief.

Beyond individual responsibility towards healthy food choices: A qualitative study among Pakistani women in Hong Kong

While biomedical understandings of food and diet coupled with discourses on individual responsibility towards healthy food choices are nowadays prominent, other social and cultural meanings attached to food and diet are largely devalued. The limits of such a reductionist approach are more evident when related to the experiences of migrant and ethnic populations, whose alternative knowledge(s) and practices about food and health are especially neglected. A multicultural city with a public healthcare system inherited from the British colonial times and largely shaped by biomedical ideas of health, Hong Kong offers a lens into the limits of such a reductionist approach. Due to their vulnerability in the context of Hong Kong as shaped by intersecting social identities, 72 women from Pakistan were recruited to be our community partners in a community-based participatory action research project to investigate their health needs and concerns. 12 focus group discussions were conducted, exploring their experiences of “healthy” food and overweight especially related to their encounters with the Hong Kong public healthcare system, as these issues emerged as key health concerns within the community. Four major themes emerged: unmet expectations of care, health is beyond the individual, constraints to a healthy diet in the context of migration, and beyond health: food as care for diasporic women. This study highlights the limit of a reductionist approach to healthy food as merely based on nutrition and individual responsibility. It stresses the need of a counter-discourse in the field of public health, emphasizing not only alternative cultural ideas of health and food, but also enlarging the field of health in biomedical terms to embrace “care” and acknowledging the structural constraints shaping migrant and ethnic population's vulnerability in making “healthy” food choices.

Developing the Feast for the Future Program through a Community Visioning Process

Abstract: Background: Three tribal communities in the Southwestern United States have a long-standing partnership with the Johns Hopkins Center for Indigenous Health (JHCIH). Objectives: In response to community concerns about obesity, three tribal communities and Johns Hopkins Center for Indigenous Health partnered to develop culturally relevant plans for a new program. Methods: Using a "community visioning" process, a community advisory board (CAB) from each community identified opportunities, challenges, goals, and visions for their communities. The CABs consulted with experts in pediatrics, nutrition, food distribution, agricultural restoration, and community and school gardening. Results: The CABs developed seven components for Feast for the Future: 1) Edible School Gardens; 2) Traditional Food-ways Education Program; 3) Community Gardens, Orchards, and Greenhouses; 4) Farmers Markets; 5) Farmers Workshops; 6) Family Gardens; and 7) a Mobile Grocery Store. Conclusions: A community-based participatory action research (CBPAR) process was critical to developing a culturally appropriate program that built on community strengths.

Relational Complexity of the Near-Age Peer Support Provider Role in Youth and Young Adult Community Mental Health Settings.

Increasingly, US community mental health settings are integrating professional near-age youth peer support providers to improve youth service engagement and outcomes. Youth peer specialists (YPS) use their lived and living experiences with a mental health diagnosis to validate, empathize, and provide individualized support, while also improving their program's overall responsiveness to young people's needs. Although promising, these roles tend to lack clarity-responsibilities vary immensely, and turnover is high. Examining near-age youth peer on-the-job experiences is needed to design effective on-the-job supports. Using community-based participatory action research methods, young adults with lived experience worked in partnership with a PhD-level qualitative researcher to design, recruit, conduct, and analyze in-depth-interviews with current and former near-age youth peer providers. Ten young adult peer mentors in Massachusetts completed interviews that revealed near-age youth peer role relational complexity. Five relational aspects were identified requiring relational practice skills and self-awareness, including relationships with (1) self, (2) clients, (3) supervisors, (4) non-peer colleagues, and (5) other near-age peer providers. Near-age peers experience relationship-related struggles with non-peer identified colleagues who do not understand nor value the near-age peer role. Findings expand on current near-age peer practice and associated on-the-job challenges. Training, supervision, and professional development activities that target these five relational areas may improve YPS on-the-job wellbeing, decrease YPS turnover, and improve youth client outcomes.

The Interplay between Hereditary Traditional Leaders, Democratically Elected Leaders and Succession: A Case Study from Makapanstad, North West Province, South Africa

Abstract This article examines the interplay between traditional leaders, democratically elected leaders and succession in Makapanstad Village, North West Province, South Africa. The article stems from community-based participatory action research conducted in Makapanstad in 2018. The article uses research data, in the form of community dialogue, together with desktop literature on the same subject. The article analyses the significance and role of traditional leadership in a democratic South Africa. It considers traditional leadership and democratically elected leadership in conjunction with succession and the demarcation of roles and responsibilities. The article analyses participants’ views to explore the form of leadership preferred by the residents of Makapanstad. It argues that, despite the recognition of traditional leadership in South Africa's Constitution, the roles and responsibilities of traditional leaders in local and provincial arms of government are limited, in contrast to those of democratically elected leaders.

Using Photovoice to Explore Determinants of Health among Homeless and Unstably Housed Women.

The lived experiences of homeless and unstably housed women, including their health-related priorities, are understudied in smaller metropolitan and rural communities. In this study, we partnered with a day center for women who experience homelessness in Spokane, Washington. We used Photovoice, a community-based participatory action research method, to explore the health-related concerns, needs, and behavior of women who are homeless or unstably housed. Participant-generated photographs and group interview data were analyzed using thematic analysis. Three themes were generated: "These are my supports", "I'm trying to make my health better", and "[My] choices are very limited". The themes illustrated individual, interpersonal, community, and societal strengths and vulnerabilities aligned with the social ecological model. Participants demonstrated resourcefulness, creativity, and hope as they strived toward health improvement. Trauma-informed, strengths-based approaches that respect the autonomy of homeless and unstably housed women and that amplify their voices are needed to minimize power imbalances in research, policy, and practice. This includes an imperative for healthcare and social work programs to ready graduates to deliver effective, empathic services by increasing their knowledge of social determinants of health and of the stigma faced by marginalized communities. Moreover, collaborating with these communities when designing, implementing, and evaluating services is critical.

Participatory Health Research With Women From Refugee, Asylum-Seeker, and Migrant Backgrounds Living in High-Income Countries: A Scoping Review

Participatory Health Research (PHR) has the potential to result in more equitable health interventions and impactful research outcomes, and is an increasingly used paradigm in migrant health research. In the context of intersecting systems of social disadvantage imposed on migrant and refugee women, PHR could offer an opportunity for researchers to challenge unequal power dynamics in academic research by co-creating knowledge to improve these women’s healthcare access and use. However, there is limited information about how PHR has been conducted with migrant women, including the extent of their involvement throughout the research process. This scoping review aimed to describe and summarize current evidence on the research approaches and methods that have been used in PHR with women of migrant and refugee backgrounds living in high-income countries, and the extent of community engagement in PHR with this population. We searched MEDLINE Ovid, CINHAL, Scopus, and Web of Science databases from 1 January 2012 to 31 December 2021 to identify qualitative, quantitative, and mixed method studies adopting a PHR approach with migrant women as participants. We included 91 studies from 12 countries. Health topics of included studies included: knowledge, screening and prevention of HPV, cervical and breast cancer, mental health, nutrition and physical activity, gender-based violence, and health promotion and education. The most common PHR approaches were Community-Based Participatory Research and participatory action research. Overall, community engagement was commonly reported in most stages of research; however, participatory engagement with migrant women was more often done by proxy through community organisations or agents, rather than women themselves. We argue that more rigorous reporting of community engagement is necessary to demonstrate PHR conducted with migrant women is following the principles of equity and inclusion in community-academic partnerships.

RHYTHM AND NATURE: APPLYING TRAUMA-INFORMED APPROACHES TO RESEARCH TO PRIORITIZE CHOICE, EXPRESSION, AND JUSTICE

Abstract Trauma-informed approaches are widespread in direct clinical and particularly in social work practice, and have gained momentum in other areas such as research, organizational culture, supervision, and leadership. Given the recent collective global trauma of the pandemic and the cumulative effects of historic and ongoing racial injustice, a trauma-informed approach to research with older adults, especially with those who have disabilities, such as relating to dementia, can contribute to the movement for access, justice, equity, and inclusion for all. Closely aligned with practices of community-based participatory action research, trauma-informed research pays particular attention to the consideration of the design of studies, the analytical and theoretical frameworks, collaboration among researchers and participants, data collection methods, research questions that capture the knowledge and experiences of participants’ resiliency, strengths, and challenges, and the processes of reflexivity. Rhythm & Nature was a 10-week pilot study designed to incorporate trauma-informed research approaches to promote principles of safety, trustworthiness, collaboration, choice, self-expression, and justice. We created a modifiable drumming and nature-based intervention to promote opportunities for self-expression and confidence. Before and after each drumming and nature-based session, we collected data using emojis (e.g., to increase access for people with limited language or literacy) to indicate how participants felt in the moment and used their ongoing feedback to continuously tailor the program to their unique abilities and needs. Both quantitative and qualitative results of this pilot study and implications for future research, policy, practice and education with older adults, particularly with disabilities, will be discussed.

How Can We Find Out What Indigenous Children and Their Families Need to Manage Weight? Lessons from Formative Nutrition Intervention Research with First Australians.

In Australia, Indigenous children have rates of overweight and obesity 1.5 times those of non-Indigenous children. Culturally safe and effective nutrition interventions are needed for this group. This paper aims to describe a Community-based Participatory Action Research (CPAR) approach to designing formative nutrition intervention research with First Australian children and their families and to reflect on the challenges arising from this process. After obtaining ethical approvals, a Steering Committee (SC), including nine Aboriginal and Torres Strait Islander people experienced in delivering or receiving health care, was established as a project governance body to develop culturally safe project materials and methods. The Indigenous research method of yarning circles was chosen by the SC for the community consultation, and the First Australian SC members were trained to collect the data. They liaised with community organizations to recruit yarning circle participants. Individual interviews conducted by an Aboriginal research assistant replaced yarning circles due to the COVID-19 pandemic lockdowns. While the CPAR approach to formative research was successful, the pandemic and other factors tripled the study duration. To authentically, ethically and safely engage First Australians in research, researchers need to decolonize their methodological approach, and funding bodies need to allow adequate time and resources for the process.

Developing STEM Career Identities among Latinx Youths: Collaborative Design, Evaluations, and Adaptations during COVID-19.

In response to the low representation of Latinx adults in STEM occupations, this community-based participatory action research study aims to increase the number of middle school youths developing STEM career identities and entering high school with the intention to pursue STEM careers. The students were provided with summer and after-school activities focusing on network science and career development curricula. Using a quasi-experimental pretest-posttest design and career narratives, this study examined the changes in STEM and career self-efficacy, as well as career identity. The results show improvements in self-efficacy, an increased number of youths with intentions of pursuing future STEM career opportunities, and deeper reflections on their talents and skills after program participation. This paper also describes the program development and implementation in detail, as well as the adaptations that resulted from COVID-19, for scholars and educators designing similar programs. This study provides promising evidence for the quality of STEM and career development lessons in supporting the emergence of a STEM career identity and self-efficacy.

Sustainable Ecotourism: The Case of the Riverine Communities in Capiz, Philippines

The Capizenos had been firmly fighting the pandemic for almost two years. The province’s economy and the people’s livelihood had drastically fallen as the virus hindered the logistics, sales, and production efforts of the region. Capiz State University implemented the RISE Capiz (Riverine Improvement towards a Sustainable Ecotourism in Roxas City, Capiz) Program to address the gaps, challenges, and needs of the riverine communities within Roxas City, Capiz, Philippines. It aimed to establish a sustainable ecotourism industry in the riverine communities. This study involved a mixed-methods approach, combining qualitative and quantitative methodologies. The qualitative component utilized a citizen-centric community-based participatory action research (CBPAR) approach, ensuring river tour members’ active participation in the research process. The results indicate that the trainings were well received and have produced tangible outcomes in terms of increased income and improved livelihoods. The implementation of the acquired knowledge and skills has not only benefited the riverine communities, but also played a role in preserving the riverine communities. It is the hope that the impact of these trainings will be long-lasting and continue to provide benefits to the riverine communities in the future. The utilization of social media pages, as a tool for promoting RISE Capiz’s Palina and Cadimahan river tour operators and their offerings, was found to be an effective strategy.

Linking the Coconut Farmers in the Philippines to Better Market Opportunities through Community-based Participatory Action Research

This research aimed to empower eight selected coconut farmers by building an economically sustainable and resilient community. Specificall , it focused on: 1. Improve coconut farmers’ economic conditions through value-added coconut products; 2. Link them with other stakeholders for producing and commercializing coconut products; 3. Design the sustainability plan in partnership with the stakeholders. The researcher employed each content, which is (1) Needs and Support Assessment. (2) the capacity-building activities on Training on Developing Entrepreneurial skills among Coconut Farmers of Burias, Training on “Bukayo” Making, Business Model Canvas, and One-on-One Consultation, Entrepreneurial Mind Setting and Intro to Business Planning and Seminar-workshop in Marketing. (3) Innovative Marketing Strategies; establish a presence on the online platform, specifically digital marketing, by creating a Facebook page that serves as a platform in which their coconut food products bring a better income for coconut farmers. The Coconut 2.0 research initiated by the researcher positively affected the quality of coconut farmers’ lives, thus building a sustainable and resilient community of coconut farmers. A memorandum of agreement was bound between the stakeholders and coconut farmers based on the sustainability plan. These documents were presented to the coconut farmers during the turning-over activity of the research.

Towards collective community education: Pasifika diabetes health forums in Southeast Queensland, Australia

Collective community education co-designed with the Māori (Indigenous people of Aotearoa (New Zealand) and Pasifika (Pacific Islander peoples living in Australia) communities through participatory community engagement, Indigenous methods and cultural knowledge are vital for development and implementation of diabetes community forums. A community-based participatory action research was co-designed with three Pasifika diabetes community forums in partnership with Māori and Pasifika communities, a university and government health organisations in Southeast Queensland. The forums provided a culturally safe space for the communities to collectively engage in diabetes education, health checks and cultural knowledge sharing. The outcomes of these forums led to co-development of a Pasifika Women’s Diabetes Wellness Program aimed at promoting diabetes prevention and management for the Māori and Pasifika diaspora in Australia and internationally. Co-designed community forums have the potential to address health equity through inclusion of communities and key stakeholders in a collaborative agenda, empowering communities to improve health outcomes.

SI-CBPAR: Towards structural indicators of community-based participatory action research.

Structural aspects of community-engaged research are not well measured yet have critical implications for community research empowerment. This is particularly so with people who use drugs. We introduce the Structural Indicators of Community-Based Participatory Action Research (SI-CBPAR) to measure structural indicators of community-research entity relationships. A three-phased process of iterative development, feasibility and applicability assessment was used to examine theinstrument with community-engaged studies as a first stage of instrument development. The development team included people with university, non-government organisation and lived/ing drug use experience. Four studies on the health of people who use drugs were reviewed for indicator evidence followed by iterative discussion about construct and item discrepancies. Indicators were measured for the degree to which they were observed using a three-point scale. All but two constructs were confirmed for meaning. Constructs of 'community' and 'coalition' required revision and explanation. The need for further exploration of power differentials between community and community-based organisations was identified. Indicator evidence was found for all six categories across studies. The instrument was deemed applicable and easy to use. It was observed that categories could apply to studies with various degrees of community engagement and to other research focal areas. SI-CBPAR applicability testing and initial category confirmation indicate its potential utility for community research collaboratives. The next phase of development involves cognitive interviewing with researchers from across community engaged research orientations, and with communities engaged in research beyond drug user health.

The development of a wellness tourism program in Thailand: a community-based participatory action research approach with an empowerment theoretical framework

Introduction: Thailand has not had a comprehensive effort to collaborate on a wellness tourism regional program for foreign travelers. The purpose of the study was exploring the key components necessary for a wellness tourism program in the lower northern region in Thailand. Methods: This is a qualitative, community-based, participatory action research guided by the empowerment theory. A descriptive qualitative approach to data collection and analysis was used to explore stakeholders’ perspectives on the development of a wellness tourism program. A total of 40 key stakeholders from nine provinces in the lower north region of Thailand participated in two phases of the study’s data collection. Individual and focus groups interviews were conducted and analyzed thematically. The purposive sample included semi-structured questionnaires among community leaders, village health volunteers, and workers from various occupations who lived in the communities. Results: Four themes emerged from the qualitative interviews and focus groups: 1) honoring local wisdom as the heart of a regional wellness tourism program; 2) the integration of historical traditions and regional lifestyles into a wellness tourism program; 3) the need for government supportive policies that help to fund community wellness initiatives to boost the local economy and tourism ;and 4) attention needed to improve the quality of life for the local communities while promoting wellness tourism in the region. Conclusion: This community-based participatory action research approach created a synergy among stakeholders from multiple provinces in the lower north region of Thailand.

Community-based participatory action research with LGBTQIA+ youth during the COVID-19 pandemic: Reflections from a collaborative autoethnography

We use a collaborative autoethnography (CAE) methodology to explore how our research team conducted community-based participatory action research (CBPAR) with lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, and other sexually and gender diverse youth (LGBTQIA+) youth during the COVID-19 pandemic, which required us to modify our original research approach. This paper describes the authors’ processes and provides critical reflections on continuing to use CBPAR during the pandemic with LGBTQIA+ youth to develop and evaluate a mental health intervention (i.e., Tuned In!) that aims to address their mental health needs. Our CAE revealed three main themes: 1) Enhancing Accessibility; 2) Centering the Voices of LGBTQIA+ Youth; 3) Prioritizing Relationships and Community Building, and an over-arching theme of Trust that facilitated our efforts. Taken together, our findings illuminate practical approaches to engage LGBTQIA+ youth through research despite myriad obstacles brought on by the pandemic.

Cultivating Mathematical Proficiencies and Identities through Culturally and Community Inspired Activities

Utilizing culturally-conscious teaching promotes instruction that values the cultural knowledge and experiences of ethnically diverse students. This qualitative study centers culturally responsive teaching (Gay, 2002) and community cultural wealth (Yosso, 2005) to contextualize mathematics learning for an after-school tutoring program in North Minneapolis, Prepare2Npsire. The aim of this research was to use a community-based participatory action research approach to: 1) explore the culture wealth of North Minneapolis, 2) create culturally responsive mathematics activities for Prepare2Nspire. Two activities were developed to center community assets and youth empowerment. The goal of these activities was to strengthen community, curriculum, and classrooms by intentionally connecting students’ multidimensional identities with mathematical learning. Specially, Muhammad’s (2020) culturally and historically responsive literacy framework was adapted using a mathematical lens to: 1) Create tasks that build mathematical proficiencies and 2) Create tasks that cultivate mathematical identities. The emphasis on participatory, community-based, and action-oriented practices in this study encouraged the disruption of deficit-based assumptions of communities while also creating joy-filled learning opportunities for Prepare2Nspire attendees.