Community-based Participatory Approach Research Articles

An Equity-Focused Assessment of Evidence-Based Parenting Intervention Research.

Evidence-based parenting interventions (EBPI) support children and families to promote resilience, address emotional and behavioral concerns, and prevent or address issues related to child maltreatment. Critiques of EBPIs include concerns about their relevance and effectiveness for diverse populations when they are implemented at population scale. Research methods that center racial equity and include community-based participatory approaches have the potential to address some of these concerns. The purpose of the present review was to document the extent to which methods associated with promoting racial equity in research have been used in studies that contribute to the evidence base for programs that meet evidentiary standards for a clearinghouse that was developed to support the Family First Prevention Services Act in the United States. We developed a coding system largely based on the Culturally Responsive Evaluation model. A sample of 47 papers that are part of the evidence base for ten in-home parent skill-based programs were reviewed and coded. Only three of 28 possible codes were observed to occur in over half of the studies (including race/ethnicity demographic characteristics, conducting measure reliability for the study sample, and including information on socioeconomic status). Although the overall presence of equity-informed methods was low, a positive trend was observed over time. This review highlights ways in which rigorous research can incorporate racial equity into the planning, design, execution, and interpretation and dissemination of programs of study. We posit that doing so improves the external validity of studies while maintaining high-quality research that can contribute to an evidence base.

Perceptions of abused Chinese women on community-based participatory approach programme in addressing their needs

ABSTRACT Background The community-based participatory approach (CBPA) has gained increasing recognition worldwide for enhancing the effectiveness of intervention. It is relatively new in Chinese societies and participants’ perceptions are underexplored. This study aims to explore abused Chinese women’s perceptions on the CBPA programme in addressing their needs. Methods A total of 11 abused Chinese women were recruited for a focus group and individual interviews. A semi-structured interview guide was used. All interviews were audio-recorded and data were transcribed verbatim. Conventional content analysis was used for analysis. Results Four themes were identified regarding the women’s perceptions and experiences of the community-based participatory approach programme: (1) Women’s perceived acceptability of the CBPA programme; (2) Women’s perceived usefulness of the CBPA programme; (3) Women’s perceived feasibility of the CBPA programme; and (4) Empowering the women through participating in CBPA. Conclusions Abused Chinese women had high perceived acceptance and positive experiences towards the community-based participatory approach. Women benefited from their robust participation throughout the process. The findings confirm the potential of using the community-based participatory approach in designing interventions for future programme planning and intervention to address the needs of abused Chinese women.

Prescribed safer supply during dual public health emergencies: a qualitative study examining service providers perspectives on early implementation

BackgroundWithin North America and worldwide, drug related overdoses have increased dramatically over the past decade. COVID-19 escalated the need for a safer supply to replace unregulated substances and to reduce toxicity and overdoses. Service providers play an integral role in the delivery of safer supply but there is little empirical evidence that conceptualizes effective safer supply from their perspectives. This study explored early implementation and impacts of a safer supply program, capturing the perspectives of an interdisciplinary team of service providers on tensions and issues encountered in the development of the SAFER program.MethodsUsing a community-based participatory approach, we conducted individual interviews with program providers (n = 9). The research team was composed of researchers from a local drug user organization, a local harm reduction organization, and academic researchers. The Consolidated Framework for Implementation Research (CFIR) informed the interview guide. Data was analyzed using thematic analysis.ResultsThere are six themes describing early implementation: (1) risk mitigation prescribing as context for early implementation; (2) developing SAFER specific clinical protocols; (3) accessibility challenges and program innovations; (4) interdisciplinary team and wraparound care; (5) program tensions between addiction medicine and harm reduction; (6) the successes of safer supply and future visions.ConclusionEarly implementation issues and tensions included prescriber concerns about safer supply prescribing in a highly politicized environment, accessibility challenges for service users such as stigma, encampment displacement, OAT requirements, program capacity and costs, and tensions between addiction medicine and harm reduction. Navigating these tensions included development of clinical protocols, innovations to reduce accessibility challenges such as outreach, wraparound care, program coverage of medication costs and prescribing safer supply with/without OAT. These findings contribute important insights for the development of prescribed safer supply programs.

Patient and public involvementin the development of health services: Engagement of underserved populations in a quality improvement programme for inflammatory bowel disease using a community-based participatory approach.

Involving people with lived experience is fundamental to healthcare development and delivery. This is especially true for inflammatory bowel disease (IBD) services, where holistic and personalised models of care are becoming increasingly important. There is, however, a significant lack of representation of underserved and diverse groups in IBD research, and there are significant barriers to healthcare access and utilisation among minority groups in IBD. IBD centres need to be aware of these experiences to address barriers via service changes, improve interactions with local communities and promote meaningful engagement for improved health outcomes. A pragmatic community-based approach was taken to engage with leaders and members of underserved groups across 11 workshops representing Roma, Afro-Caribbean, people of African descent and the wider black, Asian and minority ethnic (BAME) communities, Muslim women, refugee community members, deprived areas of South Yorkshire, LGBTQ+ and deaf populations. Thematic analysis of field notes identified patterns of attention across the community groups and where improvements to services were most frequently suggested. Findings demonstrated several barriers experienced to healthcare access and utilisation, including language accessibility, staff attitudes and awareness, mental health and stigma, continuity of support, and practical factors such as ease of service use and safe spaces. These barriers acted as a lever to co-producing service changes that are responsive to the health and social care needs of these groups. Engaging with people from a range of communities is imperative for ensuring that service improvements in IBD are accessible and representative of individual needs and values. Local community leaders and members of community groups actively participated in the co-design and development of improvements to the IBDservice for a local hospital. Their contributions further informed a pilot process for quality improvement programmes in IBD centres.

A Community-Based Participatory Approach in Applying the Sociocultural Resilience Model in U.S–Mexico Border Communities

Abstract: Background: Behavioral models play a key role in identifying pathways to better health and provide a foundation for health promotion interventions. However, behavioral models based in epidemiological research may be limited in relevance and utility in practice. Objectives: We describe a participatory approach within a community-based participatory research partnership for integrating epidemiological and community perspectives into the application of the sociocultural resilience model (SRM). The SRM posits that cultural processes have a symbiotic relationship with health-promoting social processes, which contribute to the health advantages among Mexicanorigin and other Latinx populations. Methods: Community action board members engaged with academic partners to interpret and apply the SRM to a community-clinical linkages intervention implemented in the context of three U.S.–Mexico border communities. In a two-day workshop, partners engaged in a series of iterative discussions to reach common definitions and measures for SRM constructs. Results: Partners described daily cultural processes as the food they eat, how they communicate, and a collectivist approach to getting things done. For intervention activities, the partners opted for intergenerational storytelling, sharing of food, and artistic forms of expression. Partners included measures of cultural nuances such as border identity and the complexities that often arise from navigating bicultural norms. Conclusions: Collaborative approaches within community-based participatory research partnerships can facilitate the adaptation and measurement of conceptual health behavior models in community practice.

Community engagement in local governance: A review of USA and African strategies

Community engagement in local governance is a crucial aspect of fostering inclusive and participatory decision-making processes. This paper explores and compares community engagement strategies in the United States and Africa, shedding light on the diverse approaches employed to enhance citizen involvement in local governance. In the United States, community engagement is deeply rooted in democratic principles, with a strong emphasis on transparency and collaboration between local governments and residents. Strategies such as town hall meetings, public forums, and online platforms are commonly used to facilitate dialogue and gather input from community members. The U.S. model also emphasizes the importance of community-based organizations, which play a vital role in advocating for the interests of local residents. This review delves into the effectiveness of these strategies, examining their impact on policy development and the overall governance landscape. In contrast, African countries exhibit a rich tapestry of community engagement strategies shaped by diverse cultural, social, and political contexts. Community assemblies, traditional councils, and community-based participatory approaches are often employed to integrate the voices of citizens into decision-making processes. The paper explores the challenges and opportunities associated with these strategies, considering factors such as cultural diversity, historical context, and the role of traditional leadership in African governance. Despite these regional differences, common themes emerge, emphasizing the importance of building trust, promoting inclusivity, and leveraging technology to enhance community engagement. Both the U.S. and African strategies face challenges such as overcoming socio-economic disparities, addressing power imbalances, and ensuring the meaningful inclusion of marginalized groups. The paper examines innovative initiatives and best practices that have emerged from both contexts, providing valuable insights for policymakers, practitioners, and scholars interested in strengthening community engagement in local governance. This review contributes to the understanding of community engagement in local governance by drawing on examples from the United States and Africa. By highlighting the diversity of strategies and identifying common principles, the paper aims to inform future research, policy development, and practical initiatives aimed at fostering robust and inclusive local governance worldwide.

Culturally Adapting the World Health Organization Digital Intervention for Family Caregivers of People With Dementia (iSupport): Community-Based Participatory Approach.

Informal caregivers of people with dementia are at high risk of developing mental and physical distress because of the intensity of the care provided. iSupport is an evidence-based digital program developed by the World Health Organization to provide education and support for the informal everyday care of people living with dementia. Our study aims to describe in detail the cultural adaptation process of iSupport in Switzerland. We specifically focused on the participatory strategies we used to design a culturally adapted, Swiss version of iSupport that informed the development of the desktop version, mobile app, and printed manual. We used a mixed methods design, with a community-based participatory approach. The adaptation of iSupport followed the World Health Organization adaptation guidelines and was developed in 4 phases: content translation, linguistic and cultural revision by the members of the community advisory board, validation with formal and informal caregivers, and refinement and final adaptation. The findings from each phase showed and consolidated the adjustments needed for a culturally adapted, Swiss version of iSupport. We collected feedback and implemented changes related to the following areas: language register and expressions (eg, from "lesson" to "chapter" and from "suffering from" dementia to "affected by" dementia), resources (hyperlinks to local resources for dementia), contents (eg, from general nonfamiliar scenarios to local and verisimilar examples), graphics (eg, from generalized illustrations of objects to human illustrations), and extra features (eg, a glossary, a forum session, and a read-aloud option, as well as a navigation survey). Our study provides evidence on how to culturally adapt a digital program for informal caregivers of people living with dementia. Our results suggest that adopting a community-based participatory approach and collecting lived experiences from the final users and stakeholders is crucial to meet local needs and to inform the further development, testing, and implementation of digital interventions in a specific cultural context.

Registered nurses' perceptions of healthy lifestyle counselling for immigrants in primary healthcare: A focus group study.

The use of primary healthcare and health promotion services is low among immigrants compared with native citizens. Immigrants are at risk of developing chronic diseases due to genetics, nutrition and a sedentary lifestyle. Registered nurses play an integral role in teaching, counselling for a healthy lifestyle and care coordination in primary healthcare. We aimed to explore the perceptions of registered nurses on healthy lifestyle counselling for preventing type 2 diabetes and other chronic diseases among immigrants in the primary healthcare setting. We performed a qualitative descriptive study using focus group interviews. Data were collected with semi-structured focus group interviews with a total of 23 registered nurses working in primary healthcare. We recruited the participants by using the purposive sampling method in the primary healthcare setting of four municipalities in Finland. Interviews were audio-recorded, transcribed verbatim and analysed with qualitative inductive content analysis. The participants' perceptions were related to (1) uniform counselling practice for both immigrants and native citizens, (2) challenges in counselling immigrants, (3) understanding cultural factors influencing immigrant counselling, (4) the need to improve immigrant counselling and (5) utilizing insights from practical experience to improve the counselling service. Developing a culturally sensitive health promotion service is suggested to support the health of immigrants. Moreover, both migrant communities and healthcare professionals should be involved in co-designing and implementing health promotion projects through a community-based participatory approach. Our study contributes to healthcare practice and management by underscoring the need for culturally tailored health promotion services for the at-risk group of immigrants in primary healthcare. Cultural competence in nursing education needs to be reinforced. The provided recommendations inform researchers and policymakers about the health disparities and health needs of immigrants. Healthcare professionals were consulted in the study design.

Participatory research in caring communities: Practice what you preach?

Background: Participation is presented as a key principle of caring communities. Participatory research directly includes communities and through co-producing knowledge, it would foster sustainable change that matches with local communities' needs. However, in practice, participatory approaches are challenging, and theoretical principles are not always easy to translate in practice.
 Aim: The goal of this workshop is to jointly advance our understanding of participatory research in relation to caring communities, and to discuss and exchange the challenges and pitfalls related to this type of research.
 Participants: The workshop is for everyone who is interested in developing, understanding, or evaluating caring communities or wants to be an active part of it. Both people with and without experience in the subject are welcome.
 Methods:
 
 Brainstorm about participatory research in relation to caring communities. What is meant by participation in participatory research? Who ‘should’ participate? (10min)
 
 
 
 Presenting three case studies using participatory research methods within different community settings (i.e., an urban neighborhood, a municipality, and a higher educational institution) and with different community members (i.e., inhabitants and users of the neighborhood, socioeconomically disadvantaged adults, university students and staff). Each case will present 3 challenges faced within the process. (30min)
 
 - Suzannah D’Hooghe studies the role of the perceived local environment in health-promoting behaviors among socioeconomically disadvantaged adults in two peri-urban municipalities in Flanders. Community-based participatory approaches such as walk-along interviews, photovoice, and focus groups were used to i) identify environmental factors affecting eating behavior and recreational walking, and ii) identify actions to promote healthy eating and stimulate recreational walking.
 - Octavia Kint is involved in a co-creative research project on caring communities in two neighborhoods in Brussels. 80% of the neighborhood-built surface is not used for housing, and is characterized by a large presence of ‘atypical’ neighborhood users: musea, public institutions, companies, shops, commuters,... Together with a group of neighborhood co-researchers we investigated and experimented with how a caring community could be built together with these ‘atypical’ neighborhood users.
 - Hanne Bakelants studies the development of a Compassionate University in one university setting in Brussels. A participatory action research approach is used in which staff and students i) share challenges they encounter when confronted with serious illness, death, and bereavement, ii) co-define objectives for developing a compassionate initiative within the university context, and iii) co-create and execute an implementation plan in collaboration with the research team.
 
 Interactive part: Reflections on case studies: pitfalls, challenges, and opportunities (30 min)
 
 - What are the limits of participation for community stakeholders and researchers?
 - How can we increase community support and involve new stakeholders?
 - How to deal with power relations?
 Participants will be divided into groups to discuss these questions related to their practice, followed by a collective discussion.
 
 Closing: Plenary ‘sharing’ session (20 min)
 
 End goal: People will go home having an example of what participatory research can look like in different contexts and the challenges and opportunities that appear in its practical application.

Honoring the Care Experiences of Chinese Canadian Survivors of Prostate Cancer to Cultivate Cultural Safety and Relationality in Digital Health: Exploratory-Descriptive Qualitative Study.

Prostate cancer (PCa) is the most commonly diagnosed nonskin cancer for Canadian men and has one of the highest 5-year survival rates, straining systems to provide care. Virtual care can be one way to relieve this strain, but survivors' care needs and technology use are influenced by intersecting social and cultural structures. Cultural adaptation has been posited as an effective method to tailor existing interventions to better serve racialized communities, including Chinese men. However, cultural adaptations may inadvertently draw attention away from addressing structural inequities. This study used qualitative methods to (1) explore the perceptions and experiences of Chinese Canadian PCa survivors with follow-up and virtual care, and (2) identify implications for the cultural adaptation of a PCa follow-up care app, the Ned (no evidence of disease) Clinic. An axiology of relational accountability and a relational paradigm underpinned our phenomenologically informed exploratory-descriptive qualitative study design. A community-based participatory approach was used, informed by cultural safety and user-centered design principles, to invite Chinese Canadian PCa survivors and their caregivers to share their stories. Data were inductively analyzed to explore their unmet needs, common experiences, and levels of digital literacy. Unmet needs and technology preferences were similar to broader trends within the wider community of PCa survivors. However, participants indicated that they felt uncomfortable, unable to, or ignored when expressing their needs. Responses spoke to a sense of isolation and reflected a reliance on culturally informed coping mechanisms, such as "eating bitterness," and familial assistance to overcome systemic barriers and gaps in care. Moreover, virtual care was viewed as "better than nothing;" it did not change a perceived lack of focus on improving quality of life or care continuity in survivorship care. Systemic changes were identified as likely to be more effective in improving care delivery and well-being rather than the cultural adaptation of Ned for Chinese Canadians. Participants' desires for care reflected accessibility issues that were not culturally specific to Chinese Canadians. Chinese Canadian survivors are seeking to strengthen their connections in a health care system that provides privacy and accessibility, protects relationality, and promotes transparency, accountability, and responsibility. Designing "trickle-up" adaptations that address structural inequities and emphasize accessibility, relationality, and privacy may be more effective and efficient at improving care than creating cultural adaptations of interventions.

Addressing the need for Indigenous-specific PROMs and PREMS: A focus on methodology.

Differences in Indigenous worldviews, practices and values highlight the need for Indigenous-specific health quality indicators, such as patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs). The purpose of this paper is to present our methodology, as part of a larger study that sought to develop a framework for creating Indigenous-specific PROMs and PREMs. The research design was informed by Indigenous research methodology and a community-based participatory approach. It had three core components: (1) a literature exploration of existing Indigenous-specific PROMs and PREMs; (2) interviews with researchers with expertise in PROMs and PREMs developed for Indigenous populations and community leaders interested in using these Indigenous-informed evaluation tools; and (3) conversations with Indigenous community members about their experiences with health surveys. Interviews were audio-recorded and transcribed verbatim; transcripts were analyzed qualitatively using an inductive and deductive approach. Themes and sub-themes were identified to build a framework that honours Indigenous knowledges and ways of knowing. Results were validated with select research participants and the Project Advisory Committee. Findings demonstrate how relationship building is the necessary starting point for engagement when developing survey instruments with Indigenous peoples. Engagement requires respectful collaboration through all stages of the project from determining what questions are asked to how the information will be collected, interpreted, and managed. A relational stance requires responsibility to Indigenous communities and peoples that goes beyond research carried out using a western scientific lens. It means ensuring that the project is beneficial to the community and framing questions based on Indigenous knowledge, worldviews, and community involvement. This study employed a collaborative, participatory qualitative approach to develop a framework for creating PROMs and PREMs with Indigenous peoples. The methods described offer concrete examples of strategies that can be employed to support relationship-building and collaboration when developing Indigenous-specific survey instruments.

PROMOTING MENTAL HEALTH LITERACY AMONG OLDER ADULTS IN THE EAST: AN INTEGRATIVE FRAMEWORK

Abstract Although mental health literacy is of considerable importance to advance the welfare of older adults, previous research has shown that the public has a poor understanding of mental health and recognition of mental health symptoms. Traditional mental health literacy promotion programmes utilized a top-down approach; no bottom-up model had been used. Moreover, the existing participatory research paradigms were developed in the West and might not be applicable in the East, given different socioeconomic and cultural contexts. This research aimed to fill the gap by co-creating an integrative framework with stakeholders to promote mental health literacy among older adults in the East using a community-based participatory approach as a case illustration. We conducted a mental health literacy promotion pilot project in five Hong Kong districts from May 2021 to August 2023, spanning over 2 years. Each district formed an action committee, which comprised 5-10 community older adults and 2 social workers, and 2 researchers. Each district had its own promotional activities initiated and designed by older adults, including street booths, art workshops, and publicity materials to promote mental health and introduce relevant information and resources. We conducted six focus groups (n=25) with stakeholders, and we recorded our experiences on reflection notes. Collected data suggested specific elements are important for an integrative framework in the East, including participant empowerment, stakeholders’ role and expectation management, and potential community contribution. We advance gerontological research and practice by providing an integrative framework to promote mental health literacy in the East. Implications will be discussed further.

A GREEN ACTIVITY PRESCRIPTION PROGRAM FOR CHINESE AMERICANS LIVING WITH DEMENTIA

Abstract Asian Americans account for approximately 161,000 cases of Alzheimer’s disease and related dementias (AD/ADRD) among adults ages 65 and older in the United States. Chinese Americans have among the highest incidences of AD/ADRD, and have experienced underdiagnosis, cultural stigmas, and less access to dementia care. In New York City specifically, 28.6% of Chinese American seniors live in poverty, leading to environmental racism, a lower likelihood of engagement in activities, decreased quality of life, and an increased risk of cognitive decline and developing dementia. Recommendations to support activity engagement among Chinese Americans include fostering social cohesion and linking individuals to local activity resources. Green activity prescriptions (GAPs) are one approach to achieving these objectives, and combine nature, social contexts, and meaningful activities to improve health and well-being. GAPs are co-designed with participants based on their interests, needs, and available community resources. Examples include: animal-assisted interventions, gardening, green exercise (walking), and conservation projects (composting). Past studies have provided evidence that these components have improved well-being for PLWD, supported function, and provided meaningful engagement. Yet, these early studies neglected Chinese Americans. GAPs have potential to support the health and well-being of Chinese American PLWD by addressing health inequalities and providing accessible, low-cost care, all while sustaining local green resources. Here we present the study design and implementation outcomes, including recruitment and engagement strategies, of a GAP intervention utilizing a community-based participatory approach aimed at supporting the health and well-being of Chinese American PLWD residing in lower-socioeconomic households within Brooklyn, NY.

Trust-building in countering violent extremism programs: a Muslim youth perspective

ABSTRACTThis paper explores the perspectives of young Australian Muslims and their reasons for distrusting government-led countering violent extremism (CVE) programs, while further discussing potential strategies to build trust. While previous literature has examined the relationship between the Muslim community and law enforcement in counterterrorism contexts, there is limited research on the perspectives of young Muslims involved in CVE programs. A phenomenological method was used to analyze the data. The findings indicate that these young Muslims do not question the intentions of individual CVE workers, but they do lack trust in the police as an organization and the government in general. The research recognizes the significance of both external and internal factors in shaping trust or distrust, while highlighting that a narrow focus on community policing as a means to build trust has contributed to the existing distrust among young Muslims. To address these issues, the paper suggests the implementation of a Community-Based Participatory Approach (CBPA) that empowers young Muslims by involving them in the CVE design process. This approach allows for greater community engagement and helps address the trust deficit by giving young Muslims a voice in shaping the direction and outcomes of their involvement.

Development and Evaluation of a Nurse Practitioner Huddles Toolkit for Long Term Care Homes.

Long-term care homes (LTCHs) were disproportionately affected by the coronavirus disease (COVID-19) pandemic, creating stressful circumstances for LTCH employees, residents, and their care partners. Team huddles may improve staff outcomes and enable a supportive climate. Nurse practitioners (NPs) have a multifaceted role in LTCHs, including facilitating implementation of new practices. Informed by a community-based participatory approach to research, this mixed-methods study aimed to develop and evaluate a toolkit for implementing NP-led huddles in an LTCH. The toolkit consists of two sections. Section one describes the huddles' purpose and implementation strategies. Section two contains six scripts to guide huddle discussions. Acceptability of the intervention was evaluated using a quantitative measure (Treatment Acceptability Questionnaire) and through qualitative interviews with huddle participants. Descriptive statistics and manifest content analysis were used to analyse quantitative and qualitative data. The project team rated the toolkit as acceptable. Qualitative findings provided evidence on design quality, limitations, and recommendations for future huddles.

Enhancing Counseling Services in Secondary Schools Through the Implementation of Training Modules and Counseling Materials for Peer Counselors

The implementation of this community service aims to address issues in counseling services in remote secondary schools, resulting from the lack of counselors with a background in counseling education. Counselors often play the role of subject teachers, leading to suboptimal counseling implementation, causing students in need of psychosocial assistance to receive inadequate services. The form of community service utilized combines Service Learning and Community-Based Participatory approaches. Lecturers and students actively engage in developing and implementing training modules and counseling materials for adolescent peer counselors. Meanwhile, the community, particularly secondary schools and peer counselors, are invited to participate in designing and adapting modules to fit the local context and needs. The solution derived from this community service is the development of relevant and effective training modules and counseling materials to enhance the competence of peer counselors in providing support and counseling to their peers. With the existence of these modules, it is anticipated that counseling services in remote secondary schools can be improved, ensuring that students in need of psychosocial assistance are better served. In conclusion, the implementation of this community service combines the Service Learning and Community-Based Participatory approaches to address issues in counseling services in remote secondary schools. The development of training modules and counseling materials emerges as a relevant and effective solution to enhance the quality of counseling services, involving the community as partners in the decision-making process and service implementation. It is expected that this community service will have a positive impact in assisting adolescents in overcoming issues and increasing awareness and social support within the school environment.
 Keywords: Counseling Services, Peer Counseling, Training Modules, Counseling Materials

S6: Adapting and implementing WHO iSupport among dementia caregivers worldwide: users' perspectives and future development (Session I)

Symposium OverviewThe WHO Global Action Plan against Dementia calls for “at least 75% of member states providing carer support and training by 2025”. In response to the global target, WHO has developed iSupport aiming to provide support for caregivers of people living with dementia. The generic WHO iSupport has been translated and adapted in 39 countries and 37 languages so far. The adapted versions of WHO iSupport are now being implemented worldwide, usually as an online program for caregivers. The feasibility, accessibility, effectiveness and sustainability of the iSupport program in different cultural context is now being explored extensively. This symposium aims to share the up-to-date research findings and lessons learned on the adaptation and implementation process and users’ perspectives from diverse cultural background. It will include seven presentation and be divided into sessions: 3 presentations on Session I and 4 presentations on Session II.Session I: The first presentation will be dedicated to overviewing the development and the progress of adaptation and implementation of WHO iSupport. The second presentation will focus on the adaptation of iSupport in Uganda. The presentation will inform the utility of iSupport in Sub-Sahara Africa. Based on individual semi-structural interview data from Tunisia, the third presentation will highlight that caregivers’ experience and needs are valuable for cultural adaptation of iSupport.Session II: The first presentation will demonstrate how facilitator-enabled iSupport intervention would change the interaction and engagement in learning among Chinese caregivers living in Australia and Greater China. The second presentation will focus on adapting iSupport in Switzerland using a community-based participatory approach. The third presentation will show the potential benefit of raising awareness of the Russian society about dementia after the implementation of iSupport through digital technologies. The fourth presentation will report on the co-design of an adapted version of iSupport for young caregivers.The symposium is expected to inform further development, improvement and implementation of WHO iSupport for diverse cultural background. This will be not only valuable information for participants who are interested in iSupport but also for those (interested in) investigating interventions developed in another cultural setting.

S20: Adapting and implementing WHO iSupport among dementia caregivers worldwide: users' perspectives and future development (Session II)

The WHO Global Action Plan against Dementia calls for “at least 75% of member states providing carer support and training by 2025”. In response to the global target, WHO has developed iSupport aiming to provide support for caregivers of people living with dementia. The generic WHO iSupport has been translated and adapted in 39 countries and 37 languages so far. The adapted versions of WHO iSupport are now being implemented worldwide, usually as an online program for caregivers. The feasibility, accessibility, effectiveness and sustainability of the iSupport program in different cultural context is now being explored extensively. This symposium aims to share the up-to-date research findings and lessons learned on the adaptation and implementation process and users’ perspectives from diverse cultural background. It will include seven presentation and be divided into sessions: 3 presentations on Session I and 4 presentations on Session II.Session I: The first presentation will be dedicated to overviewing the development and the progress of adaptation and implementation of WHO iSupport. The second presentation will focus on the adaptation of iSupport in Uganda. The presentation will inform the utility of iSupport in Sub-Sahara Africa. Based on individual semi-structural interview data from Tunisia, the third presentation will highlight that caregivers’ experience and needs are valuable for cultural adaptation of iSupport.Session II The first presentation will demonstrate how facilitator-enabled iSupport intervention would change the interaction and engagement in learning among Chinese caregivers living in Australia and Greater China. The second presentation will focus on adapting iSupport in Switzerland using a community-based participatory approach. The third presentation will show the potential benefit of raising awareness of the Russian society about dementia after the implementation of iSupport through digital technologies. The fourth presentation will report on the co-design of an adapted version of iSupport for young caregivers.The symposium is expected to inform further development, improvement and implementation of WHO iSupport for diverse cultural background. This will be not only valuable information for participants who are interested in iSupport but also for those (interested in) investigating interventions developed in another cultural setting.

Lessons Learned Developing Client Navigation for People who are Trans and Gender Diverse

Abstract: Background: People who are trans and gender diverse (PTGD) are underserved regarding healthcare in Canada, including the province of Saskatchewan. Objectives: Design and conduct a research project that will address immediate and pressing community-identified needs related to improving access to healthcare for PTGD in Saskatchewan. Methods: A multidisciplinary, community-based collaboration was established to address the self-identified obstacles to accessing healthcare of PTGD in Saskatchewan. This resulted in a pilot study creating and evaluating a healthcare navigation program. Lessons Learned: The project led to four key lessons: 1) prioritizing team building and the well-being of team members; 2) committing to community-based participatory approaches from the outset; 3) taking language seriously; and 4) acknowledging and addressing power imbalances in our team. Conclusions: The lessons we learned have enabled us to sustain a large, diverse, research team that centers the experience of PTGD in Saskatchewan and is responsive to community need.

A community-based approach to identifying and prioritising young people’s mental health needs in their local communities

BackgroundIdentifying locally relevant and agreed-upon priorities for improving young people’s mental health, aligned with social and environmental factors, is essential for benefiting target communities. This paper describes a participatory approach to engage young people and professionals in identifying such priorities, whilst considering the social determinants related to them.MethodsWe utilised a community-based participatory approach to support young people and professionals in identifying, reviewing, refining, and prioritising, locally relevant opportunity areas that are crucial for understanding and addressing social determinants of young people’s mental health. We adopted a flexible five-stage process, which enabled greater reflection and adaptation in response to young people’s and professionals’ feedback and reflections.ResultsOver seven months, we engaged with young people and professionals in Northern Devon, (a rural area in southwest England), involving over 290 individuals to identify locally relevant priorities for supporting young people’s mental health. Three priorities were identified for subsequent exploration using co-design approaches: (1) identity and belonging; (2) mental health awareness and literacy; and (3) diverse opportunities (for education, employment and leisure). The engagements suggested that designing initiatives and strategies in these areas could contribute to improvements in young people’s mental health.ConclusionYoung people in Northern Devon prioritised three themes for the next phase of the Kailo Programme—mental health literacy, access to diverse careers and employment opportunities, and identity and belonging within their communities. Rural communities face unique barriers associated with these issues, related to less diverse populations, lack of access to reliable and affordable transport and local industries, and seasonal working. The perceived neglect by authorities towards rural young people has resulted in a lack of activities and opportunities catering to their specific needs, compared to urban areas. Although the government has recognised the need to address these disparities, community members suggest that there is still more work to be done.