Community-based Participatory Research Approach Research Articles

Expanding our understanding of digital mental health interventions for Indigenous youth: An updated systematic review.

Past research has examined available literature on electronic mental health interventions for Indigenous youth with mental health concerns. However, as there have recently been increases in both the number of studies examining electronic mental health interventions and the need for such interventions (i.e. during periods of pandemic isolation), the present systematic review aims to provide an updated summary of the available peer-reviewed and grey literature on electronic mental health interventions applicable to Indigenous youth. The purpose of this review is to better understand the processes used for electronic mental health intervention development. Among the 48 studies discussed, smoking cessation and suicide were the most commonly targeted mental health concerns in interventions. Text message and smartphone application (app) interventions were the most frequently used delivery methods. Qualitative, quantitative, and/or mixed outcomes were presented in several studies, while other studies outlined intervention development processes or study protocols, indicating high activity in future electronic mental health intervention research. Among the findings, common facilitators included the use of community-based participatory research approaches, representation of culture, and various methods of motivating participant engagement. Meanwhile, common barriers included the lack of necessary resources and limits on the amount of support that online interventions can provide. Considerations regarding the standards and criteria for the development of future electronic mental health interventions for Indigenous youth are offered and future research directions are discussed.

565 Empowering Community Organizations with the Team Science Community Toolkit

OBJECTIVES/GOALS: To introduce the new Team Science Community Toolkit, co-created by community and academic partners, and showcase its potential to empower Community Organizations (COs) in achieving equity in community-engaged research (CER). METHODS/STUDY POPULATION: In response to the challenges faced by COs in CER collaborations, qualitative interviews were conducted with CO staff from historically marginalized communities. These interviews informed the development of the Team Science Community Toolkit, a collaborative effort involving a Community Advisory Board (CAB) and Team Science experts from Northwestern University. The toolkit, designed using a community-based participatory research approach, incorporates the Science of Team Science and User-Centered Design principles. Integrated into the NIH-sponsored COALESCE website, it includes templates, checklists, and interactive tools, along with a real-world simulation, to support COs in all stages of the research process. RESULTS/ANTICIPATED RESULTS: Focus groups and usability testing involving external community experts validated the toolkit’s content and usability. Participants expressed enthusiasm and a sense of empowerment, indicating that the toolkit allows them to actively shape research processes and infuse their specific voices and needs into their partnerships. The toolkit is designed to support breaking down barriers like jargon and cultural adaptability to improve accessibility and open conversation. The impact of this Team Science focused toolkit is under evaluation. This presentation will showcase the toolkit, detail its collaborative development, and explore potential applications, ultimately offering a path to more equitable and valuable community-based research. DISCUSSION/SIGNIFICANCE: By providing COs with the resources and knowledge to participate as equal partners in research collaborations, it enhances self-advocacy, transparency, and equity. The toolkit has the potential to utilize Team Science to foster productive communication in community-academic research partnerships.

192 Developing a community laundromat intervention to increase reproductive health literacy outreach

OBJECTIVES/GOALS: The project goal was to conduct formative work using community-based participatory research (CBPR) to inform the development of a laundromat-based reproductive health literacy intervention (LI)informed by Passhe-Orlow and Wolf’s Conceptual Model. We provide insights to support the development of similar health literacy interventions. METHODS/STUDY POPULATION: In Phase I, we recruited female patrons over the age of 18 living in DC from 4 community laundromats. Participants completed a survey with validated measures to assess reproductive health knowledge, self-efficacy, and intentions to seek care. Open-ended questions assessed participants’ experiences accessing care, communication with health providers, and laundromat use. Data informed the development of a 2-3 minute reproductive health literacy intervention (LI) storyboard. In Phase II, in-depth interviews were conducted with reproductive health providers (midwives, obstetricians-gynecologists, women’s health registered nurses, women’s health nurse practitioners) working in the communities where the laundromats are located. LI acceptability and appropriateness were explored. RESULTS/ANTICIPATED RESULTS: For Phase I, we recruited 60 patrons. Participants (68.3%) expressed interest in a laundromat-based reproductive health literacy intervention (LI). Identified reproductive knowledge gaps included: unaware of fertile days (50.0%); believe prenatal care should begin after 2nd trimester of pregnancy (50.0%); unclear about pregnancy spacing (85.0%); unable to identify use for folic acid (91.7%); believe once a cesarean always a cesarean (53.3%). In Phase II, all 14 providers supported increasing community accessibility to health information: “we have to move beyond doing public health education in a provider’s office. That’s very outdated.” Providers identified the LI as an approachable, informative, and accessible way to disseminate health information. DISCUSSION/SIGNIFICANCE: Patron and provider input informed our choice of content, style, and delivery of the reproductive health literacy intervention. An essential aspect of our CBPR approach, this research will inform effective, appropriate reproductive health education despite barriers presented by access, transportation, and work schedules.

Qualitative study of factors affecting engagement with a hospital-based violence intervention programme in Indianapolis, Indiana

BackgroundThere are few qualitative studies of firearm injury survivors and hospital-based violence intervention programme (HVIP) participants. The original study aimed to identify facilitators and barriers to survivors’ utilisation of mental...

Abstract 3945: The development of a culturally adapted tobacco prevention curriculum for LGBTQ+ youth across California: Formative research

Abstract Purpose: LGBTQ+ youth exhibit some of the highest rates of tobacco use and tobacco-related morbidity and mortality, making access to cancer prevention at an early age particularly critical. The purpose of this study is to develop an LGBTQ+ culturally tailored tobacco prevention curriculum within the Stanford Tobacco Prevention Toolkit, to help prevent LGBTQ+ students from starting or escalating the use of any tobacco product. Methods: A community-based participatory research (CBPR) was established between the Cedars-Sinai Cancer Research Center for Health Equity, facilitated by Community Outreach and Engagement, in collaboration with The Wall Las Memorias and the Stanford REACH Lab to conduct basic formative focus groups in the LGBTQ+ community. Seventy-six participants were recruited, and 9 focus groups were conducted (33 participants among LGBTQ+ youth; 19 community advocates and educators; and 24 parents/caregivers/guardians). A thematic analysis was conducted to identify lesson topics and subject matter content to be included in the curriculum and the best strategies to deliver the lesson to LGBTQ+ youth. Results: Several themes emerged from the focus groups, including an overall theme noting a desire for more safe spaces and peer support to discuss tobacco, vaping, and marijuana use among LGBTQ+ youth. LGBTQ+ youth noted tobacco, vaping, and marijuana were very accessible through friends and social groups in the school setting. They also expressed that tobacco, vaping, and marijuana use were associated with pressures to fit in, an increasing ‘normalization’ of marijuana use, and social media channels that glorify vaping and tobacco use. LGBTQ+ youth also expressed that they do not see tobacco prevention messaging relevant to themselves or their peers nor through their preferred information channels. Parents, educators, and community advocates expressed that they would like to be offered opportunities for education and direct involvement in LGBTQ+ research. With this information, the REACH Lab is developing the LGBTQ+ curriculum. Conclusions This CBPR approach builds upon the existing validated set of curricula contained in the Stanford Tobacco Prevention Toolkit, which is theory-driven and has reached over 3 million middle and high school students. Once completed, the LGBTQ+ Focused Tobacco Prevention Curriculum will be added to the Tobacco Prevention Toolkit and will be the first informed/validated tobacco prevention program for LGBTQ+ youth. Citation Format: Michael Fine, Zulfikarali Surani, Laurel J. Finster, Juanita T. Greene, Carly L. Kajiwara, Richard Zaldivar, Bonnie Halpern-Felsher, Robert W. Haile. The development of a culturally adapted tobacco prevention curriculum for LGBTQ+ youth across California: Formative research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3945.

Using community-based participatory research to support the development of a co-located intergenerational program

This paper presents the findings of a ten-week research project exploring the intricacies of a co-located intergenerational program in Southeast Queensland. The research involved an early learning centre, North Early Learning, operated by a large not-for-profit organisation, Queensland Child Learning, and an aged care residence, Aged Care Living (pseudonyms). The research question underpinning this paper focused on identifying the views of educators, children, and families currently attending the early childhood education and care centre who will participate in the co-located intergenerational program. Employing a community-based participatory research approach, the study explores the perspectives of educators, children, and families participating in the program through visual children’s surveys, facilitated interviews, and online surveys. The findings highlight positive attitudes from educators and families toward intergenerational programs, leading to the development of an implementation timeline aligned with the needs of educators, children, and families that are reflective of the unique context of the centre.

Decolonizing Indigenous Drinking Water Challenges and Implications: Focusing on Indigenous Water Governance and Sovereignty

Indigenous Peoples in Canada have shown great strength and resilience in maintaining their cultures and ways of life to date in the face of settler colonialism. Centering the Water crises within Indigenous sovereignty and self-determination, we explore the impacts these crises have on community members. Particularly, the continuous failure of the Canadian government to end the Water crises in remote Indigenous communities, Star Blanket Cree Nation, is investigated in this paper. What implications have these Water governance gaps had on Indigenous Peoples’ sovereignty and self-determination? We adopted an Indigenist theoretical framework to guide the study. Additionally, a community-based participatory research approach was adopted. To achieve our research goals of investigating the implications of the current Water crises for Indigenous sovereignty and self-determination, specific methods of sharing circles were used to gather knowledge from community members, Elders, and knowledge keepers. The research findings strongly highlight the strength and resilience shown by remote Indigenous communities in the face of the current Water crises and continuous government failure. Solving the current Water crises will involve remote Indigenous communities taking charge of their own Water governance through Indigenous-led Water governance systems. Additionally, taking steps to rebuild trust through genuine reconciliation will be key. Therefore, listening to remote Indigenous communities and taking collaborative action are fundamental.

The utility of community-based participatory research: Increasing research engagement among minoritized ethnoracial groups.

This article conceptually examined the need for and utility of community-based participatory research (CBPR) approaches for increasing rates of engagement in psychological research among underserved minoritized ethnoracial groups. This article examined the literature for relevant studies examining rates of research engagement by minoritized ethnoracial groups, significant factors precluding research engagement, and the consequences of this disparity for mental health outcomes. The theoretical literature outlining the development and utility of alternative, community-based participatory research methods was included. Key features of CBPR were examined along with limitations of current approaches. A case study example of CBPR is provided. The use of CBPR approaches has been documented to improve health outcomes, reduce stigma toward mental health research and treatment, and build the professional capacity of community partners, particularly among minoritized ethnoracial groups. CBPR engagement practices are a means of reducing the mental health research gap for ethnic and racial minoritized groups. The use of such approaches in future research and practice will directly inform how existing psychological treatments may be modified per the needs of the patient, address long standing issues of cultural mistrust toward professional institutions, and reduce mental health stigma in underserved communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Experiences of transgender persons in accessing routine healthcare services in India: Findings from a participatory qualitative study.

Despite having a higher burden of health problems, transgender persons face challenges in accessing healthcare in India. Most studies on healthcare access of transgender persons in India focus only on HIV related care, mental healthcare, gender affirmative services or on the ethno-cultural communities or transgender women. This study fills this gap by focusing on diverse gender identities within the transgender community with a specific focus on experiences in accessing general or routine healthcare services. A qualitative descriptive approach was used in this study. 23 in-depth interviews and 6 focus group discussions were conducted virtually and in-person with a total of 63 transgender persons in different regions of India between May and September 2021. The study used a community-based participatory research approach and was informed by the intersectionality approach. Thematic analysis was conducted to analyze the data. Four key themes emerged: (i) intersectional challenges in accessing healthcare start outside of the health system, continue through cisgender-binary-normative health systems that exclude transgender persons; and at the interface with individuals such as health professionals, support staff and bystanders; (ii) the experiences negatively impact transgender persons at an individual level; (iii) in response, transgender persons navigate these challenges across each of the levels: individual, health system level and from outside of the health system. This is a first of its kind qualitative participatory study focusing on routine healthcare services of transgender persons in India. The findings indicate the need to move conversations on trans-inclusion in healthcare from HIV and gender affirmative services to routine comprehensive healthcare services considering the higher burden of health problems in the community and the impact of poor access on their lives and well-being.

Radical Healing Community-Based Participatory Research to Eliminate Health Disparities

The health disparities experienced by Black older adults are associated with social determinants of health, all of which are inextricably linked to anti-Black racism. Research led by counseling psychologists has implications for promoting mental and physical health equity. We describe a new model, based on the integration of the radical healing framework and the community-based participatory research (CBPR) approach, for promoting mental and physical health and wellness among Black older adults. This model is called the radical healing CBPR model. Finally, we provide an example of a program informed by this model that helped improve the health outcomes and quality of life of Black older adults living in the low-income area of a city in the southeastern part of the United States. Notably, Black adults similar to the program participants, participated in the development and implementation of this program in ways that are consistent with the radical healing CBPR model.

Using community-based, participatory qualitative research to identify determinants of routine vaccination drop-out for children under 2 in Lilongwe and Mzimba North Districts, Malawi

ObjectiveIn recent years, full childhood routine immunisation coverage has fallen by 5% to levels not seen since 2008; between 2019 and 2021, 67 million children were undervaccinated. We aimed to...

The Radical Welcome Engagement Restoration Model and Assessment Tool for Community-Engaged Partnerships.

People experiencing addiction, houselessness, or who have a history of incarceration have worse health outcomes compared with the general population. This is due, in part, to practices and policies of historically White institutions that exclude the voices, perspectives, and contributions of communities of color in leadership, socio-economic development, and decision-making that matters for their wellbeing. Community-based participatory research (CBPR) approaches hold promise for addressing health inequities. However, full engagement of people harmed by systemic injustices in CBPR partnerships is challenging due to inequities in power and access to resources. We describe how an Allentown-based CBPR partnership-the Health Equity Activation Research Team of clinicians, researchers, and persons with histories of incarceration, addiction, and houselessness-uses the Radical Welcome Engagement Restoration Model (RWERM) to facilitate full engagement by all partners. Data were collected through participatory ethnography, focus groups, and individual interviews. Analyses were performed using deductive coding in a series of iterative meaning-making processes that involved all partners. Findings highlighted six defining phases of the radical welcome framework: (a) passionate invitation, (b) radical welcome, (c) authentic sense of belonging, (d) co-creation of roles, (e) prioritization of issues, and (f) individual and collective action. A guide to assessing progression across these phases, as well as a 32-item radical welcome instrument to help CBPR partners anticipate and overcome challenges to engagement are introduced and discussed.

Stakeholder perceptions of gaps and solutions in addressing child trafficking

IntroductionGovernments, researchers, and community-based organizations have mobilized to develop interventions and programs addressing child trafficking, resulting in large amounts of financial resources allocated to awareness-raising campaigns, crisis services for survivors, and increasing judicial responses to trafficking. Low-resource and low-income countries face the dual challenge of addressing child trafficking within an environment where extreme poverty is pervasive and customary norms might conflict with national anti-trafficking policies. The purpose of this study is to understand challenges faced in addressing child trafficking and identify interventions that are community-driven and contextually relevant. MethodologyThe study used a qualitative community-based participatory research approach by collaborating with local researchers, government, and NGOs to examine how key stakeholders perceive existing gaps in policies and programs aimed at countering child trafficking in Sierra Leone. ResultsSix gaps in policies and services were identified by stakeholders: access to and availability of local programs and services for families; access to and affordability of schooling and vocational training in local communities; lack of policy implementation and enforcement of existing laws, especially at the local level; inadequate funding for anti-trafficking service providers; lack of community support for survivors of trafficking, and a lack of coordinated and consistent community response. In a demonstration of the trauma-informed and survivor-centered study design, participants also suggested possible ways to bridge these gaps. Discussion and conclusionAn ecological approach is critical in designing policies and programs responsive to the complex problem of child trafficking within an environment of low resources and potential conflicts between cultural norms and national policies. Practitioners in such contexts must be culturally-competent and prepared to seamlessly work across the micro-mezzo-macro continuum to enhance the best interest of the child.

Toward Sustaining Web-Based Senior Center Programming Accessibility With and for Older Adult Immigrants: Community-Based Participatory Research Cross-Sectional Study.

During the COVID-19 pandemic, many community-based organizations serving Asian Americans pivoted to provide web-based care and social services. Asian American community leaders in the United States Pacific Northwest, including Asian Health & Service Center expressed that there are older immigrant adults who experienced backlash from discrimination, fear, and anxiety owing in part to anti-Asian hate and isolation, including from infection precautions. Pivoting supported staying safe from COVID-19 transmission and anti-Asian hate crimes. This study aims to examine the readiness of diverse groups of older Asian American immigrant adults (Chinese, Koreans, and Vietnamese) to use a web-based senior center, including technology access and telehealth use, and to identify the psychosocial health impacts that a web-based senior center could be positioned to meet. A community-based participatory research approach was used to conduct a cross-sectional survey study in an Asian-based health and service center in 2022. We selected surveys from the National Institutes of Health-supported PhenX Toolkit. Analyses were performed using R software. There was an 88.2% (216/245) response rate. Overall, 39.8% (86/216) of participants were Chinese, 25% (54/216) were Korean, and 24.5% (53/216) were Vietnamese. There were significant group differences in mobile data plans (P=.0005). Most had an unlimited mobile data plan (38/86, 44% Chinese; 39/54, 72% Koreans; 25/53, 47% Vietnamese). Significant group differences existed regarding whether they started using a new electronic device to communicate with friends or family after the COVID-19 outbreak (P=.0005); most were Korean participants (31/54, 57%). For written text and audio or video apps, most Chinese participants used WeChat (65/85, 76%; 57/84, 68%, respectively), most Koreans used KakaoTalk (49/54, 91%; 49/54, 91%, respectively), and most Vietnamese used Facebook Messenger for written text (32/50, 64%) and Apple Face Time (33/50, 66%) or Facebook Messenger (31/50, 62%) for audio or video. Significant group differences existed regarding whether to try telehealth (P=.0005); most Vietnamese expressed that they would never consider it (41/53, 77%). Significant group differences existed regarding how well they were able to concentrate (χ22=44.7; P<.0001); Chinese participants reported a greater inability (median 5, IQR 4-6). With regard to difficulties in life experiences (χ22=51; P<.0001), the median was 6 (IQR 5-7) for the Vietnamese group. Significant group differences existed in having had a family/household member's salary, hours, and contracts reduced (P=.0005) and having had a family/household member or friend fallen physically ill (P=.0005)-most Vietnamese (15/53, 28%) and Korean participants (10/53, 19%). To build an efficacious, web-based senior center with web-based care and social service options, more older adults need access to the internet and education about using technology-enabled communication devices. Addressing the unique psychosocial impacts of the COVID-19 pandemic on each group could improve health equity. The strength of the participating older adults was observed and honored.

INFLAMMATORY BOWEL DISEASE (IBD) COMMUNITY PREFERENCES FOR PSYCHOSOCIAL SUPPORT: THE ROLE AND SCOPE OF PEER SUPPORT FOR YOUTH WITH IBD

Abstract INTRODUCTION Youth with inflammatory bowel diseases (IBD) experience psychosocial challenges which can negatively impact their body image, self-efficacy, IBD symptoms, and risk of disease recurrence. Peer support programs have high desirability amongst IBD patients and can improve disease management skills, self-efficacy, and mental health generally. Existing peer support programs vary, ranging from one-on-one peer coaching to professionally-led support groups to IBD summer camps. However, there is limited research identifying best practices for peer support in IBD. Community-based participatory research (CBPR) is a framework that centers patient voices in all phases of research, providing an opportunity to equitably represent patient preferences in the development of peer support programs. METHODS Our mixed-methods community survey was disseminated across the US to adults eighteen or older with IBD via patient organizations. This survey assessed patient preferences for a peer support program, including structure (e.g., support group, 1:1 mentor, group activities) and program topics (e.g., body image, social life, medical care). Participants ranked these on a 5-point Likert scale (from “Not at all important” to “Extremely important”) and also had an open-ended opportunity to provide other topic suggestions. Given our CBPR approach, we recruited a Patient Advisory Board (PAB), composed of adults diagnosed with IBD in childhood, and conducted one-on-one interviews to assess patient perspectives of the survey results. RESULTS Our sample included 77 participants (mean age 29, 39.5% with ulcerative colitis, 60.5% with Crohn’s disease). Participants ranked doing non-IBD activities (e.g., games, meals) as quite a bit important, while IBD activities (e.g., IBD comic book) were ranked moderately important. PAB members emphasized that the strength of a patient-led support program is the shared experience and “normalcy” of having IBD, and that limiting a program to IBD activities wouldn’t allow for spontaneous conversation and trust-building. The average ranking of all topics surveyed fell between “extremely important” to “quite a bit important.” In order of importance, topics included navigating social life and mental health, increasing independence while growing older, planning for the future, communicating with the healthcare team, disclosure to friends, navigating school, body image, medical management, and nutrition. Themes suggested by participants included sexual intimacy, fertility, and advocacy. PAB members emphasized the role of peer support interventions as complementary to medical care, and specifically, how peer mentorship can allow for ‘real world’ examples of navigating life with IBD, outside traditional topics discussed in medical appointments. We will use this mixed-methods data to inform our design of a novel IBD peer support program.

Promoting Safe and Supportive Health Care Spaces for Youth Experiencing Racism

ObjectiveThis qualitative study applies a community-based participatory research approach to elicit formative data on pediatric patient experiences of racism in the health care setting and to explore clinic-based opportunities for supporting pediatric patients experiencing racism. MethodsThe study is situated within the outpatient practice of a large tertiary academic medical center in a midsize Midwestern city. Community partners were involved in all aspects of the research, including research protocol design, recruitment, data analysis, community dissemination, and manuscript preparation. Participants were youth between 11 and 18 years, in middle or high school, self-identifying as a person of color, Latinx or Indigenous who answered yes to the question “have you ever experienced race-related prejudice and discrimination?” Parent/guardians of youth meeting inclusion criteria participated in separate focus groups. Data were analyzed using an interpretative phenomenological analysis approach. ResultsMajor findings were divided into 2 categories: 1) racism-related experiences in the health care setting; and 2) patient and parent/guardian recommendations to support pediatric patients experiencing racism. Among health care setting experiences, primary emerging themes included racism experienced in the health care setting, patient-clinician communication around racism, patient-clinician concordance, and high-quality clinical care. Recommendations were presented within the 4 domains of racism: intrapersonal, interpersonal, structural, and institutional. ConclusionsRacism experiences worsen child biological, psychological, and behavioral functioning, yet research is lacking on how health care professionals may best support pediatric patients experiencing racism. Study findings suggest opportunities for providing safer and more supportive health care spaces for youth experiencing racism.

Strategies for recruiting adolescents in rural areas in firearm injury research

BackgroundParticipant recruitment is a central aspect of human sciences research. Barriers to participant recruitment can be categorised into participant, recruiter and institutional factors. Firearm injury research poses unique barriers to...

The Impacts of Climate Change on Tourism Operators, Trail Experience and Land Use Management in British Columbia’s Backcountry

Climate change, natural resource industries, and an expanding outdoor tourism sector have recently increased access to sensitive backcountry environments in Western Canada. Trail managers are struggling to manage trail conditions with the mounting effects of smoke, dust, fire, flood, area closures, and beetle outbreaks in their regions. Outdoor recreation trail managers are linking these events and are thinking critically about the history and interconnectedness of land use management decisions in the province of British Columbia (BC). As the effects of climate change continue to challenge both trail managers and sport recreationists, guides and trail associations have been identified as key education facilitators in the development and dissemination of environmental consciousness. Guided by a community-based participatory research approach, this study used personal interviews with trail managers across the province to highlight how a connection with local ecosystems can develop a more robust land ethic for recreational trail user communities in BC.

Examining menstrual health experiences in Philadelphia, PA: A qualitative investigation.

While menstruation is a physiologic process, it remains highly stigmatized. Despite the sheer number of menstruators, menstruation is a highly individualized experience, with wide variation in duration, symptoms, and management. This wide variability lends itself to large disparities in access to menstruation management products and subsequently the lived experience of menstruators. The research team sought to understand lived menstrual experiences, symptoms, management tactics, and commonly used and desired resources among 20 cisgendered women aged 18-45 years in Philadelphia. This project was a qualitative research study. We used a collaborative, community-based participatory research approach with No More Secrets, a Philadelphia-based grassroots sexuality awareness and menstrual health hub. Semi-structured telephone interviews were used to gain insight into general menstruation-related experiences, communication, worries, and concerns, with subsequent thematic analysis via Key Words in Context approach. Four themes emerged following analysis: cycle characteristics, menstruation management, coping resources, and future resources. Participants largely spoke about their menses as a negative experience, asked for more comprehensive, verified sources of information and needed greater access to menstrual management supplies. Menstruation is a highly individualized experience with a large variety in knowledge, menstrual product use, and individual needs. Despite the individuality of menstruation, our community-based research shows that there is a dire need for interventions that promotes knowledge and access to menstrual care.

Binational Academic-Service-Community Partnership: A Program to Train, Provide Services and Conduct Research for Sustainable Community Health in Rural Baja, California, Mexico

Background: Viaje Interinstitucional de Integración Docente, Asistencial y de Investigación (VIIDAI) is a binational community health collaboration involving transdisciplinary education, field training, and research efforts that promotes health and provides services to underserved populations in rural Mexico, while also fostering cultural competency in medical and public health students from the Mexico-U.S. border region. Purpose: This paper describes the development and operation of the VIIDAI academic-community-service organization partnership and clinical and public health training program, and highlights the impact, challenges, road map, and powerful lessons of this binational effort. Methods and Approaches: The VIIDAI partnership is a collaboration between San Diego State University, School of Public Health; Universidad Autónoma de Baja California Tijuana, School of Medicine and Psychology; University of California San Diego, School of Medicine; and Old Mission Rotary. Since 1998, VIIDAI has cooperatively implemented projects using a community-based participatory research approach, integrating community members with faculty, students, and health practitioners from the three universities alongside the Rotary to balance research and action for the mutual benefit of all partners involved. Epidemiologic investigations and interventions, health promotion, and clinical care are conducted with active community engagement during semiannual trips. Field activities are conducted in San Quintín, Baja California, Mexico within a rural, predominately indigenous community, targeting a variety of population-specific public health issues. Results: Since its inception, over 3,300 faculty and students have participated in VIIDAI. The community has responded enthusiastically, with over 14,000 clinic visits and broad participation in health promotion interactions. These efforts have led to improvements in multiple indicators of community health, such as decreased prevalence of anemia; improved access to free potable water; increased numbers of students advancing to secondary schools; reduced family sizes and older age of first pregnancy; increased community interest and engagement in health issues and disease prevention; and increased visibility and empowerment among community leaders. Conclusion: The success of the VIIDAI partnership can be attributed to five key elements: (1) stable, long-term leadership; (2) guidance from the host country; (3) equal partnership with the local community; (4) support from a non-academic service organization to help fulfill unmet needs; and (5) mutually beneficial involvement across all participants.