Community-based Participatory Research Methods Research Articles

'Is It Safe? Is it not?' A Youth-Led Photovoice Study of Youth Perspectives of COVID-19 Vaccine Confidence.

Youth have been uniquely affected by the COVID-19 pandemic. Despite high rates of COVID-19 infection, youth had one of the lowest vaccine uptake rates. Certain characteristics can affect vaccine uptake, such as mental health and substance use, but it is important to understand uptake for an effective response to pandemics. This study examined the perspectives of youth with mental health or substance use concerns on COVID-19 vaccine confidence, hesitancy and overall COVID-19 vaccine perspectives. Using photovoice, a community-based participatory research method, a sample of 27 youth aged 14-24 years participated in a series of photography workshops and focus groups. Participants submitted final photographs for discussion. Focus groups were recorded, transcribed and thematically analysed. Four themes were generated: (1) Youth deciphered the vaccine discourse in a changing information landscape; (2) mixed perspectives of families, friends and loved ones influenced the vaccine journey; (3) complex societal influences affected views and decisions around the COVID-19 vaccine; and (4) youth navigated their vaccine journeys through first- and second-hand experiences. The four themes and subthemes highlight the evolution of youth's journeys with the COVID-19 vaccine over the course of the pandemic and into the late-pandemic period. Youth with mental health or substance use challenges navigated a complex environment during the COVID-19 pandemic. The wide variety of factors influencing vaccine perspectives should be taken into account in public health messaging and future research on youth vaccine uptake. Youth-led and youth-engaged research can help solicit rich and meaningful perspectives of young people on important public health issues. This was a youth-led study. A youth research analyst conducted the study activities together with the support of a youth advisory group, an adult photographer with lived experience, and a scientific team.

Abstract B099: Addressing cancer disparities in the United States-Affiliated Pacific Island jurisdictions: Insights from the Scaling What Works program

Abstract Purpose The Scaling What Works (SWW) program aimed to build the capacity of National Comprehensive Cancer Control Program (NCCCP) recipients to scale three CDC-identified cancer control projects through training, mentorship, and technical assistance (TA). The SWW program held a Symposium to provide in-person training on adapting, implementing, evaluating, sustaining, and scaling the three projects. We recruited 100% of US-Affiliated Pacific Island (USAPI) NCCCP programs (n=6), who made up approximately 26% of all programs that attended the Symposium (n=23). The USAPI jurisdictions face high cancer burden due, in part, to the United States nuclear legacy, the effects of climate change, limited medical infrastructure, and lack of culturally competent, centralized care across the almost 4,000 miles that the USAPI spans. Through the SWW program, USAPI recipients are supported in their ongoing efforts to mitigate cancer disparities affecting their communities. MethodsWe applied community-based participatory research methods and health equity principles to ensure the SWW program was relevant and responsive to the USAPI recipients’ contexts and needs. We created a SWW subcommittee to learn about and advocate for the specific needs of the USAPI. The committee spoke with ten clinicians and researchers with experience working in the USAPI, across four informal meetings, to understand the unique cancer prevention and control context of each USAPI jurisdiction. The committee reviewed USAPI cancer plans and extracted data related to SWW activities, including cancer prevention priorities, community partners, demographic characteristics, and healthcare infrastructure. Data were added to a matrix, coded, and summarized by subcommittee team members to develop a USAPI fact sheet. We shared the fact sheet with SWW Symposium facilitators and mentors to provide them with the necessary information to support the USAPI programs. Findings We identified components critical to providing effective training and TA that will support USAPI-led work to address disparities in cancer prevention and control. These components include 1) acknowledging the current and historical power dynamics that establish the USAPI cancer prevention and control program space, 2) adjusting generalized training content to each jurisdiction’s unique context and cancer prevention goals, 3) adapting communication strategies to USAPI programs’ preferences and time zones, 4) facilitating networking opportunities both between NCCCP USAPI jurisdictions and across all NCCCP recipients to build a SWW community of practice, and 5) establishing a sustained, bidirectional partnership between USAPI program leaders and the SWW team to collaborate on future cancer prevention and control projects and to provide training and TA, as needed. ConclusionsThe lessons learned from SWW regarding health equity and capacity-building can inform the efforts of researchers, evaluators, and training and TA providers working with USAPI jurisdictions, states, and territories engaged in cancer prevention and control work. Citation Format: Amy L. Tran, Mary Wangen, Renée M. Ferrari, Jingle Xu, Alison T. Brenner, Stephanie B. Wheeler, Rebecca J. Lee, Elizabeth A. Rohan, Angela R. Moore, Shixiu Wang, Alyssa LaMonica, Mary Puckett, Amy L. Thompson, CK Smith, Katie Jones, Malesa Pereira, Rogelio Robles-Morales, Lori A. Crane, Courtney N. Petagna, Thuy T. Vu, Betsy C Risendal, Rachel Hirschey. Addressing cancer disparities in the United States-Affiliated Pacific Island jurisdictions: Insights from the Scaling What Works program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B099.

Initial development of the Sugar-Sweetened Fruit Drink Questionnaire for examining beliefs, knowledge, and behaviors in an intervention to reduce sugar-sweetened fruit drink intake in Alaska Native children.

Alaska Native children may be at increased risk for dental caries because of added sugar intake from sugar-sweetened fruit drinks. This study describes development of a questionnaire to (a) assess Alaska Native caregivers' beliefs, knowledge, and behaviors regarding sugar-sweetened fruit drinks, and (b) describe behavior changes within a community-based intervention. Questionnaire development was conducted in three phases with Yup'ik Alaska Native caregivers in Southwest Alaska: (1) initial selection and adaptation of questionnaire items; (2) cognitive testing; and (3) data collection. The Sugar-Sweetened Fruit Drink Questionnaire (SFDQ) contains 31 culturally-tailored items across six areas: beliefs/values, environment/skills, knowledge, motivation, self-efficacy, and behaviors. Eighty-one percent of caregivers gave their children sugar-sweetened fruit drinks. Motivations included: what they grew up with (52%), few other options (46%), makes child happy (46%), healthier than soda (45%), and others in community drink them (42%). On average, 93% of caregivers believed drinking a lot of sugar-sweetened fruit drinks leads to cavities in children and caregivers agreed (mean 4.1 on 5-point scale, 5 = strongly agree) it is important to limit sugar-sweetened fruit drinks. Among a sub-sample of respondents (n = 20), we found low to moderate temporal stability in some SFDQ items over a 10-14 day period, indicating respondent ambivalence and/or uncertainty. Using community-based participatory research methods, we developed a culturally tailored exploratory questionnaire that will be used to describe changes in caregiver knowledge, beliefs, attitudes, self-efficacy, and behavior within a planned intervention to reduce sugar-sweetened fruit drink intake in Alaska Native children.

Discerning Deinfibulation: Impact of Personal, Professional, and Familial Influences on Decision-Making.

The past decades have seen large numbers of Somali women migrate across the globe. It is critical for healthcare workers in host countries to understand healthcare needs of Somali women. The majority of Somali female migrants experience female genital cutting (FGC). The most common type in Somalia is Type 3 or infibulation, the narrowing of the vaginal introitus. Deinfibulation opens the introitus to reduce poor health outcomes and/or allow for vaginal births. In this study, we explored the perspectives of Somali women living in the United States about deinfibulation. We recruited 75 Somali women who had experienced FGC through community-based participatory research methods. Bilingual community researchers conducted qualitative interviews in Somali or English. University faculty and community-based researchers coded data together in a participatory-analysis process. We identified four themes. (1) Personal Views: participants reported positive attitudes toward deinfibulation and varied on the appropriateness of deinfibulation before marriage. (2) Benefits: identified benefits included alleviation of health problems; improved sexual health, in particular reduction or prevention of sexual pain; and reclamation of body and womanhood. (3) Barriers: these included associated stigma and lack of knowledge by providers. (4) Decision-Making: most reported that husbands, healthcare providers, and elder female community members may provide advice about if and/or when to seek deinfibulation, though some felt deinfibulation decisions are solely up to the impacted woman. An ecological framework is used to frame the findings and identify the importance of healthcare workers in assisting women who have been infibulated make decisions.

Operationalizing Racism as a Public Health Crisis: Moving Beyond the Rhetoric!

It is well documented that systemic racism and social injustice result in health inequities for communities of color, including premature death. To date, more than 260 municipalities across the United States have declared racism as a public health crisis. In January 2021, the Nation’s Health, a monthly American Public Health Association newsletter, acknowledged Genesee County, Michigan, as one of the communities leading the work in operationalizing these declarations. This research highlights community engagement and participatory processes, models, and tools used to operationalize racism as a public health crisis in Genesee County. A participatory approach grounded in community-based participatory research (CBPR) methods was used to operationalize Genesee County’s resolution declaring racism a public health crisis. To ensure our efforts centered community voices, experiences, and priorities, our methodology consisted of: 1) hosting community dialogues focused on systemic racism; 2) the novel application of a committee composition matrix to develop a geographically and socially diverse Community Action Council to serve as the decision-making body for our strategic plan to identify and address systemic racism within Genesee County; 3) the development of a draft county-wide strategic plan; and 4) focus groups to review and provide feedback on the drafted strategic plan. CBPR provides guidance for effective community engagement and ensures that community voices are centered when identifying effective responses to systemic racism. CBPR principles also foster co-ownership of solutions, increasing trust, transparency, and accountability between researchers, community members, and other stakeholders.

Substance use approaches among peer support specialists in community mental health early psychosis programs.

Substance use (SU) is common among adolescents and young adults, including those experiencing early psychosis. Coordinated Specialty Care (CSC), a community-based multidisciplinary team-based service model, is increasingly used to support people experiencing first-episode psychosis. In addition to prescribers, clinicians, and vocational specialists, CSC includes peer support specialists who use their own living/lived experience with mental health and treatment to engage and support young people with their recovery goals. Peer support is also foundational in SU recovery. However, little is known about how peer support specialists navigate client SU in CSC. The purpose of this article is to detail CSC peer support SU practice. Informed by community-based participatory research methods, a PhD-level qualitative researcher and a former peer support specialist conducted virtual interviews with 20 CSC peer support specialists. A multidisciplinary team including researchers with lived mental health experiences thematically coded interview transcripts. A spectrum of CSC peer support specialist SU responses emerged: (a) leverages lived SU experiences; (b) does not explore SU with clients; (c) shares client SU information with the CSC team; (d) educates, mentors, and advocates; (e) shares SU consequences and/or challenges substance use; (f) nonjudgmental, nondirective SU exploration; and (g) promotes harm reduction. CSC peer specialist SU practice is influenced by several contextual tensions that must be better understood and addressed in future research to improve peer SU practice. Study findings speak to practice nuances that are helpful for CSC peer support training and supervision. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Using community-based participatory research methods to build the foundation for an equitable integrated health data system within a Canadian urban context

Health inequalities amplified by the COVID-19 pandemic have disproportionately affected racialized and equity-deserving communities across Canada. In the Municipality of Peel, existing data, while limited, illustrates that individuals from racialized and equity-deserving communities continue to suffer, receive delayed care, and die prematurely. In response to these troubling statistics, grassroots community advocacy has called on health systems leaders in Peel to work with community and non-profit organizations to address the critical data and infrastructure gaps that hinder addressing the social determinants of health in the region. To support these advocacy efforts, we used a community-based participatory research approach to understand how we might build a data collection ecosystem across sectors, alongside community residents and service providers, to accurately capture the data about the social determinants of health. This approach involved developing a community engagement council, defining the problem with the community, mapping what data is actively collected and what is excluded, and understanding experiences of sociodemographic data collection from community members and service providers. Guided by community voices, our study focused on sociodemographic data collection in the primary care context and identified which service providers use and collect these data, how data are used in their work, the facilitators and barriers to data use and collection. Additionally, we gained insight into how sociodemographic data collection could be respectful, safe, and properly governed from the perspectives of community members. From this study, we identify a set of eight recommendations for sociodemographic data collection and highlight limitations. This foundational community-based work will inform future research in establishing data governance in partnership with diverse and equity-deserving communities.

Critical Rhetoric Meets Community-Based Participatory Research

ABSTRACT This project responds to a set of methodological challenges for the critical commitments of rhetorical fieldwork and investigates how community-based participatory research (CBPR) methods can help address them. As an example, we draw on Bailey Flynn’s CBPR research with Resilience, a not for-profit “rape crisis center” that provides services and therapy to thousands each year in Illinois. CBPR, like participatory critical rhetoric (PCR) methods, privileges field data as objects of rhetorical analysis. Unlike PCR and other approaches, CBPR methods prioritize the formalization of collaborative relationships with community stakeholders at every stage of research. We argue that greater integration of CBPR methods in rhetorical field methods will aid in privileging the epistemological perspectives of community stakeholders, solidifying critical communication scholarship’s commitment to conducting research with consequences, and providing a common ground for interdisciplinary exchange between critically trained rhetoric scholars and qualitative communication researchers.

Pelatihan Pembuatan & Penggunaan Lembar Kerja Peserta Didik (LKPD) Berbasis Literasi Sains Bagi Guru

<p><em>This Community Service (CS) activity aims to: 1) interpret the competencies possessed by South Konawe MIN 2 teachers in making Student Worksheets (LKPD) so far; 2) increase the ability of South Konawe MIN 2 teachers in designing scientific literacy-based LKPD; and 3) train MIN 2 South Konawe teachers to apply scientific literacy-based LKPD in learning activities. All MIN 2 South Konawe teachers were the target participants for this PkM, which took place on October 7 and 8, 2023. This PkM uses the Community-Based Participatory Research (CBPR) method. The results of the PkM show that: 1) South Konawe MIN 2 teachers do not yet have good competence in making LKPD based on scientific literacy, so ongoing training is needed to maximize this competency, as evidenced by the competency in deepening scientific literacy material by 25% and competence in deepening LKPD material. amounting to 41.91%; 2) South Konawe MIN 2 teachers have successfully created scientific literacy-based LKPD through training and mentoring, as evidenced by the link https://bit.ly/ANS1-PkM-Litapdimas-2023; 3) These teachers have successfully implemented scientific literacy-based LKPD in learning activities through training and mentoring, as evidenced by the link https://bit.ly/ANS2-PkM-Litapdimas-2023.</em></p>

Trauma and mental health in Pacific Islanders.

Little is known about trauma and its mental health impact on Native Hawaiians/Pacific Islanders (NH/PI), an understudied Indigenous-colonized population that endures severe mental health disparities. This novel investigation assessed trauma prevalence and its mental health and substance use correlates in NH/PIs in the U.S. Using community-based participatory research methods, survey data on NH/PI trauma, depression, anxiety, substance use, and treatment need were collected from 306 NH/PI adults using online, telephone, and in-person methods. Descriptive statistics and adjusted regression models were employed. Sixty-nine percent of participants experienced lifetime trauma, reporting mean exposure to 2.5 different trauma types. Childhood physical and sexual abuse, and lifetime forced sexual assault rates were 34%, 25%, and 27%, respectively, exceeding general population rates. Women and men reported equivalent total mean exposure to different trauma types, as well as equal prevalence for every trauma type examined (e.g. sexual abuse/assault). Confirming hypotheses, after controlling for key demographic and mental health risk factors, increased exposure to multiple trauma types uniquely associated with greater depression, anxiety, alcohol symptomology, and greater likelihood for needing treatment and using illicit substances. Trauma is prevalent in NH/PI populations and significantly impacts NH/PI mental health; serving as an important but overlooked contributor to NH/PI mental health disparities. Current findings fill critical gaps in our knowledge of NH/PI trauma and mental health while revealing the importance of screening and treating NH/PIs for trauma exposure to alleviate existing mental health disparities.

Human–Hyena (Crocuta crocuta) Conflict in the Tarangire Ecosystem, Tanzania

Interactions between people and large carnivores on shared landscapes can have harmful social and ecological consequences. Human–carnivore coexistence depends on an assemblage of sociological factors including effective management institutions that address the social costs of carnivore conservation and promote tolerance toward wildlife. In East Africa, large carnivores are particularly troublesome for herders who depend on livestock for subsistence and wellbeing. This paper provides an overview of human–hyena conflict in the Tarangire ecosystem of northern Tanzania. It presents descriptive results from a questionnaire survey (n = 1076) administered as part of an anthropological study (2019–2020; 2022; 2023) of human–wildlife interactions across twelve villages inhabited by Maasai agropastoralists. The survey instrument was designed through community-based participatory research methods to convey herder concerns about the impacts of spotted hyenas (Crocuta crocuta) on the livestock economy. Based on the perceptions and local ecological knowledge of Maasai interlocutors, the paper provides an overview of the spatial and temporal patterns of human–hyena interactions. Perceived frequencies of hyena attacks on kraaled livestock were unevenly distributed geographically, with those homesteads surrounding Manyara Ranch most heavily affected. Based on herder-reported livestock losses, the costs of depredation by spotted hyenas across the study area were estimated at approximately USD 904.84 per household per year. Most homesteads lacked fortified bomas and would benefit from the provision of lights and fencing materials to improve kraal structures. The paper’s central finding is that spotted hyenas represent a pressing, everyday concern for local pastoralists. Unsurprisingly, herders despise hyenas and are intolerant of sharing landscapes with them. For carnivore conservation outside protected areas to thrive in Tanzania, conservationists and policy makers must engage more meaningfully with the lived experiences of local herders who bear the brunt of conservation costs on their livelihoods.

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).

Navigating across anthropological and Haudenosaunee knowledge: co-developing research using CBPR and Kaswenta (Two-Row Wampum) principles in partnership with Six Nations of the Grand River.

As part of the Ohneganos research project, funded through the Global Water Futures (GWF), we document the ways we worked across Haudenosaunee and anthropological knowledge to assess the impact of water insecurity on holistic maternal health. This research was led by the Six Nation Birthing Center (SNBC), inspired by Haudenosaunee Kaswenta treaty principles. We utilized community-based participatory research (CBPR) and Indigenous research methods (IRMs), such as storytelling, to find common ground of dialogue and reciprocity. In doing so, this research goes beyond traditional anthropological ways of data collection and fieldwork and highlights the importance of active community direction and participation. We argue that different knowledge from the researchers does not need to be ignored or reduced to one singular perspective to work across worldviews. Instead, acknowledging and highlighting the differences will lead to innovative methods and scholarship. This paper contributes to the literature of research methods and policies and will be helpful to Indigenous communities and non-Indigenous researchers working together.

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.

English Teaching Assistance Employing the Multiple Intelligences Theory to Kasih Bangsa Elementary School Students

Considering that English is not the main language in Indonesia, an effective teaching method at school is crucial to students' ability to speak English fluently. However, in reality, many teachers still depend on conventional teaching methods. Therefore, this teaching assistance aims to facilitate Kasih Bangsa Elementary School students with a method that considers students' overall intelligence adapted from the Multiple Intelligences theory proposed by Howard Gardner, who argues that a person can have more than one intelligence. Furthermore, this teaching assistance is based on the Community-Based Participatory Research (CBPR) method, which focuses on the collaboration between researchers and communities. The program consists of three main processes: an interview with teachers of Kasih Bangsa Elementary School, a workshop on Multiple Intelligences Theory for the teachers, and a teaching demonstration by some of the students of the English Department, Maranatha Christian University. From this teaching assistance, the Multiple Intelligences theory is proven to improve the learning quality and boost students' motivation effectively.

Connectedness, feeling At home, and joyful Play (CAP): A place-based wellness model for cognitive health promotion in the community by the community

ABSTRACT As populations age, leveraging community resources to reduce dementia risk is increasingly vital for brain health. Using community-based participatory research methods, we co-developed and tested a pilot program with older adults in Metro Vancouver, Canada, to better understand and address brain health needs in community settings. Over 12 focus groups, older adults provided input which led to a place-based wellness model ‘Connectedness, feeling At home, and joyful Play’ (CAP). The CAP model was incorporated into an 8-week feasibility study, testing various components of a multi-domain realist controlled trial (n = 78). Older adults were recommended various existing activities in the community based on their CAP profiles. A ‘Finding Meaning in Aging’ mindful discussion program was added in response to older adults’ feedback on current gaps. Path analysis of preliminary data suggests that total attendance (β = .196, p = .070) improved brain health at week 8 by increasing a sense of playfulness at week 4 (β = .284, p = .002). Mindfulness (β = .215, p = .046) improved brain health by increasing a sense of at-homeness (β = .227, p = .025). Both pre- and post-implementation feedback from older adults centred the importance of friendship in late life, specifically to address late-life losses. The community-generated CAP model shows promise for place-based cognitive health promotion.

A rural interprofessional primary care team develops a school-based sex education program

In French rural areas, getting information about sexual health and identifying health actors on the topic is difficult for teenagers. Despite national and international guidelines, school-based sex education programs remain insufficient in France. The aim of this project was to develop a school-based psycho-affective and sexual health program (PASHP) for teenagers, led by an interprofessional primary care team (IPCT) in Montval-sur-Loir (Sarthe) and to coordinate local stakeholders. The IPCT developed the PASHP using a community-based participatory research method. The first step identified the target population and its needs for sex education. The second step was to create a steering group to tailor PASHP interventions in a participatory way and to define the PASHP’s aims and execution arrangements. The third step aimed at carrying out the PASHP and getting stakeholders’ and the target population’s feedback. The PASHP, carried out in the 2020–2021 and 2021–2022 school years, included an intervention about contraception and sexually transmitted infections, artistic workshops on consent or gender stereotypes, group discussions, and an intervention about pornography to assist parents. The PASHP developed and coordinated by the Montval-sur-Loir IPCT is innovative because of its organization. It coordinates local stakeholders, teenagers, and their parents in a disadvantaged rural area, respecting national guidelines on sex education.

Exploring Trauma- and Violence-Informed Pregnancy Care for Karen Women of Refugee Background: A Community-Based Participatory Study.

Women of refugee background experience poorer perinatal outcomes when compared to their local-born counterparts. Women of refugee background have often experienced trauma and are likely to encounter barriers to accessing health services in host countries which can exacerbate their recovery from trauma and contribute to poor health outcomes. Trauma- and violence-informed approaches to care offer opportunities to address barriers to pregnancy care which may, in turn, improve these poor outcomes. Trauma- and violence-informed care is a framework that acknowledges a person's experiences of trauma, recognises its impact and symptoms, and works toward resisting re-traumatisation by integrating knowledge into practice. Despite this, trauma- and violence-informed care in maternity care settings has rarely been explored from the perspectives of women of refugee background. This study aimed to explore trauma- and violence-informed pregnancy care from the perspectives of Karen women of refugee background using Community-Based Participatory Research methods. The lead researcher is a Karen-Australian woman with lived refugee experience. A Community Advisory Group was formed to support the study. Semi-structured interviews were conducted with seven Karen women of refugee background who had recently had a baby in Western metropolitan Melbourne, Australia. The data were analysed using Reflexive Thematic Analysis. Karen women shared what they considered to be important elements of trauma- and violence-informed pregnancy care. Three major elements were identified: (1) care design and accessibility; (2) promoting choice and control; and (3) trauma-informed interpreting. The critical importance of the interpreter-mediated setting was highlighted as women reported that they may not experience trauma- and violence-informed maternity care if they cannot access an interpreter or their relationship with the interpreter is unsafe. This study offers critical insights regarding the elements of trauma- and violence-informed pregnancy care that are important to Karen women of refugee background.

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.

Palliative and End-of-Life Care Interventions with Minoritized Populations in the US with Serious Illness: A Scoping Review.

Over the past 20years, palliative care in the United States has grown significantly. Yet, access to and/or engagement with palliative care for minoritized persons with serious illness remains limited. In addition, the focus of palliative and end-of-life care research has not historically focused on equity-informed intervention development that collaborates directly with minoritized populations. Equity-informed interventions within palliative and end-of-life care research have the potential to champion collaborations with persons with serious illness and their families to mitigate health inequities. The purpose of this scoping review was to examine and describe the literature on the approaches used in the design and development of palliative and end-of-life care interventions with minoritized populations with serious illness. The Joanna Briggs Institute methodology for scoping reviews was followed for tracking and reporting purposes. Included articles were described quantitatively and analyzed qualitatively with content analysis. Thirty-seven articles met the inclusion criteria: eight used quantitative methods, eight used qualitative methods, ten reported a community-based participatory research method, nine used mixed-methods, and two had research designs that could not be determined. The qualitative analysis revealed three themes: (1) stakeholder involvement and feedback, (2) intervention focus, and (3) target intervention population (population vs healthcare clinician). Using an equity-informed research approach is vital to improve palliative and end-of-life care interventions for minoritized communities with serious illness. There is also a need for more robust publishing guidelines related to community-based participatory research methods to ensure publication consistency among research teams that employ this complex research method.