Community-based Participatory Research Methods Research Articles

Co-designing a training package to promote health/oral health for people experiencing homelessness

Abstract Background In Scotland, 31,333 households were assessed as experiencing homelessness in 2019/20. This population present high morbidity and mortality which is a public health issue. Their health needs have been identified within Scottish policy as part of the broad goal of reducing inequalities and poverty. Those experiencing homelessness face multiple exclusions that must be addressed by practitioners from all health and social care sectors. Frontline staff have identified they often do not have adequate information and/or training on wider health issues linked with their client's needs. The aim of this research is to co-produce training resources to support front-line staff to discuss and to promote health and oral health. Methods Community-based participatory research that used online workshops to listen to the views of people with lived experience, practitioners and students from health and third sector, and policy makers regarding accessibility of services and practitioner approach towards those experiencing homelessness. Content analysis will be used to identified recurrent themes. Results The preliminary findings shown that lack of empathy from practitioners, continuity of care and stigma are barriers to access services. This is informing a co-designed knowledge exchange training packaged to help practitioners to improve knowledge and ability to promote health/oral health and to engage with people experiencing homelessness or at risk of becoming homeless. Educational materials (e-book on health promotion, comics books on barriers to access services, and a guide to promote oral health) compose this training package. Conclusions The training package allows adaptations to different settings and contexts and will be an important resource to be used by practitioners from different fields to prevent and tackle homelessness. Participants are sharing important views related to the need of a human rights and social justice-based approach to health promotion. Key messages Development of a co-designed knowledge exchange training package to improve practitioners' knowledge and ability to communicate and to engage with people experiencing homelessness. To empower people experiencing homelessness regarding positive health/oral health behavior change.

Community-based participatory research with police: Development of a tech-enhanced structured suicide risk assessment and communication smartphone application.

Police officers initiate psychiatric holds following determination of suicide risk. Such referrals constitute direct decriminalization of mental illness at the single most efficient criminal justice system diversion point. However, system-level problems with this process highlight a need to further understand and improve this service connection juncture. The goal of the present study was to inform the development of a smartphone application designed to enhance police referrals of individuals experiencing suicide crises into treatment via culturally responsive structured professional judgment. Given the developmental and qualitative nature of this study, there were no formal hypotheses tested. Research questions included the following: Would police officers broadly endorse concerns about the care referral process? Would officers support the use of technology to assist with those concerns? And would officers raise concerns about the demands on time and expertise that would be placed on them to conduct thorough risk assessments? Researchers used community-based participatory research (CBPR) methods to obtain police stakeholder-driven data through four focus groups with 47 police officers (76.6% male, 59.6% White, with a mean of 10.7 years of police employment) sampled from patrol and hostage negotiation units. Participants shared information about specific problems arising in the process through which police refer people to medical care, and they gave feedback on the beta version of a culturally responsive mobile app designed to streamline officers' evidence-based and culturally informed determinations of suicide risk. Results, qualitatively coded using grounded theory methodology, yielded key considerations for police use of culturally responsive apps to divert individuals in suicidal crisis into treatment, including the need to maintain a balance between risk assessment and communication, allow for variance in time constraints, allow for flexibility in response and report options, account for inaccurate reports of suicide risk factors, maximize utility of the app's risk report output, incorporate sensitivity around cultural questions, and consider officers' safety in their use of the app in the field. The results illustrate a theoretically based (CBPR) approach to cross-disciplinary technology development to facilitate evidence-based assessments by law enforcement. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Using Community-Based Participatory Research to Characterize Health and Lifestyle Behaviors of Montagnards, a Refugee-Origin Asian-American Subgroup

Montagnards, an indigenous multitribal refugee-origin population concentrated in North Carolina, remain an invisible, medically underserved, and socioeconomically underrepresented Asian American sub-group. Yet this group is resilient, with language diversity, rich cultural traditions and family caregiving in multigenerational households. Using community-based participatory research methods, we developed and administered a two-part survey to 144 Montagnard adults, documenting socioeconomic characteristics, health indicators and lifestyle behaviors. Forty-one percent of participants had no formal education, 76% had little/no English proficiency and 28% described having a very hard time paying their bills. Seventy-seven percent were overweight per BMI category, 79% had elevated blood pressure and 100% scored high for significant depressive symptoms. Participants reported high levels of physical inactivity and daily dietary intake of MSG. However, Montagnards reported limited tobacco and alcohol use, a diet of fresh vegetables and rice, and regular church attendance. These represent protective lifestyle behaviors and targets for culturally responsive health interventions.

From Digital Mental Health to Digital Social and Emotional Wellbeing: How Indigenous Community-Based Participatory Research Influenced the Australian Government's Digital Mental Health Agenda.

This paper describes the first six years of a government-initiated project to train Indigenous health professionals in digital mental health (d-MH). It illustrates how community-based participatory research (CBPR) methods were used to enable this “top-down” project to be transformed into a ‘ground-up’ community-guided process; and how, in turn, the guidance from the local Indigenous community partners went on to influence the national government’s d-MH agenda. The CBPR partnership between five community partners and a university rural health department is described, with illustrations of how CBPR harnessed the community’s voice in making the project relevant to their wellbeing needs. The local Indigenous community’s involvement led to a number of unexpected outcomes, which impacted locally and nationally. At an early stage, the conceptual framework of the project was changed from d-MH to the culturally-relevant Indigenous framework of digital social and emotional wellbeing (d-SEWB). This led to a significant expansion of the range and type of digital resources; and to other notable outcomes such as successful advocacy for an Aboriginal-specific online therapy program and for a dedicated “one-stop-shop” d-SEWB website, Wellmob, which was funded by the Australian government in 2019–2021. Some of the implications of this project for future Indigenous CBPR projects are discussed.

A chair at the table: a scoping review of the participation of refugees in community-based participatory research in healthcare

BackgroundRefugees often face psychosocial complexity and multi-dimensional healthcare needs. Community-Based Participatory Research (CBPR) methods have been previously employed in designing health programs for refugee communities and in building strong research partnerships in refugee communities. However, the extent to which these communities are involved remains unknown.ObjectiveTo review the evidence on the involvement of refugees in CBPR processes to inform healthcare research.MethodsA scoping review was performed, using Arksey & O’Malley’s methodological framework. A literature search in Medline, PubMed, PsycINFO, CINAHL, Embase, Global Health, Scopus, and Policy File Index for articles published until August 2020 was conducted. Articles were included if they focused on CBPR, had refugee involvement, and discussed healthcare/health policy.Results4125 articles were identified in the database searches. After removal of duplicates, 2077 articles underwent title and abstract review by two authors, yielding an inter-reviewer kappa-statistic of 0.85. 14 studies were included in the final analysis. The purpose of CBPR use for 6 (42.9%) of the articles was developing and implementing mental health/social support interventions, 5 (35.7%) focused on sexual and reproductive health interventions, 1 (7.1%) focused on domestic violence interventions, 1 (7.1%) focused on cardiovascular disease prevention and 1 (7.1%) focused on parenting interventions. In terms of refugee involvement in the various stages in the research process, 9 (64.3%) articles reported refugees having a role in the inception of the research, no articles reported including refugees in obtaining funding, all articles included refugees in the design of the research study, 10 (71.4%) articles reported having refugees involved in community engagement/recruitment, 8 (57.1%) articles reported involvement throughout the data collection process, 4 (28.6%) articles reported involvement in data analysis, 6 (42.9%) articles reported having refugees involved in knowledge translation/dissemination and 1 article (7.1%) reported having refugees contribute to scale up initiatives.ConclusionsCBPR has been identified as a methodology with the potential to make substantial contributions to improving health and well-being in traditionally disenfranchised populations. As the needs of refugee communities are so diverse, efforts should be made to include refugees as partners in all stages of the research process.

Using community-based participatory research methods to inform care for patients experiencing homelessness: An opportunity for resident education on health care disparities.

People experiencing homelessness (PEH) suffer higher burdens of chronic illnesses, have higher rates of emergency medicine (ED) use and hospitalization, and ultimately are at increased risk for premature death compared to housed counterparts. Structural racism contributes to a disproportionate burden of homelessness among people of color. PEH experience not only significant medical concerns but also complex social needs that need to be addressed concurrently for effective healing, issues that have been magnified by the COVID-19 pandemic. As health disparities and structural racism intersect among PEH, it is critically important to develop PEH-centered interventions to improve care and health outcomes as part of an effort to dismantle racism. One opportunity to address these disparities in care for PEH is through training ED physicians on methods for identifying and intervening on the unique needs of vulnerable patient groups. The Accreditation Council for Graduate Medical Education has outlined health quality pathways in the clinical learning environment to address health disparities. Community-based participatory research (CBPR) is particularly well suited for this scenario as it allows experiential learning for trainees to work with and understand a diverse group of stakeholders, to deepen their knowledge of local health disparities, and to lead research and measure outcomes of interventions to tackle health disparities. In this paper, we highlight the utility of CBPR in fostering experiential learning for EM residents on tackling health disparities and the importance of community collaboration in trainee-led interventions for comprehensive ED care.

Community-Based Participatory Research (CBPR) to Enhance Participation of Racial/Ethnic Minorities in Clinical Trials: A 10-Year Systematic Review

ABSTRACT There has not been a significant improvement in the rate of clinical trial accrual in more than 20 years. Worse, the challenge of inadequate representation among racial and ethnic minorities also persists, deepening disparities in health. Community-Based Participatory Research (CBPR) is a participatory communication method that centers on effective dialogue between researchers and community stakeholders with the goal of creating an equitable partnership for health and social change. The objective of the current study was to provide an update since a systematic review in 2012, on the current status of the empirical research, with a particular focus on the elements of CBPR methods used to improve the rate of accrual of members of racial and ethnic minority communities for clinical trials. Our systematic review found a large increase in the number of CBPR related studies and studies related to racial and ethnic representation in research. More than 85% of studies employing CBPR methods saw statistically positive outcomes. Specifically, the elements of CBPR that are associated with these positive outcomes include community partner participation in (1) a study advisory committee, (2) data collection, (3) the development of interventions, and (4) participant recruitment. However, the results of our study indicate that researchers need to be more transparent about the extent of community participation as well as more thoroughly and accurately describe the nature of the partnership with members of minority communities in order to build upon the scientific literature on community-engaged methods.

Addressing the need for indigenous and decolonized quantitative research methods in Canada

Though qualitative methods are often an appropriate Indigenous methodology and have dominated the literature on Indigenous research methods, they are not the only methods available for health research. There is a need for decolonizing and Indigenizing quantitative research methods, particularly in the discipline of epidemiology, to better address the public health needs of Indigenous populations who continue to face health inequities because of colonial systems, as well as inaccurate and incomplete data collection about themselves. For the last two decades, researchers in colonized countries have been calling for a specifically Indigenous approach to epidemiology that recognizes the limits of Western epidemiological methods, incorporates more Indigenous research methodologies and community-based participatory research methods, builds capacity by training more Indigenous epidemiologists, and supports Indigenous self-determination. Indigenous epidemiology can include a variety of approaches, including: shifting standards, such as age standardization, according to Indigenous populations to give appropriate weight to their experiences; carefully setting recruitment targets and using appropriate recruitment methods to fulfill statistical standards for stratification; acting as a bridge between Indigenous and Western technoscientific perspectives; developing culturally appropriate data collection tools; and developing distinct epidemiological methods based on Indigenous knowledge systems. This paper explores how decolonization and Indigenization of epidemiology has been operationalized in recent Canadian studies and projects, including the First Nations Regional Longitudinal Health Survey and how this decolonization and Indigenization might be augmented with the capacity-building of the future Our Health Counts Applied Indigenous Epidemiology, Health Information, and Health Services and Program Evaluation Training and Mentorship Program in Canada.

Self-Identification of Homestay Management Problems and Canvas Business Model

Laksana Village is in Ibun Sub-District, Bandung District. Geographically, Laksana Village is close to the Kamojang Tourism area, which is the leading tourism destination in Bandung District. The village has the potential for tourism development. To support the tourism development program, there are several homestays. However, it was found that many tourists spent the night outside the Laksana Village area. Another problem faced by homestay managers is the difficulty in determining homestay tariff. This Community Service (CS) activity aims to explore the problems faced by homestay managers through self-identification of problems using the Community Based Participatory Research method. The results of the self-identification became the basis for the CS Team to map the nine elements of the canvas business model. The cost structure becomes a priority scale to be handled in order to solve the tariff determination problem and is expected to increase the value proposition. This CS activity specifically resulted in self-identification of problems and a business canvas model for homestay management.

Engaging the Community in Designing a Hepatitis C Virus Treatment Program for Adults Experiencing Homelessness.

Despite the availability of cure for hepatitis C virus (HCV), people experiencing homelessness (PEH) are challenged with initiating and completing HCV treatment. The design of culturally sensitive HCV treatment programs is lacking. The objective was to employ community-based participatory research methods to understand perceptions of HCV-positive PEH, and providers, on the design and delivery of a culturally sensitive, nurse-led community health worker (RN/CHW) HCV initiation and completion program. Four focus group sessions were conducted with HCV-positive PEH (n = 30) as well as homeless service providers (HSP; n = 7) in Skid Row, Los Angeles. An iterative, thematic approach provided the themes of essentials of successful participant engagement and retention: Role of nurse-Led CHW in promoting: (a) tangible and emotional support; (b) cognitive and behavioral support; and (c) financial and structural resources. The goal of this study is to provide the groundwork for future research of HCV program design to support HCV cure among homeless populations.

466-P: Cultural Adaptation of a Diabetes Self-Management Education and Support Telehealth Intervention for Rural Colorado

Diabetes impacts rural populations at higher rates compared to their urban counterparts. Diabetes self-management education and support (DSMES) is an evidence-based standard of care for people with diabetes. Yet, in rural areas, DSMES is often not available, culturally relevant, or integrated into primary care practices where many people receive diabetes care. This study uses a community-based participatory research (CBPR) approach to adapt the language, tools, and delivery of a DSMES program for use in Spanish and English-speaking populations in the High Plains Research Network in rural eastern Colorado. Boot Camp Translation (BCT) is a CBPR method that combines medical, research, and local community member expertise to create locally relevant language, messages and materials to promote discussion and action around a medical condition. For this study, community partners included 13 diverse community members (including bilingual Spanish-speakers, patients, caregivers, and healthcare providers). The group identified a particular need to increase awareness of the connection between diabetes and mental health, specifically depression, and diabetes burnout. Language and tools to address stigma and normalize the connection, talking points to initiate discussions with care teams, and calls for practices to increase screening for depression among patients with diabetes, are under development. Additional themes identified include incorporating nutrition information for food that is culturally appropriate and locally available, and integrating DSMES within the primary care practices where people with diabetes receive their care. Community engagement is crucial to support DSMES program adoption in rural communities. Disclosure T. Oser: Advisory Panel; Self; Cecelia Health, Dexcom, Inc., Advisory Panel; Spouse/Partner; Cecelia Health, Dexcom, Inc. M. L. Litchman: Research Support; Self; Abbott Diabetes. B. Kwan: None. J. Neuberger: None. K. Curcija: None. S. Burke: None. L. K. Zittleman: None. J. S. Simonetti: Consultant; Self; Rhythm Pharmaceuticals, Research Support; Self; Rhythm Pharmaceuticals . Funding National Institute of Nursing Research; National Institutes of Health (1R56NR019466-01)

Environmental Engineering for the 21st Century: Increasing Diversity and Community Participation to Achieve Environmental and Social Justice.

Communities of color are disproportionately burdened by environmental pollution and by obstacles to influence policies that impact environmental health. Black, Hispanic, and Native American students and faculty are also largely underrepresented in environmental engineering programs in the United States. Nearly 80 participants of a workshop at the 2019 Association of Environmental Engineering and Science Professors (AEESP) Research and Education Conference developed recommendations for reversing these trends. Workshop participants identified factors for success in academia, which included adopting a broader definition for the impact of research and teaching. Participants also supported the use of community-based participatory research and classroom action research methods in engineering programs for recruiting, retaining, and supporting the transition of underrepresented students into professional and academic careers. However, institutions must also evolve to recognize the academic value of community-based work to enable faculty, especially underrepresented minority faculty, who use it effectively, to succeed in tenure promotions. Workshop discussions elucidated potential causal relationships between factors that influence the co-creation of research related to academic skills, community skills, mutual trust, and shared knowledge. Based on the discussions from this workshop, we propose a pathway for increasing diversity and community participation in the environmental engineering discipline by exposing students to community-based participatory methods, establishing action research groups for faculty, broadening the definition of research impact to improve tenure promotion experiences for minority faculty, and using a mixed methods approach to evaluate its impact.

Design suggestions for an mHealth app to facilitate communication between pharmacists and the Deaf: perspective of the Deaf community (HEARD Project).

Deaf and hard-of-hearing (DHH) patients have trouble communicating with community pharmacists and accessing the healthcare system. This study explored the views on a proposed mobile health (mHealth) app in terms of design and features, that will be able to bridge the communication gap between community pharmacists and DHH patients. A community-based participatory research method was utilized. Two focus group discussions (FGDs) were conducted in Malaysian sign language (BIM) with a total of 10 DHH individuals. Respondents were recruited using purposive sampling. Video-recordings were transcribed and analyzed using a thematic approach. Two themes emerged: (I) challenges and scepticism of the healthcare system; and (II) features of the mHealth app. Respondents expressed fears and concerns about accessing healthcare services, and stressed on the need for sign language interpreters. There were also concerns about data privacy and security. With regard to app features, the majority preferred videos instead of text to convey information about their disease and medication, due to their lower literacy levels. For an mHealth app to be effective, app designers must ensure the app is individualised according to the cultural and linguistic diversity of the target audience. Pharmacists should also educate patients on the potential benefits of the app in terms of assisting patients with their medicine-taking.

Social resilience and climate change: findings from community listening sessions

BackgroundThe mental health effects of climate change include not only those directly related to the traumatic consequences of severe weather events, but also the anxiety, fear, and distress associated with slower-moving stressors, perceptions, and attempts to understand and respond appropriately to climate change and its implications. The effects of climate change on mental health and wellbeing are not isolated, they interact with other social and environmental determinants of health including race, income, and housing stability. The modern biomedical model and dominant cultural values in the USA have placed an emphasis on the individual in terms of mental health and resilience. Mainstream mental health interventions have focused on individual psychotherapy and pharmaceuticals. These approaches, while important, often ignore the social determinants of mental health that are particularly important to climate-vulnerable communities including systemic oppression, social cohesion, stable income, cultural pride, and sense of hope or spirituality. Many concepts related to social resilience do not consider equity and power. To bring in the perspectives of communities affected by inequities, the Oregon Climate and Health Program partnered with community health workers to host listening sessions with different cultural groups across the state. MethodsIn 2019, four community listening sessions were convened on the topics of climate change and social resilience: with a Latinx community (facilitated in Spanish), with African-American and African immigrant communities, with an urban Native American community, and with a white community. Each session had about 12 participants and most were identified as leaders, connectors, or community health workers in their communities. We analysed the findings with a theoretical framework used for understanding social capital: bonding, bridging, and linking. Social capital acknowledges the importance of power in social relationships and how these can bring about change in policy, systems, and environments. In choosing this framework, we acknowledge that climate resilience is not about returning to or maintaining an ideal state. Rather, it is a dynamic process of honouring and integrating diverse solutions and approaches that build on community strengths and enable transformative, equitable change. FindingsSocial inequities and political polarisation were strong themes that emerged across all community listening sessions. In the sessions, community members talked about the connection between individual mental health resilience and the broader community and climate resilience. They emphasised the importance of meeting basic needs, such as affordable housing and food security, and validated the importance of trusting relationships, cultural traditions, and diversity. Evidence shows that these kinds of community strengths lead to greater social cohesion and stronger social networks, which act as buffers against negative health impacts of climate disasters and help communities recover more quickly after a disaster. Findings helped to inform a 2021 study on how climate change affects youth depression and the development of a new pilot project with Latinx and indigenous community leaders. Recommended actions were also prioritised in Oregon's 2021 Climate Change Adaptation Framework, including the use of community-based participatory research methods, and building capacity of community-based organisations. InterpretationGovernment agencies often see themselves as distinct and separate from communities; however, they are a key part of a community's social networks. This research resulted in recommendations for how government agencies and other organisations with power can act as social capital builders, especially in communities on the front lines of climate change. Such actions include making and following through on commitments to equity, investing in community engagement and bridging skills within the workforce, and expanding climate-related programmes to include social capital strategies and measures as necessary co-benefits of any climate resilience investment. FundingUS Centers of Disease Control and Prevention Climate and Health Program.

A Novel Application of Photovoice in a Statewide Home Visiting Evaluation

Photovoice is an empowering, qualitative, community-based participatory research method that engages participants to take photographs and reflect on their meanings. We employed a novel application of a Photovoice-inspired methodology to evaluate perinatal home visiting services. This article describes the feasibility and utility of remote implementation of a Photovoice-inspired project in one state’s federally funded Maternal, Infant, and Early Childhood Home Visiting Initiative. The initial project aimed to identify aspects of parenting roles/identities, goals, and home visitor–client relationship that can be leveraged to improve program engagement and retention. Training materials were sent to home visitors who acted as liaisons with parents. Reflective interviews about this photo-elicitation method conducted with parents, home visitors, and the evaluators following the project revealed that informational materials were beneficial to understanding the process. Home visitors were noted as gatekeepers and key motivators. Trainings, flexibility, timely communication, and logistics should be considered when remotely implementing Photovoice.

Community partnerships in emerging immigrant communities: Lessons learned addressing Latino childhood weight disparities.

Latino children have disproportionately high childhood obesity rates, and U.S.-born Latino children of immigrant parents experience higher overweight/obesity rates than other Latino children. Community-based participatory research (CBPR) to engage Latino immigrant families and Latino-serving community organizations is one mechanism to address the lack of effective and practical interventions addressing childhood obesity disparities among Latino children. We present lessons learned from applying CBPR methods to a partnership focused on developing a child obesity treatment program for Latino immigrant families in an emerging Latino immigrant destination to inform the use of CBPR methods in other partnerships in emerging immigrant communities. We encountered challenges working within the partnership related to entrenched sociopolitical hierarchies that were not inclusive of immigrant community leaders, capacity building for partners with limited literacy and administrative experience, and how best to use complementary methods and frameworks to support a community-engaged research process. This work is one way to promote shared learning among the community of researchers using CBPR and other engagement methods to partner with emerging immigrant communities. Together with our community partners, we can identify strategies to more effectively partner to promote health equity and work toward social justice for all members of our communities.

Participatory survey design of a workforce health needs assessment for correctional supervisors

The correctional workforce experiences persistent health problems, and interventions designed with worker participation show favorable outcomes. However, participatory intervention research often leaves workers out of the health needs assessment, the basis of interventions subsequently developed. This omission risks failure to detect factors contributing to the health and is less likely to result in primary prevention interventions. Partnering with a correctional supervisors' union, we followed Schulz and colleagues' community-based participatory research (CBPR) methods for participatory survey design and used Healthy Workplace Participatory Program (HWPP) tools to develop a tailored survey to assess workforce health and contributing factors. Utilizing the HWPP Focus Group Guide, we generated key themes to adapt the HWPP All Employee Survey, a generic workforce health assessment, to become thorough and contextually-relevant for correctional supervisors. Content analysis of focus group data revealed 12 priority health concerns and contributors, including organizational culture, masculinity, work-family conflict, family support, trauma, positive job aspects, health literacy and efficacy, health/risk behaviors, sleep, obesity, and prioritizing work and income over health. Twenty-six measures were added to the generic survey, mainly health-related antecedents including knowledge, attitudes, norms, and motivation. Findings yielded new insights about supervisors' lived experiences of work and health, and resulted in a customized workforce survey. CBPR methods and HWPP tools allowed us to identify health issues that we would not have detected with conventional methods, and provide opportunities for interventions that address root causes of poor health. We share challenges faced and lessons learned using CBPR with the correctional workforce.

Perspectives on Finances and Mental Health Status among Low-Income Los Angeles Latinas

Research has established a link between financial challenges and mental health outcomes. Understanding this linkage among low-income Latinas who face unique experiences and challenges in relation to managing their household finances is important. This study utilized a community-based participatory qualitative research method to explore perspectives on financial and mental health among Latinas residing in Los Angeles County. The implications of this study are applicable when conducting a culturally responsive financial therapy program. Three focus groups were conducted with mainly immigrant, Spanish-speaking, low-income Latinas (n = 37). The study found that though participants face financial stressors tied to managing finances, they were eager to learn new skills and tools for improved financial practices and mental health therapies. For financial education interventions targeted to Latinas, it is best to use interventions that incorporate peer-support groups, improve knowledge about financial management tools and financial products available in the community, and therapeutic interventions to address financial stress. Key words: immigrants, household financial decision-making, savings, formal financial services, financial stress

Service Development and Implementation: Learning From Diverse Case Examples

The development of health and social services should be based on a thorough needs assessment with all stakeholders, followed by ongoing monitoring of implementation and subsequent short and long term outcomes. Relying on four different service models, this symposium reviews their evaluation processes and summarizes the main lessons learned, in order to inform future efforts. Wyman and colleagues outline efforts to develop culturally-sensitive dementia care services for American Indian and Alaska Native older adults and caregivers using qualitative interviews and community-based participatory research methods. Findings offer guidance for culturally-tailored implementation of services. Shepherd-Banigan et al. report on a quantitative needs assessment of over 1,500 caregivers of older Veterans enrolled in Veterans Administration healthcare. Providing care to individuals with co-morbid conditions predicted higher levels of distress and burden among caregivers, pointing to likely benefit from additional caregiver-focused support programs. The paper by Gum and co-authors moves to assessment of outcomes by examining mortality and other outcomes among older adults screened by an Area Agency on Aging and either receiving or waiting for services. Finally, the paper by Ayalon and Shinan-Altman use service evaluation to demonstrate the importance of needs assessment and the gap between the vision of service developers and real life constraints. The included papers discuss the value of various methodologies, illustrating the important role that assessment and evaluation play in service development and implementation for older adults and caregivers.

A Review of Mixed Methods Community-Based Participatory Research Applications in Mental Health

The aim of the paper was to methodologically review the intersection of mixed methods research (MMR) and community-based participatory research (CBPR) in the field of mental health research. We classify this intersecting approach as MMCBPR. The methodological review of empirical literature was conducted between October 2017 and March 2020 of full-text articles in Scopus, Pubmed, ProQuest Central, Web of Science, and EBSCOhost search engine databases in the English language. Twenty-nine studies meeting the inclusion criteria were included in the final analysis. We found some evidence of MMCBPR but it was limited by factors such as a lack of explicit rationales for the use of MMR and CBPR, limited evidence of long-term commitment to a community, and an ad hoc approach to the application of MMR and CBPR. These findings informed the development of practical recommendations for psychologists, mental health professionals, and researchers in the application of MMCBPR. In particular, our MMCBPR recommendations aim to advance the social justice agenda in counseling psychology, increase the rigor of MMCBPR approaches in mental health studies, and inform how advanced mixed methods applications can be used to address the complexities associated with mental health and well-being.