Community-based Participatory Research Research Articles

Inverting social innovation to transform health system responses to climate change adaptation and mitigation in the global south

Systems thinking is aimed at understanding and solving complex problems that cut across sectors, an approach that requires accurate, timely, and multisectoral data. Citizen-driven big data can advance systems thinking, considering the widespread use of digital devices. Using digital platforms, data from these devices can transform health systems to predict and prevent global health crises and respond rapidly to emerging crises by providing citizens with real-time support. For example, citizens can obtain real-time support to help with public health risks via a digital app, which can predict evolving risks. These big data can be aggregated and visualized on digital dashboards, which can provide decision-makers with advanced data analytics to facilitate jurisdiction-level rapid responses to evolving climate change impacts (e.g., direct public health crisis communication). In the context of climate change, digital platforms can strengthen rapid responses by integrating information across systems (e.g., food, health, and social services) via citizen big data. More importantly, these big data can be used for rapid decision-making,a paradigm-changing approach that can invert social innovation, which we define as co-conceptualizing societal solutions with vulnerable communities to improve economic development with a focus on community wellbeing. However, to foster equitable and inclusive digital partnerships that invert social innovation, it is critical to avoid top-down approaches that sometimes result when researchers in the Global North and South collaborate. Equitable Global South–North partnerships can be built by combining digital citizen science and community-based participatory research to ethically leverage citizen-driven big data for rapid responses across international jurisdictions.

Participation in Critical Dialogues With Illustrative Images Increases Knowledge About COVID-19 Prevention: A Mixed Methods Longitudinal Approach

This intervention study uses community-based participatory research (CBPR) and longitudinal design to examine changes in COVID-19 prevention knowledge over time (3 time points) among racially minoritized participants ( n = 38). The intervention comprised critical dialogues alongside an illustration used to engage participants in conversations about socioeconomic conditions affecting acquisition of COVID-19 knowledge. Quantitative data showed that COVID-19 prevention knowledge was higher for participants who completed the intervention. Qualitative data were used to illustrate the context under which participants experienced COVID-19 pandemic, how they received COVID-19 prevention information, and how they engaged in decision-making around COVID-19 protective behaviors. Contributions to mixed method research: The combination of CBPR, repeated measures, and critical dialogues (with and art form) in intervention research.

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

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

Cannabis harm reduction: perspectives of women who use and allied social and health-care providers

Background Despite the legalization of cannabis use in Canada in 2018, there remains little research on cannabis harm reduction, particularly for women. Scholarship and public health guidelines tend to focus on the risks of use, emphasizing abstinence rather than harm reduction. Additionally, harm-reduction research and guidelines often lack the perspectives of women who use cannabis and allied social and health-care professionals. Methods This community-based participatory research mixed method study explores the perspectives of women who use cannabis and service providers on the Canadian Lower Risk Cannabis Use Guidelines (LRCUG) and a synthesis of scholarship from 2015 to 2020. The research synthesis and the LRCUG were presented for review by participants in two focus groups (n = 11) and respondents to an online survey (n = 19). Results Participants described public health guidelines as judgmental in tone, ineffective in conveying useful information, and foregrounding abstinence. Participants also identified shortfalls in the research presented, which did not attend to the social context of cannabis use and cannabinoids’ possible benefits alongside risks. Conclusion Participants’ responses affirm that future LRCUGs should focus on informative rather than prescriptive content with meaningful inclusion of people who use cannabis and service professionals as co-creators of knowledge for safer use.

Identifying Barriers and Facilitators to Accessing Care for Historically Marginalized Communities Affected by Parkinson Disease: A Qualitative Study.

Parkinson disease (PD) is the second most common neurodegenerative disease. Members of the Black Diaspora (MBD) and Hispanic/Latinx people are less likely to receive a timely diagnosis following the onset of symptoms and more likely to experience greater disease severity due to late diagnosis. Historically marginalized populations (i.e., MBD, Hispanic, and Latinx communities) are not accurately represented in research; this, along with many other barriers, compounds underreporting and lack of recognition of PD. It is important to understand barriers to early diagnosis and healthcare access for these historically marginalized populations from the community's perspective. Our team conducted two focus groups to identify barriers and facilitators to PD healthcare-seeking behavior. We sought to identify which barriers are modifiable to ultimately improve engagement in neurological care for MBD and Hispanic individuals affected by PD. We enrolled 15 participants (13 female; African/African American/Black n = 10, Hispanic/Puerto Rican n = 3, other n = 2) for two focus groups. Discussions revealed sources of barriers to healthcare-seeking behavior in three main domains: legacy of racism in the United States, ancestral cultural environment, and healthcare system access. These sources influenced individuals' PD knowledge and familiarity. Additionally, participants expressed a desire to know more about PD and called for increased community-based programming for education and awareness. This paper uses a community-based participatory research approach to describe the experiences of MBD, Hispanic, and Latinx people in Manhattan and the surrounding areas in relation to possible sources of healthcare disparities and delayed PD diagnosis. These sources have broad implications and should be addressed through collaborative community programming.

Immersive virtual reality for prospective memory and eye fixation recovery following traumatic brain injury: A pilot study

Rehabilitation is crucial for the recoveriy from traumatic brain injuries (TBI); yet, only 77 – 88% of TBI patients are receipients of rehabilitation. Particularly, individuals lacking insurance coverage or facing transportation hurdles, notably within the Hispanic community, are less likely to undergo rehabilitation. Virtual reality (VR), known for its mobility and affordability, is recommended as a rehabilitation alternative. This community-based participatory research project aimed to evaluate the acceptability, feasibility, and potential of VR scenarios in addressing common rehabilitative needs. Focus groups involving TBI patients (N = 12) were conducted to identify rehabilitative needs and design VR scenarios. Two novel scenarios were created to enhance prospective memory and eye tracking. The impact of the prospective memory VR scenario was assessed among individuals with brain injuries 1 year post-TBI (N = 11), who were divided into intervention and delayed-intervention groups. In addition, six participants underwent the eye-tracking VR scenario to evaluate its effectiveness. Data from memory tests and screen recordings were gathered. In the objective memory test, participants in the VR intervention group (66%) exhibited greater improvement than those in the memory card delayed intervention group (0%) after 12 sessions. However, there was no statistically significant difference in mean scores on a Prospective and Retrospective Memory Questionnaire memory scale between the intervention and delayed-intervention groups after 6 weeks. Nonetheless, all participants demonstrated enhanced eye tracking skills after completing the eye tracking VR scenario between the 6th and 12th sessions. In conclusion, the VR scenarios exhibited promise, acceptability, and feasibility in improving prospective memory and eye tracking for individuals with TBI 1 year post-injury.

MivacunaLA (MyshotLA): A Community-Partnered Mobile Phone Intervention to Improve COVID-19 Vaccination Behaviors among Low-Income, Spanish-Speaking, and Immigrant Latino Parents or Caregivers

We developed and tested MivacunaLA/MyshotLA, a community-informed mobile phone intervention, to increase COVID-19 vaccination among Latino parents/caretakers of minors in under-resourced areas of Los Angeles by addressing misinformation and building trust. We recruited Latino parents/caregivers with at least one unvaccinated child in East and South Los Angeles in the summer of 2021 and evaluated MivacunaLA as a randomized controlled trial with a wait-list control group. A difference-in-difference analysis showed Latino parents/caregivers that participated in MivacunaLA (n = 246), in comparison to the control group, were 15 percentage points more likely (p = 0.04) to report vaccination of minors aged 12–17 years, and 12 percentage points more likely (p = 0.03) to report a positive intention to vaccinate minors aged 2–11 years (when COVID-19 vaccines became available). Mobile phone-delivered digital interventions using videos and culturally tailored educational material to promote COVID-19 vaccine confidence can be an effective way to combat misinformation and deliver timely information to marginalized communities. Community-based participatory research approaches are crucial to advance health equity among minority communities, especially immigrant Spanish-speaking underserved communities.

Development of a protocol for using geo-trackers to identify zoonotic enteric pathogen transmission pathways in a pilot study in Kenya

Abstract Humans and animals can be exposed to fecally-transmitted pathogens in both private and public domain environments. Animals may also acquire pathogen infections from these two environments and transmit them to humans through different pathways. Evidence on how often and where interactions occur between the two environments could improve the effectiveness of public health programs for preventing zoonotic disease transmission and response to disease outbreaks. This study aimed to develop a protocol for using geo-trackers to measure the spatial-temporal movement and interaction between animals and children in households and public areas in low- and middle-income categories of urban neighbourhoods in Kenya. It also aimed to identify opportunities and challenges for the scale-up of these methods’ for surveillance of other zoonotic diseases of public health significance. One commercial geo-tracker device with the best technological performance and usability that met pre-defined criteria for the study context was identified. Community engagement meetings were then conducted to gather input on a proposed study protocol. Afterwards, infants and animals were geo-tracked in 10 households in urban informal settlements of Kibera and Jericho, Nairobi over two consecutive weeks with iterative improvements to protocols. The effectiveness of the geo-tracking exercise was evaluated through in-depth interviews with Community Health Volunteers (CHVs) and infant caregivers. Animal and infant behaviour and battery reliability of the geo-trackers were also monitored; and observed opportunities and challenges in implementing the protocol during the exercise were documented. Community members were receptive and accepted the use of geo-trackers on animals and children. In pilot testing, there was no change of behaviour from 10 infants tracked. Discomfort was observed for up to 30 min after the placement for some of the seven animals tracked, but the animals quickly adjusted. The battery for all geo-tracker devices lasted for the 24-h geo-tracking period. Some caregivers and CHVs were concerned whether the geo-trackers could record personal information. It was shown that geo-tracker devices can be successfully deployed to study animal-child interactions and movement in different categories of urban neighbourhoods. Recommendations have been made on the lessons learnt from the study to help scientists who would use geo-trackers for future community-based human and animal research. One Health impact statement Assessing human and animal risks of acquiring enteric infections from environmental contamination, or contributing to pathogen contamination of the environment requires understanding spatial-temporal patterns of human and animal movement between private households and the community. Movement of domestic animals is relevant for understanding household-community spatial patterns of pathogen transmission because animal ownership and contact with humans is common, and free-roaming animals carrying enteric pathogens can spread diverse faecal pathogens between environments. The community-based participatory research approach of this study evaluated implementation feasibility from the lens of technical usability and reliability of geo-tracking devices, as well as social acceptability and ethics related to using such devices for the community-based study of human and animal subjects in urban settings. Evidence and recommendations from this study will be useful to anyone interested in understanding human-animal-environment interactions and their contributions to infectious disease transmission.

#TEBWorks: Engaging Youth in a Community-Based Participatory Research and User-Centered Design Approach to Intervention Adaptation

#TEBWorks: Engaging Youth in a Community-Based Participatory Research and User-Centered Design Approach to Intervention Adaptation

Abstract PO5-20-05: The FOR ME (Fostering Opportunities in Research through Messaging and Education) study: Using multiple qualitative methods to develop a culturally sensitive narrative intervention to promote equity in clinical trials

Abstract Background: Black women are more likely to present with advanced stage disease and to die following a breast cancer (BC) diagnosis compared to women from other racial/ethnic groups. In 2020, only 7.2% of enrollees in clinical trials that led to the approval of 3 novel drugs for breast cancer were Black. While there are many contributing factors to this inequity (i.e., tumor biology, social and structural health determinants, racial injustice, and differential access to and utilization of high-quality mammography, diagnostics, and therapies), persistent underrepresentation of Black patients in cancer clinical trials (CTs) slows scientific advancements. Objective: The aim of this study is to develop, optimize, and test a narrative decision aid intervention (web-based video) for Black women diagnosed with BC to promote shared decision making and CT participation. The first aim is to conduct multiple qualitative methods with multi-level stakeholders to identify barriers, facilitators, and intervention priorities that would assist Black breast cancer patients to make informed decisions about participating in clinical trials. The second aim is to create a culturally sensitive, narrative intervention designed to support decision making and motivate Black breast cancer patients to participate in clinical trials. Aim 3 will then pilot a study to determine acceptability of the intervention among patients and assess whether it increases clinical trial participation in a safety net oncology practice. Methods: Guided by community-based participatory research approaches, we used multiple qualitative methods (key informant interviews (KIIs) and story circles) to identify barriers and facilitators that support decision-making and CT participation. The KIIs, completed in-person, via phone, or video conferencing, were recorded and professionally transcribed. The research team used thematic analysis and inductive coding approaches. Next, interviews and focus groups will invite feedback on the educational/motivational content of the intervention and will be used to develop a culturally sensitive script and story boards. A video production company will produce the narrative intervention. Finally, focus groups and interviews with participant cohorts will provide feedback on the completed intervention. Black women diagnosed with BC will view the intervention in an oncology clinic. Using a pretest/posttest design, we will analyze the acceptability of the intervention and its effect on intention to participate in clinical trials. We will then conduct a quasi-experimental study in a safety net oncology practice to determine whether the rate of clinical trial participation among Black breast cancer patients increases following implementation of the intervention as a standard component of new patient education. Progress: Recruitment started in July 2022 and currently 30 of 30 interviews with patients are completed, 20 of 20 interviews with clinical stakeholders (oncologists and clinical trial staff) are completed, and 14 of 20 interviews with advocates and community partners are completed. Data collection and the analysis of the interviews and story circles is ongoing. Citation Format: Neha Hippalgaonkar, Ryan Nguyen, Leslie Carnahan, Vida Henderson, Tigist Mersha, Eliza Cohn, Kauthar Salum, Ana Williams, Lolita Coleman, Beulah Brent, AnneMarie Murphy, Paris Thomas, Paramjeet Khosla, Kent Hoskins. The FOR ME (Fostering Opportunities in Research through Messaging and Education) study: Using multiple qualitative methods to develop a culturally sensitive narrative intervention to promote equity in clinical trials [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-20-05.

“This is it…this is our normal” - the voices of family members and first responders experiencing duty-related trauma in Ireland

BackgroundCompared to other occupational groups, first responders (FR) experience worse mental health outcomes due to duty-related trauma and occupational stressors. Despite their best efforts, they bring this stress home to friends and family. Consequently, FR and their supporters suffer from increased psychosocial difficulties and experience stigma and other barriers to help-seeking. Prior work offers little opportunity for open dialogue and shared understanding of the repercussions of this occupation for all members of the first responder community.In this qualitative study, we aimed to: (i) explore the lived experience of Irish FR and their family members (FM) related to occupational stressors, FM and FR, and (iii) identify opportunities to engage FM with existing organizational supports available for FR. MethodsUsing a community based participatory research (CBPR) approach, we conducted six focus groups involving a total of fourteen participants comprising FR, organizational representatives, and FM. All focus groups were audio recorded, transcribed, and analyzed using reflexive thematic analysis. FindingsFR and FM shared their experiences of both joining and learning to live as members of the FR community in Ireland. Through our analysis, we identified a main theme of ‘crossing thresholds’, characterizing their transformative learning experiences. This learning experience includes recognizing the consequences of this new role for them as individuals and for their relationships. Participants also shared how they have learned to cope with the consequences of their roles and what they need to better support each other. ConclusionsFM are often unheard, hidden members of the first responder community in Ireland, highlighting an unmet need for FR organizations to acknowledge FM role in supporting FR and to provide them with the appropriate training and resources required. Training for new recruits needs to move beyond the tokenistic involvement of FM and encourage knowledge sharing among experienced and novice members. Cultural change is required to support help-seeking among FR and foster a sense of peer support and community among families.

Assessing mental health and technology use in the time of COVID-19 among farmworkers in the U.S. – Mexico border

Purpose The purpose of this paper is to present findings on a community-based participatory research project where the authors examined access and ability to use technology, attitudes and perceptions of technology, and COVID-19 and mental health beliefs in the time of COVID-19, among predominantly Hispanic/Latinx farmworker males residing in the US–Mexico border city of El Paso, Texas. Design/methodology/approach This paper used a qualitative narrative analysis which consisted of in-person interviews in Spanish with male farmworkers (n = 10) between the ages of 49–60 years. This paper applied a research approach designed to engage researchers and community stakeholders as equal partners with the goal of improving practice. Findings Of the participants, eight reported having a phone and only three reported knowing how to use the internet. Before the COVID-19 pandemic, the participants reported living a relatively stress-free life. When the pandemic impacted their community, they reported experiencing heightened anxiety and stress. To relieve stress, all participants used healthy coping strategies (e.g. walking and gardening). Originality/value The findings suggest that farmworker males are receptive to obtaining mental health services. In addition, they would benefit from resources highlighting healthy stress coping mechanisms. Due to their limited knowledge of current internet technology, efforts on how to promote and deliver mental health services and resources to farmworkers should be strategic and appropriate.

Community-based participatory research approach to address health care disparities confronting members of the Black Diaspora with Parkinson’s disease

Community-based participatory research approach to address health care disparities confronting members of the Black Diaspora with Parkinson’s disease

'I thought we would be cherished and safe here': understanding the multi-faceted nature of mental health among Arab immigrants/refugees in Ontario, Canada- the CAN-HEAL study.

Mental health (MH) is a critical public health issue. Arab immigrants/refugees (AIR) may be at high risk for MH problems owing to various unique stressors, such as post-September/11 demonization. Despite the growing AIR population in Western countries, there is a lack of AIR-MH research in these nations. The CAN-HEAL study examined MH experiences and needs among AIR in Ontario, Canada. This study employed a cooperative community-based participatory research and integrated knowledge translation approach. The study used photovoice, qualitative interviews and a questionnaire survey. Sixty socio-demographically diverse AIR adults partook in this study. The research was informed by the "social determinants of health" framework and the "years since immigration effect" (YSIE) theory. The term "mental health" was deemed offensive for participants aged > 30years. Participants proposed other culturally-appropriate words including "well-being" and "emotional state". The prevalence of poor mental well-being in the sample was alarming (55%). Of first-generation immigrant participants, 86.8% reported negative changes in MH since migration. The negative changes are not straightforward; they are complex and dynamic, and mainly related to micro/macro-aggression, cross-cultural pressures, dissatisfaction with the health and social care system, and poor living conditions. Intersections between different socio-demographic factors (e.g., gender, length of residency, income, parenthood, religion) amplified the negative changes in MH and exacerbated inequities. MH needs among AIR are distinct and intersectionality aggravated inequities. Culturally and structurally competent healthcare and structural/policy reformation are required to tackle MH inequities. This can be fulfilled through intersectoral cooperation and including AIR in decision-making.

"I Had to Allow Myself to Heal": How Survivors of Sex Trafficking Have Experienced Healing From Trauma Bonding.

Among the many issues facing sex trafficking survivors, the trauma bonds they develop with their perpetrators are one of the most complex and least understood concerns. This community-based participatory research phenomenological study explored this phenomenon by asking: How have survivors of sex trafficking experienced healing from trauma bonding? The sample consisted of 19 female survivors who were all participants in or graduates of a human trafficking specialty docket. Three themes emerged: survivors shared that (a) building trusting and honest relationships, (b) their relationships with themselves, and (c) education all played a pivotal role in the healing they had experienced.

Adapting a Financial Incentives Intervention for Smoking Cessation with Alaska Native Families: Phase 1 Qualitative Research to Inform the Aniqsaaq (To Breathe) Study.

Alaska Native and American Indian (ANAI) peoples in Alaska currently experience a disproportionate burden of morbidity and mortality from tobacco cigarette use. Financial incentives for smoking cessation are evidence-based, but a family-level incentive structure has not been evaluated. We used a community-based participatory research and qualitative approach to culturally adapt a smoking cessation intervention with ANAI families. We conducted individual, semi-structured telephone interviews with 12 ANAI adults who smoke, 12 adult family members, and 13 Alaska Tribal Health System stakeholders statewide between November 2022-March 2023. Through content analysis, we explored intervention receptivity, incentive preferences, culturally aligned recruitment and intervention messaging, and future implementation needs. Participants were receptive to the intervention. Involving a family member was viewed as novel and aligned with ANAI cultural values of commitment to community and familial interdependence. Major themes included choosing a family member who is supportive and understanding, keeping materials positive and encouraging, and offering cash and non-cash incentives for family members to choose (e.g., fuel, groceries, activities). Participants indicated that messaging should emphasize family collaboration and that cessation resources and support tips should be provided. Stakeholders also reinforced that program materials should encourage the use of other existing evidence-based cessation therapies (e.g., nicotine replacement, counseling). Adaptations, grounded in ANAI cultural strengths were made to the intervention and recruitment materials based on participant feedback. Next steps include a beta-test for feasibility and a randomized controlled trial for efficacy. This is the first study to design and adapt a financial incentives intervention promoting smoking cessation among Alaska Native or American Indian (ANAI) peoples and the first to involve the family system. Feedback from this formative work was used to develop a meaningful family-level incentive structure with ANAI people who smoke and family members and ensure intervention messaging is supportive and culturally aligned. The results provide qualitative knowledge that can inform future family-based interventions with ANAI communities, including our planned randomized controlled trial of the intervention.

Protocol of the study: Multilevel community-based mental health intervention to address structural inequities and adverse disparate consequences of COVID-19 pandemic on Latinx Immigrants and African refugees.

The NIMH-funded Multilevel Community-Based Mental Health Intervention to Address Structural Inequities and Adverse Disparate Consequences of COVID-19 Pandemic on Latinx Immigrants and African Refugees study aims to advance the science of multilevel interventions to reduce the disparate, adverse mental health, behavioral, and socioeconomic consequences of the COVID-19 pandemic that are a result of complex interactions between underlying structural inequities and barriers to health care. The study tests three nested levels of intervention: 1) an efficacious 4-month advocacy and mutual learning model (Refugee and Immigrant Well-being Project, RIWP); 2) engagement with community-based organizations (CBOs); and 3) structural policy changes enacted in response to the pandemic. This community-based participatory research (CBPR) study builds on long-standing collaboration with five CBOs. By including 240 Latinx immigrants and 60 African refugees recruited from CBO partners who are randomly assigned to treatment-as-usual CBO involvement or the RIWP intervention and a comparison group comprised of a random sample of 300 Latinx immigrants, this mixed methods longitudinal waitlist control group design study with seven time points over 36 months tests the effectiveness of the RIWP intervention and engagement with CBOs to reduce psychological distress, daily stressors, and economic precarity and increase protective factors (social support, access to resources, English proficiency, cultural connectedness). The study also tests the ability of the RIWP intervention and engagement with CBOs to increase access to the direct benefits of structural interventions. This paper reports on the theoretical basis, design, qualitative and quantitative analysis plan, and power for the study.

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...

Power, Privilege, and Precarity: Attempts to Conduct Ethical Youth Participatory Action Research as Early Career Researchers.

Though community-based participatory research (CBPR) boasts a robust history, challenges to conducting such work ethically and equitably remain. Common difficulties, such as addressing power dynamics and navigating mutuality, are heightened when doing participatory research with young people, specifically youth participatory action research (YPAR). Additional obstacles also emerge when engaging in such research as junior scholars, who lack tenure and occupy more precarious positions within academia. To elucidate these hurdles and illuminate the labor required to traverse them, we draw upon our experiences as early career academics facilitating YPAR projects with young people who have been historically marginalized. Employing an autoethnographic approach, we utilize qualitative data sources including field notes and reflective memos, from which three themes emerged after iterative rounds of reflection and review. Through descriptive vignettes, we unpack how we attended to positionality and power, interrogated shared benefit and mutuality, and engaged with the unique complexities of working with young people-as informed by our specific identities. In examining our experiences and their alignment with prior research, we aim to expand upon existing literature that has explored best practices within CBPR, but with a specific focus on youth-adult partnerships and consideration of the realities of junior scholars. It is our hope that this discussion will support early career researchers who wish to conduct YPAR but are unsure how to do so given their particular positionalities, by making visible the often-invisible work involved.

The Role of Black Churches in Promoting Mental Health for Communities of Socioeconomically Disadvantaged Black Americans.

Churches in socioeconomically disadvantaged neighborhoods serve as safe havens in many Black communities. Churches provide faith and charitable services but often have limited resources to address the mental health needs of their communities. This article reports on a collaborative effort, driven by members of a Black church, to understand mental health needs, coping strategies, and resilience factors in a community of socioeconomically disadvantaged Black Americans. A community-based participatory research effort was established among a church, a community mental health organization, clinicians, and researchers to interview and survey individuals residing near the church. The sample consisted of 59 adults, most of whom were ages 46-65 years, men (N=34, 58%), and unemployed (N=46, 78%). Mean scores on the Patient Health Questionnaire-9 (9.2±7.7) and Generalized Anxiety Disorder-7 scale (9.4±6.7) were almost three times higher than those reported by studies of other Black populations in the United States. Five themes emerged: prolonged poverty and daily exposure to violence trigger emotional distress, mental health stigma affects help seeking, spirituality promotes mental relief and personal recovery, spirituality helps in coping with poverty and unsafe neighborhoods, and church-based programs are needed. Uptake of traditional mental health services was low, and reliance on faith and resource distribution by the church was high. Church-led interventions are needed to promote mental health at the individual and community levels. Mental health stigma, and negative attitudes toward mental health promotion in the community, may be addressed by integrating traditional mental health services in church-based recreational and leisure activities.