Community-based Participatory Research Research Articles

Relational knowledge and young people’s cancer care: how community-based participatory research promotes learning and directs action in practice

ABSTRACT This paper reflects on the dynamic of co-developing knowledge within a Community-Based Participatory Research (CBPR) project in the UK that set out to direct teenage and young adult Ambulatory Care. This is a service that offers cancer treatment that would have once required inpatient hospital stays. Working within a Community-of-Inquiry (CoI), young people from this cancer community became co-researchers, participating in every phase of the qualitative research. This contribution is written from the perspective of two members of the CoI, Alison, a cancer researcher-practitioner, and Michela, a young associate researcher with lived experience of cancer. Drawing on the Ambulatory Care research as a case study, they offer a reflective account of involving young people in research that directs both action and participatory action research processes. In doing so, they engage in a critical exploration of their participatory research inquiry, contextualising their discussion with some of the extant literature relevant to their chosen CBPR approach. The researchers found that both Ambulatory Care and their research dynamic foster young people’s agency. Evident too, was that within research that prioritises relationships and knowledge democracy and which associates with a sense of the collective, individuality can also sit comfortably alongside. The authors conclude this that distinctiveness is a strength, which enhances the learning, criticality, and reach of engaged research inquiry.

Reducing the harms of cannabis use in youth post-legalization: insights from Ontario youth, parents, and service providers.

Canada has one of the highest prevalence of cannabis use globally, particularly among young adults aged 20-24 (50%) and youth aged 16-19 (37%). In 2018, Canada legalized recreational cannabis with the aim of protecting youth by restricting their access and raising public awareness of health risks. However, there has been limited qualitative research on the perceptions of harms associated with youth cannabis use since legalization, which is crucial for developing effective harm reduction strategies. This qualitative study examined perceptions of cannabis use among youth from the perspectives of youth, parents, and service providers. We explored how participants described the perceived risks or harms associated with youth cannabis use, as well as how they described their own and others' approaches to reducing cannabis-related risks and harms. This qualitative study used a community-based participatory research approach in partnership with Families for Addiction Recovery (FAR), a national charity founded by parents of youth and young adults with addiction issues. Virtual semi-structured interviews were conducted, and the data were analyzed using thematic analysis. The study included 88 participants from three key groups (n = 31 youth, n = 26 parents, n = 31 service providers). Two main themes emerged regarding perceived risks or harms associated with cannabis use: (1) concerns about cannabis-related risks and harms, including addiction, brain development, impact on family, and various adverse effects on areas such as motivation, concentration, finances, employment, education, physical and mental health; and (2) minimization of risks and harms, featuring conflicting messages, normalization, and perceptions of cannabis being less harmful than other substances. Additionally, two themes related to harm reduction approaches were identified: (1) implementation of harm reduction, and (2) challenges in implementing a harm reduction approach. Specific challenges for each participant group were noted, along with structural barriers such as unavailable and inaccessible services, easy access to cannabis, inadequate public education, and insufficient information on lower-risk cannabis use guidelines. Youth cannabis use is a significant public health concern that requires a multi-pronged approach. Developing youth-centered harm reduction strategies that recognize the developmental needs and vulnerabilities of youth, as well as the important role of families, is imperative.

Building Connections: The Impact of Digital Storytelling on Communication and Leadership Skills Among Disabled Young Adults

Digital storytelling has been applied in research in varied contexts and with varied purposes. Implicit in the process of digital storytelling is the potential to develop and/or enhance a range of individual skills (e.g., multimedia, literacy, communication, etc.). However, further research is needed to gain a deeper understanding of the potential impact of digital storytelling on skill enhancement for disabled youth. This paper provides an overview of Phase 1 of the study “My life. My story: The Youth Digital Storytelling Project” that utilized elements of a community-based participatory action research approach to host a peer-facilitated digital storytelling workshop for young adults with developmental disabilities aimed at capturing and sharing their lived experiences with, knowledge of, and perspectives on significant life-stage transitions in the areas of education, employment, or living. The results from the pre- and post-workshop questionnaires suggest that the participants improved skills in media literacy, communication, and leadership. Additionally, the participants highlighted the importance of considering the delivery format, fostering connections, and enhancing self-confidence in the development of the workshop’s design and delivery. This research adds to the extant literature demonstrating the potential of digital storytelling as a pedagogical tool, offering implications for the design and implementation of online workshops for disabled youth.

“I Have One More Hour of Power and Many Miles of Communication to Go”: Lessons Learned from Community Research Interrupted by Climate Crises

The Ang Pagtanom og Binhi Project is a University–Community partnership and community-based participatory research project exploring the health benefits of food sovereignty practices in the Philippines. In late 2021, in the midst of data collection, Super Typhoon Odette made landfall in the Philippines causing massive environmental and structural devastation. In the aftermath of the storm, community partners in the Philippines and members of the research team in the United States shared photos, texts, and updates. These messages included descriptions of structural and environmental damage caused by the storm and stories of mutual aid efforts and actions taken by individuals and small organizations, each highlighting connections between food sovereignty efforts in the Philippines and the impacts of climate change. Due to the richness of the stories, the interconnectedness between these conversations and the research topic, and the alignment within the theoretical foundations of the project, the researchers understood that these communications should be included as data. With feedback from the Community Advisory Board, the Research and Design Team amended project protocols, research questions, and consent forms to incorporate this emergent data. This manuscript describes the process that the team undertook and some of the lessons learned by taking this approach.

A community action network-based intervention for improving knowledge of zoonoses among wildlife hunters and traders in Epe, Lagos, Nigeria.

The West Africa One Health project is a multi-country project designed to utilise the One Health approach and deploy the Community Action Networks (CAN), a concept rooted in the principles of community-based participatory research, to improve knowledge of high-risk communities on zoonoses. The majority of emerging zoonoses occur at the human-wildlife interface, of which wildlife hunters and traders are critical stakeholders. We assessed the effectiveness of a CAN-based intervention involving the use of a video documentary and case studies as model tools in improving the knowledge of zoonoses among wildlife hunters and traders in Epe, an established hunting community in Lagos State, Nigeria. A single-group pre-post design involving a total of 39 consenting registered wildlife stakeholders was adopted. A pre-tested, semi-structured, interviewer-administered questionnaire was used to obtain data on the participant's sociodemographic characteristics, awareness level, and knowledge of zoonoses pre and post CAN-based intervention. Data were analysed using descriptive statistics McNemar and Wilcoxon Signed Ranks tests at a 5% level of significance. The mean age of the participants was 46.7 ± 10.9 years. Most (76.9%) identified as male and had at least secondary education (89.7%). The number of participants who were aware that diseases could be contracted from animals and that it could be through inhalation and close contact increased significantly from 13 (33.3%), 2 (5.1%), and 9 (23.1%) pre-intervention to 37 (94.9%), 11 (28.2%), and 21 (53.8%) post-intervention, respectively. The overall median knowledge score increased significantly from 1 (Interquartile range (IQR): 0-2) pre-intervention to 3 (IQR: 2-4) post-intervention. The CAN-based intervention involving the use of a video documentary and case studies as model tools was effective in improving the knowledge of zoonoses among wildlife hunters and traders in the hunting community and may be beneficial for future practice.

Black men's health-related quality of life: A qualitative study to understand community-identified perception and needs.

Health-related quality of life (HRQoL) is a multidimensional indicator of overall health associated with premature mortality. Black men score low on measures of HRQoL, but it is unclear how Black men conceptualize HRQoL and whether there have been efforts to promote HRQoL among these men. The present qualitative study to understand Black men's conceptualization of HRQoL and strategies to improve HRQoL was based in community-based participatory research and the social-ecological model of health. A community advisory board (CAB) was established, and the need for an effort to promote HRQoL promotion among Black men was assessed and supported. A focus group protocol was developed in conjunction with the CAB and a group of barbers. Seven focus groups were conducted consisting of 56 Black men in the Southeastern United States. The mean age of participants was 45 years. Two reviewers coded each focus group. Reliability ranged from 71% to 76%. A thematic analysis was conducted, and the findings were confirmed with the CAB. Three themes emerged: (a) a holistic conceptualization of health that includes spiritual functioning among Black men; (b) a state of HRQoL among Black men predominately marked by mental health concerns, in addition to physical and social health concerns; and (c) multilevel determinants of HRQoL among Black men. This last theme consisted of three subthemes related to community-level, interpersonal, and intrapersonal determinants of HRQoL. Findings from this study can help inform the development of strategies to improve HRQoL and reduce health disparities among Black men. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Revitalization of Tourism Village Facilities as an Effort to Increase Income and Sustainability

Developing village tourism in Indonesia is a crucial government strategy to boost the local economy and increase regional income. Villages with diverse assets such as natural beauty, rich cultural traditions, traditional cuisine, handicrafts, and historical sites have the potential to become attractive tourist destinations. This research focuses on Gunung Wangi Nature Tourism, which offers attractions such as sunset views, city lights at night, and camping activities. However, constraints such as inadequate facilities and infrastructure are the main focus of this research. Through a Community-Based Participatory Research (CBPR) approach, this research offers solutions to revitalize the facilities and infrastructure and a long-term revitalization strategy to increase the attractiveness of Gunung Wangi. Local community involvement is integrated into every research stage, including problem identification, Focus Group Discussion (FGD), implementation, and evaluation. Revitalization efforts at Gunung Wangi Nature Park have shown positive results, with substantial improvements reported in post-revitalization evaluations. Feedback from stakeholders, including visitors, MSME players, and Gunung Wangi Tourism village managers, showed significant improvements in infrastructure and visitor experience. While a few respondents suggested room for improvement, the overall success is evident in the increase in visitor numbers, with the majority experiencing a significant increase. This revitalization has rejuvenated this tourist spot's attractiveness and boosted economic growth in the local community

A participatory study of indoor environment quality in homes of children and youth in Kanehsatake First Nation

Indoor air quality is an important determinant for the health of children and youth, but the conditions within Indigenous communities are understudied. We collaborated with Kanehsatake First Nation in Quebec, Canada, to address this gap using a community-based participatory research approach. Levels of key indoor air indicators, including particulate matter (PM2.5), CO2, and relative humidity, were measured in 31 randomly selected households between June 2021 and January 2022. Questionnaires were administered remotely to collect information on housing conditions. Excessive humidity was common, with 52% of households having a relative humidity above 55%. The mean PM2.5 concentration was 21.0 (standard deviation 38.5) µg/m3, with higher mean levels observed in smoking compared to non-smoking households (36.1 µg/m3 and 10.1 µg/m3, respectively). The mean CO2 level in participating households was 881 ppm (standard deviation 256), with 30% (n = 9) of homes exceeding 1000 ppm. Flooding rates were high, with 55% of households reporting at least one past flood. One-third of houses were inadequately ventilated relative to occupancy, and over one-quarter reported needing major repairs. The results indicate the value and importance of characterizing the indoor environment in First Nations households and the viability of data collection through community-based participatory research in environmental health research.

Access to transition-related health care among transmasculine people in India: A mixed-methods investigation.

Little research has examined the health care experiences of transmasculine people in India, where government initiatives to improve access to transition-related (also called gender-affirmative) care have recently been announced. We draw on data from 'Our Health Matters', a mixed-methods community-based participatory research project, to characterize the transition-related care experiences of transmasculine people in India. Peer researchers conducted 40 virtual qualitative interviews in Hindi or Marathi from July to September 2021. Between November 2022 and January 2023, 377 transmasculine people participated in a multi-mode survey available in five languages. Qualitative data were analysed with a combination of framework analysis and grounded theory techniques. Data were mixed using a convergent parallel approach. Transmasculine persons' care journeys began with information-seeking, relying on peers and internet searches. In choosing between the public and private healthcare systems, they weighed issues of quality and affordability: the public system was perceived as lower-quality and difficult to access but most could not afford private care, leading to delays in care. Indeed, unmet need was common; 36.4% of survey participants were planning but had not begun to receive transition-related care and 80.2% wanted at least one transition-related surgery. Although some participants encountered stigma and refusal of care when seeking hormones, survey participants reported largely positive experiences with their hormone prescribers, which may reflect the influence of peer referrals. Participants underwent psychological assessments prior to transition-related care, which some experienced as disempowering and a barrier to disclosing mental health challenges. Finally, participants who were able to access care reported improved well-being, although surgical dissatisfaction was not uncommon (26.2%). Trans-inclusive medical training and continuing education are critical to enhancing access to high-quality transition-related care. Transmasculine people generally relied on peers and grassroots organizations for information, system navigation, and financial assistance. Strengthening these existing community resources may improve access to care.

How do communities define “work precarity” and “labour exploitation”? Lessons for research from participatory research in high economic hardship communities in Chicago, Illinois/USA

Abstract Labour migration has both social and economic drivers that channel workers into jobs that are less desirable to citizens of the receiving countries. Immigrant workers find jobs through contacts from their home countries, including temporary staffing companies. These workers tend to co-locate in segregated communities and coalesce in jobs that entail hard work, low wages, and limited social benefits. As such, labour migration adds a dimension to the structural and social determinants of health (SDOH) that can broaden our understanding of health inequities, and that can point us toward policies and practices to enhance the health and wellbeing of migrant workforces. However, to generate evidence, align interventions with workers’ needs and priorities, and move evidence to action, it is crucial to engage communities. This presentation describes a community-university research partnership that co-investigates the relationship between work and health as experienced at the community level in two high-economic-hardship neighbourhoods in Chicago, Illinois/USA. The academic and practice partners co-developed and tested a conceptual model of the interrelations among migration, work and health, conducted an inventory of local employers, and executed a street-level survey of 497 workers in these two communities. The research findings helped enhance existing models of the structural/social determinants of health and of work precarity, thus informing methodological approaches to measure work precarity, labour exploitation, and their health effects. The community-based participatory research further led to several action-research projects that are ongoing. This presentation will describe the development of the community-university research partnership and its work, the subsequent enhancements made to the worker precarity and SDOH models, and preliminary findings of the partnership’s current action-research projects.

Adapting, expanding and embedding community and culture into health ecosystems

Abstract Background Community anchor organisations (CAOs) work with communities who experience health inequalities and disadvantage, providing a range of activities and services to meet individuals’ needs in an integrated way. This study explored how CAOs use art, cultural and nature-based activities as part of their work to respond to the needs of people facing inequalities and considered how activities can be scaled in this health setting. Methods This study used community-based participatory research within a case study approach to work with four purposively sampled CAOs. Participants were community members, volunteers, staff, trustees, partner organisations and commissioners. Data collection methods included: document analysis, interviews (n = 45), workshops (n = 5) and focus groups (n = 11). This study was also supported by data collected by trained community researchers (n = 18). Framework analysis was conducted for within- and cross-case analysis. Results In the context of CAOs, the delivery of art, cultural and nature-based activities were found to be an important mechanism for developing trusted relationships with marginalised groups, who may lack trust in statutory services and health focused activities. Other facilitators to community engagement were the CAOs’ longevity, localness and co-location of services within a trusted and familiar place that connect people to personalised support. Barriers to scaling up included funding models as well as insufficient dialogue and understanding between CAOs and the local public health ecosystem. Conclusions CAOs have long term trusted relationships with disadvantaged communities and are influential in connecting individuals with projects and services. Findings suggest that the effectiveness of action to address inequality through art, cultural and nature-based activities could be improved if the role of CAOs was recognised more coherently in place-based public health plans. Key messages • Creative activities enable meaningful engagement with disadvantaged groups within place-based settings. • CAOs must be recognised more coherently in place-based strategies to reduce health inequalities.

Strengthening Community Resilience in the Face of Environmental and Economic Challenges in Southeast Mexico

Objective: The problems in the sustainable management of natural resources in their fishing practices in the community of Aztlán Quinta Seccion Palomillal in Tabasco, Mexico, are analyzed to develop community solutions and improve sustainability and socioeconomic results. Theoretical Framework: It is based on the theory of sustainability (World Commission on Environment and Development, 1987, p. 43), the natural resources management model (Natural Resources Commission, 2012, p. 3) and the theory of participatory research (Reason & Bradbury, 2008, p. These frameworks are the context in which fishing practices are developed in the community, serving as a relevant case study for southeastern Mexico, facilitating the analysis of the problems and proposed solutions. Method: A qualitative case study design focused on community-based participatory research was applied, involving key community actors, including fishermen and leaders of the fishing cooperative. Data collection was through semi-structured interviews, focus groups and participant observation. The interviews were designed to learn about challenges in resource management, while focus groups facilitated discussions about possible solutions. Participant observations were carried out during community meetings and the sociocultural and environmental context. Results and Discussion: The problems of sediment accumulation, the presence of invasive species, the lack of adequate infrastructure and low educational levels were identified. There is an urgency to implement strategies that combine traditional knowledge with modern practices to improve the sustainability of fishing activities. The importance of community participation is highlighted. Research Implications: It has significant practical and theoretical implications for sustainable resource management in rural fishing communities and can be applied in other similar rural contexts and contributes to the theoretical development of community-based participatory research. Originality/Value: An innovative community-based participatory research approach is applied for sustainable natural resource management in a rural fishing community, replicable for sustainable resource management in vulnerable contexts.

Equitable community-based participatory research engagement with communities of color drives All of Us Wisconsin genomic research priorities.

The NIH All of Us Research Program aims to advance personalized medicine by not only linking patient records, surveys, and genomic data but also engaging with participants, particularly from groups traditionally underrepresented in biomedical research (UBR). This study details how the dialogue between scientists and community members, including many from communities of color, shaped local research priorities. We recruited area quantitative, basic, and clinical scientists as well as community members from our Community and Participant Advisory Boards with a predetermined interest in All of Us research as members of a Special Interest Group (SIG). An expert community engagement scientist facilitated 6 SIG meetings over the year, explicitly fostering openness and flexibility during conversations. We qualitatively analyzed discussions using a social movement framework tailored for community-based participatory research (CBPR) mobilization. The SIG evolved through CBPR stages of emergence, coalescence, momentum, and maintenance/integration. Researchers prioritized community needs above personal academic interests while community members kept discussions focused on tangible return of value to communities. One key outcome includes SIG-driven shifts in programmatic and research priorities of the All of Us Research Program in Southeastern Wisconsin. One major challenge was building equitable conversations that balanced scientific rigor and community understanding. Our approach allowed for a rich dialogue to emerge. Points of connection and disconnection between community members and scientists offered important guidance for emerging areas of genomic inquiry. Our study presents a robust foundation for future efforts to engage diverse communities in CBPR, particularly on healthcare concerns affecting UBR communities.

40 Trust, belonging and understanding - The experiences of families who use languages other than English (LOE) that are hospitalized on general paediatric inpatient units

Abstract Background Despite recognition that social determinants are critical to health outcomes, many groups, including those with lower incomes, racial/ethnic minorities, and other historically marginalized populations, continue to experience significant social and structural barriers to care. There is need for research that incorporates patient and stakeholder engagement in developing, testing, and disseminating interventions to improve outcomes for patient populations that have been marginalized in the health system. Patients who use a language(s) other than English (LOE) for healthcare communication are at increased risk for experiencing adverse events and worse health outcomes in healthcare settings, including in paediatric hospitals. Canadian census data indicates 12.7% of Canadians predominantly speak a language other than French or English. This work aims to generate knowledge to improve health outcomes for children and families who speak LOE. Objectives (1) To understand the lived experience of families who speak LOE around the hospitalization of their child and (2) To understand the perspectives of patients and families who speak LOE on how the healthcare system can improve care during hospitalization. Design/Methods The premise of this study is participatory research. We designed a qualitative study involving children hospitalized in the General Paediatric Inpatient Unit at the Hospital for Sick Children. The study includes family caregivers of children age 0 to 18 years who identify as speaking LOE. Children and families could speak any language that we were able to obtain interpreter support for. We excluded patients that spoke a traditional Indigenous language as we noted this work required a separate study in partnership with the Indigenous community. We conducted semi-structured virtual individual interviews with children and families post-discharge with a medical interpreter. An interview guide was developed and transcripts were analyzed using thematic analysis. We took several steps to ensure an effective study design given our goals of participatory research including ensuring patient and family engagement throughout the design process. Results 19 families participated in the interviews and 16 different languages were represented amongst our participant groups. Our study is unique in especially unique in it's ability to recruit and interview individuals with so many different primary languages. Our study provides rich insight into opportunities within the paediatric inpatient setting for quality improvement to address the health disparities experienced by patients and families who use LOE for healthcare communication. Our analysis of the interviews identify several themes that provide insight into the lived experience of patients and families who use LOE for healthcare communication. 1) Inconsistent interpreter use affects communication “in the moment” and the ability to develop an “overall understanding” of the current clinical situation and broader healthcare context. Our participants note a "snowball effect" when interpreters are not consistently utilized. 2) In addition to language, multiple additional social factors contribute to an increased sense of vulnerability and modulates how families “trust” the healthcare system. 3) Despite families expressing positive experiences, they noted that they did not, nor expect to feel like they “belonged” within the healthcare system. It is critical to recognize the complex interplay between many factors surrounding our participants’ identities. Though they use a LOE for healthcare, the intersectional marginalization they experience was thoroughly represented during our conversations Conclusion Our research aimed to take a participatory approach to consider the lived experience of patients and families who use LOE for healthcare communication. This work builds on the current literature on patient and family centered care, experiences of families who speak LOE and participatory community-based research in the paediatric hospital settings. Our study's findings support the development of a research and intervention agenda in Canada to improve health outcomes for patients and families with LOE.

Using the 12-item short-form health survey (SF-12) to evaluate self-rated health in an environmental justice community

The Greater Fifth Ward (GFW) is a Northeast Houston, Texas, neighborhood with a legacy of industrial contamination and a confirmed cancer cluster. To understand self-rated health in the GFW, community-based participatory research (CBPR), was used to promote the inclusion of all partners. CBPR involves the community during each stage of the research process from design to research dissemination. A complete census was conducted, and 114 surveys were obtained in the environmental justice (EJ) community from July to November 2021. EJ communities shoulder an unfair burden of environmental exposures, pollution, and poor built environments. Mental and physical health were measured using the validated 12-item Short Form Health Survey (SF-12v2). We posited that the Black or African American (Black/AA) community would have lower mental composite scores (MCS) and physical composite scores (PCS) compared to the nation and their White counterparts. The MCS and PCS were calculated and compared against the national mean. Overall, participants had higher MCS and lower PCS than the national mean. Black/AA males and females had lower MCS compared to their White counterparts. White females had the lowest PCS among all respondents, significantly lower than the national average. MCS was lower among those who lived in the neighborhood longer. Burdens from pollution may impact residents’ health and perceived health. Targeted interventions or programs that improve mental or physical health would benefit this community and other inequitably burdened neighborhoods.

Service-policy gaps in the settlement journey of Arabic-speaking immigrant newcomer and refugee older adults in Edmonton, Canada.

Immigrant newcomers and refugees (INRs) are two migrant categories that experience consistent systemic barriers to settlement and integration in Canada as older adults. This paper explores the challenges experienced by Arabic-speaking INR older adults in Edmonton, Canada, during settlement and discusses policy and service implications. A qualitative description study using community-based participatory research principles was implemented to evaluate and support digital literacy in Arabic-speaking INR older adults. We included men and women aged 55 and older who identified as immigrants or refugees and spoke Arabic. Experiences of settlement challenges were consistently identified during data collection and engagement of INR older adult participants. A thematic sub-analysis of interviews with (10 individuals and one couple) of participants' narratives was completed in 2022 and was used to identify themes related to settlement barriers for this population. Two main themes were identified: (1) Limited English skills and digital literacy gaps create service barriers for INR older adults, and (2) Gaps in services and policies as basic needs remain unmet. We describe key challenges experienced by INR older adults, such as language barriers, precarious finances, poor access to health care services and lack of transportation and employment opportunities, which hinder successful integration into the new society. This study showcases the ongoing challenges with early settlement and integration that continue despite Canada's well-developed immigration settlement landscape. INR older adults often remain invisible in policy, and understanding their experiences is a first step to addressing their needs for resources that support healthy aging in the post-migration context.

Moving psychedelic-assisted therapies from promising research into routine clinical practice: Lessons from the field of implementation science.

Psychedelics (e.g., 3,4-Methylenedioxymethamphetamine [MDMA], lysergic acid diethylamide [LSD], psilocybin) are molecules that have the potential to produce rapid therapeutic effects when paired with psychotherapy. Randomized clinical trials of psychedelic-assisted psychotherapy (PAT) have shown promising results for post-traumatic stress disorder (PTSD), depression, and substance use disorders. The U.S. Food and Drug Administration has acknowledged the promise of PAT, signaling potential approval of psilocybin-assisted therapy for depression by 2026. Given this timeline, implementation scientists must engage with PAT researchers, policymakers, and practitioners to think critically about bringing these promising new treatments into routine practice settings while maintaining quality and safety. This commentary aims to initiate a dialogue between implementation scientists and PAT researchers and practitioners on addressing these questions with a lens toward equity. Specifically, we discuss how the field of implementation science can support PAT stakeholders to accelerate the translational process from research into practice, focusing specifically on safety-net settings (i.e., Federally Qualified Health Centers and Veterans Affairs health systems) that serve historically marginalized populations. We use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework to illustrate five critical areas where implementation science can help move PAT from research into real-world practice. For each RE-AIM dimension, we highlight ways the field of implementation science can contribute tools (e.g., implementation strategies), methodologies (e.g., pragmatic hybrid implementation-effectiveness trials), and approaches (community-based participatory research) for establishing the safety, effectiveness, and accessibility of PAT for historically underserved communities.

A hand-washing community-based educational intervention to reduce abscess incidence among people who inject drugs: a cluster randomised controlled clinical trial protocol (the HAWA study protocol)

BackgroundBesides the high prevalence of HIV and HCV infections, people who inject drugs (PWID) have a cumulative risk of acquiring skin and soft tissue infections (SSTI) from, among other things, social precariousness, homelessness/unstable housing, and unhygienic injecting practices. We propose to evaluate whether a two-component educational hand hygiene intervention which combines training in hand-washing with the supply of a single-use alcohol-based hand rub, called MONO-RUB, is effective in reducing injection-related abscesses in the PWID population. Specifically, we shall implement a nationwide, two-arm, multi-centre, cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of this intervention in PWID.MethodsHAWA is a community-based participatory research study to be conducted in 22 harm reduction centres (HR) in France (not yet recruiting); the latter will be randomised into two clusters: centres providing standard HR services and the intervention (i.e., intervention group) and those providing standard HR services only (i.e., control group). After randomization, each cluster will include 220 PWID, with an inclusion period of 12 months and an individual follow-up period of 6 months. For each participant, we will collect data at M0, M3 and M6 from photos of injection sites on the participant’s body, a face-to-face injection-related SSTI questionnaire, and a CATI questionnaire. The primary outcome is the reduction in abscess prevalence between M0 and M6, which will be compared between the control and intervention arms, and measured from observed (photographs) and self-declared (SSTI questionnaire) data. We will also assess the cost-effectiveness of the intervention.DiscussionThe HAWA trial will be the first cluster randomized controlled trial to improve hand hygiene among PWID with a view to reducing SSTI. If effective and cost-effective, the intervention combined with the distribution of MONO-RUBs (or a similar cleaning product) may prove to be an important HR tool, helping to reduce the enormous burden of infection-related deaths and diseases in PWID.Trial RegistrationNCT06131788, received on 2 January 2024.

Lessons learned from a community-based participatory research project developing a smoking cessation app in socioeconomically disadvantaged areas

Lessons learned from a community-based participatory research project developing a smoking cessation app in socioeconomically disadvantaged areas

Essential(ly forgotten) workers: Latine youth farmworkers during the COVID-19 pandemic.

Essential workers across multiple industries faced a disproportionate burden of morbidity and mortality during the COVID-19 pandemic. The effects were especially severe for agricultural and food processing workers, many of whom are members of the structurally vulnerable Latine community. Under current U.S. federal laws, children under 12 years old can legally work in agriculture, one of the most hazardous U.S. industries. Many of these working youth are Latine and experience health and educational inequities. Using a community-based participatory research approach and a qualitative design, we conducted semi-structured in-depth interviews in North Carolina in 2022, with service providers in health, education, and advocacy fields (n = 10) and Latine youth farmworkers aged 10-17 (n = 24). We used participatory qualitative analysis methods and a reflexive thematic analysis to understand and describe the work experiences of these youth during the first 2 years of the pandemic. Amidst precarious economic and school situations exacerbated by the COVID-19 pandemic, many youths described an increased need to work to support their families. While aware and sometimes fearful of the added occupational health risks of COVID-19, youth and their families felt they had few other options. Service providers and youth described minimal employer-provided safety protocols or equipment, yet some workers organized their own attempts at safety protocols. Youth narratives imply limited knowledge of basic workplace safety requirements. Study findings emphasize the urgent need to address structural vulnerabilities shaping workplace policies and norms to protect Latine youth farmworkers to support their healthy development.