Community Dialogue Research Articles

Enabling mental health student nurses to work co-productively

Purpose The purpose of this paper is to investigate the use of innovative teaching methods and share a four-step model, to promote the use of co-production in mental health practice. Design/methodology/approach The case study approach highlights three real-life examples of day to day experiences in mental health nurse education with innovative approaches to sharing and developing co-production skills and attitudes in mental health student nurses. Findings The case studies highlight three settings where undergraduate mental health nurses experience co-production through a world café event and dialogical community development. Common themes include setting the environment, developing a common aim and relationship building. Research limitations/implications A limitation of this paper is that only three case studies are provided, further examples would provide a greater pool of exemplars for others to draw on. However, by focusing upon student nurse education in learning environment, these examples are transferable to other settings. Practical implications The practical applications are summarised in a four-step model that can help develop co-productive teaching methods; enable educators to set the climate and generate an understanding of co-production that empowers students and service users. Social implications The emphasis and relevance of promoting co-productive working habits early on in nurses’ mental health nursing careers will enable them to raise awareness of future social implications for a range of client groups. Originality/value This paper focuses upon mental health student nurses whilst providing an innovative model to facilitate co-production experiences applicable in a range of settings.

\u201cAs we have gathered with a common problem, so we seek a solution\u201d: exploring the dynamics of a community dialogue process to encourage community participation in family planning/contraceptive programmes

BackgroundCommunity dialogues have been widely used as a method for community engagement and participation to cover a broad range of areas. However, there has been limited documentation and evaluation of the process, particularly as a method towards achieving family planning and contraception (FP/C) programme goals. As part of the development of an intervention package aimed at increasing community and health care provider (HCP) participation in the provision of FP/C, feasibility testing of the intervention approach (a community dialogue between communities and health facilities) was carried out. Our findings offer a systematic description and evaluation of the community dialogue process, with key recommendations towards future implementation.MethodsThe dialogue was evaluated in three ways: 1) through participant observation during the community dialogue, 2) via a standardised feasibility testing tick-list for all observers of the dialogue, and 3) through three focus group discussions (FGDs) consisting of different groups of stakeholders who participated in the community dialogue. In total, 28 community members, HCPs, and key stakeholders attended the community dialogue (22 females, 6 males). Twenty-seven of the community dialogue participants participated in one of 3 FGDs held after the dialogue. Six evaluators assessed feasibility of the dialogue process.ResultsThere was good attendance, representation and participation amongst community and provider sectors based on the participant observations using the standardized feasibility check-list. The community dialogue process received positive feedback in the FGDs and was demonstrated to be feasible and acceptable. Key factors contributing to the success of the community dialogue included a skilled facilitator, good representation of participants, establishing ground rules, good timekeeping, and using a Theory of Change to facilitate goal identification and dialogue. Issues to consider are the underlying power differentials related to age, profession and gender which caused initial feelings of anxiety amongst some participants.ConclusionsOur formative findings offer a systematic description and evaluation of a community dialogue process with key recommendations that may be considered when constituting similar community dialogues in the future.

Contributions of Volunteer Community Mobilizers to Polio Eradication in Nigeria: The Experiences of Non-governmental and Civil Society Organizations.

.The Northern states were the epicenter of the wild poliovirus outbreak in Nigeria in 2016. To raise immunization coverage, particularly of polio, the Polio Eradication Initiative (PEI) in Nigeria introduced the use of nongovernmental organizations and volunteer community mobilizers (VCMs) through the CORE Group Polio Project (CGPP). The CGPP has been contributing to Nigeria’s polio eradication efforts since 2013. This article explores the contributions of the 2,130 VCMs deployed in 31 participating local government areas in the five implementing CGPP states from 2014 to 2017 to increase awareness, understanding, and acceptance of polio immunization. Data for the study were collected from primary and secondary sources using five collection methods: a survey of VCM supervisors, focus group discussions with VCMs and their supervisors, key in-depth interviews with community stakeholders, case studies of specific best practices of VCMs, and a review of documents and records. A review of the data shows that the VCMs received comprehensive training on the importance of the PEI, routine immunization, Acute Flaccid Paralysis (AFP) surveillance, social mobilization and community engagement, use of behavior change communication tools, and interpersonal communication skills. According to the data collected, the VCMs used the following innovative strategies to ensure high vaccination coverage: house-to-house mobilization, community dialogues, compound meetings, community health camps, and tracking of non-compliant families, missed children, and dropouts. The involvement of VCMs in Nigeria’s PEI efforts has been a pivotal contribution to reductions in the number of households rejecting polio immunization, the proportion of families with missed children, the proportion of families that were non-compliant, and the number of polio cases.

The CORE Group Partners Project in North East Nigeria: Community Engagement Strategies to Combat Skepticism and Build Trust for Vaccine Acceptance.

.In North East Nigeria, anti-immunization rumors and sentiments have negatively impacted the country’s polio eradication efforts. Since 2014, the CORE Group Partners Project (CGPP) has leveraged local-level strategies to help change prevailing attitudes and behaviors by improving immunization acceptability in some of the most difficult settlements in Nigeria’s states at highest risk for polio. The CGPP’s communication model in Nigeria, in part, emphasizes the need to counter suspicion and address myths and misunderstandings by convening community dialogs and compound meetings, both of which serve as safe spaces for open discussion primarily aimed at addressing non-compliance. In the communities in Kaduna, Katsina, Kano, Borno, and Yobe states located in the CGPP implementation areas, there has been a consistent reduction in the number of missed children and consistent improvement in polio immunization uptake, providing evidence of the effectiveness of the CGPP communication model. The last case of wild poliovirus in Nigeria was detected in August 2016. Since Nigeria has gone more than 3 years without a case of wild poliovirus, the CGPP communication model promises to remain highly relevant in sustaining the community’s awareness about immunizations that will be required to keep the population coverage of polio immunization high and, by extension, the herd immunity required to maintain zero transmission of poliovirus in Nigeria. This article describes the various strategies used to address noncompliance and provides examples of community engagement in Yobe state, which is one of the project’s largest implementation areas.

A Short Reflection on City Branding and its Controversies

AbstractThanks to its conceptual character the paper ‘City Branding: An Effective Assertion of Identity or a Transitory Marketing Trick?' by Kavaratzis and Ashworth (2005) is a classic piece in the area of place branding. The paper has been much cited in the literature, but did it really steer the further development of the field? Nearly fifteen years later, there is still a lot of debate in place branding circles. Taking the paper as a starting point I briefly discuss four controversies in city branding: (1) branding versus marketing; (2) places versus products; (3) policy versus politics; and (4) theory versus practice. I conclude that the complexities surrounding places and their stakeholders asks for more realism, modesty and dialogue in the place branding community.

Community-engaged Evidence Synthesis to Inform Public Health Policy and Clinical Practice: A Case Study.

Background:This case study documents the work of the Rhode Island Arts and Health Advisory Group, which convened in 2016 to develop a set of policy, clinical practice, and research recommendations for implementation by the Rhode Island Department of Health, The Rhode Island State Council on the Arts, and partners. Comprised of artists, clinicians, community members, and patients, the group partnered with researchers to complete an evidence synthesis project of arts-based health care interventions.Methods:The group took a community-engaged approach to evidence synthesis, featuring the use of online, and in-person training materials to facilitate the codesign and coexecution of the evidence synthesis protocol. The final evidence map was translated into an online evidence map to facilitate analysis and discussion on arts-based interventions in health care.Results:The evidence map informed the development of recommendations for advancing the integration of arts and health in the state. The project evaluation indicated that our community-engaged approach to evidence synthesis promoted engagement as defined by the PCORI Engagement Strategy Rubric (ie, reciprocal relationships, partnership, colearning, transparency, honesty, and trust). Participation also improved community research partners confidence in engaging with the health care system, developed greater empathy and understanding of others in the community, and increased interest in using science or research in advocacy efforts.Conclusions:Engaging community partners in evidence synthesis promotes community dialogue and engagement in research, specifically towards: (1) elucidating outcomes of import to patients and communities that are not represented in the medical literature; and (2) identifying comparisons among interventions that resonate with patients and communities.

Aligning teacher competence frameworks to 21st century challenges: The case for the European Digital Competence Framework for Educators (Digcompedu)

AbstractTeachers need to update their competence profiles for 21st century challenges. Teaching strategies need to change and so do the competences teachers need to develop so as to empower 21st‐century learners. The European Framework for the Digital Competence of Educators (DigCompEdu) represents a paradigmatic example of this endeavour, taking stock of these needs. Defining the requirements of education professionals by teacher competence frameworks can serve multiple purposes at different levels in education systems. At the micro level, it can support and guide teachers' practice and continuous professional development. At the meso level of local education governance, it can support the development of school institutions as learning organisations, providing common ground for dialogue, collaboration and reflection in professional communities of practice. At the macro level of quality assurance, it can provide reference standards for initial teacher education, and for education professionals' quality along the career continuum. The European Framework for the Digital Competence of Educators was designed to align with institutional and contextual requirements in different countries, whilst remaining open to adaptation and updating. It links teachers' and students' digital competence development, and can be linked to institutional capacity building. At the same time, the framework is generic enough to apply to different educational settings and to allow for adaptation as technological possibilities and constraints evolve.

Story Circles, Changing Culture, and Deepening Leadership.

This chapter amplifies student leader voices as they reflect on their involvement and growth as facilitators and participants of story circles, a structure and process for individuals to use empathy, the arts, and social imagination to support dialogue and change in local communities.

Theatre For Social Change: Active Techniques For Reflection And Discussion

Location: JC Room F Theatre for social change games are designed to create community and engage that community in dialogue. The techniques used come from Augusto Boal who designed his methodology for all citizens, not just actors. He said, are all actors. Being a citizen does not mean living in the world, it is changing it. This workshop offers participants an introduction to the games and theory behind Theatre of the Oppressed, a form of theater for social change created by Augusto Boal. The techniques are used by artists, activists, and drama therapists. We explore how theatre can be used as a tool to identify, discuss, and resist oppression. We spend time playing TO games, practicing Image Theatre, and discussing how these games can be utilized for any discussion or curriculum. Theater of the Oppressed can be used by anyone, at any level, wishing to dig deeper into the factors affecting community. It is often used by activists and community organizers. Augusto Boal also used it in law making when he was a representative in the National Congress of Brazil (all 14 of the bills created using his techniques passed). The games are an excellent way to engage students in whole body learning, imagination, and discussions. After each game is played participants are asked to reflect and think critically about their personal experience of the game, and how that experience reflects larger structures in society. Boal believed that imagination was a muscle, the games are designed to train that muscle -- because if we can't imagine a different way of doing things, how will we build new ways of being/change the future.

Home is where the heart is: Latinx youth expression and identity in a critical maker project

ABSTRACTMaking has been touted for its potential to democratize STEM yet could be replicating issues of limited participation of persons from educationally underserved populations. This version of making could be problematic for young women of color, limiting participation and aspirations for STEM careers. We present a counterexample with Critical Making, an approach of action, reflection, and community dialog to promote social change. We examine a multimedia design and implementation project as an expression of seven young Latinx1 women’s experiences. Participants were tasked with creating a maker artifact to display data from a community survey and produced an interactive (touch capacitive) heart-shaped word cloud capturing positive qualities of their community. We utilized cultural-historical activity theory to focus on relations of the teen participants, meanings conveyed by the word cloud, and how digital tools interacted with norms, division of labor, and community relationships to mediate understanding. We report tensions between group versus community values and between possible design features and tool limitations. We also report how participants authored intersecting identities as makers, group members, and contributors to their community. Our results document the dynamics of a Critical Maker program and expand understanding of how young Latinx women experience making and STEM learning.

Study protocol for developing #CuttingCRC: a barbershop-based trial on masculinity barriers to care and colorectal cancer screening uptake among African-American men using an exploratory sequential mixed-methods design

IntroductionColorectal cancer (CRC) is preventable, as screening leads to the identification and removal of precancerous polyps. African-American men consistently have the highest CRC mortality rates, and their CRC-screening uptake remains...

Heavy Metals in California Women Living in a Gold Mining-Impacted Community.

Gold mining activities occurred throughout the foothills of the Sierra Nevada Mountains in California, leaving behind persistent toxic contaminants in the soil, dust, and water that include arsenic and cadmium. Despite a high level of concern among local residents about potential exposure and high breast cancer rates, no biomonitoring data has been collected to evaluate the levels of heavy metals. We conducted a study to characterize the urinary levels of heavy metals among women in this region by working with the community in Nevada County. Sixty women provided urine samples and completed a questionnaire. We examined levels of arsenic, cadmium, and other metals in relation to the length of residency in the area, age, dietary factors, recreational activities, and smoking. We compared urinary metal levels in participants to levels in the United States National Health and Nutrition Examination Survey (NHANES). Overall, study participants had higher urinary levels of arsenic than women in the national sample. Cadmium levels were similar to the national average, although they were elevated in women ≥35 years who had lived in the region for 10 years or more. Arsenic levels were higher among women who smoked, ate fish, ate home-grown produce, and who reported frequent hiking or trail running, although these differences were not statistically significant. This study established a successful community–research partnership, which facilitated community dialogue about possible human health consequences of living in a mining-impacted area.

Intersubjetividade: um olhar sobre a comunidade de investigação filosófica

O paradigma da intersubjetividade preconizado por Jürgen Habermas fundou uma forma de chegar a consensos racionalmente fundamentados. A sua obra aponta para a ideia de que o que mantém as pessoas numa atitude de ação comunicativa são as forças da fundamentação racional e da motivação racional. Ao analisarmos a dimensão intersubjetiva da prática da comunidade de investigação filosófica, demo-nos conta de que é possível verificar a passagem de uma autonomia da razão centrada no sujeito (um pensar por si mesmo), para a prática de uma racionalidade comunicativa (centrada num pensamento em comunidade). Os pressupostos inevitáveis da comunicação fundam e mantêm as comunidades e permitem o clima de confiança e de cuidado que possibilita que os membros da comunidade pensem livremente e se deixem guiar pela força do we, do nós, do nos-otros. Não é somente em contexto de comunidades de investigação filosófica que se verificam as potencialidades do paradigma da intersubjetividade de Habermas. Também na discussão entre especialistas podemos encontrar essas potencialidades. Foi, em certa medida, este o rasto que conseguimos traçar ao investigarmos as diferentes abordagens de Ann Sharp, David Kennedy e Giuseppe Ferraro sobre a noção de comunidade de investigação filosófica. O diálogo estabelecido entre estes filósofos e o conceito de comunidade de investigação filosófica, os seus argumentos e as formas de concretização do diálogo filosófico em comunidade, dão conta da fecundidade da racionalidade comunicativa. Sabemos que o conceito de comunidade de investigação filosófica, tal como é pensado e vivido por Ann Sharp, é distinto do conceito de comunidade de investigação filosófica de David Kennedy. Percebemos que o círculo do pensar de Giuseppe Ferraro é uma outra abordagem ao pensamento filosófico em comunidade. No entanto, na nossa investigação estas abordagens entraram em diálogo e, em boa medida, devido ao que é permitido pelo próprio movimento de uma racionalidade comunicativa. Estas possibilidades de diálogo dão-se no pressuposto de uma relação intersubjetiva também entre conceitos, experiências e pensamento sobre os conceitos e as experiências. O caminho percorrido entre a comunidade de investigação filosófica entendida como espaço de intersubjetividade (Sharp, 1987), passando pela abertura da comunidade de investigação filosófica a outras dimensões não discursivas da comunicação (Kennedy, 1994) e avançando para o círculo do pensar que enche o espaço de tempo e o torna num lugar (Ferraro, 2018) revela como a comunidade de investigação filosófica é um conceito e uma experiência abertos e fecundos: um conceito em ação.

Insights from outside BJOG

Insights from outside BJOG

Community engagement and mobilisation of local resources to support integrated Community Case Management of childhood illnesses in Niger State, Nigeria.

BackgroundDespite strong evidence of integrated community case management (iCCM) of childhood illnesses being a proven intervention for reducing childhood morbidity and mortality, sustainability remains a challenge in most settings. Community ownership and contribution are important factors in sustainability. The purpose of this study was to document the process and scale achieved for community engagement and mobilisation to foster ownership, service uptake and sustainability of iCCM activities.MethodsA review of data collected by the RAcE project was conducted to describe the scale and achievement of leveraging community resources to support the community-oriented resource persons (CORPs). The Rapid Access Expansion (RAcE)-supported iCCM programme in Niger state (2014-2017), aimed at improving coverage of case management services for malaria, pneumonia, and diarrhoea, among children aged 2–59 months. Resources donated were documented and costed based on the market value of goods and services at the time of donation. These monetary valuations were validated at community dialogue meetings. Descriptive statistics were used to summarise quantitative variables. The mean of the number of CORPs in active service and the percentages of the mobilised resources received by CORPs were calculated.ResultsThe community engagement activities included 143 engagement and advocacy visits, and meetings, 300 community dialogues, reactivation of 60 ward development committees, and 3000 radio messages in support of iCCM. 79.5% of 1659 trained CORPs were still in active iCCM service at the end of the project. We estimated the costs of all support provided by the community to CORPs in cash and kind as US$ 123 062. Types of support included cash; building materials; farming support; fuel for motorcycles, and transport fares.ConclusionsThe achievements of community engagement, mobilisation, and the resources leveraged, demonstrated acceptability of the project to the beneficiaries and their willingness to contribute to uninterrupted service provision by CORPs.

Effect of community-based intervention on improving access to treatment for sick under-five children in hard-to-reach communities in Niger State, Nigeria.

BackgroundAccess to prompt and appropriate treatment is key to survival for children with malaria, pneumonia and diarrhoea. Community-based services are vital to extending care to remote populations. Malaria Consortium supported Niger state Ministry of Health, Nigeria, to introduce and implement an integrated community case management (iCCM) programme for four years in six local government areas (LGAs). The objective was to increase coverage of effective treatment for malaria, pneumonia and diarrhoea among children aged 2-59 months.MethodsThe programme involved training, equipping, ongoing support and supervision of 1320 community volunteers (CORPs) to provide iCCM services to their communities in all six LGAs. Demand creation activities were also conducted; these included community dialogues, household mobilization, sensitization and mass media campaigns targeted at programme communities. To assess the level of changes in care seeking and treatment, baseline and endline household surveys were conducted in 2014 and 2017 respectively. For both surveys, a 30×30 multi-stage cluster sampling method was used, the sampling frame being RAcE programme communities.ResultsCare-seeking from an appropriate provider increased overall and for each iCCM illness from 78% to 94% for children presenting with fever (P < 0.01), from 72% to 91% for diarrhoea cases (P < 0.01), and from 76% to 89% for cases of cough with difficult or fast breathing (P < 0.05). For diagnosis and treatment, the coverage of fevers tested for malaria increased from 34% to 77% (P < 0.001) and ACT treatments from 57% to 73% (<0.005); 56% of cases of cough or fast breathing who sought care from a CORP, had their respiratory rate counted and 61% with cough or fast breathing received amoxicillin. At endline caregivers sought care from CORPs in their communities for most cases of childhood illnesses (84%) compared to other providers at hospitals (1%) or health centres (9%).This aligns with caregivers’ belief that CORPs are trusted providers (94%) who provide quality services (96%).ConclusionImplementation of iCCM with focused demand creation activities can improve access to quality lifesaving interventions from frontline community providers in Nigeria. This can contribute towards achieving SDGs if iCCM is scaled up to hard-to-reach areas of all states in the country.

Reconsidering the Meaning of Knowledge Based on Experiences of Community‐Based Social Education Practice in Japan

AbstractThis article aims to build a frame of reference to reconsider the meaning of knowledge in line with collective value formation and to regain lost popular knowledge in comparison with paternalistic or scientific knowledge. Following a brief introduction of Japanese social education and a critical/creative review of Freire's concept of conscientization, a case study of a community‐based social enterprise and its learning practice in the area affected by the Great East Japan Earthquake is explored. The focus of the analysis is to clarify the restructuring process of knowledge construction through collective and dialogical community actions.

What can Somali community talk about mental health tell us about our own? Contextualizing the symptoms of mental health

Purpose The purpose of this paper is to review all the research on Somali refugee communities’ “explanatory models” of “mental health” or psychological suffering, and also report original research in order to allow for more contexts on their “mental health” terms to emerge. Design/methodology/approach The authors talked in a conversational manner with a small number (11) of Somali people (10 females and 1 male), but this was done intensively over time and on multiple occasions. They discussed their community terms for “mental health” issues but in their own contexts and with their own examples. Findings The results showed that Somali as a community had three main groupings of symptoms: Jinn or spirit possession; waali or “craziness”; and a group of terms for serious anxieties, rumination, worrying and thinking too much. What was new from their broader descriptions of context was that the community discourses were based on particular contexts of the person and their behavior within their life history, rather than aiming to universal categories like the DSM. Practical implications Both research and practice on mental health should focus less on universal diagnoses and more on describing the contexts in which the symptoms emerge and how to change those contexts, especially with refugee and other less well-understood groups. Originality/value The review and original results support symptom-based or contextual approaches to mental health; we should treat the “mental health” symptoms in their life contexts rather than as a disease or disorder. We can learn from how Somali describe their “mental health” symptoms rather than treat their descriptions as crude forms of the “correct” western diagnostics.

The effect of community dialogues and sensitization on patient reporting of adverse events in rural Uganda: Uncontrolled before-after study.

BackgroundPatients experiencing adverse drug events (ADE) in many developing countries are in the best position to report these events to the authorities but need to be empowered to do so. Systematic evaluation of community engagement and patient support especially in rural areas would provide evidence for a program to monitor potential harm from medicines. The aim of this study was to assess the effects of a community dialogue and sensitization (CDS) program on the knowledge, attitude and practises of community members for reporting ADE.MethodsThis an uncontrolled before-after study was conducted in two eastern Ugandan districts between September 2016 and August 2017ResultsAfter implementation of the community dialogue and sensitization (CDS) program, there was an overall 20% (95% CI:16% to 25%) increase in knowledge about ADE in the community compared to before the program began. Awareness levels increased by 50% (95% CI: 37% to 63%) among those with little or no education and by41% (95% CI: 31% to 52%) among young people (15–24 years). Furthermore, 5% (95% CI: 3% to 7%) more respondents recognized the need for reporting ADEs compared to before the program. Finally, there was a significant increase of 115% (95% CI:137% to 217%) in respondent recognition and reporting of ADEs compared to the beginning of the CDS program. Overall, this community found the CDS program acceptable and proposed aspects that could be improved for future use.ConclusionOur evaluation showed that the CDS program increased knowledge and improved attitudes by catalyzing discussions among community members and healthcare professionals on health issues and monitoring safety of medicines compared to before the program. Successful implementation of the program depends on holistic health systems strengthening and adaptation to the community’s way of life.

Islam in the West: Iraqi Shi'i Communities in Transition and Dialogue (Studies in Theology, Society and Culture). By KieranFlynn, Pp. x, 259, Oxford, Peter Lang, £50.94.

Islam in the West: Iraqi Shi'i Communities in Transition and Dialogue (Studies in Theology, Society and Culture). By KieranFlynn, Pp. x, 259, Oxford, Peter Lang, £50.94.