Community Engagement Strategies Research Articles

Community engagement strategies for population health research with culturally diverse adults

The purpose of this report is to describe the community engagement research (CEnR) strategies used to implement the Florida Statewide Registry for Aging Studies (FSRAS), a tri-institutional research project conducted during the height of the COVID-19 pandemic. We describe the CEnR strategies used to enroll adults aged > 25 years old self-identifying as African American (AA), Caribbean (CN), or Hispanic/Latinx (H/L) into FSRAS health research studies. The second goal is to report the number of AA, CN, and H/L adults involved in FSRAS and discuss the implications of CEnR strategies used throughout this research. More than 1600 adults aged 25 years or older participated in FSRAS health-related research activities or studies. Specifically, 25 community leaders from throughout Florida served on the FL-SAGE Council, 587 AA, CN, and H/L adults aged > 25 years old participated in listening sessions and completed surveys exploring intergenerational influence, 292 AA, CN, and H/L adults participated in marketing research, and at least 702 adults have enrolled in AgeWell, FSRAS’s health registry for persons interested in healthy aging research. Implications are researchers should continue using several CEnR strategies including technology and social media. Examining how the foundational principles of trust and authenticity are maintained when using CEnR strategies in virtual settings is warranted. Research implications are that simultaneously using CEnR strategies to recruit and enroll underrepresented populations into research is most effective although further research is needed to identify which CEnR strategy is most effective for enrolling AA, CN, and H/L older adults in aging research.

Engaging communities to inform the development of a diverse cohort of cancer survivors: formative research for the eat move sleep study (EMOVES)

BackgroundThere are more than 18 million cancer survivors in the United States. Yet, survivors of color remain under-represented in cancer survivorship research (Saltzman et al. in Contemp Clin Trials Commun 29:100986, 2022; Pang et al. in J Clin Oncol 34:3992–3999, 2016; Lythgoe et al. in Prostate Cancer Prostatic Dis 24:1208–1211, 2021). Our long-term goal is to enroll and follow a cohort of historically under-represented cancer survivors, to better understand modifiable risk factors that influence clinical and quality of life outcomes in these populations. Towards that goal, we describe herein how we applied community-based participatory research approaches to develop inclusive study materials for enrolling such a cohort.MethodsWe implemented community engagement strategies to inform and enhance the study website and recruitment materials for this cohort including: hiring a dedicated engagement coordinator/community health educator as a member of our team; working with the Helen Diller Family Comprehensive Cancer Center Office of Community Engagement (OCE) and Community Advisory Board members; presenting our educational, research, and study recruitment materials at community events; and establishing a community advisory group specifically for the study (4 individuals). In parallel with these efforts, 20 semi-structured user testing interviews were conducted with diverse cancer survivors to inform the look, feel, and usability of the study website.ResultsEngagement with community members was a powerful and important approach for this study’s development. Feedback was solicited and used to inform decisions regarding the study name (eat move sleep, EMOVES), logo, study website content and imagery, and recruitment materials. Based on community feedback, we developed additional educational materials on healthy groceries and portion size in multiple languages and created a study video.ConclusionsIncluding an engagement coordinator as a permanent team member, partnering with the institutional community outreach and engagement resources (i.e., OCE), and allocating dedicated time and financial support for cultivating relationships with stakeholders outside the university were critical to the development of the study website and materials. Our community guided strategies will be tested as we conduct enrollment through community advisor networks and via the state cancer registry.

Increasing U.S. Maternal Health Equity Among Immigrant Populations Through Community Engagement

Immigrant women in the United States are at an elevated risk of poor maternal health outcomes due to cultural, linguistic, or socioeconomic barriers that may lead to critical delays in obtaining adequate health care. Ensuring access to high-quality, culturally appropriate perinatal health care is crucial to improve the health and well-being of immigrant mothers and their children. Various aspects of perinatal health care for immigrant women can be improved through community engagement strategies. Barriers can be addressed by involving community members in designing and delivering culturally appropriate maternal health services. Some strategies discussed in this commentary include working with community health workers, encouraging telehealth through community health workers, providing breastfeeding and mental health support within cultural norms, and involving community-based doulas and midwives.

Community Engagement in Behavioral Medicine: A Scoping Review.

Behavioral medicine has made key contributions toward improving health outcomes. Engaging community partners in research is critical to addressing persistent health inequities. The aim of this scoping review was to explore how researchers engaged community partners within the field of behavioral medicine research from 2005 to 2023. Publication databases and gray literature were searched for research that engaged community partners to address questions relevant to behavioral medicine. Articles were screened by title and abstract, and then by full text. Articles meeting the inclusion criteria were coded using the framework provided by the Engagement Navigator to identify engagement approaches, methods, and tools and when they were used during the research. Of 1486 articles initially identified, 58 met the inclusion criteria. Most articles used well-known approaches (e.g., community-based participatory research; 67%), methods (e.g., advisory committees; 59%), and tools (e.g., interviews; 41%), and engaged with healthcare service providers (62%) and/or patients (53%). Community partners were most often included in research planning and design (79%), and less often in dissemination (45%). Community engagement has considerable potential to address health inequities. Our assessment of the approaches, methods, and tools used by behavioral medicine researchers to engage with a diverse range of community partners points toward promising strategies for enhancing the impact of community engagement. Researchers should incorporate explicit descriptions of community engagement strategies in publications, an outcome that could be facilitated by clear publishing guidelines, structured reporting tools, and clear messaging from funders about the value of community engagement in behavioral medicine research.

Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review

IntroductionImproving healthcare quality in low-/middle-income countries (LMICs) is a critical step in the pathway to Universal Health Coverage and health-related sustainable development goals. This study aimed to map the available...

The Hows of Resident-Driven Community Empowerment toward Health Equity

Abstract: Background: This article details community engagement, design, and implementation strategies for the Raices-Xidid-Roots (RXR) Academy. RXR provided a linguistically accessible and culturally relevant curriculum to residents of Spanish and Somali-speaking immigrant, asylee, and refugee backgrounds. Objectives: This study examined the implementation of the RXR program, including participation and adjustments needed to foster participant engagement and active voice, and explored participant actions to address self-identified aspirations as part of participation. RXR's goal was to empower Morgan County, Colorado, Spanish- and Somalispeaking cohorts of residents from immigrant, asylee, and refugee backgrounds such that they could autonomously plan, create, and sustain programs and organizations to meet their community needs. Methods: The observational study design included process and implementation evaluative approaches, including interview, project team meeting debriefings, and course organizer reflections, to identify and address implementation challenges, learn how the program met participants' needs, and understand keys to maintaining participant engagement. Results: Cultural adaptation of the content was key to maintaining consistent participant engagement, including delivering programming in participant preferred languages and tailoring curriculum to participant cultural practices. Participants indicated that language barriers had previously prevented them from accessing the content provided by the program's curriculum. Adaptations included adjusting meeting logistics, participant compensation, and unit timing. The Two RXR Academy cohorts developed initiatives that addressed community-identified needs. Lessons Learned: Three RXR design elements supported participant engagement and development of community power: 1) language access beyond the language justice model by providing programming in the participants' preferred language, 2) cultural adaptation of programming, and 3) community ownership and active voice Conclusions: The RXR program provided opportunities for skill development among Morgan County's non-native English-speaking residents and led to the design and implementation of resident-driven projects.

Look to the past to improve our future: Improving quality, safety and equity through community and patient engagement

Healthcare administrators must ensure delivery of care that is high quality, safe and produces equitable outcomes while balancing business, workforce and community needs. To meet these challenges while guiding their organisations through COVID-19 recovery, administrators can look to a strategy with a strong track record for success: engaging patients, families and communities. This paper focuses on evidence, experience and best practices for improving quality, safety and equity by engaging people, patients, families and communities. Effective patient and family engagement (PFE) and community engagement strategies draw on research and experience across a wide variety of efforts, from nationwide federal programmes such as the Centers for Medicare and Medicaid Services Partnership for Patients initiative to health system- and neighbourhood-level programmes. Research demonstrates that commitment to PFE leads to measurable improvements in quality and safety. Experience shows that engagement, when practiced with attention to diversity, equity and inclusion, can reduce health disparities. Engagement best practices include: making engagement a strategic priority, embedding patients and families with diverse perspectives into improvement efforts, supporting continuous learning by adapting engagement efforts over time, benchmarking progress and measuring disparities. To continue the advances begun before the pandemic, healthcare administrators and leaders must redouble engagement efforts and implement best practices. Administrators can meet the many challenges of the moment by returning to the proven strategy of engaging patients, families and communities to drive integrated quality, safety and equity efforts.

Abstract A047: Increasing cancer-related community-engagement strategies among Historically Black Colleges and Universities and Minority Serving Institutions

Abstract Addressing cultural beliefs and barriers is imperative to successfully designing and implementing behavior change interventions to increase cancer screening and treatment among underserved communities. Community-based participatory research (CBPR) fosters proven strategies that reduce barriers to cancer screening in several diverse population groups. Citizen scientists are laypersons who do not have formal science training but receive training to engage in research efforts responsive to community needs. Project Brotherhood, a community-based health organization on Chicago’s southside, has developed a community engagement model known as the Murray Model. It specifically engages black men in improving their health status. One aspect is engaging black men as citizen scientists to address cancer disparities within their communities. Evidence shows that citizen scientists were better equipped to understand lung cancer risks and increased their advocacy for better health within their communities. In partnership with Project Brotherhood and the University of Illinois Cancer Center, the National Cancer Institute, Informatics Technology for Cancer Research (ITCR) Training Network (ITN) Program is scaling up the citizen scientist Train-the-Trainer program at historically black colleges and universities and minority-serving universities. The Train-the-Trainer ITCR citizen scientist program is partnering with the Morehouse School of Medicine to increase its community and academic capacities in the Atlanta metro area to address cancer disparities. Citation Format: Rohan D. Jeremiah, Marcus Murray, Maisha Standifer, LeChaun Kendall, Carrie Wright, Candace Savonen, Jeff Leeks. Increasing cancer-related community-engagement strategies among Historically Black Colleges and Universities and Minority Serving Institutions [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A047.

Advancing shared accountability for meaningful community engagement with socially vulnerable communities: Lessons learned from COVID-19 health education and general outreach in an urban region.

As COVID-19 public health emergency measures come to an end, socially vulnerable communities have reduced access to resources that address social and health disparities created or exacerbated by the pandemic. Social workers must uphold access to healthcare as a human right in the post-pandemic era by reducing social vulnerability and strengthening community resilience to respond to future health emergencies and natural disasters. This paper draws on the experiences of a team of social work researchers, students, and practitioners engaged in efforts to disseminate information on COVID preventive measures and broker access to local health and social resources. This project, based in one of the fastest-growing metropolitan areas in the United States, formed part of the federal research response to promote community engagement in regions most disproportionately impacted by the COVID-19 pandemic. Through participation in health fairs and community events that targeted persons with limited access to healthcare resources, we gathered critical insights on how to build community capacity for meaningful community engagement. Drawing on a conceptual model for evaluating community engagement strategies, we describe three main barriers to collaborative community outreach: weak organizational communication and coordination, inconsistent strategies for requesting on-site health services, and low neighborhood awareness of outreach events. We advance strategies for improvement that engage community-based organizations, health systems, backbone organizations, and community members in targeted activities to build community resilience. This includes inter-organizational communication during outreach event planning, formal processes to promote greater use of mobile health services, centralized event communication, and grassroots outreach event promotion.

Hemophilia A Research Program (HARP): A Novel Study Design for a Multicenter and Decentralized Prospective Observational Longitudinal Cohort Study in Hemophilia A

Background: Hemophilia A is a rare X-linked bleeding disorder caused by factor VIII (FVIII) deficiency. There is a compelling need in hemophilia to better understand the causes of bleeding in females and the factors underlying FVIII inhibitor development. To meet this need we are establishing a new NHLBI funded Hemophilia A Analytical Cohort Research Program (HARP) as part of a public-private partnership to support an Intergenerational Precision Medicine Program for the study of factor VIII (FVIII) immunogenicity in severe hemophilia A (Harpf8.org). The HARP objectives are: 1) Longitudinal assessment of bleeding in females with a severe hemophilia A genotype beginning in pregnancy; 2) Longitudinal assessment of anti-FVIII antibody formation in severe hemophilia A from birth through at least the first 2 years of life; 3) Studies of causes of bleeding in females with a severe hemophilia A genotype; 4) Studies of the immune response to FVIII in severe hemophilia A; 5) Development of a well-curated annotated data set of genetic, hemophilia, immune, environmental, psychosocial, and quality of life metrics; 6) Development of a multi-omics and immunologic biospecimen resource; and 7) Development of the hemophilia analytical Portal (F8portal.org). Study design: The HARP is a multicenter and decentralized prospective observational longitudinal cohort study beginning in pregnancy. It will follow 50 mother-baby pairs where the babies have severe hemophilia A and the mothers have a severe hemophilia A genotype. The private Clinical Consortium (CC) will oversee the study throughout the U.S., including sites that care for the mothers (up to 200 sites) and sites that care for the child (up to 70 sites). The CC will also conduct decentralized aspects of the study including collection of patient reported outcomes and local sample collection. The primary maternal endpoint is primary postpartum hemorrhage; the primary pediatric endpoint is rate of development of humoral immune response to FVIII and proportion that progress to clinical inhibitors. Mother and child secondary endpoints reflect the diverse research the HARP resource will support. Inclusion criteria for the pregnant person are: Pregnant and prior to 37 weeks gestation, known or at-risk to have a severe hemophilia A genotype, pregnant with a fetus at-risk for severe hemophilia A, ability to give informed consent, and > 18 years old. Inclusion criteria for the child are: severe hemophilia A, born to a person in the study. Exclusion/discontinuation criteria are: Presence of another significant bleeding disorder in mother or child; mother age <18 years; no fetus is at-risk to inherit severe hemophilia A; the child does not have severe hemophilia A; the child has a severe immune disorder; the mother or child participates in another study with blood collection volumes that exceed safety limits; mother's or child's healthcare will be outside the U.S.; the mother is a prisoner; any other reason that in the opinion of the investigator a subject is unsuitable for the study Summary: The HARP innovates in multiple areas of clinical study design to conduct a national prospective longitudinal intergenerational study in a rare disorder beginning in pregnancy. The structure includes a new multidisciplinary CC, systematic inclusion of Lived Experience Experts, strategies for broad community engagement, recruitment, and retention, and decentralized operations. This cohort will enable deep characterization, including genomics and other -omics, on pregnancy-associated bleeding and drivers of FVIII inhibitors in hemophilia A. The HARP Shareable Resource will be comprised of well annotated data and biological samples accessible to researchers through a portal, F8portal.org, and a linked biorepository.

Community advisory board members' perspectives on their contributions to a large multistate cluster RCT: a mixed methods study.

Community advisory boards (CABs) are an established approach to ensuring research reflects community priorities. This paper examines two CABs that are part of the HEALing Communities Study which aims to reduce overdose mortality. This analysis aimed to understand CAB members' expectations, experiences, and perspectives on CAB structure, communication, facilitation, and effectiveness during the first year of an almost fully remote CAB implementation. Current literature exploring these perspectives is limited. We collected qualitative and survey data simultaneously from members (n = 53) of two sites' CABs in the first 9 months of CAB development. The survey assessed trust, communication, and relations; we also conducted 32 semi-structured interviews. We analyzed the survey results descriptively. The qualitative data were analyzed using a deductive codebook based on the RE-AIM PRISM framework. Themes were drawn from the combined qualitative data and triangulated with survey results to further enrich the findings. CAB members expressed strong commitment to overall study goals and valued the representation of occupational sectors. The qualitative data described a dissonance between CAB members' commitment to the mission and unmet expectations for influencing the study within an advisory role. Survey results indicated lower satisfaction with the research teams' ability to create a mutually beneficial process, clear communication, and sharing of power. Building a CAB on a remote platform, within a study utilizing a community engagement strategy, still presents challenges to fully realizing the potential of a CAB. These findings can inform more effective operationalizing of community-engaged research through enhanced CAB engagement.

TB NOTIFICATION IN CHILDREN: THE EXPERIENCE OF TARGETED COMMUNITY DEMAND CREATION AMIDST INSECURITY IN IMO STATE, NIGERIA

This paper explores the challenges and successes of tuberculosis (TB) notification in children amidst a backdrop of insecurity in Imo State, Nigeria. Emphasizing targeted community demand creation strategies, the study investigates the intricate relationship between insecurity, community engagement, and pediatric TB detection. Drawing upon a comprehensive literature review, this research delves into the epidemiology, diagnosis, and treatment of TB in children, the ramifications of insecurity on healthcare access in Imo State, and effective community engagement strategies in healthcare initiatives. The literature findings underscore the substantial burden of TB among children and the distinct hurdles faced in environments characterized by insecurity. The prevailing insecurity in Imo State significantly disrupts healthcare services, leading to delays in TB diagnosis and treatment initiation. Nevertheless, the review identifies community engagement approaches as a promising avenue for bolstering TB notification rates in pediatric populations. These approaches empower local communities to actively participate in the identification and management of TB cases, ultimately contributing to the enhancement of pediatric TB notification. A conceptual framework, derived from amalgamated literature, elucidates the intricate interplay between insecurity, community engagement, and TB notification. This study highlights the pivotal role of community-driven interventions in mitigating the challenges posed by insecurity in Imo State, Nigeria, and presents actionable recommendations for the development of healthcare policies and programs tailored to the region. This research not only augments our comprehension of TB notification among children within insecure contexts but also provides valuable insights into the broader domain of community-based healthcare interventions. It underscores the exigency for customized strategies to address TB in pediatric populations in regions marked by insecurity, ultimately contributing to the amelioration of health outcomes for children in Imo State, Nigeria, and analogous settings
 Keywords: TB, Children, Community, Nigeria.

Enhancing the Retention of Healthcare Workers in Rural Areas: A Systematic Review

Introduction: Rural areas globally face significant challenges in retaining healthcare workers, impacting the delivery of essential health services and exacerbating health disparities. This systematic review aimed to evaluate the effectiveness of various strategies implemented over the last 15 years to enhance healthcare worker retention in rural settings, with the goal of identifying evidence-based interventions that can inform policy and practice to improve rural healthcare delivery. Methods: The review focused exclusively on interventional studies and clinical trials published from 2007 to 2022. A comprehensive search of multiple databases, including PubMed, MEDLINE, Embase, CINAHL, and the Cochrane Library, was conducted using specific search terms related to healthcare worker retention in rural areas. Inclusion criteria targeted studies evaluating quantifiable outcomes of retention strategies, with exclusion criteria set to omit non-interventional studies, research focused on urban settings, and non-English publications. The study selection, data extraction, and quality assessment processes were rigorously conducted to ensure the reliability of the findings. Results: Twelve studies met the inclusion criteria, revealing a broad range of interventions from financial incentives and educational programs to supportive workplace interventions and community engagement strategies. Financial incentives demonstrated a notable positive impact on retention, with risk ratios ranging from 1.2 to 1.75, indicating a 20% to 75% increase in retention rates. Supportive workplace interventions also showed effectiveness, with a risk ratio of up to 1.4. However, the results for educational and community engagement strategies were more variable, suggesting the need for tailored approaches. Conclusions: The review highlights the effectiveness of targeted interventions in enhancing the retention of healthcare workers in rural areas, particularly financial incentives and supportive workplace interventions. These findings underscore the importance of implementing multifaceted, evidence-based strategies tailored to the unique challenges of rural healthcare settings to improve workforce stability and healthcare delivery.

Enhancing community health system resilience: lessons learnt during the COVID-19 pandemic in Uganda through the qualitative inquiry of the COVID Task Force.

This study aimed to explore the elements of a resilient community health system during the COVID-19 pandemic and discuss whether the frameworks described in previous studies can be applied to real-world situations with those who implemented the Community Engagement Strategy, a strategy to make health systems work in their communities during health crises in Uganda. Focus group discussions (22 participants in total) were conducted with COVID Task Force members in four districts in Uganda in March 2022. These districts implemented a Community Engagement Strategy to ensure that health systems in their communities continued to function during health scares, and have been evaluated to ensure that the strategies have been implemented. A thematic analysis was applied. From the results some factors which can enhance the resiliency of community health systems were identified: including health "knowledge," "communication," "governance," and "resources" health. The most important elements changed depending on the phase of the outbreak. VHTs are the key players in the transition from knowledge-and resource-oriented initiatives to communication and governance by community residents. COVID-19, a new infectious disease, provides lessons for a resilient community health system. First, the health system should be flexible enough to be able to change the elements on which it is focused, and second, VHTs play an important role in the flexibility of the health system. This suggests that it is time to assess whether VHTs are still able to continue their activities after the pandemic is over, and whether the environment, including financial and non-financial support, has improved.

IMPACT OF POLICE CYNICISM ON CRIME REPORTING: INSIGHTS FROM ANGELES CITY, PHILIPPINES

This research delves into the intricate relationship between police cynicism and crime reporting behavior in Angeles City, Philippines. It takes a comprehensive approach, aiming to identify both the factors that encourage and discourage crime reporting while examining the influence of police cynicism. The research utilizes a mixed-methods design, encompassing a descriptive survey and correlation research. The survey includes questions regarding individuals attitudes towards the police, their willingness to report crimes, and their perceptions of the polices effectiveness in combating crime. The correlation research specifically delves into the connection between police cynicism and crime-reporting behavior, hypothesizing that higher levels of police cynicism correlate with lower levels of crime reporting and vice versa. The findings of this study carry significant implications for improving crime reporting behavior, ultimately contributing to enhanced safety in Angeles City. The research underscores the existence of generally positive attitudes toward crime reporting, driven by an awareness of the seriousness of offenses, a sense of empowerment, and a shared responsibility for community well-being. This positive disposition emphasizes the need for law enforcement agencies and policymakers to consider community engagement strategies and initiatives that encourage reporting. The research also reveals that discouraging factors do exist, particularly concerning non-traditional crimes, where fears and distrust in the justice system play a significant role. While there is a prevailing trust in the local polices effectiveness, the weak correlation between positive police perceptions and actual reporting behavior highlights the need for a holistic approach in policy development. Furthermore, the positive correlation between discouragement and encouragement factors in reporting suggests potential policy implications, calling for in-depth research to further comprehend the intricate dynamics influencing reporting behavior. The findings collectively emphasize the multifaceted nature of public perceptions and reporting motivations, underlining the interconnectedness of these elements. Policymakers are encouraged to adopt comprehensive approaches that foster community trust and enhance reporting behavior, while researchers are urged to delve deeper into these nuanced relationships to inform evidence-based policies for public safety and more effective law enforcement in Angeles City. KEYWORDS: crime reporting, crime reporting behavior, police cynicism, encouraging and discouraging factors of crime reporting

Abstract 12464: Family Caregiving Support and Sleep Duration Among African American Family Caregivers

Background: African Americans family caregivers are at risk for poor sleep health and cardiovascular disease. Psychological health (i.e., depressive symptoms) and social determinants of health (i.e., social interactions) are associated with sleep health (i.e., sleep duration) and are important contextual drivers of cardiovascular health. Recently, the American Heart Association recognized sleep duration as a component of cardiovascular health. However, there is limited literature on psychological and social determinants of sleep duration among African American family caregivers. Aim: The purpose of this cross-sectional study was to examine the contribution of depressive symptoms and family caregiving support to sleep duration among African American family caregivers. We hypothesized that higher levels of depressive symptoms and lower levels of family caregiving support would be associated with shorter sleep duration. Methods: African American family caregivers ( n = 55) of adults with chronic illness were recruited through community-engaged strategies. Demographic, depressive symptoms, family caregiving support, and sleep duration data were based on self-report measures, whereas body mass index (BMI) data were based on objective height and weight assessments. Hierarchical linear regression was used to determine the contributions of depressive symptoms and family caregiving support on sleep duration, controlling for age, gender, and BMI. Results: On average, participants were 60.67 years old (SD = 12.04) and had a BMI of 34.61 (SD = 7.55). The majority self-identified as female (87.3%). Mean self-reported sleep duration was 5.87 hours (SD = 1.35) per night, which is below the recommended sleep duration of 7-9 hours for adults. In the final model, lower levels of family caregiving support were associated with shorter sleep duration ( b = -.46, p = .046), controlling for caregivers’ age, gender, BMI, and depressive symptoms. Conclusion: Family caregiving support is a modifiable target to promote sleep and cardiovascular health equity for African American family caregivers. Multilevel interventions may optimize the support that caregivers receive from other family members and friends as well as professional and community-based sources.

36 Disparities in General Mental Status Between Lower and Higher SES Ethnically Diverse Older Adults

Objective:To investigate differences in performance on a widely used cognitive screener between community-dwelling older adults from two disparate socioeconomic groups.Participants and Methods:Participants were part of a larger study of cognitive screening in healthy older adults. The total sample (N=79, 69.6% female, 19% White/Caucasian, 12.7% Asian, 43% Latino/a, 25.3% Black/African-American) consisted of community-dwelling adults (Mage=73.1 years [SD=7.2] and Meducation=14.3 years [SD=2.6]) who were initially recruited via social media, flyers, and general community announcements. A lack of ethnic minority participants resulted in a two-year commitment to reach communities of color via visits and provision of health literacy to local religious and community programs. Continuous contact with leaders/gatekeepers helped establish research study credibility and forge a stronger sense of trust among ethnically diverse participants in the greater Houston, TX, area. Testing was initially conducted at the clinical study site. Due to low participation rates among people of color, greater effort was placed on tailored strategies to overcome economic and time constraints (i.e., schedule/time conflicts, lack of transportation, inability to pay for parking). To fit the priorities and needs of the participants, testing was also conducted at their homes (25.3%) and nearby religious and community centers (22.8%). Participants identifying as Latino/a or Black were predominantly recruited and tested at their local community center (as requested by gatekeepers/participants) to increase access to the study, in contrast to Caucasian participants. Median income estimates were used to stratify participants by socioeconomic status (SES) based on zip codes into low SES (L-SES) or high SES (H-SES) groups.Results:Participants from the L-SES group had significantly lower total scores on the MoCA than their H-SES counterparts, t(77J=2.837, p=0.003, g=0.696. The average MoCA total score for participants from the L-SES group was 2.64 points lower. The observed differences in MoCA total score when stratifying by ethnicity may be attributable to differences in education level and SES, which are known risk factors for cognitive impairment and will be further examined upon recruitment completion.Conclusions:Studies have found that ethnically diverse older adults not only encounter more barriers to accessing quality health care but also experience disparities in brain health research. Communities of color comprise a sizeable portion of our older adults but have been traditionally underrepresented in clinical research, limiting the generalizability of research findings to clinical treatment. Socioeconomic deprivation has been identified as one of several barriers to research engagement for people of color, placing ethnic communities at increased risk for under- or misdiagnosis and limited access to medical intervention. Preliminary findings have implications for the recruitment of ethnically diverse groups in clinical research. Given the growing racial and ethnic diversity among the United States population, we must do our due diligence to increase understanding of participation and recruitment barriers for racial/ethnic individuals. Tailored community outreach and engagement strategies may be effective in improving the inclusion of ethnically diverse populations and facilitating recruitment and retention in clinical research studies.

COVID-19 Risks and Vulnerabilities of Street-Connected Children: A Qualitative Study in Bangladesh

The outbreak of COVID-19 exacerbated the plight of street-connected children. This qualitative study was conducted to elucidate child welfare service providers’ (CWSPs) experiences regarding the massive impact of COVID-19 on street-connected children in Dhaka city of Bangladesh. Ten CWSPs with direct experience of serving street-connected children during the pandemic were recruited purposively. Findings unveil that government administrative actions taken through lockdowns and restrictions disrupted the lives and livelihood of street-connected children. The pandemic situation caused job losses and restricted children’s opportunities to earn, and intensified their sufferings from hunger, homelessness, and physical and sexual abuse. The children were displaced and detached from their peer network. They were deprived of education, healthcare, social services, and treatment facilities. Despite the risks of COVID-19 and movement restrictions, CWSPs came forward to serve the children with food aid and emergency services in collaboration with a few community-based voluntary organizations. However, the services were not enough to address children’s needs and problems. Findings suggest that CWSPs should adopt strategies for community engagement and multi-stakeholder collaboration to provide better services to the street-connected children during emergencies. A mixed methods research focusing on child maltreatment could be helpful for better understanding of children’s sufferings during the pandemic.

Community engagement for pandemic preparedness and response in Sub-Saharan Africa: A Scoping Review

Abstract Background Community participation in epidemic and pandemic preparedness and response activities is key for the successful implementation of infection control activities. However, the strategies and approaches used by health authorities and service providers to engage communities is not well documented This scoping review aimed to summarize approaches, and strategies for community engagement for epidemic and pandemic preparedness and response in Sub-Saharan Africa. Methods The PRISMA Extension for Scoping Reviews (PRISMA-ScR) and the methodological framework for scoping review from Arksey and O'Malley (2005) was used to guide the review. Peer -reviewed, primary research was retrieved from databases including EMBASE, EBSCO-host, PubMed, Global Health, CINAHL, Google Scholar and Web of science. Grey literature was retrieved from websites of international organisations, and of Ministries of Health in African countries. A total of 124 articles were included in the review, and data was extracted and analyzed using a thematic analysis approach. Results Community engagement strategies varied widely across different contexts. Four broad categories of approaches were identified: (1) community mobilization, (2) community-based surveillance, (3) social and behavior change communication, and (4) community participation in decision-making. The review also identified key enablers and barriers to community engagement, including factors such as trust, cultural norms, and resource availability. Conclusions Effective community engagement for epidemic and pandemic preparedness and response requires a tailored approach that is responsive to the local context, and that addresses the specific needs and concerns of different communities. The review provides a comprehensive overview of the current state of knowledge on strategies for community engagement in sub-Saharan Africa and highlights the need for further research and evaluation of community engagement approaches in this context.

Risk communication during COVID-19 pandemic in Georgia

Abstract Risk communication during COVID-19 pandemic was essential to ensure community engagement. Providing accurate, timely, and reliable information about risks and preventive measures was important to reduce the likelihood of transmission. During COVID-pandemic Georgia developed Risk Communication and Public Engagement Strategy and provided easy-to-understand messages through credible channels to encourage two-way communication. Aim was to promote preparedness by developing a multi-level and multi-faceted communication system to respond emergency. In fact, several communication approaches were used for risk groups, and ethnical minorities. Additionally, stakeholders’ awareness rising was coordinated; relevant legislation was enforced; collection of a behavioral insight data (social listening and surveys) were ensured; system for analyzing misinformation, disinformation, infodemics and public views were developed, including fighting against panic and stress-management. Nonetheless, community engagement was critical for the successful implementation of measures. Given the various governmental activities to protect the public health, it was important regularly monitor the adherence to recommendations. Continuous assessment of new social norms implementation (mask wearing, social distancing, reduction of contacts) were also important. With support of the WHO Country office, Georgia introduced Knowledge-Attitude-Practice studies to identify the adherence to preventive measures and immunization across different groups. Notably, the majority of respondents follow the basic rules for infection prevention. The main preventive measures were implemented by most respondents. Indoor mask wearing and disinfecting hands remained the measures often applied in all risky situation. The attitude of the respondents toward the vaccine was not unconditional but depended on various rational factors. Key messages • Overall, the risk perception and knowledge about preventive strategies play a crucial role in limiting transmission. • It is essential from health authorities to adopt risk communication, community engagement strategies and obtain regular feedback to reduce negative impact of public health emergency.