Community-engaged Approach Research Articles

159 Community Engagement (CE) Brokers: Diversity and the Science of CE

OBJECTIVES/GOALS: Since 2013, managers of community engagement (CE) programs across the Clinical and Translational Science Award (CTSA) consortium funded by the National Center for Advancing Translational Sciences (NCATS) have convened monthly to build connections, share knowledge, and enable collaboration. METHODS/STUDY POPULATION: Notable for focus on staff leadership, the CE Brokers group has been central to the ongoing success of CTSA community engagement partnerships and approaches to research. In early 2022, a survey of the 139-member group asked about their roles and responsibilities, the ways the CE Brokers network has contributed to their hubs adoption and development of best practices and innovations, resources and lessons learned, and the creation of opportunities for members to collaboratively conduct and disseminate original research, and research on the science of community engagement. The survey also asked CE Brokers if they or their community partners are part of an underrepresented community. RESULTS/ANTICIPATED RESULTS: These demographic data will be shared, along with analyses of data on growth of the group over time, evolving themes, and a SWOT analysis completed in 2021. DISCUSSION/SIGNIFICANCE: This will provide a platform to explore new avenues for the CE Brokers and their impact within the NCATS CTSA consortium, in line with the evolving direction of the clinical and translational research enterprise.

Pathways of REDD+ Piloting in Enhancing Sustainable Forest Management: The Case of Masito-Ugalla Ecosystem, Western Tanzania.

In Tanzania, the piloting phase for the Reduced Emission from Deforestation and forest Degradation lasted for almost 8 years, between 2008 and 2016. REDD+ pilot projects were implemented to document critical lessons that would inform the development of REDD policy in the country, including the development of REDD strategy and Action Plan that the government endorsed in March 2013. Major thematic areas for piloting were to understand the drivers of deforestation and forest degradation, community engagement approaches, alternative livelihoods in the context of REDD+, measurement, reporting and verification of carbon issues in the context of REDD+ and financing questions. In western Tanzania, REDD+ was implemented in the same vein, with several activities employed with the involvement of state and non-state actors. This study evaluated the success and failure of the REDD+ mechanism in the Masito-Ugalla Ecosystem to draw lessons for future REDD+ implementation. This study employed a cross-sectional design that applied a mixed methods approach in collecting primary and secondary data, including 528 questionnaires, eight focus group discussions and data from direct observations. Before the REDD+ pilot, results indicate the existence of different forms of forest management, both traditional and modern, with traditional approaches being stricter than conventional and whose strength lost over time. The rise of conventional approaches was to alleviate deforestation that started in the aftermath that necessitated the development and implementation of conservation projects, whereby the REDD+ pilot is credited for stakeholder involvement and awareness creation programmes. However, it was challenging to balance conservation under REDD+ and community socio-economic development to achieve sustainable forest management targets, including alleviating shifting cultivation. The lack of completion of REDD+ activities such as the sale of carbon credits due to its short lifespan was an indication of REDD+ failure to achieve its milestones. Results illustrate further that transparency in planning for benefits distribution among actors, community empowerment, equity and equality and community responsiveness are necessary to foster community participation in SFM processes. Unless the transfer of tenure rights from the government (especially in JFM) to communities surrounding forests, it will be hard for local communities to effectively participate in future SFM activities. Findings highlight the need to clearly define how local communities surrounding forests can sustainably be engaged in management and conservation and benefit from their engagement in such processes.

'We do not talk about it': Engaging youth in Malawi to inform adaptation of a mental health literacy intervention.

There is limited knowledge on how to tackle mental health problems among youth in Africa. Literature describing community engagement (CE) approaches in low/middle-income countries (LMICs) health research is sparse. CE with youth from LMICS can help steer and shape culturally relevant interventions for stigmatised topics like mental health, resulting in better healthcare experiences. We share our experience of engaging youth in Malawi through advocacy organisations to inform cultural adaptation of a mental health literacy intervention. Young people were recruited using social media from universities and community youth organisations in Malawi to participate in focus group discussions to help culturally adapt content of an existing mental health literacy intervention. Nine online focus groups with 44 individuals were conducted. Discussions involved views and experiences of mental health, including impact of the coronavirus pandemic. Discussions were recorded, transcribed verbatim and analysed using content analysis. Transcript analyses revealed a vicious cycle of poverty and mental health problems for youth in Malawi. Four key themes were identified, 1) poverty-related socioeconomic and health challenges, 2) no one talks about mental health, 3) lacking mental health support and 4) relationship issues. These themes fed into one another within this vicious cycle which perpetually and negatively impacted their lives. The coronavirus pandemic worsened socioeconomic issues, health challenges, mental health and substance use issues, and burden on Malawi's already weak mental health system. Findings suggest increasing untreated mental health burden among Malawi's youth. It highlights great need to address mental health literacy using existing community structures like educational settings to minimise burden on a weak health system. Online focus groups are an effective way of acquiring views from various young people in Malawi on mental health. This CE approach has grown our stakeholder network, strengthening potential for future CE activities and broader research dissemination.

The Vave campaign: impact evaluation of a cancer awareness raising multi-media campaign in Samoa.

Cancer is a leading cause of premature death and disability in Samoa. Recognizing the importance of symptom awareness and early detection, the Samoa Cancer Society (SCS) developed the 'Vave' (quickly) campaign as the first multi-media cancer awareness campaign in Samoa. The campaign adopted a three-pronged community engagement approach including mass media; printed resources; and community outreach at culturally appropriate locations including churches, villages and schools. The campaign promoted three key messages: detect signs and symptoms quickly; quickly see a doctor; and quickly call SCS. To measure impact, data were collected using several methods around the outreach education sessions (pre- and post-surveys), campaign recall (survey) and Vave-related enquiries received by SCS. The findings revealed the campaign was effective in increasing awareness of cancer and importance of early detection demonstrated through community recall of campaign messages, increased enquiries to SCS and improved knowledge. However, it is of note that almost 30% of campaign recall respondents stated they were unsure or would not see a doctor if concerned about a sign of cancer. The reasons given being a lack of knowledge, lack of trust in hospitals and preference for traditional healing. This suggests more targeted culturally sensitive strategies are needed including partnering with traditional healers. Further, advocacy efforts are needed to address the structural barriers to cancer detection and treatment together with continuing education around causes and symptoms of cancer targeting the hard-to-reach communities in Samoa.

Evaluation in the field of early childhood development: A scoping review

Children’s early experiences and environments profoundly impact their development; therefore, ensuring the well-being of children through effective supports and services is critical. Evaluation is a tool that can be used to understand the effectiveness of early childhood development (ECD) practices, programs, and policies. A deeper understanding of the evaluation landscape in the ECD field is needed at this time. The purpose of this scoping review was to explore the state of evaluation in the ECD field across four constructs: community-driven evaluation, culturally responsive evaluation, evaluation capacity building, and evaluation use and influence. A comprehensive search of 7 electronic databases, including Canadian and international literature published in English from 2000 to 2020, was conducted. A total of 30 articles met the inclusion criteria. Findings demonstrate that some studies include aspects of a community-engaged approach to evaluation; however, comprehensive approaches to community-driven evaluation, culturally responsive evaluation, evaluation capacity building, and evaluation use in the field of ECD are not commonly achieved. This review will inform strategies for bridging evaluation gaps in the ECD sector, ultimately equipping organisations with the evaluative tools to improve practices, programs, and policies that impact the children, families, and communities they serve.

Decreasing loneliness and social isolation among the older people: systematic search and narrative review


 Introduction
 The aim of this study is to sum up the current knowledge on the effectiveness of the existing interventions for alleviating loneliness and social isolation among elderly persons.
 Methods
 We used a systematic approach and performed a literature search of MEDLINE, ISI Web of science, SCOPUS, The Cochrane Library, and CINAHL databases. After identifying 13 eligible reviews addressing interventions of our interest, we proceeded with a narrative description of the study findings.
 Results
 The initiatives largely encompassed one-to-one interventions, group activities or community engagement approaches. In particular, technology interventions were recently given much attention. Overall, the studies showed non-satisfying methodological quality and their results were often inconclusive.
 Conclusions
 Although there is a growing body of evidence referring to implementation of interventions targeting social isolation and loneliness among the elderly, future well-designed interventions are necessary in order to draw firm conclusions.

Findings from a Structured Adaptation Process for the SafeCare Parenting Program to Address Family Needs in a Diverse Refugee Community

Social workers can promote resiliency among refugee families by referring them to evidence-based programs to reduce the stressors of resettlement. The purpose of this study was to complete a structured adaptation process with the SafeCare® program for implementation in a refugee resettlement community. Participants included 21 members of an adaptation team made up of administrators, supervisors, and family service providers from three community agencies and community health workers. Quantitative findings suggested that content, process, and literacy-related adaptations were necessary to ensure cultural relevance of program materials. Qualitative feedback suggested the adaptation approach was a meaningful process that engaged community members and resulted in an acceptable and feasible curriculum for delivery in the refugee resettlement community, which will be further tested in a forthcoming implementation trial. The multi-pronged, community-engaged approach to SafeCare adaptation is presented as a potential framework for other programs that could benefit refugee children and their families.

Engaging communities to prepare for natural hazards: a conceptual model

Natural hazard preparation by communities reduces disaster-induced physical health problems and adverse experiences, lowers potential for post-traumatic stress disorders, and aids faster recovery. However, approaches to community engagement for preparedness vary widely leaving those responsible confused and often overwhelmed. This study builds on natural hazards behavior, community development, participatory, and codesign research to understand current community engagement approaches in an Australian context. Key principles for engaging communities were operationalized from document analysis and interviews with 30 community engagement practitioners from 25 Australian emergency management agencies. A thematic analysis of the agency documents and interviews led to a visualization of the pathway to community-led preparedness with the iterative community-centered engagement model for preparedness. The model reflects both current practice and aspirations. It contributes theoretically to a collaborative community-led engagement approach for risk personalization and protective action by highlighting the need to develop a deep understanding of the specific features of local communities. The model maps a pathway through different levels of community engagement toward the ultimate aim of a community-led approach to natural hazards preparation. It recognizes the changing circumstances and the situation of communities within their environment, and the barriers and enablers to support community-led preparedness. The model is significant in that it delivers a practical framework for engagement practitioners to build capacity in their communities and support their local communities to prepare for natural hazards and build relational capital for longer-term resilience.

Future Responses to Managing Muslim Ethnic Minorities in China: Lessons Learned from Global Approaches to Improving Inter-Ethnic Relations.

Current policies to manage ethnic minority unrest in Xinjiang are not working, and do not address the core root causes behind ethnic tensions. Drawing upon lessons learned from global approaches to improving inter-ethnic relations, and factoring in China’s institutional behaviour and norms, this essay looks at policy responses that could be entertained by the state to improve the conditions of ethnic minorities in Xinjiang. It suggests that in the short-term (under a year) the state could be more responsible in using the big data it collects for targeted surveillance, in tandem with a community engagement approach. In the medium-term (one to three years), the state could employ practices to reduce ethnic prejudice by encouraging increased meaningful intergroup contact, and promoting a positive media portrayal of ethnic minorities. In the long-term (three years plus), improving the relative socioeconomic ethnic inequalities is paramount.

Abstract 053: Heals Med-Tech: A Telehealth Based Behavioral Lifestyle Hypertension Control Program For High-risk African Americans Presenting At Primary Care Clinics

Background: Hypertension (HTN) related disparities have been recognized for decades among African-Americans(AAs), particularly concerning HTN control, HTN awareness, and HTN compliance, particularly among AA women.The efficacy tested HEALS Med-Tech behavioral lifestyle program offers a promising solution. We present thefindings from the first 3 months of HEALS Med-Tech intervention on BP reduction and improvement in DASH dietand exercise. Primary outcomes of interest are changes in BP, while secondary outcomes include a change in BMIand waist circumference. Methods: HEALS Med-Tech program offers 3 components: a) HEALS ( He althy Ea ting and Li ving Sp iritually) a 12-month behavioral lifestyle intervention, modified from the DASH and PREMIER programs (3-mo interventionfollowed by 9-mos of maintenance); b) Med -component provides HTN management through medications and socialsupport provided by PCP and Community Health Ambassadors; and c) Tech -component provides interactivetelehealth by mobile phone to combat barriers to healthcare access. The results were analyzed using ANOVA andregression analysis. Dietary analysis was done to obtain DASH scores from the food diaries and 24-hr dietary recalls.The program is currently in month 6 of its maintenance phase. Results: A total of 62 AA participants were enrolled and randomized to either HEALS Med-Tech or standard care(control). At the end of 3 months, HEALS Med-Tech arm showed a significant reduction in SBP (13.11 mmHg; p=0.01)and DBP (4.2 mmHg; p=0.04) compared to the standard care arm (SBP and DBP change of 7.83 mmHg and 0.32mmHg), respectively. After 12 weeks of intervention, the average DASH scores were 2.002 for HEALS and 1.592 forcontrol arm compared to 1.620 and 1.500 at baseline for HEALS and control arm, respectively. Conclusion: A multidisciplinary, community-engaged approach with telehealth component for improved access tohealthcare may be useful in fostering the acceptability of behavior change interventions among marginalized AAs.

Listening, Engaging, Advocating and Partnering (L.E.A.P): A Model for Responsible Community Engagement for Educational Leaders

Given the current, contested political climate, growing school-community inequities, and a renewed commitment to equity and justice in the National Education Leadership Preparation standards, aspiring educational leaders need practical approaches to leading school communities toward equitable outcomes. This conceptual article offers a comprehensive and practical approach for responsible community engagement for educational leaders. The authors outline a model that provides key examples of how contemporary educational leaders might begin: listening, engaging, advocating, and partnering with community-based assets to improve the outcomes of historically disenfranchised students. This scholarship concludes with implications for leadership preparation programs and aspiring educational leaders.

The impact of COVID-19 on income and employment and willingness to become vaccinated among African Americans enrolled in a smoking cessation randomized trial

Given vulnerability to COVID-19 among smokers and vaccine hesitancy among populations disproportionately burdened with COVID-19, it’s important to understand concerns about vaccines and the impact of COVID-19 on these subgroups. Among our all African American (AA) sample of smokers (N = 172) enrolled in alargersmoking cessation clinical trial, results demonstrated an intensive burden from COVID-19; 42 (24.4%) lost employment, 56 (32.6%) lost household income, and 66 (38.4%) reportedinability to pay bills and buy food due to COVID. Most, 103 (64.4%), were willing to get vaccinated. Among the vaccine-hesitant, 57 (35.6%), concerns about COVID-19 vaccine development and mistrust in vaccines were primary reasons for unwillingness to get vaccinated. Few identified doctor’s advice as most valued in deciding if the vaccine was the best option. Findings highlight high openness to the vaccine among smokers impacted by COVID but reiterate the need for community-engaged versus health system-driven approaches to improve vaccine hesitancy among racial/ethnic minorities.

Community-Engaged Use of Low-Cost Sensors to Assess the Spatial Distribution of PM2.5 Concentrations across Disadvantaged Communities: Results from a Pilot Study in Santa Ana, CA.

PM2.5 is an air pollutant that is widely associated with adverse health effects, and which tends to be disproportionately located near low-income communities and communities of color. We applied a community-engaged research approach to assess the distribution of PM2.5 concentrations in the context of community concerns and urban features within and around the city of Santa Ana, CA. Approximately 183 h of one-minute average PM2.5 measurements, along with high-resolution geographic coordinate measurements, were collected by volunteer community participants using roughly two dozen low-cost AtmoTube Pro air pollution sensors paired with real-time GPS tracking devices. PM2.5 varied by region, time of day, and month. In general, concentrations were higher near the city’s industrial corridor, which is an area of concern to local community members. While the freeway systems were shown to correlate with some degree of elevated air pollution, two of four sampling days demonstrated little to no visible association with freeway traffic. Concentrations tended to be higher within socioeconomically disadvantaged communities compared to other areas. This pilot study demonstrates the utility of using low-cost air pollution sensors for the application of community-engaged study designs that leverage community knowledge, enable high-density air monitoring, and facilitate greater health-related awareness, education, and empowerment among communities. The mobile air-monitoring approach used in this study, and its application to characterize the ambient air quality within a defined geographic region, is in contrast to other community-engaged studies, which employ fixed-site monitoring and/or focus on personal exposure. The findings from this study underscore the existence of environmental health inequities that persist in urban areas today, which can help to inform policy decisions related to health equity, future urban planning, and community access to resources.

Developing the Florida Academic Cancer Center Alliance Health Disparities Common Measure: The Florida Health and Ancestry Survey

PurposeOur specific aim was to develop and assess the consensus-based validity of common measures for understanding health behaviors and ancestry in Florida’s population subgroups and establish the feasibility of wide-scale implementation of the measures and biospecimen collection within three cancer centers’ catchment areas.MethodsUsing the National Cancer Institute’s Grid-Enabled Measures web-based platform and an iterative process, we developed the Florida Health and Ancestry Survey (FHAS). We then used three sampling approaches to implement the FHAS: community-engaged, panel respondent, and random digit dialing (RDD). We asked a subset of participants to provide a saliva sample for future validation of subjective ancestry report with DNA-derived ancestry markers.ResultsThis process supported the FHAS content validity. As an indicator of feasibility, the goals for completed surveys by sampling approach were met for two of the three cancer centers, yielding a total of 1438 completed surveys. The RDD approach produced the most representative sample. The panel sampling approach produced inadequate representation of older individuals and males. The community-engaged approach along with social media recruitment produced extreme underrepresentation only for males. Two of the cancer centers mailed biospecimen kits, whereas one did not due to resource constraints. On average, the community engaged approach was more productive in obtaining returned biospecimen samples (80%) than the panel approach (48%).ConclusionsWe successfully developed and implemented the FHAS as a common measure to show its feasibility for understanding cancer health disparities in Florida. We identified sampling approach successes and challenges to obtaining biospecimens for ancestry research.

Abstract PO-041: The impact of COVID-19 on cancer care in the Latinx community in Northern California: A mixed method community-engaged research study

Abstract The COVID-19 pandemic has negatively impacted cancer care including delayed diagnosis, procedures, and patient fears of COVID-19 infection. However, less is known about the impact on specific populations, including Latinx adults, who have been disproportionately affected by COVID-19. Cancer is the leading cause of death among Latinx adults. Alarmingly, they have low participation rates in cancer prevention programs and face multiple barriers in accessing healthcare, even before the pandemic. Rigorous methods and community-engaged approaches are needed to uncover key barriers and facilitators to cancer care across the socio-ecological spectrum and to translate findings into culturally congruent educational strategies and dissemination efforts. The present mixed methods study entails a bi-directional partnership between the Stanford Medicine Office of Community Engagement and Latinas Contra Cancer, a community-based organization increasing equitable cancer care access for Latinxs. This study aims to determine barriers and facilitators of cancer screening, diagnostics, and treatment in the Latinx community as a result of COVID-19 using a community-based survey (n=500) in Northern California. To gain a deeper understanding of the lived experience of Latinxs obtaining cancer-related care during the pandemic, we will conduct focus groups (n=4) with study participants stratified by barriers and facilitators they endorse across the socio-ecological spectrum, as well as by key demographics (e.g., socioeconomic status, nativity, health literacy). Moreover, medical providers and community clinics will be interviewed (n=15) to understand their unique circumstances during this pandemic (e.g., changing healthcare system logistics, telehealth challenges). Data collection is ongoing and expected to be complete by the end of the summer. We will present descriptive data and statistical analysis (e.g., chi-square tests, logistic regressions) exploring associations key sociocultural and demographic participants characteristics and their endorsement of a variety of barriers and facilitators to care. We will also present key themes from the qualitative data to further contextualize survey findings and gain deeper meaning of the complexities of cancer related care during the pandemic. Study findings will allow us to understand the complexity of barriers and facilitators of cancer prevention and care for Latinxs adults, inform the development of health promotion resources, and guide policy and solutions to reduce excess cancer burden for Latinxs communities. Citation Format: Patricia Rodriguez Espinosa, Darcie Green, Yessica Martinez Mulet, Miriam L. Trigo, Natalia M. Zamora Zeledon, Eric Meléndez, Lisa G. Rosas. The impact of COVID-19 on cancer care in the Latinx community in Northern California: A mixed method community-engaged research study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-041.

Designing appropriate, acceptable and feasible community-engagement approaches to improve routine immunisation outcomes in low- and middle-income countries: A synthesis of 3ie-supported formative evaluations.

As global child vaccination coverage has plateaued, understanding how to increase routine child vaccination rates further is key to avoiding preventable disease and death. To analyse how community engagement strategies can increase child vaccination, we synthesise the results from formative evaluations of interventions that aimed to increase vaccination coverage in Ethiopia, Myanmar, Nigeria, and Pakistan. This paper uses an inductive qualitative approach to synthesise the results from the six evaluations, gathering lessons for designing context appropriate interventions that are feasible to implement and acceptable to providers, communities, and caregivers. Assessing contextual, caregiver-level and provider-level barriers to vaccination is key to identifying appropriate engagement strategies. Across all contexts, low knowledge about the schedule of vaccines and the importance of timeliness represented a barrier to child immunisation. Despite the variability in how studies measured and reported caregiver attitudes, vaccine hesitancy was not found to represent an important barrier to immunisation. Frontline health workers played a critical role in community engagement approaches to increase vaccination. Interventions successfully obtained community buy-in by centre-staging community members, especially leaders, ensuring their participation in monitoring, and making immunisation an agenda item on community platforms. Interventions were implemented through existing health systems with substantial assistance from research teams. Limited data was available about intervention costs. Interventions designed around community engagement strategies can be appropriate, acceptable, and feasible approaches to overcome barriers to vaccination in a variety of low- and middle-income country contexts. However, questions remain about the ability of health systems to implement interventions at scale, both from a cost perspective and a capacity perspective.

Community-engaged Processes for Restarting Federally Funded Research in a Community-based Organization during the Coronavirus Disease 2019 Pandemic.

Birmingham AIDS Outreach (BAO) is one of three study sites partnering with the University of Pittsburgh Graduate School of Public Health (Pitt Public Health) for a National Institutes of Health-funded randomized controlled trial on a financial management intervention for people with HIV who are experiencing homelessness or housing instability. After the onset of the coronavirus disease 2019 (COVID-19) pandemic in March 2020, the study team used a community-engaged approach to adapt research protocols at this site. We sought to describe a community-engaged approach to restarting National Institutes of Health-funded research during the COVID-19 pandemic. Partners at Pitt Public Health and BAO developed a set of agency-wide COVID-19 policies and procedures for BAO organized around Rhodes' critical elements of community engagement. The challenges presented by COVID-19 in the research sector have provided an opportunity to reevaluate study activities and increase the extent to which research is conducted in a community-centered manner.

An analytical review on rethinking service-learning as critical transformative paradigm in higher education

In recent times, service-learning has emerged as a popular community-based instructional pedagogy. However, scholars have a sharp contention about the role of service-learning as a community engagement paradigm in higher education. Furthermore, limited studies exist on service-learning as a transformative instructional pedagogy in higher education. This paper addresses this gap in the literature by presenting an analytical review on the potential of service-learning as a transformative pedagogy in higher education. A traditional narrative review method was used to survey on the theme of the study to establish a theoretical framework and draw conclusions. An extensive survey of existing literature was conducted on the role of service-learning as transformative pedagogy in higher education. This research may help answer the following two critical questions: What are internal and external limits to service-learning in higher education? To what extent can service-learning replace the traditional mode of teaching and learning in higher education successfully? The review shows that service-learning is a critical transformative pedagogy that helps achieve the boarder goals of higher education in a more effective way. The review further informs that service-learning is a community engagement approach that can also be used as a teaching method for achieving specific civic and democratic goals of higher education.

Grassroots Approaches To Community-Based Representative Recruitment In Multidomain Trials

U.S. POINTER is a randomized, controlled, multi-domain clinical trial to slow the progression of cognitive decline within the American population via tailored and culturally-appropriate healthy lifestyle interventions. For findings to be broadly relevant across the American population, incorporating an inclusive and robust recruitment effort has been essential to form a diverse and properly representative participant cohort. As such, the trial’s inclusive enrollment goal is 30% from traditionally underrepresented communities that include those at elevated risk for Alzheimer’s disease and related disorders. To accomplish this goal, U.S. POINTER developed and deployed a grassroots recruitment strategy in partnership with outreach specialists at each site that includes a mix of evidence-based and innovative community engagement approaches. While the COVID-19 pandemic continues to present unique challenges for recruitment, our team has been able to strategize ways to continue working within the community to support trial recruitment. An overview of these methods will be presented.

Investigating Elder Abuse and Neglect in Diverse Refugee Communities in Greensboro, NC

Elder abuse and neglect (EAN) comprises multiple dimensions, is experienced by about 10% of older adults in the U.S in diverse communities, and is severely detrimental to older adults’ (OA) health and wellbeing. However, documentation of EAN among refugee OA is greatly lacking as are services for these communities. Refugee OA are overall underserved members of marginalized communities. This paper reports on a community-engaged study to collect information and raise awareness of EAN among OA in 2 North Carolina refugee communities - Nepali-speaking Bhutanese and Congolese. Research partners included University researchers and community refugee-serving organizations. Surveys and focus group interviews were conducted. 17 Nepali-speaking Bhutanese and 13 Congolese filled out survey questions, including the Elder Abuse Suspicion Index. They participated in focus group discussions (FGDs), separately for men and women of each community. Survey results indicated EAN more among Congolese than Nepali-speaking Bhutanese. FGD results showed both communities prefer to depend on family members, and experience difficulties with language, transportation, and economic insecurity. No EAN was reported in the FGDs. In line with principles of community-engaged approaches, a capacity-building event to increase awareness of EAN was held, attended by 25 persons from the two communities. This study adds documentation on an under-researched area and marginalized communities. Action recommendations include disseminating culturally appropriate EAN information, strengthening English language and job skills and transportation options, encouraging cooperation across state, nonprofit, educational, and service organizations to address needs of older refugee adults.