I-STRONG: an integrative, multicomponent treatment approach for chronic pain in pediatric sickle cell disease.

BackgroundClinical trials are vital for advancing medical knowledge, yet engaging diverse populations-those under-represented due to race, age, income, education, geography, sexual orientation, or gender identity-remains a challenge, limiting research generalizability.MethodsThis study used a literature review and semi-structured interviews with participants from diverse backgrounds recruited on LinkedIn. A demographic survey was conducted via Qualtrics, yielding 21 responses and 15 study participants. The research identified barriers to participation: inadequate community engagement, trial awareness, mistrust, and unaddressed social determinants of health, with data analyzed for key themes.ResultsFour themes emerged: (1) Community engagement builds trust; (2) Addressing social determinants alleviates barriers; (3) Peer education empowers participants; (4) A representative workforce enhances recruitment.DiscussionFindings emphasize the necessity of inclusive practices in clinical research, highlighting that targeted strategies can improve diversity in clinical trials, leading to more equitable healthcare outcomes. Future research should refine these strategies in specific therapeutic areas.

A Scoping Review of Toolkits Addressing Ethical Issues in Health Registry and Clinical Research Enrollment Among African Americans With CKD.

The use of public health vending machines (PHVMs) is an emerging strategy implemented to mitigate drug-related harms via the dispensation of supplies like naloxone and sterile syringes from vending machines that have been documented to reduce transmission of blood borne viruses, support hygiene and basic personal health needs, and prevent overdose. To inform future applications of this technology and performed initially as part of a technical assistance request, we sought to examine PHVM adoption and implementation by conducting semi-structured interviews with 26 individuals from diverse roles and organizations/agencies across the United States in March 2023 about their experiences launching and optimizing PHVMs. We engaged in a secondary thematic analysis of the interview data using both deduction and induction. Using the interview guide as the frame, we broadly organized our findings into themes that are pertinent to consider prior to PHVM implementation ("Pre-implementation") and those that are relevant during implementation ("Implementation and maintenance"). Pre-implementation themes included (1) Motivating factors influencing implementation, (2) Intended PHVM uptake population, (3) Partnership cultivation, (4) Responsiveness to community needs and concerns, and (5) Factors influencing placement of PHVMs. Implementation and maintenance themes included: (1) Operational components of implementation and (2) Tracking consumer use of machines and supply flow. We found that PHVMs have emerged as versatile and central tools to expand and extend critical, life-saving supplies and services to PWUD and other groups within communities throughout the United States, especially to underserved and high-risk populations, such as people of color, young people, rural residents, individuals leaving incarceration, and veterans. We also found that the planning phases of implementation were shaped by local needs, funding opportunities, collaboration, and community engagement, with PHVM placement most often determined by feasibility and willingness of host sites, as well as the perceptions and needs of the community. Operational challenges included unanticipated costs related to maintenance and supply stocking of the PHVMs. Our findings elucidate the local, ground-up, and bold approaches and innovations undertaken by many organizations, agencies, and programs throughout the country in PHVM implementation. Policymakers and government officials should consider passing local ordinances or granting permissions in support of placing PHVMs and securing access to life saving materials.

Cancer is a global disease, yet a paradox persists: The most advanced research ecosystems are concentrated in countries with lower disease burden, whereas low- and middle-income countries (LMIC)-carrying 70% of the global cancer burden-face major constraints in research capacity. Closing this gap is essential for equitable progress in cancer prevention, diagnosis, and treatment. Researchers in LMICs are creatively adapting established technologies, research pipelines, and collaborative models from higher-resource settings to local solutions. In this study, 25 American Association for Cancer Research Global Scholar-in-Training Award recipients from LMICs share how cancer research is advancing within resource-limited settings, focused on (i) infrastructure and resources, (ii) training and talent retention, (iii) funding and sustainability, and (iv) cultural and social barriers. We identified shared challenges and cross-cutting solutions, discussed gaps, and suggested steps to further advancing cancer research. We emphasized locally led innovation, strategic partnerships, and community engagement. These perspectives offer a framework for inclusive, synergistic approaches to strengthening cancer research and accelerating impact where it is needed most.

Veterinary service-learning programs can address gaps in access to care while fostering ethical, culturally responsive education. This paper examines 2 long-standing initiatives at the University of Calgary Faculty of Veterinary Medicine, the Northern Community Health Rotation, and the Equine Service-Learning Initiative, which center Indigenous partner communities through sustained, reciprocal engagement and how they relate to principles of veterinary community engagement. Program evaluations demonstrate improved animal health outcomes and transformative, culturally responsive student learning.

The prolonged waiting times for hip and knee arthroplasty have resulted in numerous negative effects for patients being reported, with none more important than increasing opioid reliance due to chronic musculoskeletal pain. Opioid use prior to surgery is a factor associated with prolonged use postoperatively, and while opioids remain a valuable resource in the management of acute surgical pain, ongoing use carries substantial clinical, psychological, and societal risks. Recent Medicines and Healthcare products Regulatory Agency (MHRA) guidance and the 2024 UK consensus statement have resulted in a shift for perioperative pain management, moving away from routine modified release opioid use towards individualized care. To address these issues and changes, interventions need to be focused both preoperatively and postoperatively using improved risk stratification, patient education, and community engagement. This annotation discusses these issues and emphasizes the importance of opioid stewardship as a unifying framework to embed principles across the arthroplasty pathway, with the aims of reducing harm, improving outcomes, and supporting safer sustainable care.

Stigma as social comorbidity in epilepsy.

Powerful policies or paper tigers? An analysis of policy implementation in the child protection space in the Nanumba North Municipality of Northern Ghana.

Culturally and linguistically diverse (CALD) communities have unique strengths, needs, and health seeking behaviours reflecting their cultural background. Therefore, top-down population-level health promotion initiatives with externally imposed performance indicators are frequently ineffective in CALD contexts. Accordingly, the Healthy New Communities (HNC) program implements an equity-based bottom-up commissioning model aimed at addressing socio-cultural factors impacting health seeking behaviours with people from refugee and migrant backgrounds. In the first phase of a comprehensive evaluation of the HNC program commissioning model, stakeholders involved in the implementation of commissioned activities and programs shared their experiences with this innovative funding model pioneered by the Queensland Health Metro South Hospital and Health Services, Health Equity and Access Team. Their perspectives were gathered in focus groups and interviews and analysed using an inductive approach to thematic analysis. The findings demonstrate the effectiveness of the HNC program commissioning model in engaging CALD communities in health promotion initiatives. Flexibility, responsiveness, trust, relationships, shared commitments, and cultural representation facilitated community members' participation in the commissioned activities. The impacts of the HNC program commissioning approach extend beyond the adoption of healthy lifestyles and include positive social, emotional, cultural, and physical impacts across a range of life domains and the creation of employment, training, and career pathways. The HNC program demonstrates how socio-cultural determinants of health can be influenced by commissioning models that prioritise community engagement, relationships, co-design, and the culturally shaped health-seeking behaviours of CALD individuals, families, and communities in the funding, design, and implementation of health promotion initiatives. SO WHAT?: Phase one results are promising and lay the foundation for an in-depth investigation of the potential of equity-based commissioning models for improving health and wellbeing outcomes for CALD communities across Queensland and beyond.

In 2024, the Lancet Commission on Investing in Health proposed targeting investment in 15 priority conditions through 19 modular interventions to improve global health by 2050. While pragmatic, this approach may not fully capture the complex-adaptive nature of health and health systems, nor their social, economic and political determinants. In an iterative, interpretive analysis, proposed global health investment frameworks were mapped against complexity, systems thinking and health epistemology frameworks; five thematic areas were identified for further development: (i)health as emergent from interdependent, social-biological systems; (ii)the non-biomedical determinants driving inequities; (iii)health systems' adaptive requirements; (iv)epistemic injustices that marginalize non-Western perspectives; and (v)the need for context-sensitive, community-led implementation of health measures. Recent major disruptions to international aid financing, while challenging, present a unique opportunity to redesign health investment on more sustainable and locally grounded foundations, where national governments deliberately invest in the social determinants of health as direct health improvement strategies rather than merely as adjacent social policy. To seize this opportunity, we propose five guiding principles for policy-makers: (i)community co-production of interventions; (ii)adaptive governance structures; (iii)complex systems literacy in workforce training to navigate interdependencies and uncertainty; (iv)cross-sectoral partnerships to address determinants of health; and (v)context-sensitive metrics that incorporate community engagement to support learning within health systems. These are not optional enhancements to existing approaches; they are the foundations without which any health investment strategy will continue to treat the symptoms of inequity rather than its causes.

Diabetic foot ulcers (DFUs) remain one of the most devastating complications of diabetes, accounting for over 80% of nontraumatic amputations and contributing to a 5-year mortality rate exceeding 30%. Despite significant clinical advances, profound disparities persist. Racial and ethnic minoritized populations, rural communities, and people with low socioeconomic resources experience disproportionate rates of severe ulceration, infection, delayed healing, and amputation. Traditional research approaches, often developed in academic settings without community input, have insufficiently addressed the contextual, cultural, and structural factors shaping DFU risk and outcomes. Community-engaged research (CEnR) offers a promising pathway to address these inequities; yet, DFU-specific evidence remains limited and heterogeneous. In response, the Diabetic Foot Consortium (DFC), a national research network funded by the National Institute of Diabetes and Digestive and Kidney Diseases, has initiated multisite efforts to embed community advisory boards, faith-based partnerships, mobile outreach, and culturally aligned engagement into DFU research. We propose the DFC-CEnR Model, a conceptual framework for integrating community-engaged approaches to DFU prevention, early detection, treatment, and research participation. The model distinguishes CEnR from related approaches (community-based participatory research, patient and public involvement, cultural humility, and equity-focused system interventions), outlining hypothesized mechanisms and evaluation domains. Illustrative consortium examples demonstrate how engagement domains may be operationalized and inform future testing of validated outcome measures. This article positions community engagement as a hypothesis-generating strategy that requires rigorous empirical testing to determine its impact on DFU outcomes and disparities.

This study aimed to develop, implement, and evaluate a multi-level violence prevention initiative codesigned with the community in Bessemer, Alabama. Guided by a community-based participatory research approach, we developed "Building a Better Bessemer," a holistic intervention targeting violent crime at the socio-ecological levels (individual, relational, community, and societal levels) through intervention mapping. The intervention included youth social-emotional learning, mentoring, parental support, police engagement, and community improvement projects. Evaluation included pre-post surveys and focus groups. Among youth self-reported outcomes, significant improvements were seen in social cohesion (p = 0.009) and decreases in conduct problems (p < 0.001) and total difficulties (p < 0.003). Focus group results reported strong support for the program's content and delivery. Community-driven, multi-level violence prevention interventions are feasible and effective in communities with high crime and show promising outcomes in youth behavior and community safety.

Grassroots organisations (GOs) often emerge spontaneously in disaster contexts to fill gaps left by formal authorities, changing their structures and functions to meet evolving community needs. While prior research documents these transformations, it offers limited insight into why they occur and what they mean for disaster recovery. Social capital (SC) is critical for collective action, but its role in shaping grassroots organisational change remains underexplored. This study, examining community-based GOs in Taiwan following Typhoon Morakot in 2009, investigates how SC influences organisational change. Using a comparative case study design, it finds that bonding SC within communities was most closely associated with whether change was sustained. Alignment between the initiatives of GOs and community priorities mediated bonding SC, sustaining trust, reciprocity, and legitimacy. Bridging and linking SC supported access to resources and external legitimacy, but they were not sufficient on their own when local support weakened. Theoretically, the study clarifies how SC subtypes interact with organisational change and helps interpret what such changes signify. Practically, it underscores the importance of responsive community engagement while strategically leveraging bridging and linking SC in post-disaster recovery.

Incidence of symptomatic Lassa virus infection in West African countries (Enable 1.0 Lassa Research Study): a prospective, multisite, cohort study.

Beyond consent: community engagement, benefit sharing and reciprocity in kidney genomics research.

The One Health approach, that integrates human, animal, and environmental health, is crucial for strengthening national and global health security. Highlights some of the key initiatives undertaken in India in this domain and explores the opportunities for future action. Further, it underscores the importance of information, education and communication materials, training programs for diverse stakeholders, and community outreach activities, in enhancing knowledge, attitude and practices among the public. The manuscript also examines potential areas to which the Central Health Education Bureau can support and contribute to the One Health approach through targeted interventions, interdisciplinary collaboration, and evidence-based research. Additionally, it emphasizes the importance of effective risk communication and community engagement in managing health risks and improving preparedness.

Public health organizations and researchers recognize community engagement as a critical practice for promoting the health and well-being of communities, but gaps remain in our understanding of factors that contribute to the development and implementation of community partnerships related to public health emergency preparedness (PHEP), particularly after the COVID-19 pandemic. To assess contextual factors that are associated with PHEP community engagement among local health departments (LHDs). Cross-sectional survey study. Health and Human Services (HHS) Region 10 (Alaska, Idaho, Oregon, Washington). PHEP practitioners who work at LHD. We developed a novel Community Engagement Scale (CES) to measure the level of community engagement activities among each LHD and adapted the Implementation Leadership Scale (ILS) to measure participants' commitment to community partnerships in PHEP. LHDs 34% (n = 26) within Health and Human Services Region 10 responded to our survey, including 17 from Washington, 4 from Oregon, and 3 from Idaho. Participants had a mean of 4.9-year experience in PHEP. The mean Community Engagement Scale score was 13.4 out of 32, with a higher score indicating a greater number and frequency of community engagement activities. The mean Implementation Leadership Scale score was 30.1 out of 48, with a higher score indicating greater participant commitment to PHEP community engagement. The state in which the LHD is located was associated with community engagement activities and individual-level commitment to community partnerships. Individual years of experience in PHEP was associated with individual-level commitment to community partnerships. This study provides a baseline assessment of engagement and partnership activities among LHDs in Region 10 using novel measures. Experience in PHEP and participants' commitment to PHEP community engagement were associated with partnership activities. Additional research is needed to uncover the state-level differences in community engagement activities and commitment to partnerships.

Intimate partner violence, which includes physical assault, sexual violation and coercion, economic abuse, as well as psychological aggression within romantic relationships, remains a pressing public health issue, affecting millions of adults in the United States each year. The costs of such experiences are high, contributing to risk of adverse physical and mental health outcomes, decreased economic and educational attainment, as well as risk of early mortality. Evidence suggests that intimate partner violence and its deleterious consequences are experienced more frequently by those holding historically and systemically marginalized social identities, including people of color, sexual and gender minorities, as well as immigrants and refugees. Yet, more research is needed to both understand why these disparities emerge; and from a clinical perspective, how to effectively address violence within historically and systemically marginalized communities. To achieve these aims, we must look outside the boundaries of psychology toward feminist and interdisciplinary frameworks. Such perspectives illuminate how structural and institutional forces interact and shape our individual and interpersonal experiences, including interpersonal violence. Integrating these perspectives into existing ecological frameworks illuminates how structural and institutional forces interact and shape survivors' individual and interpersonal experiences, including intimate partner violence. Our goal is to advance justice-oriented research and practice by both identifying the drivers of violence-related disparities and advocating for community healing and engagement as essential components of trauma-informed care for survivors. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This study presents a prospective policy analysis of healthcare workforce (human resources for health, HRH) reforms in Meghalaya, India, a state facing dual challenges of a rising burden of non-communicable diseases (NCDs) and persistent inequities in access to medical and public health specialists. Grounded in a health systems and social justice perspective, this study examines current HRH needs and proposed reforms, evaluating their potential to address the evolving health demands of the population, particularly among poor and marginalized groups vulnerable to NCDs. Using secondary evidence, including national surveys, epidemiological data, and government reports, the study maps workforce gaps, especially in rural and tribal regions, and highlights the physician-centric nature of HRH governance in India. The Walt and Gilson policy triangle, combined with adapted HRH evaluation frameworks, guided the analysis of policy context, content, processes, and actors. This approach identified key gaps in recruitment, rural retention, cadre structures, and specialist training for effective NCD prevention and management. A scenario analysis, using the Intuitive Logic method, developed a best-case trajectory of reform achievable through equity-oriented design, strong political will, and institutional capacity, while recognizing risks of policy stagnation. Findings indicate that achieving a socially accountable HRH system characterized by equitable distribution, transparent governance, and meaningful community engagement is critical for improving NCD outcomes and reducing health inequities, particularly by preventing financial distress among the poor. The study contributes to health policy and systems research by linking institutional design to future health system resilience, underscoring the need to embed justice, participation, and adaptability within HRH governance to effectively address present and future health challenges in low-resource contexts such as Meghalaya.