Community Participation In Health Research Articles

Perceived discrimination in bateyes of the Dominican Republic: results from the Everyday Discrimination Scale and implications for public health programs

BackgroundDiscrimination is a major driver of health disparities among minority groups and can impede the reach of public health programs. In the Dominican Republic, residents of bateyes, or agricultural ‘company towns,’ often face barriers to health care. This study examined the extent of perceived discrimination among batey populations and places the findings within the context of disease elimination efforts.MethodsIn March—April 2016, a stratified, multi-stage cluster survey that included the 9-item Everyday Discrimination Scale (EDS) was conducted among residents (n = 768) of bateyes across the Dominican Republic. Exploratory factor analysis, differential item functioning, and linear and logistic regression were used to assess associations between EDS scores, ethnic group status, reasons for discrimination, and healthcare-seeking behavior.ResultsThree ethnic groups were identified in the population: Haitian-born persons (42.5%), Dominican-born persons with Haitian descent (25.5%), and Dominican-born persons without Haitian descent (32.0%). Mean EDS scores (range 0–45) were highest among persons born in Haiti (18.2, 95% confidence interval [CI] = 16.4–20.1), followed by persons with Haitian descent (16.5, 95% CI = 14.9–18.0), and those without Haitian descent (13.3, 95% CI = 12.1–14.5). Higher EDS scores were significantly associated with Haitian birth (β = 6.8, 95% CI = 4.2—9.4; p < 0.001) and Haitian descent (β = 6.1, 95% CI = 3.2—9.0; p < 0.001). Most respondents (71.5%) had scores high enough to elicit reasons for their discrimination. Regardless of ethnic group, poverty was a common reason for discrimination, but Haitian-born and Haitian-descended people also attributed discrimination to their origin, documentation status, or skin color. EDS scores were not significantly associated with differences in reported care-seeking for recent fever (β = 1.7, 95% CI = − 1.4—4.9; p = 0.278).ConclusionPerceived discrimination is common among batey residents of all backgrounds but highest among Haitian-born people. Discrimination did not appear to be a primary barrier to care-seeking, suggesting other explanations for reduced care-seeking among Haitian populations. Public health community engagement strategies should avoid exacerbating stigma, build active participation in programs, and work towards community ownership of disease control and elimination goals.

Assessing knowledge and behavioural changes on maternal and newborn health among mothers following post-earthquake health promotion in Nepal.

IntroductionDisasters can disrupt the existing health system affecting the whole population, but especially vulnerable people such as pregnant women, new mothers and their babies. Despite the global progress in maternal, newborn and child health (MNCH) programmes over the years, emergency responses after a disaster are often poor. Post-disaster health promotion could play an important role in improving MNCH outcomes. However, evidence remains limited on the effect of post disaster health promotion activities in low-income countries such as Nepal.MethodsThis is an uncontrolled before and after study conducted in Dhading district which was severely affected by the 2015 earthquake in Nepal. The study participants were mothers who had a child in the previous 12 months. The intervention was implemented between 2016 and 2018 and included community-engagement health promotion activities where the local stakeholders and resources were mobilized. The outcome variables included: knowledge of danger signs of pregnancy, childbirth and in newborns; and behaviours including ever attending antenatal care (ANC), a minimum of four ANC sessions and having an institutional delivery. Data were analysed using chi-squared tests, independent sample t-tests and multiple logistic regression models.ResultsIn total 364 mothers were recruited in the pre-intervention group and 377 in the post-intervention group. The post-intervention group was more likely to have knowledge of at least three danger signs in pregnancy (AOR [Adjusted Odds Ratio] = 2.96, P<0.001), at least three danger signs in childbirth (AOR = 3.8, P<0.001), and at least five danger signs in newborns (AOR = 1.56, P<0.001) compared to the pre-intervention group. The mothers in the post-intervention group were also more likely to ever attend ANC (AOR = 7.18, P<0.001), attend a minimum of four ANC sessions (AOR = 5.09, P<0.001), and have institutional deliveries (AOR = 2.56, P<0.001). Religious minority groups were less likely to have knowledge of all danger signs compared to the majority Hindu group. Mothers from poorer households were also less likely to attend four ANC sessions. Mothers with higher education were more likely to have knowledge of all the danger signs. Mothers whose husbands had achieved higher education were also more likely to have knowledge of danger signs and have institutional deliveries.ConclusionHealth promotion intervention helped the disaster-affected mothers in improving the knowledge and behaviours related to MNCH. However, the vulnerable population would need more support to gain benefit from such intervention.

Implementation of and Early Outcomes From Anal Cancer Screening at a Community-Engaged Health Care Facility Providing Care to Nigerian Men Who Have Sex With Men.

PURPOSEAnal cancer risk is substantially higher among HIV-infected men who have sex with men (MSM) as compared with other reproductive-age adults, but screening is rare across sub-Saharan Africa. We report the use of high-resolution anoscopy (HRA) as a first-line screening tool and the resulting early outcomes among MSM in Abuja, Nigeria.METHODSFrom August 2016 to August 2017, 424 MSM enrolled in an anal cancer screening substudy of TRUST/RV368, a combined HIV prevention and treatment cohort. HRA-directed biopsies were diagnosed by histology, and ablative treatment was offered for high-grade squamous intraepithelial lesions (HSIL). HRA proficiency was assessed by evaluating the detection of squamous intraepithelial lesions (SIL) over time and the proportion biopsied. Prevalence estimates of low-grade squamous intraepithelial lesions and HSIL with 95% CIs were calculated. Multinomial logistic regression was used to identify those at the highest risk of SIL.RESULTSMedian age was 25 years (interquartile range [IQR], 22-29), median time since sexual debut was 8 years (IQR, 4-12), and 59% (95% CI, 54.2% to 63.6%) were HIV infected. Rate of detection of any SIL stabilized after 200 screenings, and less than 20% had two or more biopsies. Preliminary prevalence estimates of low-grade squamous intraepithelial lesions and HSIL were 50.0% (95% CI, 44.7% to 55.3%) and 6.3% (95% CI, 4.0% to 9.3%). HIV infection, at least 8 years since anal coital debut, concurrency, and external warts were independently statistically associated with SIL.CONCLUSIONProficiency with HRA increased with experience over time. However, HSIL detection rates were low, potentially affected by obstructed views from internal warts and low biopsy rates, highlighting the need for ongoing evaluation and mentoring to validate this finding. HRA is a feasible first-line screening tool at an MSM-friendly health care facility. Years since anal coital debut and external warts could prioritize screening.

Do Communities Really "Direct" in Community-Directed Interventions? A Qualitative Assessment of Beneficiaries' Perceptions at 20 Years of Community Directed Treatment with Ivermectin in Cameroon.

Recent studies in Cameroon after 20 years of implementation of the Community Directed Treatment with ivermectin (CDTI) strategy, revealed mixed results as regards community ownership. This brings into question the feasibility of Community Directed Interventions (CDI) in the country. We carried out qualitative surveys in 3 health districts of Cameroon, consisting of 11 individual interviews and 10 Focus Group Discussions (FGDs) with specific community members. The main topic discussed during individual interviews and FGDs was about community participation in health. We found an implementation gap in CDTI between the process theory in the 3 health districts. Despite this gap, community eagerness for health information and massive personal and financial adhesion to interventions that were perceived important, were indicators of CDI feasibility. The concept of CDI is culturally feasible in rural and semi-urban settlements, but many challenges hinder its actual implementation. In the view of community participation as a process rather than an intervention, these challenges include real dialogue with communities as partners, dialogue and advocacy with operational level health staff, and macroeconomic and political reforms in health, finance and other associated sectors.

Análisis descriptivo de la formación en participación comunitaria en salud en España

ObjectiveTo describe the professional training health professionals receive in community health engagement in Spain. MethodThe identification and descriptive analysis of trainings developed between 2013-2018 offered by public universities, public administrations and the teaching units for the specialization of family and community health doctors and nurses. ResultsTwenty eight trainings were included in the descriptive analysis. Most of them had been organized during 2018 in eight Autonomous Communities. Two of them were organized at a national level. Most trainings were attendance based and have been developed by teaching units in charge of training doctors and nurses specializing in family and community health, with an average duration of 10-25hours and no enrolment costs. ConclusionThere is a lack of training in community health engagement in the majority of autonomous communities in Spain which shows that it is scarce and not yet fully integrated in the training of health professionals. The trainings that have been analyzed are mainly part of wider specialization programs for doctors and nurses specializing in family and community health, and even so this training is not standardized and included in the specialization programs of all the Spanish regions. To develop a comprehensive health approach it is key to include community health engagement as part of the trainings professionals receive during their University degree, and to extend it to other health professions. The institutions responsible for the training of health professionals should include community health engagement as part of the different training itineraries of professionals.

Recognizing Racism in Medicine: A Student-Organized and Community-Engaged Health Professional Conference

Purpose: This piece details the evaluation and implementation of a student-led educational intervention designed to train health professionals on the impact of racism in health care and provide tools to mitigate it. In addition, this conference, cosponsored by medical, nursing, and social work training programs, facilitates development of networks of providers with the knowledge and skills to recognize and address racism in health care.Methods: The conference included 2 keynote speakers, an interprofessional panel, and 15 workshops. Participants (n=220) were asked to complete a survey assessing perceptions of conference content and impact. We compared responses pre- and postconference using Wilcoxon signed-rank tests.Results: Of the survey respondents (n=44), 45.5% were medical students, 13.6% nursing students, and 9% social work students; 65.9% self-identified as a race/ethnicity other than non-Hispanic white; and 63.6% self-identified as female. We found that 47.7% respondents reported they were more comfortable discussing how racism affects health (p<0.001), 36.4% had better understanding of the impact of racism on an individual's health (p<0.001), and 54.5% felt more connected to other health professionals working to recognize and address racism in medicine (p<0.001).Conclusion: These findings suggest that a student-organized conference could potentially be an effective strategy in addressing a critical gap in racism training for health care professionals.

Participation as Inclusion and Exclusion: Policing the Boundaries of “Citizenship” in Roma Health Mediation

Participatory health interventions have long been advocated as an approach to help marginalised community members exercise their rights as citizens, including access to health care. More than two decades ago, the Roma health mediation programme was established in Romania as a participatory community health intervention. Mediators are employed specifically to act as intermediaries between ‘Roma patients’ and local authorities or health professionals, with the overall aim to increase trust and improve access to health care. Based on data gathered during a year of ethnographic fieldwork with Roma health mediators in Romania, including participant observation and interviews, this article analyses the social processes by which participatory approaches produce both social inclusion and exclusion. It illustrates how mediators exceeded their remit of health and attempted to discipline communities into forms of neoliberal citizenship. Mediators reframed access to health care not as a right that community members already have, but as a benefit that must be individually ‘earned’ through the fulfilment of neoliberal citizenship. The article argues that far from being an ‘empowering tool’, community participation can extend the power of governing institutions and thereby may in fact contribute to the maintenance of a political status quo that perpetuates the precarisation of marginalised communities.

Supporting individuals’ healthy eating requires genuine engagement with communities

AbstractC3 Collaborating for Health (C3) aims to counter the non‐communicable disease (NCD) epidemic by focusing on the three big risk factors: tobacco use, poor diet and lack of physical activity. Community Health Engagement Survey Solutions (CHESS™) is an innovative strategy to shift decision‐making around prevention and health interventions to local communities, while also reducing inequalities in the broader determinants of health. Emerging from research in India, China, Mexico and the US, C3 has implemented CHESS™ in the UK in eight London boroughs, Halifax and Girvan. A recently completed project in England and Scotland engaged 5000 people (approximately one‐third of the local populations). CHESS™ facilitates communities to act as ‘citizen scientists’ in data‐driven investigations about health and the built environment. Through a mobile tool, communities collect and interpret quantitative and qualitative data on local assets and barriers conducive to good health (or not). These results inform evidence‐based action plans, guided by public health expertise, for interventions that make it easier for all to be healthy. The community enacts the changes they can make themselves and presents recommendations to decision‐makers in a compelling argument for change. Thanks to CHESS™ evidence, communities have received over £2 million to implement health interventions in their neighbourhoods. The Healthy Communities project, completed in September 2017, led to physical activity and healthy eating initiatives, including cooking lessons, gardening, breakfast and tea clubs, and healthy lunches for schoolchildren. Learnings from the project have informed recommendations for those wanting to improve community health, particularly in relation to diet.

The Namaus (All Things Fish) Project: Community-Engaged Environmental Health Research in Collaboration with the Narragansett Tribe in Charlestown, RI, U.S.A.

The Namaus (All Things Fish) Project: Community-Engaged Environmental Health Research in Collaboration with the Narragansett Tribe in Charlestown, RI, U.S.A.

Abstract C70: A community guide systematic review of multicomponent interventions to increase breast, cervical, and colorectal cancer screening: Findings in underserved populations

Abstract Background: Underserved adults are disproportionately not up-to-date with cancer screening. This systematic review examined effectiveness of multicomponent interventions (MCIs) to increase breast, cervical, and colorectal cancer (CRC) screening. Special attention was paid to underserved populations and interventions that engage community health workers (CHWs) and patient navigators (PNs). Methods: This systematic review consists of studies in high-income countries with eligible screening outcomes (recent or repeat mammography, Pap test, or CRC screening). Summary effects were calculated and stratified by income, insurance, involvement of Federally Qualified Health Centers (FQHCs) or community health centers (CHCs), and involvement of CHWs and PNs. Results: Eighty-eight studies were included. Among majority low-income populations, MCIs increased breast (median increase 10.5 percentage points (pp), interquartile interval (IQI) 6.5-25.7; 10 arms), cervical (median 7.0 pp, IQI 5.3-58.9; 7 arms), and CRC screening (median 15.5 pp, IQI 6.9-23.6; 13 arms). Screening use increased among majority uninsured populations across all three cancers (median 31.8 pp, range 23.2-40; 3 arms). MCIs involving FQHCs or CHCs increased breast and cervical (median 7.0 pp, IQI 2.3-11.0; 5 arms) and CRC screening (median 16.3 pp, IQI 13.9-23.8; 8 arms). Interventions engaging CHWs and PNs among low-income, majority-uninsured populations, or those utilizing FQHCs or CHCs also increased screening use across all three cancer types combined (CHWs: median 15.5 pp, IQI 5.8-60.1; 10 arms; PNs: median 11.9 pp, IQI 7.0-15.5; 11 arms). Conclusions: MCIs targeting underserved populations are effective in increasing breast, cervical, and CRC screening. MCIs engaging CHWs and PNs are effective among these populations. Citation Format: Devon Okasako-Schmucker, Yinan Peng, Susan Sabatino, Ismaila Ramon, Kristin Tansil Roberts, Shawna L. Mercer, Randy Elder. A community guide systematic review of multicomponent interventions to increase breast, cervical, and colorectal cancer screening: Findings in underserved populations [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C70.

Participação comunitária na saúde: uma revisão narrativa à produção acadêmica baseada nas desigualdades sociais

This review aims to locate historically the developments of the concept of community participation in health, and its main aspects just as they have developed over the last decades. To do so, an analytical review is made of the existing main debates and controversies, startig with the origin and the development of community participation. To that end, the sociohistorical process of construction and conceptual development can be understood. The second part explores the conformation of a subfield within the social sciences that tries to approach community participation from the perspective of networks, starting from the paradigm of complexity. After evidencing some of the gaps within the literature that deals with the topic, the authors develop an analytical approach of community participation, which attempts to problematize the distinction between urbanity and rurality. The analysis centers its interest in the social actors, the context, the relations of power, the concept of community, and the interactions that occur within it.

Using Community-Driven, Participatory Qualitative Inquiry to Discern Nuanced Community Health Needs and Assets of Chicago’s La Villita, a Mexican Immigrant Neighborhood

In predominately immigrant neighborhoods, the nuances of immigrant life in the ethnic enclave have important, yet underappreciated impact on community health. The complexities of immigrant experiences are essential to unpacking and addressing the impact of acculturative processes on observed racial, ethnic, and class-based health disparities in the United States. These insights because they are largely unexplored are best captured qualitatively through academic-community research partnership. We established the participatory mixed method Little Village participatory community health assessment(CHA) to explore community health in an ethnic enclave. In this paper, we share findings from our qualitative component exploring: how do Residents in a Predominately Immigrant Neighborhood Perceive Community Health Needs and Assets in Little Village. Three major themes emerged: rich, health promoting community assets inherent in the ethnic enclave; cumulative chronic stress impacting the mental health of families and intra-familial strain; and, work and occupation as important but underappreciated community health determinants in an immigrant neighborhood. These nuanced findings enhanced our community health assessment and contributed to the development of two additional tailored CHA methods, a community member-administered Community Health Survey, and an oral history component that provided deeper insight on the community's health needs and assets, and a focus for action on work as a social determinant of health at the community level. Conducting trusted community-driven health assessments that are adaptive and flexible to capture authentic needs and assets are critical, given health consequences of the new anti-immigrant rhetoric and growing socio-political tensions and fear in immigrant neighborhoods in the United States.

Needs Assessment for Creating a Patient-Centered, Community-Engaged Health Program for Homeless Pregnant Women.

Women who experience homelessness during pregnancy have poorer birth outcomes than the general population. This exploratory research describes the needs assessment of homeless women currently living at a shelter in Milwaukee, Wisconsin, to identify unmet needs related to maternal and infant perinatal health as the first step in designing a mutually beneficial patient-centered service-learning program for medical students to address these needs. Two 1-hour focus groups were held at a shelter for women who are homeless and/or victims of domestic violence. A total of 13 women participated in each session; four medical students and a physician served as facilitators and scribes at each session. The facilitators alternated asking predetermined open- and close-ended questions, followed by discussion among participants. Questions elicited experiences during pregnancy, what went well, what women living in the shelter struggled with, and what support they wished for but did not have. Scribes captured the conversation through hand-written notes and used content analysis in order of frequency. Thirteen themes were identified. The 5 most frequently identified themes were a need for pregnancy education, access/transportation, baby care, advocacy, and material necessities. Participating shelter residents and the medical students expressed interest in working with one another and forming a long-term partnership with the shelter. Results of this needs assessment will inform the creation of a new shelter-based medical education program that will meet homeless women's needs while preparing medical students for patient-centered, community-responsive care.

Nepal's Health Facility Operation and Management Committees: exploring community participation and influence in the Dang district's primary care clinics.

Community participation has been recognised as one of the key components for the successful implementation of primary health care (PHC) strategies, following the 1978 Declaration of Alma-Ata. In low- and middle-income countries (LMICs), HFMCs are now widely considered as a mechanism to increase community participation in health through community representation. There is some research examining the implementation process, impact and factors affecting the effectiveness of HFMCs. Despite the documented evidence of the importance of factors such as adequate representation, links with wider community, and decision-making power, there is limited evidence about the nature of community representation and degree of decision making within HFMCs in the PHC setting, particularly in LMICs. Qualitative interviews with 39 key informants were held to explore different aspects of community representation in HFMCs, and the influence of the HFMC on health facility decision-making processes. In addition, a facility audit at 22 facilities and review of HFMC meeting minutes at six health facilities were conducted.FindingsThere were Dalit (a marginalised caste) and Janajati (an ethnic group) representations in 77% and 100% of the committees, respectively. Likewise, there were at least two female members in each committee. However, the HFMC member selection process and decision making within the committees were influenced by powerful elites. The degree of participation through HFMCs appeared to be at the 'Manipulation' and 'Informing' stage of Arnstein's ladder of participation. In conclusion, despite representation of the community on HFMCs, the depth of participation seems low. There is a need to ensure a democratic selection process of committee members; and to expand the depth of participation.

Reducing Preventable Hospitalization and Disparity: Association With Local Health Department Mental Health Promotion Activities.

Serving as the center of community-engaged health programs, local health departments can play a critical role in promoting community mental health. The objectives of this study were to explore the association between local health department activities and (1) preventable hospitalizations for individuals with mental disorders, and (2) associated racial disparities in preventable hospitalizations. Employing the linked data sets of the 2012-2013 Healthcare Cost and Utilization Project state inpatient discharge file of the State of Maryland, the National Association of County and City Health Officials Profiles Survey, the Area Resource File, and U.S. Census data, the authors estimated the association between local health department activities (i.e., provision of mental health preventive care and community mental health promotion) and the reduction of the preventable hospitalizations for ambulatory care-sensitive conditions and coexisting mental disorders. All the data analyses were conducted during September 2016-August 2017. Multilevel regression showed that local health departments' provision of mental health preventive care (OR=0.76, 95% CI=0.63, 0.92) and mental health promotion activities (OR=0.77, 95% CI=0.62, 0.94) were significantly associated with lower rates of preventable hospitalizations for individuals with ambulatory care-sensitive conditions and coexisting mental disorders. Decomposition results suggested that local health departments' direct provision of mental health preventive care could reduce 9% of the racial disparities. Improving care coordination and integration are essential to meeting the growing demands for healthcare access, while controlling costs and improving quality of service delivery. These results suggest that it will be effective to engage local health departments in the integrated behavioral health system.

Beyond form and functioning: Understanding how contextual factors influence village health committees in northern India.

Health committees are a common strategy to foster community participation in health. Efforts to strengthen committees often focus on technical inputs to improve committee form (e.g. representative membership) and functioning (e.g. meeting procedures). However, porous and interconnected contextual spheres also mediate committee effectiveness. Using a framework for contextual analysis, we explored the contextual features that facilitated or hindered Village Health, Sanitation and Nutrition Committee (VHSNC) functionality in rural north India. We conducted interviews (n = 74), focus groups (n = 18) and observation over 1.5 years. Thematic content analysis enabled the identification and grouping of themes, and detailed exploration of sub-themes. While the intervention succeeded in strengthening committee form and functioning, participant accounts illuminated the different ways in which contextual influences impinged on VHSNC efficacy. Women and marginalized groups navigated social hierarchies that curtailed their ability to assert themselves in the presence of men and powerful local families. These dynamics were not static and unchanging, illustrated by pre-existing cross-caste problem solving, and the committee’s creation of opportunities for the careful violation of social norms. Resource and capacity deficits in government services limited opportunities to build relationships between health system actors and committee members and engendered mistrust of government institutions. Fragmented administrative accountability left committee members bearing responsibility for improving local health without access to stakeholders who could support or respond to their efforts. The committee’s narrow authority was at odds with widespread community needs, and committee members struggled to involve diverse government services across the health, sanitation, and nutrition sectors. Multiple parallel systems (political decentralization, media and other village groups) presented opportunities to create more enabling VHSNC contexts, although the potential to harness these opportunities was largely unmet. This study highlights the urgent need for supportive contexts in which people can not only participate in health committees, but also access the power and resources needed to bring about actual improvements to their health and wellbeing.

Service Learning: A Useful Pedagogy to Engage Community Health Education Students in a Resource Management and Grant Writing Course

Individuals in the health and social service arena are often required to obtain programmatic funds through grant and proposal writing; however, in this highly competitive era, these funding avenues have become more difficult to obtain. The literature is limited and mainly related to curriculum practices used to prepare students to work in the field of community health. A Resource Management and Grant Writing course taught in an undergraduate program that prepares students for Community Health Education Specialist certification uses a service-learning approach to teach specific National Commission for Health Education Credentialing knowledge and skills, including components of a grant. This article describes a successful service-learning process employed with these students.

Condom use peer norms and self-efficacy as mediators between community engagement and condom use among Chinese men who have sex with men

BackgroundCommunity engagement strategies are often integrated in public health interventions designed to promote condom use among men who have sex with men (MSM), a key population for HIV prevention. However, the ways in which condom use peer norms and self-efficacy play a role in the association between community engagement and condom use is unclear. This study examines the potential mediating roles of peer norms and self-efficacy in this association.MethodsA nationwide cross-sectional online survey was conducted among Chinese MSM in 2015. Recruitment criteria included being born biologically male, being older than 16 years, having had anal sex with a man at least once during their lifetime, and having had condomless anal or vaginal sex in the past three months. Mplus 6.11 was used to conduct confirmatory factor analysis and path modeling analysis to examine the structural relationships between HIV/sexual health community engagement (e.g., joining social media and community events related to HIV and sexual health services), condom use peer norms, condom use self-efficacy, and frequency of condom use.ResultsThe study found that HIV/sexual health community engagement, condom use peer norms, condom use self-efficacy, and frequency of condom use were mutually correlated. A good data model was achieved with fit index: CFI = 0.988, TLI = 0.987, RMSEA = 0.032, 90% CI (0.028, 0.036). HIV/sexual health community engagement was associated with frequency of condom use, which was directly mediated by condom use peer norms and indirectly through self-efficacy.ConclusionThe study suggests that condom use peer norms and self-efficacy may be mediators in the pathway between community engagement and condom use, and suggests the importance of peer-based interventions to improve condom use.

保健推進員の経験と健康習慣,家族の健康管理行動,地域の健康づくり参加行動との関連

保健推進員の経験と健康習慣,家族の健康管理行動,地域の健康づくり参加行動との関連

A successful model for longitudinal community-engaged health research: the 2040 Partners for Health Student Program.

Community-based participatory research [CBPR] is an emerging approach to collaborative research aimed at creating locally effective and sustainable interventions. The 2040 Partners for Health student program was developed as a unique model of longitudinal CBPR. Analysis of this program and its components illuminates both the challenges and the opportunities inherent in community engagement. The program rests on a foundation of a community-based, non-profit organization and a supportive academic university centre. Inter-professional health students and community members of underserved populations work together on different health projects by employing an adapted CBPR methodology. Three successful examples of sustainable CBPR projects are briefly described. The three projects are presented as primary outcomes resulting from this model. Benefits and challenges of the model as an approach to community-engaged research are discussed as well as secondary benefits of student participation. The 2040 Partners for Health student program represents a successful model of CBPR, illuminating common challenges and reiterating the profound value of community-engaged research.