Involvement Of Community Members Research Articles

Guidelines on the Inclusion and Protection of Adolescent Minors and Young Adults in Health Research: A Position Statement of the Society for Adolescent Health and Medicine.

Guidelines on the Inclusion and Protection of Adolescent Minors and Young Adults in Health Research: A Position Statement of the Society for Adolescent Health and Medicine.

Community-Engaged Mental Health and Wellbeing Initiatives in Under-Resourced Settings: A Scoping Review of Primary Studies

Introduction: Community-engaged initiatives are identified as promising to improve the health of communities with limited resources. This review aims to examine community-engaged mental health/wellbeing initiatives across Low- and Middle-Income Countries (LMIC) and under-resourced settings of High-Income Countries (HIC). Methods: We searched CINAHL, Embase, MEDLINE, PsycINFO, and Scopus databases to identify eligible primary studies until August 2024. Studies conducted in English language, involving community members in the initiatives’ design or implementation and targeting 1 or more mental health/wellbeing outcomes, were included. Results: About 35 studies (n = 35) reporting 29 mental health/wellbeing initiatives across LMIC-(n = 24) and HIC-(n = 11) were included. Programmes with high community engagement, including community-led initiatives, consistently reported positive mental health and well-being outcomes, including reduced clinical symptoms and enhanced personal recovery and wellbeing. However, mixed outcomes on initiatives’ impact on quality of life and diagnosed mental health conditions were evident. Various challenges, including cultural barriers, were noted, as was a lack of involvement of people with lived experience of mental health challenges. Conclusion: Community-engaged mental health and wellbeing initiatives in under-resourced settings have shown the potential to improve mental health outcomes and well-being when actively involving community members. Future work should focus on scalable initiatives and active inclusion of people with lived experience of mental health challenges. Review protocol registration at https://doi.org/10.17605/OSF.IO/367BK .

Consumer-Led Codesign of an Effective Online Consumer and Community Involvement Audit Tool.

There is evidence that consumer and community involvement (CCI) improves the quality and outcomes of health research. However, there is currently limited support for organisations to plan, implement and evaluate CCI activity. We aimed to codesign an audit tool that will enable organisations, researchers, community members and funders to measure the extent and nature of CCI in their respective settings. The tool was based on the Western Australian Health Translation Network's CCI Handbook. We offered optional online workshops to inform participants about the study (total n = 9). Following this, we obtained feedback on the appropriateness of the Handbook and audit tool (n = 11). Finally, using Qualtrics surveys, we assessed the quality and effectiveness of the tool in evaluating CCI with 10 researchers, 6 funders, and 1 community member (total n = 17) sourced from networks within Monash University and the Perron Institute for Neurological and Translational Science. Overall participants had a positive response to the audit tool and believed it had value in quantifying direct implementation of CCI in their workplaces. Gaps identified included the need to address health and research literacy of community members, culturally responsive approaches when working with community members from migrant backgrounds and an identified need for visual and digital resources. Application of the tool enabled participants to identify their respective CCI strengths, weakness and opportunities for improving the meaningful involvement of community members and community in their research activities and to support equity in these processes. The public participated in workshops providing feedback on the general structure of the audit tool as well as testing it within their research projects.

Equity in action: a scoping review and meta-framework for embedding equity in quality improvement

BackgroundThere are increasing efforts to include equity in all quality improvement (QI) initiatives. A comprehensive framework to embed equity in QI has been lacking, which acts as a barrier to...

Modelling participation in waste bank initiatives at public transport hubs to advance circular economy development

This study investigates the factors influencing community willingness to participate (WTP) in waste bank initiatives at public transport hubs, emphasizing their role in advancing smart city waste management and circular economy development. Through a comprehensive survey and the application of Structural Equation Modeling (SEM), the research highlights four crucial adaptability factors: interest level, ability to cope, ability to plan, and ability to learn. Each factor is explicitly defined with specific metrics for measurement, providing a clear understanding of their role in shaping community participation and behavior control. The findings reveal that enhancing community interest through digital platforms and interactive technologies, providing adequate waste management resources, involving the community in the planning process, and promoting continuous education are essential for fostering participation. The study demonstrates that leveraging digital platforms to disseminate real-time information and educational content can significantly boost community interest and engagement. Additionally, equipping communities with necessary tools and resources, such as accessible sorting facilities and professional assistance, enhances their ability to manage waste effectively. Involving community members in the planning process ensures that waste management strategies are tailored to local needs and preferences, thereby increasing their effectiveness. The study offers implications for policymakers and urban planners, providing a framework for developing sustainable waste management practices within public transport systems. By fostering a culture of sustainability and resilience, these practices contribute to creating eco-friendly urban environments, aligning with the broader goals of smart city initiatives and circular economy principles.

KAMPUNG SEHAT, UMKM BERKEMBANG: KOLABORASI SOSIALISASI STUNTING DAN PENDAMPINGAN UMKM DI DESA CIBOLANG KALER

In 2014, Sukabumi Regency recorded 21,795 micro businesses, 4,328 SMEs, and 877 medium businesses in the MSME sector. The number of workers absorbed reached 68,668 people and the distribution included food and beverage, trade, services, leather crafts, knitting, and other fields. However, the promotion efforts for MSMEs carried out by the Sukabumi Regency Government have only covered 3,933 of the 27,000 existing MSMEs. In the digital era, adapting to rapid business changes is very important, especially in the context of digital technology. Cibolang Kaler Village is located in Cisaat District, Sukabumi Regency, West Java, with a population of 10,931 people. This village is divided into 3 settlements with 9 RWs. Due to its strategic location, Cibolang Kaler Village is at the heart of economic and social development efforts in the region. Therefore, we created various innovations through observation methods, interviews, introduction to digital marketing, planning, implementing, and publishing logo and banner designs, as well as applying the canvas business model and SWOT analysis. All of these steps are part of a strategy that aims to encourage MSMEs towards digitalization to increase their effectiveness and marketing performance. Apart from MSMEs, stunting is also a significant threat to the quality of Indonesian society because apart from disrupting physical growth, children also experience brain development disorders which will affect their abilities and achievements. Apart from that, children who suffer from stunting will have a history of poor health due to flawed immune systems. Cibolang Kaler village has several toddlers affected by stunting in the Cisaat District. This can be proven by the number of toddlers affected by stunting, namely 3 toddlers. The method used in implementing stunting management activities in Cibolang Kaler Village is the method of counseling and socializing activities involving community members in Cibolangkaler Village. Implementation begins by looking for data on community needs, followed by designing ideas regarding these problems. After the design is perfect, the activity continues with implementing these ideas with the hope that what has been implemented will be utilized optimally by the community members in Cibolang Kaler Village. Keywords: Brand Strengthening, Simping MSMEs, Stunting, Stunting prevention

Shaping Effective Food Action Groups: Participant Perspectives on Structure and Stakeholder Involvement in Regional and Remote Western Australia.

Food systems strongly influence food security outcomes. Food Action Groups (often termed Food Policy Councils/Coalitions/Networks internationally)offer a co-ordinated and collaborative approach to local food system issues. Their organisational structure and stakeholder membership significantly impact their focus and impact. Therefore, it is imperative to understanding community member and food system stakeholders' perspectives on how regional and remote Australian Food Action Groups should be structured to maximise their impact on local food systems, and identify the most appropriate stakeholders to facilitate and drive their action. A qualitative study using focus groups, was conducted in regional and remote townships across Western Australian regions of Peel, South West, Great Southern, Wheatbelt, Midwest (including Gascoyne), Goldfields, Pilbara, and Kimberley. Participants were community members and food system stakeholders. Focus group transcript data were thematically analysed. A formal structure with sustainable funding was important for Food Action Groups, as was adopting a bottom-up approach with local community needs driving the agenda, supported by an adaptable and responsive work plan. Involving community members and ensuring a diverse membership were viewed as critical to their success. To effectively address local needs, Food Action Groups should adopt a formal structure with clear processes and involve a diverse group of community stakeholders. This would leverage local knowledge and evidence to guide actions and set well-informed priorities. The establishment of Australian Food Action Groups in regional and remote Australia has potential to follow suit of their US, Canada and UK predecessors, improve regional food systems and influence government policies.

Politics of school evaluation during quality assurance policy implementation in selected secondary schools in Dodoma, Tanzania

Purpose This study aims to examine the nature and extent of political dynamics (power struggles and contestations) among internal and external school stakeholders in the school evaluation processes and their influence on the objectivity and consistency of evaluations. Design/methodology/approach This study used a purposive sampling method to examine seven secondary schools in Dodoma Region, which were key in piloting the School Quality Assurance (SQA) policy implementation in 2018. The selected schools were government boarding institutions with long histories, managed by School Management Teams and Governing Boards that influenced school decision-making. These schools had regular SQA visits and produced School Self-Evaluation and Whole-School Evaluation reports, which served as the primary data sources. Data were analysed using a method that involved sorting, coding, identifying patterns and applying theory to interpret the findings. The analysis focused on discrepancies and power dynamics in school evaluations, particularly how internal and external evaluators’ roles were represented in the reports. Ethical considerations were ensured through confidentiality, pseudonymizing participants and obtaining clearance from relevant authorities. This study’s reliability and trustworthiness were enhanced through consistent data collection protocols, a transparent coding framework and triangulation of sources. This research offers insights into the politics of SQA policy implementation, highlighting tensions and power dynamics in school evaluations and revealing gaps between policy and practice. Findings This study identifies the SQA policy discourses that were tools and sites of power struggles and contestations among internal and external evaluators in all six quality domains. These political dynamics impacted the objectivity and consistency of evaluation outcomes due to subjectivity among evaluators. Internal evaluation had a positive image by offering higher quality indicators than external evaluation in most case study schools. Research limitations/implications Policy documents provide a high-level overview, often missing the nuanced realities of school implementation. While updated periodically, they may not reflect current practices or challenges. These documents typically present an idealized vision of education, which might not align with actual outcomes. Analysing them alone can overlook the perspectives of teachers, students, parents and other stakeholders directly impacted by the policies. Informal practices and adaptations in response to policy directives may not be documented, and the interpretation of such documents can vary widely, leading to subjective analysis. In addition, policy documents lack empirical data on the effectiveness and impact of the policies. Practical implications This study highlights the need for clear and consistent evaluation criteria to reduce discrepancies between internal and external evaluators. It also underscores the importance of training and support for school-based evaluators to ensure reliable assessments. Moreover, this study calls for addressing political dynamics influencing evaluation objectivity, ensuring that evaluations genuinely reflect school performance. Finally, the findings advocate for involving all stakeholders in the evaluation process to enhance transparency and accountability. Social implications This study has important social implications. It reveals how political dynamics can affect the fairness and transparency of school evaluations, potentially impacting stakeholders’ trust in the education system. This study highlights the need for equitable and unbiased evaluation practices to ensure that all schools are fairly assessed and supported. This can lead to better educational outcomes, as schools receive appropriate feedback and resources. Moreover, involving community members in the evaluation process can foster greater accountability and community engagement in educational development. Originality/value This study provides original value by addressing the intersection of political dynamics and educational evaluation. It uniquely examines how power struggles and political influences affect the objectivity and consistency of quality assurance practices. By highlighting discrepancies between internal and external evaluators, this study offers fresh insights into the challenges of implementing educational policies. This research contributes to the broader discourse on educational reform by advocating for more transparent and equitable evaluation processes, thereby enhancing policy effectiveness and educational outcomes.

The Role of the Police in Handling Conflicts Between Residents in Jakarta: The Perspective of Community Policing Theory and Semelser's Theory

This study investigates the role of the police in managing conflicts between residents in Jakarta through the lenses of Community Policing Theory (Polmas) and Smelser's Social Unrest Theory. Conflicts between residents in Jakarta, driven by various socio-economic, cultural, and personal factors, have increased social tensions, disrupting public order and community safety. The police's role in conflict resolution, incorporating law enforcement and community-based prevention approaches, is essential in maintaining social stability. The research explores the effectiveness of the Community Policing (Polmas) program, which fosters cooperation between the police and the community to prevent conflicts through dialogue, mediation, and active participation. The study also applies Smelser's Social Unrest Theory to analyze the structural and psychological factors contributing to social unrest, such as inequality and economic disparities. Through a qualitative, descriptive-analytical methodology, this study highlights the challenges and opportunities in implementing Polmas in Jakarta's complex urban context. The findings suggest that while the police's preventive actions are crucial, the active involvement of community members significantly enhances conflict resolution efforts. The study advocates for an integrated approach combining community-based strategies with insights from Smelser's theory to foster sustainable peace and social harmony in Jakarta.

From Normal to Disaster Response Mode: How Can Virtual Communities Reconfigure Themselves to Respond Effectively to a Disaster?

ABSTRACTDuring a disaster, many people seek information from virtual communities. However, information overload, falsehoods and unrelated topics hinder information flow in virtual communities, putting disaster victims at risk. Given many disasters are generally of a short duration, we explore how virtual communities can quickly reconfigure themselves to respond effectively to a disaster. Drawing on risk society theory, our findings suggest reconfiguration is done via a series of cycles initially involving community members and subsequently featuring both community members and moderators working together to mitigate risks. We contribute to virtual community discourse on disaster response by showing how a virtual community can configure IT features to bring about change. Practically, we find transforming a virtual community from a normal to a disaster response mode requires (1) creating a controlled information hub, (2) promoting identity revelation and (3) allowing for temporary emergent hyperlocal leadership. While earlier IS research suggests that anonymity, openness and geographical dispersion are important for information dissemination in virtual communities, we suggest these practices may need to be changed during a disaster.

Community-based interventions against HIV-related stigma: a systematic review of evidence in Sub-Saharan Africa

BackgroundHIV-related stigma remains a key barrier to the attainment of the UNAIDS global goal of ending AIDS by 2030. Due to the social and contextual nature of HIV-related stigma, community-based interventions may be more effective in addressing it. In this review, we synthesized evidence on the effectiveness and features of community-based interventions against HIV-related stigma in Sub-Saharan Africa.MethodsMEDLINE, EMBASE, CINAHL, Psych INFO, and Web of Science were searched in July 2023. We also searched Google Scholar and reference lists of all selected studies. Included studies were randomized controlled trials, mixed methods studies, as well as pre-test and post-test studies that evaluated the effectiveness of a community-based intervention to reduce HIV-related stigma in the general population or among specific groups. Data extraction was done using a pre-designed and pre-tested form. We performed a synthesis without meta-analysis, utilizing Fisher’s method to combine p-values, to demonstrate evidence of an effect in at least one study. Additionally, we applied framework thematic analysis to qualitatively synthesize the intervention characteristics of the included studies.ResultsA total of nine journal articles were included, largely with a high risk of bias. Results from the combined p-values provide strong evidence supporting the effectiveness of community-based interventions in reducing HIV-related stigma in at least one of the studies (p < 0.001, X2 = 73.1, 18 degrees of freedom). Most studies involved people living with HIV (PLH) alone as intervention recipients and as intervention implementers. Community members with unknown HIV status were involved in only 2 studies. The intervention strategies were largely information sharing through workshops and training as well as individualized counselling. In few studies, additional support in the form of referrals, nutritional supplements, and adherence support was provided to PLH during the interventions. Most studies were judged to be of moderate to high cost except in 3 where the intervention implementers were PLH within the community, volunteering in the home-based support approach. The involvement of community members in the design of intervention strategies was not seen in all the studies.ConclusionCommunity-based interventions appear to be effective in reducing HIV-related stigma. However, more robust randomized trials are needed to provide stronger evidence for this effect. Although these interventions have been multifariously developed in Sub-Saharan Africa, comprehensive strategies involving the stigmatized and the “stigmatizers” in a social change approach are lacking. The application of strategies without the involvement of community members in their design takes away a sense of community responsibility, and this threatens the sustainability of such interventions.Systematic review registrationPROSPERO CRD42023418818.

Community engagement approaches and lessons learned: a case study of the PRECISE pregnancy cohort study in Kenya.

Community engagement (CE) has been recommended as an important ethical consideration for health research to enhance informed consent and exchange knowledge between researchers and community members. The purpose of this paper is to describe how CE was developed and delivered for the PRECISE prospective pregnancy cohort study in Kenya. PRECISE enrolled pregnant women in antenatal care, followed them up to the postpartum period, and collected data and biological samples to enable the study of placental disorders in sub-Saharan Africa. Initially CE was aimed at informing the community about the study, establishing community-wide acceptance of the research and addressing concerns about biological sample collection to facilitate participation in the study. CE later evolved to be a platform for mutual learning aiming to deepen the community's understanding of research principles and informed consent and providing a feedback loop to researchers. We engaged diverse stakeholders including health workers and managers, local administrators, religious and traditional leaders, older women, pregnant women, non-pregnant women and men. We utilized a variety of CE approaches and tools adapting to the specific contextual factors at the study sites. Achievements included widespread understanding of informed consent and research principles, clarification of misconceptions, and dispelling of fears regarding biological sample collection. The relationship with the community was strengthened evidenced by frequent inquiries and active participation in CE activities and the research study. For effective CE, we recommend involvement of community members in the CE team and continuous and adaptive CE throughout the study period.

A Social Network Lens to Community Health Worker Influence and Impact.

Community Health Workers (CHWs) are members of healthcare teams that are integrated in, and often share language, beliefs, and lived experiences with their communities. They use their formal and informal social networks to promote healthy behavior, to connect community members to resources, and to build more resilient community networks. We propose a framework to conceptualize CHW interventions aiming to operationalize and optimize CHW social relations and networks. CHW-mediated network interventions can focus on the dissemination and diffusion of health messages, using the channels of trust and formal and informal relations, as well as, engaging communities to enhance the cascade of spreading/diffusion. Network interventions can also focus on network-building and community dialog, relying on the role of CHWs in bringing the community members together in facilitating conversation, promoting social justice and inclusion, and mobilizing the community in collective action. In addition, the network interventions can aim for boundary-spanning and bridging activities, to facilitate the community's access to health services and external resources, as well as bringing the community voice to health systems to influence priorities and policies. Similar to any other complex interventions, CHW network interventions should be fine-tuned and adapted to local and community needs, capacities, and network structures, and actively involve community members in the conceptualization, delivery, and evaluation.

WISDOM OVER TEA: USE OF COMMUNITY-BASED APPROACHES WITH RURAL ALASKA NATIVE ELDERS

Abstract Native Elders are often underrepresented in data collection efforts due to distrust of Western research institutions and Western methodologies. Through over 16 years and 162 interviews with Alaska Native (AN) Elders, the Alaska Native Successful Aging Team, led by Dr. Jordan P. Lewis, has been employing strategies to decolonize research. In this presentation, we will share stories and strategies for connecting with rural and remote AN Elders, including the role of sharing (food, tea, gifts, laughter), taking time to build relationships, and the importance of laughter with Elders. Furthermore, we will explain the role of an Elder-led advisory committee and its role in the implementation of Alaska Native driven values-oriented research. The use of community-based approaches, such as talk story, community member involvement, building trust, and maintaining sustainable relationships are necessary steps to conduct research that is Indigenous-driven and beneficial to the communities. Throughout this presentation, we will discuss Indigenous-driven research approaches and the necessity for the increased recognition of research strategies that involve historical, social, cultural, and inter-relational perspectives. Decolonizing approaches to data collection offer space for relationality, and offer a trusting and mutually beneficial environment to conduct research with AN Elders.

CO-CREATING EVIDENCE-BASED PROGRAMMING AND EDUCATIONAL MATERIALS FOR ALASKA NATIVE CAREGIVERS

Abstract Alaska Native Elders are rarely involved in creating educational and outreach materials. Over and over, Elders share that available educational and informative materials do not include their cultural understandings, programs do not meet their needs, and resource developers rarely attend to incorporate the specific and unique Alaska Native context. We will share our expereinces about outreach, recruitment, and establishment of an Alaska Native Community-engaged Aging Collaborative to engage community members, caregivers, and local organizations to create culturally appropriate and context-specific educational materials and programming that support Alaska Native Elders. Establishing this collaboration is the foundation for implementing research and programs driven by community needs and cultural understandings in conjunction with Western evidence-based approaches. Decolonizing strategies such as community member involvement, building trust, and sustainable relationships are not just steps but integral components of conducting Indigenous-driven research that benefits communities. These approaches not only sustain Elder participation in research related to aging well and dementia but also underscore the value and importance of their contributions. Indigenous research paradigms are gaining traction and hold immense potential in involving Indigenous older adults in research endeavors. Building these collaborations not only gives Elders a voice but also offers researchers a promising direction and invaluable insight into the specific needs of these communities, fostering a sense of hope and optimism for the future of research.

Child mortality in Eastern Ethiopia: acceptability of Postmortem minimally invasive tissue sampling in a predominantly muslim community

BackgroundIt is crucial to consider cultural, religious, and socio-behavioural factors that may influence the acceptability of Minimally Invasive Tissues Sampling (MITS). MITS is being used to understand the causes of child death and conducted in nine countries within Africa and South Asia with the highest child mortality. Progress has been made in the development of laboratory infrastructures and training for physicians to do MITS, but many communities are concerned about the religious acceptability of taking samples from deceased children. This paper explores the acceptability of MITS in a predominantly Muslim community.MethodsA qualitative study was conducted in Kersa and Harar, in Eastern Ethiopia between April 23, 2018 and April 21, 2019 where high child mortality rates have been recorded. The study involved interviews and focus groups with 76 participants, including mothers, elders, and religious leaders. In addition, observations were conducted at burial ceremonies and in grieving families’ homes. Grounded theory framework is used in this article to understand the acceptability of postmortem MITS.ResultsWe explore cultural, religious, and socio-behavioural barriers and facilitators that may influence the acceptability of minimally invasive tissue sampling. We identify three themes relating to the acceptability of MITS: (1) Perceptions and rituals related to child death (2), Religious acceptance of post-mortem investigation, and (3) Fears and suspicions of organ theft and body mutilation. Most participants hypothetically accepted MITS, but suggested that the procedure consider religious practices. Religious leaders and parents stated that they would accept the procedure if it would help reduce child deaths. Acceptance is inconsistent and differs across time and place. Some villages accepted the procedure swiftly, only to change their views when they became aware of suspicions from other villages about the procedure disfiguring the body. Parents of deceased children were concerned that taking samples from the children’s bodies would delay the burial.ConclusionsMortality surveillance requires a thorough understanding of the cultural, religious, and sociocultural aspects that may affect the acceptability of MITS. MITS research should be conducted close to communities, involving community members, incorporating religious perspectives, and promoting health outreach campaigns to facilitate sociocultural perceptions of the research activities.

'Some parts of the consent form are written using complex scientific language’: community perspectives on informed consent for research with pregnant and lactating mothers in Uganda

BackgroundAppropriate language use is essential to ensure inclusion of diverse populations in research. We aimed to identify possible language-related barriers regarding the informed consent process and propose interventions to improve clarity and understanding of pregnant and breastfeeding women participating in research.MethodsA cross-sectional qualitative study employing focus group discussions (FGD) was conducted in Uganda from August 2023 to September 2023, involving a diverse group of stakeholders from the community, including community members, research participants, and Community Advisory Board members. 19 FGD comprised adult participants representing at least six different mother tongues (Luganda, Acholi, Runyankole, Runyoro, Lugbara and English). An inductive thematic approach was utilized for data analysis using NVivo version 12 software to identify language factors that influence informed consent. A series of community validation workshops ensured concurrence.ResultsAt the individual level, language barriers, and low levels of literacy contributed to poor comprehension, thus hindering ability to achieve genuine informed consent. At the health facility level, participants reported that there was use of inappropriate, unclear language including inaccurate translations, with poor and complicated grammar in some consent forms. Participants reported that complex medical terminologies are difficult to translate to local languages. Community members highlighted that social/cultural norms in language use affected cultural perceptions of informed consent. To enhance understanding for individuals without education in science, participants suggested simplification of terminologies and avoidance of complex medical jargon. Researchers should identify participants’ preferred languages and communicate in those languages whenever possible. If researchers are not fluent, trained interpreters should be identified. Informed consent documents must be translated into local languages to ensure participants comprehend the study’s purpose, procedures, risks, and benefits. Involving community members during development and translation of these documents can provide valuable insights into local dialects and culturally specific concepts, ensuring that study tools like surveys and consent forms are accurate and respectful.ConclusionLanguage barriers influence the informed consent process within communities in Uganda. These can potentially be resolved at individual, health system and community levels. Consideration of locally understandable terms in community-facing study documentation is likely to enhance understanding and could improve research participation, although further studies are needed to assess these. The use of appropriate language ensures that informed consent is genuine in keeping with principles of Good Clinical Practice, and developing a research communication strategy should be part of inclusive research design.

Blurred lines of participation: nexus analytical tools for reflecting on the roles of researchers and participants in change-oriented research projects

Abstract This article discusses nexus analysis (NA) as a research strategy that provides specific tools for reflecting on the roles of researchers and participants in participatory research. While many research traditions use participatory methods and problematise what it means to participate in research, thus far the potential of nexus analytical concepts as tools to mediate such a reflection has not been discussed explicitly. In order to illustrate how NA promotes such reflections, we draw on four linguistic projects in multilingual settings that deal with (1) preservice teachers’ learning to design for language learning in hybrid environments on a university course, (2) plurilingual and collaborative teaching approaches to writing in language classrooms in secondary schools, (3) language socialisation of migrant mothers, and (4) family language policy in single-parent families. With this article, we demonstrate how the nexus analytical conceptual tools of ‘zone of identification’, ‘historical body’ and ‘interaction order’ facilitate reflection upon the researcher’s participatory engagement in various stages of the research process. We show that the lines between the roles of researchers and participants are blurry, in particular in research projects that focus on introducing social change. Additionally, we highlight the importance of reflecting on power relations between researchers and participants and how control over project direction and decisions can impact the representation and involvement of community members.

Engaging rural communities in Bangladesh to tackle antimicrobial resistance through the Community Dialogue Approach: a process evaluation protocol for COSTAR project in Cumilla, Bangladesh.

Antimicrobial resistance (AMR) is a global problem and is especially threatening for low-and-middle income countries like Bangladesh. The COSTAR (Community-led Solutions to Antimicrobial Resistance) project includes a Randomised Control Trial (RCT) which aims to evaluate the effectiveness of the Community Dialog Approach (CDA) to improve levels of correct and appropriate knowledge and reported practice about antibiotics, antibiotic use, and antibiotic resistance (ABR) from a One Health perspective, among adult community members in 5 selected sub-districts of Cumilla. The CDA is a community engagement approach involving community members in active discussions also known as Community Dialogs (CD), run by local facilitators. The dialogs promote collective action to produce sustainable social change. The trial's process evaluation will evaluate fidelity, dose, adaptation, reach, mechanisms of impact and the process of knowledge diffusion using the MRC framework for the evaluation of complex interventions. The process evaluation will be implemented in the catchment areas of 25 selected community clinics (CCs) in the intervention group. The key actors involved in the process evaluation are participants from master trainers and trainers training; community dialog facilitators; supervisors; community dialog participants and non-participants; and local and national level government stakeholders. Qualitative and quantitative data will be collected through Focus Group Discussion (FGDs); Case Studies; Key Informant Interview (KIIs); CD observations; monitoring forms; quarterly feedback from facilitators and supervisors, and pre-and-post-test questionnaires administered during the training of facilitators. All qualitative data will be coded using a priori coding framework in NVIVO 14. Quantitative data will be analysed using descriptive statistics. Ethical approval was obtained from the Bangladesh Medical Research Council (BMRC): BMRC/NREC/2019-2022/427 and from the University of Leeds Faculty of Medicine and Health ethics board: MREC 20-034. All results will be disseminated through a one pager summary; infographics; peer-reviewed journal articles and national and international conferences. https://www.isrctn.com/ISRCTN93756764, identifier ISRCTN93756764.

Co-creation and community engagement in implementation research with vulnerable populations: a co-creation process in China.

Background Top-down implementation strategies led by researchers often generate limited or tokenistic community engagement. Co-creation, a community engagement methodology, aims to create a shared leadership role of program beneficiaries in the development and implementation of programs, and encourages early and deep involvement of community members. We describe our experience using a four-stage co-creation approach to adapt and implement a sexually transmitted diseases (STD) testing intervention among men who have sex with men (MSM) in China. Methods We adapted a four-stage approach to co-creation. First, we conducted a needs assessment based on our prior work and discussions with community members. Second, we planned for co-creation by establishing co-creator roles and recruiting co-creators using both stratified convenience and opportunistic sampling. Third, we conducted co-creation via hybrid online/in-person focus groups (four multistakeholder groups and four MSM-only groups). Finally, we evaluated validity of the co-creation process through qualitative observations by research staff, analyzed using rapid qualitative analysis, and evaluated co-creator experience through post-discussion survey Likert scales and open-ended feedback. Results Needs assessment identified the needs to adapt our STD intervention to be independently run at community-based and public clinics, and to develop explanations and principles of co-creation for our potential co-creators. In total, there were 17 co-creation members: one co-creation lead (researcher), two co-chairs (one gay influencer and one research assistant), eight MSM community members, four health workers (two health professionals and two lay health workers) and two research implementers and observers. Co-created contents for the trial included strategies to decrease stigma and tailor interventions to MSM at public STD clinics, strategies to integrate STD testing services into existing community-led clinics, and intervention components to enhance acceptability and community engagement. Our evaluation of validity identified three main themes: challenges with representation, inclusivity versus power dynamics and importance of leadership. Surveys and free responses suggested that the majority of co-creators had a positive experience and desired more ownership. Conclusion We successfully adapted a structured co-creation approach to adapt and implement an STD testing intervention for a vulnerable population. This approach may be useful for implementation, and further research is needed in other contexts and populations.