Engaging Community Stakeholders Research Articles

Heritage as a development engine for people in nature: A case study of Wulingyuan Scenic and Historic Interest Area, China

This paper explores strategies to promote sustainable tourism for people living in natural areas through a case study implemented in the renowned World Natural Heritage Wulingyuan Scenic and Historic Interest Area, a World Heritage Site inscribed for its natural values. The study is part of the UNESCO World Heritage and Sustainable Tourism Program’s Chinese Pilot Studies. Various interventions, including understanding local values, revitalizing traditional handicrafts, and making culinary innovations, were implemented to enrich tourist experiences, empower local communities, and boost economic opportunities. Based on these interventions, this paper discusses community capacity building, stakeholder engagement, and conflict resolution as initiatives to enhance heritage conservation and promote sustainable tourism at the community level. On the level of the World Heritage property, a new management zone, the Traditional Eco-agricultural Heritage Zone, recognized the residency of the locals within the heritage site and fostered the harmonious co-existence of culture and nature. The successful integration of heritage conservation, community development, and sustainable tourism in Wulingyuan not only ensures the conservation of the site but also contributes to United Nations Sustainable Development Goals. This case study offers a model for sustainable development of Natural World Heritage Sites, emphasizing the importance of respecting and involving diverse local communities.

Corporate Social Responsibility, Bank Size and Customer Trust amongst Commercial Banks in Kenya

Despite the commercial banks’ significant position in Kenya's ever growing economy there is limited study on the influence of Corporate Social Responsibility (CSR) on consumer trust in the commercial banking industry. This study therefore sought to explore the impact of Corporate Social Responsibility (CSR) on customer trust in the commercial banking sector of Kenya. With focus on commercial banks, this research delved into how community investment, sustainable initiatives, stakeholder engagement, social welfare, and bank size influence customer trust. This study was anchored on Stakeholder Theory. A correlational research design was employed, targeting all the 39 commercial banks in Kenya. The analysis was centered on the banks as units of analysis, while observations were drawn from both customers and bank managers. The study used stratified sampling to select 384 bank customers population exceeding 1 million. Data was gathered through structured questionnaires and Key Informant Interview (KII), ensuring reliability and validity through Cronbach’s Alpha test and content/construct validity testing. Analysis was conducted using descriptive and inferential statistics, including regression analysis and ANOVA. The results were presented on tables, charts and bars. The findings revealed a coefficient of determination (R²) of 0.605 indicating that the CSR activities used in this study explain 60.5% of the variation in customer trust, suggesting a strong relationship between CSR and customer trust. The regression analysis demonstrated significant positive effects, with community investment (β = 0.354, p = 0.000), sustainable initiatives (β = 0.235, p = 0.003), stakeholder engagement (β = 0.275, p = 0.000), and social welfare (β = 0.329, p = 0.000) all positively influencing customer trust. Based on the findings, the study concludes that corporate social responsibility (CSR) activities, including community investment, sustainable initiatives, stakeholder engagement, and social welfare, significantly influence customer trust among commercial banks in Kenya. In view of the findings, the study recommends that commercial banks in Kenya should continue to invest in CSR activities as a strategic approach to enhance customer trust and loyalty. Policymakers should create supportive regulatory frameworks that encourage banks to adopt comprehensive CSR practices. Keywords: Corporate Social Responsibility, Community investment, Sustainable initiatives, Stakeholder engagement, Social welfare, Bank Size, Customer trust.

Corporate Social Responsibility, Bank Size and Customer Trust amongst Commercial Banks in Kenya

Despite the commercial banks’ significant position in Kenya's ever growing economy there is limited study on the influence of Corporate Social Responsibility (CSR) on consumer trust in the commercial banking industry. This study therefore sought to explore the impact of Corporate Social Responsibility (CSR) on customer trust in the commercial banking sector of Kenya. With focus on commercial banks, this research delved into how community investment, sustainable initiatives, stakeholder engagement, social welfare, and bank size influence customer trust. This study was anchored on Stakeholder Theory. A correlational research design was employed, targeting all the 39 commercial banks in Kenya. The analysis was centered on the banks as units of analysis, while observations were drawn from both customers and bank managers. The study used stratified sampling to select 384 bank customers population exceeding 1 million. Data was gathered through structured questionnaires and Key Informant Interview (KII), ensuring reliability and validity through Cronbach’s Alpha test and content/construct validity testing. Analysis was conducted using descriptive and inferential statistics, including regression analysis and ANOVA. The results were presented on tables, charts and bars. The findings revealed a coefficient of determination (R²) of 0.605 indicating that the CSR activities used in this study explain 60.5% of the variation in customer trust, suggesting a strong relationship between CSR and customer trust. The regression analysis demonstrated significant positive effects, with community investment (β = 0.354, p = 0.000), sustainable initiatives (β = 0.235, p = 0.003), stakeholder engagement (β = 0.275, p = 0.000), and social welfare (β = 0.329, p = 0.000) all positively influencing customer trust. Based on the findings, the study concludes that corporate social responsibility (CSR) activities, including community investment, sustainable initiatives, stakeholder engagement, and social welfare, significantly influence customer trust among commercial banks in Kenya. In view of the findings, the study recommends that commercial banks in Kenya should continue to invest in CSR activities as a strategic approach to enhance customer trust and loyalty. Policymakers should create supportive regulatory frameworks that encourage banks to adopt comprehensive CSR practices. Keywords: Corporate Social Responsibility, Community investment, Sustainable initiatives, Stakeholder engagement, Social welfare, Bank Size, Customer trust.

Community-engaged artificial intelligence research: A scoping review.

The degree to which artificial intelligence healthcare research is informed by data and stakeholders from community settings has not been previously described. As communities are the principal location of healthcare delivery, engaging them could represent an important opportunity to improve scientific quality. This scoping review systematically maps what is known and unknown about community-engaged artificial intelligence research and identifies opportunities to optimize the generalizability of these applications through involvement of community stakeholders and data throughout model development, validation, and implementation. Embase, PubMed, and MEDLINE databases were searched for articles describing artificial intelligence or machine learning healthcare applications with community involvement in model development, validation, or implementation. Model architecture and performance, the nature of community engagement, and barriers or facilitators to community engagement were reported according to PRISMA extension for Scoping Reviews guidelines. Of approximately 10,880 articles describing artificial intelligence healthcare applications, 21 (0.2%) described community involvement. All articles derived data from community settings, most commonly by leveraging existing datasets and sources that included community subjects, and often bolstered by internet-based data acquisition and subject recruitment. Only one article described inclusion of community stakeholders in designing an application-a natural language processing model that detected cases of likely child abuse with 90% accuracy using harmonized electronic health record notes from both hospital and community practice settings. The primary barrier to including community-derived data was small sample sizes, which may have affected 11 of the 21 studies (53%), introducing substantial risk for overfitting that threatens generalizability. Community engagement in artificial intelligence healthcare application development, validation, or implementation is rare. As healthcare delivery occurs primarily in community settings, investigators should consider engaging community stakeholders in user-centered design, usability, and clinical implementation studies to optimize generalizability.

Study of Environmental Education Programs and Behavior Change in Ethiopia

Purpose: The aim of the study was to investigate the Study of Environmental Education Programs and Behavior Change in Ethiopia. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Environmental education programs in Ethiopia have successfully increased awareness and promoted sustainable practices among communities. These initiatives have focused on issues like deforestation, soil erosion, and water conservation, encouraging behaviors such as waste reduction and sustainable agriculture. Community involvement and stakeholder engagement have been crucial in maintaining these positive changes. Scaling up these efforts is essential for long-term environmental sustainability in Ethiopia. Unique Contribution to Theory, Practice and Policy: Theory of planned behavior (TPB), social learning theory & diffusion of innovations theory may be used to anchor future studies on the impact of urban green spaces on air quality in Bangkok. Advocate for the integration of environmental education into formal educational curricula at all levels, emphasizing hands-on learning and practical applications. Advocate for policies that mandate or incentivize environmental education across educational systems and workplaces.

176 Translational Challenges and Facilitators of Health Equity Research Integrating Social Determinants of Health with Patient- and Community-Centered Technology

OBJECTIVES/GOALS: - Illustrate findings of a translational science case study of multi-pronged research aimed at understanding of social determinants in health disparities and integrating patient-centered technology; - Illuminate translational mechanisms by analyzing and sharing research challenges, facilitators, and benefits. METHODS/STUDY POPULATION: Utilized novel TS evaluation methods and tools: - Translational Science Case Study protocol to examine translational path from innovation to practice, barriers and facilitators for that translational movement. - Translational Science Benefits Model (TSBM) Checklist for translational/research impact analysis. Triangulated diverse data sources: - Primary data: semi-structured interviews with research partners. - Secondary data: researchers’ grant applications, reports, and publications; public stories/news related to their research; scientific publications; organizational/policy documents; and interviews with research stakeholders featured in published sources. RESULTS/ANTICIPATED RESULTS: Translational challenges include: culturally tailored education and outreach; data analysis and intervention planning; engaging community stakeholders in the development and implementation; addressing economic and resource-related challenges. Translational facilitators are: UMN CTSA funding and other support; access to data and resources; use of open-source materials; evidence-based/best practice approaches; diversity and collaboration between researchers, community organizations, healthcare providers; researchers’ drive to translate. The research contributes to community and public health, clinical/medical, and economic benefits, health equity advocacy, catalyzing further research, and public awareness. DISCUSSION/SIGNIFICANCE: The evaluation case study contributes to translational science by providing evidence and lessons learned related to translational benefits, challenges, and facilitators of community-based, patient-centered research bringing people, knowledge, and technology together and contributing to health equity.

281 Catalyzing Community and Stakeholder Engagement (CSE) in Research: Perspectives from Scientist and Stakeholder Experience

OBJECTIVES/GOALS: Community and other stakeholder engagement (CSE) is critical for relevant and equitable clinical research, yet implementation poses challenges. This study delineates the perspectives of scientists and diverse stakeholders regarding facilitators and challenges in CSE, its perceived value, and their recommendations for successful CSE. METHODS/STUDY POPULATION: The Tufts CTSI Pilot Studies Program requires applicants to propose a plan for CSE while implementing the award, including which stakeholders (SHs)—community members, clinicians, and others affected by the research--will be involved and at what stages. This qualitative study assessed the experiences of both Principal Investigators (PIs) and SHs engaged in pilot projects from three cohorts of awardees (2019-21). Recruitment targeted one PI and one SH per project. Semi-structured interviews explored their CSE experiences, including facilitators, challenges, meaningfulness, perceived impact, intent to participate in CSE in future studies, as well as recommendations for funders, research support organizations, and investigators. Inductive consensus-based coding and thematic analysis was employed. RESULTS/ANTICIPATED RESULTS: Fourteen PIs from different pilot projects and a SH from five of these projects participated. Almost all PIs (92%) had over six years of experience, but two-thirds (67%) had little or no experience with CSE. Four SHs self-identified as representatives of community organizations and one as a clinician scientist. CSE was a “win-win” for both PIs and SHs, and all PIs intended to involve SHs in other research studies. Three facilitators were identified as fostering effective CSE (e.g., PI access to CSE expertise while conducting the project), while four challenges hindered it (e.g., limits on SH capacity and CSE funding). SHs advised scientists to build authentic, sustained relationships, and PIs and SHs provided three actionable recommendations for funders and research support organizations to deepen and expand CSE. DISCUSSION/SIGNIFICANCE: Perspectives of scientists and SHs engaged in research projects are vital for expanding and sustaining effective CSE in research. Funders and research support organizations can enhance their strategies for CSE integration in clinical and translational research by incorporating these diverse views to ensure the research achieves maximal impact.

A Model of Community Health Worker Integration into Schools: Community-based Participatory Research in Action

Abstract: Background: Schools are rich sites for collaborations between health and educational sectors. Objectives: To identify lessons learned from formation of a community–academic partnership and application of community-based participatory research (CBPR) to develop a model that integrates community health workers into schools. Methods: Individuals from an academic medical center, a large public school district, and a community-based research institute applied CBPR principles to reimagine schools as a place for improving the health of children. Lessons Learned: Three lessons emerged. Leveraging each team member's expertise centered the partnership on community strengths, co-learning, and stakeholder engagement. Adherence to CBPR's principles of power sharing and equity helped navigate the challenges of collaboration between large institutions. Early focus on sustainability helped address unexpected issues, build capacity, and boost advocacy. Conclusions: This partnership demonstrates how CBPR fosters conditions in which equitable partnerships between research institutions and public schools can thrive to promote childhood health.

Zero-waste initiatives and circular economy in the U.S.: A review: Exploring strategies, outcomes, and challenges in moving towards a more sustainable consumption model

This study presents a comprehensive analysis of zero-waste initiatives and circular economy (CE) models in the United States, aiming to understand their contribution to sustainable consumption. Employing a systematic literature review methodology, the study sourced data from academic journals, government reports, and industry publications, focusing on literature from the year 2015 to 2023. The search strategy involved a combination of keywords related to zero-waste, circular economy, and sustainable consumption in the U.S. context. Inclusion and exclusion criteria were applied to ensure the relevance and quality of the selected literature, which was then subjected to thematic synthesis for data analysis. Key findings indicate that the evolution of zero-waste and CE concepts in the U.S. is driven by increasing environmental awareness, leading to innovative waste reduction strategies and sustainable consumption models. Despite significant environmental, economic, and social benefits, challenges such as institutional barriers, financial constraints, and technological hurdles persist. The study highlights the crucial role of standards, policies, and regulatory frameworks in facilitating the adoption of zero-waste and CE practices. Successful case studies underscore the importance of community involvement and stakeholder engagement. The study recommends that policymakers develop supportive legislative frameworks, businesses integrate sustainable practices into their operations, and communities actively participate in waste reduction efforts. Future research should focus on the long-term impacts of these practices and the role of emerging technologies. The transition to zero-waste and CE models is essential for sustainable development, requiring concerted efforts from all stakeholders.

Understanding Social, Cultural, and Religious Factors Influencing Medical Decision-Making on BRCA1/2 Genetic Testing in the Orthodox Jewish Community

Introduction: Although the prevalence of a pathogenic variant in the BRCA1 and BRCA2 genes is about 1:400 (0.25%) in the general population, the prevalence is as high as 1:40 (2.5%) among the Ashkenazi Jewish population. Despite cost-effective preventive measures for mutation carriers, Orthodox Jews constitute a cultural and religious group that requires different approaches to BRCA1 and BRCA2 genetic testing relative to other groups. This study analyzed a dialog of key stakeholders and community members to explore factors that influence decision-making about BRCA1 and BRCA2 genetic testing in the New York Orthodox Jewish community. Methods: Qualitative research methods, based on Grounded Theory and Narrative Research, were utilized to analyze the narrative data collected from 49 key stakeholders and community members. A content analysis was conducted to identify themes; inter-rater reliability was 71%. Results: Facilitators of genetic testing were a desire for preventive interventions and education, while barriers to genetic testing included negative emotions, feared impact on family/romantic relationships, cost, and stigma. Views differed on the role of religious leaders and healthcare professionals in medical decision-making. Education, health, and community were discussed as influential factors, and concerns were expressed about disclosure, implementation, and information needs. Conclusion: This study elicited the opinions of Orthodox Jewish women (decision-makers) and key stakeholders (influencers) who play critical roles in the medical decision-making process. The findings have broad implications for engaging community stakeholders within faith-based or culturally distinct groups to ensure better utilization of healthcare services for cancer screening and prevention designed to improve population health.

Academic seminars as tool for clinical and translational science education and dissemination: Perceptions and priorities in the COVID-19 era.

Academic seminars are an important venue through which investigators in health services research (HSR) and other clinical and translational science disciplines can share their work, gather feedback, and connect with colleagues. However, the format and focus of these seminars shifted abruptly when the coronavirus disease 2019 (COVID-19) pandemic necessitated social distancing and underscored the salience of health equity. Little is known about how contemporary academic seminars are meeting the evolving needs of the HSR community. We surveyed 2021-2022 participants in a virtual HSR seminar series to understand experiences of and priorities for the seminars. We also compared results stratified by self-reported under-represented minority (URM) status. Of 45 respondents (including 26 faculty members, 8 trainees, 9 staff members, and 2 community partners), 38% self-identified as URM. Participants reported high satisfaction with seminar quality, diversity of topics, and audience participation (median ≥4 for all outcomes in Likert-scaled items where 5 = very satisfied). Knowledge acquisition, understanding of research methods, and collaboration were commonly cited as benefits of seminar attendance. Implementation science content and external collaboration were most often endorsed as priorities for future seminars. URM participants were over three times more likely than non-URM participants to cite learning about engaging community stakeholders and historically excluded populations as a benefit of seminar participation. Virtual academic seminars can be an effective modality for knowledge sharing and collaboration worth continuing after COVID-19 restrictions are lifted. Emphasizing equity, diversity, and inclusion (EDI) values in these seminars may hold potential for advancing academic departments' own EDI goals.

Socio-environmental responsibility in Iranian universities: a multidimensional perspective

SummaryUniversities are expected to play a pivotal role in promoting environmental conservation goals, yet a comprehensive analysis of their actual contributions remains limited. This study delves into the perceptions of socio-environmental responsibility among faculty members within Iran’s top 13 universities. Using random cluster sampling, we collected 410 questionnaires from these institutions, evaluating socio-environmental responsibility through eight distinct variables. The outcomes unveil widespread deficiencies in responsibility across all universities, with 66% exhibiting low levels of engagement. Notably, Gorgan University of Agricultural Sciences and Natural Resources displays the lowest level, while Bu-Ali Sina University ranks highest. The research variables exhibit significant positive correlations, elucidating the interconnectedness of different aspects of socio-environmental responsibility. Furthermore, the study identifies a significant disparity in mean university socio-environmental responsibility concerning gender, although no significant relationships are found with factors such as professors’ academic rank, employment status or age. Sixteen codes are highlighted based on qualitative analysis. These findings underscore the urgency for universities to redefine their roles within the community and prioritize community empowerment, stakeholder engagement, capacity building and environmental education. By addressing these facets, universities can elevate their levels of socio-environmental responsibility and contribute more effectively to environmental conservation efforts.

A Convergence of Violence: Structural Violence Experiences of K–12, Black, Disabled Males across Multiple Systems

In American schools, conversations about violence prioritize direct violence, while indirect violence is virtually ignored. This current emphasis overlooks the structural violence deeply embedded in America’s social, political, and economic institutions, which were intentionally designed to exclude, and position some groups to experience disproportionate levels of poverty, exploitation, and persecution. To understand the mechanisms of structural violence, the concepts of structural violence and total institutions, the tenets of Disability Critical Race Theory can be used as an analytical lens. This retrospective comparative case study does so by exploring similarities in the lived experiences of Black, Emotionally Disturbed males across metropolitan special education, juvenile justice, and medical systems. The findings demonstrate a “convergence of violence” in America’s juvenile justice, medical, and special education systems, collectively pushing K–12-aged participants into carceral sites, denying them voice and choice, and providing them with performative healthcare. Our study recommends that institutions designed to serve K–12-aged learners use cross-sector collaborations to meet holistic learner needs and mitigate pressures to engage in direct violence. Specifically, we offer the Whole School, Whole Community, Whole Child model as a national approach to increase access to healthcare providers, social services, and mental health services, as well as engaging community stakeholders critical to understanding the cultural context of learners’ lived experiences.

Patterns of COVID-19 induced bio-medical waste management in Bangladesh: a case study of Chittagong port city

Background: The objective of this study was to investigate effective waste management practices and develop environment-friendly public health guidelines for the target audience. Methods: A cross-sectional descriptive study was conducted in 14 Upazilas of Chittagong Districts, where 200 community members were physically interviewed during the pandemic. Univariate, bivariate, and multivariate statistical analyses were conducted. Results: The majority of respondents followed government guidelines for waste management, and plastic containers, poly bags, bio-hazard bags, and metal containers were commonly used to collect waste. The type of container used was significantly associated with the level of education among community members. Non-environmental materials were used to deposit and dispose of COVID-19-induced biomedical waste. The majority of respondents had poor practices regarding the disposal of biomedical waste and were unaware of the standard duration for the disposal of infectious waste. The level of education was associated with awareness of COVID-19 rules and regulations. The recording of COVID-19-induced biomedical waste was insufficient, and the most commonly used methods for treating biomedical waste were biological, thermal, and irradiation. Plastic containers were the most frequently used disposal method for waste during COVID-19, which is hazardous to both the environment and public health. Conclusions: Community-based BCC activities by engaging community stakeholders in disseminating and raising awareness of key behaviors related to the environment and public health that are impacted by the biomedical waste in the community setting.

Response strategies for community stakeholder engagement on social media: A case study of a large infrastructure project

Social media offer new opportunities for project community stakeholder engagement due to its spatial and temporal independency. This study reveals implications for project stakeholder identification, assessment, and response strategies in the social media context. It analysed Facebook communication sequences in two cases related to establishing the Western Sydney International Airport. The analysis showed that existing stakeholder identification and assessment guidelines only apply to social media to some extent. Information about stakeholders and their concerns is limited. We suggest identifying and addressing thematic issues shared across stakeholders. Regarding possible response strategies, the project in the case study surprisingly often refrained from responding to community stakeholder comments, foregoing the opportunity to engage with community stakeholders and acknowledging supportive comments. We suggest that projects consciously apply an ‘always respond’ response strategy on social media and extend response strategies to cover engagement with an 'acknowledgement' response strategy.

Hands-on-ground in a new country: a community-based participatory evaluation with immigrant communities in Southern Alberta.

Immigrants experience a high risk of mental health deterioration following settlement in Canada. Immigrant communities benefit from health-promoting interventions that stimulate social inclusion and belonging as protective factors. In this context, community gardens have been recognized as interventions that promote healthy behaviours, place attachment and belonging.This article summarizes our experience conducting a community-based participatory evaluation (CBPE), engaging community stakeholders in planning, implementing and evaluating a community garden for immigrants. We conducted a CBPE to provide relevant and timely feedback to inform programme adaptation and development. Participants, interpreters and organizers were engaged through surveys, focus groups and semi-structured interviews. Participants expressed a range of motivations, benefits, challenges and recommendations. The garden was a place that fostered learning and promoted healthy behaviours, including physical activity and socialization. However, there were challenges in organization and communication with participants. Findings were used to adapt the activities to immigrants' needs and expand the programming of collaborating organizations. Stakeholder engagement facilitated capacity building and direct use of findings. This approach may catalyse sustainable community action with immigrant communities.

A Systematic Review of Systems Science Approaches to Understand and Address Domestic and Gender-Based Violence.

We aimed to synthesize insights from systems science approaches applied to domestic and gender-based violence. We conducted a systematic review of systems science studies (systems thinking, group model-building, agent-based modeling [ABM], system dynamics [SD] modeling, social network analysis [SNA], and network analysis [NA]) applied to domestic or gender-based violence, including victimization, perpetration, prevention, and community responses. We used blinded review to identify papers meeting our inclusion criteria (i.e., peer-reviewed journal article or published book chapter that described a systems science approach to domestic or gender-based violence, broadly defined) and assessed the quality and transparency of each study. Our search yielded 1,841 studies, and 74 studies met our inclusion criteria (45 SNA, 12 NA, 8 ABM, and 3 SD). Although research aims varied across study types, the included studies highlighted social network influences on risks for domestic violence, clustering of risk factors and violence experiences, and potential targets for intervention. We assessed the quality of the included studies as moderate, though only a minority adhered to best practices in model development and dissemination, including stakeholder engagement and sharing of model code. Systems science approaches for the study of domestic and gender-based violence have shed light on the complex processes that characterize domestic violence and its broader context. Future research in this area should include greater dialogue between different types of systems science approaches, consideration of peer and family influences in the same models, and expanded use of best practices, including continued engagement of community stakeholders. The online version contains supplementary material available at 10.1007/s10896-023-00578-8.

Community participation and stakeholder engagement in determining health service coverage: A systematic review and framework synthesis to assess effectiveness.

Community and stakeholder involvement in decision-making to determine publicly-funded health services and interventions is advocated to fulfil citizens' rights and improve health outcomes. The inclusion of public actors, particularly disadvantaged populations, in priority setting for universal health coverage (UHC) is also enshrined in guidance from the World Health Organization (WHO). However, challenges remain in operationalising this policy aim and ensuring that these approaches are effective and equitable. This study aimed to synthesise published evidence on the role of community and stakeholder participation in determining health service coverage. A systematic review was conducted, searching the Web of Science, Ovid Global Health, and PubMed Central databases from 2000 onwards, including all study types. A framework synthesis approach was used for charting and synthesising data on mechanisms, effectiveness (equity, depth, and stage), and barriers and facilitators for engagement. Twenty-seven relevant studies were identified that involve community actors and other stakeholders in priority setting and decision-making processes for defining health benefit packages and UHC, health technology assessment, and pharmaceutical coverage. Mechanisms of engagement include a wide variety of consultation approaches; participation in decision-making committees, advisory councils, and local planning meetings; and appeals mechanisms. Participation occurs primarily at Data and Dialogue stages of decision-making processes, and we found limited depth of engagement among identified cases. Limited consideration of equity was observed in planning and reporting on community involvement in priority setting. A number of challenges are identified in the literature, which we typologise as institutional, procedural, technical, and structural / normative barriers to meaningful participation. This systematic review identifies key gaps and opportunities in the literature and practice related to effective and equitable community and stakeholder participation in determining health service coverage. It offers essential considerations for planning and executing inclusive approaches to priority setting for publicly-funded health services and interventions and defining health benefit packages for UHC.

Catalyzing Collaboration Among Interprofessional Birth Transfer Teams Through Simulation.

Planned home or birth center births sometimes require emergency transfers to a hospital. Poor communication among members of the birth care team during a transfer can lead to unfavorable outcomes for the birthing person and newborn. To improve the quality of birth transfers in Utah, the Utah Women and Newborns Quality Collaborative partnered with the LIFT Simulation Design Lab to develop and pilot an interprofessional birth transfer simulation training. We engaged community stakeholders to identify learning objectives and co-design the simulation trainings using principles of participatory design. We conducted 5 simulation trainings featuring birth transfers during a postpartum hemorrhage. The LIFT Lab evaluated the trainings to determine if they were feasible, acceptable, and effective. Measures included a post-training form asking participants to evaluate the quality of the training and a 9-question pre- and post-training survey measuring changes in participants' self-efficacy regarding components of birth transfer. The changes were assessed for significance using a paired t test. A total of 102 participants attended the 5 trainings; all health care provider groups were well represented. Most participants felt the simulations were similar to real situations and would benefit others in their professions. All participants said the trainings were a good use of their time. Following the training, participants had significantly higher levels of self-efficacy regarding their ability to manage birth transfers. Birth transfer simulation trainings are an acceptable, feasible, and effective method for training interprofessional birth care teams.

Best Practice Recommendations for Integrating Health Equity into Pragmatic Clinical Trials for Dementia Care

Context Minoritized populations experience higher rates of dementia and worse health outcomes than non-Hispanic white people, but they are vastly underrepresented in pragmatic clinical trials embedded in health care systems (ePCTs). Little guidance is available to consider health equity–relevant issues in ePCTs. Objective This report describes the development, structure, and content of a guidance document developed by the National Institute on Aging Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) Collaboratory to help investigators systematically assess the integration of health equity into all aspects of ePCT design. Design Led by a task force of IMPACT investigators, a literature review of existing frameworks for health equity considerations in clinical trials was conducted. Next, priority health equity–relevant recommendations in the domains of ePCT design were solicited from Collaboratory experts. The 50 submitted recommendations were reduced to 36 nonoverlapping best practices and categorized into 6 domains, as follows: Getting Started, Community Stakeholder Engagement, Design and Analysis, Intervention Design and Implementation, Health Care System and Participant Selection, and Selecting Outcomes. Each domain had 6 best practice recommendations consisting of a succinctly worded main sentence, with 1 to 2 explanatory sentences. The content was finalized through an iterative process of editing and revision. Conclusions Although specifically focused on ePCTs involving dementia care, the best practices are applicable to any ePCT and can be useful to advance health equity in traditional clinical trials. This guidance document provides a first step toward promoting holistic, structured integration of health equity into the design and conduct of ePCTs as a matter of good science.