Engage Community Members Research Articles

Mengoptimalkan Penggunaan Teknologi untuk Pemasaran Aksesoris HP Anggota ONC Melalui Platform Digital

This Community Service (PKM) project aims to optimize the use of technology in marketing cellphone accessories carried out by members of the Ngunut Community Outlet (ONC) via digital platforms. ONC, as a local business forum, has great potential to utilize advances in information technology to increase product visibility and competitiveness in an increasingly digital market. Through an Asset-Based Community Development (ABCD) approach, the project engages ONC members in intensive training to improve their technology skills, especially in managing social media and e-commerce platforms. Project stages include identifying community needs and potential, technology skills training, market analysis, digital platform development, and marketing of attractive digital content. By utilizing collaboration with local digital marketing experts, this project aims to achieve a significant increase in sales of HP accessories through digital platforms. The results of this project are expected to not only include ONC business growth but also have a positive impact on the economic empowerment of local community members. Through technology integration and active participation of community members, this project seeks to realize digital marketing that is sustainable and competitive, in line with developing business trends in the digital era.

Collective Asset Sharing Mechanisms for PV and BESS in Renewable Energy Communities

The energy sector transition to more decentralized and renewable structures requires greater participation by local consumers, which may be enabled by innovative models such as the setup of renewable energy communities (RECs). To maximize the self-consumption of local renewable energy generated by assets normally connected to the low voltage distribution grid, these RECs typically involve jointly owned assets such as collective photovoltaic solar panels (CPVs) and collective energy storage systems (CESS). This work proposes a novel mathematical model for a REC, accounting for three distinct economic approaches to the redistribution of collective benefits among community members. The main objective of this study is to understand how the participation of community members in collective assets (CAs) can help increase the fairness and equity of RECs. An illustrative REC case comprising members with individual and collective ownership of the assets is used to assess the proposed economic approaches. Extracting several answers, among them that the most advantageous configuration comes from agents with quotas in the CESS and CPV. An important conclusion is that depending on the selected economic approach, the social welfare and agent’s revenue vary significantly. In any case, CESSs increase equity among REC members.

Promoting menstrual health and hygiene-insights from the 2023 World Menstrual Hygiene Day celebration events in the Hohoe municipality in Ghana.

The 2023 World Menstrual Hygiene Day (WMHD) celebration at the University of Health and Allied Sciences (UHAS) sought to create awareness about menstruation. Toward normalizing menstruation, the 3-day event brought together key stakeholders and engaged community members on various topics relating to menstruation. Among the stakeholders were basic school teachers (13), school children (155), in a 2:1 female vs. male ratio within the ages of 10-17 years, School Health and Education Program Coordinators (2), Health Officers (4), Academicians (15), University students (35), Media representatives (3), and Civil society representatives (130). Particular among these discussions were the biology of menstruation, nutrition related facts during menstruation, sociocultural, and mental health issues surrounding menstruation. These discussions were intended to incite more conversations about menstruation, and contribute toward the agenda 2030 goal of making menstruation a normal fact of life. The paper describes activities conducted to improve menstrual health, reduce period poverty, and involve men in breaking the stigma around menstruation. This contributes to creating supportive environments for menstruating individuals. Meanwhile, the lessons from the activities to celebrate WMHD in Ghana are relevant for other communities to consider replicating with consideration for contextual differences.

Conducting community-led research using trail cameras to develop baseline wandering domestic cat local abundance estimates

Assessing cat local abundance provides information on where wandering cat numbers are highest and what habitats or factors are associated with wandering cats. A variety of stakeholders can lead this research and then use the findings to make scientifically informed decisions to guide the physical locations of cat management actions. Here, we document a framework that engages community members, uses minimal equipment (six trail cameras), and provides scientifically derived information for interested parties to inform, direct, or test the effectiveness of cat management practices. Using these methods in Gatineau, Quebec, Canada, we demonstrate how we estimated cat population size and cat local abundances across a variety of co-variates while accounting for non-perfect detection by using 55 trail camera sites and N-mixture models. Urban areas had three-fold higher local wandering cat abundances than parkland areas, and neighbourhoods below the median income had the highest local abundances of wandering cats. We estimated there are between 8905 and 48,419 (mean 21,298) wandering cats in Gatineau, with 18%–73% of those cats being unowned. These findings can be used to identify locations for future cat management. If estimates of cat abundance are repeated, they can assess the effectiveness of management actions.

Evaluating an equity-focused approach to assess climate resilience and disaster priorities through a community survey.

As the Duwamish Valley community in Seattle, Washington, U.S.A. and other environmental justice communities nationally contend with growing risks from climate change, there have been calls for a more community-centered approach to understanding impacts and priorities to inform resilience planning. To engage community members and identify climate justice and resilience priorities, a partnership of community leaders, government-based practitioners, and academics co-produced a survey instrument and collected data from the community using the Seattle Assessment for Public Health Emergency Response (SASPER), an approach adapted from the Centers for Disease Control and Prevention's Community Assessment for Public Health Emergency Response (CASPER). In addition, we conducted a process and outcome project evaluation using quantitative survey data collected from volunteers and qualitative semi-structured interviews with project team members. In October and November 2022, teams of volunteers from partner organizations collected 162 surveys from households in the Duwamish Valley. Poor air quality, extreme heat, and wildfires were among the highest reported hazards of concern. Most Duwamish Valley households agreed or strongly agreed that their neighborhood has a strong sense of community (64%) and that they have people nearby to call when they need help (69%). Forty-seven percent of households indicated willingness to get involved with resilience planning, and 62% of households said that they would use a Resilience Hub during an emergency. Survey volunteers evaluated their participation positively, with over 85% agreeing or strongly agreeing that they learned new skills, were prepared for the survey, and would participate in future assessments. The evaluation interviews underscored that while the SASPER may have demonstrated feasibility in a pre-disaster phase, CASPER may not meet all community/partner needs in the immediate disaster response phase because of its lack of focus on equity and logistical requirements. Future research should focus on identifying less resource intensive data collection approaches that maintain the rigor and reputation of CASPER while enabling a focus on equity.

PROMOTING INTERGENERATIONAL EXCHANGES WITHIN RURAL AGE-FRIENDLY COMMUNITIES: A CBPR APPROACH

Abstract The World Health Organization (WHO) Global Age-Friendly Cities (AFC) guide identifies eight interconnected domains for promoting the well-being, engagement, and participation of older adults in community activities and events. It defines an inclusive society as one that actively encourages older adults to participate in their community’s social, civic, and economic life. Research often prioritizes addressing the physical challenges many older adults face, frequently overlooking societal engagement aspects that promote active aging and inclusion. This research outlines how a Community-Based Participatory Research (CBPR) approach was used to uncover and address the societal stigmas and counterproductive attitudes experienced by older adults in a rural age-friendly designated community. Our CBPR approach is characterized as a process encountered in three stages: (i) conducting a multigenerational survey on age-friendliness, (ii) engaging community members in planning intergenerational opportunities, and (iii) implementing intergenerational engagement activities identified in earlier stages. By participating in methodologies from both CBPR and grounded theory approaches, older adults acquired agency and voice in the research process, thus directly impacting age-friendly outcomes in their communities. Our findings detail the importance of utilizing a CBPR approach when researching core AFC fundamentals that are instrumental in creating inclusive policies and promoting healthful, mutually beneficial intergenerational opportunities.

Perspectives from community partnerships in three diverse higher education contexts


 
 
 Asset-based Community Development (ABCD) approaches in higher education have the potential to benefit a diversity of higher education settings and partners, but they can also present challenges and opportunities for growth in higher education institutions. Co- curricular community engagement and academic service-learning programs may struggle to balance the broader political and logistical constraints imposed by the university with equitable, long-term, community-guided relationships that reflect a genuine commitment to ABCD. Extension programs may face difficulty engaging community members and maintaining their commitment to the long-term nature of ABCD in an environment where ABCD is not universally utilised. Although these challenges may seem daunting, partners in all three contexts can draw on a wealth of ABCD tools and resources, including case studies like those anchoring this discussion, in order to answer the question: How can ABCD approaches be utilised most effectively in higher education contexts to address challenges and improve outcomes? Specifically, can an asset-based orientation help position community participants as peer ‘experts’ alongside their academic partners, share power and authority in the collaboration? If so, how? If not, why not? The authors explore these questions using a case study methodology, allowing for nuanced portraits of three different contexts depicting interactions among community and university partners seeking to ground their collaborations in the mobilisation of assets, gifts and strengths. This article also seeks to identify key lessons learned in each setting of the three participating United States universities – the public, four-year research institution, the private religious university and the land-grant college/cooperative extension in order to make recommendations on using ABCD to build and nurture academic-community partnerships that are generalisable across other contexts.
 
 

Community scientist program provides bi-directional communication and co-learning between researchers and community members.

Community involvement in research is key to translating science into practice, and new approaches to engaging community members in research design and implementation are needed. The Community Scientist Program, established at the MD Anderson Cancer Center in Houston in 2018 and expanded to two other Texas institutions in 2021, provides researchers with rapid feedback from community members on study feasibility and design, cultural appropriateness, participant recruitment, and research implementation. This paper aims to describe the Community Scientist Program and assess Community Scientists' and researchers' satisfaction with the program. We present the analysis of the data collected from 116 Community Scientists and 64 researchers who attended 100 feedback sessions, across three regions of Texas including Northeast Texas, Houston, and Rio Grande Valley between June 2018 and December 2022. Community Scientists stated that the feedback sessions increased their knowledge and changed their perception of research. All researchers (100%) were satisfied with the feedback and reported that it influenced their current and future research methods. Our evaluation demonstrates that the key features of the Community Scientist Program such as follow-up evaluations, effective bi-directional communication, and fair compensation transform how research is conducted and contribute to reducing health disparities.

Lessons Learned from Immigrant Health Cohorts: A Review of the Evidence and Implications for Policy and Practice in Addressing Health Inequities among Asian Americans, Native Hawaiians, and Pacific Islanders.

The health of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) is uniquely impacted by structural and social determinants of health (SSDH) shaped by immigration policies and colonization practices, patterns of settlement, and racism. These SSDH also create vast heterogeneity in disease risks across the AANHPI population, with some ethnic groups having high disease burden, often masked with aggregated data. Longitudinal cohort studies are an invaluable tool to identify risk factors of disease, and epidemiologic cohort studies among AANHPI populations have led to seminal discoveries of disease risk factors. This review summarizes the limited but growing literature, with a focus on SSDH factors, from seven longitudinal cohort studies with substantial AANHPI samples. We also discuss key information gaps and recommendations for the next generation of AANHPI cohorts, including oversampling AANHPI ethnic groups; measuring and innovating on measurements of SSDH; emphasizing the involvement of scholars from diverse disciplines; and, most critically, engaging community members to ensure relevancy for public health, policy, and clinical impact.

The Analysis of the Islamic Community Member Engagement Based on Instagram Content Types

<p class="p0"><em>This study aims to determine differences in the level of Islamic community member engagement based on Instagram content types, namely photos, videos, and carousels. </em><em>The results of this research are expected to contribute to social media users, especially Instagram, in determining the most appropriate types of content posts</em>. <em>This study is an ex post facto and uses secondary data from all posts of the most popular smartphone application-based Islamic community accounts in Indonesia, resulting in a total of 18,026 posts. Engagement rate is measured based on the number of likes and comments. </em><em>Data is collected by documenting secondary data on Instagram. </em><em>The sampling technique used was purposive sampling with the criteria of prioritizing new posts over old ones, considering that new posts tend to have a higher engagement; thus, the data will be more easily observed. The data analysis technique used is ANOVA. The findings demonstrated that there were notable distinctions in the number of likes and comments between photo posts and video posts, that photo posts had a higher degree of engagement than video posts, and that there were notable distinctions in the number of likes and comments between photo posts and carousel posts. Regarding likes and comments, photo posts receive more than carousel posts, and there is no difference between carousel posts and video posts; carousel posts and video posts receive the same amount of engagement. </em><em>Based on the findings, it can be suggested that Islamic community managers pay attention to the choice of content type when uploading a post to an Instagram account to get optimal engagement. In addition, posting a single image often elicits more attention or engagement compared to video posts and carousels as well.</em><em></em></p>

Sedation Research in Critically Ill Pediatric Patients: Proposals for Future Study Design From the Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research IV Workshop.

Sedation and analgesia for infants and children requiring mechanical ventilation in the PICU is uniquely challenging due to the wide spectrum of ages, developmental stages, and pathophysiological processes encountered. Studies evaluating the safety and efficacy of sedative and analgesic management in pediatric patients have used heterogeneous methodologies. The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research (SCEPTER) IV hosted a series of multidisciplinary meetings to establish consensus statements for future clinical study design and implementation as a guide for investigators studying PICU sedation and analgesia. Twenty-five key elements framed as consensus statements were developed in five domains: study design, enrollment, protocol, outcomes and measurement instruments, and future directions. A virtual meeting was held on March 2-3, 2022, followed by an in-person meeting in Washington, DC, on June 15-16, 2022. Subsequent iterative online meetings were held to achieve consensus. Fifty-one multidisciplinary, international participants from academia, industry, the U.S. Food and Drug Administration, and family members of PICU patients attended the virtual and in-person meetings. Participants were invited based on their background and experience. None. Common themes throughout the SCEPTER IV consensus statements included using coordinated multidisciplinary and interprofessional teams to ensure culturally appropriate study design and diverse patient enrollment, obtaining input from PICU survivors and their families, engaging community members, and using developmentally appropriate and validated instruments for assessments of sedation, pain, iatrogenic withdrawal, and ICU delirium. These SCEPTER IV consensus statements are comprehensive and may assist investigators in the design, enrollment, implementation, and dissemination of studies involving sedation and analgesia of PICU patients requiring mechanical ventilation. Implementation may strengthen the rigor and reproducibility of research studies on PICU sedation and analgesia and facilitate the synthesis of evidence across studies to improve the safety and quality of care for PICU patients.

Advancing Engagement and Enrollment of Older Black Americans in Alzheimer’s disease and Dementia‐Related Research

AbstractBackgroundThe under‐enrollment of racial and ethnic minorities in clinical trials limits the development of culturally tailored disease treatments and preventative strategies. For example, African Americans experience a greater risk of Alzheimer’s disease (AD), yet they remain woefully underrepresented in AD research. This limits understanding of how AD may operate differently in black populations, who have a higher burden of socio‐structural determinants of health. To improve older black American enrollment, The NYU Healthy Brain Aging and Sleep Center (HBASC) team developed a method tailored toward increasing minority enrollment in clinical trials by collaborating with community‐based organizations and minority populations to reexamine barriers to trial participation.MethodHBASC conducted a single‐site (New York Metropolitan Area) longitudinal study examining sleep and AD in healthy black adults (aged 60‐75). From the study, barriers to trial enrollment were evaluated on a systemic and individual level. The degree to which each level directly or indirectly contributed to barriers to enrollment was further explored using a series of steps and practices seeking to engage underrepresented communities in research. In doing so, team members established and implemented a community‐focused method called FEED. Study personnel demonstrated the feed method by Finding groups, organizations, and trusted community members to collaborate with, Educating community members, Engaging community members through events and educational seminars, and Delivering resources to the community.ResultThrough collaborations with community leaders and organizations, the study team performed community outreach events, raising disease awareness, sustaining trustful relationships, and providing educational resources. The study team saw ∼50% increase in black participant enrollment through the FEED method. Increased engagement in medical research was accomplished when underrepresented communities were empowered with the tools and resources to make knowledgeable decisions.ConclusionDiverse populations of patients face complex and multifaceted barriers to enrollment in clinical trials. A FEED framework will help address these barriers at an individual and systemic level.

Making Community Connections for Minority Outreach in Alzheimer’s Disease

AbstractBackgroundRecognizing the gap in communication that exists between minority populations and Alzheimer’s disease (AD)research community, education and outreach are a critical step in the effort to understand and address disparities. African‐Americans (AA) and Hispanics, are significantly more likely to have Alzheimer’s disease and related dementia (ADRD) as compared to non‐Hispanic Whites. In addition to biological risk, widespread and significant misperceptions about aging process, diagnosis and clinical management influence the way in which AD/ADRD is recognized and subsequently treated in minority populationsMethodAn Alzheimer’s’ Community Engagement ‐Empower Minorities (ACE‐EM) center is proposed as an addition to existing research programs at Delaware State University (DSU). As a Historically‐Black university DSU is uniquely positioned to coordinate Alzheimer’s outreach programs in minority communities of interest. Organizations with strong ties to minority populations improve intervention effectiveness and increase impact. ACE‐EM plans to foster education and training of DSU students under the guiding framework of the Alzheimer’s disease Public Health Curriculum to develop community trusted dementia advocates – an investment for a competent future public health workforce. We recognize the importance of having conversations with family and community members about aging, AD/ADRD and how we can work together to reduce the risks of Alzheimer’s disease for future generations as outlined in the CDC Healthy Brain Initiative Road Map (2018‐2023).ResultCenter will provide a hub for scientific and community exchange for research dissemination specific to cognitive health and AD/ADRD among minorities and 2) engage community members, their families, and partners through culturally targeted and linguistically appropriate education, training, and measurements. Preliminary targeted outreach efforts and data collection in process.ConclusionTo build empowered communities with increased awareness and understanding of cognitive health, through a range of community‐informed and community‐engaged dissemination activities.

Advancing Engagement and Enrollment of Older Black Americans in Alzheimer’s disease and Dementia‐Related Research

AbstractBackgroundThe under‐enrollment of racial and ethnic minorities in clinical trials limits the development of culturally tailored disease treatments and preventative strategies. For example, African Americans experience a greater risk of Alzheimer’s disease (AD), yet they remain woefully underrepresented in AD research. This limits understanding of how AD may operate differently in black populations, who have a higher burden of socio‐structural determinants of health. To improve older black American enrollment, The NYU Healthy Brain Aging and Sleep Center (HBASC) team developed a method tailored toward increasing minority enrollment in clinical trials by collaborating with community‐based organizations and minority populations to reexamine barriers to trial participation.MethodHBASC conducted a single‐site (New York Metropolitan Area) longitudinal study examining sleep and AD in healthy black adults (aged 60‐75). From the study, barriers to trial enrollment were evaluated on a systemic and individual level. The degree to which each level directly or indirectly contributed to barriers to enrollment was further explored using a series of steps and practices seeking to engage underrepresented communities in research. In doing so, team members established and implemented a community‐focused method called FEED. Study personnel demonstrated the feed method by Finding groups, organizations, and trusted community members to collaborate with, Educating community members, Engaging community members through events and educational seminars, and Delivering resources to the community.ResultThrough collaborations with community leaders and organizations, the study team performed community outreach events, raising disease awareness, sustaining trustful relationships, and providing educational resources. The study team saw ∼50% increase in black participant enrollment through the FEED method. Increased engagement in medical research was accomplished when underrepresented communities were empowered with the tools and resources to make knowledgeable decisions.ConclusionDiverse populations of patients face complex and multifaceted barriers to enrollment in clinical trials. A FEED framework will help address these barriers at an individual and systemic level.

Abstract C019: Comparing the effectiveness of different community education approaches on colorectal cancer knowledge

Abstract Introduction: Colorectal cancer (CRC) incidence and mortality varies greatly among racial/ethnic groups nationally. Community outreach and education are effective strategies to enhance knowledge of CRC and have been shown to increase screening for CRC. The University of New Mexico Comprehensive Cancer Center implements Screen to Save, a community-based CRC screening initiative through the National Outreach Network Program. During the COVID-19 pandemic, restrictions on in-person engagement led to the development and implementation of alternative delivery strategies. Our site continued in-person education as possible, and added Zoom and fully self-paced via QR code options for community member participation. Very little is known regarding the effectiveness of different delivery modes. The purpose of this research is to examine the relationship between method of education session delivery and participant CRC knowledge. Methods: Participants were recruited via community organizations, Facebook advertising, and referrals from local stakeholders. Both before and after a standardized health education session, participants completed a survey assessing their knowledge of CRC risk and screening recommendations. Participant demographics were descriptively summarized. Estimates of mean changes, and 95% confidence intervals (CI), were obtained for each content delivery type. Differences in these changes were compared using ANCOVA approaches. Results: There were 239 participants who completed the educational sessions in-person (n=81), via Zoom (n=66), or using the self-paced module (n=92), Groups did not differ significantly in composition for age (p=0.72) or gender (p=0.33), but did differ in race, ethnicity, and education level (p<0. 001). Those who participated in any delivery method improved their knowledge scores by 11.6 (95% CI: 9.9-13.3) percentage points. For in-person, Zoom, and self-paced groups, the improvements were 14.1 (95% CI: 10.6-17.6, p<0.001), 11.5 (95% CI: 9.1-13.8, p<0.001), and 9.4 (95% CI: 6.7-12.1, p<0.001) percentage points, respectively. When comparing pre vs post score differences among session types while adjusting for pre scores, and for baseline differences in race, ethnicity, and education, the differences in improvement for the three different session types were not significantly different (p=0.68). For in-person, Zoom, and self-paced groups adjusted improvements were 9.2 (95% CI: 0.5-17.5), 11.1 (95% CI: 1.9-19.8), and 10.1 (95% CI: 1.5-18.3) percentage points, respectively. Conclusion: Health education sessions delivered in person, via Zoom, and by self-paced online modules are associated with increases in participant knowledge of CRC. As Cancer Centers expand community outreach and engagement to address cancer health disparities in their catchment areas, a better understanding of the relative effectiveness of different delivery strategies is needed. Further research will help to discern population characteristics predictive of different strategies and link these approaches to screening uptake. Citation Format: Lila A. Baca, Yadira Aguero, Angelica Solares, Vernon Shane Pankratz, Shiraz I. Mishra, Miria Kano, Andrew L. Sussman. Comparing the effectiveness of different community education approaches on colorectal cancer knowledge [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C019.

Mitigating wildfire smoke inside homes: Evidence from Oregon, September 2020.

The smoke produced by wildfires can travel great distances and lead to respiratory and/or cardiovascular health impacts through inhalation. Individuals can reduce exposure by implementing smoke mitigation measures in their homes and beyond. In this article, we examine household level survey data (n=543) on wildfire smoke mitigation in response to the September 2020 wildfires that occurred in the state of Oregon (and beyond). The air quality was hazardous for about 10 days in many affected regions. This study assessed the implementation of six commonly referenced approaches to reducing exposure to smoke: staying indoors; keeping doors and windows closed, turning on HVAC; using air purifiers; replacing air filters, and wearing face masks. We found high levels of implementation of staying indoors and keeping doors and windows closed; however, statistical analysis of socioeconomic demographics suggests that respondents vary in the implementation of the other measures. Income, number of exposure days, and access to information on smoke mitigation were positively associated with the implementation. Given the importance of information access for implementation for three of the measures, we also present data on how different age groups prefer to be contacted about air quality and smoke mitigation. For example, participants above 65 years of age prefer local TV as opposed to social media, whereas text messages were favored by all age groups. These survey results will help to inform the design of campaigns to engage community members differentially and potentially affect best communication practices and other assistance/preparation for smoke mitigation across demographics.

Stronger typhoons, weaker electricity systems? A review of the impacts of extreme weather events on coastal communities and strategies for electric system resilience

Access to adequate and reliable electricity is paramount for the adaptation and resilience of typhoon-prone coastal communities, particularly in the face of intensifying challenges posed by climate change. Climate-related extreme weather events, such as typhoons and their consequent flooding and storm surges, exert significant pressure on electricity systems in these vulnerable regions, affecting every aspect from generation to transmission, distribution, and end-user utilization. Therefore, urgent action is required to fortify these communities with electric systems that are resilient enough to withstand such meteorological extremes. This review paper examines the far-reaching impacts of extreme weather events on electricity systems and showcases illuminating case studies that highlight innovative strategies to bolster these systems against such extremes. The review emphasizes the pivotal role of meticulous energy planning, strong support from local governments, and the significance of infrastructure hardening in building resilient energy systems. Future research opportunities exist in integrating renewable energy, engaging community members, assessing climate risks, and cross-sectoral resilience.

Who makes health governance decisions at the local level? A cross sectional study from primary health facilities in Tanzania.

Lower- and middle-income countries have decentralized decision-making at the community level, as well as community governance structures, to encourage community participation in governance processes, particularly in primary healthcare (PHC). In Tanzania, decentralization resulted in the establishment of Health Facility Governing Committees (HFGCs) to encourage community participation in the governance of primary health facilities to improve the quality and responsiveness of health service delivery. Nonetheless, despite the presence of HFGCs, PHC delivery remains ineffective and of poor quality. It is unclear who makes governance decisions at PHC facilities to ensure that services delivered are of expected quality and respond the community's needs, tastes, and preferences. This paper aims to assess the perspectives of members of the HFGC on who make governance decision in the context of fiscal decentralization. A cross-section design was used to collect both quantitative and qualitative data. A four-multistagesampling technique was adopted to selects regions, council, health facilities, and HFGC members. Respondents who participated in structured questionnaire responses were chosen using proportional sampling, whereas those who participated in in-depth interviews and Focus Group Discussions were chosen using purposive selection. The data was analyzed descriptively and thematically. The study revealed that HFGCs members perceive that governance decisions in primary health facilities are primarily made by the health facility management, and later are presented in HFGCs. As such, HFGCs are used a passively used to justify participation in decision that was already made by the management, which contradict with the principal of decentralization that emphasizes community participation on fiscal decisions. Decentralization of PHC facilities does not guarantee the participation of community members in fiscal decision of their respective primary health facilities through HFGCs. HFGC is passively used governance structure to substitute community participation in primary health facilities'fiscal decisions. Enforcement mechanisms are required to facilitate effective community participation.

Community benefit agreements for solar energy: Examining values, preferences and perceived benefits in the United States using a discrete choice experiment

Large-scale solar energy developments bring significant environmental and community benefits, but they can also impose negative impacts, particularly on host communities. Community Benefit Agreements (CBAs) have emerged as a strategy to mitigate these adverse effects. This study examines community preferences regarding CBAs associated with large-scale solar farms. Our investigation focuses on two critical CBAs aspects: the choice between mandated or voluntary implementation and the preference for private or collective benefit distribution. Additionally, we explore how individual values shape community members' attitudes towards solar technology. Our findings reveal a clear preference within the surveyed community for privately distributing benefits over establishing a collective trust fund, and for voluntary implementation rather than government mandates. However, it is essential to recognize that the community is not monolithic and can be placed into three classes: a minority of solar-reluctant individuals (7.5 %), a significant solar-receptive group (24.2 %), and a substantial disengaged majority (68.3 %). Among these groups, the solar-receptive segment displays the most interest in private benefits; yet, they favor government-mandated agreements. Moreover, values play a significant role in shaping preferences within each group, with biospherism correlating with greater support for mandated, private benefits among respondents in the reluctant and receptive groups. Conversely, hedonistic values predict a greater inclination among the reluctant group to live further away from solar developments. Based on these findings, policies should prioritize voluntary, private benefit distribution while remaining adaptable to align with community preferences. Engaging community members in the decision-making can help tailor solutions that resonate with their values and preferences.

A participatory approach to increase HPV vaccination in marginalized Roma communities in Slovakia

Abstract Background Roma living in marginalized communities are among underserved groups facing limited access to vaccination services. The RIVER-EU in Slovakia aims to identify and tailor the intervention to address health system barriers to HPV vaccination faced by people from marginalized Roma communities. Methods Following principles of participatory action research, a wide spectrum of stakeholders was engaged to discuss the transferability of promising evidence-based interventions. Interviews and focus groups aimed to assess the suitability of interventions and identify barriers and facilitators for the transfer and implementation taking contextual characteristics into account. Results Key stakeholders included community members (parents and daughters), Roma health mediators, healthcare providers, policymakers, and representatives of the municipality, school, and public health authority. The most challenging was to engage community members as they had almost no information about the HPV vaccination. Building relationships and trust with communities require intensive cooperation with field services, time and energy. Engaging primary care providers was difficult due to their restricted capacities and work overload causing their motivation to engage in time-consuming collaborative processes to be low. Successful engagement of all stakeholders required concentrated efforts and specific strategies of the research team. Conclusions Active participation of all those who will be affected by the intervention and those whose cooperation will be necessary for successful implementation requires to engage keep on board a number of stakeholders holding different opinions. Facilitating consensus about the design of tailored intervention requires intense communication and revisiting the ongoing integration of emerging ideas until the consensus is reached. It is a responsibility of a researcher to ensure that at the end of the process, all voices are heard and all needs are met.