Participant Engagement Research Articles

Mobilizing faith-based COVID-19 health ambassadors to address COVID-19 health disparities among African American older adults in under-resourced communities: A hybrid, community-based participatory intervention.

The COVID-19 pandemic disproportionately affected older adults, particularly those with pre-existing chronic health conditions. To address the health disparity and challenges faced by under-resourced African American older adults in South Los Angeles during this period, we implemented a hybrid (virtual/in-person), pre-post, community-based participatory intervention research project utilizing a faith-based lay health advisor model (COVID-19 Health Ambassador Program (CHAP)). We recruited COVID-19 Health Ambassadors (CHAs) and African American older adults (participants) from faith-based organizations who partook in CHA-led meetings and follow-ups that educated and supported the participants. This paper seeks to evaluate this intervention's implementation using the Consolidated Framework for Implementation Research (CFIR) as a reporting tool with an emphasis on fidelity, challenges, and adaptations based on data collected via stakeholder interviews and surveys. CHAP was delivered to 152 participants by 19 CHAs from 17 faith-based organizations. CHAs assisted with chronic disease management, resolved medication-related challenges, encouraged COVID-19 vaccination, reduced psychological stress and addressed healthcare avoidance behaviors such as COVID-19 vaccine hesitancy among the participants. Challenges encountered include ensuring participant engagement and retention in the virtual format and addressing technological barriers for CHAs and participants. Adaptations made to better suit the needs of participants included providing communication tools and additional training to CHAs to improve their proficiency in using virtual platforms in addition to adapting scientific/educational materials to suit our participants' diverse cultural and linguistic needs. The community-centered hybrid approach in addition to our partnership with faith-based organizations and their respective COVID-19 health ambassadors proved to be essential in assisting underserved African American older adults manage chronic health conditions and address community-wide health disparities during the COVID-19 pandemic. Adaptability, cultural sensitivity, and teamwork are key to implementing health interventions especially in underserved populations.

Care considerations in medical assistance in dying for persons with mental illness as the sole underlying medical condition: a qualitative study of patient and family perspectives

BackgroundPersons with mental illness as their sole underlying medical condition are eligible to access medical assistance in dying (MAiD) in a small number of countries, including Belgium, the Netherlands, Luxemburg and Switzerland. In Canada, it is anticipated that people experiencing mental illness as their sole underlying medical condition (MI-SUMC) will be eligible to request MAiD as of March 17th 2024. To date, few studies have addressed patient and family perspectives on MAiD MI-SUMC care processes. This study aimed to address this gap and qualitatively explore the perspectives of persons with lived experience of mental illness and family members on care considerations during MI-SUMC implementation.MethodsThirty adults with lived experience of mental illness and 25 adult family members residing in Ontario participated in this study. To facilitate participant engagement, the semi-structured interview used a persona-scenario exercise to discuss perspectives on MAiD MI-SUMC acceptability and care considerations. Framework analysis was used to inductively analyze data using NVivo 12 Pro. Steps, processes, or other care considerations suggested by the participants were charted in a framework matrix after familiarization with the narratives. Key themes were further identified. A lived-experience advisory group participated in every aspect of this study.ResultsSix themes were developed from the patient and family narratives: (1) Raising MAiD MI-SUMC awareness; (2) Sensitive Introduction of MAiD MI-SUMC in goals of care discussions; (3) Asking for MAiD MI-SUMC: a person-focused response; (4) A comprehensive circle of MAiD MI-SUMC care; (5) A holistic, person-centered assessment process; and (6) Need for support in the aftermath of the decision. These themes highlighted a congruence of views between patient and family members and described key desired process ingredients, including a person-centred non-judgmental stance by care providers, inter-professional holistic care, shared decision making, and the primacy of patient autonomy in healthcare decision making.ConclusionsFamily and patient perspectives on the implementation of MAiD MI-SUMC offer important considerations for service planning that could complement existing and emerging professional practice standards. These stakeholders’ perspectives will continue to be essential in MAiD MI-SUMC implementation efforts, to better address the needs of diverse communities and inform improvement efforts.

Attentional Biases and Their Association with Substance-Use-Related Problems and Addictive Behaviors: The Utility of a Gamified Value-Modulated Attentional Capture Task

BackgroundAttentional biases towards reward stimuli have been implicated in substance use-related problems. The value-modulated attentional capture (VMAC) task assesses such reward-related biases. The VMAC task widely used in lab studies tends to be monotonous and susceptible to low effort. We therefore tested a gamified online version of the VMAC that aimed to increase participant engagement. Our goal was to examine how VMAC is associated with substance use-related problems and addictive behaviors, and whether this association is moderated by cognitive control. MethodsWe recruited 285 participants from an online community, including heavy alcohol users. All participants completed a novel gamified version of the VMAC task, measures of substance use and addictive behaviors (addictive-like eating behavior, problematic smartphone use), the WebExec measure of problems with executive functions, and the Stroop Adaptive Deadline Task (SDL) as a measure of cognitive control. ResultsThe gamified VMAC task successfully identified value-modulated attentional capture effects towards high-reward stimuli. We found no significant associations between VMAC scores, problematic alcohol or cannabis use, addictive behaviors, or any moderation by a behavioral measure of cognitive control. Exploratory analyses revealed that self-reported cognitive problems were associated with more alcohol-, and cannabis-related problems, and addictive behaviors. Greater attentional capture (VMAC) was associated with more cannabis use-related problems among individuals with higher levels of self-reported cognitive problems. ConclusionsOur study is one of the first to demonstrate the utility of the gamified version of the VMAC task in capturing attentional reward biases. Self-reported problems with cognitive functions represent a key dimension associated with substance use-related problems and addictive behaviors.

Citizen Science for Enhanced Dengue Vector Surveillance in Solomon Islands: A Methods Paper

Arthropod-borne arboviral diseases—including dengue, Zika, and chikungunya—place a substantial burden on the health of populations, globally. Dengue alone is endemic in more than 100 countries and causes more than 96 million symptomatic cases and approximately 40,000 deaths annually. The recent surge in arboviral disease outbreaks, coupled with the World Health Organization’s newly published vector control guidelines, accentuates the imperative to understand the dispersion of disease-carrying mosquitoes across diverse spatial and temporal scales. However, traditional surveillance mechanisms often fall short because of workforce limitations, logistical complexities, jurisdictional boundaries, and budgetary constraints, especially in low- and low-middle-income countries. In this article, we systematically report the design, implementation, and iterative enhancement of a groundbreaking school-based citizen science initiative for augmenting mosquito surveillance in the Solomon Islands. Key reflections encompass the initiative’s role in supporting routine government-led disease vector monitoring, sustainability through integration and fostering participant engagement, and the amalgamation of citizen-collected data with government surveillance activities. The article also discusses the impact of the citizen science initiative with regard to the Solomon Islands’ pursuit of the Sustainable Development Goals. Our findings underscore the potential of citizen science methods to support and extend public health surveillance activities and to serve as a community-engagement-for-behaviour-change tool in resource-constrained contexts.

STUDENT MADE INFRASTRUCTURE IN RURAL CONTEXTS - LA ESTRELLA STEEPLE DESIGN BUILD PROJECT

The Design/Build Methodology in the Education of Architecture is an alternative to traditional and theoretical training where real projects and construction takes place. This paper focuses on a case study from the School of Architecture course “Introducción a la Construcción” at the Pontificia Universidad Católica de Chile. Its main feature is exploration on timber construction through a direct hands-on experience and development of prefabricated built projects. Timber has been used as the predominant building material since it allows to explore concepts of prefabrication, modular coordination, and structural performance. This intuitive design approach is complemented by a low-tech and low-cost solution according to the local context. Recently the course has realigned its focus to community-oriented projects outside the university in a process that entails complex management and technical issues. The project considers a steeple structure commissioned by La Estrella parish and the impact of project´s brief constraints on the timber structure in terms of: design and prefabrication process: brief constraints plus available design tools were applied to on-site and off-site construction methods to allow quick assembly. A participative and iterative process through design and testing of different timber structural components developed by groups of students; management issues: communication, consultants and construction management by the academic staff and students; relationship with community: this process includes participatory design, community engagement and participation. Conclusions drawn from this project show a successful experience of timber building systems applied to this methodology. Built results have exceeded original expectations while the engagement between the student project and the benefiting community constitute a successful experience in the exploration of these teaching strategies. Involvement of students in management process is an aspect that needs further development as a relevant feature to be considered on future off-campus projects.

Understanding the challenges of injury in providing sport programmes for physically inactive women: concept mapping insights from programme deliverers

ObjectivesInjury/poor health is an important barrier to women’s participation in sport and physical activity. This study aimed to identify perceived challenges sport programme deliverers face when supporting physically inactive women...

Exploring participation and engagement in a multi-component, universal early parenting programme

PurposeParenting programmes are increasingly a feature of services and policies aimed at improving outcomes for children and families and tackling inequality, yet they remain underused. This study aims to assess parent engagement and retention in the parent and infant (PIN) programme – a universal, multi-component intervention designed to support parents from birth to when their children reach two years of age. The programme can be tailored to parent/community needs but also includes standardised core elements including two Incredible Years parenting programmes. Programme provider perspectives on recruiting and supporting participation were also explored.Design/methodology/approachA mixed methods study was conducted involving parents (n = 106) and programme providers involved in the PIN programme. Logistic regression analyses were used to assess the impact of participant demographic characteristics on the likelihood of programme engagement and attendance. Semi-structured interviews explored facilitators’ experiences of parent recruitment and engagement, as well as barriers and facilitators of parental attendance.FindingsFirst-time mothers were more likely to initially enrol in the PIN programme than younger or lone parents. However, older age and married/cohabiting status were the strongest predictors of attending at least one-third of programme sessions. Qualitative findings highlighted the importance of relationship building and connection in supporting participant recruitment and engagement. Practical and psychological barriers to programme participation are also described.Originality/valueThe findings shed light on factors that influence engagement and attendance in universal, early parent support programmes. Barriers to parent engagement are multi-layered and tailored strategies to promote uptake of parenting programmes are needed.

Assessing Fidelity in Yoga Interventions for Chemotherapy-Induced Peripheral Neuropathy: Decision-Making to Enhance Protocol Quality Adherence.

Yoga interventions need fidelity monitoring to standardize the trial process and ensure adherence. We examined fidelity measures of current yoga trials and developed a fidelity assurance process in a phase III randomized clinical trial addressing chemotherapy-induced peripheral neuropathy among cancer survivors. We qualitatively analyzed the fidelity monitoring components in published clinical trials on yoga therapy for chemotherapy-induced peripheral neuropathy through a literature search in PubMed from inception to February 2023. Leveraging fidelity measures for community-based, complex interventions and yoga therapy reporting guidelines, we developed an instructor/participant-oriented fidelity checking approach in an ongoing phase III trial evaluating yoga for improving chemotherapy-induced peripheral neuropathy in cancer survivors. Two researchers independently assessed 4 of 8 video recordings of yoga instructor-led training sessions (50%) and participant-kept home practice logs using a developed fidelity checklist. None of the 4 eligible yoga trials specifically have intervention fidelity measures. We prospectively incorporated yoga instructor training, virtual delivery, and participant engagement strategies in the phase III trial protocol following guidelines. All trial yoga instructors were trained under study protocol to ensure compliance and participant engagement. There was high intervention fidelity in all instructor-led virtual sessions: an average of 100% adherence to class structure and three-thirds on specific skills. Assessment of participant adherence to the established home yoga protocol was 63%. Yoga trials for chemotherapy-induced peripheral neuropathy need adequate fidelity measures. Our study provides a feasible fidelity-monitoring approach to ensure trial intervention delivery and protocol adherence by instructors and participants in oncological settings.

Abstract WP75: Interprofessional Medical Education in a Stroke Escape Room to Improve Stroke Education and Communication Skills

Purpose: Acute stroke care requires a foundation of clinical knowledge to quickly recognize symptoms and facilitate rapid, safe treatment. Effective care requires a complex network of communication in a stroke response team. Simulation-based training provides a multimodal approach to learning that reinforces clinical knowledge of stroke and affords the opportunity to demonstrate effective communication skills in critical situations. An interprofessional scenario allows all participants to learn about the different roles required for effective care. Methods: Fifty new graduate nurses participated in a pilot model of a traditional didactic session on stroke knowledge, followed by an “escape room” incorporating this knowledge to solve puzzles. The second iteration was expanded to include incoming neurology PGY-2 residents, registered nurses, and pharmacy residents. After the lecture, participants formed teams including equal numbers of all provider roles. The teams were tasked to complete a timed version of the escape room by solving stroke-based puzzles. The escape room was followed by a debrief of communication skills modeled by TeamSTEPPS. Finally, the same teams were exposed to a simulated “stroke code," which included a focused assessment, interpretation of labs and imaging, and management of barriers to treatment with an end goal of collectively managing a suspected stroke. Results: A 5-point scale was used to assess level of comfort with leadership in initial stroke assessment, management, treatment, and communicating concerns. The average increase in numeric level of comfort was 0.9 (range 0.6 - 1.4). The benefit did appear greater for incoming neurology PGY-2 residents (average increase 1.3, range 0.6 - 1.6) compared to registered nurses (average increase 0.45, range 0.25 to 0.75). Conclusions: Use of an escape room during training for incoming neurology PGY-2 residents, registered nurses, and pharmacy residents provided a novel opportunity to facilitate application of clinical knowledge, leadership, teamwork, shared decision-making, and prioritization of patient safety. Providing interactive sessions in between didactic instruction increased participant engagement and level of comfort with roles in a stroke response team.

Abstract TP97: Feasibility and Reliability of Patient-Reported Scores to Assess Long-Term Functional Outcomes in Stroke: A Sub-Group Analysis of the MaRISS Trial

Obtaining delayed functional outcomes such as the modified Ranking score (mRS) after stroke is challenging in clinical practice, often resulting in missing data. Self-reported outcomes are an alternative to functional outcome collection, but their reliability and accuracy are not well-established Methods: In this subgroup analysis of the Mild and Rapidly Improving Stroke Study (MaRISS), we aimed to test the feasibility and reliability of the MaRISS Patient Reported Outcome (PRO) survey tool for obtaining delayed functional outcomes in low (0-5) National Institute of Health Stroke Scale ischemic stroke, particularly the modified Rankin Score (mRS), by assessing its inter-rater reliability with a score calculated by a clinician through a structured telephone interview. Other scores were compared as secondary outcomes. 125 surveys were distributed between January 2017 and July 2018. The tool consisted of an online survey aiming to collect information regarding the patient's functional status 90 days after stroke including the mRS (utilizing the mRS 9-Q version), Stroke Impact Scale-16 (SIS), Barthel Index (BI), European Quality of Life-5D-5L (EQ-Index). All participants also completed these scales administered by trained personnel through a structured telephone interview. Cohen's weighted kappa coefficients (κ) with 95% confidence intervals (CI) were calculated to assess the reliability of the PRO Tool Results: Of 125 surveys sent, 55/125 (46.4%) participants opened and started the survey but only 44/125 (36.8%) completed it entirely (mean age 62±12.5, 54.6% female, white 79.6%, NIHSS 2.3±1.8, ischemic stroke 84%, 16% TIA). 52 subjects completed both the online mRS 9-Q PRO and the telephone version (Table). The weighted kappa for the comparison of PRO mRS and the clinician-performed mRS was moderate [κ 0.53, SE 0.10; 95% CI (0.3-0.7)] as well as for the SIS (κ 0.43, SE 0.09) and EQ-Index (κ 0.40, SE 0.10) scores, whereas for BI was fair (κ 0.32, SE 0.15) Discussion: Engaging participants after hospital discharge remains difficult. Although participant completion rates for self-reported outcomes were low, the MaRISS PRO Tool showed moderate reliability. These findings should be confirmed in larger samples with a focus on improving participant engagement

Ethical Considerations in Social Media Utilization by Religious Organizations: An In-depth Investigation

In the contemporary landscape, social media platforms have evolved into highly effective instruments facilitating participatory communication across diverse aspects of human life. The advent of the digital revolution has introduced a novel dimension to the application of social media, extending its reach into various realms of communication, management, and development initiatives. Particularly noteworthy is the role that social media platforms play in the domain of religious communication, mobilization, and organization. Among the myriad social media platforms, Twitter and Facebook stand out as extensively utilized tools by religious organizations and leaders. Leveraging these platforms, religious entities seek to establish direct communication channels with their target groups, fostering active engagement and participation in the organizational and managerial aspects of religious institutions. This paradigm shift in communication strategies has become increasingly relevant and influential. To explore the dynamics of this intersection between social media and religious engagement, the present investigation was undertaken in Delhi, focusing on the National Capital Region (NCR) – a geographical area encompassing all major religions in the country. The study delves into the multifaceted ways in which social media platforms are employed for religious outreach, examining their impact on communication strategies, organizational dynamics, and the active involvement of the faithful within the diverse religious landscape of the NCR. Through a comprehensive analysis of the use of social media in this specific context, the research aims to contribute valuable insights into the evolving nature of religious communication in the digital age. Keywords: social media platforms, religious communication, digital revolution, national capital region, participatory engagement

Activist Co-production for the Right to Occupy, Hold Ground, and Upgrade

This article theorises a multi-year participatory action research engagement focusing on young land occupations and consolidated favelas in São Paulo’s south periphery, providing an arsenal of tools for activist-scholars. Building on Paulo Freire's legacy, we call on academia to embrace activist co-production, learn from and support informal dwellers’ everyday urbanisms, and join social movements’ struggles for social transformation. We advance three modalities of action: awareness raising through emancipatory education and capacity building; articulatção through knowledge exchange between young and consolidated informal communities; and advocacy through policy reform for the right to occupy, hold ground, and upgrade.

Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method study.

Most of the disability-related scholarly literature focuses on high-income countries, whereas there is a lack of data concerning challenges (barriers and obstacles) and opportunities (participatory research and community engagement) in the Global South. Moreover, many frameworks for interventions for people with disabilities (PWDs) have been designed for resource-rich contexts, and little is known about their translatability to low- and middle-income countries (LMICs). The main objective of this study was to design and pilot an interventional approach based on an innovative framework aimed at improving the livelihood of PWDs in LMICs. The present mixed-method study was conducted in Bamenda, North-West Region of Cameroon, through an intervention of household visits by community health workers using innovation and best practices informed by a systematic literature review and embedded into an evidence toolkit called the eBASE Family-Centered Evidence Toolkit for Disabilities (EFCETD), adapted from the WHO matrix and consisting of 43 questions across five categories (health, education, social wellbeing, empowerment, and livelihood). Out of 56 PWDs identified, 30 were randomly sampled, with an attrition of four participants. Three datasets (baseline, qualitative, and quantitative) were collected. The Washington Group tool, exploring the type of disability, gender, how long one has had the disability, their facility situation coupled with their coping strategies, and the context of livelihood, was used to design the questionnaire for baseline data collection. Qualitative data were collected through key informant interviews and focus group discussions analyzed with MAXQDA, while quantitative data were collected through the EFCETD and analyzed by means of descriptive statistics. In total, 69.2% of PWDs were female individuals. Many PWDs were aged 10-20 years (57% of the sample size). Physical/motor disability was the most common type of disability recorded (84.6%). The mean percentile for education increased from 29.9% during the first visit to 70.2% during the last visit, while the mean percentile for health increased from 65.4 to 78.7% and the mean percentile for social wellbeing moved from 73.1 to 84.9%. The livelihood and empowerment standards increased from 16.3 to 37.2% and from 27.7 to 65.8%, respectively. Overall, the temporal trend was statistically significant (F = 35.11, p < 0.0001). The adjusted score increased from the baseline value of 45.02 ± 2.38 to 61.07 ± 2.25, 65.24 ± 2.67, and 68.46 ± 2.78, at 4, 8, and 12 months, respectively. Compared to the baseline, all timepoints were significantly different, indicating a significant impact of the intervention, which became stable after 4 months and was preserved until 12 months. PWDs faced many endeavors for sustainability and challenges resulting from a lack of inclusive policies and practices, leading to their exclusion from education, employment, and healthcare. Using implementation science approaches could bridge the gap and make policies and practices more effective.

Nurturing youth film literacy: Post-qualitative arts-based inquiry into critical self-awareness

Post-digital, as a timeframe set, raises specific concerns for young adults engaged in artistic and cultural activities, seeking to establish a sustainable livelihood within a semi-rural South African context. They grapple with issues such as determining their positionality within a world marked by fading boundaries between the physical and digital. To better understand the post-digital impact on experiential learning opportunities for young adults, the authors explored the specific ways and extent to which active engagement in shortfilm-making contributes to developing critical self-awareness among the participating post-school youth. An assemblage of transformative theories and concepts, rather than pre-determined methodologies, guided this inquiry that extended beyond the development of career and workplace competencies. The strengths of spaciousness and in-between boundary positions provided by the spider’s thread metaphor served as a useful methodological tool. Moving beyond the limitations of traditional discourse and content analysis, multimodal discourse analysis in combination with a modified, six-category measuring instrument was used to explore (analyse) the evidence (data) created as products of active participant engagement in a shortfilm-making project, over a 10-month period in 2020. Findings revealed that, for the participants, it was by moving from physical self-centred understandings of reality to experiential creations of authentic reality (shortfilm-productions) and involving an expanded awareness of those alternative possibilities that nurtured their potential transpersonal growth.Transdisciplinary Contribution: A synthesis of arts-based, post-qualitative and developmental phenomenographic approaches was employed to create, explore and communicate evidence in ways that present a holistic picture of alternative pathways to knowledge production.

Operational Challenges in Conducting a Subnational TB Prevalence Survey in India: Lessons Learned for Resource-Limited, High-Burden Settings.

Estimating the burden of TB at the subnational level is critical to planning and prioritizing resources for TB control activities according to the local epidemiological situation. We report the experiences and operational challenges of implementing a TB prevalence survey at the subnational level in India. Information was collected from research reports that gathered data from periodic meetings, informal discussions with study teams, letters of communication, and various site visit reports. During the implementation of the survey, several challenges were encountered, including frequent turnover in human resources, lack of survey participation and community engagement, breakdown of X-ray machines, laboratory issues that delayed sputum sample testing, delays in X-ray reading, and network and Internet connectivity issues that impeded data management. To help ensure the survey was implemented in a timely manner, we developed several solutions, including planning ahead to anticipate challenges, ensuring timely communication, having a high commitment from all stakeholders, having strong team motivation, providing repetitive hands-on training, and involving local leaders to increase community engagement. This experience may help future states and countries that plan to conduct TB prevalence surveys to address these anticipated challenges and develop alternative strategies well in advance.

Updating the study protocol: Insight 46 – a longitudinal neuroscience sub-study of the MRC National Survey of Health and Development – phases 2 and 3

BackgroundAlthough age is the biggest known risk factor for dementia, there remains uncertainty about other factors over the life course that contribute to a person’s risk for cognitive decline later in life. Furthermore, the pathological processes leading to dementia are not fully understood. The main goals of Insight 46—a multi-phase longitudinal observational study—are to collect detailed cognitive, neurological, physical, cardiovascular, and sensory data; to combine those data with genetic and life-course information collected from the MRC National Survey of Health and Development (NSHD; 1946 British birth cohort); and thereby contribute to a better understanding of healthy ageing and dementia.Methods/DesignPhase 1 of Insight 46 (2015–2018) involved the recruitment of 502 members of the NSHD (median age = 70.7 years; 49% female) and has been described in detail by Lane and Parker et al. 2017. The present paper describes phase 2 (2018–2021) and phase 3 (2021–ongoing). Of the 502 phase 1 study members who were invited to a phase 2 research visit, 413 were willing to return for a clinic visit in London and 29 participated in a remote research assessment due to COVID-19 restrictions. Phase 3 aims to recruit 250 study members who previously participated in both phases 1 and 2 of Insight 46 (providing a third data time point) and 500 additional members of the NSHD who have not previously participated in Insight 46.DiscussionThe NSHD is the oldest and longest continuously running British birth cohort. Members of the NSHD are now at a critical point in their lives for us to investigate successful ageing and key age-related brain morbidities. Data collected from Insight 46 have the potential to greatly contribute to and impact the field of healthy ageing and dementia by combining unique life course data with longitudinal multiparametric clinical, imaging, and biomarker measurements. Further protocol enhancements are planned, including in-home sleep measurements and the engagement of participants through remote online cognitive testing. Data collected are and will continue to be made available to the scientific community.

1947 Process evaluation of a home-based intervention to promote independence among older people living with mild frailty

Abstract Introduction Frailty is a condition that makes it increasingly difficult for individuals to recover from adverse health events and gradually erodes independence. NHS interventions in England have focused on those with more severe frailty. We tested HomeHealth, a home-based, tailored, multi-domain (six-session) behaviour change intervention to promote independence in the over-65s living with mild frailty, in a RCT recruiting 388 people (intervention 195; control 193). HomeHealth was delivered by the voluntary sector in three diverse areas and addressed mobility, nutrition, socialising, and psychological goals, among other domains. We aimed to explore acceptability, participant engagement, and experiences of delivering and receiving the service. Methods Following a mixed-methods approach, we extracted quantitative data on types of goals and progress towards goals from Health and Wellbeing plans and appointment checklists. Between July 2022 and May 2023, we interviewed 49 older participants, 7 HomeHealth workers and 8 stakeholders. Older people were purposively sampled for diversity in socio-demographic characteristics, cognitive and physical functioning, intervention adherence and allocated HomeHealth worker. Interviews explored their motivations to engage; experience of participation, delivery and study support followed by their suggestions for improvement. We analysed qualitative data thematically and quantitative data descriptively. Results Most participants set mobility goals (49%), followed by a combination of goals (31%), and made moderate progress towards these. The intervention (completed by 93.3% participants) was positively received, boosted participants’ confidence, and provided emotional support. Participants reported that sometimes behaviour was maintained post-intervention, but further appointments would have been welcomed to fill the gap in other services. However, some people found it difficult to identify goals to work on, particularly when they already felt independent and well supported. Conclusions Services to support older people with mild frailty are acceptable, have good engagement, and can lead to behaviour change, particularly among those who self-identify a need for change.

A novel methodological approach to participant engagement and policy relevance for community-based primary medical care research during the COVID-19 pandemic in Australia and New Zealand.

Community-based primary care, such as general practice (GP) or urgent care, serves as the primary point of access to healthcare for most Australians and New Zealanders. Coronavirus disease 2019 (COVID-19) has created significant and ongoing disruptions to primary care. Traditional research methods have contributed to gaps in understanding the experiences of primary care workers during the pandemic. This paper describes a novel research design and method that intended to capture the evolving impact of the COVID-19 pandemic on primary care workers in Australia and New Zealand. Recurrent, rapid cycle surveys were fielded from May 2020 through December 2021 in Australia, and May 2020 through February 2021 in New Zealand. Rapid survey development, fielding, triangulated analysis and dissemination of results allowed close to real-time communication of relevant issues among general practice workers, researchers and policy-makers. A conceptual model is presented to support longitudinal analysis of primary care worker experiences during the COVID-19 pandemic in Australia and New Zealand, and key learnings from applying this novel method are discussed. This paper will assist future research teams in development and execution of policy-relevant research in times of change and may inform further areas of interest for COVID-19 research in primary care.

Fostering Inclusive Development: The Government's Role in Integrating a Gender Perspective

This research employs a descriptive qualitative method to analyze the government's role in promoting gender perspective in development within Sidoarjo Regency, Indonesia. Utilizing purposive sampling, the study draws upon role theory by Soerjono Soekanto, focusing on active, participatory, and passive roles. Findings reveal that the Sidoarjo Regency Government effectively advocates and socializes gender mainstreaming, demonstrating an active role. The government engages in education and motivation, encouraging broad societal participation, exemplifying a participatory role. However, a passive role is observed in limited active involvement in socialization activities. This research underscores the importance of government initiatives in fostering gender equality, offering insights applicable to global development discourse Highlight : Government Advocacy and Socialization: The study reveals the Sidoarjo Regency Government's effective advocacy and socialization efforts in promoting gender mainstreaming, reflecting an active role. Participatory Engagement: Through education and motivation, the government actively involves diverse societal levels, fostering a participatory role in advancing gender equality within development initiatives. Passive Role Observation: The research identifies areas where the government maintains a passive role, primarily limited to socialization activities, shedding light on potential areas for increased active involvement in gender-responsive development efforts Keywords: Gender-Responsive Development, Government Role, Sidoarjo Regency, Role Theory, Gender Mainstreaming

Shifting From Active to Passive Monitoring of Alzheimer Disease: The State of the Research.

Most research using digital technologies builds on existing methods for staff-administered evaluation, requiring a large investment of time, effort, and resources. Widespread use of personal mobile devices provides opportunities for continuous health monitoring without active participant engagement. Home-based sensors show promise in evaluating behavioral features in near real time. Digital technologies across these methodologies can detect precise measures of cognition, mood, sleep, gait, speech, motor activity, behavior patterns, and additional features relevant to health. As a neurodegenerative condition with insidious onset, Alzheimer disease and other dementias (AD/D) represent a key target for advances in monitoring disease symptoms. Studies to date evaluating the predictive power of digital measures use inconsistent approaches to characterize these measures. Comparison between different digital collection methods supports the use of passive collection methods in settings in which active participant engagement approaches are not feasible. Additional studies that analyze how digital measures across multiple data streams can together improve prediction of cognitive impairment and early-stage AD are needed. Given the long timeline of progression from normal to diagnosis, digital monitoring will more easily make extended longitudinal follow-up possible. Through the American Heart Association-funded Strategically Focused Research Network, the Boston University investigative team deployed a platform involving a wide range of technologies to address these gaps in research practice. Much more research is needed to thoroughly evaluate limitations of passive monitoring. Multidisciplinary collaborations are needed to establish legal and ethical frameworks for ensuring passive monitoring can be conducted at scale while protecting privacy and security, especially in vulnerable populations.