Local Efforts Research Articles

Effect of Local Fire Risks and Preventive Measures on the Installation of Residential Firefighting Systems in Detached House

This study analyzes the major factors affecting the installation of residential firefighting systems in detached houses. In particular, it investigates the dependence of local fire risk and local government prevention efforts, along with housing and household characteristics, on the type of installation. This study used data from the 2020 Population and Housing Census, the first nationwide survey on residential firefighter system installation, and employed multinomial logistic regression analysis. The analysis results revealed that less than half of households had installed all firefighting systems, where the installation rate differed significantly by region. Housing and household characteristics also influenced the installation type. Local fire risk as well as the local government’s fire prevention policies positively affect the installation of residential firefighting systems.

Climate-sensitive training for sustainable business in Dickson County with global applications

Purpose This paper aims to examine the implementation and impact of climate-sensitive training programs tailored to the specific climate risks and business needs of Dickson County, Tennessee. It aims to emphasize the importance of integrating climate adaptation strategies into business training and to propose a replicable model that can be adapted to regions facing similar challenges, contributing to global sustainability efforts. Design/methodology/approach The research uses Dickson County’s climate profile as a case study, analyzing its impact on local businesses in sectors such as agriculture, manufacturing and tourism. This paper integrates theoretical frameworks, including organizational learning and adaptive capacity, to provide practical strategies for climate-sensitive training. It further incorporates insights from local institutions, industry partnerships and public data, using a qualitative approach to analyze key themes related to training effectiveness and sustainability. Findings The findings demonstrate that climate-sensitive training significantly enhances the resilience and sustainability of businesses by preparing them to address local climate challenges. Critical factors for successful implementation include stakeholder engagement, industry-specific customization and the continuous evaluation of training outcomes. The model presented shows promise for broader applicability in other regions, especially when localized climate data and collaborative efforts are integrated. Originality/value This paper provides a novel, region-specific approach to climate-sensitive training, distinguishing itself by combining theoretical insights with practical strategies for businesses. By focusing on localized adaptation and stakeholder collaboration, the model addresses an existing gap in the literature on climate adaptation training for smaller, climate-vulnerable regions. This work offers a replicable and scalable framework that contributes to the global discourse on sustainable development and climate resilience in business practices.

The role and needs of teachers/schools in infection, prevention and control post covid-19

Abstract Introduction COVID-19 highlighted the importance of infection prevention and control (IPC) across all settings. As children are important transmitters of infection, teachers and schools play an important role in infection prevention. The aim of this study is to understand attitudes towards, and knowledge of IPC in schools post-Covid, and highlight any gaps in the training and resources needed. Methods An online survey of 1000 primary and secondary school teachers was carried out across England. Pearson’s chi-squared test, corrected for survey design, was used to test for differences in proportions across levels of categorical variables. Two qualitative workshops with eight head teachers were carried out to gather more in-depth information. Results 1000 teachers completed the survey across a range of teaching roles. Respondents reported that IPC measures are now less frequently implemented than during the pandemic. 71% of respondents say their role has changed since the pandemic, now having more responsibility for pupil health and hygiene; higher in primary versus secondary school teachers (31% v 25%; p < 0.05). 1/3 felt this change was permanent; 84% had no IPC training. Knowledge gaps were identified in the areas of IPC roles within schools, and IPC measures. 72% teachers claim they feel better prepared to deal with a public health outbreak compared to pre-pandemic, although 22% do not have an updated IPC policy; 35% had unmet needs. Conclusions Schools and teachers play a pivotal role in preventing the spread of communicable disease, highlighted during the COVID-19 pandemic. Teachers need, and more importantly want, more IPC training. Training and updated policies would support the educational workforce who feel their needs are not being met. Providing more streamlined, consistent, clear and concise information from trusted sources is required. Key messages • It is imperative to understand educators’ role in IPC in schools as they are key players in supporting local and national efforts to reduce the spread of infections. • Teachers desire further training with comprehensive information, and up-to-date policies to support their infection prevention and control efforts in educational settings.

Cultural Considerations in Intelligence Test Adaptations: a Critical Review of the WAIS-IV India and Its U.K. and U.S. Counterparts.

This study critically examined the adaptation and normative processes of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV)India. WAIS-IV U.K. Edition Administration and Scoring Manual, WAIS-IVIndia Administration and Scoring Manual, and WAIS-IV Administration and Scoring Manual and Technical and Interpretive Manuals were used to extract test development and adaptation process data. The analyses were descriptive and qualitative. A review of the manuals showed that the normative sample were fluent English speakers with high education levels, which is not representative of India's multilingual and educational diversity. The study identified minimal cultural and linguistic adaptations in subtests, which raised concern about potential biases in the test adaptation process across cultures. The lack of clarity in item selection, demographic data, sample selection, and psychometric properties raised questions about the test's reliability and validity. Issues related to education, age, gender, and regional distribution are discussed, emphasizing the test's limitations in capturing the diverse characteristics of the heterogeneous Indian population. WAIS-IV India may not adequately represent India's population. More careful consideration of socioecological and psychometric factors when adapting intelligence (IQ) tests and use of advanced data harmonization methods can provide robust cross-national statistical harmonization in the future along with more ecologically valid local test development efforts. This can allow consideration of social determinants of health and other factors that can inform a more nuanced approach to IQ test development in non-western contexts.

Indigenous education as community of practice: a case of grassroots learning of the Manobo in the Philippines

ABSTRACT Indigenous education efforts across the world’s Indigenous communities are being implemented to address varying challenges of poverty, cultural discrimination, resource dispossession and isolation. Engaged in a decolonisation agenda, most Indigenous communities are leading diverse localised efforts that turn inwards to their own rich tapestries of knowledge, culture and relationships. In this paper, we argue for the need to broaden the conceptualisation of Indigenous education models to account for the invaluable role that social learning and practice play in sustaining grassroots efforts on how a particular Indigenous people engage with formal educational processes. This paper explores Indigenous education as a community of practice that exemplifies mutual engagement, joint enterprise and shared repertoire, as crucial elements in sustaining Indigenous education endeavours. We use Lave and Wenger’s “communities of practice” as a theoretical framework to better understand how the Manobos, an Indigenous group in the southern Philippines, have been able to successfully operate their own school. Drawing from participant-observation and key informant interviews with teachers, community leaders and missionaries, we foreground examples of how the Manobos rely upon mutual engagement, joint enterprise and shared repertoire of actors to show that they belong to an overarching community of practice. More specifically, we demonstrate that Indigenous education as practiced by the Manobos is a socially constituted enterprise that entails grassroots learning at the individual and collective level, collaborations with external groups, as well as strategic negotiation and compliance with government’s policies that ultimately help them sustain the school’s operation.

Local biodiversity actions for sustainable development goal 15 (life on land) in China

AbstractAchieving sustainable development goal (SDG) 15 (life on land) depends on local conservation efforts. However, the lack of species data and inadequate ecological corridor designs significantly hinder conservation efficiency. This study focused on Sanmenxia City in China and utilized the Integrated Valuation of Ecosystem Services and Trade‐offs model, the GeoDetector model, and the Minimum Cumulative Resistance model to identify potential habitats, their influencing factors, and ecological corridors. We then adopted a new corridor feasibility model to compare the impacts of different ecological resistance, thereby identifying key biodiversity spaces. Results indicated a decline in habitat quality since 2000, primarily influenced by climate, topography, and land use. Simulation‐derived corridors using the habitat quality method were more effective than those based on expert experience. We identified 2808.45 km2 of potential habitats and 20 critical corridors for land animals. This study deepens the understanding of ecological resistance impacts on corridors and provides new insights into local actions for SDG 15.

Road through a broken place: the BRI in post-coup Myanmar

In the wake of the 2021 coup, Myanmar experienced a renewed civil war that has fragmented the country along a myriad of old and new conflict lines. Despite the high-intensity violence across many regions of the country, China is still pursuing an ambitious connectivity project under its Belt and Road Initiative (BRI): The China-Myanmar Economic Corridor (CMEC) is meant to connect Myanmar to the Chinese market and boost Myanmar’s industrial development. However, the challenging post-coup environment has required significant changes in China’s approach to local infrastructure development and empowered a new set of subnational actors on both sides of the border. This article analyzes how CMEC has fared since the coup, and how the fragmentation of Myanmar has gone hand in hand with that of Chinese agency in the country. Contrary to prevailing descriptions of the BRI as a coherent, strategic, and top-down project, we argue that the case of Myanmar exposes the degree to which it is shaped by local interests and circumstances, and the limits of centralized BRI implementation. Finally, it is likely that adjustments in Chinese policy triggered by the situation in Myanmar will have more long-term consequences for the future of the BRI, specifically a more direct involvement in local security efforts and greater engagement with local authorities beyond the central government.

Community Engagement in Local Governance

Community engagement in local governance is crucial for effective and inclusive decision-making. Lack of Awareness and Information has been found that limited knowledge can have its community members may not fully understand the governance processes or their rights and responsibilities. Information gaps have been found that the insufficient information about local issues and decision-making processes can hinder meaningful participation. Low Participation Rates have been found that apathy and disinterest is that some community members may be disengaged due to a lack of trust in the system or a perception that their participation will not make a difference. Barriers to access has been found that the physical, economic, or social barriers may prevent certain groups from participating, such as the elderly, disabled, or economically disadvantaged. During the initial phase (2008-2013) of the Local Governance and Community Development Program (LGCDP) in Nepal, social mobilization emerged as one of its most effective components. Approximately 1 million citizens actively influenced local government decisions, leading many local bodies to develop annual plans that more accurately addressed the needs of citizens, particularly marginalized and disadvantaged groups. However, there remain several lessons to be learned in addressing the challenges of implementation. It is crucial to harmonize local social mobilization efforts and enhance the quality and support of social mobilization initiatives across Nepal. Addressing the challenges of community engagement in local governance involves a multifaceted approach that includes enhancing communication, building capacity, fostering inclusivity, and ensuring accountability. Public education campaigns have been found to Conduct outreach programs to educate community members about their rights, governance processes, and how they can participate. Workshops and training have been identified to offer workshops and training sessions to increase understanding of local governance and decision-making procedures. Diverse engagement channels have to utilize multiple platforms for engagement, including town hall meetings, online forums, surveys, and community events, to reach a broader audience. Inclusive scheduling has to schedule meetings and events at times that are convenient for different community groups, including evenings and weekends.

Heritage Diplomacy, Neo-Ottomanism, and a Local Quest for a New Place of Worship: The Politics of Mosque Building in Batumi, Georgia

ABSTRACT Over the past few decades, Turkey has funded numerous construction and building rehabilitation initiatives in foreign countries. Amidst such efforts, this article scrutinises the implications of Turkey’s heritage diplomacy tied to Ottoman architecture and how it has the potential to overshadow the desires of local populations. It points to one such case in Batumi, Georgia, where a replica of the 1868 Aziziye Mosque was proposed as a part of Georgia-Turkey cross-border heritage exchanges in the 2010s. Here, Turkey’s fostering of the project exacerbated local Muslim Georgian efforts to construct a mosque of their own in the city. The case demonstrates how heritage diplomacy can land poorly, shining light on a range of broader domestic impacts to urban planning and national identity, electoral politics and community social cohesion. Instead of seeing local Muslims as passive bystanders, the article demonstrates how they asserted their rights, building a temporary open-air mosque and redirecting the focus back towards their particular needs. The findings are based on a long-term study of the politics of urban development in Batumi using qualitative methods. They contribute to a growing body of scholarship in critical heritage studies, highlighting connections to public policy, diplomatic relations, and religious activism.

Proposed Quality Metrics for Congenital Cardiac Anesthesia: A Scoping Review.

Congenital cardiac anesthesiologists practice in a unique environment with high risk for morbidity and mortality. Quality metrics can be used to focus clinical initiatives on evidence-based care and provide a target for local quality improvement measures. However, there has been no comprehensive review on appropriate quality metrics for congenital cardiac anesthesia to date. Members of the Quality and Safety Committee for the Congenital Cardiac Anesthesia Society proposed 31 possible candidate topics for metrics. Using a scoping review strategy, 3649 abstracts were reviewed with 30 articles meeting final criteria. Of these, 5 candidate metrics were unanimously proposed for local collection and national benchmarking efforts: use of a structured handover in the intensive care unit, use of an infection prevention bundle, use of blood conservation strategies, early extubation of cardiopulmonary bypass cases, and cardiac arrest under the care of a cardiac anesthesiologist. Many metrics were excluded due to a lack of primary data and perceived complexity beyond the scope of cardiac anesthesia practice. There is a need to develop more primary data including linking process measures with outcomes, developing risk-stratification for our patients, and collecting national data for benchmarking purposes.

Commitment to Place as Motivation for Citizen-Based Watershed Collaboration: BIMBY Effect

A growing literature in citizen-based collaboration extols the many virtues of collaboration to address complex public problems. Little attention has been paid, however, to the underlying motivation for citizen participation. Drawn from three case studies of citizen-based environmental collaborations, this paper examines the motivations of citizens to engage in collaboration. The research suggests that a longstanding commitment to “place” is an important driver for collaboration. The findings of this paper can assist citizen-based environmental collaborative groups to identify ways to more effectively engage citizens in local collaborative efforts.

EXPLORING THE IMPACT OF FOOD INSECURITY AMONG WOMEN AFFECTED BY HIV AND AIDS IN MUFAKOSE SUBURBS IN HARARE, ZIMBABWE

Food insecurity and HIV/AIDS are two intertwined pandemics ravaging Zimbabwe, disproportionately affecting women. The triple challenges such as unemployment, poverty and inequality steeped in unethical leadership and misgovernance exacerbate the preceding twin pandemic of HIV/AIDS and food insecurity in Zimbabwe. To mitigate the abovementioned challenge, the multilateral and the bilateral stakeholders in health and food security introduced the multisectoral governance systems in all the United Nations member countries. Notwithstanding the international, regional and local efforts to mitigate both the impact of HIV/AIDS and food insecurity among the women in Zimbabwe, the effects of these twin pandemics have continued to rise among the women and girls in the country. This study investigates the impact of food insecurity on women living with HIV/AIDS in Zimbabwe, shedding light on the complex relationships between poverty, nutrition and health. This qualitative study seeks to understand the complexities of human behaviour, experiences and social phenomena in the Mufakose Urban community of Zimbabwe. Women and girls who live with HIV/AIDS between the ages 15 and 49 residing in this community between 2015 and 2017 under antiretroviral therapy (ART) treatment were selected as information sources for this study. Twenty (20) informant interviews were conducted, with guided questions aimed at eliciting responses from participants, focusing on household food security. The study established that women living with HIV and AIDS face a plethora of challenges in terms of food insecurity and antiretroviral therapy. This has led to non-adherence for many of them. Most of the women fail to get adequate food and a consistent supply of ARV. Consequently, the study recommends taking a holistic approach to support women living with HIV and AIDS, both medically and nutritionally, without political or undue interference. The study further suggests exploring ways to enable policymakers and government officials to adopt a factual and non-stereotypical tone in supporting people living with HIV and AIDS in Zimbabwe.

Governing pandemics: Resilience and community responses for COVID-19 in Bengaluru and Shanghai

ABSTRACT This study explores governance strategies and community responses to the COVID-19 pandemic in Bengaluru and Shanghai. It builds on recent evidence showing China centers on territorial institutions to respond to the pandemic, whereas democratic India relies on associational politics, including alliances with different stakeholders. The study argues that increased community involvement in Shanghai arose from the state’s inadequacies during the crisis, while resident welfare associations (RWAs) in Bengaluru primarily served the middle class and had limited impact on vulnerable populations. Using a mixed-methods approach, the study highlights key lessons that contributed to effective responses in both cities, offering policy recommendations for building resilient cities with stronger leadership. Community reactions in India and China surpassed the normal during the pandemic. Despite differences in urban regimes and political systems, Shanghai’s territorial institutions contrasted with Bengaluru’s associational approach; however local governance and community efforts significantly shaped their pandemic outcomes during the health disaster.

The Analysis of Stunting Implementation Policy in Tegal Regency

Tegal is a regency with the highest stunting prevalence in toddlers in Central Java with a percentage of 22.3% in 2022. Currently, the regency has become the prioritized locus of stunting intervention in Indonesia. Tegal regency government issued the Regent Rule of Tegal Number 4 in the Year 2023 about the Communication Strategy of Behavioral Changes in Lowering Stunting Prevalence in 2023 - 2026 as the prevention and effort of decreasing the stunting rate. This research revealed the implementation of stunting prevention policy in Tegal by applying the exploratory implementation model of George Edward III, Marilee S. Grindle, and Mazmanian & Sabatier based on the triangular perspective of policy analysis. This descriptive qualitative research describes a variable orally from the respondents and the doers by observing them. The researchers collected the data by interviewing, documenting, and promoting the literature study. The researchers also interviewed the Health Agency of Tegal and Public Health Care of Kedungbanteng district. The results showed that the applied policy met the regulation in terms of local government and local apparatus organization, OPD, with collaboration and effort to realize inter-sectoral cooperation from regency to village levels. The concrete step in preventing stunting includes the provision of nutritionist teams at Kedungbanteg Public Health Care and the establishment of a police center to prevent stunting prevalence. The results were - gaining the top 99 awards of Public Service Innovation in 2023 by the Ministry of State Apparatus Utilization and Bureaucratic Reform. However, the researchers found hindrances in distributing stunting prevention at most pubic health care units in Tegal. They had not applied the concrete steps and had to improve the human resources by joining training for the cadres so they could use the measuring tool of stunting for toddlers.

The benefits of transformational leadership for addressing workplace emotions after COVID-19 at a large multi-campus university

The COVID-19 pandemic presented a series of challenges to organizations. Among those that successfully continued operating, the subsequent recovery period catalyzed pressure to redefine work structure after social distancing restrictions lifted. Here, we observed the benefits of transformational leadership in this historically unique context of organizational distress by applying an adjusted version of Ashkanasy and Dorris’s (Ashkanasy and Dorris in Annu Rev Organ Psych Organ Behav 4:67–90, 2017) framework for workplace emotions to a large, multi-campus university. We quantitatively content-analyzed semi-structured interviews of more than 300 divisional leaders and their staff from across the organization. Interviews occurred in the months following the first semester of continuous in-person service delivery, when most employees returned to working in employer-operated space. Despite disproportionate emphasis on negative and self-focused emotions, negative emotions clustered in individuals’ empathic recognition of others’ emotions; though efforts to regulate those emotions proved scant. Positive emotions primarily emerged in response to local leadership efforts to mitigate the negative emotions of students, staff, and faculty. This data pattern suggests that individuals experienced negative emotions, recognized others’ negative emotions, and appreciated leaders’ interventions to ameliorate those negative emotions. Strategies reminiscent of transformational leadership therefore productively addressed the negative impact of workplace stress imposed by the pandemic, helping to facilitate compliance and enthusiasm with return-to-work efforts. The findings thus illustrate how a transformational style of leadership can address individuals’ negative experiences during a period of pronounced existential stress.

More than medicine: antimicrobial resistance (AMR) as a social and political challenge that can be overcome

ABSTRACT Growing antimicrobial resistance (AMR) threatens modern medicine and global food security through the gradual loss of effective antibiotics and other crucial drugs and chemicals. This dispiriting but inexorable development presents daunting social and political challenges because it arises from how drugs are produced and people everywhere in the world use them. Results of monumental international efforts led by United Nations and European Union bodies to create common purpose and concerted actions against AMR since the early 2010s are so far discouraging. Declarations and plans have proliferated. But social factors such as national and local politics have stymied effective action. Nevertheless, countries in Europe demonstrate that AMR mitigation is politically possible. This article draws on contributions to the SI on AMR politics and governance to illustrate how. Specific institutional arrangements, cultural values, and leadership commitments have had strong impacts on the degree of success of AMR policies. In turn, these factors represent important political conditions that some policymakers have successfully navigated. Hence, the SI’s contributions can offer policy leaders and entrepreneurs clues for domestic and local political efforts to control AMR.

5156 Circulating MicroRNA-based Biomarker Combinations for Differentiating Uni- and Bilateral Primary Aldosteronism Using a Machine Learning Approach

Abstract Disclosure: B. Vekony: None. G. Nyiro: None. Z. Herold: None. J. Fekete: None. F. Ceccato: None. S. Gruber: None. L. Kurzinger: None. M. Parasiliti-Caprino: None. B. Szeredas: None. S.K. Nazri: None. V. Fell: None. M. Bassiony: None. E.A. Azizan: None. I. Bancos: None. F. Beuschlein: None. P. Igaz: None. Background: The differentiation of uni- and bilateral forms of primary aldosteronism (PA) is of pivotal clinical relevance. Whereas unilateral PA warrants surgical treatment, bilateral PA is treated by aldosterone antagonists. The most reliable way to differentiate these two entities is adrenal venous sampling (AVS) that is an invasive method with limited availability and requiring great expertise. Aim: To develop a circulating blood-borne microRNA-based approach using machine learning for the differentiation of uni- and bilateral PA. Methods: Circulating microRNA profiling on an Illumina MiSeq platform was performed on total RNA samples isolated from EDTA-anticoagulated blood specimens taken by AVS from 18 pairs of right and left suprarenal veins (10 uni-, 8 bilateral PA). Significantly differentially expressed microRNAs were analyzed by a neural network (90-10% learner-tester cross-validation simulation). From the top 29 significantly differentially expressed microRNAs, 9 were selected for validation by Taqman RT-qPCR on a separate cohort of 30 AVS-confirmed samples (15-15 uni- and bilateral forms) both on plasma samples from adrenal as well as from peripheral veins. The method was finally tested on another independent cohort of peripheral blood samples from 80 patients (40 uni- and 40 bilateral PA). Results: Regarding the 9 microRNAs selected for validation, microRNA abundance was non-significantly lower in peripheral samples compared to AVS samples. By analyzing peripheral plasma samples, ten combinations of 4-8 microRNAs from the pool of 9 microRNAs turned out to have maximal sensitivity and specificity values over 85 %. The best combination included 6 microRNAs with a sensitivity of 86.3 % and a specificity of 87.91 % (AUC = 0.871). The inclusion of further parameters such as imaging, potassium and renin levels did not improve the model’s performance. Conclusion: The analysis of circulating blood-borne microRNAs represents a minimally invasive and potentially reliable way of differentiating uni- and bilateral PA. If bilateral PA is confirmed by the model, no more localization efforts would be necessary thus simplifying the management of PA patients. This would be relevant both from the patient’s and a public health perspective. Presentation: 6/3/2024

Toddler Posyandu Cadres Supporting Stunting-Free Villages

Background: Posyandu (integrated health service posts) are vital for maternal and child health. Specific Background: This study explores the role of Posyandu cadres in health promotion and community empowerment in a local village. Knowledge Gap: Previous research has highlighted the importance of these cadres, but their contributions to community mobilization and stunting prevention remain underexplored. Aims: The research aims to examine the functions of Posyandu cadres in health education and community engagement. Results: Findings indicate that cadres act primarily as health educators and community mobilizers, utilizing tools like the KIA (Child Identity Card) and KMS (Healthy Growth Monitoring Card) for health information dissemination. However, their active involvement and local capacity-building efforts need improvement. Novelty: This study offers new insights into the operational challenges faced by Posyandu cadres in promoting health and preventing stunting. Implications: It emphasizes the need for training and support for cadres to enhance their effectiveness, ultimately contributing to healthier communities and reducing stunting rates. Highlights : Roles of Cadres: Primarily function as health educators and community mobilizers. Utilization of Tools: Employ KIA and KMS for effective health information dissemination. Need for Improvement: Highlight the necessity for enhanced training and active community involvement. Keywords: Posyandu, health promotion, community empowerment, stunting prevention, cadres.

High‐Resolution Modeling and Projecting Local Dynamics of Differential Vulnerability to Urban Heat Stress

AbstractClimate change‐induced heat stress has significant effects on human health, and is influenced by a wide variety of factors. Most assessments of future heat‐related risks however are based on coarse resolution projections of heat hazards and overlook the contribution of relevant factors other than climate change to the negative impacts on health. Research highlights sociodemographic disparities related to heat stress vulnerability, especially among older adults, women and individuals with low socioeconomic status, leading to higher morbidity and mortality rates. There is thus an urgent need for detailed, local information on demographic characteristics underlying vulnerability with refined spatial resolution. This study aims to address the research gaps by presenting a new population projection exercise at high‐resolution based on the Bayesian modeling framework for the case study of Madrid, using demographic data under the scenarios compatible with the Shared Socioeconomic Pathways. We examine the spatial and temporal distribution of population subgroups at the intra‐urban level within Madrid. Our findings reveal a concentration of vulnerable populations, as measured by their age, sex and educational attainment level in some of the city's most disadvantaged neighborhoods. These vulnerable clusters are projected to widen in the future unless a sustainable trajectory is realized, driving vulnerability dynamics toward a more uniform and resilient change. These results can guide local adaptation efforts and support climate justice initiatives to protect vulnerable communities in urban environments.

What is known about suicide prevention gatekeeper training and directions for future research.

Suicide prevention training that teaches skills to support a person experiencing thoughts of suicide and create community support networks, often termed, "gatekeeper" training (GKT), has been a longstanding pillar of international, national, and local suicide prevention efforts. GKT aims to improve knowledge, attitudes, and self-efficacy in identifying individuals at risk for suicide, hopefully enhancing one's willingness and ability to intervene with a person experiencing a crisis. However, little is known about GKT's effectiveness in creating the essential behavior change (e.g., increase in intervening behaviors) it sets out to accomplish. This paper explores the history and theoretical background of GKT, reviews the current state of research on GKT, and provides framing and recommendations for next steps to advance research and practice around GKT. Through positioning GKT appropriately within the field of suicide prevention, we argue that the field of suicide prevention needs more rigorous research around GKT that includes long-term follow-up data on usage of skills learned during training, data on outcomes of those who have received an intervention from a trained gatekeeper, and the integration of implementation science to further our understanding of which trainings are appropriate for which helpers.