Meaningful Community Engagement Research Articles

84. TEACHING SOCIAL DETERMINANTS VIA SERVICE LEARNING AND COMMUNITY EXPLORATION

Background Residents must be familiar with the community they serve and understand the impact of social determinants of health (SDH). Service learning is an educational approach that combines community service with reflection to achieve meaningful community engagement and understanding of SDH. We designed an intern orientation program to engage new trainees in conversations about SDH and advocacy through service learning and a team building experience. Objective Assess the impact of a community tour and volunteer experience on knowledge of local community, attitudes around SDH screening, and intern bonding. Methods The intervention included a didactic session on SDH; a walking tour of East Harlem (EH), the hospital neighborhood; and a visit to a local food pantry/community-based organization where residents engaged in a volunteer activity (packing meals). Residents completed a mixed methods survey with retrospective pre/post questions to reflect on the impact of the activity on knowledge and attitudes regarding: patient demographics, SDH (particularly food insecurity), and familiarity with co-interns. Data were analyzed using McNemar's test. RESULTS:35 residents were surveyed in 2017-2018. The program was effective in increasing interns’ understanding of the demographics and health issues affecting EH children (p=0.001) as well as increasing comfort discussing food insecurity with patients (p=0.001). All respondents reported a future plan to screen patients for food security, and 100% affirmed that program participation provided tools to help their patients. 97% agreed the activity helped them get to know their fellow interns. When asked for favorite aspects of the day, “volunteering at the pantry and giving back to the community,” “learning more about the EH community” and “getting to know our co-residents,” were identified. Conclusion A volunteer experience followed by a walking tour gave interns the opportunity to learn about EH while performing community service and bonding with their co-interns. Future research is needed to ascertain whether this hands-on experience inspires and sustains a program culture of advocacy.

Community-Based Tourism in Developing Countries: A Framework for Policy Evaluation

Many developing countries have recognized the potential of their natural resources for the development of tourism. However, the policies designed to provide a framework for socially inclusive and ecologically sound tourism turn out to be weak in fostering community-based tourism (CBT). There is a spectrum of conditions that lead to success or failure of CBT initiatives that should be accounted for by national policies to ensure meaningful community engagement. This paper proposes a framework for the evaluation of tourism policy documents based on factors that facilitate and constrain CBT in developing countries. The framework was applied to seven tourism policy documents in Colombia using a content analysis approach. The results showed that the policies are weak in providing a base for community engagement in CBT. International experiences indicate that the barriers to CBT are similar throughout the world; thus, the framework is useful in the evaluation of policy documents in other developing countries.

Reciprocal learning in service-learning? Measuring bidirectional outcomes of college students and service recipients in tutor-based services in Hong Kong

ABSTRACTThe emergence of literature critically examining reciprocity in the determination of service-learning outcomes has signalled a need to rethink and re-evaluate service-learning research and practice. The current study seeks to give clarity by investigating the bidirectional benefits accrued by college students and their partners in four tutor-based service contexts. Quantitative results indicated that there is a reciprocal relationship between college students and their paired service recipients at the end of the service-learning program, in terms of interpersonal skills and personal responsibility. Overall, the study makes a case for the bidirectional nature of service-learning in promoting meaningful community engagement.

Student-Based Budgeting as a Mechanism for Promoting Democratic Decision Making: Testing the Theory of Action

Although student-based budgeting (SBB) is a multifaceted finance, governance, and management reform, little research has examined its governance effects. This article addresses that gap by reporting findings from a “critical case” of SBB, implemented under conditions that might promote meaningful teacher, parent, and community engagement in site-based policy decisions. Anchored in theories of the micropolitics of schools and conceptions of democratic decision making, this case demonstrates that SBB did not alter how principals engaged teachers, parents, and community members in budget decision-making processes. Generally speaking, decision-making processes represented narrow and shallow forms of actor engagement and democratic decision making. Study findings reveal that SBB in its current form is not a robust mechanism for realizing its governance aims and suggest that other factors, including but not limited to the misalignment of accountability and authority, warrant the attention of researchers and policy makers.

Health in Action: Evaluation of a Participatory Grant-Making Project in East Harlem.

Decision-making processes that include resident input have been shown to be effective in addressing community needs. However, few examples discuss the role of a local health department in leading a participatory decision-making process. In 2016, the New York City Department of Health and Mental Hygiene implemented a participatory grant-making process to allocate grant funds to community organizations in East Harlem. Findings from the evaluation suggest that a participatory grant-making process can be an effective way to include community member as decision makers. It can also build capacity among organizations and foster meaningful community engagement with a local health department.

Stakeholder acceptability of adolescent participation in clinical trials for biomedical HIV prevention products: considerations from Tanzania and India

ABSTRACTResearchers and advocates have increasingly called for adolescent participation in clinical trials for new HIV prevention products, particularly adolescent girls in areas most affected by the epidemic. However, recent trials have highlighted the challenges for young women and adolescents to be able to effectively use new products that require daily dosing. This analysis provides a highly relevant context for this challenging environment by examining community members acceptability of adolescent girls’ participation in clinical trials for new HIV prevention products. We conducted 41 in-depth interviews in Dar es Salaam, Tanzania and Pune, India with 22 key informants (KIs). Cultural perspectives on adolescent sexuality varied between countries, with KIs in Tanzania more readily acknowledging adolescent girls’ sexual activity than KIs in India. KIs in both countries felt strongly adolescents must be well-informed about research concepts prior to participation, and emphasis should be given to preventative misconception. Despite concern in both countries that the trials might be seen as encouraging sexual behavior, KIs in Tanzania overwhelmingly supported adolescent inclusion, whereas KIs in India were more cautious. Involving adolescent girls in clinical trials for new HIV prevention products is potentially acceptable, although meaningful community engagement will be necessary.

My history, your history, our history

Varying models of community engagement provide methods for museums to build valuable relationships with communities. These relationships hold the potential to become ongoing, dynamic opportunities for active community participation and engagement with museums. Nevertheless, the nuances of this engagement continue to remain a unique process that requires delicate balancing of museum obligations and community needs in order to ensure meaningful outcomes are achieved. This article discusses how community engagement can be an active, participatory process for visitors to museums. Research projects that utilise aspects of community-driven engagement models allow museums to encourage a sense of ownership and active participation with the museum. Indeed museums can balance obligations of education and representation of the past with long-term, meaningful community needs via projects that utilise aspects of community-driven engagement models. Using an oral history project at Historic Ormiston House as a case study, the article argues that museums and historic sites can encourage ongoing engagement through active community participation in museum projects. While this approach carries both challenges and opportunities for the museum, it opens doors to meaningful and long-term community engagement, allowing visitors to embrace the museum and its stories as active participants rather than as passive consumers.

Prioritizing Racial Equity: How Efforts to Advance Racial Equity Helped Shape the W.K. Kellogg Food & Fitness Initiative.

Racial equity is closely linked to principles of fairness and justice. It is distinct from the concept of racial equality. Community engaged strategies aimed at creating racial equity have generated effective ways to dismantle structural racism-the racialized policies and practices that have shaped economic and social institutions in the United States throughout its history. In crafting the Food & Fitness Initiative, the W.K. Kellogg Foundation made advancing racial equity a top priority. By doing so, it encouraged the community partnerships funded under the initiative to apply theories of expanding equity to real-world situations in order to reduce racial disparities in their neighborhoods. This article reviews the methods that were employed over the course of the initiative to support the partnerships with their efforts. It highlights three key components: (1) being intentional about maintaining a focus on racial equity, (2) concentrating on changing policies and systems, and (3) consistently incorporating meaningful and authentic community engagement into the work. The importance of making the concept of equity concrete and measurable is explored. Furthermore, the article discusses strategies that strengthened the capacity of the partnerships to navigate the policy-making process and to build leadership and shift power to community residents. The article concludes by detailing measures that could guide future efforts to make racial equity a priority and emphasizes that doing so is crucial given the rapid demographic shifts underway across the country.

Abstract C25: Bridging the gap through a targeted research fellowship: Introduction and recruitment of under-represented minority students to the cancer research physician scientist pipeline

Abstract Introduction: The Chicago Cancer Health Equity Collaborative (ChicagoCHEC) is a National Cancer Institute comprehensive cancer partnership led by the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Northeastern Illinois University, and the University of Illinois at Chicago. The mission of ChicagoCHEC is to advance cancer health equity through meaningful scientific discovery, education, training, and community engagement. The current number of individuals in research and cancer health equity-related careers does not mirror the nation's demographics. While there are several gains in health status among racial and ethnic minority groups, disparities in health status have widened for certain indicators. At the culmination of the eight weeks, Research Fellows learned fundamental research practices and methodologies, pertinent research content topics (e.g., cancer inequity and recruitment of underserved minorities in clinical trials), social contexts for health inequity across the cancer continuum, and critical professional development practices and networks. Methods: Eligible participants were all undergraduate and post-baccalaureate students without graduate education from Northwestern University, Northeastern Illinois University, the University of Illinois at Chicago, and City Colleges of Chicago. Quantitative and qualitative data were collected and entered into RedCap via responses to module evaluations and a baseline survey with questions on self-efficacy in cancer disparity research. We applied modules around overarching core competencies envisioned by the ChicagoCHEC Research Education Core: (1) research practices, (2) research content, (3) social context/ interaction and personal development, and (4) professionalization. We recruited an intentional selected sample of underrepresented minorities to achieve representation across various definitions of “underrepresented” not limited to race/ethnicity, citizenship status, gender identification, sexual orientation, first-generation college student, and more. To achieve a high number of competitive candidates, the Research Education Core, one of four cores of the overarching U54 ChicagoCHEC, utilized existing cross-institutional inventories of student programs and groups, and corresponding recruitment strategies. This included Research Education Core staff collaborative presentations at career fairs, with student organizations, and in classes. The program leveraged the expertise of leading scholars and cancer researchers, health professionals, institutional leadership, and community leaders across Chicago taking part as guest lecturers, project mentors, and site visit hosts. The program served as an opportunity to move the needle on health by expanding opportunities to the next generation in a way that also changes the architecture of collaboration, community engagement, and the culture of research education to address health inequities. Core components of the intervention include individual and personal reflection, group exercises, didactic lecture, and classroom-based, and immersion and hands on experiences. These learning vehicles aimed to advance core values and competencies. Core values include teamwork, mentorship, critical thinking, value alignment, professionalism, intellectual curiosity, social justice, and reflective dialogue. Citation Format: Shaneah Taylor, Melinda Monge. Bridging the gap through a targeted research fellowship: Introduction and recruitment of under-represented minority students to the cancer research physician scientist pipeline [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C25.

From Homemaking to Solidarity: Global Engagement as Common Good in an Age of Global Populism

ABSTRACTThe challenging and rapidly evolving times in which we live require that students understand, analyze, and address the complex realities facing their nation and world. However, efforts in global learning have primarily focused on expansion of programs rather than student learning and meaningful community engagement. Building on Bouma-Prediger and Walsh's (2003) essay entitled, “Education for Homelessness or Homemaking: The Christian College in a Postmodern Culture,” this article explores how global engagement models can establish local and global community partnerships for the common good. It also explores how glocalization pedagogies can expand concepts of homemaking and solidarity to reflect important recent trends in development and higher education.

The shifting dynamics of social roles and project ownership over the lifecycle of a community-based participatory research project.

. Community based participatory research (CBPR) is often initiated by academic researchers, yet relies on meaningful community engagement and ownership to have lasting impact. Little is understood about how ownership shifts from academic to community partners. . We examined a CBPR project over its life course and asked: what does the evolution of ownership look like from project initiation by an academic (non-community) champion (T1); to maturation-when the intervention is ready to be deployed (T2); to independence-the time when the original champion steps aside (T3); and finally, to its maintenance-when the community has had an opportunity to function independently of the original academic champion (T4)? . Using sociometric (whole network) social network analysis, knowledge leadership was measured using 'in-degree centrality'. Stakeholder network structure was measured using 'centralisation' and 'core-periphery analysis'. Friedman rank sum test was used to measure change in actor roles over time from T1 to T4. . Project stakeholder roles were observed to shift significantly (P < 0.005) from initiation (T1) to project maintenance (T4). Community stakeholders emerged into positions of knowledge leadership, while the roles of academic partners diminished in importance. The overall stakeholder network demonstrated a structural shift towards a core of densely interacting community stakeholders. . This was the first study to use Social network analysis to document a shift in ownership from academic to community partners, indicating community self-determination over the research process. Further analysis of qualitative data will determine which participatory actions or strategies were responsible for this observed change.

Long-term and meaningful community leadership and engagement in natural resources and environmental governance through university access programs

Indigenous and local people are increasingly asked to participate in natural resources and environmental governance with limited training and knowledge of environmental, economic, and social policies. This article presents the case for the development of university access programming with a specialization in environmental, economic, and social policy towards building long-term capacity of communities for participating in governance. It does so by looking at examples of existing access programs, identifying potential focus areas, and considering the institutional support networks that would be required for such a program to succeed. Access programs are increasingly becoming part of the university landscape, typically filling gaps where community people require skills and qualifications. Access programs also present unique opportunities for interdisciplinarity, decolonization, and community-focused approaches to education.

Home but still engaged: participation in social activities among the homebound.

PurposeParticipation in social and community activities that require leaving one’s home is important to older adults; however, many older adults have difficulty or are unable to leave their dwellings, and little is known from national samples about issues related to remaining active outside the home or the barriers faced by these older adults.Design and methodsWe used the National Health and Aging Trends Study, a nationally representative study of older adults (n = 7197), to understand the following: (1) the importance that homebound and semi-homebound adults place on involvement in social or community activities, (2) their current level of involvement, and (3) reported barriers to participation.ResultsDespite the heavy burden of functional limitations, depression, pain, and falls, homebound adults reported that activities outside the home were important to them ranging from 25.2 % (attend clubs) to 70.0 % (visit family). Similarly, semi-homebound older adults had a strong interest in such participation, including visiting friends and family (81.8 %), attending religious services (72.6 %), and going out for enjoyment (72.5 %). Many homebound adults reported health (42.9–64.1 % depending on the activity) and transportation (12.2–18.2 %) as barriers to participation. Semi-homebound adults also identified health (23.8–41.0 %) and transportation (6.5–10.2 %) as participation barriers.ImplicationsThis information can be useful in designing community programs that will foster meaningful social and community engagement for older adults, which may improve their quality of life.

Appreciative Organizing: Charting a Course for Community Engagement

This article provides a brief overview of Appreciative Organizing (AO), a term coined by the author in her graduate work to describe the roles that dialogue, listening, storytelling, community networks, social bonding, and leadership play in designing and leading meaningful community engagement initiatives that result in transformative partnerships. It offers constructive steps and a real-life example of how AO was used to strengthen relationships between an institution of higher learning and the community it serves. AO posits that in order to strengthen America’s sense of community, public engagement practices must become more inclusive and innovative, and better networked. It illustrates how this community-centered method, grounded in the philosophical principles of partnership, appreciation, hope, and imagination, transformed an administration and built a culture of continuous engagement that helped the college meet and exceed its institutional goals. Further, through this example, the article’s larger objective is to share ways in which this method, when broadly applied, can be used to build trust and strengthen working relationships within a community setting.

The promise of treatment as prevention for hepatitis C: Meeting the needs of people who inject drugs?

Treatment as prevention (TasP) is a concept common to the HIV sector. In this commentary we draw on the literature addressing HIV and HCV TasP, alongside qualitative HCV research, to critically appraise the promise of TasP for HCV and assess the needs of PWID in the future of HCV care. With the advent of highly effective direct-acting antiviral HCV treatments, TasP is now under consideration for HCV. A growing body of literature documents numerous social structural barriers to HCV treatment access and uptake for PWID, among whom HCV is highly prevalent. Yet these barriers – and suggestions for surmounting them – are rarely included in emergent literature on HCV TasP. Although HCV TasP has important advocacy potential for increasing treatment access among PWID, critical reflection on its implications are warranted. We outline potential limitations of TasP for HCV and the conditions under which it might be optimised. We argue that HCV treatment as a prevention strategy can only be realisable in a context of enhanced harm reduction access, meaningful community engagement, and enabling environment interventions informed by the needs and perspectives of PWID.

Conceptualising scholarship within college-based higher education

Purpose – During a period of significant crisis within HE on a global scale, there is a clear need for colleges to clearly articulate the distinct nature of their higher vocational education provision. This need is particularly acute given the current financial and political pressures impacting on a diverse HE landscape. The purpose of this paper is to argue that colleges are well placed to develop and implement an approach to scholarly activity which revitalises links with local communities. Design/methodology/approach – This paper provides a synthesis of recent research on scholarly activity within college-based higher education (CBHE) and the concept of a “civic university”. It also provides a brief case study of how scholarship within the college context can be utilised to promote meaningful community engagement. Findings – Working productively with community organisations, groups and individuals, colleges will be provoked to recast the complex relationship between teaching, research and community engagement in a manner appropriate to their immediate context rather than a national agenda. Moreover, a strengthened relationship between colleges and their local communities will recapture the rich heritage of vocational education in widening participation and raising aspirations towards education in general. Originality/value – This paper attempts to relocate current discussions of CBHE scholarly activity within the context of civic engagement. It will be of interest to colleagues across the higher vocational education sector, both nationally and internationally, in situating their institutional and departmental scholarly activity strategies within the context of the communities which they serve.

Partnering with American Indian communities in health using methods of strategic collaboration.

The Association for Prevention Teaching and Research (APTR) sponsored six regional workshops in 2010 on community engagement and community-engaged research. One of the six workshops was a collaborative effort between the Great Plains Tribal Chairman's Health Board (GPTCHB)-Northern Plains Tribal Epidemiology Center and the College of Public Health at the University of Nebraska Medical Center (UNMC-COPH). To create a meaningful and dynamic forum for the exchange of ideas and co-learning between researchers from urban, tribal and nontribal communities and to build the groundwork for development of sustainable partnerships between researchers and American Indian (AI) communities to eliminate health disparities. To enhance meaningful community engagement, we utilized methods of Strategic Collaboration using the Appreciative Inquiry, 4D Change Process Model and designed several interactive group activities including Collaborative Learning and Understanding Exercises (CLUE) and the Research Café. The key themes that emerged from the interactive sessions stressed the importance of building relationships and trust; mutual use and sharing of data; and acquiring knowledge, skills, and abilities to enable sustainable research partnerships with AI communitiesConclusions: Innovative, dynamic, and strategic collaborative methods of Appreciative Inquiry and the World Café can served to engage people in a constructive dialogue to create a shared vision and plan for more meaningful research partnerships based on principles of equity and social justice, essential for the elimination of health disparities. These collaborative methods can be replicated and adapted in diverse communities, locally, nationally, and globally.

Conceptualizing and Measuring Community Preparedness Within Public Health Preparedness and Response

Since 2001, the Centers for Disease Control and Prevention's Public Health Emergency Preparedness cooperative agreement has supported state, territorial, and local public health departments in preparing for and responding to public health emergencies. This conceptual article describes complexities identified and lessons learned in developing community preparedness performance measures for the Centers for Disease Control and Prevention's public health preparedness program. Challenges arose in (a) defining community; (b) measuring meaningful community engagement; and (c) determining a strategy for collecting, aggregating, and analyzing data from diverse state, territorial, and local health departments. This article contributes to prior work describing conceptual challenges in developing standardized measures of performance at the federal level and suggests ways to potentially mitigate general performance measurement challenges as well as measurement complexities specific to community preparedness. It may be informative for those state, territorial, and local health departments currently implementing (or contemplating implementing) community preparedness activities and for individuals more generally engaged in performance measurement.

Assessing participatory practices in community-based natural resource management: Experiences in community engagement from southern Africa

The emphasis on participatory environmental management within international development has started to overcome critiques of traditional exclusionary environmental policy, aligning with shifts towards decentralisation and community empowerment. However, questions are raised regarding the extent to which participation in project design and implementation is meaningful and really engages communities in the process. Calls have been made for further local-level (project and community-scale) research to identify practices that can increase the likelihood of meaningful community engagement within externally initiated projects. This paper presents data from three community-based natural resource management (CBNRM) project case studies from southern Africa, which promote Joint Forest Management (JFM), tree planting for carbon and conservation agriculture. Data collection was carried out through semi-structured interviews with key stakeholders, community-level meetings, focus groups and interviews. We find that an important first step for a meaningful community engagement process is to define ‘community’ in an open and participatory manner. Two-way communication at all stages of the community engagement process is shown to be critical, and charismatic leadership based on mutual respect and clarity of roles and responsibilities is vital to improve the likelihood of participants developing understanding of project aims and philosophy. This can lead to successful project outcomes through community ownership of the project goals and empowerment in project implementation. Specific engagement methods are found to be less important than the contextual and environmental factors associated with each project, but consideration should be given to identifying appropriate methods to ensure community representation. Our findings extend current thinking on the evaluation of participation by making explicit links between the community engagement process and project outcomes, and by identifying further criteria that can be considered in process and outcome-based evaluations. We highlight good practices for future CBNRM projects which can be used by project designers and initiators to further the likelihood of successful project outcomes.

Community as Agency: Community Partner Experiences with Service Learning

The bulk of research on service learning has focused on student outcomes; however, there is a scarcity of research examining the lived experiences of community partners. Additionally, the few studies that exist to date involve agencies and have not included informal networks and civically active citizens. This study consisted of interviews with nine community partners, a combination of agency employees, and active citizens. All of the partners resided in a rural Southern town that worked with a network of service-learning classes on a variety of community-identified projects. The current study supports the contribution of service learning to communities, the importance of investing in reciprocal relationships, and the value added of including community partners who are members of informal networks and civically active residents. Recommendations for further research and strategies to support reciprocal and meaningful community engagement are discussed.