Community Engagement Model Research Articles

COVID-19, Social Isolation, and Mental Health Among Older Adults: A Digital Catch-22.

One of the most at-risk groups during the COVID-19 crisis is older adults, especially those who live in congregate living settings and seniors’ care facilities, are immune-compromised, and/or have other underlying illnesses. Measures undertaken to contain the spread of the virus are far-reaching, and older adults were among the first groups to experience restrictions on face-to-face contact. Although reducing viral transmission is critical, physical distancing is associated with negative psychosocial implications, such as increased rates of depression and anxiety. Promising evidence suggests that participatory digital co-design, defined as the combination of user-centered design and community engagement models, is associated with increased levels of engagement with mobile technologies among individuals with mental health conditions. The COVID-19 pandemic has highlighted shortcomings of existing technologies and challenges in their uptake and usage; however, strategies such as co-design may be leveraged to address these challenges both in the adaptation of existing technologies and the development of new technologies. By incorporating these strategies, it is hoped that we can offset some of the negative mental health implications for older adults in the context of physical distancing both during and beyond the current pandemic.

Living with conflicts in Ghana's Prestea mining area: Is community engagement the answer?

Large scale mines acknowledge that their continuous existence in indigenous communities is threatened without the cooperation and support of local people. In recent times, large-scale mines have attempted to secure Social License to Operate (SLO) and ensure sustainable development (SD) by reconciling business interests with local needs and aspirations. Accomplishing local cooperation and support without threatening business interest remains a top priority for the large-scale mines. Community engagement forms part of the broader Corporate Social Responsibility (CSR) policy initiatives which are often promoted as a way of enhancing sustainable development. This paper examines the local perceptions of the design and application of Golden Star Resources' (GSR) community engagement program. This paper contends that this community engagement model has a positive impact on conflict management regardless of age, sex, education, marital status and occupation of participants. However, presently the model remains symbolic and has not yet attain the status of a real functional strategy since many of local grievances that result in clashes are unresolved. Furthermore, it is believed that GSR's community engagement program is not adequately developed, systematic or moulded to achieve the exact or intended community relation. This paper further contends that the dominant sources and causes of conflict in Prestea is land use conflicts and environmental impact issues.

‘Going digital’ - Lessons for future coastal community engagement and climate change adaptation

Recent decades have witnessed a steady increase in efforts from a range of actors to facilitate and support meaningful and effective engagement with coastal communities and stakeholders. Indeed, this move towards improved participatory approaches are increasingly framed as being integral to successful and sustainable management of coastal resources and spaces, including in the context of climate adaptation The effectiveness of the processes, structures and frameworks underpinning coastal community engagement has always been subject to external and internal drivers; however, the global threat posed by COVID-19 presented, and continues to present, an unexpected shift in approach, and the need for rapid adaptation by those of us working within these spheres. Using the Coastal Communities Adapting Together (CCAT) project as a case study, we explore how engagement with coastal communities and stakeholders in the project areas of Fingal, Ireland, and Pembrokeshire, Wales, has been impacted and forced to adapt as a result of COVID-19. Through a qualitative data collection process, we explore how project teams across different scales have rapidly adapted their models of community and stakeholder engagement, identify successes and failures, and explore challenges that have been faced. Finally, we consider if the legacy of COVID-19 has provided an opportunity for coastal community engagement approaches being used across the globe to become more diverse, adapting to new technologies and increasing accessibility and effectiveness. Insights identified as fundamental to successful adaptation and enhancing resilience include: a rapid response to change, adoption of a diversity of techniques, broadened participation and supported social learning and knowledge exchange.

Accessing Mental Health Services: a Systematic Review and Meta-ethnography of the Experiences of South Asian Service Users in the UK

BackgroundDespite calls to address ethnic inequalities to accessing mental health services in the UK, governmental initiatives have had limited impact. Studies indicate that South Asian communities underutilise mental health services. Previous reviews have identified cultural and institutional factors that may influence service use, but these are mostly narrative and limited in their scope.MethodA systematic literature search resulted in fifteen studies exploring the experiences of seeking help and barriers to accessing and using services from the perspective of British South Asian service users.FindingsQualitative data was synthesised through meta-ethnography, and three themes emerged: Distanced from Services, Dilemma of Trust and Threat to Cultural Identity. South Asian service users were positioned at a distance from being able to access services and stuck in a dilemma of mistrusting White and Asian professionals. They constructed their cultural identity through a set of important values which were neglected by mental health services. Service users, therefore, appeared to engage in an ongoing evaluation of the potential benefits of accessing services against the risks of threat to their personal and cultural identities. The findings are discussed in relation to Eurocentric models of care and community engagement approaches.ConclusionThe review argues that institutional racism and cultural dissonance marginalise South Asian service users from access to quality and effective mental healthcare. It is recommended that services acknowledge the impact of alienation and powerlessness and advance their practices to establish trust and cultural safety for South Asian service users in the UK.

Community-directed distributors-The "foot soldiers" in the fight to control and eliminate neglected tropical diseases.

The neglected tropical diseases (NTDs) affect hundreds of millions of people, predominantly in rural, often difficult-to-access areas, poorly served by national health services. Here, we review the contributions of 4.8 million community-directed distributors (CDDs) of medicines over 2 decades in 146,000 communities in 27 sub-Saharan African countries to control or eliminate onchocerciasis and lymphatic filariasis (LF). We examine their role in the control of other NTDs, malaria, HIV/AIDS interventions, immunisation campaigns, and support to overstretched health service personnel. We are of the opinion that CDDs as community selected, trained, and experienced “foot soldiers,” some of whom were involved in the Ebola outbreak responses at the community level in Liberia, if retrained, can assist community leaders and support health workers (HWs) in the ongoing Coronavirus Disease 2019 (COVID-19) crisis. The review highlights the improved treatment coverage where there are women CDDs, the benefits and lessons from the work of CDDs, their long-term engagement, and the challenges they face in healthcare delivery. It underscores the value of utilising the CDD model for strong community engagement and recommends the model, with some review, to hasten the achievement of the NTD 2030 goal and assist the health system cope with evolving epidemics and other challenges. We propose that, based on the unprecedented progress made in the control of NTDs directly linked to community engagement and contributions of CDDs “foot soldiers,” they deserve regional and global recognition. We also suggest that the World Health Organization (WHO) and other international stakeholders promote policy and guidance for countries to adapt this model for the elimination of NTDs and to strengthen national health services. This will enhance the accomplishment of some Sustainable Development Goals (SDGs) by 2030 in sub-Saharan Africa.

Towards people-private-public partnerships: An integrated community engagement model for capturing energy access needs

It is widely accepted that community engagement is vital for achieving sustainable development outcomes. While governments in several low-income countries have introduced community engagement for their electrification initiatives, the adequacy of traditional top-down approaches to capture community needs has been contested. In this paper, we holistically assess the barriers to needs-centric community engagement. Based on a community survey with 1.016 participants and 54 semi-structured interviews with government institutions and energy businesses in Uganda and Zambia, we unpack the relationships between communities and the public sector, and between communities and energy companies to interrogate the realities of community engagement in rural electrification. We find considerable gaps between community preferences for needs-centric engagement and how public and private sectors are currently engaging. Key institutional barriers for needs-centric community engagement are vertical and horizontal disconnections within the public sector as well as challenging and ineffective sharing of crucial information. For energy companies the main obstacle is the limited value attributed to a deep understanding of community needs. Based on our results, we develop an integrated model for community engagement focused on capturing energy needs. The model combines top-down and bottom-up engagement approaches where public institutions play a catalytic role in setting a flexible enabling environment for energy companies to establish deep connections with local communities, and where communities are given a platform to define and communicate immediate and long-term needs through context-specific means.

Muslim perspectives on advance care planning: a model for community engagement.

Background:Advance care planning is the process of communicating and documenting a person’s future health care preferences. Despite its importance, knowledge of advance care planning is limited, especially among the Islamic community. In addition, little is known about how the Islamic community views advance care planning in the context of their religious and cultural beliefs.Objectives:We aimed to increase knowledge of the importance of advance care planning, to improve health care provider and public knowledge, and to encourage dialogue between the community and health care providers.Methods:We organized a community event and assembled a multi-disciplinary panel. Through a moderated discussion, the panel members offered their perspectives of advance care planning within a Muslim context.Results:Approximately 100 individuals attended the event including community members, health care providers, medical students, and faith leaders. More than 90% of respondents rated the event as very good or excellent, found the session useful and were encouraged to reflect further on advance care planning.Conclusion:This event was successful in raising awareness about advance care planning within the Islamic community as well as educating health care providers on Islamic views. This model of community and health care provider engagement may also be beneficial for other faith groups wishing to discuss advance care planning within their respective religious and cultural contexts.

Leadership, Education, Advocacy, and Development (LEAD): A Latina Leadership and Community Engagement Model on the US-Mexico Border

Leadership, Education, Advocacy, and Development (LEAD): A Latina Leadership and Community Engagement Model on the US-Mexico Border

Process of community engagement in a mixed model research: A success story from Kolkata India

Community engagement in relation to HIV/AIDS has so often been a topic of discussion in India, substantial involvement of the community has rarely been a mainstream practice The general concept of community engagement is letting research projects achieve success by involving the participants directly into the research work, and implementing the results and the inferences obtained from those projects for the betterment of participants. We tried our level best to put this theory in practice at Medical College and Hospital, Kolkata, India during year 2015-2016. Apart from some teething problems that cropped up at the initial stage of the study, which was difficult and time taking to solve. The advantages of community involvement, as the experience showed, outweighed such minor difficulties. The final developed model for community engagement among marginalized population was successful and we can recommend this model for robust data collection and interpretation expecting a fruitful end result. Keywords: HIV/AIDS, Community engagement, Community involvement.

Abstract PO-021: A hub and spoke model to improve cancer care quality: Advancing Cancer Care Together (ACCT) for Asian American Medicaid beneficiaries in Orange County, California

Abstract Introduction: Orange County (OC) is home to the third-largest population of Asian Americans in the U.S., including the largest population of Vietnamese outside of Vietnam. While breast, lung and colorectal cancers are the top overall causes of cancer incidence and mortality in OC, unique cancers are prevalent among Asian and Pacific Islanders including liver and stomach cancers. The University of California, Irvine Chao Family Comprehensive Cancer Center (UCI CFCCC) adapted a hub-and- spoke model of care (Elrod & Fortenberry, 2017) to increase efficiency among underserved Asian Americans who continue to experience disparities in screening, early detection, and access to cancer treatment. Methods: Our hub-and-spoke model arranges service delivery assets into a network between community organizations through culturally/linguistically competent and trained community health navigators, OC medicaid primary and specialty care providers for low/moderate complexity patients, and UCI CFCCC for high-complexity cancer treatment. UCI CFCCC serves as the anchor establishment (hub) which offers a full array of services. This is complemented by community providers and care coordinators at local Federally Qualified Health Centers (spokes) which offer culturally-tailored primary prevention services. The community patient navigators (rim) located at community-based organizations, routes patients needing more tailored services to the spokes or hub for screening or treatment. Results: Patient Navigators at OC Herald Center, OC Asian Pacific Islander Community Alliance, and Vietnamese American Cancer Foundation have educated 2,246 Korean, Vietnamese, and Chinese individuals on cancer prevention and screening guidelines. Of those, 320 medicaid members have been routed to KCS Health Centers (Korean-serving FQHC lookalike), Southland Integrated Services, Inc (Vietnamese and Chinese-serving FQHC), or Medicaid community providers for cancer screening and/or follow-up. 64 community providers have been trained on NCCN guideline adherent care for Korean, Vietnamese, and Chinese. UCI CFCCC has developed an algorithm/pathway for Medicaid-serving community physicians to easily refer qualified Vietnamese, Chinese, or Korean patients to the hub for complex care or clinical trials. Conclusions: The current COVID-19 pandemic has exacerbated disparities in screening and early detection, and compounds the uncertainty about the importance of optimizing cancer care quality (i.e. access proportion and timeliness, adherence to guidelines, patient satisfaction). Disparities being highlighted in COVID-19 has shown us the power and need of community engagement models to rapidly catalyze and create unique community-based efforts that strengthen capacities and infrastructures, and promote best practices in cancer prevention and early detection designed to decrease cancer incidence and/or mortality in the communities we serve. Citation Format: Cevadne Lee, Ellen Ahn, Mary Anne Foo, Sherry Huang, Becky Nguyen, Tricia Nguyen, Jacqueline Tran, Robert Bristow, Sora Park Tanjasiri. A hub and spoke model to improve cancer care quality: Advancing Cancer Care Together (ACCT) for Asian American Medicaid beneficiaries in Orange County, California [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-021.

Building and Sustaining a Community Advisory Board of African American Older Adults as the Foundation for Volunteer Research Recruitment and Retention in Health Sciences.

Older African Americans' participation in health-related research is severely limited; they are not involved in sufficient numbers to ensure the applicability of advancements in medical and behavioral health. This research participation gap exacerbates older African Americans' vulnerability to poor health outcomes and disparities. The Michigan Center for Urban African American Aging Research employs a progressive community-based participatory model that utilizes a structured community advisory board (CAB) of African American older adults in metro Detroit, Michigan to oversee the research recruitment and retention of fellow minority older adult research participants. CAB members develop and support community health programming that provides free resources to older adults and also serves as fertile ground for recruiting participants in a volunteer research registry. CAB members are also provided ongoing training on social and behavioral health research and are supported in acting as a consultancy to outside researchers where they can be compensated for their expertise and engagement. This community-engaged model of sustaining a CAB of African American older adults offers key lessons learned on building relationships and trust, valuing and leveraging community members' expertise and time, sharing decision-making, and fostering genuine community all while promoting research recruitment and retention among underserved populations.

Systems Thinking for Bottom-Up Social Innovation: An Examination of Social Practices

The principles of sustainability and social design have been widely adopted to develop new models of community practice, engagement and innovation. Considering the growing interest of social practices and sustainable models, systems thinking provides an opportunity to further frame and organise various design activities to develop a deeper understanding of the spaces of impact through social innovation. This paper examines the practices of existing social enterprise models and the complexities involved in implementing new structures for community involvement through co-creation, co-design and facilitation. Cybernetics, as a way of looking at and engaging with systems, is discussed to position the role of the designer. Using mapping as a visualisation tool and conversational activity, case-studies are evaluated to provide a broad framework of bottom-up systems thinking through participatory methods to enhance social and cultural values.

From the Outside in: Bringing Student Engagement to the Centre

This case study looks at the University of Manchester Library Student Team (UMLST) as a model for inclusive community engagement. It examines the impact of working with students as co-creators and explores how the ideas, insights and value they bring serve to drive change in a way that enables the Library to deliver in relation to current student needs, rather than react to past requirements. It discusses how the UMLST have engaged in and delivered peer-led support, how they have shaped space and policies and how this model places the Library within the community, instead of framing the community as an outside group or other with which to engage.

Developing and evaluating a model of public involvement and engagement embedded in a national longitudinal study: HealthWise Wales.

IntroductionWorldwide large cohort studies have invested in community engagement to promote studies and aid recruitment. HealthWise Wales, a national population study, aims to create a register of ‘research ready’ participants and provide long-term follow up data on health behaviours, outcomes and wider social and environmental determinants. Public involvement and engagement was key to the development of HealthWise Wales. We describe how a model for promoting HealthWise Wales was co-produced with members of the public.MethodsMembers of the public were invited to take part in a workshop, either in North or South Wales, to discuss public involvement in long-term cohort studies. Information on community engagement, projects that had used the concept of "citizen scientists" to promote involvement, and other large longitudinal studies was provided to 15 members of the public prior to the meeting. Eight of these attended the workshops, to explore the concept of citizen scientist and how it may relate to HealthWise Wales.ResultsData from two workshops was used to draft a protocol for involvement that was reviewed and refined by members of the public. The protocol describes two levels of public involvement, HealthWise Wales Champion or Supporter. The Champion is a more formal role that requires promoting the project at public events, whereas Supporters pledge to promote the study to friends and family. Training was provided to 17 of the 26 members of the public who had expressed interest in becoming HWW Champions. Twelve trained Champions attended 41 events to promote the study and collect ’consent to contact’ forms from members of the public.ConclusionsIt is possible to develop a model of community engagement with members of the public to promote and raise awareness of a national population study in Wales. It is essential that adequate resource is provided to support the concept.

Viewpoint: Defeating the water crisis: Community matters!

Community participation is critical in enhancing rural sustainability in terms of managing indigenous water harvesting structures. The long-standing illusion that the water crisis can only be tackled through a top down strategy design has been shattered by a successful community engagement model using the social, financial, and human capital of the community in the semi-arid village Laporiya of Rajasthan in India. The positive externalities created through the process of community engagement are not only via knowledge sharing but also water sharing with neighboring villages. The appropriate policy suggestion for the positive externalities so created is to build an extra market for ‘ideas’ creating incentives for these innovative practices in rural settings by allowing them to flourish in a hazard free manner, free from the risk of encroachment of common lands, or of future inter-sectoral resource conflict arising out of any industrial activity. The state-managed community participation has also been successful in reviving and creating water harvesting structures, but the sustainability of such program is at stake, in the absence of social capital. Communities do matter but in ways that sustain the local economy.

Stakeholder Perspective of Handling the Deceased during the Nipah Virus Outbreak in Kerala, South India, 2018.

In any outbreak situation, a poor stakeholder response can impede the outbreak control and can have high economic and social cost. We conducted a qualitative study to understand stakeholder response in handling of the Nipah deceased persons during the outbreak of Nipah in Kerala, 2018. To understand the responses and to generate knowledge from the data, we used grounded theory approach for the study and conducted in-depth interviews and focus group discussion. Mixed public response and swift state response emerged as the main themes in our study. Under the "mixed public response," three categories emerged, including anxiety and fear, conflicting religious beliefs, and humanitarian concern. Under the "swift state response," the categories emerged were critical resources and robust guidance. A collective effort involving the administration, local and religious groups, and a culturally acceptable scientific protocol proved to be good examples of gaining social acceptance. Kerala puts forth a model of efficient community engagement and communication to gain public support and acceptance in a fatal disease outbreak.

Cultural Competency Education in Pharmacy Curricula-Need and Implementation

Abstract: Cultural competency is the ability to interact effectively with people of different cultures. Development of cultural competency skills among health professions students has been a challenge to integrate into curricula. However, further integration of cultural competency concepts may be needed in the future as some literature has shown that training in this area can lead to benefits in patient outcomes. To date there have been different methodologies used to enhance cultural competency including didactic training, community engagement and experiential models focused on communication. The Substance Abuse and Mental Health Services Administration has also provided a multi-step plan to help in advancing health professionals’ skills in the area of cultural competency. In addition, the Accreditation Council for Pharmacy Education has made cultural competency a major standard for pharmacy programs, thus further integration of valuable instructional methods for cultural competency are needed. Other professional organizations have also started to develop tools and resources to help educate individuals in the area of cultural competency. In the future, further integration of cultural competency education will be necessary to comply with accreditation standards and to improve health professionals’ skillset, which may in turn result in improved patient outcomes. Key words: Cultural competency, United States, Curriculum, Education, Healthcare.

Uptake and acceptability of human papillomavirus self-sampling in rural and remote aboriginal communities: evaluation of a nurse-led community engagement model

BackgroundAboriginal women experience disproportionately higher rates of cervical cancer mortality yet are less likely to participate in screening for early detection. This study sought to determine whether a community-based HPV self-sampling service model can effectively recruit never-screened and under-screened Aboriginal women to participate in cervical cancer screening; assess the clinical outcomes; and explore the acceptability of the model from the perspective of the participants.MethodsAboriginal women aged 25–69 years of age were recruited from eight rural and remote communities in New South Wales, Australia to participate in HPV self-sampling via a community-based service model. Outcome measures were: number of women screened by HPV self-sampling, their prior cervical screening status (under-screened or never-screened), clinical outcomes and participation in follow-up pathways of care, and satisfaction with the service model.ResultsIn total, 215 women conducted a HPV self-sampling test and 200 evaluation surveys were completed. One-fifth of participants (n = 46) were never-screened and one-third (n = 69) were under-screened. Many were unsure of their screening status. Nine women were HPV 16/18 positive and eight had completed all follow up by the conclusion of the study. A further 30 women tested positive for a high risk type other than HPV 16/18 (HPV other), of which 14 had completed follow up at the conclusion of the study. Satisfaction with the HPV self-sampling kit, the process of self-sampling and the service model was high (> 92% satisfied on all items). Many women had difficulty understanding their official HPV results and placed high importance on the nurse explaining it to them.ConclusionsA community-based service model that respects Aboriginal Women’s Business can effectively recruit under-screened and never-screened Aboriginal women to complete cervical cancer screening. Furthermore, this service model supports them to complete recommended follow-up care and engage with their local existing health services.

Emergent model for community engagement: Developing courses and programs

This retrospective emergent design qualitative evaluation study documents the development of a unique model for community engagement and engaged scholarship in higher education. The primary novel aspect of the model is participatory involvement of both the target audience for the program and representatives of various stakeholder groups who initiated, conceptualized, tested, assessed, and evaluated the courses and program with the professor. Members of the target audience and stakeholder groups also recruited participants, contributed to refining the courses and program to meet the needs of the stakeholder groups, and contributed to redesigning courses for online learning. The model emerged while developing and evaluating the Informal Science Institutions Environmental Education Graduate Certificate Program (ISI Program) at the University of South Florida. Garnering the resources of a previously untapped audience, the informal science education (ISE) community, presented the university with a way to increase enrollment. Also reported are sample benefits accrued to learners in the program, to the ISI community, to the community at large, and additional benefits to the University.

From "Step Away" to "Stand Down": Tailoring a Smartphone App for Self-Management of Hazardous Drinking for Veterans.

BackgroundUS military veterans who screen positive for hazardous drinking during primary care visits may benefit from a mobile app. Step Away is an evidence-based mobile intervention system for the self-management of hazardous drinking. However, Step Away was not designed for veterans, and differences between veterans and civilians could limit the reach and effectiveness of the app with this population.ObjectiveThe primary objective of this study was to repurpose Step Away to address the needs and preferences of the veteran primary care population. The Method for Program Adaptation through Community Engagement (M-PACE) model was used to guide the adaptation process. This model can serve as a generalizable approach that other researchers and intervention developers can follow to systematically tailor mobile health tools for a new population.MethodsVeteran patients who screened positive for hazardous drinking during a primary care visit (n=12) and peer providers employed by the US Veterans Health Administration (n=11) were recruited to systematically review Step Away and provide feedback on its content and presentation via Web-based surveys and a semistructured interview. Participant feedback was reviewed through an iterative process by key stakeholders who adjudicated which suggested modifications to the app could enhance engagement and effectiveness with veterans while maintaining program integrity.ResultsUsability ratings of the individual modules of Step Away were uniformly positive across patients and peers, as was the perceived utility of the app overall. Personalized feedback on the health consequences and costs of drinking, options for customization, and the measurement-based care capabilities of the app were viewed as facilitators of engagement. Conversely, lengthy text, small font, and a lack of interactive features were viewed as potential barriers with the older primary care population. Modifications to create a veteran version of the app (Stand Down: Think Before You Drink) included altering the appearance of the app to incorporate more veteran-centric content, adding links and options for resources and activities for veterans, and reducing the amount of text and adding veteran-specific references and common concerns and triggers for drinking in this population.ConclusionsThe M-PACE model provided a systematic approach to repurpose Step Away to fit the needs and preferences of veteran primary care patients who engage in hazardous drinking. Stand Down may serve as an innovative, low-cost means of expanding access to care for veterans who engage in hazardous drinking.