Community Organizations Research Articles

Developing Secular, Non-Dominant Moral Capital in Nonbeliever Communities

Nonbelievers experience harmful marginalization because of the persistence of the immoral nonbeliever stereotype. Nonbelievers is a broad affinity category that includes individuals who are skeptical of religion and identify using terms like atheist, agnostic, secular, humanist, spiritual, and non-religious. Across cultures, nonbelievers are perceived as morally deficient and therefore untrustworthy, resulting in higher rates of harms commonly associate with stigmatization, including emotional abuse, poor habitus, isolation, depression, and violence. One promising pedagogical approach to counteracting the harmful effects of the immoral nonbeliever stereotype focuses on helping secular communities develop secular, non-dominant, moral capital as a source of confidence and resilience. Drawing on a combination of critical re-storying and moral foundations theory, it is possible to develop a secular moral pedagogy that is philosophically robust, accessible to non-philosophers, and applicable in a wide range of nontraditional learning environments. The ultimate goal of this approach is the development of morally intensive secular communities through value centered community organizing. Secular value centered community organizing faces practical challenges arising from within secular communities and from the broader culture. Within secular communities, there is an ambivalence toward value centered community organizing and any other activity that community members associate with religion. At a societal level, the promotion of secular moral education faces strong headwinds in both liberal public schooling spaces and marginalized communities where the community capital has historically been centered in the church. Given these challenges, it is essential that our approach to secular moral pedagogy include a critical analysis of cultural assumptions endemic in secular spaces that put us at odds with our own goals as secular community educators and organizers. Developing secular, non-dominant moral capital provides nonbelievers with the capacity to resist the immoral nonbeliever stereotype and cope with the costs of being seen as untrustworthy, while avoiding strategies that reproduce harmful and exclusionary assumptions.

P-549. Early Results from a Community-Based HIV Rapid Start Initiative, Memphis TN

Abstract Background In 2023, Memphis ranked second in the US for the highest rates of new HIV infections. Friends for All (FFA) is a community-based organization located in Memphis whose aim is to prevent the spread of HIV and improve health outcomes of those living with HIV through a holistic and client-centered approach. To improve health outcomes for people diagnosed with HIV and prevent further transmission, FFA launched a rapid test and treat HIV initiative with the primary aim of increasing viral suppression and retention in care. Methods We offered free HIV testing at our sexual health clinic and pop-up community testing sites. Individuals that tested positive for HIV and had no prior HIV diagnosis were offered rapid start HIV treatment, defined as treatment initiation within 72 hours. Staff administered an assessment of barriers to linkage and scheduled the appointment. Results Between July 2023 and March 2024, FFA tested 2131 clients for HIV. Of the 125 who tested positive, 14 met rapid start criteria. We successfully initiated treatment inside the 72-hour window for 12 (83%) of the 14 eligible. Ninety days post rapid start, 10 (83%) achieved viral suppression and 10 (83%) attended at least 3 medical appointments. The two clients who did not initiate rapid start treatment were identified at pop-up events outside of normal clinic hours, and it was not possible to schedule an appointment within 72 hours. Both of these clients did, however, initiate treatment within 7 days of diagnosis. Conclusion While linkage to rapid start ART has been successful in the clinical setting, barriers remain at the patient and organizational level that prevent similar outcomes in the outreach setting. Patients reported barriers to appointment attendance, including food insecurity and transportation. At the organizational level, limited access to ART outside of clinic hours and prescriber requirements for in-person care prevent successful linkage from outreach settings. We are investigating the use of a mobile unit to initiate rapid start treatment in outreach settings and telehealth options for ongoing HIV care. To address patient level barriers, FFA will continue to provide transportation and food services to those living with HIV. Disclosures David Closs, MPH, Gilead Sciences: Grant/Research Support

P-1462. Utilization of a Point-of-Care Hepatitis C Test to Treat in People Experiencing Homelessness with Street Medicine Outreach

Abstract Background Persons experiencing homelessness (PEH) have disproportionately higher rates of untreated chronic hepatitis C virus (HCV) than the public. Improved community funding and resources are needed to expand HCV rapid point-of-care (POC), confirmatory testing, treatment and follow-up. Given that PEH face competing priorities (unstable housing, food access, addiction, other infections), it is our role as clinicians to reduce barriers to HCV treatment, understand hesitancies for deferring treatment, and design programs to improve accessibility. This is the pilot project of a Street Medicine (SM) based initiative to use POC testing for HCV amongst PEH with linkage of care to a federally qualified health clinic (FQHC). Hepatitis C Screening and Treatment Protocol HCV- Hepatitis C Virus POC- Point of Care CHASS- Community Health and Social Services HbsAg- Hepatitis B Surface Antigen CBC- Complete Blood Count CMP- Complete Metabolic Panel Methods SM provides medical care to PEH outside of a hospital setting. Medical students and residents were recruited to form a HCV outreach team at Henry Ford Hospital and trained in HCV testing via OraQuick rapid antibody (Ab) test. During SM outreach, PEH were provided education on HCV and offered POC testing with a $10.00 grocery gift card. If a patient was identified as HCV Ab positive they were provided free transportation to a FQHC for confirmatory testing. If diagnosis was confirmed, they were evaluated for eligibility for simplified HCV treatment, check-ins to assess adherence and sustained virologic response (Figure 1). Results From February-April 2024, 103 PEH were tested using POC HCV testing on SM runs, with 4 positive results. 3 of 4 patients were confirmed for CHASS clinic appointments. 1 patient presented to clinic follow-up but deferred confirmatory testing bloodwork, demonstrating challenges in arranging for HCV clinic follow-up care. Conclusion Previous studies have shown that lack of insurance, prior authorization and referral process, active injection drug use or alcohol use, lack of knowledge of HCV treatment, and limited healthcare workforce and infrastructure have all contributed to the low treatment rate in the homeless. Using trusted community organizations with SM, this initiative aims to reduce testing and transportation barriers in order to eliminate HCV in PEH. Larger numbers of positive patients are needed to best assess the feasibility of the program, and if providing all testing and treatment at the point of care is needed to improve compliance. Disclosures Marcus Zervos, MD, Johnson and johnson: Grant/Research Support|Moderna: Grant/Research Support Seema Joshi, MD, AbbVie: Grant/Research Support

P-484. Community Food Pantries Provide Unique Opportunities for Linkage to HIV Care in Newly Diagnosed Individuals

Abstract Background Food insecurity has been associated with sexual risk behavior that increases Human Immunodeficiency Virus (HIV) risk in cis women and sexual and gender minority (SGM) individuals such as transactional sex for money or food and multiple sexual partners. SGM people and cis women experiencing insecure immigration status also often face financial and housing instability, stigma, discrimination, lack of social support as well as food insecurity. North Jersey Community Research Initiative (NJCRI) is a non- profit organization in Newark, NJ that provides medical care and support services for highly vulnerable and hard to reach patient populations including unhoused individuals, people living with HIV/AIDS, LGBQTIA community members, people who use drugs and new immigrants. In 2023, NJCRI expanded food pantry status neutral services to the community and offered onsite HIV counselling and testing to pantry visitors. Methods From April 2023 to April 2024, NJCRI provided HIV testing for 3630 individuals with 1025 being tested at the pantry. Results There were 63 total positive tests with 13 diagnosed at the pantry. Of those diagnosed at the pantry, 2/3 (9) identified as SGM and 1/3 (4) as cis women. All the SGM individuals were Latinx. All reported to be new migrants. All diagnosed were linked to care and services and started on ART on the day of diagnosis.OrganizationTotal Test (Statewide)NJCRI Pantry TotalTotal (+) - StatewideNJCRI Pantry - (+)NJCRI363010256313Self-IdentificationSGMn/ax429Cis-Womenn/ax94EthnicityLatinxn/an/a4213Blackn/an/a170Othern/an/a40 Conclusion Migrant individuals from known groups for higher HIV associated risk experiencing food insecurity benefit from HIV testing at nontraditional testing sites. Food pantries run by trusted community partners who provide integrated HIV care and prevention services can serve as entry points for HIV care for new immigrants. Community organizations serving this community should be aware of the opportunity to engage individuals in HIV care and prevention services and link to care. Disclosures All Authors: No reported disclosures

Recordkeeping needs and capabilities of small migrant community organisations run by volunteers

Purpose This paper aims to present the findings from a qualitative study of recordkeeping needs and capabilities in four small migrant community organisations run by volunteers. Design/methodology/approach The authors conducted eight semi-structured interviews and two workshops with leaders and people responsible for creating and managing records in four small migrant community organisations in Australia to understand the records that they create and the problems they encounter in managing these records. Findings The research revealed a wide variety in the recordkeeping competencies and the digital skills in the four community organisations. The organisations focus their efforts on financial records, which they manage relatively well in the short term, but they have no strategy in place to preserve records for the long term. Practical implications Simple recordkeeping guidelines that focus on the basics and can be adapted to different socio-cultural contexts and levels of technological expertise should be developed for community organisations that rely on volunteers to manage their records. Originality/value The findings from this research provide a unique contribution to the records management literature, which previously had not paid much attention to how small community organisations run by volunteers manage their records.

Attitudes and Perspectives of Service Providers on Persons Who Use Stimulants in Northern and Central Mexico.

Methamphetamine and other stimulant use are increasing across Mexico while treatment options and public funding remain scarce for substance use treatment. This study examined the attitudes and perspectives of service providers who work with persons who use stimulants in Mexico. Semistructured qualitative interviews were conducted with 20 service providers in diverse cities in the northern and central regions of Mexico, from healthcare centers and harm reduction community-based organizations (CBOs). All interviews were audio-recorded, transcribed, and de-identified. We conducted a thematic analysis to identify and compare common themes and patterns among participants, including portrayal of persons who use stimulants, dynamics of use, attitudes toward persons who use stimulants, and treatment availability and effectiveness. First, service providers considered that persons who use stimulants have more complex backgrounds than others who use other substances. Second, although most providers mentioned trauma, pain, and the risk environment, CBO providers also stressed the importance of accounting for hedonism for understanding stimulant use trajectories. Third, treatment options are based on the type of services the institutions provide, usually constrained to guidelines for any substance use. In a few cases, cocaine treatment guidelines are used regardless of the type of stimulant used. Fourth, although health care services are abstinence-based, providers acknowledge the effectiveness of harm reduction approaches. In contrast, CBOs provide person-centered options. Overall, although service providers are aware of the increase in stimulant use, stigmatizing attitudes are prominent among some of them. However, providers in CBOs were more sensitized to their communities' specific needs. Public policy recommendations include training to eliminate institutional stigmatization, the importance of first-person language, harm reduction effectiveness, and implementing community-based interventions to improve stimulant use-related services.

Perspectives and experiences regarding pre-exposure prophylaxis (PrEP) in a community sample of Veterans with unhealthy alcohol use: overall and across sexual orientation and gender identity

BackgroundUnhealthy alcohol use is an independent, modifiable risk factor for HIV, but limited research addresses alcohol use and HIV prevention synergistically. Groups that experience chronic stigma, discrimination, and/or other marginalization, such as sexual and gender minoritized groups, may have enhanced HIV risk related to unhealthy alcohol use. We described awareness of and experiences with pre-exposure prophylaxis (PrEP) among a community sample of Veterans reporting unhealthy alcohol use (relative to those without), overall and across self-reported sexual orientation and gender identity.MethodsUsing data collected from a national online survey of Veterans recruited via Facebook ads, community organizations, and listservs, we assessed variation in four PrEP outcomes (knowledge, experience, willingness, and conversations with doctors) across patterns of unhealthy alcohol use among all respondents reporting any lifetime drinking (n = 1,041) and then within sexual orientation and gender identity groups using Chi-square or Fisher’s exact tests.ResultsAmong 1,041 eligible Veterans, 440 (42%) screened positive for unhealthy alcohol use. Veterans with unhealthy alcohol use were not more likely to have heard of PrEP (58.2% vs. 55.4%, p = 0.37), but trended toward more likely to have taken PrEP (7.5% vs. 5.0%, p = 0.09), to be willing to take PrEP (30.5% vs. 27.6%, p = 0.06), and to have spoken with a doctor about PrEP (11.4% vs. 7.7%, p = 0.04). Those with heavy episodic drinking also trended toward higher prevalence of PrEP awareness (60.0% vs. 54.6%, p = 0.09), and were more likely to have taken PrEP (8.3% vs. 4.7%, p = 0.02), to be willing to use PrEP (34.6% vs. 25.5%, p < 0.01), and to have had conversations with doctors about PrEP (12.7% vs. 7.2%, p < 0.01). Similar patterns were observed for severe unhealthy alcohol use and past-year frequent heavy episodic drinking. Generally, sexual/gender minoritized Veterans with unhealthy alcohol use reported more PrEP-affirming responses than those without but associations with unhealthy alcohol use were similar.ConclusionsUnhealthy alcohol use was prevalent, particularly among Veterans with minoritized sexual orientation/gender identity, but not clearly linked to increased PrEP-literacy and use despite its known status as an HIV risk factor. Across groups, > 25% of individuals were willing to take PrEP. Interventions targeting both alcohol use and HIV prevention should capitalize on this.

Service Accessibility and Wellbeing in Amman’s Neighborhoods: A Comparative Study of Abdoun Al-Janoubi and Al-Zahra

Amman, the capital of Jordan, has undergone significant urbanization over the past seventy years, evolving from a small village into the nation’s largest city. This rapid growth has led to unpredictable population increases, creating socioeconomic disparities and affecting residents’ access to services and overall wellbeing. This study investigates the impact of service accessibility on wellbeing in two neighborhoods of Amman: Abdoun Al-Janoubi and Al-Zahra. Data were gathered from 492 household heads through structured interviews and systematic sampling. The study analyzed accessibility factors such as safety, convenience, comfort, and esthetics, and their influence on residents’ wellbeing, defined by positive emotions, social relationships, and overall life meaning. The results indicate a robust correlation between service accessibility and resident wellbeing, with Abdoun Al-Janoubi demonstrating superior accessibility and higher wellbeing compared to Al-Zahra. Key insights are illustrated, with data supporting the idea that enhanced urban service access improves quality of life. Safety and esthetics are critical factors, while comfort is less significant. Abdoun Al-Janoubi’s favorable attributes lead to higher wellbeing scores. Recommendations for urban planners include improving Al-Zahra’s infrastructure, enhancing esthetics, and optimizing public transport. Community organizations should promote social engagement, while local governments need to adjust zoning laws and upgrade public amenities.

HIV service use among minoritized racial and ethnic transgender and gender non-conforming youth in the U.S South: a qualitative investigation

ABSTRACT Transgender youth are disproportionately affected by HIV, particularly minoritized youth in the US south. To understand HIV service use among transgender youth, we interviewed 25 young racial and ethnic minority clients of four southern community-based HIV service organizations (CBOs), and CBO staff (n = 12), about service access and use. Participants were assigned male at birth and identified as female (n = 8), transgender (n = 11) or gender-fluid or nonbinary (n = 6). The majority were Black/African American or mixed race; four were Hispanic or Latino/a. Most were unemployed; nearly half were unstably housed or homeless during the prior year. Four service types were each used by approximately two-thirds of participants: counseling/support, HIV/STD testing/education, pre-exposure prophylaxis education/prescriptions, and transgender-related medical services (primarily hormone provision). Just over a quarter used social services (e.g., housing, employment). Key facilitators to service use included a non-stigmatizing CBO atmosphere, and easy and convenient access. Poor access (e.g., inconvenient hours, location), lack of transportation or parking, social service needs, and lack of money were barriers. Qualitative reports highlighted unmet social service needs, particularly housing, especially for those without HIV. To reduce disparities, HIV prevention for racial and ethnic minoritized transgender youth should simultaneously address hormone provision, HIV risk reduction and social service needs.

Insight from Latine Community-Based Organizations on Accessing Government Assistance Programs for Low-Income Latine Families in North Carolina

Insight from Latine Community-Based Organizations on Accessing Government Assistance Programs for Low-Income Latine Families in North Carolina

Examine The Role Played by International Actors in Providing Psycho-Social Support to GBV Survivors in Nakivale Refugee Settlement.

This study examines the role of international actors in providing psychosocial support to survivors of gender-based violence (GBV) in the Nakivale Refugee Settlement. Employing a pragmatic research philosophy, a mixed-methods approach was utilized, integrating both qualitative and quantitative data to gain a comprehensive understanding of the psychosocial challenges faced by refugees. A cross-sectional survey was conducted involving 166 participants, including 151 household heads and key informants such as local leaders and NGO representatives. Results revealed that an overwhelming 87% of respondents reported being psychologically affected by GBV, underscoring the urgent need for effective psychosocial interventions. The data indicated that 45.2% of survivors benefited from psychosocial support, enabling them to resume normal lives after experiencing depression. However, significant gaps remain, including economic instability and limited access to legal services, which hinder recovery and reintegration efforts. The findings highlight the critical importance of coordinated efforts among international actors, local governments, and community organizations to enhance the effectiveness of psychosocial support for GBV survivors. Recommendations include strengthening multi-sectoral collaboration, improving access to legal services, and addressing underlying socio-economic factors contributing to GBV in refugee contexts. This study contributes to the discourse on GBV in humanitarian settings and emphasizes the need for sustained investment in mental health and psychosocial services.

Medically Tailored Grocery Deliveries to Improve Food Security and Hypertension in Underserved Groups: A Student-Run Pilot Randomized Controlled Trial

Background/Objectives: Randomized controlled trials (RCTs) are needed to evaluate the impact of food is medicine (FIM) programs, such as medically tailored groceries (MTGs) to treat hypertension among diverse populations. Partnerships between academic centers’ student-run organizations (SROs) and community-based organizations (CBOs) offer critical safety nets for historically underserved groups, positioning these organizations to effectively undertake FIM programs among populations disproportionately affected by hypertension. We conducted an unblinded pilot RCT whose objectives were to assess the feasibility and acceptability of an SRO-coordinated, CBO-partnered MTGs intervention targeting blood pressure (BP) and food insecurity (FI) in underserved groups. Methods: Adult Black/African American and Hispanic/Latinx patients in Durham, North Carolina, where essential hypertension and FI were randomized (parallel arm, computerized 1:1 ratio) to 12 weeks of home-delivered, hypertension-focused MTGs plus in-person nutrition education sessions with compensation (intervention) versus data collection sessions with compensation (control). We offered transportation, childcare, and home visits to facilitate session attendance. The primary outcomes were the eligibility, enrollment, and retention rates (feasibility), and the survey feedback from the participants and CBO partners (acceptability). The secondary outcomes included the changes in the mean BP and median FI score with associated 95% confidence intervals. Results: Medical record screening identified 1577 eligible participants. Of the 94 reached to confirm eligibility, 77 met the enrollment criteria, and 50 were randomized (82% post-screen eligibility, 65% enrollment). A conventional content analysis of 15 participant surveys and CBO partner feedback affirmed the acceptability, noting intervention components that enhanced the retention (e.g., home delivery, transportation support, home visits). Pre–post analyses of secondary outcomes for 13/25 intervention and 15/25 control participants completing ≥2 sessions ≥2 months apart were performed. The intervention was associated with an average change in systolic BP of −14.2 mmHg (−27.5, −4.5) versus −3.5 mmHg (−11.7, 5.9) in the control group. The FI scores improved by −2 (−2.2, −0.5) in the intervention group and −1 (−1.3, −0.2) in the control group. No adverse events were reported. Conclusions: SRO-CBO partnerships could be feasible and acceptable avenues for conducting FIM trials among underserved populations. This multi-component FIM approach enhanced the study equity by addressing the participants’ disease-related social needs and warrants expansion into a powered RCT.

Substance Use Classes Among YMSM in an HIV Digital Health Intervention Program: Implications for Acceptability, Engagement, and Health Outcomes.

Young men who have sex with men (YMSM) have high rates of substance use, which increases their risk for HIV. Digital Health Interventions (DHI) have the potential to address HIV risk overall and reduce harms in the context of substance use. However, there is limited research on how YMSM with different substance use patterns respond to HIV DHIs and how these programs impact participant outcomes. In this study, we used latent class analysis (LCA) to identify subgroups of participants with specific substance use behaviors in the Keep It Up! (KIU! ) program, an HIV DHI with prior documented effectiveness. This study involved 2,124 participants in a Type III Hybrid trial, comparing two implementation strategies: one via 22 community-based organizations and another through direct-to-consumer recruitment. Evaluations were done at baseline and 12-week follow-up. This analysis identified four classes of substance use: Low Use (minimal alcohol risks, low illicit drug use, infrequent marijuana), Heavy Use (highest alcohol problems, frequent marijuana, elevated illicit drug use), Alcohol and Marijuana Use (high alcohol problems, frequent marijuana), and Methamphetamine and GBH Use (low alcohol risk, moderate marijuana frequency, high illicit drug use). Participants in the Meth & GHB User class were more likely to have an STI at baseline compared to those in the Low User class. Moreover, Heavy Use, Alcohol & Marijuana Use, and Meth & GHB Use reported a greater number of condomless anal sex partners compared to Low Use. Additionally, although Alcohol & Marijuana Use were more likely to use PrEP at the time of their most recent casual partner at baseline, they exhibited the smallest increase in PrEP use during follow-up compared to the other substance use classes. Our analysis did not unveil substantial differences in the success of implementation in terms of reach, suggesting that both implementation strategies effectively engaged YMSM with different levels of substance use. Our research showed a similar level of engagement, as evidenced by the completion rates of modules and time spent, across all substance use classes. However, those within the Meth & GHB category found the intervention highly acceptable, but less so compared to Low Use and Alcohol & Marijuana Use. Understanding how distinct substance use profiles influence intervention outcomes and exploring varied implementation methods can augment future prevention endeavors, broadening the scope and impact of public health initiatives.

“If we rebuild the kitchen, we rebuild the heart”: Post-relief transformational politics in the Isthmus of Tehuantepec, Mexico

In September 2017, the strongest earthquake in the last century shook the Isthmus of Tehuantepec, Mexico, the region hosting the largest concentration of wind turbines in Mexico. In the municipalities with over 1600 wind turbines, the seismic shock affected 70% of the dwellings. After the disaster, community organisations undertook efforts to foster collective processes of territorial autonomy in towns hosting wind projects or expected to host projects in the future. Drawing on participant ethnographic methods and long-term collaboration with social movements, this article provides insights into the processes whereby disaster recovery holds the potential for territorial practices that imply a shift away from capitalist norms to alternative practices of territorial autonomy, sufficiency and rebellion. To this end, the article analyses a women-led kitchen reconstruction project implemented by the Assembly of Indigenous People of the Isthmus in Defence of Land and Territory (APIIDTT) to re-activate local economies through endemic crops and traditional crafts in six towns of the region. While emphasising broader tensions, pressures and contradictions resulting from disaster capitalism, the article argues that the project fostered collective autonomy processes against present and future extractive projects through endemic crops, traditional crafts and the identification of female leadership within and across the communities. Therefore, the article spotlights the different forms of bottom-up emancipatory politics that emerge in post-disaster contexts while interlinking them with wind power expansion.

Service capacity and disability resource integration: A strategic survey of immigrant and refugee-serving agencies in Illinois.

Immigrants and refugees in the United States often face significant barriers in accessing social services, including mental health support, legal assistance, ESL or related education, housing, vocational training, workforce resources, transportation, and citizenship support. This article explores the strengths and challenges of community-based organizations welcoming centers (CBO WC) in Illinois that serve these populations, including people with disabilities, in culturally appropriate and inclusive ways. The Immigrant and Refugee-Led Capacity Development Network of Illinois, based at the University of Illinois Chicago, collaborated with the state's Office of Welcoming Centers to explore the service capacities of 17 CBO grantees. Thirty-three CBO staff members and 13 CBO leaders participated in online surveys designed to identify organizational strengths, assess needs, and explore opportunities to advance their missions. The findings show a range of strengths and abilities to assist immigrant and refugee communities and the limitations they face in addressing critical needs. Implications and future research approaches are discussed.

NHS-Galleri trial: Enriched enrolment approaches and sociodemographic characteristics of enrolled participants.

Certain sociodemographic groups are routinely underrepresented in clinical trials, limiting generalisability. Here, we describe the extent to which enriched enrolment approaches yielded a diverse trial population enriched for older age in a randomised controlled trial of a blood-based multi-cancer early detection test (NCT05611632). Participants aged 50-77 years were recruited from eight Cancer Alliance regions in England. Most were identified and invited from centralised health service lists; a dynamic invitation algorithm was used to target those in older and more deprived groups. Others were invited by their general practice surgery (GP-based Participant Identification Centres in selected regions); towards the end of recruitment, specifically Asian and Black individuals were invited via this route, as part of a concerted effort to encourage enrolment among these individuals. Some participants self-referred, often following engagement activities involving community organisations. Enrolment took place in 11 mobile clinics at 151 locations that were generally more socioeconomically deprived and ethnically diverse than the England average. We reduced logistical barriers to trial participation by offering language interpretation and translation and disabled access measures. After enrolment, we examined (1) sociodemographic distribution of participants versus England and Cancer Alliance populations, and (2) number needed to invite (NNI; the number of invitations sent to enrol one participant) by age, sex, index of multiple deprivation (IMD) and ethnicity, and GP surgery-level bowel screening participation. Approximately 1.5 million individuals were invited and 142,924 enrolled (98% via centralised health service lists/invitation algorithm) in 10.5 months. The enrolled population was older and more deprived than the England population aged 50-77 years (73.3% vs 56.8% aged 60-77 years; 42.3% vs 35.3% in IMD groups 1-2). Ethnic diversity was lower in the trial than the England population (1.4% vs 2.8% Black; 3.3% vs 5.3% Asian). NNI was highest in Black (32.8), Asian (28.2) and most-deprived (21.5) groups, and lowest in mixed ethnicity (8.1) and least-deprived (4.6) groups. Enrolment approaches used in the NHS-Galleri trial enabled recruitment of an older, socioeconomically diverse participant population relatively rapidly. Compared with the England and Cancer Alliance populations, the enrolled population was enriched for those in older age and more deprived groups. Better ethnicity data availability in central health service records could enable better invitation targeting to further enhance ethnically diverse recruitment. Future research should evaluate approaches used to facilitate recruitment from underrepresented groups in clinical trials.

Resilience Amidst Adversity: Experiences of Black Older Adults During the COVID-19 Pandemic.

The paucity of research and policy on the impact of COVID-19 on the experiences of Black older adults in Canada and around the world has intensified the enduring impacts of racism on their health and well-being. To bridge this gap, our study explored the mental health of Black older adults in Montreal during the early period of the pandemic. Using an Afro-emancipatory mixed-method research design, we collected and analyzed data from three sources: a survey, focus group interview with service providers from Black community organizations, and individual interviews with Black older adults. Our findings reveal that Black older adults struggled with mental health challenges, including loss, grief, and intergenerational tensions, and encountered systemic barriers in accessing services. Despite these adversities, participants demonstrated remarkable resilience, drawing upon their faith and community networks for support. This study illuminates the complex experiences of Black older adults during the pandemic and underscores the imperative of addressing mental health and systemic barriers. Understanding ongoing challenges is crucial for developing targeted interventions and policies that promote long-term resilience and equitable healthcare for Black older adults.

Effectiveness of Adaptive Physical Education Programs for Students with Disabilities in Canada

Purpose: The aim of the study was to analyze the effectiveness of adaptive physical education programs for students with disabilities in Canada Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Adaptive Physical Education (APE) programs in Canada aim to enhance the physical fitness and overall well-being of students with disabilities by tailoring physical activities to their unique needs. Research indicates that such programs can lead to improvements in various fitness components, including muscular strength, cardiovascular endurance, and flexibility. For instance, a three-year study involving adolescents with intellectual disabilities demonstrated significant positive outcomes in body composition, muscular endurance, explosive strength, flexibility, and cardiovascular fitness over time. Unique Contribution to Theory, Practice and Policy: Self-determination theory, ecological systems theory &amp; social cognitive theory may be used to anchor future studies on the effectiveness of adaptive physical education programs for students with disabilities in Canada. Teachers should undergo specialized training in adaptive methods, rapport-building, and the use of assistive technologies, such as virtual reality and motion-capture tools, to enhance student engagement. Policies should encourage collaborations between educational institutions, healthcare providers, and community organizations to create sustainable, multi-sectoral APE programs.

The Strength of a Story: Partnering With a Community Organization to Destigmatize Substance Use Disorder.

Stigmatizing attitudes held by health care professionals against individuals with substance use disorder (SUD) result in worse clinical outcomes. Story-listening has been shown to help mitigate bias for medical trainees. We created a narrative-based small-group facilitated discussion between medical students and an individual in recovery from SUD through a direct partnership with a community peer-recovery organization. All session materials were formulated in direct partnership with the community organization. After completing prework, second-year medical students engaged in a 1.5-hour facilitated discussion with a community member in recovery and one attending physician preceptor. Student perceptions of the session and SUD were evaluated using open-ended and Likert-scale questions through an online survey. Community members engaged in their own postsession debrief. One hundred twenty-four second-year medical students, 16 attending physician preceptors, and 10 community members in recovery participated in the session. Students agreed or strongly agreed that they appreciated the session format (92%), that they learned something new about SUD (83%), and that the session was applicable to their future career (92%). Students appreciated the small-group format and hearing someone's lived experience/perspective. Community members expressed how the session helped humanize health care providers and had interest in participating in future sessions. Working in direct partnership with a local community organization to create an intimate narrative-based educational experience for medical students is feasible, appreciated by medical student participants, and mutually beneficial to community members and can facilitate positive changes in student knowledge and, potentially, bias regarding SUD.

The Role of Community Organisation, Religion, Spirituality and Cultural Beliefs on Diabetes Social Support and Self-Management in Sub-Saharan Africa: Integrative Literature Review.

To examine the evidence for the role of community organisations, religion, spirituality, cultural beliefs, and social support in diabetes self-management, we undertook an integrative literature review utilising MEDLINE, APA PsycINFO, CINAHL, and grey literature databases. The selected articles were appraised for quality, and the extracted data were analysed thematically. The search yielded 1586 articles, and after eliminating duplicates, 1434 titles and abstracts were screened, followed by a full-text review of 103 articles. Ultimately, 47 articles met the inclusion criteria for the review, utilising various study designs, including qualitative, quantitative, mixed-methods, and nonrandomised clinical trials. These findings indicate that spirituality and religiositycan positively affectdiabetes self-managementby providing motivation, coping skills, social support, and guidance for healthy behaviours. A strong social support system enhances diabetes self-management and glycaemic control for individuals with diabetes. However, some aspects of religion and culture, such as beliefs about medications, may also pose challenges or barriers to diabetes self-management. Adherence to medication, food choices, physical activity, and the use of complementary oralternative medicine can be influenced by sociocultural factors. Additionally, cultural beliefs and social norms influence understanding diabetes aetiology, management, and symptom reactions. The findings highlight that it is crucial to understand the cultural, religious, orspiritual influences that can either assist or impede self-management habits in individuals with diabetes and could inform interventions that support personalised and effective care.