Partnership Outcomes Research Articles

Climate Justice Strategies Implemented by Public Health Nurses and Their Community Partners.

To describe nurses' and community-based organization representatives' collaborative strategies for advancing climate justice with communities. This study used a descriptive, qualitative research design. Data were gathered from August 2022 to February 2023 with nurses (n = 8) and their community partners (n = 5) in the United States. Community partners were representatives of community-based organizations. Photovoice provided greater context for the thematic analysis of collaborative strategies discussed in semi-structured interviews. Nurse participants worked in academic or non-profit settings. Nurse-community partnerships addressed corporate pollution and promoted Indigenous sovereignty and multispecies justice. Themes included investigating disease and health events, identifying at-risk populations and connecting them with resources, providing health teaching and counseling, organizing communities and coalitions, and advocating for policy development and enforcement. Self-care supported resilience and well-being in the long struggle for climate justice. Findings from this study indicated that nurses and their community partners strategize to transition communities away from systems of extraction towards local and regenerative systems that support resilience. Nurses and their community partners recognized the importance of applying an expansive understanding of climate justice, including intersections of pollution and multispecies justice, to promoting planetary health. Findings from this study support nurse-community collaboration in policy work to advance planetary health. This study also supports nurses' collective action with their community partners to address the effects of white supremacy and colonization. Future research is needed to evaluate the outcomes of nurse-community partnerships for planetary health. Nurses have called for action on climate justice; however, evidence of effective nursing strategies that advance climate justice is sparse. This study is the first to describe the collaborative strategies nurses implement with community partners to support the transition from injustice to justice in communities most burdened by climate change and industrial pollution.

Exploring academic and clinical nurses’ perspectives on evidence-based nursing course for undergraduates from perspectives of academic-practice partnerships: a qualitative study

AimTo explore nurses’ perceptions of evidence-based nursing courses for undergraduates through academic-practice partnerships.DesignA deductive thematic analysis based on the practice-academic logic model.MethodsFifteen academic and clinical nurses were interviewed between November and December 2023, either online or through face-to-face meetings. Each interview lasted 20–30 min. The interview outline was constructed based on the practice-academic partnership logic model, which was followed during the process of recorded, analyzed, and checked.ResultsThemes identified include inputs (e.g., stakeholder commitment), activities (e.g., communication), outputs (e.g., nursing projects), and outcomes (e.g., improved competence). These themes highlight the various aspects and outcomes of academic-practice partnerships in evidence-based nursing courses.ConclusionEffective academic-practice partnerships are crucial for developing evidence-based nursing courses, leading to positive educational and professional outcomes.ImpactNurses’ perceptions provide valuable guidelines for developing effective evidence-based nursing courses.Patient or public contributionNo patient or public users participated in this study.

The Associations Between Parenting Self-Efficacy and Parents’ Contributions to the Home-School Partnership Among Parents of Primary School Students: a Multilevel Meta-analysis

High-quality partnerships between families and schools can bring enormous benefits to the development, learning, and wellbeing of children. Decades of research has identified parenting self-efficacy as a key factor influencing parents’ contributions toward effective home-school partnerships. However, the strength of this association has varied significantly across studies with the aggregated strength remaining unclear. This meta-analysis aimed to investigate the associations between parenting self-efficacy and various aspects of parents’ contribution to the home-school partnership, namely home-based involvement, school-based involvement, home-school communication and relationships, as well as parental expectations and aspirations among parents of primary school students. Moderator effects were also examined. Through systematically searching six databases and screening papers, we included 50 independent studies involving 185 effect sizes (N = 20,043 children). Results showed a small to medium correlation between parenting self-efficacy and the multidimensional construct of home-school partnership outcomes (r = .189). The associations were stronger for education-focused parenting self-efficacy (r = .183) than general parenting self-efficacy (r = .114) and were stronger still for home-based participation (r = .248) and parental expectations and aspirations (r = .248) than school-based participation (r = .124) and parent-teacher communication/relationship (r = .090). We detected limited moderating effects of child gender, parent gender, ethnicity, sample type (general or targeted), and socio-economic status and publication bias. Overall, this meta-analysis provides evidence to support the positive relationship between parenting self-efficacy and parents’ contributions to the strength of the home-school partnership. Implications and suggestions for future research are discussed.

Exploring drivers of success in partnerships that support federal trail management in the United States

The use of partnerships with external stakeholders to support federal land management objectives is a common practice amongst government agencies. At the US Forest Service and National Park Service, partnerships provide critical support to each agency’s recreation stewardship objectives. While partnerships help these agencies increase capacity and meet recreation objectives, literature on federal land management partnerships typically focuses on large-scale collaborations and single case studies. Little remains known about how inputs and processes relate to partnership success across multiple individual partnerships to support federal trail management objectives. This exploratory study examines the perceptions of agency and partner managers in a sample of 89 partnerships to support trail work at the US Forest Service and National Park Service. Using linear regression and relative importance analysis, results show that trust, capacity, and interdependence are the most salient factors to partnership success. Furthermore, our analysis reveals a secondary set of factors that should also be considered when attempting to improve partnership outcomes.

Culture of engagement

Students can influence their education through evaluations and as representatives in university decision-making bodies. A way to give them more power is through participation in course development as equal partners. In this study, the relationship between the outcome of a student-teacher partnership and a culture of student influence and engagement is explored. This is done through specifically targeting examination, an area where formal power rests far away from the actual partnership. The partnership outcome was evaluated through post-project surveys and group interviews, together with post-course evaluations. The students in the project, most of them with significant experience as student representatives, emphasized their ability to make meaningful change. At the same time, the students taking the revised course appreciated the implemented changes. A culture of engagement positively affected the outcome of the partnership, while the partnership itself strengthened students in their roles as change agents.

LCLS-II Helium Refrigeration System : A comprehensive overview of the project

SLAC National Accelerator Laboratory has upgraded to LCLS-II, featuring a 4 GeV superconducting accelerator composed of 37 cryomodules and two large helium refrigeration systems with a total cooling capacity of 8 kW at 2.0 K. The cryogenic system at SLAC is the successful outcome of a nine-year partnership between SLAC, Fermilab, and Jefferson Lab. This paper highlights the joint efforts between Jefferson Lab and SLAC in the development and implementation of the LCLS-II Cryogenic Plants. It details the project organization, schedule, budget, staffing profile and procurement strategy.

Financial system dynamics model for multidimensional flexibility in toll road PPPs: a life-cycle analysis

Although scholars have developed simulation models and analyzed bankability criteria in numerous papers to enhance the financial outcomes of Public-Private Partnerships (PPPs), the intersection between both fields considering alternatives to assess the financial impact of flexibility in both scope and financing, remains underdeveloped. To address this gap, this paper introduces a financial model that assesses the financial impact of suitable life-cycle flexibility alternatives while coexisting with revenue performance alterations in each project phase within toll road PPPs. This model serves as a tool to gain insight into the planning of strategic actions to implement flexibility in both scope and financing. Based on system dynamics and validated using financial data from two toll road PPPs in India and East Europe, simulation results suggest that two key drivers (capital expenditures and debt repayment period) have the greatest influence on financial performance. Findings support the implementation of flexible scopes to effectively address the most influential exogenous factor impacting the financial performance of PPPs, namely traffic shortfalls. This model provides a suitable tool for assessing the life-cycle economic sustainability of PPPs in uncertain and complex environments.

Composing Math: An Interdisciplinary Faculty Partnership to Improve Undergraduate Writing in a Research-Focused Capstone Course

This article describes the outcomes of a faculty partnership between a math professor and a composition professor to improve the final paper in a research-focused senior capstone math course. Much attention has been paid in recent years to the importance of undergraduate research experiences and how to best create and support such endeavors. However, little space has been dedicated to helping math faculty design and scaffold writing assignments to support their students' development as scholars. We describe how our partnership took place, the changes we made to existing assignments and the creation of new ones, and an assessment of our efforts completed by an interdisciplinary group of faculty and students, which showed marked improvement in the areas of information literacy, critical thinking, and quality of writing.

Understanding the evolution of trust in a participatory health research partnership: A qualitative study.

Advancements in evaluating the impact of participatory health research (PHR) have been made through comprehensive models like the community-based participatory research (CBPR) conceptual model, which provides a useful framework for exploring how context and partnership processes can influence health research design and interventions. However, challenges in operationalising aspects of the model limit our understanding and evaluation of the PHR process. Trust is frequently identified as an important component of the CBPR model, which supports the development of key partnership outcomes, such as partnership synergy. However, trust continues to be limited to a binary view (as present or absent), which is problematic given its inherently dynamic and temporal nature. The aim of this qualitative study is to understand the evolution of trust in the national public and patient involvement (PPI) network in Ireland. Participants from the PPI network (n = 15/21) completed a semistructured interview discussing the evolution of trust by reviewing four social network maps derived from a previous longitudinal study. Following Braun and Clarke, we used reflexive thematic analysis, to iteratively develop, analyse and interpret our mediated reflection of the data. Participants described the evolution of trust as a function of three contextual factors: (1) the set-up and organisation of the network, (2) how people work togetherand (3) reflection on the process and outcomes. Their descriptions across these themes seemed to vary depending on partnership type with National Partners and Site Leads having more opportunities to demonstrate trust (e.g., via leadership roles or more resources), compared to Local. Thus, visibility and the opportunity to be visible, depending on the set-up and organisation of the network and how people work together, seemingly play an important role in the evolution of trust over time. Based on these findings, we provide important questions for reflection across themes that could be considered for future PHR partnerships. Given that the opportunity and visibility to build and maintain trust over time may not be equally available to all partners, it is important to find ways to invest in and commit to equitable relationships as the key to the success (i.e., longevity) of partnerships. We reflect on/offer important implications for those engaging in PHR partnerships and those who fund such research. A Research Advisory Group comprising four research partners (representing academic, serviceand community organisations) from the PPI Ignite Network provided input and approval for the research objectives of this study as well as previously published work informing this study. Informal consultation occurred with members of this group to discuss findings from this study, assisting with the way findings are presented and described, to be accessible for diverse audiences. Two Research Advisory Group members were involved in the interpretation of the results, and one is a co-author of this manuscript (Zoe Hughes).

The Measurement Approaches to Partnership Success (MAPS) Questionnaire and Facilitation Guide: A Validated Measure of CBPR Partnership Success.

Partnerships that effectively engage in certain key structural and process functions are more likely to meet their research goals and contribute to longer-term health equity outcomes. Ongoing evaluation of partnerships' level of achievement of these key functions, along with their fidelity to the guiding principles of community-based participatory research (CBPR), is therefore essential to understand how they can achieve desired partnership outcomes. This article describes the validated Measurement Approaches to Partnership Success (MAPS) Questionnaire and the use of an accompanying Facilitation Guide in helping members of CBPR partnerships evaluate their partnership's state of development and interpret findings to improve its structure, processes, and outcomes. We describe the conceptual framework guiding the development of the MAPS Questionnaire and its 81-item across seven key outcome dimensions, along with 28 items measuring precursor characteristics of CBPR partnership outcomes. The Facilitation Guide provides general guidelines for sharing, interpreting, and applying results within partnerships using a participatory process, definitions and items for each dimension, an example of presenting summary means, and dimension-specific reflective questions for discussion. We offer recommendations for practical uses of the MAPS Questionnaire and Facilitation Guide. Whether used as a comprehensive tool or by dimension, the MAPS Questionnaire is conceptually sound and empirically validated for evaluating how CBPR partnerships can achieve long-standing success. CBPR partnerships at any stage of development will find the MAPS Questionnaire and Facilitation Guide useful in measuring and interpreting indicators of partnership success, sharing results, and improving their ability to contribute to achieving health equity goals.

Assessing the Outcomes of Circular Economy and Waste Management Partnerships between Indonesia and Denmark

In the pursuit of sustainable environmental solutions, the bilateral collaboration between Indonesia and Denmark has emerged as a focal point of study, particularly within the spheres of the circular economy and waste management. This research, anchored in a qualitative descriptive methodology, delves deep into the intricacies of this partnership, shedding light on its commendable strides in fostering the exchange of best practices and pioneering waste reduction techniques, notably waste incineration. The collaboration, rooted in a shared commitment to environmental sustainability, has not only aimed at diminishing the adverse environmental repercussions of waste but has also sought to catalyze opportunities for both nations to achieve their waste management objectives more efficiently. However, the journey has not been devoid of challenges. A significant impediment identified is Indonesia's constrained reservoir of expert resources, which has had tangible repercussions on the effective implementation and scaling of circular economy initiatives. This limitation underscores a broader challenge faced by many emerging nations, emphasizing the critical need for capacity building and resource augmentation. The research's implications are manifold, extending beyond policy formulation to influence practitioners and academics in the environmental and sustainable development sectors. By offering a nuanced perspective on the dynamics of international collaborations, the study underscores the potential and challenges of such partnerships in addressing pressing global environmental issues, thereby serving as a beacon for similar endeavors in other developing contexts.

Peer MD Coaching Partnership Outcomes Between an NCI-designated Cancer Center Genetics Service and a Community Cancer Network Hospital

Purpose Patients with cancer seen in rural and underserved areas disproportionately face barriers to access genetic services. Genetic testing is critical to inform treatment decisions, early detection of another cancer, and to identify at-risk family members who would benefit from screening and prevention. Methods We conducted a prospective cohort study to examine medical oncologist’s genetic testing ordering trends at Olympic Medical Cancer Center (OMCC), a community network hospital. Phase I focused on observation of clinic processes. Phase II incorporated peer coaching from cancer genetics experts from Fred Hutchinson Cancer Center (FHCC) for OMCC medical oncologists. Number of genetic testing tests ordered was compared between phases. Results Of the total patients with cancer, 29 out of 415 (7.0%) received genetic testing in phase I and 25 out of 219 (11.4%) in phase II. Although it did not reach statistical significance (p=0.057), uptake of genetic testing increased by 22% between phases. 4 out of 19 (21.1%) patients with pancreatic cancer and 6 out of 35 (17.1%) patients with ovarian cancer received testing when NCCN recommends offering genetic testing to 100% of these patients. Conclusion Peer coaching intervention from cancer genetics experts led to increased ordering of genetic testing by medical oncologists. Efforts made to 1) standardize gathering of personal and family history of cancer, 2) review biomarker data suggestive of a hereditary cancer syndrome, 3) facilitate ordering tumor and/or germline genetic testing every time NCCN criteria are met, 4) encourage data sharing between institutions, and 5) advocate for universal coverage for genetic testing will help realize the benefits of precision oncology for patients and their families seeking care at community cancer centers.

The Scaling Down of SAGCOT Public Private Partnerships

Abstract This study analyses SAGCOT’s public-private partnership policy, which anticipated attracting external investors in large-scale nucleus farms to commercialise smallholder farmers. Data were collected from a review of SAGCOT policy documents, a compilation of SAGCOT registered partners and qualitative interview data collected from private companies, government officials, farmers and outgrower associations. The majority of SAGCOT registered commercial partners are small- to medium-scale and most of them were already operating in the area before SAGCOT was established. We conclude that the SAGCOT investment strategy, in practice, has been linked to small- to medium-scale operations and also mainly to already existing enterprises, which stand in contrast to the initially envisioned model of attracting new large-scale farming enterprises to the region. We argue that there is a need for SAGCOT and policy makers to learn from this dissonance between initial policy ambition and actual outcomes of SAGCOT public-private partnerships.

Research priorities to prevent and treat diabetic foot ulcers-A digital James Lind Alliance Priority Setting Partnership.

To establish outcomes of a priority setting partnership between participants with diabetes mellitus and clinicians to identify the top 10 research priorities for preventing and treating diabetic foot ulcers (DFUs). Due to the COVID-19 pandemic, the James Lind Alliance Priority Setting Partnership process was adapted into a digital format which involved a pilot survey to identify understandable uncertainties with high relevance for participants tested by calculating the content validity index; a main survey answered by 53 participants living with diabetes and 49 clinicians; and a final digital workshop to process and prioritise the final top 10 research priorities. The content validity index was satisfactory for 20 out of 25 uncertainties followed by minor changes and one additional uncertainty. After we processed the 26 uncertainties from the main survey and seven current guidelines, a list of 28 research uncertainties remained for review and discussion in the digital workshop. The final top 10 research priorities included the organisation of diabetes care; screening of diabetes, impaired blood circulation, neuropathy, and skin properties; vascular surgical treatment; importance of self-care; help from significant others; pressure relief; and prevention of infection. The top 10 research priorities for preventing and treating DFUs represent consensus areas from persons living with diabetes and clinicians to guide future research. These research priorities can justify and inform strategic allocation of research funding. The digitalisation of James Lind Alliance methodology was feasible.

Different in so many ways: Exploring consumer, health service staff, and academic partnerships in a research advisory group through rapid ethnography.

Consumer and community involvement (CCI) encompasses the range of consumer engagement activities across the research cycle. Research advisory groups (RAGs) are a common method of CCI that may empower the consumer voice in research. However, there is limited evaluation of RAGs to guide occupational therapists considering this as a CCI strategy in research. The aim of this study was to explore the processes and outcomes of a RAG partnership for an eDelphi study. Rapid ethnography enabled a rich, thick description of the RAG through triangulation of field notes, a monthly research team log, focus groups, and an individual interview. Data were analysed using reflexive thematic analysis. Recruitment targeted consumers, health service staff, and academics with experience in CCI to enhance the diversity of perspectives guiding the eDelphi study. The RAG met four times over 4 months. Seven diverse RAG members were recruited resulting in a RAG of 12 members, including the research team that included two consumers. Reflexive thematic analysis resulted in an overarching theme: Different in so many ways, which reinforced that authentic CCI in research continues to be rare even for stakeholders with experience in CCI. There were four subthemes: Set up for success, Authentic and capable facilitation, Structures and strategies for genuine partnerships, and A ripple effect of benefits. Findings added to the limited research regarding RAGs and highlighted that a short-term RAG with 12 diverse stakeholders was an effective strategy to foster mutually beneficial and meaningful collaboration. Partnering with two consumer co-researchers in RAG planning, implementation, and evaluation was central to success. Findings demonstrated that with careful co-planning and recruitment, capable facilitation with support of a committed research team (inclusive of consumers), and empowering meeting processes and structures, a short-term RAG resulted in many benefits to participants and enhanced research outcomes.

How do adoption choices influence public private partnership outcomes? Lessons from Spain and Portugal transport infrastructure

Purpose Maximising real efficiency benefit (REB) is currently being replaced with access to private finance as core public–private partnership (PPP) adoption motive. This later choice focusses on short-term performance, compromising REB and the procurement of infrastructure that meets the need of the present and future generations, which the former accomplishes. The paper aims to review these observed changes to understand the rationales and significance behind such switch.Design/methodology/approach Secondary data powered exploratory study. Deployed X-inefficiency theory to triangulate and reduce bias and select country cases to provide the proper foundation for the descriptive “what happened?” question, such as “what was the failure concerns with a particular adoption choice?”Findings The shift to accessing private finance adoption motive against REB failed to improve PPP project performance or meet efficiency and sustainability. Instead, it allows the private sector to assume financial risk without synergistic monitoring from the government to determine their contractual and commitment trust level, which would help achieve the five-dimensional sustainable performance measurement system for PPP. This led to the struggles of PPP projects in Portugal and Spain, where cost overruns and high demand forecast led to project failures. A recommendation, blended finance with its technical assistance additionality, is considered pivotal to addressing access to private finance motive shortcomings.Originality/value This study improves best practices for new and existing adopters by systematically establishing that adoption ideology is a cardinal variable that influences PPP project success. When not correctly adopted, it can make the most successful structured projects face complexities and uncertainty.

Learning together: A case study of a partnership to co-create assessment criteria

This case study outlines a staff-student partnership to co-create generic assessment criteria to use in a UK business school. It highlights the potential for staff-student partnerships to create a temporary subfield, in which the established power differentials of academia are dissolved and partnership values can be established. We draw on a series of 10 semi-structured interviews with partnership participants. The values that underpin partnerships are linked to three major phases of the partnership process: establishing the partnership, partnership operation and atmosphere, and the partnership outcomes. The findings indicate that the values of authenticity, reciprocity, and inclusion are critical antecedents to establishing a successful partnership and that careful attention should be paid to establishing the partnership. The case extends our understanding of the partnership process by emphasising these antecedents. The study is multi-authored, which reflects an extension to the partnership process described in the case study.

Improving primary health care through partnerships: Key insights from a cross-case analysis of multi-stakeholder partnerships in two Canadian provinces.

Background and AimsMulti‐stakeholder partnerships offer strategic advantages in addressing multi‐faceted issues in complex, fast‐paced, and rapidly‐evolving community health contexts. Synergistic partnerships mobilize partners' complementary financial and nonfinancial resources, resulting in improved outcomes beyond that achievable through individual efforts. Our objectives were to explore the manifestations of synergy in partnerships involving stakeholders from different organizations with an interest in implementing organizational solutions that enhance access to primary health care (PHC) for vulnerable populations, and to describe structures and processes that facilitated the work of these partnerships.MethodsThis was a longitudinal case study in two Canadian provinces of two collaborative partnerships involving decision makers, academic representatives, clinicians, health system administrators, patient partners, and representatives of health and social service organizations providing services to vulnerable populations. Document review, nonparticipant observation of partnerships' meetings (n = 14) and semi‐structured in‐depth interviews (n = 16) were conducted between 2016 and 2018. Data analysis involved a cross‐case synthesis to compare the cases and framework analysis to identify prominent themes.ResultsFour major themes emerged from the data. Partnership synergy manifested itself in the following: (a) the integration of resources, (b) partnership atmosphere, (c) perceived stakeholder benefits, and (d) capacity for adaptation to context. Synergy developed before the intended PHC access outcomes could be assessed and acted both as a dynamic indicator of the health of the partnership and a source of energy fuelling partnership improvement and vitality. Synergistic action among multiple stakeholders was achieved through enabling processes at interpersonal, operational, and system levels.ConclusionsThe partnership synergy framework is useful in assessing the intermediate outcomes of ongoing partnerships when it is too early to evaluate the achievement of long‐term intended outcomes. Enabling processes require attention as part of routine partnership assessment.

Partnering for UN SDG #17: a social marketing partnership model to scale up and accelerate change

Purpose The United Nations (UN) 17 Sustainable Development Goals (SDG) places partnerships as a vital mechanism, which strengthens the implementation of change strategies. The SDG targets are ambitious; acknowledging the interconnected multifaceted issues that are currently facing society. Similarly, social marketing thought is transitioning to embrace systemic change strategies, realising no one organisation can have an impact on the emerging grand challenges. Partnerships are the 5th P in the social marketing mix, however, partnerships is also a nebulous term which has been criticised for lacking theoretical development. This study aims to answer the call from both the UN and social marketing community for further research to guide the development and implementation of impactful transformative partnerships. Design/methodology/approach A robust mixed method approach to develop and test a social marketing partnership model is presented. Trust and relationship commitment are at the forefront of successful partnership exchanges. Morgan and Hunt’s (1994) trust and relationship commitment model is extended into the social marketing domain. Findings The findings validate Hasting’s (2003) call for social marketers to listen to their commercial marketing counterparts, positioning trust and commitment as essential to change strategies. As the degree of complexities in the multifaceted world continues to accelerate, partnerships for change (UN SDG #17) will pay off, driving more effective and smarter collaborations amongst a diverse range of stakeholders at different levels in different networks. Partnerships will elevate social marketing to deliver systemic transformation for complex problems with far reaching collective and sustainable consequences. Research limitations/implications With trust/mistrust critical to successful exchanges and exchange central to social marketing, quantitative measurement of the antecedents to and outcomes of partnerships can inform the evaluation, impact and management of social marketing interventions. Practical implications Three contributions are made, which support the selection, implementation and evaluation of social marketing partnerships. Key social marketing partnership characteristics are operationalised supporting the partnership selection process. Measurement scales are developed to assist in evaluating partnership relationships over time. The model is empirically tested to investigate the relationships between key mediating variables of social marketing partnerships. Originality/value This paper presents a validated 5th P Partnership model for social marketers, accelerating social marketing’s capacities to deliver systemic transformation for complex problems with far reaching collective and sustainable consequences and UN SDG #17.

A community-engaged approach to understanding environmental health concerns and solutions in urban and rural communities

BackgroundFocus groups and workshops can be used to gain insights into the persistence of and potential solutions for environmental health priorities in underserved areas. The objective of this study was to characterize focus group and workshop outcomes of a community-academic partnership focused on addressing environmental health priorities in an urban and a rural location in Alabama between 2012 and 2019.MethodsSix focus groups were conducted in 2016 with 60 participants from the City of Birmingham (urban) and 51 participants from Wilcox County (rural), Alabama to discuss solutions for identified environmental health priorities based on previous focus group results in 2012. Recorded focus groups were transcribed and analyzed using the grounded theory approach. Four follow-up workshops that included written survey instruments were conducted to further explore identified priorities and determine whether the priorities change over time in the same urban (68 participants) and rural (72 participants) locations in 2018 and 2019.ResultsConsistent with focus groups in 2012, all six focus groups in 2016 in Birmingham identified abandoned houses as the primary environmental priority. Four groups listed attending city council meetings, contacting government agencies and reporting issues as individual-level solutions. Identified city-level solutions included city-led confiscation, tearing down and transferring of abandoned property ownership. In Wilcox County, all six groups agreed the top priority was drinking water quality, consistent with results in 2012. While the priority was different in Birmingham versus Wilcox County, the top identified reason for problem persistence was similar, namely unresponsive authorities. Additionally, individual-level solutions identified by Wilcox County focus groups were similar to Birmingham, including contacting and pressuring agencies and developing petitions and protesting to raise awareness, while local policy-level solutions identified in Wilcox County included government-led provision of grants to improve septic systems, and transparency in allocation of funds. Workshops in 2018 and 2019 further emphasized water quality as the top priority in Wilcox County, while participants in Birmingham transitioned from abandoned houses as a top priority in 2018 to drinking water quality as a new priority in 2019.ConclusionsApplying a community-engaged approach in both urban and rural locations provided better understanding of the unique opportunities and challenges for identifying potential interventions for environmental health priorities in both locations. Results can help inform future efforts to address locally defined environmental health issues and solutions.