Participatory Action Research Approach Research Articles

Bridges between evidence on vaccination intervention and Ukrainian migrant community needs in Poland

Abstract Background Vaccination coverage in Ukrainian migrants’ (UM) children is lower compared to their Polish counterparts. We aimed to identify and adapt effective evidence-based interventions which would address health system barriers to HPV/MMR vaccination in this community. Methods With the help of the Participatory Action Research (PAR) approach, 4 researchers, 6 experts, 6 UM, 7 Ukrainian GPs and 3 teachers identified and discussed transferability of promising HPV/MMR vaccination interventions and their adaptation from the Polish and contextual perspective. The Population-Intervention-Environment-Transfer Model of Transferability (PIET-T) model was used to accompany the steps for determining transferability. Results Three intervention elements were considered as capable for increasing HPV/MMR vaccination uptake: a health promoter, group educational sessions and an online provider training. Adaptations were needed to make them consistent with the contextual needs. The intervention was adapted to involve Ukrainian GPs delivering culturally sensitive education and a Ukrainian coordinator offering navigation support; barriers (lack of information/language barrier) were addressed. The education sessions for parents were taken into account as having potential to increase knowledge and facilitate making informed decisions regarding vaccination. The online education course was assessed as a strategy to possibly enhance GPs knowledge to let them make strong HPV/MMR vaccine recommendations to UMs. Conclusions Both, community-based PAR approach, and the PIET-T model, facilitated the assessment of intervention transferability and adaptation in terms of covering the individual context, pattern and needs of UMs community in Poland, to finally increase HPV/MMR vaccination uptake.

8.N. Scientific session: Transferability and adaptation of vaccination interventions: Learning from underserved communities

Abstract Removing barriers in the health system that make it difficult for cultural, religious or ethnic minorities to access vaccinations is an urgent concern in order to prevent infectious diseases in the future. Childhood vaccine uptake for MMR and HPV in most underserved communities is lower than in the general population. The project RIVER-EU (Reducing Inequalities in Vaccine uptake in the European region - Engaging Underserved communities) engages the migrant community in Greece, females with a Turkish or Moroccan migration background in the Netherlands, the Ukrainian minority in Poland and marginalized Roma communities in Slovakia to remove health system barriers to vaccination. Barriers include, e.g., lack of culturally and linguistically appropriate information, financial barriers, insufficient capacities, coordination and delivery of health care. Based on a Participatory Action Research (PAR) approach we selected and adapted potentially transferable evidence-based interventions in partnership with the communities. First, we pre-selected 6 useful interventions from a realist review on 36 effective vaccine uptake interventions. Second, we assessed them in depth for their transferability. Building a bridge between evidence on interventions and community needs is not an easy task: We involved various stakeholders in a longitudinal process under consideration of contextual conditions in the primary intervention context and the context of the respective underserved community. We co-created knowledge through 25 workshops and 39 interviews or focus groups for decision-making and determining need for adaptation of selected interventions. The aim of this workshop is to present the results of this co-creative process in each country. Special attention is payed to facilitators and barriers for transferability of evidence-based interventions from the perspective of underserved communities, and contextual commonalities and differences that lead to a specific intervention tailoring. This workshop will contribute to an improved understanding of how to consider contextual needs underserved communities have to remove health system barriers to vaccination on the one hand and suitable evidence on interventions to improve their situation on the other hand. The workshop will include five presentations of eight minutes and a questions and answers session to involve the audience. First, an introductory presentation on transferability of interventions for HPV and MMR vaccine uptake to underserved communities in specific contexts will be given. Then each country will present the intervention(s) to address health system barriers adapted to their context. Thereby, we will underline common key elements that have potential for transferability in all countries. After all presentations, we will discuss the need for context-based decision-making on evidence-based interventions and intervention tailoring to improve vaccine uptake for cultural, religious or ethnic minorities. Key messages • Improving vaccine uptake in underserved communities requires local solutions with tailored interventions. Trusted partnerships with various stakeholders are key to reducing health system barriers. • Participatory approaches to evidence-informed decision-making build bridges between evidence on interventions and needs of underserved communities to understand the transferability of interventions.

Immigration‐related stress, depression, and positive parenting among undocumented Central American immigrant mothers

AbstractObjectiveThe purpose of the current study was to examine whether immigration‐related stress is associated with reduced positive parenting and whether this association is mediated by depressive symptoms in undocumented Central American immigrant mothers.BackgroundIn the context of “illegality,” parents can face myriad stressors related to their immigration status, which may lead to heightened emotions, including depressed mood. These experiences may affect family life, including the ways in which immigrant mothers parent their children.MethodThis study examined survey data generated in 2016–2017 by researchers using a community‐based participatory action research approach in partnership with Central American immigrant mothers residing in the Washington, DC, region. The sample for this study included 117 undocumented Central American immigrant mothers of children aged 3 to 11 years.ResultsControlling for age of child, mother's education, and relationship status, analyses revealed that immigration‐related stress was associated with heightened levels of depressive symptoms for mothers. However, mothers' symptoms of depression were not associated with positive parenting. Additionally, no association between immigration‐related stress and positive parenting was found.ConclusionsFindings suggest that mothers, although affected by immigration‐related stress in terms of their own mood symptoms, may deploy mechanisms such as parental self‐sacrifice to protect their children from anti‐immigrant harms.ImplicationsFindings hold implications for future research, including research approaches, and practice.

Implementation of a tailored multifaceted antibiotic stewardship intervention to improve antibiotic prescribing for urinary tract infections in frail older adults (ImpresU) in four European countries: a process evaluation alongside a pragmatic cluster randomized controlled trial

BackgroundWe previously performed a pragmatic cluster randomized controlled trial (RCT) in general practices and older adult care organizations in Poland, the Netherlands, Norway, and Sweden. We found that a multifaceted antibiotic stewardship intervention (ASI) substantially reduced antibiotic use for suspected urinary tract infections (UTIs) in frail older adults compared with usual care. We aimed to evaluate the implementation process of the ASI to provide recommendations for clinical practice.MethodsWe conducted a process evaluation alongside the cluster RCT. The ASI consisted of a decision-tool and a toolbox, which were implemented using a participatory-action-research (PAR) approach with sessions for education and evaluation. We documented the implementation process of the intervention and administered a questionnaire to health care professionals (HCPs) from participating organizations in the intervention and usual care clusters. We evaluated the multiple components of the intervention and its implementation following a structured framework.ResultsThe questionnaire was completed by 254 HCPs from the 38 participating clusters. All components were largely delivered according to plan and evaluated as useful. The decision-tool and toolbox materials were reported to facilitate decision-making on UTIs. Regarding the PAR approach, educational sessions focusing on the distinction between UTIs and asymptomatic bacteriuria were held in all 19 intervention clusters. In 17 out of these 19 clusters, evaluation sessions took place, which were reported to help remind HCPs to implement the ASI. During both sessions, HCPs valued the reflection that took place and the resulting awareness of their behavior. It allowed them to explore implementation barriers and to tailor their local implementation process to overcome these. For example, HCPs organized extra educational sessions or revised local policies to incorporate the use of the decision-tool. Various HCPs took key roles in implementation. Staff changes and the COVID-19 pandemic were important contextual barriers.ConclusionsWe found each component of the multifaceted ASI and its implementation to have added value in the process to improve antibiotic prescribing for suspected UTIs in a heterogeneous older adult care setting. We recommend using a multifaceted, multidisciplinary approach that enables HCPs to reflect on their current practice and accordingly tailor local implementation.Trial registrationClinicalTrials.gov NCT03970356. Registered on May 31, 2019.

Austerity Infrastructure, Gentrification, and Spatial Violence: A Ceaseless Battle over Urban Space in Exarcheia Neighbourhood

AbstractIn this paper, we aim to understand how long‐term state neglect of public infrastructure coexists with a renewed emphasis on profit‐driven infrastructure development in urban contexts. We focus on Exarcheia, an Athens neighbourhood known for its radical character, where a lack of public infrastructure investment aligns with plans for new transport infrastructure and urban regeneration. Using a participatory action research approach and engaging in collective discussions with grassroots organisations opposing these plans, we argue that prolonged austerity following the 2008 economic crisis has redefined state‐funded public infrastructures, aligning them more closely with the speculative interests of real estate, commercial, and infrastructure capital. The interplay of austerity infrastructure, gentrification, and spatial violence manifests as a form of slow urbicide, paving the way for revanchist urban regeneration that prioritises the commercial exploitation of urban space at the expense of the historical, political, and cultural identities of affected neighbourhoods.

Community-based palliative care needs and barriers to access among cancer patients in rural north India: a Participatory action research

BackgroundThis paper aimed to explore the palliative care (PC) needs and barriers to access among cancer patients in a rural region of North India with a high cancer burden.MethodsA Participatory action research (PAR) approach was employed. Situational assessment, community sensitization workshops (CSWs) and door-to-door surveys were planned, conducted and developed over three PAR cycles. A parallel convergent mixed-methods approach was adopted wherein the quantitative data from door-to-door surveys and qualitative data from CSWs and investigator field notes were collected and analyzed to provide a comprehensive understanding of PC needs and barriers to access. Descriptive statistics and thematic analysis were used.ResultsA total of 27 CSWs involving 526 stakeholders were conducted. A total of 256 cancer patients were assessed for PC needs and symptom burden using the Supportive and Palliative Care Indicators (SPICT-4ALL) and the Edmonton Symptom Assessment System (ESAS) tool, respectively. Based on the SPICT assessment, all patients (n = 256) satisfied general and/or cancer-specific indicators for PC. The majority (56.6%) had ≥ one moderate-severe symptom, with the most common symptoms being tiredness, pain and loss of appetite. Analysis of qualitative findings generated three themes: unmet needs, burden of caregiving, and barriers and challenges. Cancer affected all domains of patients’ and their families’ lives, contributing to biopsychosocial suffering. Social stigma, discrimination, sympathizing attitudes and lack of emotional and material support contributed to psychosocial suffering among cancer patients and their caregivers. Lack of awareness, nearby healthcare facilities, transportation, essential medicines, trained manpower and education in PC, collusion, fear of social discrimination, faulty perceptions and misconceptions about cancer made access to PC difficult.ConclusionsThe study emphasize the need for and provide a roadmap for developing context-specific and culturally appropriate CBPC services to address the identified challenges and needs. The findings point towards education of CHWs in PC; improving community awareness about cancer, PC, government support schemes; ensuring an uninterrupted supply of essential medicines; and developing active linkages within the community and with NGOs to address the financial, transportation, educational, vocational and other social needs as some of the strategies to ensure holistic CBPC services.Trial registrationClinical Trial Registry of India (CTRI/2023/04/051357).

In-service teacher education in death education through participatory action research (PAR)

ABSTRACT Current teacher education neglects educational needs, such as death education. A participatory action research (PAR) approach based on the needs and interests of teachers was adopted. One private and two state schools at all levels of non-university education were involved. The objective was to understand a process of change in teaching facilitated by PAR in the context of a teaching innovation project in death education. The results are presented according to the PAR phases. Conclusions are that the training process reduced the gap between scientific knowledge and educational practice, and that specific death education competencies were developed alongside personal growth amongst teachers.

Living less safely through the pandemic in England for people with serious mental and physical health conditions: qualitative interviews with service users and carers of Black African, Caribbean, and South-Asian descent.

COVID-19 Ethnic Inequalities in Mental health and Multimorbidities (COVEIMM) is a mixed methods study to explore whether COVID-19 exacerbated ethnic health inequalities in adults with serious mental and physical health conditions. We analysed data from electronic health records for England and conducted interviews in Birmingham and Solihull, Manchester, and South London. Sites were selected because they were pilot sites for the Patient and Carer Race Equality Framework being introduced by NHS England to tackle race inequalities in mental health. Prior to the pandemic people in England with severe mental illnesses (SMIs) faced an 11-17-year reduction in life expectancy, mostly due to preventable, long-term, physical health conditions. During the pandemic there was a marked increase in deaths of those living with an SMI. This qualitative interview study aimed to understand the reasons underlying ethnic inequalities in mortality and service use during the COVID-19 pandemic for adult service users and carers of Black African, Black Caribbean, Indian, Pakistani, and Bangladeshi backgrounds living with serious multiple long-term mental and physical health conditions. We took a participatory action research approach and qualitative interviews undertaken by experts-by-experience and university researchers Participants were purposively sampled by ethnicity, diagnoses, and comorbidities across three geographically distinct sites in England. Transcriptions were coded inductively and deductively and analysed thematically. Findings indicated multiple points along primary and secondary health pathways for mental and physical health that have the potential to exacerbate the unjust gap in mortality that exists for Black and Asian people with SMIs. Issues such as timely access to care (face-to-face and remote), being treated in a culturally appropriate manner with empathy, dignity and respect, and being able to use services without experiencing undue force, racism or other forms of intersectional discrimination were important themes arising from interviews. These poor experiences create systemic and enduring healthcare harms for racialised groups with SMIs that need to be addressed. Our findings suggest a need to address these, not only in mental health providers, but across the whole health and care system and a need to ensure more equitable healthcare partnerships with service users, carers, and communities from racialised backgrounds who are often excluded.

Efficacy of the Nutrition Education and Screening Tool as a Foundation for Exploring Perinatal Diet and Determinants in Aboriginal and Torres Strait Islander Women of Far North Queensland.

Assessing perinatal diet and its determinants in Australia's Aboriginal and Torres Strait Islander women remains challenging, given the paucity of tools that incorporate Aboriginal ways of knowing, being, and remembering within a quantitative framework. This study aimed to explore the determinants of perinatal nutrition in this population and to evaluate the efficacy of the Nutrition Education and Screening Tool (NEST) in collecting diet-related data in this population. This study employed a Participatory Action Research approach using the NEST as a foundation for structured research inquiry. Self-reported diet and determinants were collected from a cross-sectional cohort of Aboriginal and Torres Strait Islander women from Far North Queensland. Participants (n = 30) declared excess consumption of meat and alternatives, fruit, vegetables and legumes, and dairy and alternatives. Grain and cereal consumption aligned with recommendations; wild-harvested foods comprised a mean 19.75% of their protein intake. Food frequency data were supported by participants' descriptions of how they eat, combine, rotate, and cook these foods. Standard food frequency questionnaires are challenging for Aboriginal and Torres Strait Islanders as their concepts of time and ways of remembering are different from Western understanding. Use of the NEST allowed food frequency items to be explored, clarified, and cross-referenced; yarning provided a degree of support for quantitative data. The results of this study translate to future public health research, practice, and policy. Alternative quantitative measures to determine food frequency should be considered in future studies. These may include the cyclical approach to time that is well understood and integrated by Indigenous cultures.

Peningkatan Pola Asuh Melalui Penyuluhan Gizi dan Kesehatan di Kelurahan Samaan, Kota Malang

Nutrition and health counseling in Samaan Village, Malang City, aims to increase parents' understanding of the importance of proper parenting in supporting child development, especially in the context of stunting prevention. Through a Participatory Action Research (PAR) approach, this activity involved posyandu cadres and the PKK mobilizing team in designing and implementing counseling. The materials presented focused on balanced nutrition, psychological stimulation, and the importance of routine health checks for toddlers. The results of the counseling showed an increase in parents' understanding of the importance of nutrition in supporting children's physical and cognitive development, as well as the application of better parenting.

Edukasi dalam upaya Menekan Kasus Perceraian melalui Pendidikan Agama Islam di Dusun Dasan Lendang Desa Kerumut

The problems that are the basis for divorce in the Dasang Lendang hamlet are caused by quarrels, economic problems, failure to fulfill the elements of kafa'ah in marriage, online shopping that causes debt, online gambling. So this Community Service aims to increase the optimization of religious knowledge in reducing divorce cases in the Dasan Lendang hamlet community, Kerumut Village. This Community Service activity uses the Participatory Action Research (PAR) approach. The method used in this service is Socialization. The results of the service show that providing understanding and knowledge to the community is carried out with a socialization strategy from students and lecturers by providing lectures, counseling and marriage advice to the community. So that the community is aware of the dangers of things such as a) Quarrels, b) economic problems, c) online shopping addiction. the above factors have the potential to cause household problems and trigger divorce. So that the implications for the community are expected to be active in participating in educational activities through the majlis taklim held in the prayer room and in the mosque and lectures by the tuan guru to deepen their knowledge of religion.

Scientific Paper Writing Training: A Boost to Scientific Publication at Institut Agama Islam Nahdlatul Ulama Bangil

Institut Agama Islam Nahdlatul Ulama Bangil is a private university in East Java, Indonesia, affiliated with Nahdlatul Ulama. Despite its commitment to quality education based on Islamic values, the university's lecturers face challenges in publishing scientific articles. Previous research underscores the importance of training, workshops, and technology tools in improving lecturers' scientific publication skills. This article proposes a Participatory Action Research approach for scientific article writing training, involving issue identification, active lecturer involvement, planning, implementation, and evaluation. This approach fosters collaboration and enhances lecturers' scientific writing abilities. Similar successful approaches in other institutions highlight the potential positive outcomes of such training. The goal is to empower lecturers, boost publication rates, and contribute to individual and institutional advancement.

Optimising remote health workforce retention: protocol for a program of research

BackgroundNowhere is optimising healthcare staff retention more important than in primary health care (PHC) settings in remote Australia, where there are unacceptably high rates of staff burnout and turnover. Ensuing consequences for the remote health services and the community are acute – staffing shortfalls in clinics; organisational instability; excessive costs associated with frequent staff recruitment and orientation; diminished access to PHC for patients in need; and lack of continuity of patient care; all of which further entrench poor health outcomes for the community. Optimising remote healthcare staff retention is critical in order to provide high quality and continued PHC. Currently, however, there is paucity of knowledge to inform targeted and effective retention strategies in remote health services.This research program seeks to develop a stronger evidence base to understand (i) what retention strategies are effective in improving morale, job satisfaction, intention to remain in the job, and consequent length of service for remote healthcare staff; (ii) how best to ‘bundle’ these strategies for different health workforce groups; and (iii) how these ‘bundles’ work in different service contexts.MethodsThis paper describes a five-year implementation research program in partnership with twelve remote Aboriginal and Torres Strait Islander Community Controlled Health Services (ATSICCHS) in the Northern Territory and Queensland, Australia. Overall methodology follows a participatory action research approach which incorporates co-design and realist elements. The program comprises two broad phases involving evidence consolidation and synthesis (Phase 1), and co-design, implementation, and prospective evaluation of ‘bundles’ of retention strategies (Phase 2) to improve retention of healthcare staff in participating ATSICCHSs.DiscussionThis innovative research program has the potential to develop a comprehensive evidence base required to optimise health workforce retention in remote health services. This new evidence will strengthen understanding of what ‘bundles’ of retention strategies are effective, for which groups of employees, and how they work to improve staff retention.

Exploring the feasibility of using Participatory Action Research (PAR) as a mechanism for school culture change to improve mental health

ABSTRACT Adolescence is a key time to prevent or reduce poor mental health outcomes. Supportive school environments play an important role in this, and the concept of health-promoting schools have been supported globally. Participatory action research (PAR) combines theory, practice, action, and reflection by developing practical solutions to address concerns and issues within communities. Running four PAR groups across three secondary schools, we explored the feasibility of using the approach as a mechanism for bringing about culture change and improving mental health. We undertook interviews and focus groups with students (n = 24), school staff (n = 11), facilitators (n = 3), and parents/carers (n = 2). Findings are organised under five key headings: 1) Establishing PAR groups, and the PAR cycle; 2) PAR group impact; 3) Facilitators of PAR success; 4) Barriers to PAR success; 5) Future recommendations. This study demonstrated the feasibility of PAR as a tool to improve school culture. Students participating in PAR were engaged, passionate, and motivated to influence and transform school culture to improve mental health. Future research should aim to trial the PAR approach on a larger scale, to determine whether the barriers and facilitators of PAR success identified here are relevant and transferable to schools in other contexts, and to measure the impact of such initiatives on mental health outcomes.

Peering Deeper: Student Perspectives on School Well-being and Youth Engagement

We examined students’ perspectives on well-being and youth engagement in schools using a Youth Participatory Action Research approach. Students (N = 11) trained as peer researchers and then interviewed their peers. Interviews (N = 21) were analyzed using reflexive thematic analysis and six themes were developed: desire for versus reality of a healthy school, insufficient school strategies to promote well-being and mitigate harm, listening to and actioning students’ ideas, diverse opportunities for student engagement, pre-conceived ideas of student capability, and importance of a support role. Through this project, we peered deeper into students’ viewpoints about well-being and youth engagement in their schools.

Blending Human-Centred Design and Community-Based Participatory Action Research Approaches: Designing Community Sport and Recreation Provisions for Equity-Owed Communities

Addressing the social and economic disparities equity-owed low-income residents experience that prevent participation in community sport and recreation is complex. Community-based participatory action research (CBPAR) has been utilized to facilitate the participation of equity-owed communities in sport and recreation initiatives. However, in this paper, we discuss how CBPAR and human-centred design (HCD) help engage communities in discourse and action to support innovative social change in the context of sport and recreation for equity-owed low-income communities. This paper compares processes, core principles, and outcomes of CBPAR and HCD. It highlights how they can collectively drive discourse and action to foster innovative social change in sport and recreation for equity-owed communities. The proposed integration, called CBPAR+HCD, is suggested to initiate solutions that address the multifaceted challenges through a social justice lens, placing community-driven social innovation at the forefront. This paper highlights the benefits of combining CBPAR+HCD and acknowledges the inherent challenges in implementing this dual approach. Furthermore, it offers recommendations to support the combined approach, emphasizing the importance of this integrated methodology in promoting social change and addressing inequities within community sport and recreation initiatives.

Exploring the health and wellbeing landscape at a third level institution

In line with the Healthy Campus framework, this study explored the health, health literacy, and wellbeing landscape for students at an Irish third level institution using a participatory action research approach with the aim to identify potential need, and inform future health promotion action(s). Methods. This mixed-method study involved three phases; (1) a scoping review to audit what activities are currently available to support student health and wellbeing on campus, (2) assessment of students’ current health literacy using the Health Literacy Questionnaire, analysed using Cohen's d to investigate the magnitude of differences between student groups, (3) qualitative discussions with university stakeholders, analysed using reflexive thematic analysis, to provide greater understanding and context to the results of the previous phases. Results. The scoping review identified 151 activities on campus to support students’ holistic health, with the majority focused on individual support. Students’ health literacy scores were in line with the broader literature. A number of themes were identified within the qualitative data; i) the need for an ‘opt-in’ approach to support a health-integrated culture, ii) barriers and facilitators to health information, iii) the importance of ‘walking the walk’, iv) the specific university experience of 2022 as society emerged from Covid-19, and v) factors that influence student engagement. Conclusion. Insight into the participatory action approach undertaken in this study may be useful to inform other higher education institutions (HEIs) interested in undertaking similar work. Thorough description of the findings may also allow these to be transferred to other contexts. The findings of this study can help inform and direct the current university's, and potentially other HEIs, future actions in regards to enhancing the health and wellbeing of its stakeholders. To foster an authentic ‘Healthy Campus’, a whole-university approach is needed HEIs, supported by open dialogue between stakeholders and senior leadership commitment.

ECONOMIC EMPOWERMENT THROUGH COLLABORATION AND BUSINESS INNOVATION IN IMBI VILLAGE, JAYAPURA

This study aims to empower the economy of the community in Kelurahan Imbi, Jayapura, through collaboration and business innovation using the Participatory Action Research (PAR) method. The PAR approach involves active community participation in every stage of the research, from problem identification to solution implementation and evaluation. Problem identification was carried out through focus group discussions and in-depth interviews, revealing various challenges such as limited access to capital, low levels of education and skills, poor infrastructure, and a lack of collaboration among stakeholders. Based on these findings, an action plan was formulated, including business financing programs, skills training and business mentoring, infrastructure improvements, and strengthening collaboration. The program implementation was conducted with active community involvement. The research results showed an increase in business actors' access to capital through low-interest loan schemes and savings and loan cooperatives. Training and business mentoring successfully enhanced community knowledge and skills, and encouraged product innovation and digital marketing. Infrastructure improvements increased mobility and market access, while the collaborative forum among stakeholders strengthened synergy and the effectiveness of economic empowerment programs. In conclusion, the PAR approach is effective in empowering the economy of the Kelurahan Imbi community, creating targeted and sustainable solutions, and building community capacity to develop local economic potential. This success underscores the importance of community participation and stakeholder collaboration in creating sustainable socio-economic change.

Constructing Diaspora Space and Consciousness Through Sport and Livelihoods in Kampala, Uganda

Applying the concept of diaspora, this paper examines an organization in Kampala, Uganda that utilizes sport to foster cultural belonging and increase livelihood opportunities for refugees. A participatory action research approach was implemented with multiple forms of data collection including semistructured interviews, photovoice, and photocollaging. Findings highlight how sport and livelihoods are used by refugees to resist exclusion and other inequalities in Kampala and to express diaspora space and consciousness. Discussion highlights the usefulness of the concept of diaspora for understanding the intersections of sport, refugees, livelihoods, and, more importantly, to stimulate a homing desire for refugees forcibly displaced.

Enhancing Awareness and Understanding of Autism Spectrum Disorder in Minchinabad A Participatory Action Research Approach

This study investigates the effectiveness of interventions aimed at enhancing awareness of Autism Spectrum Disorder (ASD) in Minchinabad through a participatory action research approach. A total of 100 participants were included in this research. They were Community Leaders, Healthcare Professionals, Religious Leaders, and Educators picked through Convenience Sampling. Initial data collection reveals prevalent misconceptions and barriers surrounding ASD awareness. Among them, 89% of respondents expressed a lack of sufficient awareness and 85% attributed ASD to divine factors. Subsequently, community-led workshops, social media campaigns, and Religious institutions-based awareness activities were implemented to address these challenges. Evaluation indicates a significant improvement in awareness levels. Improvement with 53% acknowledging adequate awareness. However, more than 40% still perceive a stigma associated with seeking an ASD diagnosis. While cultural beliefs persist, such as 60% to 68% believing in the divine causation of ASD. The interventions have contributed to a positive shift in community perceptions. The findings underscore the importance of sustained efforts to promote understanding and acceptance of ASD within the community, emphasizing the need for continued engagement and advocacy for ASD Awareness.