Participatory Model Research Articles

Precision medicine approaches in obstructive sleep apnoea: The role of dentist-sleep physician partnerships.

Obstructive Sleep Apnoea (OSA) is a common heterogenous sleep disorder that is associated with a wide range of comorbidities and consequences, including the development of neurocognitive and cardiometabolic disorders. The heterogeneity of OSA necessitates a precision medicine approach to accurately diagnose this condition and to effectively manage patients. One of the primary models of precision medicine is described by the P4 approach of predicting those who are susceptible to disease, preventing the occurrence of disease, personalizing treatment, and encouraging patients to participate in their individual healthcare journey. Recent advances in oral appliance therapy and OSA monitoring techniques have fostered an exciting opportunity for enhanced collaboration between dentists and sleep physicians to optimize OSA precision medicine care. This review aims to discuss the sources of heterogeneity among OSA patients, provide an overview of the growing applications of oral appliance therapy and tailored monitoring programs for OSA that are shifting treatment to a more personalized and participatory model of care, and outline the pivotal role of dentists in managing patients with OSA.

An Overview of Transdisciplinary and Bottom-up Approach for Urban Resilience: The Case of Turkey

While top-down strategies have traditionally dominated urban planning in Turkey, recent shifts towards participatory practices and project-based policies have aimed to involve citizens in decision-making processes. Nevertheless, in the case of Turkey, these participatory models are inadequate for effectively addressing resilience. This article therefore discusses the role of participatory processes in creating resilient cities, as well as how to strengthen transdisciplinary (TR) and bottom-up approaches to urban participation in Turkish urban contexts. The article presents a theoretical framework that connects TR and bottom-up approaches based on existing literature, practices, and planning policy examples. It argues that TR approaches complement bottom-up approaches to urban governance by enhancing urban and social resilience, strengthening local communities, and reducing urban inequalities. Urban planning efforts that promote collaboration, incorporate multiple perspectives, and involve local communities in decision-making processes can address complex urban issues while also fostering long-term sustainability and resilience. This approach not only instills a sense of ownership and empowerment among urban residents but also leverages knowledge and skills to generate more effective and sustainable solutions. By creating a framework that promotes long-term education and citizenship awareness, urban governance can sustain urban resilience in a more viable manner over the long term in Turkey.

There Is More to Life Than Walking: A Qualitative Study of Survivorship Among Peer Mentors in the Spinal Cord Injury Community.

Objective: To identify factors impacting survivorship among people living with spinal cord injury (SCI) and volunteering in a peer mentorship program. Research Method/Design: Semi-structured interviews were conducted by a leader of a non-profit organization designed to promote independent living after SCI. Questions explored intrinsic factors such as resilience and emotional coping as well extrinsic factors such as family support and accessibility challenges that impacted their SCI survivorship journey. Two independent anonymous reviewers conducted thematic analysis to identify these factors. Results: Twenty-eight members of the SCI peer mentorship program participated. Four themes affecting survivorship were identified: Sense of Achievement, Post-Injury Growth, Post-Injury Challenges, and Giving and Receiving Support. Nearly all participants focused their responses on Post-Injury Growth and Giving and Receiving Support as reasons for their interest in serving as peer mentors. Conclusions: This study highlights a need for peer community integration following SCI and underscores the importance of using a community-driven participatory model to inform and guide research. Peer mentorship programs can link SCI survivors to mentors and facilitate other sources of social fulfillment and thus can have a profound impact on individuals' survivorship post-SCI. This study identified a Sense of Achievement, Post-Injury Growth, Giving and Receiving Support, and Post-Injury Challenges as factors that most impact the SCI survivorship journey. This community leader's work underscores the importance of cognitive framing and social networks in post-injury rehabilitation in this population. Future directions include analyzing the longitudinal effects of peer mentorship participation on life satisfaction and community building in individuals living with SCI.

PENGUATAN KAPABILITAS DIGITAL UKM BATIK CANTING KHAS GEMPOL KABUPATEN PASURUAN MELALUI PEMBINAAN DAN PENDAMPINGAN TRANSFORMASI BISNIS DIGITAL

The Batik Canting Khas Gempol SMEs in Pasuruan Regency face challenges in adopting digital technology to expand their market and enhance competitiveness. Low digital literacy is the main barrier. This program is designed to provide training and assistance for digital business transformation. The aim of this activity is to increase digital capabilities and motivate SME members to more actively utilize digital technology. This program uses a participatory action research model involving training, workshops, seminars, and individual consultation sessions to enhance participants' digital skills. As a result, 20 participants attended the training and workshops, with an average attendance rate of 97%. Significant improvements were observed in the participants' digital understanding, with an average post-test score of 90% compared to a pre-test score of 50%. About 95% of participants successfully created digital content, and 90% were able to use social media platforms for promotion. Within 2 months after the training, 70% of participants reported an average online sales increase of 30%. This program successfully improved the digital capabilities of Batik Canting Khas Gempol SMEs, demonstrating that external support and guidance are effective in empowering SMEs to undergo digital transformation.

Reducing mental health emergency visits: population-level strategies from participatory modelling

BackgroundEmergency departments (EDs) are often the front door for urgent mental health care, especially when demand exceeds capacity. Long waits in EDs exert strain on hospital resources and worsen distress for individuals experiencing a mental health crisis. We used as a test case the Australian Capital Territory (ACT), with a population surge of over 27% across 2011–2021 and a lagging increase in mental health care capacity, to evaluate population-based approaches to reduce mental health-related ED presentations.MethodsWe developed a system dynamics model for the ACT region using a participatory approach involving local stakeholders, including health planners, health providers and young people with lived experience of mental health disorders. Outcomes were projected over 2023–2032 for youth (aged 15–24) and for the general population.ResultsImproving the overall mental health care system through strategies such as doubling the annual capacity growth rate of mental health services or leveraging digital technologies for triage and care coordination is projected to decrease youth mental health-related ED visits by 4.3% and 4.8% respectively. Implementation of mobile crisis response teams (consisting of a mental health nurse accompanying police or ambulance officers) is projected to reduce youth mental health-related ED visits by 10.2% by de-escalating some emergency situations and directly transferring selected individuals to community mental health centres. Other effective interventions include limiting re-presentations to ED by screening for suicide risk and following up with calls post-discharge (6.4% reduction), and limiting presentations of frequent users of ED by providing psychosocial education to families of people with schizophrenia (5.1% reduction). Finally, combining these five approaches is projected to reduce youth mental health-related ED presentations by 26.6% by the end of 2032.ConclusionsPolicies to decrease youth mental health-related ED presentations should not be limited to increasing mental health care capacity, but also include structural reforms.

Applying a community-engaged participatory machine learning model.

Although predictive algorithms have been described as the definitive solution to bias in health care, machine learning techniques may also propagate existing health inequities within the community context. However, there may be ways in which machine learning techniques can help community psychologists, public health researchers and practitioners identify patterns in data in a way that empowers improved outcomes. Incorporating community insight in all stages of machine learning research mitigates bias by positioning members of underrepresented communities as the experts of their lived experiences. As community psychologists already prioritize community-based participatory practices, we propose three core guiding principles for a community-engaged participatory model for research using machine learning techniques: shared decision-making, reflexivity and structural humility, and flexibility and adaptability. Guided by these three principles, we emphasize grounding priority setting, problem formation, model assumptions, and interpretation of the resulting algorithmic patterns in the truths born from the lived experiences of people closest to the problem. We also suggest opportunities for bidirectional and mutually empowering partnerships between algorithmic scientists and the communities to which their algorithms will be applied. Inclusion of community stakeholders in all stages of machine learning for health research provides an opportunity to develop algorithms that are both highly effective and ethically grounded in the lived experiences of target populations.

Systems Modeling of the Water-Energy-Food-Ecosystems Nexus: Insights from a Region Facing Structural Water Scarcity in Southern Spain

The complex relationship between water, energy, food, and ecological systems, known as the WEFE nexus, has emerged as a major topic in the debate about sustainable economic development and resource management. This subject is of special interest in Mediterranean coastal areas as rapid economic expansion driven by population growth, higher influx of tourists, and intensification of agriculture is leading to structural water scarcity conditions. However, addressing the diverse range of issues associated with the nexus is a difficult task due to the existence of intricate interconnections, interdependencies, and nonlinearities within and across its various components. Accordingly, this case study applies a combination of participatory systems modeling and network analysis tools to yield insights into the complexity of this nexus in Axarquia, a region with features that make it an example of water-stressed jurisdictions in the Mediterranean. Overall, our results provide a strong foundation to understand the dynamics that govern this nexus in regions where the availability of freshwater resources is a significant concern. Furthermore, they lay the groundwork for the development of models and scenarios to simulate the impact of various policies and interventions on the overall system.

Development of strategic participatory moral education management model in private vocational colleges

Addressing society’s current ethical dilemmas necessitates urgent reinforcement of moral standards. Transforming student behavior necessitates integrating legal and social measures through proactive youth cultivation within educational institutions. This study focuses on a participatory, strategic approach to managing ethics in private vocational colleges in Thailand. The researchers gathered data through structured, in-depth interviews and opinion surveys from a sample group of 400 individuals, which included directors and department heads of these colleges. The research identified two main dimensions and eleven factors essential for moral education management in private vocational colleges. The first dimension encompasses six critical factors: resource management, structural policies, educational services, personnel, financial management, and materials and equipment management. The second dimension includes five key factors: school strategies, administrative policies, teacher roles, student engagement, and community stakeholder involvement. Statistical analysis supports the causal relationship model, revealing a Chi-Square value of 33.492 and a P-value of 0.055. This comprehensive approach aims to foster sustainable moral development and cultivate desirable societal behaviors among students. It contributes to national stability and aligns with educational and vocational development plans, effectively addressing broader socio-economic challenges. The findings underscore the importance of strategic, ethical management in private vocational education institutions as a cornerstone for nurturing a morally responsible student body and supporting national development goals.

The governance of public space by legally unique bodies: A case study of Vancouver’s Granville Island

This article focuses on the governance of Granville Island, a former industrial stretch of land that operates as an arts destination abutting the City of Vancouver’s waterfront. While Granville Island might look like any other neighbourhood in Vancouver, it is in fact owned and managed by the Canada Mortgage and Housing Corporation, a federal agency, on behalf of the Government of Canada. This article examines what it means, democratically speaking, for the federal government to operate public space in a city. Public entities are each legally unique, raising questions as to how they and their relationships with other entities can be understood, evaluated and adjudicated. This article animates how public entities are understood under Canadian law by demonstrating the difficulty in crafting inclusive, participatory governance models that respond to the many interests involved in public space, especially spaces that are explicitly identified as ‘innovative’. Drawing on qualitative data and document review, the article highlights the manner in which Granville Island has been structured and operated by the federal government, its singular focus on commerce and tourism and its weak commitments to accountability, transparency and representation. Granville Island is rendered ‘invisible’ in its governance: it blends into the urban form as though part of the City of Vancouver, while at the same time lacking in accountability, transparency and representation. We conclude that while Granville Island governs public space, making it seem like a neighbourhood in a municipality, it cannot be conceptualised as a ‘democratic body’.

Modeling fisheries and carbon sequestration ecosystem services under deep uncertainty in the ocean twilight zone

Mesopelagic fishes are a vital component of the biological carbon pump and are, to date, largely unexploited. In recent years, there has been an increased interest in harvesting the mesopelagic zone to produce fish feed for aquaculture. However, great uncertainties exist in how the mesopelagic zone interacts with the climate and food webs, presenting a dilemma for policy. Here, we investigate the consequences of potential policies relating to mesopelagic harvest quotas with a dynamic social-ecological modeling approach, combining system dynamics and global sensitivity analyses informed by participatory modeling. Our analyses reveal that, in simulations of mesopelagic fishing scenarios, uncertainties about mesopelagic fish population dynamics have the most pronounced influence on potential outcomes. The analysis also shows that prioritizing the development of the fishing industry over environmental protection would lead to a significantly higher social cost of climate change to society. Given the large uncertainties and the potential large impacts on oceanic carbon sequestration, a precautionary approach to developing mesopelagic fisheries is warranted.

Understanding Socio-Ecological Complexity of Mangrove-Crocodile-Fisher System of Bugsuk Island, Balabac, Palawan, the Philippines

The mangrove forest in Palawan has the most extensive distribution in the Philippines. The fisher community's perception of the mangrove forest as a known habitat for saltwater crocodiles (Crocodylus porosus) and its fishery benefits in Bugsuk Island were gathered using a participatory systems mental modeling framework for the coastal social-ecological system. From the causal loop diagram, six reinforcing and one balancing feedback loop were derived. The respondents observed a positive growth in the interaction between mangroves and crocodiles in Bugsuk Island, with both populations expanding and providing support to fishery resources. Bugsuk Island represents a unique diversity with great potential for resource conservation and economic benefit.

Developing a fine-scale spatial operating model of eastern oyster population dynamics in Chesapeake Bay, Maryland, U.S.A.

Management decisions for the eastern oyster (Crassostrea virginica) fishery in Maryland are made at a finer spatial scale than the spatial data resolution of the current stock assessment. This mismatch creates concerns that the consequences of management actions and fishing activities are not being adequately represented when assessing fishery status. To produce a model that could support a participatory modeling process intended to differentiate results of fine-scale management actions we developed a method for conditioning a down-scaled oyster stock assessment model to produce a spatially-explicit operating model at the scale of individual oyster bars for eastern oysters in Chesapeake Bay, Maryland. To ensure that parameter values of the operating model were consistent with data at multiple scales we fitted the model to bar-specific harvest data during 2004–2020 and regional abundance estimates from the current Maryland Oyster Stock Assessment during 1999–2020. The operating model can then predict effects of different management actions, such as planting hatchery-reared oysters, addition of substrate, or modifying fishing regulations, at a bar-specific scale and compare outcomes among different scenarios. Model outputs included a suite of management performance metrics, including but not limited to oyster abundance and fishery harvest, that were important to stakeholders. These bar-specific scenarios would not have been possible using an operating model with the same spatial resolution as the current Maryland Oyster Stock Assessment. Accounting for fine scale spatial processes can be important to engaging participants and our model provides an expedient option to develop an operating model that downscales stock assessment models.

Community-Based Participatory Research and System Dynamics Modeling for Improving Retention in Hypertension Care

The high prevalence of hypertension calls for broad, multisector responses that foster prevention and care services, with the goal of leveraging high-quality treatment as a means of reducing hypertension incidence. Health care system improvements require stakeholder input from across the care continuum to identify gaps and inform interventions that improve hypertension care service, delivery, and retention; system dynamics modeling offers a participatory research approach through which stakeholders learn about system complexity and ways to model sustainable system-level improvements. To assess the association of simulated interventions with hypertension care retention rates in the Nigerian primary health care system using system dynamics modeling. This decision analytical model used a participatory research approach involving stakeholder workshops conducted in July and October 2022 to gather insights and inform the development of a system dynamics model designed to simulate the association of various interventions with retention in hypertension care. The study focused on the primary health care system in Nigeria, engaging stakeholders from various sectors involved in hypertension care, including patients, community health extension workers, nurses, pharmacists, researchers, administrators, policymakers, and physicians. Simulated intervention packages. Retention rate in hypertension care at 12, 24, and 36 months, modeled to estimate the effectiveness of the interventions. A total of 16 stakeholders participated in the workshops (mean [SD] age, 46.5 [8.6] years; 9 [56.3%] male). Training of health care workers was estimated to be the most effective single implementation strategy for improving retention in hypertension care in Nigeria, with estimated retention rates of 29.7% (95% CI, 27.8%-31.2%) at 12 months and 27.1% (95% CI, 26.0%-28.3%) at 24 months. Integrated intervention packages were associated with the greatest improvements in hypertension care retention overall, with modeled retention rates of 72.4% (95% CI, 68.4%-76.4%), 68.1% (95% CI, 64.5%-71.7%), and 67.1% (95% CI, 64.5%-71.1%) at 12, 24, and 36 months, respectively. This decision analytical model study showed that community-based participatory research could be used to estimate the potential effectiveness of interventions for improving retention in hypertension care. Integrated intervention packages may be the most promising strategies.

Modeling with a municipality: Exploring robust policies to foster climate-neutral mobility

Many European cities are investigating how to transition to climate-neutral transport systems. Due to the transport system’s complexity and uncertainty about the future, identifying drivers and choosing effective policies to make the city more sustainable is challenging. Additionally, the chosen policies need to be supported by relevant actors. This study aims to support the municipality of The Hague in generating robust policies supported by and within the municipality. We build on participatory modeling and decision-making under deep uncertainty to create a novel approach to address this goal. In two workshops, the participants formulated goals and objectives, created Causal Loop diagrams, and identified potential interventions. Using a set of possible futures, the interventions were then stress-tested to evaluate their robustness. By explicitly linking, for the first time, participatory modeling and decision-making under deep uncertainty approaches, the participants could understand the system better and deal with uncertainty. Participants gained insight into systemic complexity and methods to deal with it, the inter-relatedness of interventions and their effects, and a shared understanding of the problem and its scope. This study demonstrates the potential of a novel approach to generate supported robust interventions to achieve the goal of a climate-neutral transport system.

A Participatory Model for Cocreating Accessible Rehabilitation Technology for Stroke Survivors: User-Centered Design Approach.

Globally, 1 in 3 people live with health conditions that could be improved with rehabilitation. Ideally, this is provided by trained professionals delivering evidence-based dose, intensity, and content of rehabilitation for optimal recovery. The widely acknowledged inability of global health care providers to deliver recommended levels of rehabilitation creates an opportunity for technological innovation. Design processes that lack close consideration of users' needs and budgets, however, mean that many rehabilitation technologies are neither useful nor used. To address this problem, our multidisciplinary research group have established a cocreation center for rehabilitation technology that places the end user at the center of the innovation process. This study aims to present the participatory cocreation model that has been developed from our center and illustrate the approach with 2 cases studies. The model is built around user participation in an intensive rehabilitation program (2-hour sessions, 2-5 times per week, and 8-week duration), supervised by qualified therapists but delivered exclusively through commercial and prototype technology. This provides participants (chronic stroke survivors with movement and/or speech disability) with a rich experience of rehabilitation technology, enabling them to provide truly informed feedback, as well as creating an observatory for the research team. This process is supported by short-term focus groups for specific product development and a longer-term advisory group to consider broader issues of adoption and translation into everyday health care. Our model has been active for 3 years with 92 (92%) out of 100 participants completing the program. Five new technologies have evolved from the process with further ideas logged for future development. In addition, it has led to a set of cocreated protocols for technology-enriched rehabilitation, including recruitment, outcome measures, and intervention structure, which has allowed us to replicate this approach in an acute hospital ward. Suboptimal rehabilitation limits recovery from health conditions. Technology offers the potential support to increase access to recommended levels of rehabilitation but needs to be designed to suit end users and not just their impairment. Our cocreation model, built around participation in an intensive, technology-based program, has produced new accessible technology and demonstrated the feasibility of our overall approach to providing the rehabilitation that people need, for as long as needed.

A proof of concept participatory study on virtual sound immersion: developing an inclusive prototype to improve the experience of planning leisure activities outside the home

Individuals with atypical sensory and/or cognitive profiles have little access to out-of-home activities during their free time. A lack of information on activities and the characteristics of the outside environment often prevents them from investing in or obtaining new experiences. When they do participate, they often encounter difficulties and various obstacles that lead to failed attempts. This may lead to disengagement and a significant reduction in their social participation. The aim of this study was to co-construct a prototype based on the user’s needs and evaluate its feasibility and social validity from an exploratory perspective. A participatory research model using a mixed method based on an iterative design thinking methodology was used. The results show that describing the sensory attributes of environments increases people’s sense of familiarity and self-evaluation of accessibility. As a proof of concept, a virtual sound immersion prototype has been developed. It enables users to explore the sound environment and project themselves into new activities, including the emergence of the idea, the journey to get there and the performance of the activity itself. This study establishes the first step in the development of inclusive assistive technology and discusses issues related to the universal accessibility of the device.

SDG Innovations & Impact: Relational Approach in Enabling Innovative Solutions and Impact Creation at the Grassroots

SDG localisation is a primary goal of APPGM-SDG, and solution projects are the key component of this effort. Formed in 2019, mirroring the UK Parliament setup, the APPGM-SDG Malaysia has been the forefront organisation in localising SDGs in parliamentary constituencies. Despite Covid-19 and other practical challenges. The grounded research approach undertaken by APPGM-SDG paved the way for innovative grassroots solutions designed and undertaken by local organisations targeting vulnerable communities in their own localities. From 2020 to November 2023, APPGM-SDG has undertaken targeted solution projects at an unprecedented level, with 664 SDGs solution projects in 4 years and 364 solution providers around the country. These innovative solutions are developed through a unique relational approach between multiple stakeholders and engagements in multiple processes in the making. This approach has been the key framework in designing solution projects that have proven to have a much greater impact towards the community as a whole and personally on the livelihoods of the participants involved. This is also evident in our recent publication, SDG Solution Projects: Best Practices Impacting the Grassroots, which carries 35 best practices for solution projects and innovative stories from the ground that can be examples of model solutions for vulnerable communities. This paper will discuss the relational approach that brings out SDG innovations in finding solutions between the partners involved, the empowerment and participatory models in place, and the processes involved in curating suitable solutions. The lessons learnt from 2020 until now in crafting fine-tuned solutions will also be included in this paper, together with real-life case studies of SDG innovative solutions that have a greater relational approach between stakeholders.

The bench to community initiative: community-based participatory research model for translating research discoveries into community solutions.

The BCI program was established to understand sociocultural determinants of personal care product use, evaluate the biological impact of endocrine disrupting chemicals, and develop community interventions. The three pillars of the program include research, outreach and engagement as well as advocacy activities. The research pillar of the BCI includes development of multidisciplinary partnerships to understand the sociocultural and biological determinants of harmful chemical (e.g., endocrine disrupting chemicals) exposures from personal care products and to implement community interventions. The outreach and engagement pillar includes education and translation of research into behavioral practice. The research conducted through the initiative provides the foundation for advocacy engagement with applicable community-based organizations. Essential to the mission of the BCI is the participation of community members and trainees from underrepresented backgrounds who are affected by breast cancer disparities. Two behavioral interventions will be developed building on prior research on environmental exposures with the focus on personal care products including findings from the BCI. In person and virtual education activities include tabling at community events with do-it-yourself product demonstrations, Salon Conversations-a virtual platform used to bring awareness, education, and pilot behavior change interventions, biennial symposiums, and social media engagement. BCI's community advisory board members support activities across the three pillars, while trainees participate in personal and professional activities that enhance their skills in research translation. This paper highlights the three pillars of the BCI, lessons learned, testimonies from community advisory board members and trainees on the impact of the initiative, as well as BCI's mission driven approaches to achieving health equity.

Bridging Global Protocols and Local Wisdom: Innovating Refugee Assistance Through a Harmonized Protection Model

This paper examines the critical need to integrate the Global Protection Cluster (GPC) approach with local knowledge to improve the effectiveness of refugee aid programs. It analyses the foundational principles of the GPC method in conjunction with the valuable insights provided by indigenous knowledge systems, proposing a comprehensive model to align global strategies with local realities. The study highlights the multifaceted advantages of this integrated approach through an extensive literature review and illustrative case studies from various contexts, including Afghanistan, Jordan, Uganda, Ethiopia, and Indonesia. Particular emphasis is placed on the Rohingya refugee situation in Aceh, which serves as a pivotal case study demonstrating the transformative potential of incorporating local wisdom into program design. The paper advocates for a participatory model that prioritizes the active involvement of displaced communities in decision-making processes, ensuring that aid programs are culturally competent and responsive to refugees' specific needs. Key recommendations are provided for a wide range of stakeholders—policymakers, practitioners, organizations, and donors—emphasizing the importance of collaborative partnerships, adaptive program design, and community-led initiatives. The findings suggest that by embracing local knowledge and fostering inclusive participation, refugee aid programs can achieve greater sustainability and effectiveness, ultimately contributing to more resilient and empowered displaced populations.

Addressing COVID-19 and Health Literacy Disparities Among Correctional Facility Residents Through Dialogue-Based Education.

Carceral communities face heightened COVID-19-related risks while simultaneously experiencing medical mistrust and limited access to health information and services. Health education programs that incorporate dialogue-based, participatory learning models have been shown to motivate health behavior and increase health knowledge in carceral settings. To increase health literacy and change COVID-19-related health behavior among jail residents in the United States, a local health department developed a dialogue-based education program centered around COVID-19 prevention, misinformation, and navigating health care systems. Dialogue-based health information sessions took place in person in a county jail. Pre- and postsurveys gauged the sessions' influence on self-reported health literacy and behavior intention. Overall, 595 residents collectively attended 43 facilitated discussions. Key findings indicate that dialogue-based education can temper medical mistrust, influencing COVID-19 preventive behaviors and increasing health literacy in a carceral setting.