Community Stakeholder Perceptions Research Articles

Perceptions of an acceptance-based weight management treatment among adults living in rural areas.

Obesity and obesity-related comorbidities disproportionately affect rural communities. Research has emerged in support of a novel acceptance-based behavioural weight management treatment (ABT) that integrates the principles and procedures of acceptance-commitment therapy (ACT) with traditional components of standard behavioural treatment (SBT). The current study assessed the perceptions of community stakeholders in rural areas to session materials of a commercially available ABT program. Surveys and focus groups were used to solicit feedback from three former interventionists with experience delivering SBTs in rural counties and from 17 former participants in these programs. Qualitative responses encompassed four overarching themes: (1) recommendations to support participant engagement, (2) comments about preferences for specific ABT and SBT strategies, (3) concerns about specific aspects of treatment delivery, and (4) requests for aesthetic changes to session materials to enhance clarity and engagement. Overall, participants viewed ABT materials and concepts favourably but believed it would be important to begin the intervention with rapport building and training in traditional SBT strategies prior to delving into ACT strategies. Future studies should investigate the efficacy of ABT for weight loss in adults with obesity living in rural communities and continue to solicit feedback from rural community stakeholders.

Coastal microplastic pollution: Understanding coastal community stakeholder perceptions and resolution priorities

While scientific research and media coverage has led to some legislation and policy changes in relation to the plastic pollution problem, in general these developments have been uncoordinated. In 2022 the United Nations Environment Assembly (UNEA) resolution to end plastic pollution became the first legally binding provision to address the problem; it includes a requirement for multi-level stakeholder action agendas. In this research, we examine how key stakeholders with management responsibilities within a coastal area on the south coast of the United Kingdom view the issue of coastal microplastics. We find that stakeholders are susceptible to the same influences as the public and are focussed on the global rather than the local issues of plastic pollution. We also find that visitors to these coastal areas appear to be unconcerned about the potential threat caused by MP either due to a lack of awareness or assessment of risk. The research also highlights the management priorities amongst the stakeholders and makes recommendations for a more localised approach to implementing management policies in the future.

Recommendations for improving adolescent addiction recovery support in six northwest tribal communities.

American Indian and Alaska Native (AI/AN) communities offer tangible and intangible resources, including centuries of indigenous wisdom and resiliency, to support their young people in recovery from substance use disorders. At the same time, tribal youth returning home from residential or inpatient treatment are vulnerable to relapse, especially if they encounter the same environmental triggers in which their substance misuse developed. This study endeavored to learn about community stakeholder perceptions of existing strengths and needs for supporting recovering adolescents among six tribal communities of the Inland Northwest. Using a Tribal Participatory Research approach, we conducted Group Level Assessments with key stakeholders representing educators/coaches, medical and behavioral health providers, social service providers, cultural leaders/elders, and legal professionals among each participating tribe (N = 166). We used content analysis to identify emergent themes among participants' recommendations for improving recovery support. The five emergent themes were (1) Communication, Collaboration, and Accountability among Tribal Departments and Agencies; (2) Community-wide Education; (3) The Importance of Providing Wraparound/Supportive Services; (4) Youth-focused Education, Services, and Events; and (5) Recovery Coaching Model. AI/AN culture was infused within nearly all recommendations for improving recovery support that composed these themes. We discuss specific ways to implement these recommendations, including the forthcoming development of a culturally-grounded community-wide mental health training program developed specifically for, and with, these tribes.

P81 Extension Nutrition Educators and Community Stakeholders Perceive the Healthfulness of Their Under-Resourced Florida Communities Differently

<h3>Background</h3> Community stakeholders and Extension nutrition educators (NEs) are invested in the health of their under-resourced communities and should be included in the development of interventions designed to improve the health of their residents. These groups understand barriers and facilitators to healthy living that can help inform appropriate health interventions. As perceptions can differ, input from both groups can provide a more well-rounded approach. <h3>Objective</h3> To compare Extension NE and community stakeholder perceptions on the healthfulness of the environment of under-resourced communities in the 5 Florida Extension districts <h3>Study Design, Settings, Participants</h3> Focus groups (n = 8) with Extension NEs (N = 49) and in-depth interviews (n = 10) with community stakeholders were conducted using semi-structured scripts following the Social Cognitive Theory to explore perceptions on the healthfulness of the communities. <h3>Measurable Outcome/Analysis</h3> Focus groups and in-depth interviews were audio-recorded, transcribed verbatim, and coded. Cross-tab analysis was used to compare data from the districts' participants. <h3>Results</h3> Overall, participants described healthy eating and physical activity as the main components of a healthy lifestyle. They also viewed access to and availability of food as an essential part of a healthy community. While both NEs and stakeholders perceived food access (Northwest, Southwest), safety (Central), and lack of education (Southeast) as major barriers to a healthy lifestyle, NEs also identified lack of knowledge and education as major barriers, whereas stakeholders perceived financial constraints (ie, unemployment) as the primary challenge. When asked about resources available to address challenges, NEs (all districts) did not perceive many, which they attributed to a lack of promotion of resources. In contrast, stakeholders (all districts) perceived multiple opportunities available but noted a lack of participation from community members. <h3>Conclusion</h3> Extension NEs and community stakeholders provide unique perspectives about barriers and opportunities in the under-resourced communities they serve. Differences among the districts and between participants highlight diverse characteristics of these communities, which should be considered when developing interventions.

Community-networks that facilitate engagement in health research: Ifakara Health Research Institute-Bagamoyo case study

Background: Involvement of communities in the field of health research has been at the forefront of what is considered as ethical conduct of research. A commonly used approach is regular meetings with locally recognized community leaders to consult about research activities, i.e. community engagement. At the Ifakara Health Research Institute (IHI) in Bagamoyo, Tanzania, different approaches to engaging with the community in health research have been used, but there has not been a systematic understanding of the functioning of the community network that is engaged within health research. Methods: To understand the community networks engaged in health research, perceptions of community stakeholders and researchers on the functionality of the community networks was performed. We conducted six focus group discussions with respondents who have participated in IHI research for the past five years and 49 in-depth interviews. Results: Community networks involved in engagement were influenced by the type of research project and kind of participants needed. Different community networks were involved in engagement activities, namely village executive officers, community health workers, hamlet leaders, nurses, doctors and community advisory boards. Approaches used during engagement processes to inform potential participants about the work of IHI and specific studies that are undertaken were useful in passing key information, however, they did not always reach the target population due to having limited levels of interaction with potential participants. Participants and researchers suggested additional ways to engage with the community. Conclusion: There is a need of developing a community engagement unit that would work across projects to support engagement with the community. The unit will maintain continuous engagement with the community and conduct research to understand the relationship between communities we work in and researchers. Funding of this unit could be done through contributions from the core budget, individual’s projects or competitive grant application.

Impact of an urban regional medical campus: perceptions of community stakeholders.

BackgroundRegional medical campuses (RMC) have shown promise in addressing physician shortages. RMCs have been positively evaluated in rural/remote communities, however, it is unclear whether this model will be as beneficial in underserved urban areas. This study evaluated the impact of a RMC on a midsized urban city (Windsor, Ontario). We compare our results with a similar study conducted in a remote community in British Columbia (BC).MethodsA broad array of community stakeholders representing different sectors were consulted using a semi-structured interview format replicated from the BC Northern Medical Program (NMP) study. Thematic analysis based on the resulting rich data was conducted within a grounded theory context.ResultsTwenty-three participants (52% male) representing healthcare, education, business, community and government/politico sectors were consulted. Their views regarding the Windsor Regional Medical Campus (WRMC) aligned around several themes: improved healthcare, enhanced community reputation, stimulated economic/community development, expanded training opportunities and an engaged community regarding the WRMC. These results were compared to the main findings of the NMP study with both similarities (e.g. increased community pride) and differences (e.g. resource concerns) discussed.ConclusionCommunity stakeholders provided strong support for the WRMC through their perceptions of its positive impact on this urban region. These findings are consistent with similar RMC studies in rural/remote areas. Those interested in developing a RMC might benefit from considering these findings.

Impacts of Health Care Industry Consolidation in Pittsburgh, Pennsylvania: A Qualitative Study.

While most studies of health care industry consolidation focus on impacts on prices or quality, these are not its only potential impacts. This exploratory qualitative study describes industry and community stakeholder perceptions of the impacts of cumulative hospital, practice, and insurance mergers, acquisitions, and affiliations in Pittsburgh, Pennsylvania. Since the 1980s, Pittsburgh’s health care landscape has been transformed and is now dominated by competition between 2 integrated payer-provider networks, health care system UPMC (and its insurance arm UPMC Health Plan) and insurer Highmark (and its health care system Allegheny Health Network). Semi-structured interviews with 20 boundary-spanning stakeholders revealed a mix of perceived impacts of consolidation: some positive, some neutral or ambiguous, and some negative. Stakeholders perceived consolidation’s positive impacts on long-term viability of health care facilities and their ability to adopt new care models, enhanced competition in health insurance, creation of foundations, and pioneering medical research and innovation. Stakeholders also believed that consolidation changed geographic access to care, physician referral behaviors, how educated patients were about their health care, the health care advertising environment, and economies of surrounding neighborhoods. Interviewees noted that consolidation raised questions about what the responsibilities of non-profit organizations are to their communities. However, stakeholders also reported their perceptions of negative outcomes, including ways in which consolidation had potentially reduced patient access to care, accountability and transparency, systems’ willingness to collaborate, and physician autonomy. As trends toward consolidation are not slowing, there will be many opportunities to experiment with policy levers to mitigate its potentially negative consequences.

Quality and sustainability of tourism development in Copper Canyon, Mexico: Perceptions of community stakeholders and visitors

The assessment of tourism development, based on the perspectives and opinions obtained from hosts and visitors could be considered as a basic requirement for the participatory management of destination sustainability. The general objective of this research is to study the contrasted perceptions of tourism development in Copper Canyon Park, according to the opinions of hosts and visitors, with the purpose of evaluating the perceived quality and sustainability of the destination within the context of an implanted territorial tourism development model. In this study, a characterization of the tourism development of Copper Canyon Park was conducted, local public opinion relating to the implanted tourism development model was studied, and perceptions of visitors regarding the destination were analyzed. Utilizing this methodology allowed the identification of compatibilities and incompatibilities, relating to the convergence between the community's perceptions, the visitors' experiences, and the characteristics of the receiving environment.

Based on the perceptions of community stakeholders, how can adolescent pregnancies be prevented? A qualitative study

Background: Adolescent pregnancy an important problem in adolescent health and government agencies need to focus on solving problem. The purpose of this research was to survey the perceptions of community stakeholders concerning the prevention of adolescent pregnancies in rural communities.Methods:Data collection was performed using group meetings with 103 stakeholders involved in adolescent pregnancy prevention. They were nurses, public health officials, parents or guardians, students, teachers, public health volunteers and community leaders. Thematic analysis indicated work on adolescent pregnancy prevention problems in rural areas was carried out by only some agencies such as district and sub-district health promoting hospitals, providing youth-friendly health service clinics and educating student leaders in schools on sex education.Results: Collectively, these results draw attention to the need for an appropriate program to strengthen adolescent, family and practitioner skills for the prevention of teenage pregnancies. Schools provide sex education as part of a health education curriculum, and some schools provide additional instruction in guidance classes. Problems from inconsistent work when networks fail were encountered. Stakeholders believe adolescent pregnancy prevention should focus on the following: (1) adolescents should receive training for skill development with content related to knowledge about sex, negotiation, refusal, morality and ethics, (2) teachers should receive training on comprehensive sexual education, and, (3) families should work to improve their communication on sexual health and developmentConclusions: There is a strong need for families to develop the ability to communicate with each other about sexuality and reproductive health. Developing parenting skills on how and when to talk about sex with their adolescents and open parental communication on sexuality issues at home is necessary. Activities need to also be developed for adolescents who are more inclined to engage in risky sexual behaviors.

Stakeholder Perceptions of Cyberbullying Cases: Application of the Uniform Definition of Bullying

PurposeThe Uniform Definition of Bullying was developed to address bullying and cyberbullying, and to promote consistency in measurement and policy. The purpose of this study was to understand community stakeholder perceptions of typical cyberbullying cases, and to evaluate how these case descriptions align with the Uniform Definition. MethodsIn this qualitative case analysis we recruited stakeholders commonly involved in cyberbullying. We used purposeful sampling to identify and recruit adolescents and young adults, parents, and professionals representing education and health care. Participants were asked to write a typical case of cyberbullying and descriptors in the context of a group discussion. We applied content analysis to case excerpts using inductive and deductive approaches, and chi-squared tests for mixed methods analyses. ResultsA total of 68 participants contributed; participants included 73% adults and 27% adolescents and young adults. A total of 650 excerpts were coded from participants' example cases and 362 (55.6%) were consistent with components of the Uniform Definition. The most frequently mentioned component of the Uniform Definition was Aggressive Behavior (n = 218 excerpts), whereas Repeated was mentioned infrequently (n = 19). Most participants included two to three components of the Uniform Definition within an example case; none of the example cases included all components of the Uniform Definition. ConclusionsWe found that most participants described cyberbullying cases using few components of the Uniform Definition. Findings can be applied toward considering refinement of the Uniform Definition to ensure stakeholders find it applicable to cyberbullying.

‘Church hurt can be the worst hurt’: community stakeholder perceptions of the role of Black churches in HIV prevention among young Black gay and bisexual men

Black gay and bisexual men aged 15–29 are disproportionately represented among new cases of HIV in the USA. Researchers have argued that community-based prevention cannot succeed without the participation of faith-based organisations, particularly given the salience of religion and spirituality in the lives of young Black gay and bisexual men. Yet some Black churches may be hesitant to engage in HIV prevention efforts given their beliefs about same-sex behaviour. It is less clear, however, whether and how public health practitioners in the field of HIV prevention have approached church inclusion. We therefore explored how community stakeholders describe the involvement of Black churches with the HIV continuum of care. We draw on a qualitative dataset of 50 in-depth semi-structured interviews conducted in Detroit, USA. Participants offered multiple perspectives on the response of Black churches to the HIV epidemic, from overt stigma to gradual acceptance and action. Nevertheless, participants agreed that when stigma was present in the pews and the pulpit, young Black gay and bisexual men were at potential risk of social isolation. Furthermore, tensions may exist between Black churches and secular community-based organisations that are attributable to histories of mistrust. These findings have important implications for future community-based intervention strategies among young Black gay and bisexual men.

Understanding and integrating knowledge to improve invasive species management

Most successful control or eradication programs have been implemented in uninhabited regions, where little or no consideration of socio-political factors has been required. A considerable challenge for invasion scientists and decision-makers lies in controlling and eradicating species from inhabited regions, where challenges related to community stakeholder perceptions of the need to act, animal rights and uncertainty surrounding the presence and abundance of invasive species can threaten program development and implementation. We interviewed senior policy advisors and scientists who developed and implemented European red fox eradication policies on the inhabited island state of Tasmania, Australia. Our aim was to understand how they perceived that scientific evidence and community stakeholders’ knowledge and preferences should be involved in developing and implementing policy for fox detection and eradication. Respondents perceived that scientific evidence was best used in determining the need to act, assessing risks, designing eradication operations and monitoring progress. Overall, they perceived that involving community stakeholders was important in creating socially acceptable eradication operations that enable access to private land to implement eradication options. Community stakeholders’ knowledge was perceived, largely by scientists, to be based on misinformation, misconceptions and mistrust in science and, therefore, of limited value in informing policy. Community stakeholders were therefore not viewed as equal partners in the policy-making process by scientists. Only those stakeholders who performed a clear function were considered valuable. We propose that increased likelihood of successful eradication of invasive species from inhabited areas can be achieved by using a functional approach to stakeholder inclusion, to prevent dissent and conflict by legitimizing varied knowledge and capacity, leading to co-production of knowledge within a co-management governance system.

ARSH 5: Reproductive Health Needs Assessment of Adolescents and Young People (15–24 y): A Qualitative Study on ‘Perceptions of Community Stakeholders’

To explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among adolescents in order to improve reproductive health services for adolescents. The study was conducted in three districts of Kerala and need assessment was done qualitatively using focus group discussions (FGDs), five each from all the three districts among junior public health nurses (JPHNs), anganwadi workers (AWWs), non-government organizations (NGOs), community leaders and adolescents. Majority of community stakeholders expressed that adolescents get knowledge regarding personal hygiene from their family itself and that they have poor knowledge about genital hygiene. Pain and associated problems are the most important difficulties faced by adolescent girls during menstrual periods. Most of the adolescents believed that excessive masturbation is a very dangerous practice. Most of the community stakeholders pointed out that though our adolescents know about HIV, they have very poor knowledge about other STIs and that parental ignorance increases vulnerability for sexual abuse among adolescents. They also suggested family life education sessions at schools and colleges for younger ones and premarital counseling for older ones, apart from counseling services and adolescent clinics. The important barriers in the utilization of services for adolescents are lack of awareness of parents, stigma to utilize services, economic factors, facility available at faraway places, and non-availability of services. The need for adolescent friendly health services and premarital counseling services in the community attached to health facilities, has been highlighted.