Perspectives Of Community Members Research Articles

Exploring the perceived dynamic system driving inequities in the community obesogenic environment

Abstract Introduction Persons in socioeconomically disadvantaged situations (PSEDS) are more susceptible and disproportionally exposed to obesogenic environments, resulting in poorer dietary outcomes and lower levels of physical activity. This study aimed to map the complex dynamic system within the community obesogenic environment driving unhealthy eating and insufficient physical activity among PSEDS in Flanders, and to identify potential local actions. Methods Participatory group model building (GMB), a qualitative system dynamics method, was used to engage PSEDS (n = 7), local decision makers (n = 7) and local stakeholders (n = 5) in two Flemish municipalities. A two-day GMB session was held in each municipality during which a causal loop diagram (CLD) was created and potential local actions were identified by considering causal pathways and reinforcing loops in the system. Results The CLD was designed around two main variables (i) healthy eating and (ii) physical activity among PSEDS. Seven sub-systems could be identified: 1) social environment, 2) facilities and activities, 3) mobility options, 4) information, 5) affordability, 6) safety (specifically for physical activity), and 7) industry and advertisement (specifically for eating behaviour). Several actions to improve the local environment to promote eating behaviour and physical activity among PSEDS were identified. Conclusions The CLD illustrates the complex interactions between individual and environmental determinants contributing to inequalities in eating behaviour and physical activity by including multiple perspectives of community members in socioeconomically disadvantaged situations, local decision makers and local stakeholders. Both the participatory GMB approach and the final CLD visualization can provide the basis for planning local actions for promoting healthy eating behaviour and physical activity among PSEDS. Key messages • Group model building is an effective approach to explore and understand a dynamic complex system through a shared understanding among diverse stakeholders. • A systems approach is valuable to provide a more comprehensive and context-specific understanding of the perceived factors contributing to inequities in the obesogenic environment.

Why do new-borns die? Perspectives of community members and health care providers in the Lawra municipality of the Upper West Region, Ghana

BackgroundNeonatal deaths contribute significantly to under-five mortality and serve as a crucial indicator of a country’s socioeconomic development, quality of life, and health status. These deaths occur both at home and in health facilities. Therefore, the perspectives of community members and healthcare providers are essential in defining neonatal survival.AimThis study explored the perceived causes of neonatal deaths among healthcare professionals and community members at the Lawra Municipality in the Upper West Region, Ghana.MethodThis study employed a qualitative descriptive approach. A purposive sample of 30 participants including 18 community members and 12 healthcare providers, was selected. Data were gathered using Focus Group Discussion (FGD), transcribed verbatim, coded and analysed using thematic-content analysis.ResultsThree themes were constructed to describe the factors leading to newborn deaths both at health facilities and in the community. These factors included: (1) personal factors related to newborns, mothers/families and health staff; (2) physical factors related to hospital facilities and equipment; and (3) logistical factors related to transport, referral and presentation delays.ConclusionThe study identified differences in perspectives between healthcare providers and community members, which can affect interventions in neonatal care. Health authorities are encouraged to develop a shared vision to engage communities by addressing geographic-specific factors causing neonatal deaths. This approach can help in understanding how collective actions can contribute to reducing neonatal deaths.

Adapting citizens’ jury methodology for use in Uganda: use of creative arts as a tool in deliberative, participatory research

ABSTRACT A citizens’ jury is a method of deliberative action research to determine the perspectives of community members regarding complex healthcare issues. This approach is a novel paradigm in settings such as Uganda. Implementation of electronic medical records brings the potential to use routinely collected data for health research. It is important to understand community perspectives. A two-day citizens’ jury was hosted in Kampala. ‘Expert witnesses’ provided topical evidence. Three creative arts techniques were implemented to enable interaction and reflection. First, a local Ugandan film team produced summaries. Secondly, a local artist painted emerging themes. Finally, a drama team comprised community members living with HIV developed an interactive sketch highlighting key points. This creative methodology enabled vibrant interaction. Jurors reached a unanimous verdict that with appropriate consent and data protection, electronic medical data could be used for research. This adapted citizens’ jury methodology could be used in other similar settings.

The Role of Complicated Grief in Health Inequities in American Indian Communities

Complicated grief is both a cause and a consequence of health inequities in Native (American Indian/Alaska Native [AI/AN]) communities. Given disproportionately high rates of physical (e.g., cancer, diabetes, and heart disease) and mental health problems (e.g., substance use disorder, posttraumatic stress disorder) in Native communities, it is common for AI/AN people to suffer many losses each year. Experiences of traumatic or repeated losses may lead to the development of maladaptive grief, often known as complicated grief. The aim of the current study was to understand the perspectives of community members on grief and its connection with health inequities among AI people who have experienced the loss of a person with whom they were close. Using a community-based participatory research framework, we conducted semi-structured interviews with 12 AI adults from a rural reservation community. The ages of the participants ranged from 32 to 80 years ( M = 54.33, SD = 14.46) and women ( n = 7, 58.3%) and men ( n = 5, 41.7%) were included. The participants reported many barriers to healthy grieving and linked chronic, complicated grief with the development of multifaceted health problems, which were seen as exacerbating health disparities and leading to additional losses and grief. While coping with loss was difficult, many people were able to heal from extraordinary losses through community support and cultural practices. Future research with AI/AN communities is needed to develop, implement, and evaluate culturally responsive therapeutic grief treatments. There is also a pressing need to address current physical and mental health inequities to reduce the mortality rate and, thus, complicated grief in AI/AN communities.

What are individual‐level nature amends? Rescaling biodiversity offsetting from the community members' perspective

AbstractEffective solutions to biodiversity loss are multidimensional, requiring engagement from diverse stakeholders across various sectors and commitment levels. In this context, voluntary actions from community members emerge as a valuable addition to the large‐scale nature conservation activities conducted by states and municipalities. Such actions complement biodiversity protection measures and legal requirements aimed at companies. This article delves into the rescaling of biodiversity offsetting to the community members level and explores it from the perspective of community members. Through workshops organized in four Finnish municipalities, participants were prompted to reflect on biodiversity offsetting in their daily lives. The results show community members' limited resources to conduct pro‐biodiversity actions and highlight their diverse interpretations of the topic. Beyond direct biodiversity‐enhancing action, like maintaining rural biotopes, eradicating alien species, or protecting forests, workshop participants called for indirect actions. These included education, eco‐taxes, and the development of sharing economies. Thus, rather than solely focusing on biodiversity offsetting or the mitigation hierarchy, these suggestions underscore the need for diverse pro‐biodiversity actions at the community member's level. Furthermore, the results highlight the need for support that enables community members and communities' work for biodiversity. Introducing the concept of nature amends addresses this need, enhancing the mitigation hierarchy's capacity to incorporate community members in nature conservation endeavors.

Prevention & management of snakebite envenomation: A qualitative study on perspectives & practices in Maharashtra & Odisha.

Background & objectives Snakebite envenoming (SBE) is a major public health concern, with India bearing the highest global burden of SBE-related deaths. SBE is concentrated in rural and tribal regions of India, where the knowledge, attitude and behaviour of the dwelling communities largely influence mortality and morbidity. Understanding these factors is crucial to designing effective SBE prevention and management strategies. The present study's objective was to document the perspectives of community members and practices in selected blocks of Maharashtra and Odisha States regarding SBE prevention, first aid and health-seeking behaviour. Methods Between March and April 2022, 28 focus group discussions (FGDs) were conducted. Study sites included Shahapur block in Thane district, Aheri block in Gadchiroli district of Maharashtra, and Khordha block in Khordha district, Kasipur block in Rayagada district of Odisha. Separate FGDs were held for males (n=14) and females (n=14), involving about 8-16 participants above 18 yr. All discussions were audio recorded, and a grounded theory approach was employed to identify key themes from the translated transcripts. Results The findings of this study revealed a variety of perspectives and practices determining the SBE burden at the study sites. The findings included insufficient knowledge about snake species and their nature of toxicity, use of non-scientific first aid techniques, inaccessible health care and reliance on traditional healers, non-utilization of prevention methods, varied cultural beliefs and practices, and differential treatments based on gender. The findings have been collated in two simplistic frameworks; barriers to effective prevention and barriers to effective management. Interpretation & conclusions SBE burden results from a complex interplay between socioeconomic, cultural, and demographic factors, necessitating a collaborative inter-sectoral effort for adequate control. Through crucial regional inputs and the barriers to prevention and management models, this study provides critical insights and priority intervention areas to strengthen India's upcoming National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) in all high-burden States.

Voices from the community: The perspective of nonprofit organizations in student philanthropy courses

ABSTRACT This paper investigates the perspective of community members engaged with experimental learning in student philanthropy courses. While most scholarship explores the impact that student philanthropy practices have on students’ learning process and the overall effectiveness of these courses, this study aims to understand the impact of student philanthropy courses on community partners. We rely on a survey and focus groups to assess the perspectives of both nonprofits that participated in student philanthropy courses and nonprofits that decided against participating. We find that nonprofits see relational and advocacy benefits in participating in these courses, beyond the most obvious potential benefit of being awarded a grant. While we found overall satisfaction with the course, we also identified barriers to participation, which informs a list of practical recommendations. This study points to the possibility to better student philanthropy processes and improve the experience of participating nonprofits.

Using community-based participatory research methods to build the foundation for an equitable integrated health data system within a Canadian urban context

Health inequalities amplified by the COVID-19 pandemic have disproportionately affected racialized and equity-deserving communities across Canada. In the Municipality of Peel, existing data, while limited, illustrates that individuals from racialized and equity-deserving communities continue to suffer, receive delayed care, and die prematurely. In response to these troubling statistics, grassroots community advocacy has called on health systems leaders in Peel to work with community and non-profit organizations to address the critical data and infrastructure gaps that hinder addressing the social determinants of health in the region. To support these advocacy efforts, we used a community-based participatory research approach to understand how we might build a data collection ecosystem across sectors, alongside community residents and service providers, to accurately capture the data about the social determinants of health. This approach involved developing a community engagement council, defining the problem with the community, mapping what data is actively collected and what is excluded, and understanding experiences of sociodemographic data collection from community members and service providers. Guided by community voices, our study focused on sociodemographic data collection in the primary care context and identified which service providers use and collect these data, how data are used in their work, the facilitators and barriers to data use and collection. Additionally, we gained insight into how sociodemographic data collection could be respectful, safe, and properly governed from the perspectives of community members. From this study, we identify a set of eight recommendations for sociodemographic data collection and highlight limitations. This foundational community-based work will inform future research in establishing data governance in partnership with diverse and equity-deserving communities.

Legitimacy through representation? Media sources and discourses of offshore wind development

IntroductionThe choice of which individuals and entities to include as sources in newspaper articles is an important decision for journalists, in large part because they can shape how readers understand the issue and which arguments become most salient. This is particularly important for issues that are relatively new or unknown to readers. The growing topic of offshore wind in the United States is a prime example of an issue that many people are encountering for the first time via media reporting. This issue has also proven to be highly divisive, with heated oppositional arguments being promoted by different entities. This study seeks to understand which entities are being represented in media coverage of offshore wind, and the different framing strategies that various entities use in quotes about the first two large-scale projects in the United States, South Fork Wind and Vineyard Wind I.MethodsWe use a newspaper content analysis to identify and code the sources quoted in articles reporting on South Fork Wind and Vineyard Wind I from 2013-2022, as well as the emphasis frames used by each entity.ResultsWe find that coverage varies in the two cases, but developers and political officials are quoted most frequently. As these entities tend to use frames highlighting the benefits of offshore wind more frequently than the risks, those perspectives dominate news coverage. Meanwhile, perspectives of community members and impacted industries such as the fishing industry are represented less frequently in news coverage.DiscussionThese findings help explain the dominance of certain frames and perspectives in offshore wind, and they raise important questions about which voices are legitimized through representation in news media.

Resident perspectives on a pre-booking diversion program.

Numerous cities are experimenting with pre-booking diversion programs that allow police officers to divert community members to supportive services in instances that would otherwise result in arrest and prosecution. These programs aim to decrease harmful involvement with the criminal justice system while reducing crime and public disorder. Although previous research has explored the experiences of people receiving diversion referrals and of police officers initiating them, none have examined the perspectives of community members who can offer crucial insights into planning, evaluation, and implementation barriers. We administered a survey to 293 people living in four police districts where the Philadelphia Police Department operates a pre-booking diversion program. The survey explored residents' perspectives on the program as well as their broader views on associated issues like decriminalization of substance use, sex work, and minor theft. Bivariate χ2 tests and multivariate logistic regression examined differences in responses between subgroups. Perspectives were diverse and varied based on demographic attributes of the respondents as well as on district level attributes, like crime patterns. Most surveyed community members perceived pre-booking diversion to be a valuable tool for improving the experiences and outcomes of policing. However, residents living in areas with more crime and with more public disorder held significantly less positive perspectives. Their skepticism may reflect the possibility that pre-booking diversion and similar reforms are necessary but not sufficient to transforming individual health and public safety in some areas.

Towards human-centred standards for legal help AI.

As more groups consider how AI may be used in the legal sector, this paper envisions how companies and policymakers can prioritize the perspective of community members as they design AI and policies around it. It presents findings of structured interviews and design sessions with community members, in which they were asked about whether, how, and why they would use AI tools powered by large language models to respond to legal problems like receiving an eviction notice. The respondents reviewed options for simple versus complex interfaces for AI tools, and expressed how they would want to engage with an AI tool to resolve a legal problem. These empirical findings provide directions that can counterbalance legal domain experts' proposals about the public interest around AI, as expressed by attorneys, court officials, advocates and regulators. By hearing directly from community members about how they want to use AI for civil justice tasks, what risks concern them, and the value they would find in different kinds of AI tools, this research can ensure that people's points of view are understood and prioritized, rather than only domain experts' assertions about people's needs and preferences around legal help AI. This article is part of the theme issue 'A complexity science approach to law and governance'.

Perspectives of community members on community-based participatory research: A systematic literature review

ABSTRACT Anchor institutions are a part of a complex urban governance regime influencing policy, investment and programming in urban neighborhoods. Anchor land-grant educational institutions are questioning their role in conducting impactful research in and with the community. We find growing evidence of interest in community-based participatory research (CBPR) by universities and funders. Utilizing a systematic literature review we analyze peer-reviewed scholarship on CBPR. While the number of CBPR publications has been on the rise since 2005 and the term CBPR among others is used most frequently across the fields, the trend in the social sciences is lagging. About half of the CBPR literature provides community perspectives, and less than a third was coauthored with community partners. We find community perspectives and voices are more limited in the social sciences. We attribute this phenomenon to funding limitations and the potential for bias in the peer-review process of relevant journals.

Looking Inward, Looking Forward: Articulating Alternatives to the Current Education System for Adivasis, by Adivasis

This article explores the conceptualisation of alternative education based on the lived realities of marginalised indigenous communities. By amplifying the voices of the Bettakurumba, Kattunayakan, Mullakurumba and Paniya communities, the article explores their vision for an alternative education system that promotes equality and justice, and the implications of such an alternative to the larger discourses on alternative education. The study foregrounds the lived experiences and perspectives of community members, utilising qualitative data gathered from focus group discussions and workshops involving 165 participants. The participants demand for an education that enables their children to navigate both their traditional environments and the modern world, fostering knowledge, dignity, character and contentment. Recognising that schools alone are inadequate, the article suggests reclaiming the village as a learning space and strengthening leadership within these communities. Furthermore, it outlines specific educational practices that can facilitate the development of a culturally relevant education system for Adivasi children.

Subaltern perspectives of developing communication campaigns: Re-examining the culture-centered approach in addressing health disparities

ABSTRACT A central component of the culture-centered approach is the co-development of communication infrastructures for health and wellbeing within subaltern communities. However, there is an absence in the representation of these infrastructures in esteemed journals. This is problematic for illuminating the tensions and complexities in bringing theory into practice from the perspective of community members. This study draws from two culture-centered projects to explore how communities make sense of the process of participating in building interventions, comprising 119 initial in-depth interviews with residents, 10 community advisory board focus groups, and 21 evaluative interviews. The residents’ narratives reveal a relationship between subalternity and distrust toward interventions delivered by providers outside of their community, emphasizing the need to create spaces of listening that anchor community relationships. The formation of relationships was crucial to the development of communication infrastructures, which continued beyond the study. The contributions to intercultural and international communication are discussed.

“The needle is already ready to go”: communities’ and health care professionals’ perceptions of routine vaccination in Nunavik, Canada

ABSTRACT Inuit living in the northern region of Nunavik continue to experience significant health inequalities, which are rooted in colonialism that still have repercussions on their health-related perceptions and practices, including vaccination. This study aimed to explore the perceptions and determinants of routine vaccination among the Inuit of Nunavik by describing factors influencing vaccination decisions from the perspective of community members and health professionals. Semi-structured interviews focusing on the perception of vaccination and experience with vaccination and health services were conducted with 18 Inuit and 11 non-Inuit health professionals. Using the socio-ecological model, factors acting at the community and public policy (e.g. rumours and misinformation about vaccination, language barrier), organisational (e.g. complexity of the vaccination process, staff turnover, lack of specialised vaccination workers and interpreters), and intrapersonal and interpersonal (e.g. past experiences with vaccination, vaccine attitudes, social norms) levels were identified as having an impact on vaccination decisions. Improving vaccination coverage in Nunavik requires a more global reflection on how to improve and culturally adapt the health care and services offered to the Inuit population.

Health Resource Gaps in Primary Health Care Facilities: Community Members’ Perspectives in the Era of Universal Health Coverage in Lawra Municipality, Ghana

Background. Health resources are key determinants of healthcare coverage. Community members who utilise healthcare have significant insights into the availability of health resources in providing healthcare. Aim. This study sought to explore community (health committee) members’ perspectives on health resource gaps in lower-level health facilities in the municipality. Methods. The qualitative descriptive study explored the perspectives of community members who served on the health committee. Thirty-four community health committee members at community-based health planning and services (CHPS) compounds, maternity-unit CHPS, and health centres were studied. Results. The study found three high-level categories of resource gaps deemed relevant to community members—infrastructural gaps, equipment gaps, and safety-quality gaps. Conclusion and Recommendation. There are perceived gaps in health resources from the community members’ perspective. It is recommended that the Lawra Municipal Health Directorate and other health directorates with similar health resource challenges take steps to fill health resource gaps to ensure universal health coverage.

The CPT1A Arctic variant: perspectives of community members and providers in two Alaska tribal health settings.

Newborn screening in Alaska includes screening for carnitine palmitoyltransferase 1A (CPT1A) deficiency. The CPT1A Arctic variant is a variant highly prevalent among Indigenous peoples in the Arctic. In this study, we sought to elicit Alaska Native (AN) community member and AN-serving healthcare providers' knowledge and perspectives on the CPT1A Arctic variant. Focus groups with community members and healthcare providers were held in two regions of Alaska between October 2018 and January 2019. Thematic analysis was used to identify recurring constructs. Knowledge and understanding about the CPT1A Arctic variant and its health impact varied, and participants were interested in learning more about it. Additional education for healthcare professionals was recommended to improve providers' ability to communicate with family caregivers about the Arctic variant. Engagement with AN community members identified opportunities to improve educational outreach via multiple modalities for providers and caregivers on the Arctic variant, which could help to increase culturally relevant guidance and avoid stigmatization, undue worry, and unnecessary intervention. Education and guidance on the care of infants and children homozygous for the CPT1A Arctic variant could improve care and reduce negative psychosocial effects.

Exploring the perspectives of community members on use of Nyaope in Tshwane, South Africa

Background: Substance use is a major public health issue in South Africa. Cocktails, containing two or more low-quality substances, have been reported. Nyaope is one of the most popular and is widely available. It has a significant impact on users and communities. The aim of this study was to explore community members’ perceptions of the potential contributors to Nyaope use and dependency.Methods: This was an exploratory descriptive qualitative study that conducted three focus group interviews with 29 community members. A maximum variation sample was used. Data were analysed using the framework method, assisted by Atlas-ti.Results: Seven main themes were identified, namely unfavourable home environments, distrust between community members and the local police, easy access to Nyaope at school, inadequate social services, lack of religious or spiritual drive, unfavourable community environments and the effects of Nyaope on users.Conclusion: The factors identified, were used to construct an emerging model of how Nyaope use is driven in Tshwane. It is clear that a multisectoral response is required involving health and social services, basic education, policing and community leadership. Further research will explore the views of family members and users and quantify the importance of the factors identified.Contribution: This study showed that rather than a simple linear chain of events, Nyaope use is enabled by a complex system of interconnected elements. According to the respondents, variables in the community at large, the school, the home and the specific user all have a role in Nyaope usage and dependency.

The Perspective of Community Members in the Assessment of the Social Value Generated by Non-profit and Voluntary Organizations

This study aimed at developing a scale to measure Social Added Value (SAV) according to the perspective of community members, building on the relational framework and complementing the work of Mannarini et al. (Voluntas: Int J Voluntary Nonprofit Organ 29(6):1315–1329, 2018). The study was conducted on 720 Italian citizens who were not directly involved in Nonprofit and Voluntary Organizations (NPVOs) as active members to examine the statistical validity and psychometric properties of the SAV scale. Confirmatory factor analyses showed that good and satisfactory fit indexes were obtained by a third-order factor model saturated by two second-order variables (contribution to community and quality of external relationships) and eight first-order variables (services and tasks, vision, social responsibility, control mutuality, communality relationship, trust, commitment, capacity to build community connections). Additional analyses revealed that both perceived NPVOs target values and sense of belonging to the community were positively associated with SAV. Theoretical, methodological and practical implications of the findings are discussed.

Knowledge and perspectives of community members on risk assessment for stroke prevention using mobile health approaches in Nigeria

ObjectivesTo assess the knowledge of community dwelling adults on stroke risk and their willingness to use mobile health (mHealth) technology in assessing their stroke risk. Materials and MethodsA cross-sectional study was conducted among adults (≥18 years old) using survey questionnaires designed by neurologists and health promotion experts and administered by trained study staff. Logistic regression models were used to assess factors associated with receptivity toward knowing individual stroke risk score and willingness to use a mobile application (App) to assess stroke risk. ResultsThe survey was administered to 486 participants in Nigeria, with a mean age of 47.4 ± 15.5 years, comprising 53.5% females. Up to 84% of participants wanted to know their risk for developing stroke but only 29.6% of respondents had ever previously had their stroke risk assessed. Factors associated with willingness to know stroke risk were age [aOR (95% CI): 0.97 (0.95 – 0.99)], and Hausa tribe [16.68 (2.16 – 128.92)]. Up to 66% of participants wanted to know their immediate risk of stroke, compared with 6.6% and 2.1% who wanted to know their 5-year or 10-year future stroke risks respectively. Regarding locations, participants preferred stroke risk assessment to be performed at a health facility, at home by health professional, on their own using mHealth (stroke risk calculator application), or at communal gatherings (decreasing order). About 70% specifically wished to learn about their stroke risk via an mHealth application. ConclusionsCommunity dwelling Nigerians wanted to know their immediate risk of stroke using digital platforms, such as a mobile phone stroke risk calculator application. Clinical trials are needed to assess the effectiveness of such a strategy for primary prevention of stroke in sub-Saharan African communities.