Communities organizing to promote equity: engaging local communities in public health responses to health inequities exacerbated by COVID-19-protocol paper.

Background: The COVID-19 pandemic has disproportionately impacted rural and under-resourced urban communities in Kansas. The state's response to COVID-19 has relied on a highly decentralized and underfunded public health system, with 100 local health departments in the state, few of which had prior experience engaging local community coalitions in a coordinated response to a public health crisis. Methods: To improve the capacity for local community-driven responses to COVID-19 and other public health needs, the University of Kansas Medical Center, in partnership with the Kansas Department of Health and Environment, will launch Communities Organizing to Promote Equity (COPE) in 20 counties across Kansas. COPE will establish Local Health Equity Action Teams (LHEATs), coalitions comprised of community members and service providers, who work with COPE-hired community health workers (CHWs) recruited to represent the diversity of the communities they serve. CHWs in each county are tasked with addressing unmet social needs of residents and supporting their county's LHEAT. LHEATs are charged with implementing strategies to improve social determinants of health in their county. Monthly, LHEATs and CHWs from all 20 counties will come together as part of a learning collaborative to share strategies, foster innovation, and engage in peer problem-solving. These efforts will be supported by a multilevel communications strategy that will increase awareness of COPE activities and resources at the local level and successes across the state. Our mixed methods evaluation design will assess the processes and impact of COPE activities as well as barriers and facilitators to implementation using aspects of both the Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) models. Discussion: This protocol is designed to expand community capacity to strategically partner with local public health and social service partners to prioritize and implement health equity efforts. COPE intentionally engages historically resilient communities and those living in underserved rural areas to inform pragmatic strategies to improve health equity.

Prevention is a privilege: Implementing drug-free community coalitions in Black communities.

Community-based interventions for youth substance use prevention require high levels of capacity to organize and coordinate community resources to support youth development and create opportunities to prevent youth substance use. This project aimed to better understand what Black prevention practitioners perceive as the requirements for a successful drug-free community coalition. Black prevention practitioners, who were engaged in drug-free community funded coalitions, had discussions about coalitions as a strategy for youth substance use prevention in Black communities. These facilitated discussions resulted in consensus over a set of nine core principles regarding successful youth substance use prevention coalition building in these communities.

Differences in perceptions of community stigma towards opioid use disorder between community substance use coalition members and the general public.

INTRODUCTION: To examine differences in perceptions about community stigma towards individuals with opioid use disorder (OUD) between community members involved in the opioid response (i.e., coalition members) and the general public, and how community geography may moderate this relationship. METHODS: This study administered identical cross-sectional surveys about perceived community opioid-related stigma to two distinct populations in 66 communities participating in the HEALing Communities Study prior to the intervention period (i.e., coalition members, November 2019-January 2020; residents, March-April 2020). Linear-mixed models compared survey responses of populations, including the moderating effect of community rural/urban location. RESULTS: A total of 826 coalition members and 1131 residents completed the surveys. The study found no differences between the coalition members and residents for general perceived community opioid-related stigma. In both urban and rural communities, coalition members reported greater perceived community stigma than residents reported towards medication for opioid use disorder (MOUD), naloxone, and drug treatment as an alternative to incarceration. CONCLUSION: Our findings suggest similar perceived community opioid-related stigma between coalition members and residents, yet differences emerge related to evidence-based practices (i.e., MOUD, naloxone, and drug treatment as an alternative to incarceration) to reduce opioid overdose deaths. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04111939.

Programa de promoción de la salud en una comunidad nativa de Alaska:: un caso de planificación estratégica y colaboración comunitaria / A program for health promotion in Alaska Native Community:: a case os strategic planning and community collaboration

En este trabajo se describe una iniciativa de promoción de la salud en una comunidad nativa de Alaska. La etnia Yupik vive en condiciones de aislamiento en la zona occidental de Alaska y tiene dificultades de acceso a servicios públicos, además de problemas de salud relacionados con los hábitos de vida. El proyecto "Healthy Living Through a Healthy Lifestyle" se basó en la planificación estratégica de servicios de salud y en la implementación de iniciativas de promoción de la salud en un asentamiento de esta etnia. Para ello se organizó un comité compuesto por miembros de la comunidad, profesionales de los servicios y personal investigador de la universidad. Además se contó con dos mediadores comunitarios de salud para facilitar el acceso de las familias a los servicios públicos. El programa puso el acento en la adaptación cultural de sus contenidos, en la colaboración entre los investigadores y los participantes y en la implicación de la comunidad en el diseño, implementación y evaluación del programa.

In this paper, we describe a health promotion initiative in a native community in Alaska. The Yupik ethnic group lives in isolation in Western Alaska and has poor access to public services, as well as health problems related to lifestyle. The "Healthy Living Through a Healthy Lifestyle" project was based on the strategic planning of health services and on the implementation of health promotion initiatives in a settlement of this ethnic group. For this, it was organized a committee of community members, service professionals and University researchers. It included also two community health mediators to facilitate families' access to public services. The program emphasizes cultural adaptation of contents, collaboration between researchers and participants and community involvement in the design, implementation and evaluation of the program.