Training Community Leaders to Serve as Equal Partners in Research: Penn Community Scholars Program, 2015-2023.

An implementation and effectiveness evaluation of the Community Scholars Program was conducted at the University of Pennsylvania to enhance community capacity to collaborate with academics in mutually beneficial, equitable, and transformative research. Mixed methods were employed using administrative data, surveys, and key informant interviews. Participants expressed high satisfaction, valued interactive learning, and identified areas for improvement. The program increased knowledge and self-confidence in research-related skills and trust in the research process. The program serves as an institutional model to create long-term, mutually beneficial community-academic partnerships. (Am J Public Health. 2024;114(3):284-288. https://doi.org/10.2105/AJPH.2023.307549).

Co-designing community-level integral interventions for active ageing: a systematic review from the lens of community-based participatory research.

BACKGROUND: While community-level interventions for promoting active ageing have received increasing attention and there is a trend to leverage technology to support traditional physical or social interventions, little hands-on guidance exists for designing these integral interventions. This study aimed to examine the interventions reported in the literature guided by Community-Based Participatory Research (CBPR) principles. The goal is to extract insights that inform future practices in co-designing integral interventions for active ageing. METHODS: The systematic review focused on community-level interventions promoting active ageing that integrated physical, social, and digital elements, i.e., integral interventions. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The included interventions were analysed abductively based on the CBPR principles. RESULTS: A total of 13 studies were included, and 24 design considerations were generated under eight categories. Further reflection identified the interrelated nature of these design considerations and pinpointed the gaps in current research. This study highlights the urgency and importance of sharing recruitment methods and resource allocation details, recording and reporting collaboration specifics, and disseminating findings to stakeholders beyond academia. CONCLUSIONS: This study offers valuable insights and practical guidance to researchers and practitioners developing community-level integral interventions for active ageing. The findings also serve as a starting point for accumulating knowledge and practice in co-designing integral interventions for active ageing at the community level. The next crucial phase involves evaluating these design considerations within real-world cases to assess their applicability and identify potential areas for improvement.

Cultivating Relationships as a Community-Based Recruitment Strategy in Transdisciplinary Aging Research: Lessons From an Academic-Community Partnership.

Participation of Black American older adults in community-engaged research remains challenging in health sciences. The objectives of this study were to describe the specific efforts, successes, and challenges in recruiting Black American older adults in research led by the Health and Wellness in Aging Across the Lifespan core, part of the Virginia Commonwealth University Institute for Inclusion, Inquiry, and Innovation (iCubed). We conducted a cross-case analysis of 6 community-engaged research projects using the community-engaged research continuum model. Successful recruitment strategies comprised a multifaceted approach to community-based collaboration, including a wellness program with a long standing relationship with the community, engaging key stakeholders and a community advisory board, and building a community-based coalition of stakeholders. Posting flyers and modest monetary compensation remain standard recruitment strategies. The cross-case analysis offered critical lessons on the community's nature and level of engagement in research. Relationship building based on trust and respect is essential to solving complex aging issues in the community.

The Báa nnilah Program: Results of a Chronic-Illness Self-Management Cluster Randomized Trial with the Apsáalooke Nation.

Indigenous people in Montana are disproportionately affected by chronic illness (CI), a legacy of settler colonialism. Existing programs addressing CI self-management are not appropriate because they are not consonant with Indigenous cultures in general and the Apsáalooke culture specifically. A research partnership between the Apsáalooke (Crow Nation) non-profit organization Messengers for Health and Montana State University co-developed, implemented, and evaluated a CI self-management program for community members. This article examines qualitative and quantitative program impacts using a pragmatic cluster randomized clinical trial design with intervention and waitlist control arms. The quantitative and qualitative data resulted in different stories on the impact of the Báa nnilah program. Neither of the quantitative hypotheses were supported with one exception. The qualitative data showed substantial positive outcomes across multiple areas. We examine why the data sets led to two very different stories, and provide study strengths and limitations, recommendations, and future directions.

Weaving community-based participatory research and co-design to improve opioid use treatments and services for youth, caregivers, and service providers.

Integrating the voices of service users and providers in the design and delivery of health services increases the acceptability, relevance, and effectiveness of services. Such efforts are particularly important for youth opioid use treatments and services, which have failed to consider the unique needs of youth and families. Applying community-based participatory research (CBPR) and co-design can facilitate this process by contextualizing service user experiences at individual and community levels and supporting the collaborative design of innovative solutions for improving care. However, few studies demonstrate how to effectively integrate these methods and engage underserved populations in co-design. As such, this manuscript describes how our team wove CBPR and co-design methods to develop solutions for improving youth opioid use treatments and services in Canada. As per CBPR methods, national, provincial, and community partnerships were established to inform and support the project's activities. These partnerships were integral for recruiting service users (i.e., youth and caregivers) and service providers to co-design prototypes and support local testing and implementation. Co-design methods enabled understanding of the needs and experiences of youth, caregivers, and service providers, resulting in meaningful community-specific innovations. We used several engagement methods during the co-design process, including regular working group meetings, small group discussions, individual interviews and consultations, and feedback grids. Challenges involved the time commitment and resources needed for co-design, which were exacerbated by the COVID-19 pandemic and limited our ability to engage a diverse sample of youth and caregivers in the process. Strengths of the study included youth and caregiver involvement in the co-design process, which centered around their lived experiences; the therapeutic aspect of the process for participants; and the development of innovations that were accepted by design partners.

A Community-Based Participatory Approach in Applying the Sociocultural Resilience Model in U.S-Mexico Border Communities.

BACKGROUND: Behavioral models play a key role in identifying pathways to better health and provide a foundation for health promotion interventions. However, behavioral models based in epidemiological research may be limited in relevance and utility in practice. OBJECTIVES: We describe a participatory approach within a community-based participatory research partnership for integrating epidemiological and community perspectives into the application of the sociocultural resilience model (SRM). The SRM posits that cultural processes have a symbiotic relationship with health-promoting social processes, which contribute to the health advantages among Mexicanorigin and other Latinx populations. METHODS: Community action board members engaged with academic partners to interpret and apply the SRM to a community-clinical linkages intervention implemented in the context of three U.S.-Mexico border communities. In a two-day workshop, partners engaged in a series of iterative discussions to reach common definitions and measures for SRM constructs. RESULTS: Partners described daily cultural processes as the food they eat, how they communicate, and a collectivist approach to getting things done. For intervention activities, the partners opted for intergenerational storytelling, sharing of food, and artistic forms of expression. Partners included measures of cultural nuances such as border identity and the complexities that often arise from navigating bicultural norms. CONCLUSIONS: Collaborative approaches within community-based participatory research partnerships can facilitate the adaptation and measurement of conceptual health behavior models in community practice.

Heads Together Online Peer Education (HOPE): co-design of a family-led, video-based resource for families affected by paediatric acquired brain injury.

Background Many families of children with acquired brain injuries (ABI) desire opportunities to connect with peers who have shared similar experiences, but such opportunities are often unavailable. Heads Together Online Peer Education (HOPE) is a co-designed online video-based resource that provides information and early support to families following paediatric ABI. This study is part of a larger co-creation project using a community-based participatory research approach to develop and implement HOPE for families impacted by paediatric ABI in Australia. This study aimed to explore parents' and clinicians' perspectives regarding HOPE's usability, acceptability, and future implementation. Methods Parents and clinicians were recruited from a state-wide, interdisciplinary rehabilitation service. Parents were eligible to participate if their child had sustained an ABI within 2 years of recruitment. Participants accessed HOPE, completed the System Usability Scale (SUS), and participated in a semi-structured interview. Transcripts were analysed using inductive content analysis. Results Ten parents and 13 rehabilitation clinicians participated. Average SUS scores were 80.5/100 and 81.73/100, respectively. Participants were satisfied with HOPE's family-centred content and delivery. They expressed having benefited from using HOPE and offered suggestions for its optimisation. Finally, participants reflected on how HOPE could be introduced to and used by families, and its potential usefulness in educating others about paediatric ABI. Conclusions HOPE was developed through a family-led co-design process and aims to provide information and support to families in the early stages following paediatric ABI. This study's findings demonstrate HOPE's usability and acceptability from end-users' perspectives and will guide implementation.

Mi Gente, Nuestra Salud: Protocol for a People's Movement for Health Ownership.

BACKGROUND: Community-based participatory research (CBPR) is an increasingly recognized approach to address health inequities. Although in CBPR all processes occur within the community context, its diagrammatic model places the intervention/research outside of the community rather than conceptualizing it as an event in a complex web of system components. OBJECTIVES: We sought to 1) introduce a systems-oriented community ownership conceptual framework that integrates a systems perspective with CBPR and 2) to describe an application of this framework in the form of the Mi Gente, Nuestra Salud initiative, a research-based, action-oriented collaboration between Cal Poly investigators and community partners in Santa Maria and Guadalupe, California. METHODS: We conducted a stocktake of community assets and partnerships in Santa Maria and Guadalupe, among California's poorest and most medically underserved cities; created marketing materials; launched the initiative in December 2020; and collected survey and interview data on community health concerns. An advisory board guides direction of the work. Activities are intended to affect partnerships (who is involved in actions and decisions) and processes (what actions will be taken), as well as resources (e.g., building human and social capital by changing narratives of local, historically rooted power dynamics and offering peer learning opportunities on advocacy and health care interactions). Implementation challenges within this framework are also discussed. CONCLUSIONS: By de-centering specific interventions and conceptualizing them as single events in a complex web, our system-oriented community ownership model brings the focus back to the system itself, and to system-based processes and solutions, while still guided by CBPR principles.

Community-engaged Research Disruption: The Impact of the COVID-19 Pandemic on Research With Communities.

BACKGROUND: The pandemic has had dire consequences on community-engaged research. OBJECTIVES: We describe research challenges imposed by the pandemic on our breast and cervical cancer intervention study with Southeast Asian immigrant women, and strategies used to maintain study continuity. METHODS: The pandemic's impact on the research team, recruitment and retention of participants, study design, and strategies executed to these issues are described. RESULTS: Strategies employed to address research challenges include implementing coronavirus disease 2019 protocols for conducting community research; recruiting participants online, outside of the planned community locations, and through social media; and enhancing the study design by using respondent-driven sampling. In addition to educating communities about early cancer detection, we also provided information and resources about coronavirus disease 2019, including transmission mitigation, testing, and vaccination. CONCLUSIONS: Continuing to engage the communities in our study is critical to our long-term goal of eliminating cancer screening disparities in Southeast Asian immigrant communities.

"Community 101 for researchers": an online training program to build capacity for ethical community-engaged research with Native Hawaiians and Pacific Islanders.

To address the history of unethical research and community distrust in research among Native Hawaiian and Pacific Islander communities, we developed the "Community 101 for Researchers" training program, which was launched in 2014 to enhance the capacity of researchers to engage in ethical community-engaged research. The purpose of this paper is to describe the development of this training program as well as its reach and feedback from participants. The Community 101 training program is a self-paced, 2-h online training program featuring community-engaged researchers from the University of Hawai'i and their longstanding community partners. Throughout the five modules, we highlight the historical context of Native Hawaiians and Pacific Islander populations in Hawai'i related to research ethics and use examples from the community as well as our own research projects that integrate community ethics, relevance, benefits, and input. To determine reach and gather participant feedback on the training, we extracted data from the user accounts. The training has been completed by 697 users to-date since its launch. Despite very little advertisement, an average of nearly 70 users have completed the Community 101 Program each year. The majority of the participants were located in Hawai'i though participants were also from other states and territories in the US, and international locations. The majority of participants were from universities in Hawai'i in 51 different departments demonstrating multidisciplinary relevance of the program's training. The general feedback from the 96 participants who completed an optional anonymous evaluation survey given at the end of the training was positive. The "Community 101 for Researchers" Training program is an accessible and relevant tool that can be used to advance ethical community engaged research, specifically with Native Hawaiian and Pacific Islander communities.

Territórios rurais contra a Covid-19: saberes, fazeres e reflexões por meio da Educação Popular em Saúde / Territorios rurales contra la Covid-19: saberes, haceres y reflexiones a partir de la educación popular en salud / Rural territories against Covid-19: knowledge, actions and reflections from popular health education

Este artigo se apoia na sistematização de experiências de Oscar Jara para reconstruir os caminhos de uma pesquisa-ação participativa em saúde nas comunidades rurais com base em experiências de prevenção e cuidado à saúde no enfrentamento da Covid-19. Desde junho de 2020 temos desenvolvido experiências de Educação Popular em Saúde (EPS) no campo, pautadas pela pedagogia freiriana nos territórios do norte e na baixada litorânea do estado do Rio de Janeiro, especificamente áreas de reforma agrária vinculadas ao Movimento dos Trabalhadores Rurais Sem Terra; em um território quilombola; e em um coletivo de mulheres interligado à Articulação de Agroecologia Serramar. A análise dessas experiências aponta alternativas pedagógicas produzidas pelo encontro entre saberes acadêmicos e populares, buscando amparo na comunicação popular, no protagonismo das comunidades rurais, em especial de mulheres, como produtoras de conhecimento, práticas de cuidado e de resistência.(AU)

Este artículo se apoya en la sistematización de experiencias de Oscar Jara para reconstruir los caminos de una investigación-acción participativa en salud con comunidades rurales, a partir de experiencias de prevención y cuidado de la salud en el enfrentamiento de la Covid-19. Desde julio de 2020, desarrollamos experiencias de educación popular de salud en el campo basadas en la pedagogía de Paulo Freire con territorios del norte y en la región conocida como "Baixada" del Estado de Río de Janeiro, específicamente áreas de reforma agraria vinculadas al Movimiento de los Trabajadores Rurales Sin Tierra, un territorio quilombola y un colectivo de mujeres interconectado a la Articulación de Agroecología Serramar. El análisis de esas experiencias señala alternativas pedagógicas producidas a partir del encuentro entre saberes académicos y populares, buscando amparo en la comunicación popular, en el protagonismo de las comunidades rurales, en especial de mujeres, como productoras de conocimiento, prácticas de cuidado y resistencia.(AU)

This article is founded on the systematization of Oscar Jara's experiences to rebuild the paths of Participatory Action Research in Health in rural communities based on experiences of prevention and health care in coping with Covid-19. Since June 2020, we have been developing popular education experiences in rural health guided by Paulo Freire's pedagogy in northern territories and in the coastal lowlands of the state of Rio de Janeiro, specifically in areas of agrarian reform linked to the Landless Workers Movemen (MST); a quilombola territory; and a women's collective connected to the Working Group of Women of the Serramar Articulation of Agroecology (GT Mulheres Serramar). The analysis of these experiences points towards pedagogical alternatives produced from academic and popular knowledge, seeking support in popular communication, in the protagonism of rural communities, especially with regard to women as producers of knowledge, care practices and resistance.(AU)

Estrategias comunitarias para la seguridad alimentaria en indígenas wayuu, La Guajira, Colombia / Community strategies for food security in indigenous wayuu, la guajira, colombia

Fundamentos: La desnutrición infantil como problema de inseguridad alimentaria aflige principalmente a las poblaciones más vulnerables, entre ellas las comunidades indígenas. El objetivo fue dar a conocer los microproyectoscreados con tres comunidades indígenas Wayuu sobre su seguridad alimentaria y evaluar la implementación de dichas estrategias. Métodos: investigación participativa basada en la comunidad (Community Based Participatory ResearchCBPR), incluyó la participación de 46 familias (204 personas). Se aplicaron técnicas de recolección como foros comunitarios, círculos de saberes, fotovoz, observación participante y recorridos del territorio. Resultados: La seguridad alimentaria de estas comunidades está atravesada por estrategias como a) creación dehuertas comunitarias como una alternativa sostenible para su autonomía y el rescate de sus prácticas ancestrales, b) educación nutricional intercultural al propiciar una articulación de saberes propios y académicos alrededor de la alimentación y la nutrición y c) fortalecimiento comunitario que a partir de los planes de vida fomenta el equilibrio, la armonía y el bienestar dentro del territorio. Conclusiones: La seguridad alimentaria debe ser concebida como un pilar en el plan de vida de las comunidades indígenas en tanto fomenta su autonomía y la restauración de sus vidas en el territorio, en su cultura y en sus conocimientos. (AU)

Background: Child malnutrition as a problem of food insecurity mainly afflicts the most vulnerable populations among them, indigenous communities. The objective was to publicize the microprojects created with three Wayuuindigenous communities on their food security and to evaluate the implementation of these strategies.Methods: Community Based Participatory Research (CBPR), included the participation of 46 families (204 people).Collection techniques such as community forums, circles of knowledge, photo voice, participant observation and tours ofthe territory were applied. Results: The food security of these communities is crossed by strategies such as a) creation of community gardens as a sustainable alternative for their autonomy and the rescue of their ancestral practices, b) intercultural nutritional educationby promoting an articulation of their own and academic knowledge about food and nutrition and c) community strengthening that, based on life plans, promotes balance, harmony and well-being within the territory. Conclusions: Food security must be conceived as a pillar in the life plan of indigenous communities as it fosters their autonomy and the restoration of their lives in the territory, in their culture and in their knowledge. (AU)

Inserção de um grupo virtual na rede social de apoio ao aleitamento materno exclusivo de mulheres após a alta hospitalar / Inclusion of a virtual group in a social support network to exclusive breastfeeding after hospital discharge / Inserción de un grupo virtual en la red social de apoyo a la lactancia materna exclusiva de mujeres después de recibir el alta del hospital

Apesar dos benefícios do aleitamento materno exclusivo para a saúde materno-infantil, sua interrupção precoce ainda é muito frequente. O período após a alta hospitalar é o momento em que a mulher se depara com a maioria das dificuldades, sendo importante fortalecer as ações de apoio à amamentação. Este trabalho teve por objetivo desvelar as contribuições da inserção de uma comunidade virtual na rede social de apoio ao aleitamento materno exclusivo de mulheres após a alta hospitalar. Trata-se de um estudo qualitativo, realizado em um grupo privado da rede social Facebook, gerenciado por profissionais de saúde, utilizando-se como referencial metodológico a Pesquisa Participativa Baseada na Comunidade. O grupo foi um instrumento de promoção de diálogo e interação entre mulheres a partir de experiências contextualizadas com a realidade, propiciando a construção de novas relações interpessoais e ampliando suas redes sociais de apoio.(AU)

Despite the health benefits of exclusive breastfeeding to moms and their children, its early interruption is still quite common. After hospital discharge is the period when women face the most challenges, being important to strengthen breastfeeding support actions. This study aimed at unveiling the contributions of including a virtual community in a social support network to exclusive breastfeeding after hospital discharge. This qualitative study was conducted in a private Facebook group managed by health professionals using a Community-Based Participatory Research as methodological reference. The group was used to foster dialog and interaction among women based on experiences contextualized in the real world, being possible to build new interpersonal relationships and expand their support networks.(AU)

A pesar de los beneficios de la lactancia materna exclusiva para la salud materno-infantil, su interrupción precoz todavía es muy frecuente. El período después de recibir el alta en el hospital es el momento en el que la mujer se depara con la mayoría de las dificultades, siendo importante fortalecer las acciones de apoyo a la lactancia. Este trabajo tuvo el objetivo de desvelar las contribuciones de la inserción de una comunidad virtual en la red social de apoyo a la lactancia materna exclusiva de mujeres después de recibir el alta del hospital. Se trata de un estudio cualitativo, realizado en un grupo privado de la red social facebook, administrado por profesionales de la salud, utilizando como referencial metodológico la Encuesta Participativa Basada en la Comunidad. El grupo fue un instrumento de promoción de diálogo e interacción entre mujeres a partir de experiencias contextualizadas con la realidad, propiciando la construcción de nuevas relaciones interpersonales, ampliando sus redes sociales de apoyo.(AU)

Clinical manifestations and quality of life in hidradenitis suppurativa patients: survey of participants from an internet support group

Abstract: Background: Hidradenitis suppurativa is a complex and infrequent autoinflammatory disease that impacts on quality of life. Its pathogenesis is not fully understood, which limits the development of curative treatments. Objectives: To evaluate clinical and quality of life aspects of hidradenitis suppurativa patients from a social group on the Internet. Methods: A cross-sectional, Internet-based survey study among participants in a discussion group (Facebook) of individuals with hidradenitis suppurativa. Patients were asked to answer a questionnaire about clinical-demographic aspects and quality of life (DLQI-BRA). Results: A total of 390 individuals agreed to participate in the study, 82% of them female, median age (p25-p75), of 31 (25-37) years old, disease onset at 15 (13-23) years, family member affected in 20% of cases, overweight (BMI 29 [25-33]) kg/m2 and severe impact on quality of life (DLQI 20 [13-25]). Regarding Hurley's classification, the participants provided information that enabled classification into: I (19%), II (52%) and III (29%). More severe cases were associated with males (OR = 1.69), higher weight (BMI: OR = 1.03) non-white color (OR = 1.43) and higher frequency of other autoinflammatory diseases (OR = 1.37). Study limitations: Voluntary adherence survey with self-completion of the questionnaire by 390 from about 1600 group members. Conclusions: Hidradenitis suppurativa patients who participated in a social network group had onset of the disease after puberty, with a predominance in females and overweight people, with great impact on the quality of life.

A pesquisa-intervenção participativa como estratégia metodológica: relato de uma pesquisa em associação / La investigación-intervención participativa como estrategia metodológica: relato de una investigación en asociación / Participatory intervention research as a methodological strategy: report of a research in association

Resumo A pesquisa-intervenção é uma estratégia de produção de conhecimento que se insere no universo mais amplo das pesquisas participativas, e que se caracteriza por pressupostos teórico-metodológicos específicos. Este artigo apresenta uma experiência de pesquisa-intervenção na qual a dimensão participativa foi colocada em relevo, à medida que o próprio processo de pesquisar foi compartilhado entre os sujeitos envolvidos no campo (uma associação de saúde mental). A partir desta experiência, discutimos a pesquisa como dispositivo de transversalidade no contexto de pesquisa-intervenção. Apostamos que, em determinados contextos, a radicalização da dimensão participativa na produção de conhecimento pode ter efeitos de mobilização das relações de saber-poder e de aumento do coeficiente de transversalidade dos coletivos.

Resumen La investigación-intervención es una estrategia de producción de conocimiento que se inserta en el universo más amplio de las investigaciones participativas, y que se caracteriza por su marco teórico-metodológico específico. Este artículo presenta una experiencia de investigación-intervención en la cual la dimensión participativa se puso de relieve, a medida que el propio proceso de investigación fue compartido entre los sujetos implicados en el campo (una asociación de salud mental). A partir de esta experiencia, discutimos la investigación como dispositivo de ransversalidad en el contexto de investigación-intervención. Apostamos que, en determinados contextos, la radicalización de la dimensión participativa en la producción de conocimiento puede tener efectos de movilización de las relaciones de saber-poder y de aumento del coeficiente de transversalidad de los colectivos.

Abstract Intervention research is a knowledge production strategy that is part of the broader universe of participatory research and is characterized by a specific theoretical and methodological framework. This article presents a research-intervention experience in which the participatory dimension was emphasized, as the research process was collectively conducted by all the subjects involved in the field (a mental health association). From this experience, we discuss research as a device in the context of transversality in intervention research. We argue that, in certain contexts, the radicalization of the participatory dimension in the production of knowledge can mobilize knowledge-power relations and increase the coefficient of transversality in the collectives.

Investigación-acción y Enfermería en educación ambiental: reflexión metodológica / Action-research and Nursing in environmental education: methodological reflection

Las metodologías participativas vienen siendo incorporadas por investigadores en el campo de la salud ambiental en todo el mundo. La investigación-acción se presenta como un método participativo innovador que posibilita el uso de múltiples técnicas de recolección y análisis de datos. El objetivo de este artículo es reflexionar sobre el uso de la Investigación-Acción como método que viabilice la conducción de prácticas de educación ambiental por la enfermería pautadas en la pedagogía freireana. Inicialmente, se traza un paralelo entre el papel de la enfermería en el cuidado de la salud del planeta y las modificaciones en la concepción de salud a lo largo de los años, subrayando el papel de la ciencia en ese proceso. Posteriormente, se discurre sobre la Investigación-Acción y su aplicabilidad en los estudios educativo-ambientales, relacionando puntos de convergencia entre ese método y la pedagogía freireana. Las transformaciones históricas en la relación hombre/ambiente suscita la necesidad de formación de profesionales enfermeros ambientalmente comprometidos y calificados en desarrollar prácticas de cuidado-educativas que alcancen el cuidado ambiental a nivel planetario

Participatory methodologies have been appropriated by researchers in the field of environmental health around the world. Action Research presents itself as an innovative participatory method that allows the use of multiple techniques of data collection and analysis. The purpose of this article is to reflect on the use of Action Research as a method that enables the conduction of environmental education practices by nursing based on Freirean pedagogy. Initially, there is a parallel between the role of nursing in the health care of the planet and the changes in the conception of health over the years, highlighting the role of science in this process. Subsequently, it is discussed the Action Research and its applicability in educational-environmental studies relating points of convergence between this method and Freirean pedagogy. Historical transformations in the relationship between man and the environment raise the need for the training of environmentally committed and qualified nurses in developing care-educational practices that achieve environmental care at a planetary level

Pesquisa participativa e as estratégias de promoção da saúde integral da criança no Sistema Único de Saúde (SUS) / Investigación participativa y las estrategias de promoción de la salud integral del niño en el Sistema Brasileño de Salud (SUS) / Participative research and comprehensive child healthcare promotion strategies in the Brazilian National Health System (SUS)

Neste artigo, discutem-se aspectos metodológicos de uma investigação que tomou a promoção da participação dos envolvidos como desafio. Interessou compreender os sentidos atribuídos por equipes de Saúde da Família à Caderneta de Saúde da Criança (CSC) e ao desenvolvimento infantil. A pesquisa-intervenção promoveu o compartilhamento de pontos de vista entre pesquisadores e trabalhadores em grupos focais com utilização de narrativas, construindo condições para que os participantes se tornassem protagonistas da investigação proposta. A realização dessa estratégia promoveu: 1) maior apropriação do instrumento; 2) aprofundamento e reposicionamento quanto a questões cristalizadas nos modos de funcionamento das equipes; 3) validação dos resultados da pesquisa. Tais resultados indicam que há uma contribuição das pesquisas participativas para a consolidação do SUS, pois, ao proporem o acesso a um plano comum como estratégia metodológica, promovem também maior engajamento das equipes em relação aos temas propostos.(AU)

En el artículo se discuten aspectos metodológicos de una investigación que consideró la promoción de la participación de los envueltos como un desafío. El interés se concentró en entender los sentidos atribuidos por equipos de Salud de la Familia a la Cartilla de Salud del Niño (CSC, por sus siglas en portugués) y al desarrollo infantil. La investigación-intervención promovió la compartición de puntos de vista entre investigadores y trabajadores en grupos focales con utilización de narrativas, construyendo condiciones para que los participantes pasaran a ser protagonistas del estudio propuesto. La realización de esta estrategia promovió: 1) mayor apropiación del instrumento; 2) profundización y reposicionamiento con relación a cuestiones cristalizadas en los modos de funcionamiento de los equipos; 3) validación de los resultados del estudio. Tales resultados indican que hay una contribución de los estudios participativos para la consolidación del SUS, puesto que al proponer el acceso a un plan común como estrategia metodológica también promueven un mayor compromiso de los equipos en relación a los temas propuestos.(AU)

The article discusses methodological aspects of an investigation aimed at promoting the involvement of participants as a challenge. We were interested in understanding how family health teams made sense of the child handbook - Caderneta de Saúde da Criança, and child development. The intervention-research promoted the sharing of viewpoints among researchers and providers in focal groups with the use of narratives making it possible for the participants to become key players of the proposed investigation. The implementation of the strategy promoted: 1) the greater ownership of the instrument, 2) the deepening and repositioning regarding crystalized issues in the functioning of teams, and 3 ) the validation of research results. These results indicate that there is a contribution of participatory research to the consolidation of SUS because they propose access to a common plan as methodological strategy and promote greater engagement of the teams in relation to the proposed themes.(AU)

Adolescent health promotion based on community-centered arts education / Promoción de la salud del adolescente basada en el arte/educación y centrada en la comunidad / Promoção da saúde do adolescente baseada na arte/educação e centrada na comunidade

ABSTRACT Objective: To evaluate the contribution of arts education to health promotion of adolescents in situations of urban social vulnerability. Method: Participatory evaluative research, with a qualitative approach, using as a reference the theoretical constructs of Paulo Freire's Conscientization and the Empowerment Evaluation as a method of collecting with adolescents and teachers of an arts education program in the field of the Family Health Strategy. Results: Participants constructed a collective mission that represented the concept of adolescent health promotion. Arts education activities were prioritized and ranked with a mission focus, and over a three-month period, the program implemented health goals through art. In the reevaluation, the group presented a broad look at the implementation of activities and self-determination for change. Final considerations: Arts education is a potential space for nurses to act in the conscientization and empowerment of adolescent health in Primary Health Care.

RESUMEN Objetivo: evaluar las contribuciones del arte/educación para la promoción de la salud de adolescentes en situación de vulnerabilidad social urbana. Método: pesquisa evaluativa, participativa, abordaje cualitativa, que utilizó como referencial los constructos teóricos de Concientización de Freire y como método de colecta a Evaluación de Empoderamiento con adolescentes y profesores de un programa de arte/educación en el territorio de la Estrategia de Salud de la Familia. Resultados: los participantes construyeron una misión colectiva que representó el concepto de promoción de la salud del adolescente. Las actividades de arte/educación fueron priorizadas y clasificadas con foco en la misión y durante un período de tres meses el programa implementó metas en la salud por medio del arte. En la reevaluación, el grupo presentó una mirada ampliada acerca de la ejecución de las actividades y autodeterminación para cambios. Consideraciones finales: el arte/educación fue un potencial espacio para actuación del enfermero en la concientización y empoderamiento en salud del adolescente en Atención Básica a la Salud.

RESUMO Objetivo: Avaliar as contribuições da arte/educação para a promoção da saúde de adolescentes em situação de vulnerabilidade social urbana. Método: Pesquisa avaliativa, participativa, abordagem qualitativa, que utilizou como referencial os constructos teóricos de Conscientização de Freire e como método de coleta a Avaliação de Empoderamento com adolescentes e professores de um programa de arte/educação no território da Estratégia de Saúde da Família. Resultados: Os participantes construíram uma missão coletiva que representou o conceito de promoção da saúde do adolescente. As atividades de arte/educação foram priorizadas e classificadas com foco na missão, e, durante um período de três meses, o programa implementou metas na saúde por meio da arte. Na reavaliação, o grupo apresentou um olhar ampliado acerca da execução das atividades e autodeterminação para mudanças. Considerações finais: A arte/educação foi um potencial espaço para atuação do enfermeiro na conscientização e empoderamento em saúde do adolescente na Atenção Básica à Saúde.

Herramientas y métodos participativos para la acción comunitaria. Informe SESPAS 2018 / Participatory tools and methods for community action. SESPAS Report 2018

La participación es un proceso que requiere la implicación de responsables de la política, del personal directivo y técnico de las instituciones, y de la ciudadanía, así como de la acción intersectorial e interdisciplinaria. Para generar cambios transformadores es necesaria una infraestructura que favorezca la participación y la acción planificada, reconociendo a todos los actores del proceso. Se precisan tiempo y compromiso para su continuidad a través de la producción conjunta de acciones, y de ahí la importancia de consolidar proyectos participativos que continúen más allá de los cambios políticos para que los servicios públicos sean sostenibles. La formación, el uso adecuado de las herramientas de participación y una política horizontal de poder delegado son imprescindibles para el desarrollo de la participación. Herramientas como sondeos, sociogramas, flujogramas, mapeos de activos para la salud, presupuestos participativos o matrices de evaluación participativa son algunas de las que pueden elegirse, en función del tipo de materias abordadas, el tiempo y los recursos disponibles, las características de la población participante y del territorio, así como del uso que se va a hacer de la información generada para la siguiente fase. Las herramientas de participación son útiles para que la ciudadanía profesionales analicen, comprendan, debatan y decidan colectivamente con el fin de mejorar las condiciones de vida y los entornos. En la última década, las redes sociales en el entorno virtual han generado nuevas tendencias de participación masiva y autogestionada por la ciudadanía

Participation is a process that requires the involvement of the policy makers, managers, technicians and staff of the institutions, and of citizens, as well as intersectoral and interdisciplinary action. To generate transformative changes, an infrastructure that encourages participation and planned action is required, and that recognises all the actors in the process. It takes time and commitment to ensure continuity through the joint production of actions, hence the importance of consolidating participatory projects that continue beyond political changes making public services sustainable. Training, the appropriate use of participation tools and a horizontal policy of delegated power are essential to ensure participation. Surveys, sociograms, flowcharts, health assets mapping, participatory budgets and participatory evaluation matrices are some of the tools that can be chosen, depending on the type of subjects addressed, the time and resources available, the characteristics of the participating population and territory, as well as determining the use that will be made of the information generated for the next phase. Participation tools are useful for citizens and professionals to analyze, understand, debate and decide collectively how to improve living conditions and environments. Over the past decade, social networks in the virtual environment have generated new trends in mass participation, which are self-managed by citizens

Modelo participativo para el abordaje de la violencia contra las mujeres en La Araucanía, Chile / A participatory model for addressing violence against women in La Araucanía, Chile / Modelo participativo para abordagem da violência contra a mulher em La Araucanía, Chile

RESUMEN La violencia contra la mujer se considera un problema de salud pública que afecta a las mujeres en todo el mundo. Recientemente, el Consejo Directivo de la Organización Panamericana de la Salud declaró sus graves repercusiones sociales y económicas en la Región de las Américas y se comprometió a emprender acciones en los servicios de salud para afrontar el problema. En ese marco, se presentan los pasos de una investigación-acción-participativa (IAP), que se está desarrollando en el territorio wenteche de la región de La Araucanía de Chile, que apuesta por fortalecer los vínculos comunitarios, revalorizar los espacios de diálogo con y entre las personas del territorio, la participación social y la democracia en la generación de conocimientos pertinentes y participativos sobre este problema, y obtener información para diseñar un modelo de intervención que se adecúe a las características locales.(AU)

ABSTRACT Violence against women is considered a public health problem that affects women worldwide. Recently, the Directing Council of the Pan American Health Organization declared its serious socioeconomic impact in the Region of the Americas and committed to undertaking actions in the health services to address this problem. Within that framework, this paper describes the steps of a participatory action research (PAR) approach that is being implemented in the Wenteche Territory of the La Araucanía region of Chile, which aims to strengthen community bonds, rekindle opportunities for dialogue with and among the people of the territory, foster social participation and democracy in the generation of pertinent, participatory knowledge regarding this problem, and obtain information to support design of an intervention model adapted to local characteristics.(AU)

RESUMO A violência contra a mulher é um problema de saúde pública que atinge mulheres em todo o mundo. Recentemente, o Conselho Diretor da Organização Pan-Americana da Saúde reconheceu as sérias repercussões socioeconômicas do problema na Região das Américas e se comprometeu a realizar ações nos serviços de saúde para combatê-lo. Como parte deste enquadramento, são apresentadas as etapas de uma pesquisa-ação participativa sendo desenvolvida no território wenteche da região de La Araucanía, no Chile, que visa reforçar os vínculos na comunidade, revalorizar os espaços de diálogo com e entre os habitantes locais, a participação social e a democracia na geração de conhecimento pertinente e participativo sobre esta problemática e obter dados para a elaboração de um modelo de intervenção adequado às características locais.(AU)