Ending "domestic helicopter research".

"Helicopter research" refers to a practice where researchers from wealthier countries conduct studies in lower-income countries with little involvement of local researchers or community members. This practice also occurs domestically. In this Commentary, we outline strategies to curb domestic helicopter research and to foster equity-centered collaborations.

Consumer and community involvement in preventive health: current insights and considerations for future best practice.

Consumer and community involvement (CCI) in preventive research and health initiatives is not only encouraged but is expected within a rapidly evolving landscape across health policy, practice and research. Here, we summarise the fundamental principles of CCI, as well as outline the barriers and current developments in working towards best practices at organisational and systems levels. CCI stands at a critical juncture. Best practice emphasises meaningful partnerships with consumers and communities to deliver impactful research and prevention activities, yet complex challenges and systematic barriers remain. We need further evidence to demonstrate both 'what' and 'how' CCI should be best implemented in these settings. We present key considerations for researchers, organisations and systems to catalyse the transition of CCI from mere recognition of its importance to pragmatic and optimum implementation and, ultimately, to systemic reform. These include changes to capacity building, funding structures, equitable engagement and transparent evaluation. These must be underpinned by evidence-based approaches, partnership, trust and broad consensus processes to achieve meaningful and impactful CCI in research and healthcare improvement through a lens of inclusivity.

Profiling the medical, functional, cognitive, and psychosocial care needs of adults assessed for home care in Ontario, Canada: The case for long-term 'life care' at home.

Calls to leverage routinely collected data to inform health system improvements have been made. Misalignment between home care services and client needs can result in poor client, caregiver, and system outcomes. To inform development of an integrated model of community-based home care, grounded in a holistic definition of health, comprehensive clinical profiles were created using Ontario, Canada home care assessment data. Retrospective, cross-sectional analyses of 2017-2018 Resident Assessment Instrument Home Care (RAI-HC) assessments (n = 162,523) were completed to group home care clients by service needs and generate comprehensive profiles of each group's dominant medical, functional, cognitive, and psychosocial care needs. Six unique groups were identified, with care profiles representing home care clients living with Geriatric Syndromes, Medical Complexity, Cognitive Impairment and Behaviours, Caregiver Distress and Social Frailty. Depending on group membership, between 51% and 81% of clients had identified care needs spanning four or more Positive Health dimensions, demonstrating both the heterogeneity and complexity of clients served by home care. Comprehensive clinical profiles, developed from routinely collected assessment data, support a future-focused, evidence-informed, and community-engaged approach to research and practice in integrated home-based health and social care.

Using GPS and Self-Report Data to Examine the Relationship Between Community Mobility and Community Participation Among Autistic Young Adults.

IMPORTANCE: Community participation of autistic adults is important for health and well-being. Many clinical efforts and interventions aim to enhance community participation in this population. OBJECTIVE: To empirically examine the relationship between community participation and community mobility. DESIGN: A randomized controlled trial using data from baseline and 4- to 6-wk follow-up. SETTING: Community organizations serving autistic adults in Philadelphia. PARTICIPANTS: Sixty-three autistic young adults with data on community mobility and participation from a prior study on public transportation use. OUTCOMES AND MEASURES: Participants were tracked with GPS-enabled cell phones over a 2-wk period. A spatiotemporal data mining algorithm was used to compute the total number of destinations, nonhome destinations, unique destinations, percentage of time spent outside the home, and median daily activity space area from the GPS data. The Temple University Community Participation measure was used to collect self-report data in 21 different areas, and total amount, breadth, and sufficiency of participation were calculated. RESULTS: Moderate and statistically significant associations were found between community mobility and participation variables at baseline and follow-up. However, changes in community mobility were not related to changes in community participation. CONCLUSION: Health policymakers and providers should consider community mobility as a factor that can affect community participation in autistic individuals. Plain-Language Summary: Lower levels of community participation among autistic young adults affect health outcomes and overall quality of life. Community mobility is often a barrier to community participation. An understanding of the relationship between community mobility and community participation can lead to occupational therapists tailoring specific interventions and policies that support autistic young adults to engage in important life activities within the community.

Decision analysis of PPP project's parties based on deep consumer participation.

Although PPP(Public-private partnership) mode has been applied for a long time in infrastructural project, the success rate is not very high. The sustainability of PPP projects is still influenced by many factors. In order to examine the evolutionary stable strategies (ESSs) of social capital, government, and paying consumers, a tripartite evolutionary game model is established in this work. In order to further promote consumer participation, it is necessary to make the assumption that customer oversight and review can have an impact on service prices. The results show: i)The strategy choice of consumer depends on the comparison between supervision cost of consumer and price coefficient for consumer to social capital. ii)Consumer supervision can promote the provision of high-quality services by social capital. iii)The difference between high-quality cost and low-quality cost, subsidy coefficient, price coefficient and supervision cost of consumer are critical factors influencing both evolutionary results and trajectories. This paper also puts forward policy implications for the three stakeholders to promote social capital's high-quality strategy so as to maintain the sustainability of PPP projects.

Implementation of a strengths-based approach in a traumatic brain injury community service; perspectives of community workers.

Background The strengths-based approach (SBA) was initially developed for people living with mental health issues but may represent a promising support option for community participation of people living with a traumatic brain injury (TBI). A community-based organisation working with people living with TBI is in the process of adapting this approach to implement it in their organisation. No studies explored an SBA implementation with this population. This study explores the implementation of key components of the SBA in a community-based organisation dedicated to people living with TBI. Methods A qualitative descriptive design using semi-structured interviews (n = 10) with community workers, before and during implementation, was used. Transcripts were analysed inductively and deductively. Deductive coding was informed by the SBA fidelity scale. Results Group supervision and mobilisation of personal strengths are key SBA components that were reported as being integrated within practice. These changes led to improved team communication and cohesiveness in and across services, more structured interventions, and greater engagement of clients. No changes were reported regarding the mobilisation of environmental strengths and the provision of individual supervision. Conclusion The implementation of the SBA had positive impacts on the community-based organisation. This suggests that it is valuable to implement an adaptation of the SBA for people living with TBI.

Prescribed safer supply during dual public health emergencies: a qualitative study examining service providers perspectives on early implementation.

BACKGROUND: Within North America and worldwide, drug related overdoses have increased dramatically over the past decade. COVID-19 escalated the need for a safer supply to replace unregulated substances and to reduce toxicity and overdoses. Service providers play an integral role in the delivery of safer supply but there is little empirical evidence that conceptualizes effective safer supply from their perspectives. This study explored early implementation and impacts of a safer supply program, capturing the perspectives of an interdisciplinary team of service providers on tensions and issues encountered in the development of the SAFER program. METHODS: Using a community-based participatory approach, we conducted individual interviews with program providers (n = 9). The research team was composed of researchers from a local drug user organization, a local harm reduction organization, and academic researchers. The Consolidated Framework for Implementation Research (CFIR) informed the interview guide. Data was analyzed using thematic analysis. RESULTS: There are six themes describing early implementation: (1) risk mitigation prescribing as context for early implementation; (2) developing SAFER specific clinical protocols; (3) accessibility challenges and program innovations; (4) interdisciplinary team and wraparound care; (5) program tensions between addiction medicine and harm reduction; (6) the successes of safer supply and future visions. CONCLUSION: Early implementation issues and tensions included prescriber concerns about safer supply prescribing in a highly politicized environment, accessibility challenges for service users such as stigma, encampment displacement, OAT requirements, program capacity and costs, and tensions between addiction medicine and harm reduction. Navigating these tensions included development of clinical protocols, innovations to reduce accessibility challenges such as outreach, wraparound care, program coverage of medication costs and prescribing safer supply with/without OAT. These findings contribute important insights for the development of prescribed safer supply programs.

"They didn't think we'd do it!": Community gardening as an act of resistance for people with dementia.

People living with dementia commonly report negative experiences such as disempowerment, stigma, and oppression. Community gardening has demonstrated its potential as a forum for the practice of resistance against the oppressions experienced by other marginalised groups; however, this element of the experience of community gardening has yet to be explored in the context of dementia. A collaboratively-designed community gardening project took place over six weeks, involving six people with dementia. The participants selected all activities undertaken in the garden. Data were collected through semi-structured group interviews with the gardeners and researcher observations. Context-setting semi-structured individual interviews were conducted with four day centre staff members, and three key informants who had experienced working with people with dementia in the garden. The garden acted as a platform for the articulation of both verbal and embodied expressions of resistance against the disempowerment and loss of agency experienced by many people with dementia. The participatory design of the gardening sessions enabled the gardeners to assert their autonomy and independence, and defy the negative stereotypes associated with dementia, which some of the group members appeared to have internalised. Community gardening activities may offer a forum for expressions of resistance against the structures oppressing individuals with dementia. However, in order for this potential to be unlocked, such initiatives must be collaboratively designed, following an approach which recognises the strengths and enduring abilities of people living with dementia. Additionally, the empowering impact of community gardening should not be diluted by positioning the activity as a substitute for adequate statutory health and social care provision, thereby individualising responsibility for the wellbeing of people with dementia.

Citizen science and social innovation as citizen empowerment tools to address urban health challenges: The case of the urban health citizen laboratory in Barcelona, Spain.

Urban health faces significant challenges due to the rapid growth of cities and the concentration of population in urban settings that have a strong impact on people's health. The approach to characterize and address these challenges requires increased societal involvement and interdisciplinary solutions to ensure their effectiveness and democratic nature. With this purpose, it is necessary to explore methodologies for citizen participation that foster a critical understanding of the environment and promote their active role in generating scientific knowledge and change. This article describes the creation of a collaborative space for experimentation and learning that, through the intersection of citizen science and social innovation, aims to engage citizens in the research and diagnosis of their local environment, as well as in the design and implementation of local solutions, while raising awareness about the main challenges to urban health. Through a collaborative and participatory framework, the community identified relevant challenges to urban health they wanted to investigate, co-designed and developed the methodology for data collection and analysis, and ultimately, they devised, designed, and implemented innovative solutions based on the scientific evidence obtained. The framework and results of this project hold potential interest for the scientific community, facilities, institutions, and society by offering an innovative and participatory approach to addressing the present and future urban health challenges.

Building citizen science intelligence for outbreak preparedness and response: a mixed-method study in nine countries to assess knowledge, readiness and feasibility.

INTRODUCTION: Citizen science (CS) is an emerging approach in public health to harness the collective intelligence of individuals to augment traditional scientific efforts. However, citizens' viewpoint, especially the hard-to-reach population, is lacking in current outbreak-related literature. We aim to understand the awareness, readiness and feasibility of outbreak-related CS, including digitally enabled CS, in low-income and middle-income countries. METHODS: This mixed-method study was conducted in nine countries between October 2022 and June 2023. Recruitment through civil society targeted the general population, marginalised/indigenous groups, youth and community health workers. Participants (aged ≥18 years) completed a quantitative survey, and a subset participated in focus group discussions (FGDs). RESULTS: 2912 participants completed the survey and 4 FGDs were conducted in each country. Incorporating participants' perspectives, CS is defined as the practice of active public participation, collaboration and communication in all aspects of scientific research to increase public knowledge, create awareness, build trust and facilitate information flow between citizens, governments and scientists. In Bangladesh, Indonesia, the Philippines, Cameroon and Kenya, majority were unaware of outbreak-related CS. In India and Uganda, majority were aware but unengaged, while in Nepal and Zimbabwe, majority participated in CS before. Engagement approaches should consider different social and cultural contexts, while addressing incentivisation, attitudes and practicality factors. Overall, 76.0% expressed interest in digital CS but needed training to build skills and confidence. Digital CS was perceived as convenient, safer for outbreak-related activities and producing better quality and quantity of data. However, there were concerns over non-inclusion of certain groups, data security and unclear communication. CONCLUSION: CS interventions need to be relatable and address context-specific factors influencing CS participation. Digital CS has the potential to facilitate collaboration, but capacity and access issues must be considered to ensure inclusive and sustainable engagement.

Participación ciudadana, imprescindible en procesos comunitarios: experiencia en la realización del diagnóstico de salud de Santpedor / Citizen participation, essential in community processes: experience in the Santpedor health diagnosis

Introducción. En este artículo se quiere plasmar la grata experiencia de hacer un diagnóstico de salud en la población de Santpedor. El diagnóstico se llevó a cabo con acción participativa desde el primer momento y durante todo el proceso. Se hizo con un grupo motor, donde solo dos de las 15 personas que lo representan eran agentes sanitarios. Estos agentes legitimaron el proceso comunitario, coordinaron el grupo motor y lo guiaron. Sin embargo, eran una pieza más del puzle comunitario, siendo los otros 13 agentes comunitarios no sanitarios los auténticos protagonistas al posibilitar llegar a la población y completar el puzle comunitario. Objetivo. Realizar el diagnóstico de salud de Santpedor con acción participativa. Métodos. Se utilizó una metodología mixta secuencial y explicativa, con una parte cuantitativa (descriptivo transversal) y una parte cualitativa (acción participativa). En este artículo se explica la metodología que se utilizó para hacer el diagnóstico de salud de Santpedor y se describen las estrategias participativas para llegar a la población y favorecer la pertinencia en el proceso comunitario, así como las técnicas empleadas para la detección de las necesidades y su priorización. Las técnicas cualitativas utilizadas para la detección de los activos fueron el mapping party y la marcha de activos. Las técnicas empleadas para identificar las necesidades fueron la encuesta y las entrevistas grupales (grupos focales, grupo nominal y entrevistas individuales). Resultados. Se identificaron 604 activos de Santpedor. En el análisis cuantitativo se observó que Santpedor presentaba un gran relevo generacional y un tejido económico diversificado. En el análisis cualitativo, se logró una gran cantidad de información con la que, una vez analizada y trabajada con todo el grupo motor, se confeccionó un listado con 17 necesidades que había que cubrir para mejorar la salud de la población. ... (AU)

Introduction. In this paper we seek to capture the pleasant experience in making a health diagnosis in the Santpedor population. The diagnosis was made with participation from the very first moment and during the entire process. It was made with a driving group where only two of the 15 people representing it were health agents. These agents legitimized the community process, coordinated the driving group and guided it. However, they were just one more piece of the community puzzle, the other 13 non-health community agents being the real protagonists to reach the population and complete the community puzzle. Aim. To make a health diagnosis in Santpedor with the population taking part. Methods. A mixed explanatory sequential methodology was used. Comprised of a quantitative part (cross-sectional descriptive) and a qualitative part (participation). This paper explains the methodology used to made this. It reports the participation used to reach the population and favour relevance in the community process; as well as the techniques used to detect needs and their prioritization. The qualitative techniques used to detect assets were: mapping party, asset march. The techniques used to detect needs were by means of a survey ("bustiada") and group interviews (focus groups, nominal group and individual interviews). Results. A total of 604 Santpedor assets were identified. In the quantitative analysis, it was observed that Santpedor had a major generational change and a diversified economic fabric. In the qualitative analysis, a large amount of information was obtained which, once analyzed and worked on with the entire driving group, led to a list of 17 needs to improve the health of the population. These needs were prioritized by means of a simple vote, where a large citizen participation was attained with 754 votes from the citizens. The first need detected was "housing needs", followed by "public transportation needs", and "work needs". ... (AU)

Servicios de ayuda en el hogar en Galicia, ¿un recurso para intervenir en la soledad? / Home Help Services in Galicia, a resource to intervening in loneliness?

La soledad es un factor social que afecta a personas de todas las edades, perjudicando su salud y aumentando la utilización de servicios sociosanitarios. Su abordaje requiere una perspectiva comunitaria integral, ya que es un sentimiento subjetivo con consecuencias complejas en la salud y en el bienestar. En una sociedad envejecida, la soledad se convierte en un problema de salud pública significativo, especialmente entre las personas mayores. Por ello, este estudio se centra en los servicios de ayuda en el hogar (Servicio de Axuda no Fogar, SAF) en Galicia y su papel en la lucha contra la soledad, con el objetivo de comprender este sentimiento entre las personas usuarias del SAF y recopilar sus opiniones para entender cómo abordarla y diseñar estrategias intersectoriales y participativas que permitan ayudar a disminuirla. Los resultados iniciales muestran que más del 50% de los usuarios del SAF se sienten solos. A través de la elaboración de un cuestionario propio y de mediciones utilizando la escala de soledad UCLA, el estudio destaca la importancia de la colaboración comunitaria y la necesidad de difundir los resultados para orientar intervenciones futuras. Se concluye que los SAF tienen un potencial significativo para mejorar el bienestar de los usuarios y abordar la soledad, un factor social determinante de la salud. (AU)

Loneliness is a social factor that impacts individuals of all ages, impairing their health and increasing the use of socio-health services. Tackling this requires a comprehensive community perspective, as it is a subjective feeling with complex consequences for health and well-being. In an aging society, loneliness becomes a significant public health issue, especially among the elderly. Therefore, this study focuses on Home Help Services (SAF) in Galicia and their role in responding to loneliness. The main aim is to understand this feeling among SAF users, gather their opinions on how to tackle this, and devise intersectoral and participatory strategies to reduce loneliness. Initial results reveal that over 50% of SAF users feel lonely. By means of a customized questionnaire and measurements using the UCLA Loneliness Scale, the study underscores the importance of community collaboration and the need to disseminate results to guide future interventions. It is concluded that SAF has significant potential to improve user well-being and tackle loneliness, a decisive social factor on health. (AU)

Escuelas de salud para personas mayores. Espacios que sanan, personas que curan / Health Schools for the elderly. Spaces that heal, people who cure

Las escuelas de salud son proyectos comunitarios con un bagaje y una evidencia científica ya conocidos y demostrados. Su influencia en la mejora de la calidad de vida de las persones mayores con soledad no deseada es uno de sus grandes beneficios. Por este motivo, como equipo de Atención Primaria apostamos por ella. El objetivo principal de la escuela es promover el envejecimiento activo y mejorar el estado de salud percibido por las persones mayores de 60 años participantes. Las escuelas de salud son espacios sanadores. Su repercusión es bidireccional, ya que influye en todas las personas que participan, mejorando su calidad de vida y dotándolas de herramientas útiles y sencillas para su día a día a través de los conocimientos adquiridos y las experiencias compartidas. Generar puntos de encuentro en el barrio enriquece y aporta salud más allá de los centros sanitarios. Salir a la calle, hablar de igual a igual, fomentar las redes de apoyo y vincularse a una red, son elementos que fortalecen y mejoran la vertiente social de las personas, ayudándolas a curar heridas de vida. Apostar por la salud comunitaria, es apostar por la salud en todas sus dimensiones. (AU)

Health schools are community projects with a well-known and proven scientific past and background. Their influence in improving the quality of life for elderly individuals experiencing unwanted loneliness is one of their significant benefits. That's why we, as a primary health care team, decided to support it. The main aim of the school is to promote active aging and enhance the perceived health status of participants aged over 60. Health schools are healing spaces. Their impact is bidirectional, which has an impact on all participants. Our quality of life improves as we share knowledge and experiences, providing us with healing, useful and straightforward tools for our daily lives. Creating meeting points in the neighbourhood enriches us and contributes to our well-being beyond healthcare centres. Going out into the community, having peer to peer conversations, fostering support networks, and connecting with others sustain us and make us socially stronger, healing life's wounds. To take a chance on the community is in essence to bet on health in all its dimensions. (AU)

Intervención participativa comunitaria: necesidades de salud de las personas mayores durante el período de la pandemia por COVID-19 / Community participatory intervention: health needs of older people during the COVID-19 pandemic period

Objetivo. Proponer una intervención participativa comunitaria según las necesidades de salud percibida por las personas mayores del Programa de Salud Cardiovascular de un centro de salud familiar y comunitaria de una comuna de Santiago de Chile durante el período de la pandemia de la COVID-19. Métodos. Se utilizó una metodología participativa de la comunidad, la cual se desarrolló en dos fases: diagnóstico participativo comunitario y desarrollo de la propuesta participativa de una intervención en salud comunitaria. Resultados. Desde el diagnóstico participativo comunitario, los participantes eligieron el desarrollo de un programa educativo fundamentado en las necesidades de salud, además de la entrega de material educativo sobre estilos de vida saludable y recomendaciones para tener un buen control de sus enfermedades. Conclusión. Desde el diagnóstico y planificación participativa, es posible intervenir en pro de las necesidades de las personas, familias y comunidades y capacitarlas en el manejo de su propia salud. (AU)

Aim. To propose a community participatory intervention according to the health needs perceived by elderly people in the Family and Community Health Centre Cardiovascular Health programme of a Santiago de Chile commune during the COVID-19 pandemic. Methods. A community participatory methodology was used, which was developed over two phases: community participatory diagnosis and development of a participatory proposal for a community health intervention. Results. From the community participatory diagnosis, participants opted for development of an educational programme based on health needs, in addition to the delivery of educational material related to healthy lifestyles and recommendations for robust control of their diseases. Conclusion. From diagnosis and participatory planning, it is possible to intervene in favour of the needs of individuals, families and communities and train them in managing their own health. (AU)

Factors influencing public participation behavior relating to government microblogs on COVID-19 updates.

Introduction: During the global COVID-19 pandemic, densely populated megacities engaged in active international exchanges have faced the most severe impacts from both the disease and the associated infodemic. This study examines the factors influencing public participation behavior on government microblogs in these megacities during the pandemic. It guides megacities in disseminating epidemic information, promoting knowledge on epidemic prevention, managing public opinion, and addressing related matters. Methods: Utilizing the elaboration likelihood model's central and peripheral routes, drawing on an empirical analysis of 6,677 epidemic-related microblogs from seven Chinese megacities, this study analyses the influence mechanisms influencing public participation behavior and reveals the regulatory role of confirmed case numbers. Meanwhile,a qualitative comparative analysis examines and discusses diferent confgurations of ixn fuential factors. Results: The study reveals that microblog content richness demonstrates a U-shaped impact on public participation behavior. Conversely, content interaction, content length, and the number of fans positively impact participation, while update frequency has a negative impact. Additionally, the number of new confrmed cases positively regulates the impact of microblog content and publisher characteristics on public participation behavior. Public participation behavior also varies based on publishing time and content semantic features. This study further revealed the different confgurations of influential factors by QCA method. Conclusion: This study reveals the impact mechanism of the microblog content and publisher characteristics on public participation behavior. It also demonstrates the regulatory role of newly confrmed cases in the way content and publishers' characteristics influence public participation behavior. This study is of great significance for the operation of government microblogs, the release of emergency information, and the promotion of public participation.

A community-engaged approach to translate a Vaccine Hesitancy Scale into Haitian Creole.

OBJECTIVE: Accurately translated health materials are needed to achieve equity in vaccine uptake among U.S. individuals with non-English language preferences. Verbatim translations may not capture the cultural and linguistic vernacular required to understand vaccine hesitancy. We leveraged a community-engaged approach to translate the Vaccine Hesitancy Scale (VHS) into Haitian Creole. METHODS: Following the "WHO Guidelines on Translation and Adaptation of Instruments" and a community-engaged framework, a validated 10-question Vaccine Hesitancy Scale (VHS) underwent forward translation, expert panel review, back translation, and focus group pilot testing. RESULTS: Haitian Creole-speaking translators included two community leaders, one community partner, one study team member, and 13 Haitian, greater Boston-based community members who participated in a focus group to pretest the survey. After four iterations, a linguistic and cultural translation of the VHS was created. CONCLUSION: A community-engaged framework strengthened community partnerships and resulted in a culturally relevant Haitian Creole vaccine hesitancy scale.