Inclusive education for children with disabilities in a refugee camp.

Children in refugee camps, and particularly those with disabilities, face unique challenges in accessing education and are at high risk of being marginalised. Best practices suggest that main-streaming is the optimal strategy for serving students with disabilities. This study examines the extent to which mainstreaming in a refugee camp helps to promote children's prosocial behaviours, taking into account their emotional and behavioural problems. In Kakuma Refugee Camp, Kenya, researchers collected data from the parents of children currently enrolled in special needs education centres (n=65) and from those formerly enrolled at these facilities who transitioned to mainstream classrooms (n=81). Children in mainstream schools functioned better in terms of prosocial behaviours, but this relationship disappeared when factoring in children's emotional and behavioural difficulties. In the context of a refugee camp, mainstreaming alone is not likely to help children's psychosocial and educational functioning, which requires dedicated supports, appropriate facilities and infrastructure, and a dual focus on disability-specific and disability-inclusive initiatives.

Implementing and Evaluating a Stakeholder-Driven Community Diffusion-Informed Early Childhood Intervention to Prevent Obesity, Cuyahoga County, Ohio, 2018-2020.

PURPOSE AND OBJECTIVES: The purpose of this article is to demonstrate and evaluate aspects of a Stakeholder-Driven Community Diffusion (SDCD)-informed intervention with a group of stakeholders drawn from a large coalition seeking a novel approach for promoting policy, systems, and environmental-level change. The objectives were to implement an SDCD intervention, assess changes in participants' perspectives, and evaluate where the group's actions fit within the context of a systems map that the group created during the intervention. INTERVENTION APPROACH: An SDCD-informed intervention convened 12 multisector stakeholders from the Early Ages Healthy Stages coalition in Cuyahoga County, Ohio. They participated in group model building activities to promote systems thinking related to childhood obesity prevention, reviewed evidence about topics of interest to the group, and were provided with technical assistance and seed funding to guide the selection and implementation of actions prioritized by the group. EVALUATION METHODS: Data were collected via meeting notes and group model building outputs to demonstrate implementation and action prioritization; online surveys and qualitative interviews to measure perspective change among stakeholders; and a follow-up survey to the broader coalition assessing actions coalition members were taking. RESULTS: An SDCD-informed intervention guided the development of a systems map and the selection of 4 actions: 1) develop a better understanding of the local early childcare environment; 2) assess the effectiveness and impact of Ohio Healthy Programs (OHP); 3) advocate for OHP and improved early childhood education quality; and 4) hold OHP designees accountable to high-quality programming. Data collected from surveys and interviews showed increased awareness of programs, resources, and collaboration opportunities among stakeholders. Follow-up survey results showed ongoing coalition action throughout the systems map. IMPLICATIONS FOR PUBLIC HEALTH: Using an SDCD-informed intervention among a coalition of community stakeholders provided a unique approach for implementing, assessing, and analyzing collaborative efforts to prevent childhood obesity in Cuyahoga County. Our approach can be applied to help researchers and stakeholders improve efforts to address childhood obesity in their communities.

How the Senior Community Service Employment Program Influences Participant Well-Being: A Participatory Research Approach With Program Recommendations.

The federal Senior Community Service Employment Program (SCSEP) provides on-the-job training to people 55 years and older with incomes at or below 125% of the federal poverty level with multiple barriers to employment. This study examined the processes by which SCSEP may influence participant financial, physical, and mental well-being. We engaged 15 SCSEP participants and case managers over four virtual and one telephone session using a participatory research method called community-based system dynamics. Activities included identifying key problem trends, variable elicitation, developing a causal map, and identifying changes to the system to increase participant well-being. Respondents identified how individual, organizational, and program and policy factors relate to participant well-being (e.g., SCSEP participation reduces social isolation, which increases desire to participate) and suggested program and policy recommendations to strengthen SCSEP (e.g., benchmarks of success should include health and well-being outcomes). These findings highlight the benefits and potential of this long-running program.

Implementing a stakeholder-driven community diffusion-informed intervention to create healthier, more equitable systems: a community case study in Greenville County, South Carolina.

This case study describes the application of a theory-informed, stakeholder-driven intervention with a group of 19 multi-sector stakeholders from an existing coalition to promote whole-of-community change that supports childhood obesity prevention. The intervention applied community-based system dynamics to design and implement activities that promoted insights into the systems driving childhood obesity prevalence and helped participants prioritize actions to influence those systems. This led to three new priority areas for the coalition: addressing food insecurity; building power among historically marginalized voices within the community; and supporting advocacy efforts to promote community-wide change beyond the coalition's previous focus on organizational-level policy, systems and environment change. The intervention spurred the application of community-based system dynamics to other health issues and in partner organizations, which demonstrates paradigm shifts about how to address complex public health issues in the community.

Using a community-based system dynamics approach for understanding inclusion and wellbeing: a case study of special needs education in an eastern African refugee camp.

BACKGROUND: Children with disabilities face unique challenges in humanitarian aid settings and education may provide protective measures against abuse and exploitation. There are growing calls for inclusive education of children with disabilities in formal education, but little guidance exists on how to enhance inclusion in complex and resource-constrained contexts of humanitarian settings. CASE PRESENTATION: This study used a community-based system dynamics approach to understand key stakeholders' perspectives of the drivers and effects of inclusion and wellbeing for children with disabilities, and to elicit recommendations to enhance educational inclusion in a refugee camp in Eastern Africa. Community-based system dynamics sessions, designed based on group model building scripts and facilitated by a team of four people, took place with organization staff, community leaders, and parents and caregivers of children with disabilities. The process produced a causal loop diagram depicting the stakeholders' perspectives of how multiple components interact in a system to drive inclusion and wellbeing of children with disabilities over time. CONCLUSIONS: Findings indicate participants have a broad conceptualization of inclusion, highlighting the value of community interaction and importance of meeting basic needs, and also demonstrate that including children in mainstream educational settings in a complex humanitarian context requires a more nuanced approach given the lack of existing resources to support Western models of educational inclusion fully.