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Background: Global evidence on psychosis is dominated by studies conducted in Western, high-income countries. The objectives of the Study of Context Of Psychoses to improve outcomes in Ethiopia (SCOPE) are (1) to generate rigorous evidence of psychosis experience, epidemiology and impacts in Ethiopia that will illuminate aetiological understanding and (2) inform development and testing of interventions for earlier identification and improved first contact care that are scalable, inclusive of difficult-to-reach populations and optimise recovery. Methods: The setting is sub-cities of Addis Ababa and rural districts in south-central Ethiopia covering 1.1 million people and including rural, urban and homeless populations. SCOPE comprises (1) formative work to understand care pathways and community resources (resource mapping); examine family context and communication (ethnography); develop valid measures of family communication and personal recovery; and establish platforms for community engagement and involvement of people with lived experience; (2a) a population-based incidence study, (2b) a case-control study and (2c) a cohort study with 12 months follow-up involving 440 people with psychosis (390 rural/Addis Ababa; 50 who are homeless), 390 relatives and 390 controls. We will test hypotheses about incidence rates in rural vs. urban populations and men vs. women; potential aetiological role of khat (a commonly chewed plant with amphetamine-like properties) and traumatic exposures in psychosis; determine profiles of needs at first contact and predictors of outcome; (3) participatory workshops to develop programme theory and inform co-development of interventions, and (4) evaluation of the impact of early identification strategies on engagement with care (interrupted time series study). Findings will inform development of (5) a protocol for (5a) a feasibility cluster randomised controlled trial of interventions for people with recent-onset psychosis in rural settings and (5b) two uncontrolled pilot studies to test acceptability, feasibility of co-developed interventions in urban and homeless populations. [ABSTRACT FROM AUTHOR]

Community participation (CP) and empowerment (CE) have long been viewed internationally as cornerstones of comprehensive primary health care (PHC). Accordingly, policies for new PHC models in Italy, such as the Community Health Centres called "Case della Salute" in 2006 and "Case della Comunità" in 2022, highlight the importance of implementing participatory processes with communities and creating opportunities for CE. This study's objective is to identify the understandings of CP and CE that emerge among practitioners and stakeholders who design participatory approaches in PHC practice and policy in the Emilia-Romagna region in Italy. Nineteen semistructured interviews were conducted with practitioners working on CP and CE processes in these Community Health Centres and with stakeholders involved in research on or the coordination of such processes in the context of these health centres. The data were analysed using qualitative content analysis in light of the following two questions, which emerged inductively from the data: (1) How to support CP and CE processes in practical doing (how do CP/CE)? (2) With which function or aim to support CP and CE (why do CP/CE)? This study shows that the participating practitioners and stakeholders exhibited various understandings of CP and CE in the context of PHC. Four main themes were identified: CP and CE as (a) a variety of forms of dialogue and cooperation, (b) tools for service development, (c) levers for empowerment, collectivism, and democracy and (d) stimuli for institutional change and a new level of professionalism. Moreover, the participants defined "the community" in different ways and often chose specific subgroups within the community to promote CP and CE processes. This study elucidates different perspectives on CP and CE and highlights the opportunities and obstacles for policymaking, research and practice that result from these understandings. [ABSTRACT FROM AUTHOR]

Background: Globally, there is growing attention towards health system strengthening, and the importance of quality in health systems. However, fragile and conflict-affected states present particular challenges. The aim of this study was to explore health system strengthening in fragile and conflict-affected states by synthesising the evidence from published literature. Methods: We conducted a review of systematic reviews (Prospero Registration Number: CRD42022371955) by searching Ovid (Medline, Embase, and Global Health), Scopus, Web of Science, and the Cochrane Library databases. Only English-language publications were considered. The Joanna Briggs Institute (JBI) Critical Appraisal Tool was employed to assess methodological quality of the included studies. The findings were narratively synthesised and presented in line with the Lancet's 'high-quality health system framework'. Results: Twenty-seven systematic reviews, out of 2,704 identified records, considered key dimensions of health systems in fragile and conflict-affected states, with the 'foundations' domain having most evidence. Significant challenges to health system strengthening, including the flight of human capital due to safety concerns and difficult working conditions, as well as limited training capacities and resources, were identified. Facilitators included community involvement, support systems and innovative financing mechanisms. The importance of coordinated and integrated responses tailored to the context and stage of the crisis situation was emphasised in order to strengthen fragile health systems. Overall, health system strengthening initiatives included policies encouraging the return and integration of displaced healthcare workers, building local healthcare workers capacity, strengthening education and training, integrating healthcare services, trust-building, supportive supervision, and e-Health utilisation. Conclusion: The emerging body of evidence on health system strengthening in fragile and conflict-affected states highlights its complexity. The findings underscore the significance of adopting a comprehensive approach and engaging various stakeholders in a coordinated manner considering the stage and context of the situation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to establish best ways of improving household soybean processing and utilization in selected districts in the Eastern Province of Zambia. This was a concurrent triangulation study design, nested with a cross sectional survey and barrier analysis. Up to 1,237 households and 42 key informants participated in the quantitative and qualitative studies respectively. Quantitative data was analysed using Stata MP 15 software (StataCorp, College Station, TX, USA). NVIVO QSR10 software (QSRInt, Melbourne Australia) was used to organize qualitative data which was later analysed thematically. In this study whole soybean processing and utilization in eastern province was at 48%. However, accessibility to soybean for household consumption throughout the year was negligible (0.29%). Based on the food systems an interplay of factors influenced soybean processing and utilization. In the food environment, a ready-made Textured Soya Protein mainly imported [1,030/1237(83%)] and a milled whole soybean-maize blend AOR 816.37; 95%CI 110.83 to 6013.31 were preferred. Reports of labour intensity, hard to cook properties, coarse milling and beany flavour with associated anti-nutrients negatively influenced whole soybean utilization. In the enabling environment, soybean production AOR 4.47; 95%CI 2.82 to 7.08 increased the chances of utilization. Lack of inputs, poor access to affordable credit and lack of ingredients were deleterious to utilization. Low coverage of existing projects and poor access to technologies were other adverse factors. Among the Socioeconomic factors, a higher social hierarchy shown by owning a bed AOR 1.75; 95%CI 1.22 to 2.49, belonging to the Chewa community AOR 1.16; 95%CI 1.08 to 0 1.25, gender of household head particularly male AOR 1.94; 95%CI 1.21 to 3.13, off farm income and livestock ownership were supportive to soybean utilization. Unfavourable factors were; belonging to any of the districts under study AOR 0.76; 95%CI 0.58 to 0.98, lack of knowledge (55.65%), low involvement of the male folks AOR 0.47; 95%CI 0.30 to 0.73 and belonging to a female headed household AOR 1.94; 95%CI 1.21 to 3.13. Age, time and household size constraints as well as unreliable soybean output markets, lack of land, poor soils in some wards and poor soybean value chain governance were other negative factors. Immediately in the food environment there is need to boost milling of whole soybean while strengthening cooking demonstrations, correct processing, incorporation of soybean in the local dishes and conducting acceptability tests. In the enabling environment, there should be access to inputs, affordable credit facilities and subsidized mineral fertilisers. Post-harvest storage, collective action with full scale community involvement and ownership should be heightened. Socioeconomic approaches should target promotion of soybean processing and utilization among all ethnic groups, participation of male folks and female headed households as well as advocating for increased nutrition sensitive social protection. In the medium or long term, capacity building, market development, import substitution agreements, creation of new products, development of cottage industries, information exchange and inter district trade as well as more public-private partnerships and more local private sector players should be bolstered. Lastly farm diversification should be supported. [ABSTRACT FROM AUTHOR]

Introduction: The global HIV/AIDS initiative in Africa aims for eradication by 2030 and treatment for 95% of HIV-positive adults by 2025. Adult People living with HIV (PLWHs) face health complications, including metabolic syndrome (MS), which heightens the risk of non-communicable diseases (NCDs) and cardiovascular problems. WHO and UNAIDS advocate for the integration of NCDs into primary healthcare, yet addressing MS remains a significant challenge in Africa. The WHO's Global Action Plan aims to reduce chronic diseases by managing risk factors and promoting healthy lifestyles within this population. However, effectively promoting healthy lifestyles necessitates an understanding of the sociocultural contexts that influence behaviors related to MS. Therefore, this study investigates how sociocultural contexts influences on knowledge, attitudes, and practices of PLWHs in Ethiopia regarding MS prevention and associated lifestyle risks, utilizing the PEN-3 model as a sociocultural framework. Methods: The study utilized a deductive descriptive phenomenological approach, involving 32 voluntarily selected PLWHs who sought routine care at public health institutions from December 29, 2017, to January 22, 2018. Data collection was facilitated by experienced research and task teams using standardized guidelines for focus group discussions and in-depth interviews tailored to the research context. The collected text and survey data were managed with Atlas.ti and SPSS software and analyzed through thematic content analysis. Results were reported in accordance with the consolidated criteria for reporting qualitative research (COREQ) checklist. Results: A study of 32 HIV-positive adults found that knowledge, attitudes, and health-related behaviors were key factors in their health. Participants learned about metabolic syndrome (MS) risks through mass media, peer discussions, and family education. However, there was a lack of awareness about the impact of HIV medications on MS and limited understanding of lifestyle factors for disease prevention. Attitudes reflect complex challenges for PLWHs in perceiving MS and its management. Health-related behaviors varied, with positive practices like fruit and vegetable consumption, regular exercise, and avoidance of harmful substances. Negative practices included sedentary lifestyles, raw meat consumption, alcohol, smoking, and 'Khat' use, which could negatively affect health outcomes. Addressing these culturally preferred behaviors is crucial for improving health among PLWHs. Conclusion: The study revealed a notable knowledge gap regarding metabolic syndrome (MS) and its risk factors, leading to inadequate health attitudes and practices. Sociocultural factors—such as beliefs, values, family dynamics, and community support—are crucial in shaping the knowledge, attitudes and practice of PLWHs toward the prevention and management of chronic diseases like MS. The finding suggested that addressing the sociocultural factors affecting HIV-positive individuals' knowledge and practices regarding metabolic syndrome requires a comprehensive, inclusive approach that emphasizes education, community involvement, policy reform, and a focus on reducing stigma. [ABSTRACT FROM AUTHOR]

Introduction: Efficient NTDs elimination strategies require effective surveillance and targeted interventions. Traditional methods are costly and time-consuming, often failing to cover entire populations in case of movement restrictions. To address these challenges, a morbidity image-based surveillance system is being developed. This innovative approach which leverages the smartphone technology aims at simultaneous surveillance of multiple NTDs, enhancing cost-efficiency, reliability, and community involvement, particularly in areas with movement constraints. Moreover, it holds promise for post-elimination surveillance. Methodology: The pilot of this method will be conducted across three states in southern Nigeria. It will target people affected by Neglected Tropical Diseases and members of their communities. The new surveillance method will be introduced to target communities in the selected states through community stakeholder's advocacy meetings and awareness campaigns. The pilot which is set to span eighteen months, entails sensitizing NTDs-affected individuals and community members using signposts, posters, and handbills, to capture photos of NTDs manifestations upon notice using smartphones. These images, along with pertinent demographic information, will be transmitted to a dedicated server through WhatsApp or Telegram accounts. The received images will be reviewed and organized at backend and then forwarded to a panel of experts for identification and annotation to specific NTDs. Data generated, along with geocoordinate information, will be used to create NTDs morbidity hotspot maps using ArcGIS. Accompanying metadata will be used to generate geographic and demographic distributions of various NTDs identified. To protect privacy, people will be encouraged to send manifestation photos of the affected body part only without any identifiable features. Evaluation protocol: NTDs prevalence data obtained using conventional surveillance methods from both the pilot and selected control states during the pilot period will be compared with data from the CIMS-NTDs method to determine its effectiveness. Expected results and conclusion: It is expected that an effective, privacy-conscious, population inclusive new method for NTDs surveillance, with the potential to yield real-time data for the identification of morbidity hotspots and distribution patterns of NTDs will be established. The results will provide insights into the effectiveness of the new surveillance method in comparison to traditional approaches, potentially advancing NTDs elimination strategies. [ABSTRACT FROM AUTHOR]

Background: Significant health disparities exist among American Indian and Alaska Natives (AI/ANs), yet AI/ANs are substantially underrepresented within health-related research, including randomized controlled trials (RCTs). Although research has previously charted representation inequities, there is however a gap in the literature documenting best practice for recruitment techniques of AI/ANs into RCTs. Therefore, the aim of this review was to systematically gather and analyze the published literature to identify common strategies for AI/AN participant recruitment for RCTs in the US. Methods: A scoping review methodology was engaged with a systematic search operationalized within relevant databases to February 19, 2022, with an additional updated search being carried out up until January 1, 2023: PubMed, Embase, Web of Science, PsycINFO, CINAHL, and Google Scholar. A two-stage article review process was engaged with double reviewers using Covidence review software. Content analysis was then carried out within the included articles by two reviewers using NVivo software to identify common categories within the data on the topic area. Results: Our review identified forty-one relevant articles with the main categories of recruitment strategies being: 1) recruitment methods for AI/ANs into RCTs (passive advertising recruitment approaches, individual-level recruitment approaches, relational methods of recruitment); 2) recruitment personnel used within RCTs; and, 3) relevant recruitment setting. The majority of the included studies used a culturally relevant intervention, as well as a community-involved approach to operationalizing the research. Conclusion: Increasing AI/AN representation in RCTs is essential for generating evidence-based interventions that effectively address health disparities and improve health outcomes. Researchers and funding agencies should prioritize the engagement, inclusion, and leadership of AI/AN communities throughout the RCT research process. This includes early community involvement in study design, implementation of culturally tailored recruitment strategies, and dissemination of research findings in formats accessible to AI/AN communities. [ABSTRACT FROM AUTHOR]

There have been many calls for community participation in MRV (measuring, reporting, verification) for REDD+. This paper examines whether community involvement in MRV is a requirement, why it appears desirable to REDD+ agencies and external actors, and under what conditions communities might be interested in participating. It asks What’s in it for communities? What might communities gain from such an involvement? What could they lose? It embraces a broader approach which we call community MMM which involves mapping, measuring and monitoring of forest and other natural resources for issues which are of interest to the community itself. We focus on cases in México because the country has an unusually high proportion of forests under community communal ownership. In particular, we refer to a recent REDD+ initiative—CONAFOR-LAIF, in which local communities select and approve local people to participate in community-based monitoring activities. From these local initiatives we identify the specific and the general drivers for communities to be involved in mapping, measuring and monitoring of their own territories and their natural resources. We present evidence that communities are more interested in this wider approach than in a narrow focus on carbon monitoring. Finally we review what the challenges to reconciling MMM with MRV requirements are likely to be. [ABSTRACT FROM AUTHOR]

This paper examines the relationships between social participation and disaster risk reduction actions. A survey of 557 households in tsunami prone areas in Phang Nga, Thailand was conducted following the 2012 Indian Ocean earthquakes. We use a multivariate probit model to jointly estimate the likelihood of undertaking three responses to earthquake and tsunami hazards (namely, (1) following disaster-related news closely, (2) preparing emergency kits and/or having a family emergency plan, and (3) having an intention to migrate) and community participation. We find that those who experienced losses from the 2004 tsunami are more likely to participate in community activities and respond to earthquake hazards. Compared to men, women are more likely to prepare emergency kits and/or have an emergency plan and have a greater intention to migrate. Living in a community with a higher proportion of women with tertiary education increases the probability of engaging in community activities and carrying out disaster risk reduction measures. Individuals who participate in village-based activities are 5.2% more likely to undertake all three risk reduction actions compared to those not engaging in community activities. This implies that encouraging participation in community activities can have positive externalities in disaster mitigation. [ABSTRACT FROM AUTHOR]

Globally, increasing efforts have been made to hold duty-bearers to account for their commitments to improve reproductive, maternal, newborn, child and adolescent health (RMNCAH) over the past two decades, including via social accountability approaches: citizen-led, collective processes for holding duty-bearers to account. There have been many individual studies and several reviews of social accountability approaches but the implications of their findings to inform future accountability efforts are not clear. We addressed this gap by conducting a review of reviews in order to summarise the current evidence on social accountability for RMNCAH, identify factors contributing to intermediary outcomes and health impacts, and identify future research and implementation priorities. The review was registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42019134340). We searched eight databases and systematic review repositories and sought expert recommendations for published and unpublished reviews, with no date or language restrictions. Six reviews were analysed using narrative synthesis: four on accountability or social accountability approaches for RMNCAH, and two specifically examining perinatal mortality audits, from which we extracted information relating to community involvement in audits. Our findings confirmed that there is extensive and growing evidence for social accountability approaches, particularly community monitoring interventions. Few documented social accountability approaches to RMNCAH achieve transformational change by going beyond information-gathering and awareness-raising, and attention to marginalised and vulnerable groups, including adolescents, has not been well documented. Drawing generalisable conclusions about results was difficult, due to inconsistent nomenclature and gaps in reporting, particularly regarding objectives, contexts, and health impacts. Promising approaches for successful social accountability initiatives include careful tailoring to the social and political context, strategic planning, and multi-sectoral/multi-stakeholder approaches. Future primary research could advance the evidence by describing interventions and their results in detail and in their contexts, focusing on factors and processes affecting acceptability, adoption, and effectiveness. [ABSTRACT FROM AUTHOR]

Ronald Inglehart's postmaterialist theory suggests that with the advancement of industrialization and economic prosperity, there will be a significant transformation in people's societal values. Concurrently, their forms of political participation shift from conventional activities to unconventional politic activities. However, most research on this topic has been predominantly focused on Western countries. In fact, rural farmers in China serve as an excellent experimental group for testing this theory since they have experienced rapid economic growth while still being deeply influenced by traditional authoritarianism culture.Using a sample of 6,689 respondents from the 2019 Chinese Social Survey (CSS) and employing a Binary Logistic Regression Model, we discovered that Chinese farmers' perception of overall societal justice exhibits a U-shaped relationship with various forms of political participation. Specifically, it shows a significant negative correlation with non-institutional political participation, such as contact-officer participation, but a significant positive correlation with institutional political participation types like community participation and election participation.Our further research indicates that the three subtypes of perception of societal justice are significantly negatively correlated only with non-institutional political participation, while their statistical relationship with institutional political participation is not significant. We believe that the underlying reason for this phenomenon lies in the unique interpretation of societal justice within Chinese traditional culture. Additionally, through a comparative analysis of models on political participation behavior and willingness, we found that despite significant inequalities and disparities in institutional structures and levels of economic development between rural and urban areas in China, rational considerations of the risks and costs associated with defying the government deter Chinese farmers from engaging in non-institutional politic activities unless their emotional resentment towards unjust practices reaches a certain threshold. [ABSTRACT FROM AUTHOR]

Background: Ageing in Place is the emerging social policy drive for long-term care coordination of older persons globally. This decision may be the only viable option in many low- and middle-income countries like Nigeria. Nevertheless, the risk of older persons being 'stuck in place' is high if their preferences are not considered or other alternatives are neither acceptable nor available. This study determined factors associated with the preferred care setting among community-dwelling older persons and explored their views about their choices. Methods: The study utilised a mixed-methods approach. Participants were older persons (≥ 60 years) in a selected rural and urban community in Oyo State, south-western Nigeria. Quantitative data were collected using an interviewer-administered, semi-structured questionnaire and analysed using Stata version 14 at p<0.05. Qualitative data collection involved 22 Focus Group Discussions (FGD). The discussions were audiotaped, transcribed verbatim and analysed thematically using ATLAS.ti version 8. Selected quotations were used to illustrate themes. Results: 1,180 participants (588 rural vs 592 urban) were interviewed with a mean age of 73.2 ±9.3 years. More rural participants preferred to AIP (61.6%) compared to urban participants (39.2%), p = 0.001. Factors associated with the decision for rural participants were older age [OR:2.07 (95%CI:1.37–3.14)], being male [OR:2.41(95%CI:1.53–3.81)] and having assistance at home [OR:1.79 (95%CI:1.15–2.79)]. In comparison, significant factors for urban participants were older age (≥70years) [OR:1.54(95%CI:1.03–2.31)] and home-ownership [OR:5.83 (95%CI:3.82–8.91)]. The FGD revealed that the traditional expectation of reciprocity of care mostly influenced the desire to AIP. Advantages include improved social connectedness, quality of care, community participation and reduced isolation. Interestingly, participants were not opposed to the option of institutional care. Conclusion: Ageing in place is preferred and influenced by advanced age and home ownership in our setting. Information provided could guide age-friendly housing policies and community-based programmes for the care of older persons. [ABSTRACT FROM AUTHOR]

Background: Despite international evidence supporting community participation in health for improved health outcomes and more responsive and equitable health systems there is little practical evidence on how to do this. This work sought to understand the process involved in collective implementation of a health-related local action plan developed by multiple stakeholders. Methods: Communities, government departments and non-government stakeholders convened in three iterative phases of a participatory action research (PAR) learning cycle. Stakeholders were involved in problem identification, development, and implementation of a local action plan, reflection on action, and reiteration of the process. Participants engaged in reflective exercises, exploring how factors such as power and interest impacted success or failure. Results: The local action plan was partially successful, with three out of seven action items achieved. High levels of both power and interest were key factors in the achievement of action items. For the achieved items, stakeholders reported that continuous interactions with one another created a shift in both power and interest through ownership of implementation processes. Participants who possessed significant power and influence were able to leverage resources and connections to overcome obstacles and barriers to progress the plan. Lack of financial support, shifting priorities and insufficient buy-in from stakeholders hindered implementation. Conclusion: The process offered new ways of thinking and stakeholders were supported to generate local evidence for action and learning. The process also enabled exploration of how different stakeholders with different levels of power and interest coalesce to design, plan, and act on evidence. Creation of safe spaces was achievable, meanwhile changing stakeholders' level of power and interest was possible but challenging. This study suggests that when researchers, service providers and communities are connected as legitimate participants in a learning platform with access to information and decision-making, a shift in power and interest may be feasible. [ABSTRACT FROM AUTHOR]

The objective was to explore the care experiences and service design related to rehabilitation for mobility and participation in the community among individuals with acquired brain injury (ABI), as perceived by clinicians and patients. Five focus groups were held: three with clinicians and two with individuals with ABI. Focus group discussions were transcribed and analyzed using an inductive and deductive thematic content approach. Five themes were identified: Enabling continuity of care; System design; Accessibility and services in the community; Transportation services; and Uncertainty about the provided services. The results of participants' experiences contributed to developing recommendations of service provision for mobility, leading to a patient-centered continuum of rehabilitation services. Accessibility to rehabilitation to improve the quality of care by addressing needs during transitions and mobility-related deficits, providing needed information, coordinated care, and self-management support in the community. [ABSTRACT FROM AUTHOR]

Research into the experiences of students in mathematics with a marginalized sexual identity has remained largely underexplored, relegating these experiences and individuals to remain invisible. In this study, we leverage Queer Theory to address this gap in research by reporting on the experiences of Queer-spectrum undergraduate students (n = 2,454) enrolled in introductory mathematics courses (Precalculus, Calculus 1, and Calculus 2) across the United States. Drawing on student data (n = 24,327) from the Student Post-Secondary Instructional Practices Survey, we examine reported outcomes of math learning experiences and access to learning environments. Overall, within introductory math courses, sexual identity had a significant relationship with accessing learning environments and mathematical learning experiences. Asexual students were among those that reported higher levels of interactions with peers and instructors, a greater sense of community & participation, positive math affect, and were more likely to access learning environments external to the course yet anticipated receiving a lower course grade when compared to straight students. Bisexual students reported lower levels of interactions with instructors, a diminished sense of community & participation, math engagement, positive math affect, and were less likely to access learning environments compared to straight students. These findings suggest that Queer-spectrum students experience mathematical learning in a different manner than their straight peers and in relation to other Queer spectrum identities. Queer-spectrum students with a sexualized identity perceive that mathematics environments are not normative places to be a part of the community, resulting in negative dispositions, reduced interactions, and lower academic success. The impact of sexual identity, although small, contributes to negative indicators of positive mathematical experiences and suggests that the normative discourses in mathematics that are identity neutral, heteronormative, and aligned with binary thinking are differentially impacting Queer-spectrum students. [ABSTRACT FROM AUTHOR]

Introduction: General practitioners (GP) increasingly face the challenge of meeting the complex care needs of multi-morbid patients. Previous studies show that GP practices would like support from other institutions in advising on social aspects of care for multi-morbid patients. Already existing counselling services, like community care points, are not sufficiently known by both GPs and patients. The aim of COMPASS II is to investigate the feasibility of cooperation between GP practices and community care points. Methods and analysis: During the intervention, GPs send eligible multi-morbid patients with social care needs to a community care point. The community care points report the consultation results back to the GPs. In preparation for the intervention, in a moderated process, GP practices meet with the community care points to agree on information exchange. The primary outcome is the feasibility of the cooperation: Questionnaires will be sent to GPs, medical practice assistances and community care point personnel (focus: practicality, acceptability). Data will be collected on frequency and reasons for GP-initiated consultations at community care points (focus: demand). Qualitative interviews will be conducted with all participating groups (focus: acceptability, satisfaction). The secondary outcome is the assessment of changes in health-related quality of life, social support and satisfaction with care: participating patients complete a questionnaire before and three to six months after their counselling. The results of the study will be incorporated into a manual in which the experiences of the cooperation will be made available to other GP practices and community care points. Discussion: In COMPASS II, GP practices establish cooperation with community care points. The latter are already existing institutions that provide independent and free advice on social matters. By using an existing institution, the established cooperation and experiences from the study can be used beyond the end of the study. Trial registration: The trial is registered with DRKS-ID: DRKS00023798, Coordination of Medical Professions Aiming at Sustainable Support II. [ABSTRACT FROM AUTHOR]

The present study investigates the perception of local communities and obtains the socio-economic impacts of ecotourism development in Terengganu, Malaysia. Two ecotourism places of Terengganu namely Lake Kenyir and Sekayu Recreational Forest had purposively been chosen for study. A non-probability convenience sampling was adopted for sample selection and a structured questionnaire was administered among 310 respondents to investigate the perception of the local communities. Factor analysis was done to identify the latent constructs and a theoretical Structural Equation Model (SEM) was proposed and tested. Results show that employment opportunities, homestay accommodations, and community participation are some positive socio-economic impacts of ecotourism development. Moreover, degradation of natural resources and break-up of religious traditions have been identified as negative socio-economic impacts. To ensure sustainable ecotourism development and endure the maximum benefit to the local communities, these negative impacts should be minimized. Encouragement should be given to local communities to accelerate the positive impacts of ecotourism. [ABSTRACT FROM AUTHOR]

Background: Despite the emphasis placed on Community Based Tuberculosis Care (CBTC) implementation by Health Extension Workers (HEWs) within the National Tuberculosis Program (NTP) in Ethiopia, there is little evidence on contribution of HEWs on TB case notification. Therefore, this study aimed to describe the contribution of HEWs on TB case notification and its associated factors in Tigray region, Northern Ethiopia. Methods: A concurrent mixed method (quantitative and qualitative) cross-sectional study design was conducted in three randomly selected districts in Tigray region, Northern Ethiopia. Quantitative data were collected using a pre-tested semi-structured questionnaire. Qualitative data were collected using Focused Group Discussions (FGDs) and Key Informant Interviews (KIIs) to further describe the community participation and presumptive TB identification and referral system. For the quantitative data, binary logistic regression analysis was done and all variables with P-value of < 0.25 in bivariate analysis were included in the multi-variable model to see predictors of HEWs contribution to TB notification. The qualitative data were thematically analyzed using Atlas.ti version 7. Results: In this study, a total of 68 HEWs were included. From March 1, 2017 to February 28, 2018, a total of 427 TB cases notified in the study areas and one-third (34%) of them were notified by the HEWs referral. Provision of Community Based-Directly Observed Treatment Short course (CB–DOTS) (Adjusted Odds Ratio (AOR) = 3.63, 95% Confidence Interval (CI) = 1.18–11.19) and involvement of community volunteers on CBTC (AOR = 3.31, 95% CI = 1.10–10.09) were significantly associated with the contribution of HEWs on TB case notification. The qualitative findings indicated that high workload of HEWs, inaccessibility of TB diagnostic services at nearby health facilities, and transportation and investigation costs were identified as factors affecting for presumptive TB referral by HEWs. Conclusions: Provision of CB-DOTS and involvement of community volunteers in CBTC activities should be strengthened to improve the HEWs contribution on TB case notification. Additionally, HEWs should be empowered and further interventions of TB diagnostic services at diagnostic health facilities are needed to improve presumptive TB referral by HEWs. [ABSTRACT FROM AUTHOR]

Background: Star Rating Assessment (SRA) was initiated in 2015 in Tanzania aiming at improving the quality of services provided in Primary Healthcare (PHC) facilities. Social accountability (SA) is among the 12 assessment areas of SRA tools. We aimed to assess the SA performance and its predictors among PHC facilities in Tanzania based on findings of a nationwide reassessment conducted in 2017/18. Methods: We used the SRA database with results of 2017/2018 to perform a cross-sectional secondary data analysis on SA dataset. We used proportions to determine the performance of the following five SA indicators: functional committees/boards, display of information on available resources, addressing local concerns, health workers' engagement with local community, and involvement of community in facility planning process. A facility needed four indicators to be qualified as socially accountable. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine facilities characteristics associated with SA, namely location (urban or rural), ownership (private or public) and level of service (hospital, health centre or dispensary). Results: We included a total of 3,032 PHC facilities of which majority were dispensaries (86.4%), public-owned (76.3%), and located in rural areas (76.0%). On average, 30.4% of the facilities were socially accountable; 72.0% engaged with local communities; and 65.5% involved communities in facility planning process. Nevertheless, as few as 22.5% had functional Health Committees/Boards. A facility was likely to be socially-accountable if public-owned [AOR 5.92; CI: 4.48–7.82, p = 0.001], based in urban areas [AOR 1.25; 95% CI: 1.01–1.53, p = 0.038] or operates at a level higher than Dispensaries (Health centre or Hospital levels) Conclusion: Most of the Tanzanian PHC facilities are not socially accountable and therefore much effort in improving the situation should be done. The efforts should target the lower-level facilities, private-owned and rural-based PHC facilities. Regional authorities must capacitate facility committees/boards and ensure guidelines on SA are followed. [ABSTRACT FROM AUTHOR]

Background: Increasing both the frequency and quality of social interactions within treatments for anxiety and depressive disorders in older adults may improve their mental health outcomes and quality of life. This study aims to evaluate the clinical efficacy and cost utility of an enhanced cognitive behavioural therapy (CBT) plus social participation program in a sample of older adults with depression and/or anxiety. Methods: A total of 172 community-dwelling adults aged 65 years or older with an anxiety and/or depressive disorder will be randomly allocated to either an enhanced CBT plus social participation program (n = 86) or standard CBT (n = 86). Both treatments will be delivered during 12 weekly individual sessions utilising structured manuals and workbooks. Participants will be assessed at pre-treatment, post-treatment, and 12-month follow-up. The primary outcome evaluates mean change in clinician-rated diagnostic severity of anxiety and depressive disorders from baseline to post-treatment (primary endpoint) based on a semi-structured diagnostic interview. Secondary outcomes evaluate changes in symptomatology on self-report anxiety and depression measures, as well as changes in social/community participation, social network, and perceived social support, loneliness, quality of life, and use of health services. Economic benefits will be evaluated using a cost-utility analysis to derive the incremental cost utility ratios for the enhanced CBT program. Discussion: Outcomes from this study will provide support for the establishment of improved psychosocial treatment for older adults with anxiety and/or depression. Study outcomes will also provide health systems with a clear means to reduce the impact of poor emotional health in older age and its associated economic burden. In addition to the empirical validation of a novel treatment, the current study will contribute to the current understanding of the role of social participation in older adult wellbeing. Trial registration: Prospectively registered on the Australian New Zealand Clinical Trials Registry (ID: ACTRN12619000242123; registered 19th February 2019) and the ISRCTN registry (ID: ISRCTN78951376; registered 10th July 2019). [ABSTRACT FROM AUTHOR]

Most studies on COVID-19 preventive behaviors have focused on single-level factors such as national policy, community social capital, or individuals' sociodemographic characteristics. Through a social-ecological model, this study attempts to comprehensively examine the multilevel factors associated with COVID-19 preventive practices in South Korea. Accordingly, a web survey involving 1,500 participants was conducted in December 2020. An ordinary least squares (OLS) regression was used to examine the multilevel factors (individual, interpersonal, community, and policy levels) related to COVID-19 preventive measures, which are based on wearing a mask, washing hands, covering the mouth when coughing or sneezing, and social distancing. When factors at each level were investigated, higher scores of COVID-19 fear and correct knowledge at the individual level, COVID-19 information share at the interpersonal level, and better evaluation of the national government policies in regard to COVID-19 at the policy level were positively associated with COVID-19 preventive behaviors. Community-level factors—neighborhood perception and community participation—were negatively significantly related to COVID-19 preventive behaviors. Additionally, older age, being female, and having a graduate-level education were positively related to better preventive behaviors. The findings of the current study suggest that multilevel efforts are needed to promote preventive behaviors. Specifically, more effort to alleviate COVID-19-related fear and disseminate correct knowledge among Korean citizens is needed as the individual-level characteristics explained the preventive behaviors more than the factors at upper levels. [ABSTRACT FROM AUTHOR]

Background: Postnatal home visits (PNHVs) have been endorsed as strategy for delivery of postnatal care (PNC) to reduce newborn mortality and improve maternal outcomes. Despite the important role of the Health Extension Workers (HEWs) in improving the overall healthcare coverage, PNHV remains as a missed opportunity in rural Ethiopia. Thus, this study aimed to explore the barriers and facilitators of scheduled postnatal home visits in Northern Ethiopia. Methods: We conducted an exploratory qualitative study on a total of 16 in-depth interviews with HEWs and mothers who gave birth one year prior to the study. In addition, focus group discussions were conducted with HEWs and key informant interviews were conducted with women development group leaders, supervisors, and healthcare authorities from April to June 2019 in two rural districts of Northern Ethiopia. Discussions and interviews were audio recorded and transcribed verbatim in the local language (Tigrigna) and translated into English. The translated scripts were thematically coded using Atlas ti scientific software. Field notes were also taken during the discussion and while conducting the interviews. Results: Health system factors, community context, and individual level factors were considered as the barriers and facilitators of scheduled PNHVs. Leadership, governance, management, support and supervision, referral linkages, overwhelming workload, capacity building, logistics and supplies are the major sub-themes identified as health system factors. Physical characteristics like geographical location and topography, distance, and coverage of the catchment; and community support and participation like support from women's development groups (WDGs), awareness of the community on the presence of the service and cultural and traditional beliefs were community contexts that affect PNHVs. Self-motivation to support and intrinsic job satisfaction were individual level factors that were considered as barriers and facilitators. Conclusion: The finding of this study suggested that the major barriers of postnatal home visits were poor attention of healthcare authorities of the government bodies, lack of effective supervision, poor functional linkages, inadequate logistics and supplies, unrealistic catchment area coverage, poor community participation and support, and lack of motivation of HEWs. Henceforth, to achieve the scheduled PNHV in rural Ethiopia, there should be strong political commitment and healthcare authorities should provide attention to postnatal care both at facility and home with a strong controlling system. [ABSTRACT FROM AUTHOR]

Since their introduction two decades ago, Community Wildfire Protection Plans (CWPPs) have become a common planning tool for improving community preparedness and risk mitigation in fire-prone regions, and for strengthening coordination among federal and state land management agencies, local government, and residents. While CWPPs have been the focus of case studies, there are limited large-scale studies to understand the extent of, and factors responsible for, variation in stakeholder participation—a core element of the CWPP model. This article describes the scale and scope of participation in CWPPs across the western United States. We provide a detailed account of participants in over 1,000 CWPPs in 11 states and examine how levels of participation and stakeholder diversity vary as a function of factors related to planning process, planning context, and the broader geographic context in which plans were developed. We find that CWPPs vary substantially both by count and diversity of participants and that the former varies as a function of the geographic scale of the plan, while the latter varies largely as a function of the diversity of landowners within the jurisdiction. More than half of participants represented local interests, indicating a high degree of local engagement in hazard mitigation. Surprisingly, plan participation and diversity were unrelated to wildfire hazard. These findings suggest that CWPPs have been largely successful in their intent to engage diverse stakeholders in preparing for and mitigating wildfire risk, but that important challenges remain. We discuss the implications of this work and examine how the planning process and context for CWPPs may be changing. [ABSTRACT FROM AUTHOR]

Although Opisthorchis viverrini (OV), lifestyle, and diet co-factors have a relatively high prevalence in the Greater Mekong Subregion (GMS) population, cumulative (0–74) incidence rates of cholangiocarcinoma (CCA) do not reach 5% in this region. Other co-factors must influence, but in this study, we only highlighted positive factors for guiding joint planning to address public health problems at the regional level. Therefore, we aimed to study prevalence and factors associated with CCA incidence focusing only on protective factors. A cross-sectional analytic study was carried out from June to October 2017. Participants with informed consent completed the questionnaires. Descriptive statistics were used to analyze general information. Primary variables were classified into high and low levels by mean. Logistic regression was employed to investigate the correlation between interesting variables and the overall risk level of CCA. The overall prevalence of CCA protective factors of the whole region was knowledge (61.39%), health beliefs (42.32%), prevention behavior (31.93%), and community participation (14.53%). When considering the proportions at a high level, they were 49.53%, 53.72%, 35.37%, and 49.67%, respectively. Significant factors associated with CCA prevention were females with secondary or vocational education, a high level of perceived seriousness and benefits, and community participation. These findings are likely to be helpful for both the public and administrators. First, it can be information for people to be aware of CCA risk. Second, policy-driven authorities at the local or regional level should apply the critical issues from this study for joint planning to sustainably solve regional public health problems. [ABSTRACT FROM AUTHOR]

Background: Despite several intervention programs, the Bedouin population living in the Southern District of Israel has the highest mortality rate among children and adolescents from unintentional injuries. Our research questions asked: (1) How does increasing the involvement and participation of Bedouin community members influence the issue of unintentional injuries among children? (2) How does reframing of the technical issue of safety into security influence community involvement and cooperation? Objectives: 1) To identify effective and efficacious positive deviance practices through community-based participatory research with adults, children, and professionals in the Bedouin community. 2) To create wider and deeper connections and cohesion between and among diverse Bedouin communities by seeding and sparking opportunities for social networking and cross-learning. Methods: The study used a qualitative multi-method approach to generate a hybrid intervention model for reducing unintentional childhood injuries among the Bedouins. To frame the issue of unintentional injuries from the lived perspective of the Bedouins, we employed the Positive Deviance (PD) and Community Based Participatory Research (CBPR) approach. Drawing upon theatrical traditions, entertainment-education (EE), was employed as a way to narratively engage and persuade the Bedouins. Results: Our research resulted in: (1) the emergence of several PD ideas and practices for preventing and avoiding children's injuries; (2) the actual creation of a safe and secure playroom for children at a neighborhood mosque; and (3) the creation of cascading and cross-learning social networks between and among members of the Bedouin community spread across various locations. Conclusion: This study helped in reframing the technical issue of accidents and safety into the notion of sacredness and security, enhanced the association between emotions and cognition by means of experiential and EE methods, and stimulated creative thinking and the emergence of new culturally and contextually relevant ideas and practices through the PD process. It demonstrated the synergistic power of using a hybrid model that combined the rigor and vigor of different health communication approaches to address a significant disparity in the burden of child accidents faced by the Bedouins. Our study generated solutions that emerged from, and directly benefitted, Bedouin children—those, who face overwhelming risk of injury and death from preventable accidents. [ABSTRACT FROM AUTHOR]

This study examines multi-stakeholders' perceptions of vandalism at tourist attractions in two Asian cities: Bangkok and Singapore. It provides an opportunity to explore the differences and similarities in stakeholder attitudes towards attraction management and reveals desired levels of participation of community in managing vandalism in tourism. This mixed method research employs community survey and interviews of site managers and government officials as its main data collection approach. It also offers an innovative approach to data analysis using the severity and optimist/pessimist psychographic variables coupled with quantitative analytical techniques. The results reveal complex relationship between psychographic profiles, future and current time dimensions, and location. In conclusion, the study offers several recommendations to city managers and policymakers on methods of vandalism control. It also highlights the importance of cultural context and its influence on community involvement. While this study is limited to tourism attractions, it provides a solid foundation for future research, one that can extend into urban planning and public policy design. [ABSTRACT FROM AUTHOR]

Background: High maternal mortality is still a significant public health challenge in many countries of the South-Asian region. The majority of maternal deaths occur due to pregnancy and delivery-related complications, which can mostly be prevented by safe facility delivery. Due to the paucity of existing evidence, our study aimed to examine the factors associated with place of delivery, including women's preferences for such in three selected South-Asian countries. Methods: We extracted data from the most recent demographic and health surveys (DHS) conducted in Bangladesh (2014), Nepal (2016), and Pakistan (2017–18) and analyzed to identify the association between the outcome variable and socio-demographic characteristics. A total of 16,429 women from Bangladesh (4278; mean age 24.57 years), Nepal (3962; mean age 26.35 years), and Pakistan (8189; mean age 29.57 years) were included in this study. Following descriptive analyses, bivariate and multivariate logistic regressions were conducted. Results: Overall, the prevalence of facility-based delivery was 40%, 62%, and 69% in Bangladesh, Nepal, and Pakistan, respectively. Inequity in utilizing facility-based delivery was observed for women in the highest wealth quintile. Participants from Urban areas, educated, middle and upper household economic status, and with high antenatal care (ANC) visits were significantly associated with facility-based delivery in all three countries. Interestingly, watching TV was also found as a strong determinant for facility-based delivery in Bangladesh (aOR = 1.31, 95% CI:1.09–1.56, P = 0.003), Nepal (aOR = 1.42, 95% CI:1.20–1.67, P<0.001) and Pakistan (aOR = 1.17, 95% CI: 1.03–1.32, P = 0.013). Higher education of husband was a significant predictor for facility delivery in Bangladesh (aOR = 1.73, 95% CI:1.27–2.35, P = 0.001) and Pakistan (aOR = 1.19, 95% CI: 0.99–1.43, P = 0.065); husband's occupation was also a significant factor in Bangladesh (aOR = 1.30, 95% CI:1.04–1.61, P = 0.020) and Nepal (aOR = 1.26, 95% CI:1.01–1.58, P = 0.041). Conclusion: Our findings suggest that the educational status of both women and their husbands, household economic situation, and the number of ANC visits influenced the place of delivery. There is an urgent need to promote facility delivery by building more birthing facilities, training and deployment of skilled birth attendants in rural and hard-to-reach areas, ensuring compulsory female education for all women, encouraging more ANC visits, and providing financial incentives for facility deliveries. There is a need to promote facility delivery by encouraging health facility visits through utilizing social networks and continuing mass media campaigns. Ensuring adequate Government funding for free maternal and newborn health care and local community involvement is crucial for reducing maternal and neonatal mortality and achieving sustainable development goals in this region. [ABSTRACT FROM AUTHOR]

Introduction: Community participation in the governance of health services is an important component in engaging stakeholders (patients, public and partners) in decision-making and related activities in health care. Community participation is assumed to contribute to quality improvement and goal attainment but remains elusive. We examined the implementation of community participation, through collaborative governance in primary health care facilities in Uasin Gishu County, Western Kenya, under the policy of devolved governance of 2013. Methods: Utilizing a multiple case study methodology, five primary health care facilities were purposively selected. Study participants were individuals involved in the collaborative governance of primary health care facilities (from health service providers and community members), including in decision-making, management, oversight, service provision and problem solving. Data were collected through document review, key informant interviews and observations undertaken from 2017 to 2018. Audio recording, notetaking and a reflective journal aided data collection. Data were transcribed, cleaned, coded and analysed iteratively into emerging themes using a governance attributes framework. Findings: A total of 60 participants representing individual service providers and community members participated in interviews and observations. The minutes of all meetings of five primary health care facilities were reviewed for three years (2014–2016) and eight health facility committee meetings were observed. Findings indicate that in some cases, structures for collaborative community engagement exist but functioning is ineffective for a number of reasons. Health facility committee meetings were most frequent when there were project funds, with discussions focusing mainly on construction projects as opposed to the day-to-day functioning of the facility. Committee members with the strongest influence and power had political connections or were retired government workers. There were no formal mechanisms for stakeholder forums and how these worked were unclear. Drug stock outs, funding delays and unclear operational guidelines affected collaborative governance performance. Conclusion: Implementing collaborative governance effectively requires that the scope of focus for collaboration include both specific projects and the routine functioning of the primary health care facility by the health facility committee. In the study area, structures are required to manage effective stakeholder engagement. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the effectiveness of an experiential learning program based on Kolb's theory in increasing dementia supporters' motivation and activity involvement within the community. Method: In this interventional study, the sample was divided into two groups. The intervention group underwent dementia supporter training and participated in an experiential learning program, which was conducted two weeks after the initial training session. The control group underwent only the dementia supporter training. Results: Kolb's experiential learning model consists of four stages: concrete experience, reflective observation, conceptualization, and active experimentation. A total of 37 and 44 individuals constituted the intervention and control groups, respectively. The Wilcoxon signed-rank test revealed that there was a significant increase in motivation among the intervention group participants, when compared to the control group participants. Moreover, the activity rate was higher among the intervention group participants. Discussion: The experiential learning program was effective in increasing motivation levels and activity involvement among the dementia supporters. Conclusions: The experiential learning program for dementia supporters can be used to improve other volunteer and professional programs. Moreover, Kolb's theory can be used to support individuals with dementia within the community. [ABSTRACT FROM AUTHOR]

Trans individuals (e.g. trans men and women, non-binary, gender fluid) are at higher risk for mental health concerns, in part due to marginalization. Previous work has documented the effects of social support and community engagement on health outcomes. However, individuals' perceptions of community engagement effects may point to opportunities for intervention. This mixed methods study examines trans individuals' perceived effects of participating in trans communities on health outcomes. Semi-structured in-person interviews were conducted with 20 individuals, and 60 individuals participated in cross-sectional online surveys. Perceived discrimination had a strong negative association with self-assessed mental health. Effects of participation included a) positive: contextualization and normalization of experience, self-appraisal, safety, and relief; and b) neutral/negative: energy drain and stigmatization. Effects of not participating included loneliness, depression, isolation, hiding identity, and losing resources. Both discrimination and non-participation in trans communities had negative effects on mental health. Though community participation is often discussed as positive for marginalized populations, it may be important to include possible negative effects (such as energy drain) in research. [ABSTRACT FROM AUTHOR]

Background: Community participation is widely believed to be beneficial to the development, implementation and evaluation of health services. However, many challenges to successful and sustainable community involvement remain. Importantly, there is little evidence on the effect of community participation in terms of outcomes at both the community and individual level. Our systematic review seeks to examine the evidence on outcomes of community participation in high and upper-middle income countries. Methods and findings: This review was developed according to PRISMA guidelines. Eligible studies included those that involved the community, service users, consumers, households, patients, public and their representatives in the development, implementation, and evaluation of health services, policy or interventions. We searched the following databases from January 2000 to September 2016: Medline, Embase, Global Health, Scopus, and LILACs. We independently screened articles for inclusion, conducted data extraction, and assessed studies for risk of bias. No language restrictions were made. 27,232 records were identified, with 23,468 after removal of duplicates. Following titles and abstracts screening, 49 met the inclusion criteria for this review. A narrative synthesis of the findings was conducted. Outcomes were categorised as process outcomes, community outcomes, health outcomes, empowerment and stakeholder perspectives. Our review reports a breadth of evidence that community involvement has a positive impact on health, particularly when substantiated by strong organisational and community processes. This is in line with the notion that participatory approaches and positive outcomes including community empowerment and health improvements do not occur in a linear progression, but instead consists of complex processes influenced by an array of social and cultural factors. Conclusion: This review adds to the evidence base supporting the effectiveness of community participation in yielding positive outcomes at the organizational, community and individual level. Trial registration: Prospero record number: . [ABSTRACT FROM AUTHOR]

Objectives: Reducing injuries in adults requires work with diverse stakeholders across many sectors and at multiple levels. At the local level, public health professionals need to effectively bring together, facilitate, and support community partners to initiate evidence-based efforts. However, there has been no formal review of the literature to inform how these professionals can best create action among community partners to address injuries in adults. Thus, this scoping review aims to identify theories, models or frameworks that are applicable to a community-based approach to injury prevention. Methods: Searches of scientific and less formal literature identified 13,756 relevant items published in the English language between 2000 and 2016 in North America, Europe and Australia. After screening and review, 10 publications were included that (1) identified a theory, framework or model related to mobilizing partners; and (2) referred to community-based adult injury prevention Results: Findings show that use of theories, frameworks and models in community-based injury prevention programs is rare and often undocumented. One theory and various conceptual models and frameworks exist for mobilizing partners to jointly prevent injuries; however, there are few evaluations of the processes to create community action. Conclusions: Successful community-based injury prevention must build on what is already understood about creating partnership action. Evaluating local public health professional injury prevention practice based on available theories, models and frameworks will identify successes and challenges to inform process improvements. We propose a logic model to more specifically guide and evaluate how public health can work locally with community partners. [ABSTRACT FROM AUTHOR]

Citizen Science (CS) strengthens the relationship between society and science through education and engagement, with win-win benefits. Marine Citizen Science (MCS) is increasingly popular, thanks to society’s growing interest in marine environments and marine issues. Scuba diving significantly increases the potential of MCS, thanks to the skills and behavioural properties of people who participate in the sport. To be able to exploit this potential, however, MCS needs to face challenges related to CS, to scuba diving activities and to the broader scuba diving industry. In particular, engagement and recruitment of potential volunteers, as well as retention of active participants, represent key milestones. In order to reach these milestones, information is required on current participation levels of scuba divers in MCS, as well as the motivations behind participation, and the opinions held by potential participants in MCS. This study explored different case studies and methods of data collection to provide an overview of actual and potential participation in MCS by the scuba diving community. The results show that scuba divers, whether active or potential marine citizen scientists, are well disposed towards MCS. Some barriers, however, prevent the full participation of scuba divers as marine citizen scientists. Certain barriers extend beyond the control of both divers and MCS projects, while others, such as limited access to MCS projects and poor feedback after participation, can and should be addressed. The recommendations of this research provide strategic direction to MCS, so that the broad scuba diving community can be successfully integrated into MCS. These recommendations acknowledge the important role played by stakeholders in the scuba diving industry, as well as professional intermediaries and hired experts. [ABSTRACT FROM AUTHOR]

There is a major gap in funding required for conservation, especially in low income countries. Given the significant contribution of taxpayers in industrialized countries to funding conservation overseas, and donations from membership organisation, understanding the preferences of ordinary people in a high income country for different attributes of conservation projects is valuable for future marketing of conservation. We conducted a discrete choice experiment with visitors to a UK zoo, while simultaneously conducting a revealed preference study through a real donation campaign on the same sample. Respondents showed the highest willingness to pay for projects that have local community involvement in management (95% confidence interval £9.82 to £15.83), and for improvement in threatened species populations (£2.97 - £13.87). Both of these were significantly larger than the willingness to pay for projects involving provision of alternative livelihoods, or improving the condition of conservation sites. Results of the simultaneous donation campaign showed that respondents were very willing to donate the suggested £1 or above donation (88% made a donation, n = 1798); there was no effect of which of the two campaigns they were exposed to (threatened species management or community involvement in management). The small number of people who did not make a donation had a higher stated willingness to pay within the choice experiment, which may suggest hypothetical bias. Conservationists increasingly argue that conservation should include local communities in management (for both pragmatic and moral reasons). It is heartening that potential conservation donors seem to agree. [ABSTRACT FROM AUTHOR]

Purpose: Brooke is a non-government organisation with working equine welfare programmes across Africa, Asia and Latin America. In 2014, staff from ten country programmes were asked to identify ‘no-win’ situations (subsequently reframed as ‘hard-wins’)—where improving equine welfare is proving difficult, expensive and/or marginal—in order to inform strategic decisions on how to approach, manage and mitigate for such situations. Methods: The Delphi-type consultation process had three phases. Round 1 posed five questions in the form of a workshop, survey and semi-structured interviews. Round 2 re-presented key themes and sense-checked initial conclusions. Round 3 reviewed the nature and prevalence of hard-win situations at an international meeting of all participants. Results: Reasons given for hard-win situations included: no economic or social benefit from caring for working animals; poor resource availability; lack of empathy for working equids or their owners among wider stakeholders; deep-seated social issues, such as addiction or illegal working; areas with a high animal turnover or migratory human population; lack of community cooperation or cohesion; unsafe areas where welfare interventions cannot be adequately supported. Participants estimated the prevalence of hard-win situations as 40–70% of their work. They suggested some current ways of working that may be contributing to the problem, and opportunities to tackle hard-wins more effectively. Conclusion and animal welfare implications: Respondents agreed that if equine welfare improvements are to span generations of animals, interventions cannot rely on relatively simple, technical knowledge-transfer strategies and quick-wins alone. Programmes need to be more flexible and iterative and less risk-averse in their approaches to embedding good equine welfare practices in all relevant actors. Consultation recommendations informed development of Brooke’s new global strategy, a revised organisational structure and redefinition of roles and responsibilities to streamline ways to approach hard-wins in the complex environments and socio-economic contexts in which working equids are found. [ABSTRACT FROM AUTHOR]

Despite threats to human wellbeing from ecological degradation, public engagement with this issue remains at low levels. However, studies have shown that crafting messages to resonate with people’s personal experiences can enhance engagement. Recreational fishing is one of the principal ways in which people interact with aquatic environments, but long-term data from this perspective are considered rare. We uncovered 852 popular media records of recreational fishing for an Australian estuary across a 140-year period. Using information contained in these articles we analysed the species composition of recreational catches over time and constructed two distinct time series of catch and effort (n fish fisher-1 trip-1; kg fish fisher-1 trip-1) for recreational fishing trips and fishing club competitions (mean n and kg fish caught across all competitors, and n and kg fish caught by the competition winner). Reported species composition remained similar over time. Catch rates reported from recreational fishing trips (1900–1998) displayed a significant decline, averaging 32.5 fish fisher-1 trip-1 prior to 1960, and 18.8 fish fisher-1 trip-1 post-1960. Mean n fish fisher-1 competition-1 (1913–1983) also significantly declined, but best n fish fisher-1 competition-1 (1925–1980) displayed no significant change, averaging 31.2 fish fisher-1 competition-1 over the time series. Mean and best kg fish fisher-1 competition-1 trends also displayed no significant change, averaging 4.2 and 9.9 kg fisher-1 competition-1, respectively. These variable trends suggest that while some fishers experienced diminishing returns in this region over the last few decades, the most skilled inshore fishers were able to maintain their catch rates, highlighting the difficulties inherent in crafting conservation messages that will resonate with all sections of a community. Despite these challenges, this research demonstrates that popular media sources can provide multiple long-term trends at spatial scales, in units and via a recreational experience that many people can relate to. [ABSTRACT FROM AUTHOR]

The studies in this PLOS ONE collection investigated the feasibility of community participation in Measuring, Reporting and Verifying (Participatory MRV–PMRV) initiatives in the context of national programs to reduce emissions from deforestation and forest degradation (REDD+). While such participation is desirable, its feasibility has been uncertain. This collection builds the empirical foundations for putting PMRV into practice. The authors of this article identified five crucial considerations: (1) clarify the stakeholders, (2) understand their motivation to participate, (3) integrate knowledge and information from multiple disciplines and sources, (4) convey knowledge and information across multiple levels of governance, and (5) clarify and enable the links to REDD+ safeguards. We conclude that local communities and other local actors can play a major role in achieving REDD+ MRV, however, this requires attention to their needs and motivations. Future activities should include assessment of past PMRV experiences, costs and benefits, operationalization of reporting and verification, formalization of PMRV and full scale testing on the ground. [ABSTRACT FROM AUTHOR]

Measurement, Reporting, and Verification (MRV) systems are thought to be essential for effective carbon accounting and joint REDD+ carbon, conservation, and social development goals. Community participation in MRV (PMRV) has been shown to be both cost effective and accurate, as well as a method to potentially advance stakeholder empowerment and perceptions of legitimacy. Recognizing land tenure as a long-standing point of tension in REDD+ planning, we argue that its engagement also has a key role to play in developing a legitimate PMRV. Using household surveys, key informant interviews, and participatory mapping exercises, we present three ‘lived’ land tenure contexts in Indonesia to highlight their socially and ecologically situated natures and to consider the role of tenure pluralism in shaping PMRV. We then raise and interrogate three questions for incorporating lived land tenure contexts into a legitimate PMRV system: 1) Who holds the right to conduct PMRV activities?; 2) How are the impacts of PMRV differentially distributed within local communities?; and 3) What is the relationship between tenure security and motivation to participate in PMRV? We conclude with implementation lessons for REDD+ practitioners, including the benefits of collaborative practices, and point to critical areas for further research. [ABSTRACT FROM AUTHOR]

Sustainable approaches to water management require broad community acceptance of changes in policy, practice and technology, which in turn, requires an engaged community. A critical first step in building an engaged community is to identify community knowledge about water management, an issue rarely examined in research. To address this, we surveyed a representative sample of Australian adults (n = 5172). Knowledge was assessed using 15 questions about impact of household activities on waterways, the urban water cycle, and water management. This survey also examined demographics, psychosocial characteristics, exposure to water-related information, and water-related behaviors and policy support. Participants correctly answered a mean of 8.0 questions (Range 0–15). Most respondents knew that household actions can reduce water use and influence waterway health, whereas less than one third correctly identified that domestic wastewater is treated prior to entering waterways, urban stormwater is not treated, and that these are carried via different pipes. Higher water knowledge was associated with older age, higher education and living in non-urban areas. Poorer water knowledge was associated with speaking a language other than English in the home. Garden size, experience of water restrictions, satisfaction, waterway use for swimming, and certain information sources were also associated with knowledge. Greater water knowledge was associated with adoption of water-saving and pollution-reduction behaviors, and support for both alternative water sources and raingardens. These findings confirm the importance of community knowledge, and identify potential subgroups who may require additional targeting to build knowledge and support for water management initiatives. [ABSTRACT FROM AUTHOR]

Background: Acquired brain injury (ABI) is a leading cause of permanent disability, currently affecting 20,000 Australian children. Community participation is essential for childhood development and enjoyment, yet children with ABI can often experience barriers to participation. The factors which act as barriers and facilitators to community participation for children with an ABI are not well understood. Aim: To identify the viewpoints of parents of children with an ABI, regarding the barriers and facilitators most pertinent to community participation for their child. Methods: Using Q-method, 41 parents of children with moderate/severe ABI sorted 37 statements regarding barriers and facilitators to community participation. Factor analysis identified three viewpoints. Results: This study identified three distinct viewpoints, with the perceived ability to participate decreasing with a stepwise trend from parents who felt their child and family “can” participate in viewpoint one, to “want” in viewpoint two and “try” in viewpoint three. Conclusions: Findings indicated good participation outcomes for most children and families, however some families who were motivated to participate experienced significant barriers. The most significant facilitators included child motivation, supportive relationships from immediate family and friends, and supportive community attitudes. The lack of supportive relationships and attitudes was perceived as a fundamental barrier to community participation. Significance: This research begins to address the paucity of information regarding those factors that impact upon the participation of children with an ABI in Australia. Findings have implications for therapists, service providers and community organisations. [ABSTRACT FROM AUTHOR]

The reliance on small samples and underpowered studies may undermine the replicability of scientific findings. Large sample sizes may be necessary to achieve adequate statistical power. Crowdsourcing sites such as Amazon’s Mechanical Turk (MTurk) have been regarded as an economical means for achieving larger samples. Because MTurk participants may engage in behaviors which adversely affect data quality, much recent research has focused on assessing the quality of data obtained from MTurk samples. However, participants from traditional campus- and community-based samples may also engage in behaviors which adversely affect the quality of the data that they provide. We compare an MTurk, campus, and community sample to measure how frequently participants report engaging in problematic respondent behaviors. We report evidence that suggests that participants from all samples engage in problematic respondent behaviors with comparable rates. Because statistical power is influenced by factors beyond sample size, including data integrity, methodological controls must be refined to better identify and diminish the frequency of participant engagement in problematic respondent behaviors. [ABSTRACT FROM AUTHOR]

Background: Community participation is a major principle of people centered health systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health systems intervention research. Objective: To explore the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries. Methodology: We searched for peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health systems research and low- and middle-income countries. The initial search yielded 3,092 articles, of which 260 articles with more than nominal community participation were identified and included. We further excluded 104 articles due to lower levels of community participation across the research cycle and poor description of the process of community participation. Out of the remaining 160 articles with rich community participation, we further examined 64 articles focused on service delivery and governance within health systems research. Results: Most articles were led by authors in high income countries and many did not consistently list critical aspects of study quality. Articles were most likely to describe community participation in health promotion interventions (78%, 202/260), even though they were less participatory than other health systems areas. Community involvement in governance and supply chain management was less common (12%, 30/260 and 9%, 24/260 respectively), but more participatory. Articles cut across all health conditions and varied by scale and duration, with those that were implemented at national scale or over more than five years being mainstreamed by government. Most articles detailed improvements in service availability, accessibility and acceptability, with fewer efforts focused on quality, and few designs able to measure impact on health outcomes. With regards to participation, most articles supported community’s in implementing interventions (95%, n = 247/260), in contrast to involving communities in identifying and defining problems (18%, n = 46/260). Many articles did not discuss who in communities participated, with just over a half of the articles disaggregating any information by sex. Articles were largely under theorized, and only five mentioned power or control. Majority of the articles (57/64) described community participation processes as being collaborative with fewer describing either community mobilization or community empowerment. Intrinsic individual motivations, community-level trust, strong external linkages, and supportive institutional processes facilitated community participation, while lack of training, interest and information, along with weak financial sustainability were challenges. Supportive contextual factors included decentralization reforms and engagement with social movements. Conclusion: Despite positive examples, community participation in health systems interventions was variable, with few being truly community directed. Future research should more thoroughly engage with community participation theory, recognize the power relations inherent in community participation, and be more realistic as to how much communities can participate and cognizant of who decides that. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to assess participatory methods for obtaining community views on child health research. Background: Community participation in research is recognised as an important part of the research process; however, there has been inconsistency in its implementation and application in Australia. The Western Australian Telethon Kids Institute Participation Program employs a range of methods for fostering active involvement of community members in its research. These include public discussion forums, called Community Conversations. While participation levels are good, the attendees represent only a sub-section of the Western Australian population. Therefore, we conducted a telephone survey of randomly selected households to evaluate its effectiveness in eliciting views from a broader cross-section of the community about our research agenda and community participation in research, and whether the participants would be representative of the general population. We also conducted two Conversations, comparing the survey as a recruitment tool and normal methods using the Participation Program. Results: While the telephone survey was a good method for eliciting community views about research, there were marked differences in the profile of study participants compared to the general population (e.g. 78% vs 50% females). With a 26% response rate, the telephone survey was also more expensive than a Community Conversation. The cold calling approach proved an unsuccessful recruitment method, with only two out of a possible 816 telephone respondents attending a Conversation. Conclusion: While the results showed that both of the methods produced useful input for our research program, we could not conclude that either method gained input that was representative of the entire community. The Conversations were relatively low-cost and provided more in-depth information about one subject, whereas the telephone survey provided information across a greater range of subjects, and allowed more quantitative analysis. [ABSTRACT FROM AUTHOR]

Scientists are increasing their efforts to promote public engagement with their science, but the efficacy of the methods used is often not scientifically evaluated. Here, we designed, installed and evaluated the educational impact of interactive games on touchscreens at two primate research centres based in zoo environments. The games were designed to promote interest in and understanding of primates and comparative psychology, as a scaffold towards interest in science more generally and with the intention of targeting younger individuals (under 16's). We used systematic observational techniques and questionnaires to assess the impact of the games on zoo visitors. The games facilitated increased interest in psychology and science in zoo visitors, and changed the knowledge of visitors, through demonstration of learning about specific scientific findings nested within the games. The impact of such devices was greatest on younger individuals (under 16's) as they were significantly more likely to engage with the games. On the whole, therefore, this study demonstrates that interactive devices can be successful educational tools, and adds to the growing body of evidence that conducting research on public view in zoos can have a tangible impact on public engagement with science. [ABSTRACT FROM AUTHOR]

Background: Most HIV prevention for female sex workers (FSWs) focuses on individual behaviour change involving peer educators, condom promotion and the provision of sexual health services. However, there is a growing recognition of the need to address broader societal, contextual and structural factors contributing to FSW risk behaviour. We assess the cost-effectiveness of adding community mobilisation (CM) and empowerment interventions (eg. community mobilisation, community involvement in programme management and services, violence reduction, and addressing legal policies and police practices), to core HIV prevention services delivered as part of Avahan in two districts (Bellary and Belgaum) of Karnataka state, Southern India. Methods: An ingredients approach was used to estimate economic costs in US$ 2011 from an HIV programme perspective of CM and empowerment interventions over a seven year period (2004–2011). Incremental impact, in terms of HIV infections averted, was estimated using a two-stage process. An ‘exposure analysis’ explored whether exposure to CM was associated with FSW’s empowerment, risk behaviours and HIV/STI prevalence. Pathway analyses were then used to estimate the extent to which behaviour change may be attributable to CM and to inform a dynamic HIV transmission model. Findings: The incremental costs of CM and empowerment were US$ 307,711 in Belgaum and US$ 592,903 in Bellary over seven years (2004–2011). Over a 7-year period (2004–2011) the mean (standard deviation, sd.) number of HIV infections averted through CM and empowerment is estimated to be 1257 (308) in Belgaum and 2775 (1260) in Bellary. This translates in a mean (sd.) incremental cost per disability adjusted life year (DALY) averted of US$ 14.12 (3.68) in Belgaum and US$ 13.48 (6.80) for Bellary - well below the World Health Organisation recommended willingness to pay threshold for India. When savings from ART are taken into account, investments in CM and empowerment are cost saving. Conclusions: Our findings suggest that CM and empowerment is, at worst, highly cost-effective and, at best, a cost-saving investment from an HIV programme perspective. CM and empowerment interventions should therefore be considered as core components of HIV prevention programmes for FSWs. [ABSTRACT FROM AUTHOR]

There has been a substantial increase in research activity on autism during the past decade. Research into effective ways of responding to the immediate needs of autistic people is, however, less advanced, as are efforts at translating basic science research into service provision. Involving community members in research is one potential way of reducing this gap. This study therefore investigated the views of community involvement in autism research both from the perspectives of autism researchers and of community members, including autistic adults, family members and practitioners. Results from a large-scale questionnaire study (n = 1,516) showed that researchers perceive themselves to be engaged with the autism community but that community members, most notably autistic people and their families, did not share this view. Focus groups/interviews with 72 participants further identified the potential benefits and remaining challenges to involvement in research, especially regarding the distinct perspectives of different stakeholders. Researchers were skeptical about the possibilities of dramatically increasing community engagement, while community members themselves spoke about the challenges to fully understanding and influencing the research process. We suggest that the lack of a shared approach to community engagement in UK autism research represents a key roadblock to translational endeavors. [ABSTRACT FROM AUTHOR]