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Summary: Despite progression in the ethical and methodological conduct of Aboriginal and Torres Strait Islander health research, disparities still pervade, indicating limitations in knowledge translation. One identified gap is a lack of documented experiences detailing how ethical guidelines may be practically applied. This paper aims to (i) describe the research processes involved in co-designing a physical activity and psychosocial health program for Aboriginal and Torres Strait Islander girls and (ii) highlight learnings of the collaborative research journey. The Criteria for Strengthening Reporting of Health Research involving Indigenous Peoples (CONSIDER) statement was used to document participatory research activities undertaken with an Aboriginal community partner. Building upon the CONSIDER statement, Aboriginal (N = 3), Torres Strait Islander (N = 1) and non-Indigenous (N = 4) research team members engaged in critical reflection to identify lessons learnt. Researchers identified a tension between participatory research principles and the expectations of funding agencies and research institutions. Consequently, timelines must be flexible to foster meaningful community engagement and participatory processes. Additionally, researchers and community stakeholders are encouraged to embrace tensions that may associated with participatory research or the pressures Aboriginal and Torres Strait Islander researchers face from their community and organization. Furthermore, differences in professional (i.e. occupational) and cultural knowledge systems need to be acknowledged and accounted for within the early stages of a project to ensure informed decision-making. Identified lessons will assist relevant stakeholders in the development of future Aboriginal and Torres Strait Islander health programming, ensuring the most appropriate health solutions are devised with community. Lay Summary: The ethical and methodological quality of Aboriginal and Torres Strait Islander health research and associated community engagement has progressed significantly in the last thirty years. Despite this progress, improvements in Aboriginal and Torres Strait Islander health disparities have been slow and inconsistent, indicating there are limitations in the available information for health promotion stakeholders. One identified gap is a lack of documented experiences detailing how guidelines may be practically applied. This paper, therefore, details how an intercultural, intersectoral team engaged in a participatory Aboriginal and Torres Strait Islander health research project (i.e. Tidda Talk). In addition to documenting research processes, the paper also offers lessons learnt: (i) Prioritize a flexible response within the project plan, (ii) Embrace Aboriginal and Torres Strait Islander community empowerment whilst working at the cultural interface (i.e. a place of knowledge exchange between Aboriginal and Torres Strait Islander and Western culture, resulting in two-way learning) (iii) Plan to navigate different knowledge systems, (iv) Acknowledge the pressures and demands placed on Aboriginal and Torres Strait Islander researchers. These documented experiences and lessons learnt have the potential to benefit researchers and practitioners in future health service design and evaluation, allowing for culturally appropriate practices to be identified and replicated. [ABSTRACT FROM AUTHOR]

Photovoice distinguishes itself from other qualitative research methods for its visual features and participant empowerment. As a powerful tool for community-based participatory research and health promotion programs, researchers and practitioners are paying more attention to this method in recent years. Accordingly, some photovoice systematic reviews have been published and more are underway to synthesize evidence in various research fields. However, due to the exploratory nature of the photovoice method, broad research questions for photo taking, flexible steps in photo discussion and analysis, and lack of standardized qualitative review guidelines, it could be challenging to conduct a photovoice systematic review. The purpose of this paper is to provide an overview of the photovoice method, debrief the process of a previous review, summarize lessons learned, and provide suggestions to facilitate future photovoice systematic reviews. This paper may also be of benefit to researchers who intend to apply photovoice to their research topics, or plan to conduct other types of photovoice literature reviews (e.g., scoping reviews). [ABSTRACT FROM AUTHOR]

Background: Addressing Indigenous food security and food sovereignty calls for community-driven strategies to improve access to and availability of traditional and local food. Participatory approaches that integrate Indigenous leadership have supported successful program implementation. Learning Circles: Local Healthy Food to School is a participatory program that convenes a range of stakeholders including food producers, educators and Knowledge Keepers to plan, implement and monitor local food system action. Pilot work (2014–2015) in Haida Gwaii, British Columbia (BC), showed promising results of the Learning Circles (LC) approach in enhancing local and traditional food access, knowledge and skills among youth and adolescents. The objective of the current evaluation was therefore to examine the process of scaling-up the LC vertically within the Haida Nation; and horizontally across three diverse First Nations contexts: Gitxsan Nation, Hazelton /Upper Skeena, BC; Ministikwan Lake Cree Nation, Saskatchewan; and Black River First Nation, Manitoba between 2016 and 2019. Methods: An implementation science framework, Foster-Fishman and Watson's (2012) ABLe Change Framework, was used to understand the LC as a participatory approach to facilitate community capacity building to strengthen local food systems. Interviews (n = 52), meeting summaries (n = 44) and tracking sheets (n = 39) were thematically analyzed. Results: The LC facilitated a collaborative process to: (1) build on strengths and explore ways to increase readiness and capacity to reclaim traditional and local food systems; (2) strengthen connections to land, traditional knowledge and ways of life; (3) foster community-level action and multi-sector partnerships; (4) drive actions towards decolonization through revitalization of traditional foods; (5) improve availability of and appreciation for local healthy and traditional foods in school communities; and (6) promote holistic wellness through steps towards food sovereignty and food security. Scale-up within Haida Gwaii supported a growing, robust local and traditional food system and enhanced Haida leadership. The approach worked well in other First Nations contexts, though baseline capacity and the presence of champions were enabling factors. Conclusions: Findings highlight LC as a participatory approach to build capacity and support iterative planning-to-action in community food systems. Identified strengths and challenges support opportunities to expand, adopt and modify the LC approach in other Indigenous communities with diverse food systems. [ABSTRACT FROM AUTHOR]

The World Health Organization defines health promotion as process of enabling people to increase control over their health and its determinants, and thereby improve their health. As the world transitions into the information age, incorporating digital technologies into health promotion is becoming commonplace. This article discusses current applications of digital health promotion (DHP) and addresses its potential benefits, challenges, as well as how differences in cultures, governance models and digital readiness across the globe will shape the implementation of DHP differently in each society. The benefits include expanding access to health information and health promoting services, lowering scaling up costs, personalizing health advice and real-time 'nudging' toward healthier options. Key challenges would involve privacy control, appropriate use of data including secondary usage beyond the original intention, defining the limits of 'nudging' and the right of free choice, and ensuring widespread accessibility and affordability to minimize the exacerbation of social inequities. Finally, we discuss the enabling factors for successful DHP implementation, suggesting measures that should be taken at both individual and system levels. At the individual level, we explore the factors necessary to access and benefit from DHP meaningfully; at the system level, we examine the infrastructure required to provide wide access, establish trust among users and enable sustainability of behavioral changes. [ABSTRACT FROM AUTHOR]

Background: Active School Travel (AST) initiatives align with the Ottawa Charter for Health Promotion, which calls for 'creating supportive environments' and 'strengthening community action.' However, their reliance on volunteers poses sustainability challenges. The main objectives of this study were to document the motivations, satisfaction, and experiences of volunteers involved in sustaining two AST initiatives in Ontario for an entire school year. Methods: Two volunteer-led School Street initiatives in Kingston, Ontario successfully operated during pick-up and drop-off times of each school day. The first initiative operated for the entire 2021-2022 school year, and the second operated for the entire 2022-2023 school year. These initiatives were the first of their kind in the province of Ontario, Canada. Volunteers from both sites (n = 56) participated in online surveys and their motivations, satisfaction, and experiences of their role were compared using the 2-sided Fisher's Exact Test. Results: Over 80% of volunteers were highly motivated to promote safety and over 70% of volunteers were highly motivated to disrupt the status quo of unsupportive, car-centric urban environments by reimagining how streets can be used. By taking collective action to re-shape the environment around these public schools to support healthy, active living, our findings reveal that over 90% of volunteers were highly satisfied. Of the volunteers, 87% felt they contributed to child safety and 85% felt they had developed stronger community connections. They appreciated the short (i.e., 40 minute) time commitment of each shift, weekly email communications by the community organization leading the initiative, and the volunteer schedule. They also appreciated the positive social interactions during volunteer shifts, which they felt outweighed the minimal resistance they experienced. Conclusions: This research demonstrates the importance of logistical, motivational, and social factors in recruiting and retaining volunteers for community-led School Streets. Our findings support appealing to prospective volunteers' influence in achieving School Street objectives (e.g., improved safety) in recruitment efforts, as well as highlighting School Streets' innovative approach. Communicating with volunteers throughout School Street planning and implementation processes and limiting traffic in the closed street zone (i.e., by excluding the school staff parking lot and private driveways from the scope) are additional recommendations based on the findings of this study. [ABSTRACT FROM AUTHOR]

Physical and cognitive exercises can prevent or at least mitigate the symptoms of certain diseases and help older adults perform a range of daily functions. Yet, most seniors do not meet the World Health Organisation's recommended guidelines for physical activity. The objective of this study is to promote and maintain the physical and cognitive capacity of older adults by implementing a feasible and effective low-threshold, age-appropriate, motor–cognitive training outdoors. In the German city of Chemnitz, citizens aged 60 years and older participated in a quasi-randomised intervention trial. Exercises to train coordination, strength, endurance, and cognition were integrated into a 12-week outdoor motor–cognitive exercise programme. Both the physical (e.g., 6MWT) and cognitive skills (e.g., TMT B) of the intervention group (n = 41) and control group (no intervention, n = 58) were measured before (T1) and after (T2) completion of the exercise programme. Some of the participants' physical and all their cognitive measures improved. Neurocognitive performance (DSST) showed a significant time × group interaction effect (F(1,95) = 6.943, p = 0.010, η p 2 = 0.068). Sex and age were found to be influencing factors. We consider our exercise programme to be successfully implemented, well received by the participants, and feasible and useful to promote the continued exercise of daily functions as part of healthy aging in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Background: Noncommunicable diseases can be prevented or delayed through health promotion programs. Little is known about programs delivered by partnership organisations that address lifestyle behaviours. The study's purpose was to review the literature on physical activity or healthy eating health promotion programs, delivered in partnership by the local government and local health services, to describe characteristics of programs and their impact on physical activity, healthy eating or related health outcomes among middle‐aged adults. Methods: This rapid review was conducted from November 2021 to June 2022, informed by the Cochrane Rapid Reviews Methods guidance for conducting rapid reviews. Articles published in English since 2000 were identified in Medline, Embase, CINAHL, AgeLine and Scopus databases. A narrative synthesis was performed. Results: Ten articles involving 19 802 participants were identified from a total of 4847 articles identified from the search. The primary role of the partnership was providing funds. Other roles were facilitating stakeholder involvement, program development, delivery and recruitment. Positive outcomes were likely if programs were developed by collaborative stakeholder partnerships, informed by previous research or a behaviour change framework. The heterogeneity of study designs and reported outcomes did not permit meta‐analysis. Conclusion: This review highlights the lack of evidence of local government‐health service partnerships delivering physical activity or healthy eating health promotion programs for middle‐aged adults. Programs designed collaboratively with an evidence base or a theory base are recommended and can guide future work investigating strategies for partnership development. So What?: Physical activity or healthy eating health promotion programs need early stakeholder collaborative input designed with a theory/evidence base. This can guide future work for investigating strategies for partnership development. [ABSTRACT FROM AUTHOR]

There is a need for both feasible and enjoyable physical activity programmes for people on a cancer journey. Emerging evidence suggests that dance can have a positive effect on health and well-being in this cohort. We aimed to synthesize the quantitative and qualitative literature exploring the effectiveness and impact of community dance interventions in people with all types and stages of cancer. A systematic search was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in Pubmed, EMBASE, Medline Ovid, CINAHL and PEDro databases. Quantitative and qualitative data were extracted and synthesized using a convergent segregated approach. The numeric data were analysed using descriptive statistics, narrative synthesis and meta-analysis where possible. The qualitative data were analysed using thematic analysis. The Downs and Black critical appraisal tool and the Critical Appraisal Skills Programme were used to assess the quality of the quantitative and qualitative literature, respectively. Eighteen studies were included in this mixed-methods review with seven trials included in the meta-analysis. Statistically significant improvements were found in favour of community dance for functional capacity, fatigue, quality-of-life and depression in comparison to no intervention. Evidence suggests dance is a safe and feasible form of physical activity both during and after cancer treatment. Participants reported good social support, education regarding physical activity and local access as key facilitators to participation. We concluded that dance is a feasible and enjoyable intervention for many people with various forms of cancer. Community dance programmes can improve both physical and psychological outcomes in people on a cancer journey. [ABSTRACT FROM AUTHOR]

This article highlights the significance of prioritizing Indigenous voices and knowledge systems, using whānau-centred initiatives (a concept that encompasses the broader family and community) as a foundation for health promotion within an Indigenous context. Tū Kahikatea, a conceptual framework, is used to demonstrate the relationship between the values underpinning different whānau-centred initiatives and their corresponding outcomes. The framework highlights the capacity of whānau-centred initiatives to support whānau in attaining mana motuhake, which represents collective self-determination and the ability to exercise control over their own future. By doing so, these initiatives contribute to the improvement of whānau health outcomes. With recent changes to Aotearoa New Zealand's health system, the findings underscore the benefits and potential of whānau-centred initiatives in enhancing whānau health outcomes, and advocate for continued strengths-based practices in Aotearoa New Zealand's health system. By bridging the gap between academia and grassroots community action, the article demonstrates the potential of whānau-centred initiatives and contributes to a global call for integrating Indigenous viewpoints and practices into Westernized healthcare, in order to improve Indigenous health outcomes. [ABSTRACT FROM AUTHOR]

Limited access to health education can be a barrier for reaching the Sustainable Development Goals, especially in rural communities in sub-Saharan Africa. We addressed this gap by installing community information spots (InfoSpots) with access to the internet and a locally stored digital health education platform (the platform) in Migoli and Izazi, Tanzania. The objective of this case study was to explore the perspectives and experiences of InfoSpot users and non-users in these communities. We conducted 35 semi-structured interviews with participants living, working or studying in Migoli or Izazi in February 2020 and subsequently analysed the data using content analysis. The 25 InfoSpot users reported variations in use patterns. Users with more education utilized the platform for their own health education and that of others, in addition to internet surfing. High school students also used the platform for practicing English, in addition to health education. Most InfoSpot users found the platform easy to use; however, those with less education received guidance from other users. Non-users reported that they would have used the InfoSpot with the platform if they had been aware of its existence. All participants reported a positive view of the digital health messages, especially animations as a health knowledge transfer tool. In conclusion, different and unintended use of the platform shows that the communities are creative in ways of utilizing the InfoSpots and gaining knowledge. The platform could have been used by more people if it had been promoted better in the communities. [ABSTRACT FROM AUTHOR]

As persistent inequities in health gained increased attention nationally due to COVID-19 and racial justice protests in 2020, it has become increasingly important to evaluate both the process and outcomes associated with coalition-based efforts to address health inequities. The Two Georgias Initiative supports coalitions in 11 rural counties to (1) achieve greater health equity, (2) improve health and health care, (3) build healthier rural communities and improve social conditions that impact the health of rural populations, and (4) build community, organizational, and individual leadership capacity for health equity. Rural communities suffer significant health disparities relative to urban areas, and also experience internal inequities by race and poverty level. The evaluation framework for The Two Georgias Initiative provides a comprehensive mixed methods approach to evaluating both processes and outcomes. Early results related to community readiness and capacity to address health inequities, measured through a coalition member survey (n = 236) conducted at the end of the planning phase, suggest coalitions were in the preparation stage, with higher levels of readiness among coalition members and organizations/groups similar to the coalition members' own, lower levels among public officials and other leaders, and the lowest levels among county residents. In addition, coalition members reported more experience with downstream drivers (e.g., access to care) of health than upstream drivers (e.g., affordable housing, environmental or racial justice). By providing a logic model, evaluation questions and associated indicators, as well as a range of data collection methods, this evaluation approach may prove practical to others aiming to evaluate their efforts to address health equity. [ABSTRACT FROM AUTHOR]

The current state of knowledge indicates that regular sports practice helps prevent and treat non-communicable diseases. The promotion of sport is, therefore, an important community health intervention for maintaining and improving the health of individuals and populations. Culture is identified as being associated with sports practice and sedentary behaviour of ethnic and national minorities. This study aims qualitatively to analyse the potential for culture as a basis for the promotion of sport among immigrants in four regions of Mediterranean Europe. Ten focus groups (n = 62) were conducted with immigrants—adults and young people over the age of 11—and people involved in promoting sport. Thematic content analysis was conducted. The results enabled identifying two major issues: sport as a vehicle for cultural expression and synergies between sport and culture. Accordingly, sport serves to express global, local and non-ethno-national cultural belonging. Regarding synergies, culture and sport feed each other positively and contribute to immigrants' health and cultural well-being. Culture as a strategy for promoting sports practice requires an interdisciplinary approach that involves collaboration between healthcare practitioners and social sciences professionals. There is also a need to use the various axes of cultural definition—global, local and non-ethno-national—of those involved, and for them to take part themselves in designing sports activities. Moreover, promoting sport through non-ethno-national axes of cultural definition may help with immigrants' social inclusion, as intercultural relations between migrants and newcomers are promoted. [ABSTRACT FROM AUTHOR]

Non-communicable diseases and associated risk factors, such as obesity, are prevalent and increasing in Malaysia. To address this burden and the heightened vulnerability of low-income communities to these risk factors, the Better Health Programme Malaysia conducted a partial-profile discrete choice experiment (DCE) to inform the design of a community-based obesity-prevention programme. The DCE survey was conducted with community members (n = 1453) from three publicly supported low-cost, high-rise flat complexes in urban Kuala Lumpur. In the survey, community members were asked to choose between different sets of potential evidence-based interventions for obesity prevention. Their responses to these choice tasks were analysed to quantify preferences for these different health interventions using a random utility maximization model. Based on these results, we determined participants' relative prioritization of the different options. The most preferred interventions were those that reduced the price of fruit and vegetables; altered cooking practices at restaurants and food vendors to reduce salt, sugar and oil; and offered reward incentives for completing online educational activities. Community members did not prioritize several evidence-based interventions, including changes to product placement or product labelling, suggesting that these effective approaches may be less familiar or simply not preferred by respondents. The DCE enabled the clear articulation of these community priorities for evidence-based interventions that focus on the supply and promotion of affordable healthy foods within the local food environment, as well as community demand for healthier food options. [ABSTRACT FROM AUTHOR]

Background: Faith, Activity, & Nutrition (FAN) helps churches create a healthier environment for physical activity (PA) and healthy eating (HE) through policy, systems, and environmental changes. Objective: The purpose of this paper is to describe the implementation, evaluation, and revision of the FAN Program Plan across a two-phase study to help churches create guidelines and policies for PA and HE. Methods: In Phase 1, church committees attended trainings led by Community Health Advisors (CHA) where they assessed current practices to PA and HE. Committees used the FAN Program Plan to outline an implementation plan to increase opportunities, programs, messages, pastor support, and guidelines/practices for PA and HE. FAN Program Plans were submitted to the research team for review. Findings from Phase 1 plans directed revisions in program materials for Phase 2, where the submission and review processes were repeated. Results: Review of Phase 1 FAN Program Plans (53/54 churches submitted a Program Plan) revealed that church committees confused guidelines/practices with programs and had trouble differentiating programs for PA and HE from providing opportunities (i.e., building PA/HE into existing events). The CHA training, FAN church committee training, FAN Program Plan, and other documents were revised to use the term “guidelines (policies)” instead of “guidelines/practices.” In addition, CHAs facilitated a training section on guidelines (policies) to committees, and a guidelines (policies) section was added in the FAN Program Plan and other program documents. These changes in Phase 2 were helpful for differentiating policies from programs and programs from opportunities in FAN Program Plans (53/115 churches submitted a Program Plan), although some confusion remained. Conclusions: This study underscored challenges churches may have in setting policies for PA and HE and discusses strategies to address these challenges in future faith-based initiatives.

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Affordances offered by new media platforms are perceived as revolutionary instruments for removing the inequities of access to health promotion and communication. However, the production and dissemination of health promotional material on digital platforms does not necessarily translate into uniform access across diverse demographics. This article addresses the lacuna when it comes to analyzing Health Promotion initiatives in India, with a specific focus on the governmental publicity carried out on social media during the four phases of COVID-19 national lockdown between 24 March and 31 May 2020. Our intervention examines how governmental social media health promotion in India played a key role in shaping the 'outbreak narrative' during the lockdown across different levels of social and economic privilege. Through a combination of quantitative data analysis and qualitative interview methods, this article analyzes the circulation and impact of official publicity in online and offline spaces, during the COVID-19 lockdown in India. Resultant findings allow for a comprehensive assessment of whether such publicity contributed to democratized citizen science discourses: enabling social protection measures for vulnerable majorities or potentially reified the existing privileges of the economically and socially affluent minority. We find that health promotion campaigns during a pandemic must focus on reaching the widest possible audience in the most efficient manner. Specifically, in the Indian context, health promotion through mass-media like Television and Radio, and participatory media platforms needed to be implemented in tandem with new media platforms, to achieve required engagement with vulnerable communities on key health issues. [ABSTRACT FROM AUTHOR]

This study focused on the development of a scale to assess community capacity. The concept of community capacity has become a core concept in governmental community-based programs in recent years. Community capacity is also considered to be the foundation for promoting community health service programs. Although some scholars have engaged in the study of community capacity issues, the discussion pertaining to a community capacity scale remains nascent. Thus, in order to develop a community capacity scale, this research followed a methodology consisting of reviewing relevant literature, conducting expert focus groups and employing the Delphi technique. Finally, the six-dimensional modified draft scale, which consisted of 24 indicators in total was tested in 97 community organizations across seven Taiwanese counties in July and August 2016. The developed community capacity scale includes six dimensions, namely leadership and organization, administrative management, resource mobilization, residents' participation, collaborative work and network and public relations and initiatives. Each dimension includes four indicators, and each indicator has clear descriptions to aid assessment and evaluation. The tested data was evaluated for its reliability, content validity, criterion validity and examined by factor analysis. The results show that the developed scale is highly reliable, valid and is suitable for professional community work. The scale could be used as a reference tool in developing community service plans and reviewing the effects of community programs. Undeniable, this scale still has limitations in Taiwan context, and the test with a limitation for its sample size and characteristics. [ABSTRACT FROM AUTHOR]

This study reports on a health promotion intervention (HPI), where graphic facilitation (GF) was used as an innovative method to enable participation in a co-design process in a multi-ethnic and disadvantaged neighbourhood in Denmark. The aim was to enable middle-aged and older residents to participate in the research process of planning and evaluating the HPI, as well as in the activities it constituted. GF was used to document statements and inputs from residents through visual meeting minutes and resident experiences with coronavirus disease 2019 (COVID-19) lockdown were drawn by a graphic facilitator. We use the ladder of participation as a framework to unfold the participation enabled by GF. During the HPI, data were produced through ethnographic field studies in and outside the neighbourhood and in design workshops with residents. The study finds that GF helped in reaching a target group difficult to engage in research and that the engagement of a graphic facilitator shifted the power-balance between the researchers and the residents, redistributing expertise. Carrying out GF in a HPI is a collaborative endeavour and in addition to research competences, it requires the artistic and relational skills of a graphic facilitator. The co-created process of the visual minutes and COVID-19 experiences created a sense of ownership and encouraged the residents to reflect on their interaction with the researchers. The redistribution of expertise was conditioned by the power dynamics present and GF helped unfold these dynamics. This is especially important in an HPI engaging socio-economically vulnerable populations. [ABSTRACT FROM AUTHOR]