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Background: Much remains unknown about how complex community-based programmes can successfully achieve long-term impact. More insight is needed to understand the key mechanisms through which these programmes work. Therefore, we conducted an in-depth study in five communities that implemented the Healthy Youth, Healthy Future (JOGG) approach, a Dutch community-based obesity prevention programme. We aimed to identify perceived outcomes and long-term impacts among local stakeholders and explore potential causal pathways and working mechanisms. Methods: We used ripple effects mapping (REM), a qualitative participatory method to map outcomes and identify causal pathways, in five communities. We involved 26 stakeholders, professionals and policy-makers affiliated with the local JOGG approach, spread over eight REM sessions and conducted individual interviews with 24 additional stakeholders. To uncover working mechanisms, we compared outcomes and causal pathways across communities. Results: Over 5–9 years of implementation, participants perceived that JOGG had improved ownership of local stakeholders, health policies, intersectoral collaboration and social norms towards promoting healthy lifestyles. Causal pathways comprised small initial outcomes that created the preconditions to enable the achievement of long-term impact. Although exact JOGG actions varied widely between communities, we identified five common working mechanisms through which the JOGG approach contributed to causal pathways: (1) creating a positive connotation with JOGG, (2) mobilizing stakeholders to participate in the JOGG approach, (3) facilitating projects to promote knowledge and awareness among stakeholders while creating successful experiences with promoting healthy lifestyles, (4) connecting stakeholders, thereby stimulating intersectoral collaboration and (5) sharing stakeholder successes that promote healthy lifestyles, which gradually created a social norm of participation. Conclusions: The JOGG approach seems to work through activating initial stakeholder participation and bolstering the process towards ownership, policy change, and intersectoral collaboration to promote healthy lifestyles. Key working mechanisms can inform further development of JOGG as well as other complex community-based prevention programmes. [ABSTRACT FROM AUTHOR]

The purpose of this research is to evaluate the feasibility, acceptability, and preliminary efficacy of a household food-waste prevention and minimization intervention, titled the Culinary Home Empowerment for Food Waste Prevention and Minimization (CHEF-WPM), which consists of a culinary education video series for home cooks. The specific aims are to (1) assess the effects of the intervention at a population level across process (feasibility, usage, acceptability, satisfaction) and preliminary efficacy (motivation, opportunity, ability) metrics and (2) assess the effects of the intervention at a community level across process (feasibility, usage, acceptability, satisfaction) and preliminary efficacy (motivation, opportunity, ability, household food waste, sustainable dietary practices) metrics. The intervention includes eight modules, each containing three to five brief videos, as well as downloadable recipes and worksheets. The evaluation will explore the effects of the program through two distinct investigations, namely (1) voluntary access to the intervention content in a population-based setting and (2) intensive delivery of the intervention content as part of a remote class in a community setting. Evaluation of the intervention in the population-based setting will use a single-arm, quasi-experimental post-test only study design. All home cooks who access the videos will be invited to answer a five-question post-video survey about acceptability, satisfaction, and potential implementation of the learning. A separate sample of individuals will be recruited to participate in a more in-depth evaluation (pre- and multiple post-test survey). Evaluation of the community-based intervention will use a mixed methods study design. Findings from the two distinct evaluation studies will be jointly discussed and triangulated to support larger conclusions about the intervention's desirability, impact on motivation, opportunity, ability, and food waste, and the potential directions for further improvement. [ABSTRACT FROM AUTHOR]

Abstract Background Much remains unknown about how complex community-based programmes can successfully achieve long-term impact. More insight is needed to understand the key mechanisms through which these programmes work. Therefore, we conducted an in-depth study in five communities that implemented the Healthy Youth, Healthy Future (JOGG) approach, a Dutch community-based obesity prevention programme. We aimed to identify perceived outcomes and long-term impacts among local stakeholders and explore potential causal pathways and working mechanisms. Methods We used ripple effects mapping (REM), a qualitative participatory method to map outcomes and identify causal pathways, in five communities. We involved 26 stakeholders, professionals and policy-makers affiliated with the local JOGG approach, spread over eight REM sessions and conducted individual interviews with 24 additional stakeholders. To uncover working mechanisms, we compared outcomes and causal pathways across communities. Results Over 5–9 years of implementation, participants perceived that JOGG had improved ownership of local stakeholders, health policies, intersectoral collaboration and social norms towards promoting healthy lifestyles. Causal pathways comprised small initial outcomes that created the preconditions to enable the achievement of long-term impact. Although exact JOGG actions varied widely between communities, we identified five common working mechanisms through which the JOGG approach contributed to causal pathways: (1) creating a positive connotation with JOGG, (2) mobilizing stakeholders to participate in the JOGG approach, (3) facilitating projects to promote knowledge and awareness among stakeholders while creating successful experiences with promoting healthy lifestyles, (4) connecting stakeholders, thereby stimulating intersectoral collaboration and (5) sharing stakeholder successes that promote healthy lifestyles, which gradually created a social norm of participation. Conclusions The JOGG approach seems to work through activating initial stakeholder participation and bolstering the process towards ownership, policy change, and intersectoral collaboration to promote healthy lifestyles. Key working mechanisms can inform further development of JOGG as well as other complex community-based prevention programmes.

This study examined the association between salt-related knowledge, attitudes, and behaviors (KAB) and salt excretion using the 24-hour (24 h) urinary collection method. Data were utilized from the Community-Based Management of Non-Communicable Diseases in Nepal (COBIN) Salt Survey, a community-based cross-sectional study conducted among a sub-sample of COBIN cohort in Pokhara Metropolitan City, Western Nepal, from July to December 2018, among adults aged 25–70 years. A total of 451 adults participated in the study, and a single 24 h urine sample was collected from each participant. The mean [(standard deviation (SD)] age of the participants was 49.6 (9.82) years, and the majority were female (65%). The mean urinary salt excretion was 13.28 (SD: 4.72) g/day, with 98% of participants consuming ≥5 g of salt/day. Although 83% of participants knew the risks of high salt intake and 87% believed it was important to reduce their intake, only 10% reported doing so. Salt-related attitude i.e., self-perceived salt intake was significantly associated with urinary salt excretion, adding extra salt to food, consuming processed foods, and taking actions to salt control. Participants who perceived themselves as consuming high salt had higher urinary salt excretion [(14.42 g/day; 95% confidence interval (95% CI): 13.45, 15.39, p = 0.03)], were more likely to add extra [(Odds ratio (OR) = 3.59; 95% CI: 2.03, 6.33, p < 0.001)], and consume processed foods more often (OR = 1.90; 95% CI: 1.06, 3.40, p < 0.05) compared to those who self-perceived consuming a normal amount of salt. Conversely, participants who perceived themselves as consuming low salt were more likely to take actions to control salt intake (OR = 4.22; 95% CI: 1.90, 9.37, p < 0.001) compared to their counterparts who perceived consuming a normal amount of salt. There existed a gap between salt-related knowledge, attitudes, and actual behaviors, resulting in a high salt intake among the Nepalese population. Nepal urgently requires tailored national salt reduction programs that comprise both policy and community-level interventions to achieve a 30% reduction in mean population salt intake by 2025. Further validation studies are needed to assess the effectiveness of community-based intervention in Nepal. [ABSTRACT FROM AUTHOR]

Chimeric Antigen Receptor T-cell (CAR-T) therapy has transformed the treatment landscape for hematological malignancies, showing high efficacy in patients with relapsed or refractory (R/R) disease and otherwise poor prognosis in the pre-CART era. These therapies have been usually administered in the inpatient setting due to the risk of cytokine release syndrome (CRS) and immune effector cellassociated neurotoxicity syndrome (ICANS). However, there is a growing interest in the transition to outpatient administration due to multiple reasons. We review available evidence regarding safety and feasibility of outpatient administration of CD19 targeted and BCMA targeted CAR T-cell therapy with an emphasis on the implementation of outpatient CAR-T programs in community-based centers. [ABSTRACT FROM AUTHOR]

Issue addressed: Aboriginal and Torres Strait Islander Peoples' holistic concepts of wellbeing are inadequately represented in the health promotion discourse. The aim of this article was to explore what sustains an Aboriginal wellbeing program, to inform critical reflection and reorientation to empower Aboriginal wellbeing approaches in health promotion practice and policy. Methods: Aboriginal and non‐Indigenous researchers collaboratively designed a critically framed, strengths‐based research approach with Aboriginal Community Controlled Health Service staff and wellbeing program participants. Data from Individual Yarning (n = 15) with program participants and staff inspired co‐researchers to co‐develop interpretations over two half‐day Collaborative Yarning sessions (n = 9). Results: Co‐researchers depicted five lifeworld qualities that sustain an Aboriginal wellbeing program: love, connection, respect, culture and belonging. The lifeworld qualities are relational, communicative and involve the dynamics of identity, power and self‐determination. Conclusions: The five qualities support a lifeworld approach to an Aboriginal wellbeing program, opening communicative and relational opportunities to mediate culturally responsive interactions. The qualities mediated interactions between people in the lifeworld including program participants and coordinators, and systems representatives including health service providers. A lifeworld approach provides a way to empower Aboriginal self‐determination and leadership through embedment of cultural determinants of health in wellbeing programs. So what?: Health service providers and policy makers can use lifeworld approaches to guide critical reflection and reorient practice and policy related to Aboriginal health. The lifeworld qualities that encompass this approach in wellbeing programs are communicative and relational, centred on local community voices and co‐produced with community for Aboriginal identity, empowerment and self‐determination. [ABSTRACT FROM AUTHOR]

This study aimed to develop a deeper understanding of the long-term impacts of place-rich community-based learning on university students. This study was informed by transformative learning theory, which recognizes how learning experiences that expand the learner’s worldview help develop autonomous thinking. A mixed-methods approach was used to explore the perspectives of graduates who participated in immersive community-based learning (CBL) experiences. Graduates from two programs at the University of Prince Edward Island between 2004 and 2017 completed the Civic-Minded Professional scale online. A subset of respondents were invited to participate in interviews. Students’ experiences of dissonance, transformational learning moments, reflection, and civic engagement were also assessed. Key findings include participants’ expanded and deeper appreciation for cross-cultural awareness, their more deliberate engagement with volunteer opportunities, and their emergence as advocates for the communities they worked with. Findings will be used to improve, diversify, and develop new CBL experiences for university students. [ABSTRACT FROM AUTHOR]

Enrekang Regency is the locus of stunting, although natural resources are so abundant compared to other districts in South Sulawesi but have a high rate, as well as child marriage, so it requires special assistance from the community or community-based in increasing family resilience. This study examines the capacity of community-based companions, with a theoretical approach to social assistance and dominated by the concept of Parsons et. al. stating that the empowerment process is generally carried out collectively. From the results of the study found, among others: high stunting rates, child marriage, and divorce rates so that single parents, especially women, can survive to continue their lives by gardening or farming (especially onion farmers). Along with the decline in family resilience that is happening in Enrekang district as a whole, local community-based mentors are needed, because they are the spearhead for a change, but the important problem is their lack of knowledge about the concept of mentoring. The research method used is a qualitative type of research, which focuses on collecting information or in-depth interviews, and this research was conducted for 3 months in 2022-2023. [ABSTRACT FROM AUTHOR]

Chimeric Antigen Receptor T-cell (CAR-T) therapy has transformed the treatment landscape for hematological malignancies, showing high efficacy in patients with relapsed or refractory (R/R) disease and otherwise poor prognosis in the pre-CAR-T era. These therapies have been usually administered in the inpatient setting due to the risk of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). However, there is a growing interest in the transition to outpatient administration due to multiple reasons. We review available evidence regarding safety and feasibility of outpatient administration of CD19 targeted and BCMA targeted CAR T-cell therapy with an emphasis on the implementation of outpatient CAR-T programs in community-based centers.

Gianyar regency has a diverse culture and crafts as one of authentic tourism attraction. This study aims to map the creative tourism potential in accordance with the distinction of the artisan village in Gianyar regency. This study solely examined the tourism potential of 14 creative village that had been identified by the government tourism office have creative potential to support promote Gianyar district as a World Craft City in 2023. In this study, a qualitative approach, checklist of observations was also made in each creative village along with interviews with informants from the Gianyar Regency Tourism Office and village head. Each village’s uniqueness and characteristics can be displayed by the development of creative ideas in packaging tourism potential as attractiveness and also other potential to support the main characteristic of the village to create branding of each village. Gianyar needs to market its tourist villages because the tourism potential of many of the villages is essentially comparable, so branding is necessary to each village to create their own identity and have competitiveness. Mapping of natural, cultural and arts made possibilities can be used to ascertain a village’s identity. Based on finding from 14 creative villages in Gianyar regency, it is possible to focus on expanding tourism potential in general while also creating creative tourism such as: Development of a Creative Tourism Village based on the crafts Industry, Development of Gastronomy-based Creative Tourism Villages, Development of a creative tourism village based on performing arts, Development of Nature-based Creative Tourism Villages.

One Health as integrated approach to link human, animal and environmental health has become current by the COVID-19 pandemic. Its veterinary and medical scientific and occidental cultural origin raises several paradoxes. Health is culturally constructed whereas the reductionist medical sciences focus on disease and reducing health hazards. Critical reflection on the ontology and epistemology underlying the One Health approach, actors and activities, assists in identifying strategic directions to further shape One Health. To incorporate eco-health and societal health calls for a Systemic One Health approach, requiring different leadership structures, community-based approaches and political engagement. Health hazard risk reduction and preparedness and response are non-systemic activities, but no less important to pursue. [ABSTRACT FROM AUTHOR]

The livelihoods of the majority of Uganda's population depend on declining environmental resources. The sustainability of the natural environment requires that the people who are interdependent with it, as well as the structures of governance and leadership around them, understand the implications of resource degradation and take deliberate steps towards restoration. The interdependency of human and environment conditions in Uganda requires multidisciplinary attention and this paper reflects a contribution to this end. Socio‐cultural perceptions and relations with a vulnerable environment are put into dialogue with the physical status of environmental resources in Alebtong District, Uganda. Southern epistemological perspectives are considered in relation to Western scientific paradigms. Culturally responsive socio‐cultural research data are related to MODIS NDVI data, using time series analyses and NDVI as a proxy for productivity. The research confirms the declining availability and condition of natural resources and the acknowledgement of local influence on this condition. Despite this, deliberate community and governance efforts towards conservation and restoration varied from non‐existent to insufficient. The causes for this inconsistency revolve around conflicting priorities. This paper demonstrates and discusses the difficult trade‐offs in decision‐making about natural resources that rural communities face, and supports new partnership models as a route to improvement. [ABSTRACT FROM AUTHOR]

Background: Rhesus isoimmunization is preventable by giving anti-rhesus D immune globulin during and after each pregnancy. There is limited evidence on the awareness of reproductive age group women about rhesus isoimmunization in the country Ethiopia. Objectives: This study is aimed at assessing awareness and associated factors towards Rhesus isoimmunization among reproductive age women in Debre Markos Town. Methods: A community-based cross-sectional study design was conducted at Debre Markos Town from December 1–30, 2022. Six hundred and five study subjects were selected using the multistage sampling technique. Data were collected by using an interviewer-administered, pretested, structured questionnaire. Data were entered into Epi-data version 4.2 and then exported to SPSS version 25 for further analysis. A binary logistic regression model was used. Variables with a p value of ≤ 0.05 in the multivariable logistic regression with a 95 % CI were declared statistically significant. The adjusted odds ratio was used to show the strength of the association between the dependent and independent variables. Results: Among the 605 respondents, 367 (60.7 %, 95 % CI; 56.9 %, 64.7 %) had poor awareness about rhesus isoimmunization. Women who can only read and write (AOR = 0.38, 95 % CI: 0.23, 0.65), completed primary school (AOR = 0.40, 95 % CI: 0.24, 0.68), secondary school (AOR = 0.40, 95 % CI; 0.24, 0.67), women who did not get health information (AOR = 0.50, 95 % CI; (0.33, 0.75), and average monthly income

Abstract Globally, health systems are increasingly striving to deliver evidence based care that improves patients’, caregivers’ and communities’ health outcomes. To deliver this care, more systems are engaging these groups to help inform healthcare service design and delivery. Their lived experiences—experiences accessing and/or supporting someone who accesses healthcare services—are now viewed by many systems as expertise and an important part of understanding and improving care quality. Patients’, caregivers’ and communities’ participation in health systems can range from healthcare organizational design to being members of research teams. Unfortunately, this involvement greatly varies and these groups are often sidelined to the start of research projects, with little to no role in later project stages. Additionally, some systems may forgo direct engagement, focusing solely on patient data collection and analysis. Given the benefits of active patient, caregiver and community participation in health systems on patient health outcomes, systems have begun identifying different approaches to studying and applying findings of patient, caregiver and community informed care initiatives in a rapid and consistent fashion. The learning health system (LHS) is one approach that can foster deeper and continuous engagement of these groups in health systems change. This approach embeds research into health systems, continuously learning from data and translating findings into healthcare practices in real time. Here, ongoing patient, caregiver and community involvement is considered vital for a well functioning LHS. Despite their importance, great variability exists as to what their involvement means in practice. This commentary examines the current state of patient, caregiver and community participation in the LHS. In particular, gaps in and need for resources to support their knowledge of the LHS are discussed. We conclude by recommending several factors health systems must consider in order to increase participation in their LHS. Systems must: (1) assess patients’, caregivers and community understanding of how their feedback are used in the LHS and how collected data are used to inform patient care; (2) review the level and extent of these groups’ participation in health system improvement activities; and (3) examine whether health systems have the workforce, capacity and infrastructure to nurture continuous and impactful engagement.

Background: The foundation of any nation is children. Malnutrition in children is global issue that may have both short- and long-term irreversible negative health consequences and thus associated with morbidity and mortality. Aims and Objectives: The study aims to determine the prevalence and associated risk factors of under-nutrition among under-five children in rural area of Haldwani. Materials and Methods: A community-based cross-sectional study conducted on Four hundred children residing in the rural field practice area of the Department of Community Medicine, Government Medical College, Haldwani. Results: The prevalence of underweight, stunting, and wasting was 7.75%, 9.25%, and 4%, respectively among under five children. The risk factors found significantly associated with undernutrition and sociodemographic profile were family size, parent’s education, mother’s occupation, and the socioeconomic class. The maternal factors found significantly associated with undernutrition were intake of iron folic acid tablets during antenatal care and postnatal care period, duration of pregnancy, site of delivery. Prelacteal, colostrum given, exclusive breastfeeding, and age of introducing complementary feeding and occurrence of recurrent diarrhea, recurrent acute respiratory infection, and worm infestation were child characteristics and medical illness found significantly associated with undernutrition. Conclusion: In this study, 17.5% of children were found undernourished. Factors determining undernourishment were parents literacy, social class, type and size of family, iron folic acid taken during pregnancy, feeding practices, immunization status, history of recurrent diarrhea, and other infections in the past 1 year.

Globally, health systems are increasingly striving to deliver evidence based care that improves patients', caregivers' and communities' health outcomes. To deliver this care, more systems are engaging these groups to help inform healthcare service design and delivery. Their lived experiences—experiences accessing and/or supporting someone who accesses healthcare services—are now viewed by many systems as expertise and an important part of understanding and improving care quality. Patients', caregivers' and communities' participation in health systems can range from healthcare organizational design to being members of research teams. Unfortunately, this involvement greatly varies and these groups are often sidelined to the start of research projects, with little to no role in later project stages. Additionally, some systems may forgo direct engagement, focusing solely on patient data collection and analysis. Given the benefits of active patient, caregiver and community participation in health systems on patient health outcomes, systems have begun identifying different approaches to studying and applying findings of patient, caregiver and community informed care initiatives in a rapid and consistent fashion. The learning health system (LHS) is one approach that can foster deeper and continuous engagement of these groups in health systems change. This approach embeds research into health systems, continuously learning from data and translating findings into healthcare practices in real time. Here, ongoing patient, caregiver and community involvement is considered vital for a well functioning LHS. Despite their importance, great variability exists as to what their involvement means in practice. This commentary examines the current state of patient, caregiver and community participation in the LHS. In particular, gaps in and need for resources to support their knowledge of the LHS are discussed. We conclude by recommending several factors health systems must consider in order to increase participation in their LHS. Systems must: (1) assess patients', caregivers and community understanding of how their feedback are used in the LHS and how collected data are used to inform patient care; (2) review the level and extent of these groups' participation in health system improvement activities; and (3) examine whether health systems have the workforce, capacity and infrastructure to nurture continuous and impactful engagement. Plain English summary: Patients, caregivers and communities have started taking more hands on roles in health systems, partnering with healthcare providers and researchers to impact the ways healthcare services are made and delivered. Their input has been shown to improve patient health. While many systems are working to include patients, caregivers and communities in helping improve healthcare, this work often focuses on collecting and analyzing patient data without using it in a timely way. Also, the level of their input can vary and is often limited to the start of a research project. As more health systems recognize the importance of their input in creating better healthcare, some are using different approaches to make this feedback a constant part of their systems. The learning health system (LHS) is one approach that can support deeper and ongoing patient, caregiver and community involvement in health system change. In the LHS, projects are frequently reviewed and feedback used to help health systems make changes as they go. While their involvement is critical to a well functioning LHS, it is unclear what this involvement looks like. This commentary reviews the current state of this involvement. We offer readers a way forward and suggestions to help them determine if they are actively including patients, caregivers and communities in their LHS. Suggestions include reviewing: (1) the ways data are collected and used; (2) how patients, caregivers and communities are involved in health system improvement efforts; and (3) whether or not systems have the tools needed to frequently partner with these groups. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) refers to cervical cancer as a public health problem, and sub-Saharan Africa bears the world's highest incidence. In the realm of screening, simplified WHO recommendations for low-resource countries now present an opportunity for a public health approach to this public health problem. We evaluated the feasibility of such a public health approach to cervical cancer screening that features community-based self-administered HPV testing and mobile treatment provision. In two rural districts of western-central Uganda, Village Health Team members led community mobilization for cervical cancer screening fairs in their communities, which offered self-collection of vaginal samples for high-risk human papillomavirus (hrHPV) testing. High-risk human papillomavirus-positive women were re-contacted and referred for treatment with cryotherapy by a mobile treatment unit in their community. We also determined penetrance of the mobilization campaign message by interviewing a probability sample of adult women in study communities about the fair and their attendance. In 16 communities, 2142 women attended the health fairs; 1902 were eligible for cervical cancer screening of which 1892 (99.5%) provided a self-collected vaginal sample. Among the 393 (21%) women with detectable hrHPV, 89% were successfully contacted about their results, of which 86% returned for treatment by a mobile treatment team. Most of the women in the community (93%) reported hearing about the fair, and among those who had heard of the fair, 68% attended. This public health approach to cervical cancer screening was feasible, effectively penetrated the communities, and was readily accepted by community women. The findings support further optimization and evaluation of this approach as a means of scaling up cervical cancer control in low-resource settings.

BackgroundGlobally, low birthweight (LBW) infants (

Abstract Background The impact of policing practices on the engagement of people who use drugs (PWUD) with harm reduction services is well evidenced. Although the police have traditionally taken an enforcement role in responding to drug use, it is increasingly clear that they can play an important part in multiagency delivery of harm reduction interventions. Despite this, there have been no studies exploring police officer perceptions of drug checking services (DCS), which provide analytical testing of client drug samples alongside harm reduction support and advice. Methods Semi-structured interviews were conducted with 10 police officers to explore the policing and legal challenges which could be encountered in the delivery of DCS in Scotland. Results Participants expressed general support for DCS and described this support as part of a wider organisational shift towards public health-oriented policing. Participants also discussed different potential approaches to the policing of areas surrounding DCS including: formal limits on police presence around the service and/or stop and search powers in relation to personal possession; the effective decriminalisation of personal possession within a specified boundary around the service; and informal agreements between local divisions and DCS outlining expected policing practices. Any formal limitation on the capacity of police officers to respond to community concerns was viewed as problematic and as having the potential to erode public confidence in policing. Participants also highlighted the potential for frontline officers to utilise discretion in ways which could undermine public health goals. Legislative change, or national strategic guidance from relevant stakeholders, was seen as a means of providing ‘cover’, enabling local divisions to support the operation of drug checking. Conclusions Despite a small sample of participants, this study summarises key challenges to be addressed in the implementation and operation of DCS in Scotland, and more widely. The paper concludes with suggested opportunities to develop approaches to policing that can facilitate rather than impede implementation and operation of these services.

Purpose – India has over half a million diabetics, with many others at risk. The Indian Diabetes Risk Score (IDRS) is a simple and validated tool used for mass screening of diabetes mellitus type 2 at the community level. This study assessed the vulnerability of developing diabetes in adults of a rural community of West Bengal using the IDRS and finds out the relationship of the risk of developing diabetes with socioclinical variables. Design/methodology/approach – Multi-stage sampling was employed to select one eligible nondiabetic adult from selected families residing in the rural field practice area of a medical college in West Bengal. They were interviewed with a predesigned and pretested data collection schedule and examined. Findings – Among 197 participants, 83.8% were female, 51.8% were illiterate and 57.4% came from Class IV of Prasad's socioeconomic scale. Of participants, 22.8% had existing known morbidities, and 23.9% had some form of substance addiction. In total, 46.8% of the participants on whom the IDRS could be applied (n = 175) were at high risk of developing diabetes (Score = 60). Gender and existing comorbidities significantly predicted a high risk of diabetes. Originality/value – A large proportion of the Indian population yet to be diagnosed with diabetes are at a high risk of having the disease. Early detection of the disease can help curtail its complications and reduce its clinical, social and economic burden. Mass screening tools like the IDRS thus become a very important tool in India's attempts to fight diabetes.

Background: Depression in older adults has serious biological, psychological, and social consequences. Homebound older adults experience a high burden of depression and significant barriers to accessing mental health treatments. Few interventions to address their specific needs have been developed. Existing treatment modalities can be challenging to scale up, are not tailored to unique population concerns, and require significant staffing support. Technology-assisted, layperson-facilitated psychotherapy has the potential to overcome these challenges. Objective: The aim of this study is to assess the efficacy of a layperson-facilitated internet-delivered cognitive behavioral therapy program tailored for homebound older adults. The novel intervention, Empower@Home, was developed based on user-centered design principles and partnerships between researchers, social service agencies, care recipients, and other stakeholders serving low-income homebound older adults. Methods: This 2-arm, 20-week pilot randomized controlled trial (RCT) with a waitlist control crossover design aims to enroll 70 community-dwelling older adults with elevated depressive symptoms. The treatment group will receive the 10-week intervention immediately, whereas the waitlist control group will cross over and receive the intervention after 10 weeks. This pilot is part of a multiphase project involving a single-group feasibility study (completed in December 2022). This project consists of a pilot RCT (described in this protocol) and an implementation feasibility study running in parallel with the pilot RCT. The primary clinical outcome of the pilot is the change in depressive symptoms after the intervention and at the 20-week postrandomization follow-up. Additional outcomes include acceptability, adherence, and changes in anxiety, social isolation, and quality of life. Results: Institutional review board approval was obtained for the proposed trial in April 2022. Recruitment for the pilot RCT began in January 2023 and is anticipated to end in September 2023. On completion of the pilot trial, we will examine the preliminary efficacy of the intervention on depression symptoms and other secondary clinical outcomes in an intention-to-treat analysis. Conclusions: Although web-based cognitive behavioral therapy programs are available, most programs have low adherence and very few are tailored for older adults. Our intervention addresses this gap. Older adults, particularly those with mobility difficulties and multiple chronic health conditions, could benefit from internet-based psychotherapy. This approach can serve a pressing need in society while being cost-effective, scalable, and convenient. This pilot RCT builds on a completed single-group feasibility study by determining the preliminary effects of the intervention compared with a control condition. The findings will provide a foundation for a future fully-powered randomized controlled efficacy trial. If our intervention is found to be effective, implications extend to other digital mental health interventions and populations with physical disabilities and access restrictions who face persistent disparities in mental health. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: In recent years, the occurrence of natural disasters, including floods, earthquakes, storms, and the like, has increasingly resulted in severe concerns in Iran as such disasters were unfortunate, causing human and financial losses, especially in disaster-prone areas like the south of Kerman province. Thus, it is critical to focus on innovative Community-based Crisis Management approaches. The present research aims to study the effect of community-based crisis management on the resilience to disasters with the role of social capital in the south of Kerman province. Although much research has been conducted in this area in recent years, no study can be found that has simultaneously measured these three variables and from the citizens' perspective, which is the innovation of this paper. METHODS: Research data were collected using a questionnaire; thus, the research questionnaire was distributed among many citizens in the south of Kerman province. Research findings were analyzed through using LISREL.FINDINGS: The results showed that the community-based crisis management variable with an impact factor of 0.37 has a positive and significant effect on citizens' resilience. Social capital also plays a mediating role in the relationship between community-based crisis management and resilience, while having a positive and significant effect on citizens' resilience.CONCLUSION: The research findings help policymakers, managers, and crisis management experts deliver effective programs to reduce vulnerability and enhance citizen resilience of south of Kerman province against natural disasters.

Abstract Surveillance of human and animal health is often carried out separately worldwide, which leads to the under-reporting of zoonotic and emerging diseases. Early cross-information between wildlife, domestic animal and public health sectors may reduce both exposure and cost of outbreaks. We have assessed the feasibility of a One Health Surveillance and Response System (OHSRS) in the Adadle district of Ethiopia in the Somali Region (SRS), with regard to integration into the existing regional surveillance-response system in the Somali Region of Ethiopia (SRS). To meet the objectives of a surveillance-response system, we established a One Health Surveillance and Response Unit (OHSRU) at the district level. Community Animal Health Workers, Community Health Workers (CHWs), and both human and animal health district staff and regional experts were trained together on the OHSRS. An inception workshop was held with all relevant stakeholders. To ensure the active engagement of communities in the surveillance response system, a Community-Based Emergency Fund (CBEF) and CAHW cost recovery mechanisms were established. All public and animal health staff of different administration levels were linked together. Human and animal health information was collected and shared effectively among sectors. This approach helped bridging the physical separation between the public and animal health sectors in disease surveillance in the Adadle district. Joint interventions, such as disease outbreak investigations and community awareness were initiated by the OHSRU. We demonstrated that the OHSR was successfully operationalized in Adadle districts and contributed to improving the early detection and response of zoonotic diseases. However, technical barriers, cost-effectiveness, legality of data and ethical safeguarding, along with political commitment should be addressed to effectively operationalize the OHSR in the whole region. Designing the OHSR through the existing surveillance system, engaging communities and other relevant sectors using a participatory process is an important contribution to a sustainable OHSR. One Health Impact Statement In this research work, the public and animal health sectors collaborated in data collection and initiated joint interventions. By integrating the surveillance operational costs for disease outbreak investigation and cost of public health associated with zoonotic diseases can be reduced as One Health surveillance and response lead to early detection and response to zoonotic diseases. As one health is collaborative efforts multispectral, multidisciplinary and transdisciplinary, i.e. involvement of all relevant sectors including community members and different disciplines in the launching workshop of surveillance system helped to define and agree the role of each sectors or partner’s in the One Health approach. This played a curtail role in the success of the approach. Lessons learned from this work can be used for further improvement in One Health approach in different settings.

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Local stakeholders offer significant insight and perspectives throughout the implementation of revitalization projects that would be difficult to otherwise garner by individuals not native to the specific town. The purpose of this study was to examine what conditions exist for local stakeholders to support or oppose revitalization in a rural, southern Georgia town and if able to support, what were their priorities. In-depth individual interviews with 32 business owners and other stakeholders were done. Questions were based on the guidelines and stakeholder survey developed by Schmeer (2001). Interviews were recorded, transcribed, and analyzed for themes within each question. Themes were identified and communicated to city officials to provide guidance to stakeholders of perceived priorities. An overwhelming majority of the participants interviewed (87.5 %) strongly supported revitalization. Renovation had the highest priority, followed by demolition, and creation of green space. Conditions that might lead to support existed including leadership and actions by others, a clear plan, and no negative impact to business. Conditions that might lead to opposition included conflict with culture or beliefs, and a lack of planning or transparency. Understanding the perceptions of local business owners is essential to understanding how to maintain stakeholder support, mitigate disruptions caused by revitalization, and avoiding stakeholder alienation. [ABSTRACT FROM AUTHOR]

Background: Approximately every 37 seconds, someone in the United States dies of cardiovascular disease (CVD). It has emerged as an important contributor to morbidity among persons with HIV. Black and Latinx sexual minority men are at higher risk of both HIV and CVD when compared to heterosexual, nonethnic or minority men. Persons with HIV have a 1.5 to 2-times risk of having CVD than do HIV-negative persons. Data suggest that by the year 2030, an estimated 78% of persons with HIV will have CVD. The relationship between HIV and CVD in marginalized populations is not well understood because overall awareness of HIV and CVD as comorbid conditions is low, which further heightens risk. This has created a critically pressing issue affecting underrepresented ethnic and racial populations with HIV and requires immediate efforts to mitigate risk. Objective: The purpose of this formative, mixed methods study is to use a community-engaged approach to map a behavioral intervention for CVD prevention in Black and Latinx sexual minority men with HIV in New York City. Methods: Literature reviews focused on behavioral prevention studies using intervention mapping. In Aim 1, we will use qualitative interviews with HIV program managers and community members to understand facilitators and barriers to CVD prevention, chronic illnesses of concern, and early design elements needed for a web-based CVD prevention intervention. In Aim 2, we will conduct qualitative interviews and administer cross-sectional validated surveys with 30 Black and Latinx sexual minority men with HIV. We will assess illness perceptions of chronic conditions, such as HIV, hypertension, and diabetes. A total of 40 participants (program managers and community members) for Aims 1 and 2 will be enrolled to participate. To develop the protocol, we will follow steps 1 through 3 (needs assessment, change objectives, implementation strategy) of intervention mapping, using mixed methods. Results: The study was approved by New York University Institutional Review Board in February 2021 (IRB-FY2021-4772) and also by the Yale University Institutional Review Board in June 2022 (#2000031577). We anticipate completing data collection on or before December 2022. Early analyses suggested concerns about illnesses outside of HIV and associated comorbid conditions, such as COVID-19 and monkeypox. Additionally, we noted a strong interest in using a web-based platform for CVD prevention education. Conclusions: Web-based, behavioral, CVD prevention interventions may be promising modalities to closing the cardiovascular health disparities gap in Black and Latinx sexual minority men with HIV by extending the reach of prevention interventions using community-informed approaches and technological modalities that have been underused in this population. [ABSTRACT FROM AUTHOR]

Background: Dual-task training is an emerging field used for people with Parkinson disease (PD) to improve their physical and cognitive well-being, but the patients’ acceptability, safety, and adherence to such training in online settings are unknown. Objective: This study aims to evaluate the acceptability of a dual-task cognitive and motor online training program for people with PD as a group online community program. Methods: People with PD were invited to participate in an online program (PD3 Move) consisting of physical and vocal exercises in response to different cognitive challenges displayed as dynamic backgrounds on Zoom. The program ran twice per week for 16 weeks. Patient acceptability was assessed at 4 months by monitoring attendance rates and feedback from an exit questionnaire emailed to all participants assessing satisfaction, perceived benefit, safety, and willingness to continue and recommend to others. Results: The online program was delivered to 15 participants (n=9, 60%, females) with a diagnosis of PD, a mean age of 69.4 (SD 9.3) years, and Hoehn and Yahr (H&Y) stages I-IV. The attendance rate was high, with participants coming to more than 13 (81%) of the sessions. Participants were very satisfied (n=8, 53%) or satisfied (n=7, 47%) with the program. Participants reported that what they most liked were the new cognitive physical challenges. The 3 main facilitators to participating were perceiving the benefits, instructor’s flexibility and engagement, and the social interaction moments with others. The 3 main difficulties were dealing with motor fluctuations (n=3, 20%), difficulties in using technology (n=2, 13%), and difficulty hearing instructions due to hearing loss (n=2, 13%). Patients had favorable perceived benefits of the program, with 14 (93%) considering it very useful for the current management of health and 1 (7%) moderately useful. No adverse events were reported, and all participants said that they were willing to continue the program and recommend it to others. Conclusions: Our findings suggest that the online cognitive and motor program was well received, safe, and perceived to be of benefit to this group of medically stable people with PD in H&Y stages I-IV. Access to specialized care and enhancement of long-term adherence to regular exercise can be achieved with online community group programs. [ABSTRACT FROM AUTHOR]

This phenomenological study involved focus groups with church-affiliated, African American women and men ( N = 50; ages 50 and older) in southeast Michigan to determine their attitudes and expectations around formal mental health care. Data analysis employed a constant comparative approach and yielded themes related to formal mental health care, along with delineating concerns about defining depression, health, and well-being. Health and well-being were defined as inclusive of physical and spiritual aspects of self. Churches have a central role in how formal mental health care is viewed by their attendees, with prayer being an important aspect of this care. Provider expectations included privacy and confidentiality; respect for autonomy and need for information, having providers who discuss treatment options; and issues related to environmental cleanliness, comfort, and accessibility. Implications include providing effective, culturally tailored formal depression care that acknowledges and integrates faith for this group.

AbstractIn this study, strategies to promote public participation in policy in Talouqan Municipality of Takhar Province, Afghanistan with the theme of social community has been studied. The present research is an applied research and in terms of method it can be considered a descriptive-survey research. The study population in the present study includes 240 employees and managers of Talouqan Municipality in Takhar Province, Afghanistan and 15 university professors in Takhar Province, Afghanistan.Cochran's formula was used to determine the sample size and the sample size was calculated to be 152 people. Then online questionnaires were distributed and the data were collected through this method. The results of the tests showed that the respondents believe that the mass media index has the greatest impact on promoting public participation and ranks first among the indicators. In addition, the indicators of social cohesion, services and facilities, promotion of social trust, elimination of gender discrimination, promotion of political awareness and fair distribution of power are ranked second to sixth, respectively. Accordingly, it is proposed that the new regime in Afghanistan use the capacity of the media and civil society and women to promote participation in the policy-making process. IntroductionParticipation as­ an effective mechanism in public programs and risk reduction in the future is to strengthen the effect of national programs in the future. In addition, participation is a catalyst for social change (Evans et al., 2019: 2). From the UN perspective, participation is the presence of people in the decision-making process and for the growth of social awareness and meeting their needs in the intervention process (Darabi & Abdi et al., 2009: 73). The importance and importance of participation in decision-making is such that much research has been done in different countries. In research, participation is defined as a process by which people can organize themselves and comment on the country's development activities (kuldi, 2003: 3). The concept of policy is defined as "a set of actions or inactions that one or more actors take on a problem or concern" (Smith & Larimer, 2009: 3).In light of the above; the question now arises as to what are the ways to promote public participation in community-oriented policy-making in Talouqan Municipality, Takhar Province, Afghanistan?Case StudyThe population size in the study is 250 employees and managers of Talouqan Municipality in Takhar-Afghanistan province, to determine the sample size of Cochran's formula at a confidence level of 0.95 and p = q = 0.5 and the error value is 0.05 Was used. In this study, the sample size was calculated for 152 people and the data were collected through an online questionnaire and available.Theoretical FrameworkIn fact, participation is a process that includes a variety of individual and group actions in order to intervene in determining one's own destiny and society and to influence decisions about public affairs (Basri, 2009: 81). According to thinkers, if a political revolution is taking place around the world, that revolution is nothing but an explosion of participation. In all the developing and modern countries of the world, people believe that ordinary people should be involved in politics and that people should be involved in politics. Has become commonplace (Millbrae & Gobil, 2007: 1996). Participation means to contribute to something and to benefit from it, or to participate in a group and therefore to cooperate with it. For this reason, from a sociological point of view, a distinction must be made between participation as a state or condition (the matter of participation) and participation as an action and commitment (the act of participation). Participation in the first sense signifies belonging to a particular group and having a share in its existence and in the second sense conveys active participation in the group (Toile, 2003: 66-67). From a global perspective, participation is a process in which stakeholders intervene to oversee development initiatives, decisions, and resources that have an impact on life (World Bank, 2015).Methodologyhe statistical population of this study is the staff and managers of Talouqan Municipality in Takhar-Afghanistan province and considering the importance of the issue, knowledgeable experts, university professors and senior managers will be considered. The population size in the study is 240 employees and managers of Talouqan Municipality and 15 university professors in Takhar's province Afghanistan. To determine the sample size of Cochran's formula at a confidence level of 0.95 and p = q = 0.5 and the error value is 0.05 Was used. In this study, the sample size was calculated for 152 people and the data were collected through an online questionnaire and available.Discussion and Result The result has shown in all of the above cases, a significance level of less than 0.05 has been reported, which indicates that all indicators extracted are factors in promoting public participation in policy-making. In addition to the significance level of T-index was more than 1.96, which is another reason to confirm the impact of indicators on promoting public participation in policy-making. The test results show that the respondents believe that the "mass media index" with an average of 3.80 has the greatest impact on promoting public participation and ranks first among the indicators.In addition, indicators of social cohesion (average 3.51), services and facilities (average 3.43), promotion of social trust (average 3.40), elimination of gender discrimination (average 3.33), promotion of political awareness (average 3, 32) and fair distribution of power (with an average of 3.31) are ranked second to sixth, respectively.ConclusionFirst hypothesis of research shows that respondents believe strategies based on political capacity have been effective in promoting public participation in policy-making with a community-based approach. On the second hypothesis respondents believe that social capacity-based strategies have been effective in promoting public participation in policy-making with a community-based approach. On third hypothesis based on respondent responses, sometimes strategies based on cultural capacities have been effective in promoting public participation in policy-making with a community-based approach. On the last hypothesis Respondents believe that solutions based on technology capabilities have been effective in promoting public participation in policy-making with a community-based approach.

Background: The impact of policing practices on the engagement of people who use drugs (PWUD) with harm reduction services is well evidenced. Although the police have traditionally taken an enforcement role in responding to drug use, it is increasingly clear that they can play an important part in multiagency delivery of harm reduction interventions. Despite this, there have been no studies exploring police officer perceptions of drug checking services (DCS), which provide analytical testing of client drug samples alongside harm reduction support and advice. Methods: Semi-structured interviews were conducted with 10 police officers to explore the policing and legal challenges which could be encountered in the delivery of DCS in Scotland. Results: Participants expressed general support for DCS and described this support as part of a wider organisational shift towards public health-oriented policing. Participants also discussed different potential approaches to the policing of areas surrounding DCS including: formal limits on police presence around the service and/or stop and search powers in relation to personal possession; the effective decriminalisation of personal possession within a specified boundary around the service; and informal agreements between local divisions and DCS outlining expected policing practices. Any formal limitation on the capacity of police officers to respond to community concerns was viewed as problematic and as having the potential to erode public confidence in policing. Participants also highlighted the potential for frontline officers to utilise discretion in ways which could undermine public health goals. Legislative change, or national strategic guidance from relevant stakeholders, was seen as a means of providing 'cover', enabling local divisions to support the operation of drug checking. Conclusions: Despite a small sample of participants, this study summarises key challenges to be addressed in the implementation and operation of DCS in Scotland, and more widely. The paper concludes with suggested opportunities to develop approaches to policing that can facilitate rather than impede implementation and operation of these services. [ABSTRACT FROM AUTHOR]

Estimates inform that mental health problems are on the rise across the globe including in Bangladesh. To reduce the global disease burden caused by mental health disorders, community-based mental health care has gained significant consideration worldwide alongside conventional approaches to treat mental health disorders. In the face of growing mental health problems, limited resources, and centralized mental health facilities, Bangladesh – a low- and middle-income country – has prospects in ensuring mental health care through the implementation of community-based mental health services across the country. This article discusses the opportunities and challenges in implementing community-based mental health services in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: To contribute to the World Health Organization's End TB Strategy, the active tuberculosis (TB) case-finding approach has been proven effective. Methods: A total of 66 chest camps were organised for patients in 15 selected districts in Punjab, Pakistan, in 2017. A mixed-method process evaluation was conducted in four randomly selected districts to evaluate the use of chest camps for active TB case finding to reach the maximum number of people with TB and to assess the implementation outcomes, such as effectiveness, feasibility, fidelity, and costs. Results: Results indicated that 1458 attendees visited 24 chest camps in four selected districts. Among attendees, 297 presumptive cases were found and smear-tested; and 34 of the smear-tested were diagnosed as smear-positive TB patients. The prevalence of smear-positive TB patients among the chest camp participants was found to be 2.3%. The findings from interviews showed that preparation of chest camp activities, especially the involvement of community leaders, was found to be effective in achieving the desired level of attendance. The respondents found attending the chest camps for TB symptoms feasible and acceptable. The chest camp costs approximately US$280, including the pre-camp mobilisation events, whereas the cost per TB-positive patient was found to be US$197.64. Conclusions: The higher number of attendees without TB symptoms, the low proportion of smear-negative case registrations; and relatively high unit cost (per patient detected) were the areas identified for further attention. The study supports the continuation of chest camp activity, with further attention required for quality and efficiency concerns. Is TB really as pervasive as it seems in Pakistan? Despite its high prevalence rates, there are many TB cases that go unnoticed and unreported. This study indicates that further attention is required to address quality and efficiency concerns, while supporting the continuation of chest camp activity for increased TB case finding. This is quite essential as cases that go unreported may result in spread of the disease and increased burden on the health budget that is already severely affected, which is in addition to the effects of the coronavirus disease 2019 (COVID-19) pandemic. [ABSTRACT FROM AUTHOR]

BACKGROUND: Community-based pulmonary rehabilitation (PR) programs can be offered to patients with COPD, but the literature on its effects is still not well summarized. Our purpose was to investigate the health-, physical-, and respiratory-related effects of community-based PR in individuals with COPD as compared to control groups. METHODS: The PubMed and Embase databases were searched up to May 17, 2021. We included randomized control trials that compared the effects of community-based PR as compared to control groups in individuals with COPD. The risk of bias was judged using the Cochrane Risk of Bias 2 (RoB2). Meta-analysis was performed using a random-effects model to estimate the standardized mean difference (SMD) with 95% CI of the mean changes from baseline between groups. The Grading of Recommendations Assessment, Development, and Evaluation was used to interpret certainty of results. RESULTS: We included 10 randomized control studies comprising a total of 9,350 participants with weighted mean age of 62.3 ± 2.38 y. The community-based interventions were based on exercise programs (resistance and/or endurance). All studies were judged as high risk and/or some concerns in one or more domains the risk of bias. All meta-analyses displayed very low certainty of evidence. The community-based PR interventions were significantly superior to control interventions in improving the St. George Respiratory Questionnaire Activity subscore (-0.40 [95% CI -0.72 to -0.08]; k = 5, n = 382) and total score (-0.73 [95% CI -1.29 to -0.18]; k = 4, n = 268) and the Chronic Respiratory Disease Questionnaire dyspnea subscore (0.36 [95% CI 0.03-0.69]; k = 6, n = 550). The mean changes from baseline were not different between the groups for all other outcomes. CONCLUSIONS: Community-based PR tended to result in superior health-related quality of life and symptoms than control interventions, but the findings were inconsistent across outcomes and with very low certainty of evidence. Further studies are warranted for stronger conclusions. [ABSTRACT FROM AUTHOR]

This article highlights the role of community among Latina/o/x students pursuing degrees in science, technology, engineering, and mathematics (STEM) at 2- and 4-year Hispanic Serving Institutions (HSI). Community-based perspectives are often missing from traditional STEM disciplinary contexts; however, our Community-Centered STEM Identity model recognizes how Latinx students develop STEM identities by grounding, engaging, and bridging community. Implications for HSIs include cultivating community-based partnerships and perspectives as these are critical for the retention of Latinx students in STEM. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: In recent years, the occurrence of natural disasters, including floods, earthquakes, storms, and the like, has increasingly resulted in severe concerns in Iran as such disasters were unfortunate, causing human and financial losses, especially in disaster-prone areas like the south of Kerman province. Thus, it is critical to focus on innovative Community-based Crisis Management approaches. The present research aims to study the effect of community-based crisis management on the resilience to disasters with the role of social capital in the south of Kerman province. Although much research has been conducted in this area in recent years, no study can be found that has simultaneously measured these three variables and from the citizens' perspective, which is the innovation of this paper. METHODS: Research data were collected using a questionnaire; thus, the research questionnaire was distributed among many citizens in the south of Kerman province. Research findings were analyzed through using LISREL. FINDINGS: The results showed that the community-based crisis management variable with an impact factor of 0.37 has a positive and significant effect on citizens' resilience. Social capital also plays a mediating role in the relationship between community-based crisis management and resilience, while having a positive and significant effect on citizens' resilience. CONCLUSION: The research findings help policymakers, managers, and crisis management experts deliver effective programs to reduce vulnerability and enhance citizen resilience of south of Kerman province against natural disasters. [ABSTRACT FROM AUTHOR]

Abebe Sorsa, Ashenafi Habtamu, Muhammedawel Kaso Arsi University College of Health Science, Asella, EthiopiaCorrespondence: Abebe Sorsa Email dr.abebesorsa@yahoo.comBackground: Globally, anemia is a public health problem affecting children living in both developed and developing countries with bad consequences on children’s cognitive, social, and economic development.Objective: To assess the prevalence and predictors of anemia among children aged 6– 23 months residing at Dodota district, Southeast Ethiopia.Methods: A community-based cross-sectional study was conducted from January–July 2019, at Dodota district, in Southeast Ethiopia. Multistage, random, and systematic sampling techniques were employed to recruit households and study participants. Trained community health extension workers were involved in the data collection. Data were entered into Epi_info 7.2.2 for clean-up and exported to SPSS 21 for analysis. Frequency and proportion were used to describe nominal and ordinal variables. Mean with SD were used to describe continuous variables. Pearson correlation coefficient was used to assess correlation between numeric variables. Regressional analysis was used to assess factors predicting the occurrence of anemia. P< 0.05 with 95% CI was considered significant.Results: A total of 917 children were included and the prevalence of anemia was found to be 407 (44.4%, 95% CI=41.1– 47.4). When stratified to age category, the prevalence of anemia was highest among the age group of 6– 12 months. Lack of ANC visits, lack of iron supplementation during pregnancy, untimely initiation of complementary feeding, and initiation of cow’s milk before 1 year of age were factors associated with anemia.Conclusion: The prevalence of anemia was at the level of major public health problems. Antenatal and obstetric factors as well as child feeding practices were risk factors associated with anemia; and utilizing obstetric and childcare practices is highly recommended to mitigate this public health problem.Keywords: anemia, prevalence, community based, children aged 6– 23 months

Introduction: As part of undergraduate training in community medicine, students of 1st-year MBBS at our medical college in South India undergo rural residential community-based training called Rural Orientation Program (ROP). Objective: The objective was to study the impact of ROP at a medical college in South India. Methodology: Short-term impact was studied immediately before and after ROP using a 30-item questionnaire administered to 142 students. Medium-term impact was studied among 23 students in 2nd-year MBBS. Quantitative component consisted of objective structured practical examination scores and qualitative component documented reflections on learnings. Long-term impact was studied by surveying 287 alumni (batches of 1979 onward) to explore the impact of ROP on their career. Results: We found a significant (P < 0.001) improvement in the median posttest score (21, interquartile range [IQR]: 20–23) when compared to pretest (12, IQR: 10–16). The mean OSPE score was 19.34 ± 3.19 (maximum score = 25) with 54.55% obtaining a score ≥20. Thematic analysis of reflections depicted that students gained insights on factors influencing health and social organizations in rural areas. ROP helped develop empathy toward patients and a holistic approach toward health, in understanding rural dynamics and improved communication skills. Conclusion: ROP increases subject knowledge and plays a role in molding attitudes of students toward the care of people in rural areas and improves communication skills. This time-tested model can be replicated in other medical colleges across the country.