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Objective: There is growing utilization and acknowledgement of the benefits of community-based participatory action research (CBPAR) in advancing health practices and equity. However, the sustainability and full impact of CBPAR in health care settings faces many obstacles and limitations. The present article examines the synergies between CBPAR and Clubhouse programs, presents the demonstration and ongoing implementation of sustainable CBPAR practices at Fountain House in New York City, and offers lessons learned for other Clubhouses and similar programs seeking to integrate CBPAR. Methods: Alignment in practice and principles between CBPAR and Clubhouse programs are presented. The innovation and ongoing sustainable CBPAR practices in the Fountain House Clubhouse program are examined with a contribution of practice guidance for other Clubhouse and similar programs in further adopting and learning CBPAR into participatory health practices. Results: Clubhouse psychosocial rehabilitation programs present structurally conducive settings for the success and sustainability of CBPAR activities and projects. The Fountain House examination and demonstration of integrating CBPAR sustainably into core Clubhouse programming presents opportunities for further integration, research, and practice guidance in uniquely leveraging features of the Clubhouse model to advance health equity and rehabilitative outcomes through CBPAR. Conclusions and Implications for Practice: The opportunity for incorporating structural CBPAR activities within Clubhouse programs can be informed by the experience, processes, and lessons applied in the Fountain House example. Further research into the rehabilitation, program, and equity benefits of Clubhouse and CBPAR integration could uniquely contribute to the advancement of sustainable participatory research practices across the mental health field generally. Impact and Implications: The article provides an examination of the synergies between community-based participatory action research and Clubhouse programming through an examination of the sustainable integration of community-based participatory action research activities within a particular Clubhouse program that can serve as a guide and resource for replication. [ABSTRACT FROM AUTHOR]

Background: Age‐friendly care, addressing what matters most, medications, mentation, and mobility, is a successful model for improving older adult care. We describe the initial outcomes of age‐friendly care implementation in five primary care clinics in an academic health system. Methods: In partnership with a regional quality improvement (QI) organization, we used practice facilitation to implement age‐friendly care from July 2020 to June 2023. Clinic workflows and electronic health record (EHR) templates were modified to capture six QI measures for patients ≥65 years:Documenting what matters most to patientsAdvance care planning (ACP)Annual cognitive screeningCaregiver referral to dementia community resourcesFall‐risk screeningCo‐prescription of opioid and sedative‐hypnotic drugs Providers were alerted if patients had positive screens and given support tools for clinical decision‐making. QI measures from January–June 2023 were compared to the year prior to implementation. Providers and staff were interviewed about implementation barriers and facilitators. Results: All six measures improved in Geriatrics and and other clinics showed improvement in ACP and cognitive screening. All clinics had high fall‐risk screening rates (≥85%). The least improved measure was co‐prescription of opioids and sedative‐hypnotics with co‐prescription rates ranging from 7% to 39%. Implementation hinged on leadership prioritization, practice facilitator guidance, clinical team buy‐in, EHR functionality, and clinical performance review. Three clinics received Age‐Friendly Health System recognition. Conclusions: A QI approach using practice facilitation and EHR templates improved some but not all age‐friendly care measures. Future interventions will focus on training in high‐risk medication tapering and elicitation of health goals. See related editorial by Lauren J Gleason and Katherine Thompson. [ABSTRACT FROM AUTHOR]

Health and wellness interventions addressing risk factors for early mortality among individuals with serious mental illness have demonstrated success and can be further augmented with digital technology. These programs may be suitable for delivery in psychosocial rehabilitation clubhouses, especially given many services have transitioned to digital platforms during the pandemic. This qualitative study aimed to: (a) explore clubhouse members' experiences engaging with the virtual clubhouse platform, and their preferences for accessing digital wellness and health promotion content; and, (b) gauge members' interest in an online peer-driven lifestyle intervention and their suggestions for program design. This study was guided by a community-based participatory action research framework. Ten focus groups were conducted with clubhouse members. Focus groups were coded and analyzed thematically by trained clubhouse members and the research team. Thirty-three members participated in the focus groups. Participants expressed the importance of having technical support from staff; that one-on-one support and consistent communication are important to keep them engaged in health and wellness programming; and described mixed views about use of the virtual platform, but generally were open to engaging in lifestyle intervention programming virtually. Participants who joined the clubhouse during the pandemic expressed feeling overwhelmed by in-person gatherings, and were especially interested in opportunities for remote participation. This study can inform health and wellness programming for delivery on the virtual clubhouse platform for members. The taxonomy of codes, created to generate a framework with recommendations, will inform the design of a virtual health and wellness intervention. [ABSTRACT FROM AUTHOR]