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ABSTRACT Introduction Aim Methods Results Discussion Implications Trial Registration Given that recovery‐oriented care focuses on empowering individuals with mental health challenges, collaborative care can be an effective tool for nurses in mental health day hospitals.To deepen knowledge about the impact of collaborative nursing care for improving health outcomes of mental health day hospital users.A sequential and transformative mixed methods study was designed. In the first phase of this mixed methods study, quantitative data were collected from 144 users of mental health day hospitals. In phase two, a group of users underwent an intervention based on collaborative nursing care, through participatory action research, and qualitative data were collected. Finally, quantitative data were again collected from all users.The users who participated in the intervention group improved quantitatively in terms of the quality of the therapeutic relationship. They also improved at different stages of the recovery process, thus the qualitative results confirmed that collaborative nursing care was an essential component in their recovery process.The findings highlight the critical role of collaborative nursing care in health outcomes. The therapeutic relationship was identified as a key factor in facilitating patient empowerment.The study supports implementing collaborative nursing care models in mental health settings to enhance patient outcomes.ClinicalTrials.gov identifier: NCT04814576 [ABSTRACT FROM AUTHOR]

Action research methodologies are dynamic, as they often evolve with a group and are shaped by multiple contributions that can change over time. As researchers are embedded within this process, reflexivity is paramount to remain attuned to how they move with and shape the research. In search of a dynamic way of engaging with reflexivity in action research, this paper explores intra-active and diffractive theory and considers how diffracting reflexivities (Serra Undurraga 2021) can help researchers grasp a deeper understanding of their role in shaping the research process. This paper draws from a doctoral researcher’s experience navigating their reflexivity within an action research project to design sexuality education materials with young people in Aruba. Through its documentation of three multi-modal apparatuses, including doodling, audio/written journaling and blackout poetry, it offers a snapshot into creative methods for reflexivity and maps how their intra-actions go on to shape research practice. This paper contributes to the literature by providing insight into the ‘doing’ of reflexivity. It concludes that thinking with a diffractive lens and remaining curious to intra-actions are valuable tools for building a dynamic personal practice that compliments the emergent nature of action research methodologies. [ABSTRACT FROM AUTHOR]

Objectives: Despite cervical cancer (CC) being a preventable disease, its incidence remains high in marginalized communities due to inequalities that restrict access to health services. This article investigates the experiences, perceptions, and attitudes regarding the screening of indigenous women in a region of the Colombian Amazon during a cervical cancer prevention initiative facilitated by community participation. Design: Qualitative study based on interviews conducted with women and indigenous leaders from Paujil reserve. They participated in research focused on cervical cancer prevention, which employed a methodology of collaboration between academia and communities aimed at enhancing women's health and reducing inequalities in access to healthcare services. The analysis utilized a deductive and inductive approach. Results: Five main themes were addressed: 'Barriers within health services'; 'Individual and cultural constraints'; 'Motivations and facilitators'; 'Positive experiences within the research framework'; and 'Suggestions for encouraging women's participation.' Challenges related to appointment scheduling and result delivery were frequently cited as obstacles to access. Misinformation, feelings of shame, fear, and distrust towards health services played significant roles in the reluctance to undergo screening. Factors such as support from family and community networks, respectful treatment, ease of scheduling appointments, the presence of female healthcare professionals, and involvement of leaders fluent in indigenous languages were identified as positive facilitators of screening acceptance. Conclusion: Understanding the factors that influence access to screening is crucial for reducing inequalities in service delivery for indigenous women. The involvement of trained leaders who can identify these factors and motivate women can have a positive impact on the acceptance and guidance of cervical cancer prevention programs. [ABSTRACT FROM AUTHOR]

Background: Individuals with a higher level of awareness and knowledge of HPV are more likely to dispel misconceptions about HPV and reduce their likelihood of engaging in risky sexual behavior. Behavioural change can be achieved through interventions such as participatory action research (PAR), which has been applied in various contexts. Few studies have reported on the use of PAR in Nigeria. This study aims to utilise PAR as an intervention to increase HPV awareness, improve knowledge of HPV infection, and promote behavioural change for HPV prevention among young adolescents in Benue State, Nigeria. Methods: The study design uses a school-based, pre-post intervention approach with a cross-sectional component. Study participants are young adolescents aged 10–19 years in selected co-educational secondary schools in three local government areas (LGAs) spread across the three senatorial zones in Benue State, Nigeria. Two-stage sampling was used to select the LGAs and schools, and the sample size was computed using the before and after implementation with some prior information from a previous study. Data on sociodemographic characteristics, HPV awareness and knowledge of infection and prevention, prevention practices, and willingness for HPV vaccination were obtained with a self-administered semi-structured questionnaire adapted from the Vaccination and HPV Knowledge (THinK) survey. The HPV Knowledge survey (New Zealand) was utilized to collect information from students at baseline and post-implementation after PAR intervention. The Wilcoxon Signed Test (WST) was used to investigate the significance of the median differences before and after the intervention. A p-value less than 0.05 or 0.001 was considered significant. Results: A total of 548 adolescents were sampled before the intervention. After the intervention, the sample size decreased to 503, reflecting an 8% attrition rate. PAR effectively increased HPV awareness among the participants from 80.9% before the intervention to 99.8% afterward. The PAR led to a significant change in knowledge of HPV infection and primary prevention and an increase in perception of HPV primary prevention. decrease in misconceptions and risky sexual behaviours, increase in HIV screening tests, and increase in the willingness of participants to uptake the HPV vaccine. Among the measures of risky sexual behaviours was a decreased perception that having more than one sexual partner is not a risk factor for HPV after the PAR intervention. The number of participants in sexual relationships decreased from 84 (16.7%) at baseline to 37 (7.4%) post-implementation. The PAR also led to a decrease in the number of participants who reported having STDs. The Wilcoxon Signed test was further disaggregated based on sex (male and female), school funding type (public and private), and school class level (junior and senior). Conclusions: PAR led to a significant increase in awareness and knowledge of HPV, knowledge of different aspects of HPV infection, and willingness to uptake the HPV vaccine. Additionally, the study has provided evidence that PAR interventions can be a viable tool in delaying sexual initiation and reducing sexual behavioural tendencies, especially in high-risk groups. [ABSTRACT FROM AUTHOR]

In this longitudinal qualitative study, we examined how 23 undocumented college students with and without DACA navigated the college graduation process and transitioned out of higher education. Despite the growing number of undocumented students with and without DACA enrolling and graduating from college over the past 10 years, few studies have been conducted about this significant life event that can involve numerous new challenges and opportunities for them. We used Schlossberg's (2008) transition theory to design the study and analyze our data. We found that undocumented students with and without DACA perceived their transition out of higher education as an expected change with unanticipated conditions and non-events out of their control. Surprisingly, the data showed that having DACA did not translate into more stability for participants at the time of graduation. The uncertainty connected to participants' immigration status, coupled with the ambiguous sociopolitical climate and the COVID-19 pandemic, continuously created unpredictable situations that clouded their ability to navigate the changes with confidence. In this article we present our findings through two in-depth participant narratives to bolster humanizing and counterstorytelling practices in higher education scholarship. We offer implication for research, policy, and practice. [ABSTRACT FROM AUTHOR]

The majority of previous studies focused on the role of social responsibility (SR) in business settings, however, how to incorporate SR into translation training appears to be unexplored. This study concerns incorporating SR authentic activities into translator training through situated learning in translation projects. It investigates how incorporating SR into translator training benefits the development and learning of translation students and preserves a sustainable learning environment. The aim is twofold: to gain a deep understanding of the processes of development and implementation of SR initiatives at translator training, and to reflect on the adoption of Participatory Action Research (PAR) in this context. A representative sample of final-year translation students at a public university in Saudi Arabia completed two distinct types of authentic translation tasks and turned in final project reports. The qualitative findings indicated that students' attitudes toward SR were generally positive. They further revealed that collaborative project-based education is a very effective way to improve translation and generic skills and increase awareness of SR necessary for learning sustainability. In light of the findings, valuable pedagogical insights for university and curriculum designers to create or adapt curricula for situated translator training in line with learning sustainability are recommended. [ABSTRACT FROM AUTHOR]

This paper documents the hopes, desires and structural betrayals experienced by young people attending transfer schools in New York City. Transfer schools enroll more than 15,000 students each year who are disproportionately young people of color, poor and working-class youth, from immigrant families, and youth with disabilities. Most have fallen behind on academic benchmarks. Many have been systematically pushed out of school through zero tolerance policies, high stakes testing cultures, and a lack of culturally relevant approaches to curriculum and pedagogy. This paper explores survey responses from 842 transfer school students, collected as part of a broader participatory action research study. Our analysis reveals that many transfer school students persist in the face of multiple obstacles that disrupt their educational progress, including material insecurity, previously alienating school experiences, housing insecurity, violence and struggles with mental health. Moreover, we find that students experience the transfer schools in this study as relationally rich, caring, intellectually rigorous, and mutually accountable learning communities that help them overcome obstacles that previously held them back. Our analysis confirms transfer school students' desires and persistence in the face of adversity and demonstrates the academic and socio-emotional commitments and impact of educators and counselors in transfer schools. Under current federal and state accountability frameworks, transfer schools are threatened by one-size-fits all metrics, punitive policies, and racialized austerity. As such, their importance and impact is consistently mismeasured and under-acknowledged. In this paper, we present evidence that these schools represent the radical rim of what is possible in public education, and we argue that we must support their efforts, honor their commitments, and establish a more equitable system for evaluating the essential work they do. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors face many barriers to physical activity (PA). Solving physical inactivity after stroke requires a "systems-based" approach. We aimed to develop a complex intervention targeted at improving PA after stroke in Singapore using behaviour change theory and a co-design approach involving multiple stakeholders. Methods: We carried out the intervention development in three phases: i. preparation phase, ii. co-design phase, and iii. intervention refinement phase. During the preparation phase, we conducted surveys (n = 38 stroke survivors, 71 physiotherapists and 35 exercise professionals) and interviews (n = 19 stroke survivors) to understand the factors influencing PA after stroke. The co-design phase consisted of two-co-design workshops held in August 2022 and were attended by 13 stroke survivors and 4 caregivers. Relevant domains of the Theoretical Domains Framework (TDF) and items in the Template for Intervention Description and Replication (TIDieR) checklist guided the discussion topics in the first co-design workshop. Solution prototypes such as exercise videos, arm and leg straps and information resources were shown in the second co-design workshop to gather feedback. In the intervention refinement phase, eight healthcare professionals from various sectors participated in two virtual Zoom meetings in August 2023, and used the Acceptability, Practicability, Effectiveness, Affordability, Spillover effects and Equity (APEASE) grid to rate the active ingredients in the complex intervention by considering the current healthcare landscape in terms of resources and manpower. Results: Stroke survivors and caregivers want a personalised PA program, stroke-specific PA opportunities and information resources, medical clearance, advice and help from healthcare professionals skilled in stroke care, face-to-face sessions at preferred exercise spaces, and access to adaptive equipment. A complex intervention consisting of 21 behaviour change techniques, 6 intervention functions and 8 options was developed. Conclusions: Using behaviour change theory and a co-design approach involving multiple stakeholders, a complex intervention was developed to target physical inactivity after stroke. The intervention titled MOTIVATE is currently being tested in a type 1 hybrid effectiveness-implementation trial. [ABSTRACT FROM AUTHOR]

The involvement of peer researchers has recently gained popularity in social research, and the incentives for using participatory methodologies are well recognised. However, as we argue, the sole presence of peer researchers does not equate to their immediate empowerment, and more attention should be given to the roles they play in the research and the ways in which they can tangibly benefit from such collaborations. We explore the seemingly mundane aspects of work such as recruitment, training, conducting research, dissemination and the afterlife of the project, to suggest that meaningful engagement of peer researchers demands a tailored approach that is receptive to their particular needs and motivations, and is supportive of their individual growth. Our critical reflection stems from a two-year-long collaboration with peer researchers in Poland undertaken as part of a Horizon 2020 project, which explored the lives of young migrants and refugees in Europe. [ABSTRACT FROM AUTHOR]

In China, social work was reestablished in 1988. Despite the number of social work programmes increased very fast throughout the 1990s, there was a huge need for social work-trained educators. The Hong Kong Polytechnic University and Peking University launched the MSW (China) Programme in 2000 to create a critical mass of social work educators who would assume future leadership in social work development in mainland China. Participatory action research was employed as a methodology to explore how social work education could transform students into catalysts for social work education and social development. Purposive sampling was adopted, and seven cohorts totaling 238 graduates who graduated from the programme were the participants in this research. Data collection and analysis were carried out throughout the action research process. We found the triple capacity building model to be a good pedagogy to foster transformation among participants, and to steer the knowledge co-creation, practice innovation, policy reform, and social change through social work education. In this paper, we will provide an overview of the background, vision, and mission, as well as the teaching pedagogy of the programme and a case study to demonstrate how social work education has an impact on policy and practice innovation in China. [ABSTRACT FROM AUTHOR]

Background: This paper aimed to explore the palliative care (PC) needs and barriers to access among cancer patients in a rural region of North India with a high cancer burden. Methods: A Participatory action research (PAR) approach was employed. Situational assessment, community sensitization workshops (CSWs) and door-to-door surveys were planned, conducted and developed over three PAR cycles. A parallel convergent mixed-methods approach was adopted wherein the quantitative data from door-to-door surveys and qualitative data from CSWs and investigator field notes were collected and analyzed to provide a comprehensive understanding of PC needs and barriers to access. Descriptive statistics and thematic analysis were used. Results: A total of 27 CSWs involving 526 stakeholders were conducted. A total of 256 cancer patients were assessed for PC needs and symptom burden using the Supportive and Palliative Care Indicators (SPICT-4ALL) and the Edmonton Symptom Assessment System (ESAS) tool, respectively. Based on the SPICT assessment, all patients (n = 256) satisfied general and/or cancer-specific indicators for PC. The majority (56.6%) had ≥ one moderate-severe symptom, with the most common symptoms being tiredness, pain and loss of appetite. Analysis of qualitative findings generated three themes: unmet needs, burden of caregiving, and barriers and challenges. Cancer affected all domains of patients' and their families' lives, contributing to biopsychosocial suffering. Social stigma, discrimination, sympathizing attitudes and lack of emotional and material support contributed to psychosocial suffering among cancer patients and their caregivers. Lack of awareness, nearby healthcare facilities, transportation, essential medicines, trained manpower and education in PC, collusion, fear of social discrimination, faulty perceptions and misconceptions about cancer made access to PC difficult. Conclusions: The study emphasize the need for and provide a roadmap for developing context-specific and culturally appropriate CBPC services to address the identified challenges and needs. The findings point towards education of CHWs in PC; improving community awareness about cancer, PC, government support schemes; ensuring an uninterrupted supply of essential medicines; and developing active linkages within the community and with NGOs to address the financial, transportation, educational, vocational and other social needs as some of the strategies to ensure holistic CBPC services. Trial registration: Clinical Trial Registry of India (CTRI/2023/04/051357). [ABSTRACT FROM AUTHOR]

AbstractThis study draws from qualitative research conducted using a participatory action framework with 47 young adults who identified as people living with HIV, men who have sex with men, transgender, non-binary, or sex workers in Vietnam. The research objectives were to explore their experiences using mobile phones to access sexual and reproductive (SRH) health information and support and the impact of the digital turn in health on their autonomy, privacy and equality. The research was conducted through key informant interviews, focus group discussions, and digital ethnography. The project utilised a participatory action research framework. The research was led by the Vietnam Network of People Living with HIV within the frame of a three-country study, and the authors describe how the network used the findings to advance policy. The paper concludes by proposing participatory action research as a useful methodology for studying human rights and digital health governance. [ABSTRACT FROM AUTHOR]

Current teacher education neglects educational needs, such as death education. A participatory action research (PAR) approach based on the needs and interests of teachers was adopted. One private and two state schools at all levels of non-university education were involved. The objective was to understand a process of change in teaching facilitated by PAR in the context of a teaching innovation project in death education. The results are presented according to the PAR phases. Conclusions are that the training process reduced the gap between scientific knowledge and educational practice, and that specific death education competencies were developed alongside personal growth amongst teachers. [ABSTRACT FROM AUTHOR]

The rapid growth in digital technologies continues to accelerate, bringing not only new opportunities, but also new challenges and needs to the field of education. As educational technologists design research to improve the implementation of learning technologies, they must adapt their research approaches to social and cultural contexts. In Participatory Action Research (PAR), teachers, students, or other members of the educational community participate as co-researchers who collaborate with researchers to build understanding and solve problems that are relevant to the school or community. This article describes the purpose, background, characteristics, and potential applications of PAR methods. It employs a meta-synthesis approach to investigate five adult-youth PAR collaborations that implement educational technology to meet needs in diverse educational and community settings. The main questions asked are: How can PAR advance educational technology research? In educational technology research, how can adult and youth collaborations in PAR benefit learning and the community? Results show that PAR collaborations not only provide opportunities to gather and assess information, but can also increase dialogue that leads to meaningful understanding, insightful action, and positive change in the community and digital environments. Findings suggest that, in educational technology research that is focused on improving learning or addressing a community need, combining technology with adult/youth collaborative research relationships can increase insights and understanding while moving community members to actively address the issue. [ABSTRACT FROM AUTHOR]

Cancer in teenagers and young adults (TYAs) coincides with major life transitions and presents unique psychosocial challenges. Understanding the experiences and needs of TYAs is critical. TYAs want to play an active role in improving cancer for TYAs; however, few opportunities exist for TYAs to do so. Using a tri-partite methodology, an international team collaborated with four TYA co-researchers in this pilot study to explore how performative staging strategies help convey TYA experiences with cancer. Using creative video, TYA co-researchers shared cancer experiences and insights in novel, impactful ways. The process provided intrinsic benefits for co-researchers to connect with other TYAs and creatively share their experiences and perspectives. Furthermore, it provided space for dialogue between TYAs and cancer care allies where TYAs could convey the nuances of their cancer experiences and how cancer care could be improved. This tri-partite methodology can support TYAs to actively engage in a process of connection, reflection, creation, and dissemination to improve cancer experiences for TYAs. [ABSTRACT FROM AUTHOR]

Introduction: The Activating Lived Experience Leadership (ALEL) project was a South Australian participatory action research project that aimed to improve the ways lived experience is recognised, valued and integrated across mental health and social sector systems. ALEL was completed during 2019–2021, where it engaged 182 participants in generating community action and research knowledge. Objective: Our paper discusses the project's processes of building a collective partnership among lived experience leaders and other leaders from within the sector, so that the actions and strategies identified through research could be implemented by systems‐level impact. We describe the collaborative process and key learnings that resulted in eight key action areas for transformative systems change in South Australia. Methods: The project invited a diverse range of self‐identified lived experience and other leaders to be involved in a PAR process featuring formal qualitative research (focus groups, surveys and interviews) as well as community development activities (leaders' summit meetings, consultations, training and community of practice meetings). These processes were used to help us describe the purpose, achievements and potential of lived experience leadership. Project priorities and systems‐level analysis was also undertaken with lived experience sector leaders and project advisors across two leaders' summit meetings, integrating research outcomes with sector planning to define high‐level actions and a vision for transformational change. Results: Participatory action research as informed by systems change and collective impact strategies assisted the project to generate detailed findings about the experiences and complexities of lived experience leadership, and collective responses of how systems could better support, be accountable to and leverage lived experience perspectives, experience and peer‐work approaches. Conclusion: Systems change to define, value and embed lived experience leadership benefits from collective efforts in both formal research and sector development activities. These can be used to generate foundational understandings and guidance for working together in genuine ways for transforming mental health and social sector systems, experience and outcomes. Public Contribution: Members of lived experience communities codesigned the project, and contributed to project governance and the development of all findings and project reports. [ABSTRACT FROM AUTHOR]

Issue Addressed: The Deadly RED redesign and implementation research aimed to improve take own leave (TOL) rates within a Queensland emergency department by providing a culturally competent care pathway. Methodology: A mixed methods pre/post evaluation of the feasibility, acceptability and usability of the Deadly RED pathway for First Nations patients presenting to ED was performed. This pathway combined early welcome and information sharing, introduction of screening and follow up for patients who TOL and enhanced access to alternative community healthcare. Yarning circles facilitated co‐design of research protocols and tools while a purposefully designed research Yarn enhanced understanding of the 'story' of the people. Qualitative analysis of Yarns allowed deductive themes to be extracted. A Participatory Action Research (PAR) approach and Indigenous research methodology involving First Nations people in design, knowledge sharing and joint ownership of results was used. Results: Common themes from the 85 yarns included the negative impact of long waiting times and positive impact from wholistic care. Unique themes identified included interpretation of waiting room placement and paracetamol prescription as a dismissal. Knowledge dissemination from yarning drove improvements in communications and processes to promote treatment completion resulting in elimination of these themes in post implementation yarns. Eighteen patients who had TOL were included in the post implementation yarns, however only eight of these believed that their treatment was incomplete. Conclusion: The use of yarning for consumer engagement has allowed deeper understanding of the reasons for TOL in First Nations emergency patients. The reciprocal knowledge sharing has guided targeted improvements in wholistic emergency care and communication resulting in First Nations patients feeling their care is complete even when the 'number' reports otherwise. So What?: Indigenous Research methodology including yarning with First Nations patients suggests alternative engagement methods to guide enhanced quality of care monitoring for ED presentations. [ABSTRACT FROM AUTHOR]

This article brings new empirical evidence and nuanced reflections on the social processes of transformation within grassroots agri‐food initiatives that propose relocalised, decentralised and autonomous ways of organising around food systems. We facilitated and analysed a fieldlab on the initial phase of designing a participatory guarantee system with a Dutch consumer‐buying group (CBG) who explored ways to define, measure and assess sustainable production and consumption in collaboration with its producers. Our analysis focuses on three social processes that emerged from this fieldlab: (a) deepening of community relations around and through agri‐food; (b) learning in agri‐food initiatives and (c) politicisation of agri‐food systems. We analyse the manifestations of and limitations of these three processes concerning the CBG's attempt to become a local food community. We conclude that our findings bring about practical, theoretical and strategic implications to understanding the social dynamics of grassroots agri‐food initiatives within and beyond capitalist agri‐food systems. [ABSTRACT FROM AUTHOR]

The article outlines a multidisciplinary theoretical-conceptual and methodological proposal for the study and support of what we have conceptualized as transnational social movements of migrants, made up of people affected by the consequences of migration: migrants, former migrants, immigrants, migrants in transit, and or their family members. These groups protest against the effects of temporary worker programs and base their struggles on injustices such as dispossession, abuse, discrimination, labor arbitrariness, exploitation, and disappearances of migrants. They shape their speeches from emotions such as grief, annoyance, indignation, and mourning for their missing relatives. All this added to the struggle for recognition and respect for social, economic, political, and cultural rights for migrants and their families. The multidisciplinary proposal is based on the historiographic line History of the Present Time; the 'restoration of historical memory' proposal is taken up from the studies of memory; and to analyze the future of the struggles the study of social movements is resorted to a theoretical pluralism. On the methodological level, oral history is proposed for the collection and treatment of testimonies, and through Participatory Action Research (PAR), it's proposed that greater rapprochement and eventual accompaniment of these groups be sought. [ABSTRACT FROM AUTHOR]

AbstractEvery individual has a fundamental right to communicate and access equal opportunities to fully participate in society. However, this right may not be fully manifested for individuals with communication access needs especially those from underrepresented groups. This project had two aims, to determine 1) the specific experiences, challenges, and aspirations related to the cultural identities of people of color (POC) who use augmentative and alternative communication (AAC) and 2) how AAC service providers and manufacturers can support POC AAC users in a culturally and linguistically responsive manner. We conducted an online, asynchronous focus group with seven participants over eight weeks. The participants’ responses were coded qualitatively. Seven major themes were identified: AAC is a Culture, AAC System Features, Self-Identity as a Person of Color who uses AAC, Experience with Service Providers, Improvements to the Field of AAC, Racial Inequities in AAC Support, and Future Research. Suggestions are provided regarding how service providers and manufacturers can serve as better allies to support POC who use AAC. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is a common and costly condition of pregnancy. The Healthy Gut Diet for Preventing Gestational Diabetes study is a novel randomised controlled trial that aims to prevent GDM through a diet that modulates the gut microbiota for pregnant women with GDM risk factors. Despite increasing interest in co‐designing interventions with consumers (lived experience experts), co‐design methods and outcomes are often poorly reported. The present study aims to report on the co‐design process used to develop The Healthy Gut Diet intervention. Methods: Co‐design occurred across three online workshops with consumer participants (women with a lived experience of GDM, n = 11), researchers (n = 6) and workshop co‐facilitators (including a consumer co‐facilitator, n = 2). The workshops explored women's preferences for the mode and length of education sessions, as well as the types of information and supportive resources women wanted to receive, and undertook a "behaviour diagnosis" to understand barriers and enablers to the target behaviours (eating for gut health). The final intervention is reported according to the Template for Intervention Description and Replication. Results: A co‐designed dietary intervention (The Healthy Gut Diet), delivered via telehealth, with a suite of educational and supportive resources that integrates published behaviour change techniques, was developed. Generally, the co‐design process was reported as a positive experience based on participant feedback and evidenced by no participant dropouts over the 3‐month study period. Conclusions: Co‐design is recognised as a process that creates a partnership between lived experience experts and researchers who can engage and empower research recipients and improve health behaviours. Highlights: Co‐designing dietary interventions with consumers can reduce research waste, improve applicability and intervention adherence, and enable selection of behaviour change techniques.Although increasing in popularity, co‐design methods, processes and outcomes are minimally described in diet research.Co‐design for The Healthy Gut Diet for Preventing Gestational Diabetes study involved 12 consumers with a lived experience of gestational diabetes and six researchers.Three online co‐design workshops were used to explore and decide on educational formats, content and delivery for the intervention, communication methods and a "behavioural diagnosis".The result was a dietary and behaviour change intervention (The Healthy Gut Diet), which is reported using the Template for Intervention Description and Replication. [ABSTRACT FROM AUTHOR]

This article explores the concept of "public scholarship" and its different models, specifically the "public intellectual" and the "engaged scholar." The author reflects on their own research trajectory, moving from theory to practice to engagement, and argues that engaged scholarship is more accountable to the demands of justice. The article also discusses the barriers to engaged scholarship and suggests that the "engaged university" should center the work of activist scholars and their community partners. The author acknowledges the importance of diverse perspectives and the need to learn from research traditions that have paved the way. The text discusses the difference between public intellectuals and engaged scholars in the context of advancing justice. Public intellectuals speak to a broad audience but do not interact with specific public stakeholders or contribute to social change. Engaged scholars, on the other hand, work directly with non-academic interest groups to co-produce knowledge that leads to social change. The text emphasizes the importance of community-based research and the need to prioritize the learning of long-time community-based scholars to ensure the integrity and accountability of engaged scholarship. The author also reflects on their own academic trajectory and the limitations of theory in effecting change, highlighting the importance of understanding how scholarship participates in the material matrices of public life. This article discusses the importance of engaged scholarship, which involves collaborating with non-academic partners in the research process. The author shares their experience working on a project funded by the California Department of Cannabis Control to study the impact of cannabis cultivation on Tribal sacred sites and cultural resources. They [Extracted from the article]

This article examines how elderly people living in poverty established an active space for ancestral territorial management called Wiñenani-Pikenani Intergenerational School. 16 elders waorani of Ecuador acted as mentors of their kids. This school arises from critical social work to transfer important knowledge to live successfully in a biodiverse environment. The intergenerational learning as resistance to an extractive economy that systematically impoverishes and dispossesses them. The qualitative methodological contributions to learning by doing were: Ludic-Intergenerational Workshops, Daily Coexistence Space, and Knowledge Dialogue Meetings community-university. Concluding that participatory approaches must be continually rethought to include invisible people in circumstances of poverty. [ABSTRACT FROM AUTHOR]

Background: Nowhere is optimising healthcare staff retention more important than in primary health care (PHC) settings in remote Australia, where there are unacceptably high rates of staff burnout and turnover. Ensuing consequences for the remote health services and the community are acute – staffing shortfalls in clinics; organisational instability; excessive costs associated with frequent staff recruitment and orientation; diminished access to PHC for patients in need; and lack of continuity of patient care; all of which further entrench poor health outcomes for the community. Optimising remote healthcare staff retention is critical in order to provide high quality and continued PHC. Currently, however, there is paucity of knowledge to inform targeted and effective retention strategies in remote health services. This research program seeks to develop a stronger evidence base to understand (i) what retention strategies are effective in improving morale, job satisfaction, intention to remain in the job, and consequent length of service for remote healthcare staff; (ii) how best to 'bundle' these strategies for different health workforce groups; and (iii) how these 'bundles' work in different service contexts. Methods: This paper describes a five-year implementation research program in partnership with twelve remote Aboriginal and Torres Strait Islander Community Controlled Health Services (ATSICCHS) in the Northern Territory and Queensland, Australia. Overall methodology follows a participatory action research approach which incorporates co-design and realist elements. The program comprises two broad phases involving evidence consolidation and synthesis (Phase 1), and co-design, implementation, and prospective evaluation of 'bundles' of retention strategies (Phase 2) to improve retention of healthcare staff in participating ATSICCHSs. Discussion: This innovative research program has the potential to develop a comprehensive evidence base required to optimise health workforce retention in remote health services. This new evidence will strengthen understanding of what 'bundles' of retention strategies are effective, for which groups of employees, and how they work to improve staff retention. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONThis study aims to overcome the challenges experienced in the regional development and implementation of home-based stroke rehabilitation (HBSR) and to understand the change process needed.Using participatory action research (PAR), participants and researchers collaboratively produced knowledge and took action to improve the offered HBSR. Different methods for data generation and analysis were used, depending on the aim of the PAR phase and the participants’ stages of change. The Consolidated Framework for Implementation Research (CFIR) was used to select implementation strategies and to evaluate the implementation process.Developing and implementing HBSR resulted in multiple products that promoted the implementation of a regional stroke network and affiliated work arrangements. Work arrangements were embodied in a stroke care pathway, follow-up tool, and expertise requirements. Evaluating the PAR process identified participants being able to take the lead, being facilitated by others, and making progress visible, as implementation facilitators. Collaborating within a primary care project can be challenging but is considered essential and has a positive impact on multiple levels. Also, the implementation of HBSR calls for multiple implementation strategies reflecting multiple CFIR constructs.This study highlights the complexity and achievements of developing and implementing HBSR using PAR.When developing home-based stroke rehabilitation, important topics concern: interprofessional collaboration, follow-up care, professional expertise, attention to the social network and “invisible consequences” of stroke, case management, and supporting self-management.When developing a regional stroke network, viewpoints and work arrangements should be documented, for example through a stroke care pathway, and a tool for follow-up care. This can overcome the challenges experienced regarding interprofessional collaboration while delivering home-based stroke rehabilitation.When implementing a complex intervention such as home-based stroke rehabilitation, participatory action research can be used to empower professionals and to facilitate the development of practical solutions to experienced implementation problems in the community.When developing home-based stroke rehabilitation and/or executing participatory action research, facilitation by a person with an overview of the project is important to guide the knowledge transformation process.When developing home-based stroke rehabilitation, important topics concern: interprofessional collaboration, follow-up care, professional expertise, attention to the social network and “invisible consequences” of stroke, case management, and supporting self-management.When developing a regional stroke network, viewpoints and work arrangements should be documented, for example through a stroke care pathway, and a tool for follow-up care. This can overcome the challenges experienced regarding interprofessional collaboration while delivering home-based stroke rehabilitation.When implementing a complex intervention such as home-based stroke rehabilitation, participatory action research can be used to empower professionals and to facilitate the development of practical solutions to experienced implementation problems in the community.When developing home-based stroke rehabilitation and/or executing participatory action research, facilitation by a person with an overview of the project is important to guide the knowledge transformation process. [ABSTRACT FROM AUTHOR]

Consent is essential for legal and ethical psychological practice. EPs in the UK work with children and young people from ages 0 to 25, meaning that consent gaining practices must take account of the complexities of different professional guidelines, legislation, and case law depending on the age and competence of individual service users. This study used participatory action research to develop consent gaining guidance specific to EPs, considering issues related to children’s rights, parental responsibility, Gillick competence, mental capacity, and data protection. Findings from a preliminary study were used by a stakeholder group of EPs to create draft guidance. The project was guided by a working party comprising a trainee educational psychologist, a main grade EP, a professional body representative and a solicitor specialising in education law. Implications for professional practice and future research are discussed. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this demand driven research is to co-design an intervention for upper-secondary students that addresses issues of consent and healthy relationships. In this paper, we (university researchers, student coresearchers, school staff), present the engagement framework that has been critical to the project's development and planned implementation. Methods: An iterative co-design approach grounded in a participatory research approach is currently being adopted. Student co-researchers from three independent secondary schools on Whadjuk Nyungar Country in Boorloo/ Perth, Western Australia, have been engaged as co-researchers in the design of the intervention. Supplementary quantitative and qualitative data from students enrolled at each school site is also being collated to further inform the intervention design. Student co-researchers will provide insights on the overarching design of the intervention including: the scope of key concepts they want to learn, interpretation of supplementary data, and the development of contextually relevant educative content. Results: Retrospective and prospective components of the engagement framework are described and supported with applied examples where applicable. Preliminary results demonstrate the imperative of adopting iterative co-design, and the efficacy of our authentic engagement framework. A draft intervention has been formalized and will soon undergo piloting. The codesign process has already resulted in an intervention that differs from the initial program first conceptualized by university researchers. Conclusion: Imperative to our engagement framework is centering students as experts of their lived experience. It is anticipated that this engagement framework will provide insights around the feasibility, value, and necessity for authentic engagement of upper-secondary school students in the design of their consent and healthy relationship education. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Methods Results Conclusion Impact Reporting Method Patient or Public Contribution To explore patterns and dynamics during the co‐design process of nurse practitioners' role development in three departments in a Belgian tertiary hospital.Participatory action research was utilised in conjunction with principles of a Grounded Theory approach to explore patterns and dynamics.Sixteen meetings were conducted between January and June 2021 with interdisciplinary teams to develop the roles. Thirteen exploratory interviews were held with the stakeholders involved between March and June 2022. All meetings and interviews were recorded and transcribed verbatim. Data were systematically analysed using researcher triangulation and thematic analysis.Stakeholders' initial conception of the nurse practitioner roles affected development. A dynamic interplay of individual, team‐related and contextual (e.g., financial and legal) factors shaped these conceptions. Through co‐design, stakeholders' conception evolved as insights were shared, misconceptions challenged and perspectives broadened. Physicians generally the developmental process, while nursing leadership was more fragmented.This study identifies patterns and dynamics in interdisciplinary teams during the developmental process. The key findings underpin the crucial role of stakeholders' conceptions, use of co‐design and leadership in this process. Therefore, a thorough understanding of initial conceptions is ess, and efforts should be directed towards providing sufficient knowledge and experience to prevent misconceptions. Additionally, this study emphasises the significance of a balanced team composition that incorporates diverse conceptions of the role. Finally, actions should be taken to empower leadership among nurses.Identified dynamics offer insights for healthcare organisations developing nurse practitioner roles. Educational institutions can use these insights to enhance healthcare professionals' curricula, preparing healthcare professionals for evolving advanced nursing roles and leadership. Additionally, it emphasises the necessity for policy work to establish a legal framework for nurse practitioners in Belgium.The ‘Standards for Reporting Qualitative Research’ were used for reporting.This study did not involve direct participation from patients or the public. [ABSTRACT FROM AUTHOR]

This paper presents a practice-based enquiry exploring how photovoice methods can be adapted to visualise caring behaviours in multi-sited contexts, within an environment and peace education context. Photovoice methods typically have an exclusively single-sited focus that can neglect opportunities for empathy and cross-cultural engagement that arise when considering multiple sites. This research explores these opportunities through broadening and integrating multi-sited dimensions into photovoice processes. Two novel multi-sited photovoice methods are adapted – photo-action interviews, and photo-letter exchanges, with participating youth in urban sites across Bangladesh, Australia and China. The visualisations of caring actions depicted in the resulting photo-stories are then analysed, affirming these methods’ efficacy and inviting expanded considerations of agency and subjectivity as represented through the images. I employ an analytical approach encompassing both qualitative content and relational analysis across the interview and exchange methods to affirm the importance of materiality, relationality and empathy to participation and visualisation of environmental caring behaviour. These explorations of novel photovoice methods in multi-sited contexts confirm the importance of bringing global perspectives to local photovoice practices, contributing to participatory visual research in environmental and peace educational contexts. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To explore experiences of nursing home staff in implementing self‐designed interventions to foster trusting relationships with family in practice.This qualitative study used a Participatory Action Research approach.Data collection included focus groups (n = 15), interviews (n = 28) and observations (n = 5). A holistic narrative approach was used for data analysis, resulting in co‐constructed narratives representing experiences of nursing home staff in implementing four different interventions in five Dutch dementia special care units in nursing homes. The data collection period began in August 2021 and ended in April 2022.Nursing home staff implemented self‐designed interventions to foster trusting relationships with family, including initiating informal conversations, sharing residents’ ‘happy’ moments, discussing mutual expectations, and being more aware of families’ emotional burdens. Identified facilitators emphasise the importance of reciprocity, familiarity, transparency, realistic goal setting and empathy. Identified barriers are related to moral uncertainty in balancing competing demands, conflicting social norms, prioritising hands‐on care tasks over family contact and lack of courage to act.Nursing home staff conclude that their interventions contribute positively to building and maintaining a trusting relationship with families.Sharing the narratives of nursing home staff with peers would support them in implementing interventions to foster trust. Regular Moral Case Deliberations can be used to address moral uncertainty. Collective dialogue among nursing home staff can be useful in establishing new social norms that prioritise family involvement. Conversation skills training can empower nursing home staff.Trust between nursing home staff and families can be improved by implementing the conducted interventions.This report adheres to the standards for reporting qualitative research (COREQ).No patient or public contribution. [ABSTRACT FROM AUTHOR]

ABSTRACT Smoking is responsible for over 8 million deaths globally per annum. While socially disadvantaged communities are disproportionately affected, few interventions effectively reach these groups. We progressed a participatory action research (PAR) study on smoking‐related health inequalities in the context of the current UK cost‐of‐living crisis. We worked with people living in deprived neighbourhoods in rural northeast Scotland. The objective was to engage affected communities together with the health authority in cooperative action learning. Community‐based participants (n = 9) engaged in a series of workshops (n = 8) adopting roles as co‐researchers, collecting and arranging new data and evidence. We then connected with service providers in a series of additional workshops (n = 3) to analyse and interpret the data, appraise local action and reflect on the process. Community partners identified a convergence between increased stress owing to the crisis, and increased availability, affordability and acceptability of tobacco‐related products, namely e‐cigarettes. The situation was compounded by lack of awareness of available cessation services. A shared action agenda was developed prioritising: (a) the stress‐related root causes of smoking, (b) inclusive access to cessation support, (c) incentivised cessation with locally framed messaging and (d) deliberative dialogue between communities and service providers. There was a high level of engagement, openness and honesty and the strategic relevance of the process was acknowledged. The study provides holistic understandings of health and hardship and demonstrates that existing services can be enhanced with community intelligence. We provide practical methods to support policy commitments to community health emphasising mutual empowerment between service users and providers. [ABSTRACT FROM AUTHOR]

The article focuses on the final years of my PhD research in which I (Bernadette) explored in-school professional learning opportunities with a group of teachers who were working to support collaborative teaching methodologies to allow pupils to take an active role in their learning. This was set in the context of the development phase of Cosán, the national framework for teachers’ learning in Ireland, in which the profession could examine what it would mean for them in the context in which they practise. Explicit in this framework is the emphasis on the growth of teacher professional learning to enhance student outcomes. Central to this is reflective practice. The reader will see how this research shows that our facilitated engagement in the process of reflection through ongoing, sustained, critical and collaborative conversations allowed us not only to celebrate successes but also to challenge values, beliefs, and assumptions about why we do what we do, supporting us to make conscious decisions about possible future actions. In taking ownership of our practice, we were motivated to take the risk to examine it and take collective responsibility for making a difference in each other’s learning and in the interests of improving student learning. [ABSTRACT FROM AUTHOR]

Research demonstrates that young people value mental health support that is tailored to their needs and preferences, rather than a "one size fits all" offer, which is often not equitably accessible (National Children's Bureau, 2021). Understanding young people's lived experiences across different sociocultural contexts is important. The aim of this research was to conduct an international qualitative study on the views of young people with lived experience and professionals, on proposed aspects of personalised support for anxiety and/or depression. Participatory action focus groups were conducted with N = 120 young people with lived experience of anxiety and/or depression (14–24 years) and with N = 63 professionals in Brazil, India, Kenya, Pakistan, Portugal, South Africa, Turkey, and the United Kingdom. Data were analysed using the rigorous and accelerated data reduction (RADaR) technique. Overall, although some country-specific differences were found in terms of what aspects of support young people found to be most important, individual preferences were considered stronger, furthering the view that support should be personalised to the needs of the individual young person. Young people experiencing anxiety and/or depression should be able to choose for themselves which aspects of support they would prefer in their own care and support plans, with families and mental health professionals providing guidance where appropriate, rather than removing the young person from the decision-making process altogether. It should also be ensured that the aspects of personalised support can be understood by young people and professionals from different contexts, including marginalised and minoritised groups and communities. [ABSTRACT FROM AUTHOR]

After the 1960s, breeding activities carried out on many crops, including wheat, and the use of chemical fertilizers and pesticides, saw increased criticism of the negative consequences in terms of nutrition, social, and environmental impacts. There is a current re-emphasis upon changing the methods of flour and bread production technologies, and wheat landrace varieties have made a resurgence. Wheat landrace varieties have become widespread and create the demand for their consumption as an alternative to industrial wheat. Producers have come together to form collectives of different structures and seek ways to expand production of wheat landraces. As a result, alternative food consumption communities have become established in which consumers can access wheat landrace products. The factors related to the development of wheat, flour, bulgur, bread, etc. should be put forward to consumers and producers. The fieldwork of this research is based on five community supported food groups formed by consumers in the İzmir province of Turkey, and associations/groups that produce wheat varieties in Çanakkale, Balıkesir and Kars provinces. The aim of the research is to identify common problems that reduce the separation between wheat production and consumption and how to increase the use of wheat landraces and their products by using participatory action research. [ABSTRACT FROM AUTHOR]

With the rapidly emerging development of technology-mediated tourism experiences and place-based digital services for visitors, there is a lack of awareness regarding the spatial implications of technological implementations. Based on a participatory action research method applied in this study on five research-based destination development projects in Sweden, we propose a spatially sensible approach when developing enhanced experiences for visitors through digital technology. This paper is motivated by the emerging criticism of how media technology is shaping and reshaping spaces. Drawing on the theoretical underpinnings of the growing field of geomedia studies, we propose "geomedia sensibility" as a way to offer a sensible approach in the co-creation of digital experiences at destinations. [ABSTRACT FROM AUTHOR]

Settlers of colour occupy a liminal space in the settler colony of Australia, and this liminality was exacerbated during the COVID‐19 pandemic. Through the literature on digital activism, technological immersion, and placemaking, this paper explores Radical Placemaking as a route for culturally and linguistically diverse (CALD) people based in Brisbane to stake their right to the city through alternative digitised modalities. Three projects using situated digital stories were created: (i) the Chatty Bench Project; (ii) the TransHuman Saunter Project; and (iii) Chatty Bench Festival Community Media Visual Projections. We analysed the experiences of study participants creating the digital stories and eventual user experiences of the stories for their ability to provoke self‐reflection, immersiveness, and belonging through evocation and representation of lived experiences. The paper suggests that radical placemaking offers CALD communities subversive tactics of occupying space through emerging technologies without engaging in erasure of existing histories of place. [ABSTRACT FROM AUTHOR]

Research on interventions that aim to cultivate character strengths, or virtues, has been conducted primarily among highly resourced, predominantly White communities, and the interventions have been developed to reflect the values of those communities. The purpose of this study was to use a participatory action research approach to develop a virtue intervention focused on addressing the community-identified problem of violence in a predominantly Black community, and to test its effectiveness in a pilot study. Participants were 37 youth (M age = 12.1 years old; 97% Black) who attended summer programs in two sites (on intervention, one control condition). Participants in the intervention group had greater increases in effective nonviolent behavior than participants in the comparison group according to teacher report. Overall, the results of this pilot test suggest it is possible to build a feasible, attractive, evidence-based intervention to promote character strengths using participatory action research. [ABSTRACT FROM AUTHOR]

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Introduction: The use of e-cigarettes is increasing worldwide, especially among young adults. Due to the health risks, this study aimed to assess undergraduate students' e-cigarette use and attitudes toward them, and evaluate the effectiveness of an intervention program to develop e-cigarette control leaders at the University in Lampang province, Thailand. Methods: Participatory action research (PAR) was conducted among 46 undergraduate students. To assess the situations of undergraduate students' e-cigarette use and attitudes toward them, in-depth interviews were conducted with 18 of those students – nine users and nine non-users. The remaining 28 were student leaders who were given questionnaires and took part in focus groups to evaluate the effectiveness of the intervention program in developing e-cigarette control leaders. Descriptive statistics and the Wilcoxon signed rank test were used to analyze quantitative data. The qualitative data were analyzed using a thematic analysis of the content. This study took place at the University in Lampang province, Thailand, in 2023. Results: Regarding the use of e-cigarettes on the part of undergraduate students and their attitudes about their use, the majority of users stated that e-cigarettes were accessible, appealing, and more socially acceptable than conventional cigarettes. However, most non-users cited vapor smell and health impacts as their main reason for not using e-cigarettes. The intervention program to develop leaders in e-cigarette control could significantly enhance the leaders' knowledge (p<0.001) and attitude regarding e-cigarettes (p=0.001). After their anti-e-cigarette campaign, the soft skills and managerial abilities of the leaders in e-cigarette control improved, and the knowledge and attitude regarding e-cigarettes of undergraduate students who attended the campaign also increased. Conclusions: The intervention program to develop leaders in e-cigarette control resulted in positive outcomes. This program could enhance the leaders' knowledge and attitude regarding e-cigarettes. Their soft skills and managerial abilities in e-cigarette control also improved. [ABSTRACT FROM AUTHOR]

Private Islamic schools in Southern Thailand face significant challenges, particularly in adhering to national educational standards, which impacts students' academic outcomes. Most Islamic Studies teachers lack formal pedagogical training, resulting in a teaching approach that often fails to engage students effectively. This study employed participatory action research (PAR) involving 32 Islamic Studies teachers across 10 schools. The research was structured around the four phases of PAR: establishing relationships, collaborative design, implementation through LS and Open Approach, and reflective assessment. The implementation of Lesson Study and Open Approach led to significant improvements in teaching practices, shifting from traditional teacher-centered methods to learner-centered approaches that emphasized critical thinking, self-directed learning, and the integration of ICT. This study demonstrates that adapting LS to the context of Islamic education can enhance professional development for teachers and improve educational outcomes. This approach could serve as a model for broader educational reforms in the region. [ABSTRACT FROM AUTHOR]

Critical Participatory Inquiry (CPI) is an emergent epistemological anchoring of Participatory Action Research (PAR) that grounds its users in a spectrum of participation that considers the way that social constraints including race, politics, and power dynamics influence how researchers operationalize and practice amplification of minoritized voices in their research. This article is a scholarly and reflexive perspective piece that invites scholars, practitioners, and scholar-practitioners to explore the ontology and axiology of their own ideologies and their alignment with how they show up in the world and how they manage the implicit hierarchies within healthcare research and within healthcare organizations. The author uses her own positionality to explain how she grounds and frames her research in her lived experience and personal truths. It considers the types of knowledge and the knowledge holders that are privileged in academia and compares that to the realized hierarchies and power dynamics in the healthcare setting. [ABSTRACT FROM AUTHOR]

Globally, migrant and culturally and linguistically diverse (CALD) communities are known to have inequitable access to HPV vaccination. One participatory research approach used to engage CALD communities around vaccination is participatory action research (PAR), but we know little about the use of PAR to engage priority migrant and CALD communities around school and HPV vaccination. To address this gap, we partnered with our local Multicultural Health Service to understand how the largest CALD group in our region of New South Wales, Australia, engages with their local school and HPV vaccination program. Through a long-standing PAR relationship, we used a participatory research method (World Café) approach to explore the level of awareness and engagement a multi-generational community member had concerning HPV vaccination. We acted by sharing a co-designed information website to answer the community's questions about HPV vaccination. We then evaluated these engagements with surveys, focus groups and online analytic platforms. Last, we reflected with project partners and health service stakeholders on the overall project outcomes and shared our learnings. In our discussion, we shared our lessons learned and contributed to a wider conversation about the benefits, challenges, and practicalities of using PAR to engage a priority CALD community around HPV vaccination. [ABSTRACT FROM AUTHOR]

Abstract Background Social isolation and loneliness are a growing public health concern. Inadequacies in neighbourhood social infrastructure can undermine social connectedness, particularly for youth, who are dependent on their local environments yet often marginalized from public spaces and city planning. Integrating citizen science with participatory action research, the Youth.hood study set out to explore how neighbourhood built environments help or hinder social connectedness from the understudied perspective of youth in under-resourced and racialized communities. Methods Youth (n = 42) from three neighbourhoods in Vancouver, Canada were recruited to: (1) Assess environmental assets and barriers to connectedness in their neighbourhoods using a digital photovoice app; (2) Analyze and prioritize their collective data into themes; and (3) Design and advocate for environmental improvements through a participatory workshop and forum with residents, city planners, and elected officials. Data on participant characteristics and neighbourhood perceptions were collected via an online survey and analyzed descriptively. Participatory analysis was conducted with youth using methods from thematic analysis, photovoice, and design thinking. Results Youth captured 227 environmental features impacting their connectedness. The most frequently reported assets were parks and nature (n = 39, 17%), including formal and informal green spaces, and food outlets (n = 25, 11%). Top barriers included poor neighbourhood aesthetics (n = 14, 6%) and inadequate streets and sidewalks (n = 14, 6%). Thematic analysis with youth underscored four themes: (1) Connecting through mobility: The fun and functionality of getting around without a car; (2) The power of aesthetics: Mediating connections to people and place; (3) Retreating to connect: Seeking out social and restorative spaces for all; and (4) Under-resourced, not under-valued: Uncovering assets for sociocultural connection. Youth described their local environments as affording (or denying) opportunities for physical, emotional, and cultural connection at both an individual and community level. Conclusion Our findings extend evidence on key environmental determinants of social connectedness for youth, while highlighting the potential of community design to support multiple dimensions of healthy social development. Additionally, this work demonstrates the resilience and agency of youth in under-resourced settings, and underscores the importance of honouring assets, co-production, and intergenerational planning when working to advance healthy, connected, and youthful cities.

Purpose: It appears to be inadequate communication and a lack of information transfer between physiotherapists in the specialist (SH) and primary health services (PH). This project aimed to develop and test recommendations for the content of discharge summaries and routines to improve communication. Method: A working group was established with physiotherapists from SH and PH with diverse backgrounds and areas of responsibility. Through co-production, they developed templates with recommendations for the content of discharge summaries. These templates were tested in practice and evaluated by clinicians. Findings: Challenges and expectations were revealed in the interaction between physiotherapists in SH and PH. Each topic was discussed, resulting in the creation of discharge summary templates, along with guidelines for their use. The results showed that the discharge summary templates contributed to a more comprehensive service. However, several physiotherapists reported that differences in digital solutions were a major challenge. Conclusion: Our experience indicates that co-production can be a useful method for identifying and highlighting clinical challenges, generating new understandings, ideas and a sense of ownership, and applicable solutions for clinical practice. We believe that the template can be used by physiotherapists with similar needs.

Abstract Background Individuals with a higher level of awareness and knowledge of HPV are more likely to dispel misconceptions about HPV and reduce their likelihood of engaging in risky sexual behavior. Behavioural change can be achieved through interventions such as participatory action research (PAR), which has been applied in various contexts. Few studies have reported on the use of PAR in Nigeria. This study aims to utilise PAR as an intervention to increase HPV awareness, improve knowledge of HPV infection, and promote behavioural change for HPV prevention among young adolescents in Benue State, Nigeria. Methods The study design uses a school-based, pre-post intervention approach with a cross-sectional component. Study participants are young adolescents aged 10–19 years in selected co-educational secondary schools in three local government areas (LGAs) spread across the three senatorial zones in Benue State, Nigeria. Two-stage sampling was used to select the LGAs and schools, and the sample size was computed using the before and after implementation with some prior information from a previous study. Data on sociodemographic characteristics, HPV awareness and knowledge of infection and prevention, prevention practices, and willingness for HPV vaccination were obtained with a self-administered semi-structured questionnaire adapted from the Vaccination and HPV Knowledge (THinK) survey. The HPV Knowledge survey (New Zealand) was utilized to collect information from students at baseline and post-implementation after PAR intervention. The Wilcoxon Signed Test (WST) was used to investigate the significance of the median differences before and after the intervention. A p-value less than 0.05 or 0.001 was considered significant. Results A total of 548 adolescents were sampled before the intervention. After the intervention, the sample size decreased to 503, reflecting an 8% attrition rate. PAR effectively increased HPV awareness among the participants from 80.9% before the intervention to 99.8% afterward. The PAR led to a significant change in knowledge of HPV infection and primary prevention and an increase in perception of HPV primary prevention. decrease in misconceptions and risky sexual behaviours, increase in HIV screening tests, and increase in the willingness of participants to uptake the HPV vaccine. Among the measures of risky sexual behaviours was a decreased perception that having more than one sexual partner is not a risk factor for HPV after the PAR intervention. The number of participants in sexual relationships decreased from 84 (16.7%) at baseline to 37 (7.4%) post-implementation. The PAR also led to a decrease in the number of participants who reported having STDs. The Wilcoxon Signed test was further disaggregated based on sex (male and female), school funding type (public and private), and school class level (junior and senior). Conclusions PAR led to a significant increase in awareness and knowledge of HPV, knowledge of different aspects of HPV infection, and willingness to uptake the HPV vaccine. Additionally, the study has provided evidence that PAR interventions can be a viable tool in delaying sexual initiation and reducing sexual behavioural tendencies, especially in high-risk groups.

Abstract Background Stroke survivors face many barriers to physical activity (PA). Solving physical inactivity after stroke requires a “systems-based” approach. We aimed to develop a complex intervention targeted at improving PA after stroke in Singapore using behaviour change theory and a co-design approach involving multiple stakeholders. Methods We carried out the intervention development in three phases: i. preparation phase, ii. co-design phase, and iii. intervention refinement phase. During the preparation phase, we conducted surveys (n = 38 stroke survivors, 71 physiotherapists and 35 exercise professionals) and interviews (n = 19 stroke survivors) to understand the factors influencing PA after stroke. The co-design phase consisted of two-co-design workshops held in August 2022 and were attended by 13 stroke survivors and 4 caregivers. Relevant domains of the Theoretical Domains Framework (TDF) and items in the Template for Intervention Description and Replication (TIDieR) checklist guided the discussion topics in the first co-design workshop. Solution prototypes such as exercise videos, arm and leg straps and information resources were shown in the second co-design workshop to gather feedback. In the intervention refinement phase, eight healthcare professionals from various sectors participated in two virtual Zoom meetings in August 2023, and used the Acceptability, Practicability, Effectiveness, Affordability, Spillover effects and Equity (APEASE) grid to rate the active ingredients in the complex intervention by considering the current healthcare landscape in terms of resources and manpower. Results Stroke survivors and caregivers want a personalised PA program, stroke-specific PA opportunities and information resources, medical clearance, advice and help from healthcare professionals skilled in stroke care, face-to-face sessions at preferred exercise spaces, and access to adaptive equipment. A complex intervention consisting of 21 behaviour change techniques, 6 intervention functions and 8 options was developed. Conclusions Using behaviour change theory and a co-design approach involving multiple stakeholders, a complex intervention was developed to target physical inactivity after stroke. The intervention titled MOTIVATE is currently being tested in a type 1 hybrid effectiveness-implementation trial.

This empirical study examines the factors that pose challenges to the implementation of instructional leadership in township secondary schools in the Western Cape province of South Africa. The study adopts Critical Emancipatory Research (CER), which promotes peace, hope, freedom, and social justice, as its theoretical framework. Participatory action research (PAR), utilising focus group interviews, is employed to collect data. PAR is situated within a transformative paradigm, and a qualitative research approach is chosen to align with this paradigm. Data is collected through focus group discussions with the school management team (SMT), consisting of the principal, two deputy principals, and six heads of department. These discussions aim to gather information on threats to instructional leadership and strategies to mitigate these threats. The findings reveal that the local community and its dynamics, along with the prevalence of violence in the neighbourhood, are external factors that significantly impede the smooth operation of the school and negatively affect the implementation of effective instructional leadership. Conversely, factors such as limited interference from the local community, reduced workload, adherence to compliance guidelines and requirements set by the Department of Education, and an unimpeded leadership role for the management team may contribute to the successful implementation of instructional leadership. Therefore, the study recommends promoting effective and transparent communication as well as open engagement among all stakeholders within the school.