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Community-Engaged Research to Address Health and Healthcare Disparities

Special Issue Editors


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Guest Editor
School of Global Public Health, New York University, New York, NY 10003, USA
Interests: biostatistics; community health; community-based participatory research; health disparities; health equity; minority health; quantitative research
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Guest Editor
Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA
Interests: African American racial identity; mental health services use; cancer screening; cultural competence; community engagement; disparities in health and mental health; implications of race and ethnicity for health behavior and promotion; HPV vaccination

Special Issue Information

Dear Colleagues,

We define community-engaged research as that which has community, patient, and/or stakeholder engagement, feedback, and bidirectional communication as approaches used in the research process. Engaging community health stakeholders in the research process is often the missing link to improving the quality and outcomes of health promotion activities, disease prevention initiatives, and research studies.

Health and healthcare disparities research has three phases, and each phase asks different types of research questions. The detection phase seeks to determine if disparities exist. The understand phase seeks to determine the root causes of health disparities. The solutions phase is focused on developing, testing, and implementing potential solutions to address health disparities. A significant amount of the literature is focused on the detection phase. It is necessary to focus our efforts on understanding the root causes and developing sustainable solutions that address modifiable risk factors, policies, and system- and community-level issues in order to reduce and eliminate disparities in health and healthcare.

This Special Issue seeks papers on community-engaged research to address health and healthcare disparities in the understand and solutions phases. We are interested in all forms of disparities (e.g., racial/ethnic, socioeconomic status, and sexual orientation) that impact vulnerable populations across a broad range of health outcomes (e.g., access, prevention, treatment, policy, mental health, and physical health). 

Prof. Dr. Melody Goodman
Prof. Dr. Vetta Sanders Thompson
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • community engagement
  • health disparities
  • health inequities
  • stakeholder engagement
  • healthcare disparities
  • engagement science

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Published Papers (10 papers)

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Research

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13 pages, 759 KiB  
Article
Say Something, Do Something: Evaluating a Forum Theater Production to Activate Youth Violence Prevention Strategies in Schools
by Keon L. Gilbert, Elizabeth A. Baker, Karen Bain, Julia Flood and John Wolbers
Int. J. Environ. Res. Public Health 2024, 21(1), 39; https://doi.org/10.3390/ijerph21010039 - 27 Dec 2023
Cited by 1 | Viewed by 2199
Abstract
Background: Youth violence that takes place within school settings exposes youth to serious social, mental and physical consequences that affect education performance, and life opportunities. Previous work shows positive youth development frameworks can promote social-emotional learning by enhancing empathy and building problem-solving and [...] Read more.
Background: Youth violence that takes place within school settings exposes youth to serious social, mental and physical consequences that affect education performance, and life opportunities. Previous work shows positive youth development frameworks can promote social-emotional learning by enhancing empathy and building problem-solving and conflict management skills. Theater-based interventions have been shown to enhance social emotional development by privileging youth voices, and building youth capacities and strengths. The current manuscript presents the evaluation of an arts-based and public health framework conducted to assess the development, implementation and impact of a forum theater production, Say Something, Do Something (SSDS) in St. Louis, Missouri. Methods: An iterative mixed methods approach was used, starting with observations of productions. Using convenience sampling, we then conducted post interviews of the theater team (n = 8) and school personnel (n = 10). Results: Respondents highlighted that as a result of engagement of school personnel in program development, the language and scenarios presented were relevant to students. Data indicated that SSDS increased student knowledge and changed attitudes, developed student conflict management and problem-solving skills, and improved interpersonal behavior. SSDS also raised awareness of the importance of, and created the foundation for, additional system and policy changes in the schools. Conclusion and implications: Forum theater is an approach that can enhance socio-emotional learning and conflict management among youth. Collaborative initiatives between public health and the arts are poised to uniquely engage community partners, animate interventions, and impact critical public health issues including youth violence prevention. Full article
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16 pages, 3885 KiB  
Article
Photovoice Reveals Residents’ Concerns for Air and Water Quality in Industry-Impacted Rural Community
by Shelby M. Rimmler, Sarah Shaughnessy, Ellis Tatum, Naeema Muhammad, Shaelyn Hawkins, Alexandra Lightfoot, Sherri White-Williamson and Courtney G. Woods
Int. J. Environ. Res. Public Health 2023, 20(9), 5656; https://doi.org/10.3390/ijerph20095656 - 27 Apr 2023
Cited by 1 | Viewed by 2060
Abstract
Rural communities of color in the southeastern U.S. experience a high burden of environmental hazards from concentrated industry placement. Community-engaged research and qualitative methods can improve our understanding of meaning-making in a community impacted by polluting facilities. This study applies the photovoice method [...] Read more.
Rural communities of color in the southeastern U.S. experience a high burden of environmental hazards from concentrated industry placement. Community-engaged research and qualitative methods can improve our understanding of meaning-making in a community impacted by polluting facilities. This study applies the photovoice method to assess how a predominantly African American community in rural North Carolina, impacted by a landfill and confined animal feeding operations (CAFOs), perceives their health-related quality of life (HRQoL). Two research questions were developed with community-based partners: (a) How do environmental health concerns in this community influence residents’ perceptions of their HRQoL? and (b) How do community and county factors facilitate or inhibit community organizing around these concerns? Three photo assignment sessions were held to engage participants in discussions related to the research questions. Researchers analyzed discussion audio recordings and identified themes related to concerns about the following issues: health and quality of life, the landfill industry’s influence on community cohesion and self-determination, and actions to address environmental injustice in Sampson County. Photovoice benefits community-engaged researchers by providing a process for assessing the research interests of a community. Photovoice also serves community organizers by providing residents with a structured way to discuss their lived experiences and strategize ways to reduce hazard exposure. Full article
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24 pages, 1138 KiB  
Article
Collaboration for Developing and Sustaining Community Dementia-Friendly Initiatives: A Realist Evaluation
by Marjolein Thijssen, Maud J. L. Graff, Monique A. S. Lexis, Maria W. G. Nijhuis-van der Sanden, Kate Radford, Pip A. Logan, Ramon Daniels and Wietske Kuijer-Siebelink
Int. J. Environ. Res. Public Health 2023, 20(5), 4006; https://doi.org/10.3390/ijerph20054006 - 23 Feb 2023
Cited by 3 | Viewed by 2082
Abstract
Background: Dementia-friendly communities (DFCs) are seen as key to the inclusion and participation of people with dementia and carers. Dementia-friendly initiatives (DFIs) are important building blocks for the growth of DFCs. The collaboration between different stakeholders is a central aspect in developing and [...] Read more.
Background: Dementia-friendly communities (DFCs) are seen as key to the inclusion and participation of people with dementia and carers. Dementia-friendly initiatives (DFIs) are important building blocks for the growth of DFCs. The collaboration between different stakeholders is a central aspect in developing and sustaining DFIs. Aim: This study tests and refines an initial theory about collaborating for DFIs with special attention for the involvement of people with dementia and their carers during the collaboration for DFIs. The realist approach is used for deepening contextual aspects, mechanisms, outcomes, and its explanatory power. Methods: A participatory case study design using qualitative data (focus groups, observations, reflections, minutes from meetings, and exit interviews) was executed in four Dutch municipalities that have ambitions to become dementia- friendly communities. Results: The refined theory on the collaboration for DFIs incorporates contextual aspects such as diversity, shared insights, and clarity. It draws attention to the importance of mechanisms such as the recognition of efforts and progress, informal distributed leadership, interdependency, belonging, significance, and commitment. These mechanisms resonate with feeling useful and feeling collectively powerful in the collaboration. The outcomes of collaboration were activation, getting new ideas, and fun. Our findings address how stakeholders’ routines and perspectives impact the involvement of people with dementia and their carers during collaboration. Conclusion: This study provides detailed information about collaboration for DFIs. The collaboration for DFIs is largely influenced by feeling useful and collectively powerful. Further research is needed to understand how these mechanisms can be triggered with the involvement of people with dementia and their carers in the heart of the collaboration. Full article
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14 pages, 337 KiB  
Article
Community Research Fellows Training Program: Evaluation of a COVID-19-Precipitated Virtual Adaptation
by Nicole Ackermann, Sarah Humble, Jacquelyn V. Coats, Carlette Lewis Rhone, Craig Schmid, Vetta Sanders Thompson and Kia L. Davis
Int. J. Environ. Res. Public Health 2023, 20(4), 3254; https://doi.org/10.3390/ijerph20043254 - 13 Feb 2023
Cited by 1 | Viewed by 1717
Abstract
Community engagement is important for promoting health equity. However, effective community engagement requires trust, collaboration, and the opportunity for all stakeholders to share in decision-making. Community-based training in public health research can build trust and increase community comfort with shared decision-making in academic [...] Read more.
Community engagement is important for promoting health equity. However, effective community engagement requires trust, collaboration, and the opportunity for all stakeholders to share in decision-making. Community-based training in public health research can build trust and increase community comfort with shared decision-making in academic and community partnerships. The Community Research Fellows Training (CRFT) Program is a community-based training program that promotes the role of underserved populations in research by enhancing participant knowledge and understanding of public health research and other relevant topics in health. This paper describes the process of modifying the original 15-week in-person training program to a 12-week online, virtual format to assure program continuation. In addition, we provide program evaluation data of the virtual training. Average post-test scores were higher than pre-test scores for every session, establishing the feasibility of virtual course delivery. While the knowledge gains observed were not as strong as those observed for the in-person training program, findings suggest the appropriateness of continuing to adapt CRFT for virtual formats. Full article
8 pages, 312 KiB  
Communication
Promoting Authentic Academic—Community Engagement to Advance Health Equity
by Darrell Hudson, Keon Gilbert and Melody Goodman
Int. J. Environ. Res. Public Health 2023, 20(4), 2874; https://doi.org/10.3390/ijerph20042874 - 7 Feb 2023
Cited by 10 | Viewed by 2512
Abstract
Meaningful community engagement is critical to achieving the lofty goal of health equity. Nonetheless, implementing the principles of community engagement is not easy. Attempting to implement best practices for collaborating on transdisciplinary teams and working with community partners can be challenging, particularly in [...] Read more.
Meaningful community engagement is critical to achieving the lofty goal of health equity. Nonetheless, implementing the principles of community engagement is not easy. Attempting to implement best practices for collaborating on transdisciplinary teams and working with community partners can be challenging, particularly in locales that have a long history of strained university–community relationships. The purpose of this paper is to provide additional context and consideration for researchers, community partners, and institutions interested in conducting community-engaged research. Here, we provide guidance and highlight exemplary programs that offer effective approaches to enhance the strength of community partnerships. These partnerships not only hold promise but are also essential in the development of the local, multi-factor solutions required to address racial/ethnic inequities in health. Full article
16 pages, 1815 KiB  
Article
Building Capacity for Community-Academia Research Partnerships by Establishing a Physical Infrastructure for Community Engagement: Morgan CARES
by Payam Sheikhattari, Emma Shaffer, Rifath Ara Alam Barsha, Gillian Beth Silver, Bethtrice Elliott, Christina Delgado, Paula Purviance, Valerie Odero-Marah and Yvonne Bronner
Int. J. Environ. Res. Public Health 2022, 19(19), 12467; https://doi.org/10.3390/ijerph191912467 - 30 Sep 2022
Cited by 5 | Viewed by 2724
Abstract
Research partnerships between universities and communities following the principles of community-based participatory research (CBPR) have the potential to eliminate cycles of health disparities. The purpose of this article is to describe the process of establishing a community-campus network with a distinct mission and [...] Read more.
Research partnerships between universities and communities following the principles of community-based participatory research (CBPR) have the potential to eliminate cycles of health disparities. The purpose of this article is to describe the process of establishing a community-campus network with a distinct mission and vision of developing trusting and successful research partnerships that are sustained and effective. In 2019, Morgan CARES was established to facilitate community engagement by founding a community center “within” a low-income residential neighborhood as a safe and accessible hub for creating a vibrant learning community. A community needs assessment and asset mapping was conducted and several necessary resources and services were provided to maximize networking opportunities, nurture innovative ideas and proposals, and provide seed funding. Lessons learned informed the optimization of a theoretical model that has guided the development and implementation of the program’s key components. By December 2021, Morgan CARES had recruited 222 community and 137 academic members representing diverse expertise from across Baltimore City. We also successfully established new partnerships and funded a total of 17 small community-academic awards. Although in its early stages, Morgan CARES has established a dynamic learning community following a conceptual framework that could guide future similar initiatives. Full article
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Review

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19 pages, 790 KiB  
Review
A Systematic Narrative Review of Implementation, Processes, and Outcomes of Human Library
by Gary Yu Hin Lam, Hei Ting Wong and Mengge Zhang
Int. J. Environ. Res. Public Health 2023, 20(3), 2485; https://doi.org/10.3390/ijerph20032485 - 30 Jan 2023
Cited by 4 | Viewed by 3025
Abstract
First started in Denmark in 2000, Human Library (HL) has been adopted by different communities around the world. It is an innovative approach that engages “readers” from the general public to have collaborative conversations with “books” from minority or marginalized communities to learn [...] Read more.
First started in Denmark in 2000, Human Library (HL) has been adopted by different communities around the world. It is an innovative approach that engages “readers” from the general public to have collaborative conversations with “books” from minority or marginalized communities to learn about their lived experiences and reduce public stigma and stereotypes. While the HL is popularized, its research base and implementation structure remain limited. This systematic narrative review aims to review the HL literature to (1) summarize the design, implementation, processes, and outcomes of existing HL programs and (2) synthesize recommendations for future implementation of more effective, ethical, and sensible HL. A systematic search in eight electronic databases yielded 23 journal articles and book chapters about HL published from 2010 to 2022. The identified literature demonstrated variations in format, venue, scale, preparation, and recruitment. A wide range of books with different social identities and from different cultural groups were reported, while readers were mostly from university and school communities. Reduced prejudices and improved attitudes were reported in readers, while both readers and books reported various facets of personal growth. Future HL using implementation guidelines with clearly articulate ethical considerations and diverse rigorous research methodologies are recommended. Full article
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Other

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10 pages, 310 KiB  
Brief Report
The Local Awareness-Raising of Public Mental Health in the Capital City of Poland through Launch of Local Alliance against Depression
by Piotr Toczyski
Int. J. Environ. Res. Public Health 2023, 20(5), 3892; https://doi.org/10.3390/ijerph20053892 - 22 Feb 2023
Cited by 1 | Viewed by 2210
Abstract
The goal of this brief report is to show the specificity of building local alliances against depression in an Eastern European country within and after the series of 2021 lockdowns. It will be described in the form of a short communication piece. The [...] Read more.
The goal of this brief report is to show the specificity of building local alliances against depression in an Eastern European country within and after the series of 2021 lockdowns. It will be described in the form of a short communication piece. The semi-peripheral specificity of Poland adds some insights which will be useful for other leaders of similar alliances globally. This short report can be read as a higher resolution of the European Alliance Against Depression (EAAD) method activities known from other recent works. We want to answer the question of how to begin the activity and launch such an alliance in the semi-peripheral context of non-Western Europe. Full article
12 pages, 1571 KiB  
Brief Report
An Engaged Community of Faith to Decrease HIV Stigma in the U.S. South
by Latrice C. Pichon, Erin N. Jewell, Andrea Williams Stubbs, DeMarcus Jones, Bettina Campbell, Katrina M. Kimble, Gina M. Stewart, LaRonia Hurd-Sawyer, Lacretia Carroll and Terrinieka W. Powell
Int. J. Environ. Res. Public Health 2023, 20(3), 2100; https://doi.org/10.3390/ijerph20032100 - 24 Jan 2023
Cited by 1 | Viewed by 2027
Abstract
Community members from a city in the U.S. Deep South identified root causes of HIV racial disparities, including stigma. This meeting report describes how we developed and implemented a conference series to address HIV stigma. We used community feedback and bidirectional learning to [...] Read more.
Community members from a city in the U.S. Deep South identified root causes of HIV racial disparities, including stigma. This meeting report describes how we developed and implemented a conference series to address HIV stigma. We used community feedback and bidirectional learning to host two meetings in observance of National HIV Testing Day (June 2021) and National Southern HIV/AIDS Awareness Day (August 2021). We established a 10-member organizing committee workgroup that met monthly to plan the Faith Summit in honor of National Black HIV Awareness Day (February 2022). Lessons learned include (a) the effectiveness of different community engagement strategies, including participatory evaluative approaches, and (b) strategies to maintain engagement and increase participation, such as reliance on personal and professional networks and prompting the community about forthcoming interventions. Sustaining a conference series to end HIV stigma requires commitment and inclusive participation. This collaborative project offers additional evidence that faith communities can be a part of the solution to ending the HIV epidemic and related health disparities. Full article
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12 pages, 819 KiB  
Protocol
Implementing and Evaluating Community Health Worker-Led Cardiovascular Disease Risk Screening Intervention in Sub-Saharan Africa Communities: A Participatory Implementation Research Protocol
by Kufre Okop, Peter Delobelle, Estelle Victoria Lambert, Hailemichael Getachew, Rawleigh Howe, Kiya Kedir, Jean Berchmans Niyibizi, Charlotte Bavuma, Stephen Kasenda, Amelia C. Crampin, Abby C. King, Thandi Puoane and Naomi S. Levitt
Int. J. Environ. Res. Public Health 2023, 20(1), 298; https://doi.org/10.3390/ijerph20010298 - 24 Dec 2022
Cited by 7 | Viewed by 3474
Abstract
The increasing burden of non-communicable diseases (NCDs), particularly cardiovascular diseases (CVD) in low- and middle-income countries (LMICs) poses a considerable threat to public health. Community-driven CVD risk screening, referral and follow-up of those at high CVDs risk is essential to supporting early identification, [...] Read more.
The increasing burden of non-communicable diseases (NCDs), particularly cardiovascular diseases (CVD) in low- and middle-income countries (LMICs) poses a considerable threat to public health. Community-driven CVD risk screening, referral and follow-up of those at high CVDs risk is essential to supporting early identification, treatment and secondary prevention of cardiovascular events such as stroke and myocardial infarction. This protocol describes a multi-country study that aims to implement and evaluate a community health worker (CHW)-led CVD risk screening programme to enhance referral linkages within the local primary care systems in sub-Saharan Africa (SSA), using a participatory implementation science approach. The study builds upon a prior community-driven multicentre study conducted by the Collaboration for Evidence-based Health Care and Public Health in Africa (CEBHA+). This is a participatory implementation research. The study will leverage on the CVD risk citizen science pilot studies conducted in the four selected CEBHA+ project countries (viz. Ethiopia, Rwanda, Malawi, and South Africa). Through planned engagements with communities and health system stakeholders, CHWs and lay health worker volunteers will be recruited and trained to screen and identify persons that are at high risk of CVD, provide referral services, and follow-up at designated community health clinics. In each country, we will use a multi-stage random sampling to select and then screen 1000 study participants aged 35–70 years from two communities (one rural and one urban). Screening will be done using a simple validated non-laboratory-based CVD risk assessment mobile application. The RE-AIM model will be used in evaluating the project implementation outcomes, including reach, fidelity, adoption and perceived effectiveness. Developing the capacities of CHWs and lay health worker volunteers in SSA to support population-based, non-invasive population-based CVD risk prevention has the potential to impact on early identification, treatment and secondary prevention of CVDs in often under-resourced communities. Using a participatory research approach to implementing mobile phone-based CHW-led CVD risk screening, referral and follow-up in SSA will provide the evidence needed to determine the effectiveness of CVD risk screening and the potential for scaling up in the wider region. Full article
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