Research suggests that stakeholder investment is maximized when partnerships understand the assumptions held by partners of the benefits to be derived and contributions to be made to the partnership. In 2011, representatives from seven rural county high schools and five university departments participated in a planning workshop designed to identify elements of an effective community-academic partnership to address adolescent obesity disparity in Southern Appalachia. The purpose of this investigation was to examine key elements of partnership building by way of the Give-Get Grid partnership tool. Content analysis was conducted to identify emerging themes. University representatives consistently identified more proposed program contributions as well as benefits than their high school partners. University personnel responses generally pertained to their level of participation and investment in the partnership, whereas high school personnel tended to identify contributions fundamental to both partnership and program success. Additionally, content analysis uncovered programmatic facilitators and potential barriers that can be instrumental in program planning and forming program messages. Findings suggest that although partners often share common goals, perceptions of the value of investment and benefits may vary. The Give-Get Grid can be used during the program-planning phase to help identify these differences. Implications for practice are discussed.

Traditional models for public health professional education tend to be didactic, with brief, discrete practica appended. National reports of both practitioners and academicians have called for more competency-driven, interdisciplinary-focused, community-based, service-oriented, and experientially-guided learning for students across the curriculum. East Tennessee State University began its own curricular revisioning in health professions education nearly 2 decades ago with a grant from the W.K. Kellogg Foundation, emphasizing competencies development through community-based learning in community-academic partnerships. This article describes 3 examples that grew from that initiative. In the first example, students in multiple classes delivered a longitudinal community-based employee wellness intervention for a rural county school district. BS public health students conducted needs assessments and prepared health education materials; MPH students conducted health assessments and worked with school wellness councils to deliver client-centered interventions; DrPH students supervised the project and provided feedback to the schools using participatory methods. In the second example, MPH students in a social-behavioral foundations course used experiential learning to investigate the region's elevated cancer mortality ranking. Following meetings with multiple community groups, students employed theoretical constructs to frame regional beliefs about cancer and presented findings to community leaders. One outcome was a 5-year community-based participatory research study of cancer in rural Appalachia. In the third example, MPH students in a health-consulting course assessed local African Americans' awareness of the university's health and education programs and perceptions of their community health issues. Students learned consultation methods by assisting at multiple regional African American community meetings to discover issues and interest that resulted in the organization of a regional African American health coalition, multiple community health interventions, and the region's first health disparities summit. Lessons learned are presented which identify key elements of success and factors that influence adoption of community-based teaching and learning in public health.

Using a community-based participatory research (CBPR) approach, community members, community stakeholders, and academic researchers from Virginia Tech formed a community-academic partnership in 2009. In the formative months, the coalition decided to focus on reducing obesity in the region. The coalition adopted the name of The Dan River Partnership for a Healthy Community (DRPHC) with a mission to "foster community partnerships to combat obesity in the Dan River Region through healthy lifestyle initiative". During a planning workshop, the DRPHC created six causal models for the root causes of obesity in the region. Two causal models that focused on geographic and environmental influences for obesity are the foundation for this series of research. The focus of this dissertation is at the intersection of the food and physical activity environments and their characteristics that contribute to meeting fruit and vegetable intake and minutes of physical activity recommendations. The food environment is one aspect of built environment research that examines food locations for procurement and the variety, availability, and quality of different food options. To date, the vast majority of research on the food environment is based in urban, suburban, and metropolitan areas with high residential densities and populations. Rural areas are often understudied because of their dispersed and hard-to-reach populations; yet these individuals experience some of the worst health outcomes in the nation. This is due, in part, to the large overlaps of rural regions and food deserts, resulting in poor food choices and poor diets. The overall objective of this dissertation is to examine the associations of the food and physical activity environments with individual healthy behaviors. Three studies were conducted within the broader research plan to meet the overall objective. The first study systematically examined the food environment using the Nutrition Environment Measures Survey (NEMS) for all food outlets in Danville, VA, a small regional city within the health disparate region, to compare differences in healthy available food options by block group race and income. The second study expanded NEMS methodology to encompass all food outlets in the three-county Dan River region to examine if food environment and availability of healthy options was predictive of meeting fruit and vegetable intake recommendations. The last study examined the objective and perceived distance individuals must travel to reach a physical activity outlet and whether or not distance was a predictive factor of individual weekly minutes of moderate to vigorous physical activity and meeting physical activity recommendations. / Ph. D.

Background: Community engagement—the collaborative process of addressing issues that impact the well-being of a community—is a strategic effort to address community issues. The Gulf States Health Policy Center (GS-HPC) formed the Hattiesburg Area Health Coalition (HAHC) in November 2014 for the purpose of addressing policies impacting the health of Forrest and Lamar counties in Mississippi. Objectives: To chronicle the community-based participatory research (CBPR) process used by HAHC’s identification of infant and maternal health as a policy area, domestic violence in pregnancy as a priority area within infant and maternal health, and a community action plan (CAP) regarding this priority area. Methods: HAHC reviewed data and identified infant and maternal health as a priority area. They then conducted a policy scan of local prenatal health care to determine the policy area of domestic violence in pregnancy. Results: HAHC developed a CAP identifying three goals with regard to domestic violence and pregnancy that together informed policy. Changes included the development of materials specific to resources available in the area. The materials and recommended changes will first be implemented by Southeast Mississippi Rural Health Initiative (SeMRHI) through a screening question for all pregnant patients, and the adoption of policies for providing information and referrals. Conclusions: The lack of community-level data was a challenge to HAHC in identifying focus and priority areas, but this was overcome by shared leadership and community engagement. After completion of the CAP, 100% of expecting mothers receiving prenatal care in the area will be screened for domestic violence.

This thesis addresses food security and road development in Tuktoyaktuk (population 995), a primarily Inuvialuit (Indigenous, Inuit) community in the western Canadian Arctic. Initially, I had hoped to conduct interviews in Tuktoyaktuk to better understand how the new Inuvik-to-Tuktoyaktuk Highway (ITH), opened in 2017 (the first highway to the Arctic Ocean) had affected food security in Tuktoyaktuk. This plan was interrupted. // INTERRUPTION \\ --THIS THESIS HAS BEEN INTERRUPTED \\ What do we do when our plans are forced to change? How do we react, adapt, and overcome these changes? How do we reflect on such interruptions? These questions are the underlying essence of this thesis and they reflect my experience of engaging in Arctic community-based research during the COVID-19 pandemic. This thesis presents two articles that are a result of many interruptions. The first (1) is an econometric evaluation of the cost of food before and after the opening of the ITH and the subsequent rescission of the Nutrition North Canada federal food subsidy program to the now road-accessible community of Tuktoyaktuk. The results suggest a significant increase in market basket prices which can be attributed to the opening of the highway and the subsidy loss (+CAD$44, SE = 16.77, p = 0.02). This research is the first to document the impacts of highway development on food prices in Arctic Indigenous communities. The second (2) is a co-authored methods piece about friendship, reciprocity, and reconciliation between two young women; a 17 year old Inuvialuit journalist and myself, a 25 year old Québécoise Master’s student, navigating research for the first time and during the pandemic. In the process, we reflect on what reconciliation means to us and provide recommendations for Arctic community-based research in a post-pandemic world. // BREAK. BREAK. THIS THESIS IS AN INTERRUPTION \\ In form and content, this thesis offers a reflection on the process of conducting and writing about research, juxtaposing qualitative (at times creative) and quantitative methods under a community-based research framework for working with Inuit.

While partnerships for health delivery and improvement are frequently described by their structure, goals, and plans, less attention is paid to the interactive relationships among partners or for larger stakeholder groups’ coalition memberships. The Give-Get Grid group process tool can be used to assess each stakeholders’ expected benefits (“gets”) and contributions (“gives”) needed to establish and maintain long-term, mutually advantageous community–academic partnerships. This article describes three case study experiences using the Give-Get Grid in real-world context to understand and generate ideas to address contemporary health promotion opportunities among a variety of stakeholders. The case studies address three distinct community health promotion opportunities: prevention of school-based adolescent obesity disparities, higher education health professions training programs in rural community-based settings, and methods for engaging community coalitions in state Comprehensive Cancer Control Programs. The case studies demonstrate the Give-Get Grid’s utility in both planning and evaluating partnerships and documenting key elements for progress in health promotion initiatives built on long-term community–academic relationships. Steps are explained with practical lessons learned in using the Grid.

The purpose of this descriptive phenomenological study was to give voice to an underserved and vulnerable population in Uganda, Africa to advocate for health priorities. Nineteen members of the village of Namagera, identified as a leper colony, were selected by community members and volunteered to participate in every element of this study. Descriptive phenomenology was the guiding philosophy and community-based participatory research methods and photovoice provided the lens for social action. Leininger’s theory of culture care diversity and universality (Leininger & McFarland, 2006) anchored the study in cultural caring and the community nursing practice model (Parker et al., 2020) kept the researcher grounded in the purpose of advancing the science of caring in community nursing. The research team included the researcher, the 19 participants, and six research assistants, who also served as language facilitators. Using photovoice methods, participants identified strengths and needs and used digital cameras to capture health concerns in the community. Eighty photos were analyzed by the participants and priorities were determined. The selected photos were placed on a photo board and shared with the whole community for input. Community members selected the health priorities and ranked them in importance: access to clean water, sanitation, disease, challenges for the elderly and disabled, lack of medical treatment, transportation, unemployment, and protection of the environment. The participants categorized the health priorities into three clusters of themes: basic needs, safety, and social/environmental. The themes were further incorporated into action plans identifying impeding factors for which the community would require outside assistance and promoting factors for which the community could solve themselves. Findings of this study illuminate the emergence of community empowerment: Community members found their voices, identified health priorities, and advocated for solutions. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

The South African National Development Plan (NDP) (National Planning Commission, 2011, p. 1) provides the road map for a reformed public health system by 2030. The proposed health system will be facilitated by, amongst others, training an appropriate balance of healthcare professional s including a cadre of community health workers (CHWs) that have a broad skills mix suited to reaching a larger number of people with first level intervention. With this in mind, a pilot group of CHWs were up-skilled as Rehabilitation Care Worker s (RCWs). The training program was a joint project between the Division of Disability Studies and the Departments of Occupational Therapy, Physiotherapy and Speech and Language Therapy at UCT. Problem: Little is known about the perspectives of RCWs on the benefits and challenges of additional training in rehabilitation and disability related skills. Rationale: To inform the curriculum for a rehabilitation care worker (RCW) training program and the Western Cape Department of Health (WCDoH) of ways in which this cadre of worker could contribute to the realization of the 2030 Healthcare Plan. Aim: To describe the outcomes of a pilot RCW training program from the perspective of the pilot group of graduates. The objectives were to identify the areas of practice where RCWs feel competent/incompetent, to identify aspects of the health services where RCWs believe they can contribute the most/the least and to identify the facilitators/barriers they experienced when deployed in the health field. Methodology: A qualitative descriptive study was conducted. Method: Focus groups were carried out with three groups of six participants. Findings: The plot that permeated the participants’ perspectives revolved around how the RCWs were pioneers in breaking new ground for the Western Cape Department of Health (WCDoH). Two themes informed the plot: "we move health services to a new level" and "we manage change in new ways". Discussion: It is argued that the pilot RCW curriculum achieved its’ objective of equipping a cadre of worker with basic rehabilitation, care and disability inclusion skills. While the envisaged role of RCWs in the health service and in making the NDP a reality is supported, it is argued that attention needs to be given to supervision structures and to training of all other health workers in order to promote inter professional practice. Conclusions: The pilot group of RCWs believe that they have acquired a new and large variety of skills that have enabled them to make a broad and positive impact in their places of work, at home and in the broader community.

The purpose of the study is to contribute to the development of a tool that can support the rehabilitation care worker towards intervention planning and the monitoring of their clients. The National Health Insurance and the Framework and Strategy for Disability and Rehabilitation of the South African Department of Health are strategies to work towards accessible, affordable, equitable and quality health care, which includes health promotion, disease prevention, curative, rehabilitation and palliative services for all South Africans. Both strategies emphasise the use of community health workers and mid-level workers as a key component of primary health care. In the Western Cape provincial Department of Health a new cadre, namely the rehabilitation care worker has been introduced as a member of the rehabilitation team. The introduction of the rehabilitation care worker is still in the pilot phase. The rehabilitation care workers face many barriers to providing effective care. One such challenge is the lack of a contextually relevant resource tool to collect information on the rehabilitation and health needs of persons with disabilities. The aim of the study was to develop a contextually relevant resource tool that would support the rehabilitation care worker in understanding and documenting how the rehabilitation and related health needs of persons with disabilities are met in home- and community-based settings. Three specific objectives were defined: i) to develop the content and domains of the rehabilitation and health information tool; ii) to establish the validity (face and content) of the rehabilitation and health information tool; and, iii) to test the application of the rehabilitation and health information tool on a sample of persons with disabilities. This study was an exploratory descriptive study adopting a sequential mixed methods design. There were two phases in this study. Phase 1 involved qualitative research methods in the development of the rehabilitation and health information tool through the use of document review and a focus group discussion with experts. Phase 2 of the study involved quantitative research methods in the field testing of the rehabilitation and health information tool by the rehabilitation care workers on a sample of persons with disabilities. The results of phase 1 included the development of the rehabilitation and health information tool, which was deemed by the experts to be a comprehensive, contextually relevant tool with face and content validity and could be easily administered by the rehabilitation care worker. The conceptual framework of the International Classification of Functioning, Disability and Health provided domains that could comprehensively document the multidimensional needs of persons with disabilities. The result was a draft rehabilitation and health information tool with 17 questions ranging across the domains of activities of daily living, sexual health, health behaviours, barriers and facilitators to good health, finance and understanding of disability. Changes were proposed to the wording, layout and flow of the tool and the persons with disabilities’ goals were included as an element . The inclusion of the end users as experts in the development resulted in a richer understanding needed for the shaping of this tool. The results of phase 2 highlighted that the rehabilitation and health information tool was able to describe the rehabilitation and health needs of persons with disabilities. Additionally the tool was able to document the specific goals of the persons with disabilities which is useful to plan and monitor intervention. The rehabilitation care workers reported the tool to be useful, easy to use, and provided a structured manner to collect information. They also reported that it was useful in stimulating conversations on sensitive topics. However, it was indicated that it took too long to complete and there were components that were incomplete. The rehabilitation and health information tool requires further refinement, validation and further follow-up testing before it can be formally adopted and implemented as part of the rehabilitation care worker’s standard practice.

The purpose of this research was to review a significant body of literature that related to music and arts education in the context of community engagement. An examination of the literature identified several issues affecting the engagement of communities in arts education pertaining to arts education policies, the role of arts organizations and the relationship between schools and communities. The summation of this research included an overview of models of successful collaborations between the public school and community institutions at national, state, and local levels in the United States with implications of future reform to the arts education policy. With such a vast array of program offerings initiated through the collaborative partnering of schools with communities and local arts agencies, valuable insights can be gained from concerted research efforts in the field of music education as to the unique opportunities afforded through purposeful community engagement.