Community-engaged research (CEnR) involves a collaborative research approach between researchers and community members. Community advisory groups, often central to CEnR, have a strong tradition and role in HIV research. Applying an established framework for community group processes, we describe the formation, operation, and maintenance planning of a community-led coalition housed within a Center for AIDS Research (CFAR), whose mission is to support HIV-related CEnR. While most academically affiliated community groups are led by researchers, our Coalition utilizes a governance structure that prioritizes community leadership. Using a human-centered design framework, we led a 2-hr group meeting on November 25, 2025 in which Coalition members discussed group strengths and weaknesses, opportunities for change, and how to better meet the needs of the community. Human-centered design is an accessible framework used to stimulate group discussion and identify priorities. Participants identified community-led leadership and geographic diversity as major strengths. Although representation of racial, ethnic, sexual, and gender minorities remains insufficient, enhancing diversity of the coalition was identified as both an opportunity for growth and the Coalition’s top priority for the coming year. Our Coalition’s experience exemplifies the dynamic nature of community groups and the need to continuously revisit group priorities. It also highlights the importance of community-led advisory groups to ensure HIV researchers and their support systems center community needs and prioritize them.
Since their inception in the 1990s, School-Based Health Centers (SBHCs) in Vermont have largely been conceived and sustained through the interest and investment of local communities. Vermont does not have a formal SBHC state policy, dedicated funding, or coordinated technical assistance. Recognizing the need to better understand and support SBHCs in our state, we conducted the first exploratory study of SBHC utilization in Vermont. Data were collected from six SBHCs operating in 16 different schools in Vermont over 2 weeks in the winter of 2025. We sought to determine reasons for seeking care as well as the time saved in learning. The main reasons for seeking care in SBHCs in Vermont were acute illnesses, followed by mental health concerns. However, a wide range of services were also provided, including physical therapy and ophthalmological exams. Over 80% of students returned to class after being seen in a Vermont SBHC, saving, on average, 3.67 hr of instructional time compared to seeking that service outside of the school setting. SBHC services thus were shown to reduce time away from school and minimize disruptions for caregivers who might otherwise need to take children to appointments. Findings from this study have the potential to inform future state policy development and underscore the role that SBHCs can play to promote access to care and to reduce school absenteeism.
Digital-first public health efforts often miss linguistically isolated immigrant communities because of structural barriers and stigma. Ethnic legacy media can reach these groups, but keeping programs funded and operational over the long term is frequently difficult. This Practice Note examines a Cantonese-language radio health program in "Los Angeles County" that ran 128 live broadcasts across a full 12-year Chinese zodiac cycle. Instead of a top-down clinical model, the show endured by acting as an informal community navigation hub. We examine two recurring administrative frictions: anonymous off-air calls about urgent economic needs (e.g., hotel job referrals) and on-air audience corrections of mispronounced medical terms. We argue these interactions should be seen not as disruptions but as measurable indicators of structural trust that sustain programs. We offer practical guidance for recruiting undergraduates to expand reach via ethnic print newspapers, using peer-recovery milestones to amplify impact. The note concludes with a pragmatic blueprint for health educators to manage professional boundaries, preserve commercial-clinical separation, and uphold cultural safety in isolated communities.
The purpose of this study was to examine the relationship among exercise habit strength, self-control, and the valuation of physical effort with vigorous exercise participation in adults who were participating in an 8-week exercise program. Participants engaged in the Mindless to Mindful (M2M) program, an 8-week behavior-change intervention integrating tailored coaching and self-regulation strategies. The average vigorous exercise was 4.2 hr (SD = 2.17) per week. There was a significant decrease in fat mass (t(124) = -16.306, p < .001, d = -1.458) and an increase in exercise habit strength (t(124) = 5.565, p < .001, d = 0.498), self-control (t(124) = 3.618, p < .001, d = 0.324), and the relative valuation of physical effort (t(124) = 2.837, p = .003, d = 0.254) from pre- to post-M2M. These findings align with TEMPA and add novelty by suggesting that approaching and avoiding physical effort can be modified through a self-regulation intervention.
Youth participatory action research (YPAR) elevates youth as change agents in their schools and communities. The YPAR studies have demonstrated impact on psychological empowerment and civic engagement, both thought to lead to improved health. This exploratory evaluation assessed physical and emotional health among youth in a YPAR program. We implemented an eight-session YPAR program across four neighborhoods in Pittsburgh, PA. Surveys were administered at baseline, end-of-program (EOP), and 1 year from baseline (T3) to measure changes in the following: psychological empowerment, civic engagement, emotional health, health care access and quality of life, and substance use. Descriptive statistics were used to summarize variables at each timepoint. Generalized linear mixed models assessed changes in outcomes over time, with results presented as odds ratios (ORs) or parameter estimates (β) with 95% confidence intervals. Seventy-one youth completed baseline surveys, 58 completed EOP surveys, and 43 completed T3 surveys. Most youth identified as non-Hispanic Black. Compared to baseline, youth at EOP and T3 reported consistently higher levels of psychological empowerment (EOP: β = 0.39 [0.22-0.56]; T3: β = 0.36 [0.17-0.55]) and civic engagement (EOP: β = 0.34 [0.15-0.54]; T3: β = 0.34 [0.12-0.56]). Youth reported greater difficulties in emotion regulation (β = 0.26 [0.07-0.45]) and fewer activity limitations (OR = 0.31 [0.12-0.77]) at EOP, but findings did not persist at T3. There were no changes in measures of health care access or substance use. The YPAR is consistently associated with increases in psychological empowerment and civic engagement. Findings suggest opportunities to integrate health-related resources in YPAR programming and to assess health impacts of such interventions.
Worksite wellness programs are popular employer offerings as of the last few decades. The COVID-19 pandemic caused major shifts in behavior since these programs were implemented. The purpose of this study was to understand how the COVID-19 pandemic affected participation in a worksite wellness program. This study is a secondary analysis of a university worksite wellness program that compared monthly participation in 2019 (pre-pandemic) versus 2020 (after the onset of the COVID-19 pandemic). The main outcome measures included participation within two offerings (single-visit or ongoing programming) for each of the three arms (MoveWell, EatWell, and BeWell) of the worksite wellness program. Statistical analyses included the Shapiro-Wilk test for data normality, paired t-tests for year-to-year differences in overall participation, and Wald confidence intervals for year-to-year differences in specific offerings. Overall, participation in the worksite wellness program decreased during the pandemic when compared with participation of the previous year (p = .016). Participation in the BeWell and EatWell offerings had no significant change from 2019 to 2020. Among the MoveWell offerings, the group fitness classes (ongoing programming) were the only worksite wellness offering that showed decreased participation. Predictably, overall participation in a worksite wellness program decreased while employees were not physically in their workplace. However, it is noteworthy during the pandemic that employees were still participating in EatWell and BeWell programming such that participation was not significantly different from 2019. The results from this study could potentially be used to inform worksite wellness programming in future pandemics or other public health emergencies.
Medical students increasingly engage in community-based initiatives to address health inequities among marginalized populations, yet often lack structured guidance for translating intent into feasible practice. This Practice Note describes how the Exploration, Preparation, Implementation, and Sustainment framework was used to guide a student-led foot and wound care initiative serving people experiencing homelessness or housing insecurity in northern Minnesota. In a setting marked by extreme cold and rising homelessness, students partnered with community organizations and volunteer registered nurses to assess needs, develop evidence-informed protocols, and deliver supervised care. Bridging factors, including trusted harm reductionists and clinical supervision, proved critical for aligning outreach with safe clinical practice amid concerns about xylazine-associated wounds from the local drug supply. We illustrate how implementation science can support student-led health promotion by strengthening partnerships, clarifying roles, and enabling adaptation to evolving community needs.
BACKGROUND:Group-based exercise programs for older adults produce substantial health benefits, yet they often fail to reach equity-deserving populations in representative proportions. An understanding of local and systemic factors surrounding exercise programs is needed to guide strategies to reduce these gaps. PURPOSE:Our purpose was to understand the local and system-wide factors that influence equitable participation in the Forever . . . in motion (FIM) older adult exercise program in Saskatchewan, Canada. METHODS:Seventeen people who served as program implementers and/or exercise leaders in the FIM program participated in semi-structured interviews. Guided by the Health Equity Implementation Framework (HEIF), codebook thematic analysis involved coding into categories of the HEIF and then inductively eliciting themes relevant to equity-focused implementation. RESULTS:Innovation characteristics such as low-cost, adaptive group exercise in community settings and online options for attending training courses or exercise classes helped promote equity, as did leader and implementer characteristics and contextual factors that centered on community collaboration. Other HEIF domains negatively impacted equitable participation, including participant barriers relating to social determinants of health, lack of knowledge in the leader and implementer, and contextual factors such as a lack of equity-focused goals or metrics or varied levels of implementation support across jurisdictions. Three themes were identified: A Disjointed Provincial System, Inclusion is Poorly Understood and Actioned, and Goals and Measures Lack an Equity Focus. CONCLUSION:Implementation frameworks such as the HEIF can help health-promotion professionals develop a comprehensive understanding of determinants of inequities and guide strategies to address equity-related gaps.
Maternal mortality remains a global concern, with more than 700 women losing their lives each day in 2023. Preconception care (PCC) improves maternal and child health by addressing preventable risks. Assessing community readiness ensures effective implementation. The study aims to assess community readiness for PCC interventions using the Community Readiness Model to identify local barriers and facilitators. This qualitative study used an exploratory approach to evaluate community readiness for PCC, incorporating diverse stakeholder perspectives. It was conducted in selected villages within the field practice area of a rural tertiary care teaching hospital in India between April and August 2024. Stakeholders, including health service provider, local governance representatives, administrative liaison, and community beneficiaries, were purposively selected, and 19 in-depth interviews were included using a purposive sampling technique, capturing varying levels of community involvement. Institutional ethical approval (IEC/406/2023) was obtained, and informed consent was collected from participants. Community readiness was assessed through a nine-level framework using stage-based scoring analysis grounded in the Community Readiness Model, with thematic analysis complemented by triangulation to validate findings and enhance reliability. Overall consensus community readiness score of the current study was 3.09, indicating moderate readiness for PCC (vague awareness stage) across communities. The stakeholder's scores ranged from 3.60, reflecting strong preparedness, to the lowest 2.15, highlighting significant gaps in readiness in certain areas. The findings of the study suggest that although some stakeholders are well-prepared, targeted interventions are needed to enhance readiness in communities with lower engagement and resource availability. Raising community awareness ensures women access quality PCC, improving maternal and child health and reducing mortality.
Bexar County is a South Texas county with low human papillomavirus (HPV) vaccination rates, which hinders efforts to prevent HPV-related cancers. We conducted a community assessment from the perspective of community members who administer social/health services and/or coalitions in Bexar County. We aimed to assess perceived barriers and possible community solutions to HPV vaccination in Bexar County. Data were collected using an online quantitative survey measuring knowledge and attitudes toward HPV vaccination based on the Increasing Vaccination Model, as well as perceived barriers to HPV vaccination and potential solutions to improve vaccination. Participants included persons administering social/health services/part of coalitions in Bexar County from January to March 2025 (N = 45). Descriptive statistics were estimated. Most participants strongly agreed that HPV vaccination rates could be improved and that it was very important for 9- to 26-year-olds to get vaccinated for HPV. Primary barriers at the organizational level were competing health priorities, lack of provider knowledge/training, language barriers, and patient lack of awareness. Participants were asked to consider what community-level strategies could be deployed to increase HPV vaccination; the highest rated were mobile vaccination, public awareness campaigns, and financing for the vaccine. There is a strong community interest in improving HPV vaccination in Bexar County. Developing a multi-component intervention that addresses direct access issues, coupled with provider recommendations, could surmount the reported barriers to HPV vaccination in this community.
Cultural tailoring is increasingly recognized in sexual and gender minority (SGM) focused health interventions, yet its effectiveness in anti-smoking messages for sexual minority women (SMW) remains underexplored. This formative study examined how culturally tailored messages were received among SMW populations. Using a quantitative online experiment ( N = 155), we investigated whether tailored messages are more effective than non-tailored messages in influencing SMW’s message perceptions (i.e., perceived message effectiveness and perceived targetedness) and whether message effects varied by sexual orientation. Participants were randomly assigned to view either SGM-tailored messages, which featured rainbow colors and LGBTQ+-themed slogans, or non-tailored messages that used pink colors and slogans highlighting general women’s health. Tailored and non-tailored anti-smoking messages were equally influential in shaping young adult SMW’s message perceptions. However, variations were observed within different SMW subgroups. Compared to bisexual participants, gay/lesbian participants and those with another sexual orientation (e.g., asexual, queer, and pansexual) showed a preference for tailored messages, with gay/lesbian participants rating non-tailored messages as less effective and those of another sexual orientation considering non-tailored messages as less personally relevant. In contrast, bisexual participants reported relatively high message effectiveness across both conditions but did not find either message type particularly targeted. These findings suggest that while broad tailoring efforts may enhance general appeal, their impact may vary across SMW subgroups. More nuanced and inclusive tailoring strategies may be needed to strengthen the relevance and impact of health communication among SMW populations.
The COVID-19 pandemic accelerated demand for public health professionals trained in infodemiology, or the science of using health-related information, particularly in digital environments, to inform public health decision-making. To build workforce capacity, The Public Good Projects and the de Beaumont Foundation developed the Infodemiology Training Program (ITP), an asynchronous, online course designed for professionals in U.S. state and local health departments. This process evaluation describes the development, pilot testing, and implementation of the ITP, along with early indicators of its reach, relevance, and use in practice. Mixed methods were used to assess program engagement and outcomes, including platform metrics ( n = 3,319 registrants), surveys ( n = 61), and interviews ( n = 4). Quantitative data showed high engagement in Module 1 (49.5% completion), declining across subsequent modules. More than half of survey respondents (60.0%) reported applying the training in their work, and 92.5% found it relevant to their roles. Qualitative findings indicated participants valued the program’s flexibility, applicability, and emphasis on misinformation response. Barriers to completion included time constraints and misalignment with job responsibilities. Findings suggest that while the ITP filled an important training gap, shorter segments and applied learning tools may support future uptake. The ITP represents an early step toward formalizing infodemiology practice in the U.S. public health workforce, with future directions focused on integration into academic programs and public health systems.
The physical literacy for communities (PL4C) project aimed to promote physical literacy using a participatory community mobilization approach; organizing multi-sectoral community-led tables that developed and promoted physical literacy initiatives. As part of a scale-up across Canada, we set out to design an evaluation protocol to assess the effectiveness of the PL4C intervention that was aligned with table processes and activities. We conducted interviews with members of two original community tables that would then serve as exemplar communities for the scale-up evaluation with the goal of understanding: (1) how the existing PL4C intervention functioned; and (2) the promotion of physical literacy in these communities. Through qualitative interviews with 13 (11 women) existing PL4C table members, we identified three broad categories: working together, sustainability, and promoting physical literacy in different settings. Participants identified several areas important for evaluation of PL4C scale-up and implementation, including unpacking partnership operations and capacity building, supporting and understanding the sustainability of multi-sectoral action, and measuring the effectiveness of physical literacy program delivery. We used findings from these interviews to design an evaluation of the PL4C intervention that included milestone tracking, interviews and surveys with table members and community leaders, and direct measures of physical literacy alongside school and community-based physical literacy interventions being delivered in exemplar communities.
As businesses continue to adapt post-COVID-19 pandemic, there is increased interest among employers in their employees' mental health and work-life balance. However, few studies have looked at how the pandemic may have impacted employer perceptions of workplace health promotion (WHP), despite its role in addressing mental health and work-life balance. Small low-wage businesses have unique characteristics, including thin profit margins, limited financial reserves, and few employees, so the impact of the pandemic hit them particularly hard. Using a framework guided by social marketing principles, 25 small-business employers from across the United States were interviewed. Questions included what they thought was most needed in post-pandemic WHP, how the pandemic changed WHP, how comfortable they would be providing support to their employees around physical health, mental health, and work-life balance, and what avenues they would use to promote those benefits and resources. Interviews were coded and analyzed via thematic analysis. Small low-wage business employers value the importance of WHP programs and recognize how the pandemic highlighted the need to support employee mental health. These employers are interested in providing support in the domains of mental health, physical health, and work-life balance; they would use similar avenues to promote resources in these domains; and they agree that the source of these supports should be trustworthy. Small-business employers now find WHP programs incomplete if they do not support employee mental health; health promotion practitioners should collaborate with employers to identify resources suitable for small businesses and determine how best to integrate them into existing offerings.
Prenatal education programs are a key component of maternal and newborn health promotion. Although the use of digital platforms for prenatal education increased during the COVID-19 pandemic, evidence for their effectiveness remains limited. In addition, conventional programs often omit content addressing adverse pregnancy outcomes due to concerns about increasing maternal anxiety or worry. This quasi-experimental study aimed to (1) evaluate participants' satisfaction and perceived acquisition of knowledge and health habits following a novel online prenatal education program delivered via Facebook, and (2) assess the impact of a novel session on managing complications during pregnancy and childbirth-preterm birth, newborn adaptation difficulties, and stillbirth-on participants' levels of pregnancy-related anxiety and worry. Participants completed the State Anxiety Inventory and Cambridge Worry Scale (CWS) before and after the session on complications (N = 162), and the modified EDUMA2 questionnaire at the program's conclusion (N = 93). High satisfaction (mean 9.01/10), improved self-rated knowledge and health habits, and high rates of recommendation were found. Post intervention, statistically significant reductions were observed in worry scores (CWS), particularly regarding fetal health, childbirth, and miscarriage, with no significant increase in anxiety levels (State-Trait Anxiety Inventory [STAI-S]). The online modality did not fully meet the social interaction needs of pregnant women and appeared to limit the participation of women's partners and migrant women. Online prenatal education can effectively promote maternal health literacy and may effectively address sensitive topics such as pregnancy and childbirth complications. Future programs should integrate hybrid formats and strategies to reduce digital access barriers, especially among vulnerable populations.
OBJECTIVES:This study evaluated the Fathers Empowered to Learn, Lead, and Achieve Success (FELLAS®) fatherhood program. Outcomes commonly used in fatherhood program evaluations align with key social determinants of health (SDOH) identified in Healthy People 2030, including economic stability, family functioning, and social relationships. Examining these outcomes provides insight into how fatherhood programs may influence upstream determinants of health behavior and long-term well-being. METHODS:Fathers participated in a 35-hour, multi-component intervention designed to improve life skills, parenting practices, relationship functioning, and economic stability. The analytic sample included 216 fathers who completed questionnaires at pretest, posttest, and six-month follow-up. Outcomes included five multi-item self-report scales (attitudes toward finances, parenting skills, father involvement, conflict resolution, and communication with partner) and two employment indicators (unemployment and full-time employment). Qualitative focus groups were conducted to assess participant experiences and perceived skill development. RESULTS:Participants demonstrated statistically significant improvements from pretest to posttest across all seven outcome measures. Improvements were sustained at six-month follow-up for six outcomes, with attenuation observed for father involvement. Significant reductions in unemployment and increases in full-time employment were observed and maintained over time. Qualitative findings supported these results, with participants reporting improvements in parenting, relationships, communication, and employment-related behaviors. CONCLUSION:FELLAS demonstrated meaningful improvements in outcomes aligned with SDOH domains. These findings suggest that fatherhood programs may contribute to improved family and population health through upstream pathways. Results from this descriptive evaluation provide a foundation for more rigorous future research examining causal effects and mechanisms of change.
Climate change is increasingly recognized as a public health issue that exacerbates existing social and structural inequities. While growing attention has been paid to gendered impacts of climate-related hazards, transgender populations remain largely absent from climate research, policy, and practice, especially in low- and middle-income country contexts. This article introduces Invisible in the Storm: Climate Change and the Lived Realities of Transmasculine People in India , a community-led and produced health promotion resource developed by Transmen Collective, India’s first national organization dedicated to transmasculine rights and well-being. Based on a mixed-method, survey-based study conducted with transmasculine participants across multiple regions of India, the report documents how climate events such as heatwaves, floods, and water scarcity intersect with gender identity, health care and resource access, and mental and emotional well-being. Quantitative findings highlighted exposure to climate stressors and disruptions to essential resources, while qualitative narratives illuminated how climate stress is embodied through constraints on gender expression and experiences of discrimination. Together, these findings reveal how climate change amplifies existing inequities and how the needs of the transgender community are rendered invisible in climate planning and responses. Positioned as a community-led health promotion resource, Invisible in the Storm offers insights for practitioners, organizations, and policymakers across climate, disaster, and public health sectors, highlighting the urgent need to integrate gender-diverse perspectives into climate responses. The report also underscores the importance of integrating lived experience into climate responses and demonstrates the value of gender-inclusive approaches to advance climate justice and health equity.
The needs of people experiencing homelessness (PEH) are at a modern high, yet health-promotion programs typically operate from clinic-based models that do not reliably reach unsheltered settings. Street engagement, conducted with community partners, can support access to basic needs, trust-building, and continuity of care. We present the BRIDGE framework (Build trust, Rapidly assess, Identify needs, Direct connections, Guide handoffs, Evaluate follow-up), distilled from sustained community outreach with PEH in Milwaukee, Wisconsin, integrating harm-reduction, trauma-informed communication, and warm handoffs through practical tools (approach scripts, packing lists, and safety checklists). We collect feasible process indicators (e.g. number of contacts, referrals initiated, and successful connections) and provide a flow figure and protocol table to guide action. Embedded vignettes from multiple perspectives provide implementation context. BRIDGE operationalizes equitable health promotion for street engagement centered on ethics, safety, and trust and can be adopted by health departments, academic programs, and community partners to systematize outreach and strengthen continuity of care. A clear, replicable framework with minimal metrics can elevate street engagement beyond goodwill to accountable practice that advances health equity.
