title: Using Participatory Mapping to Inform a Community-Randomized Trial of HIV Counseling and Testing Community-based participatory research (CBPR) in South Africa: engaging multiple constituents to shape the research question. “Losing the tombola”: a case study describing the use of community consultation in designing the study protocol for a randomised controlled trial of a mental health intervention in two conflict-affected regions The spread of drug abuse in rapidly urbanizing communities in Vientiane, Lao People's Democratic Republic. Tailored Hospital-based Risk Reduction to Impede Vascular Events After Stroke (THRIVES) study: qualitative phase protocol.
abstract: Participatory mapping and transect walks were used to inform the research and intervention design and to begin building community relations in preparation for Project Accept , a community-r and omized trial sponsored by the National Institute of Mental Health . Project Accept is being conducted at five sites in four countries : Thail and , Zimbabwe , South Africa , and Tanzania . Results from the mapping exercises informed decisions such as defining community boundaries and identifying appropriate criteria for matching community pairs for the trial as well as where to situate the services . The mapping also informed intervention-related decisions such as where to situate the services . The participatory methods enabled research ers at each site to develop an underst and ing of the communities that could not have been derived from existing data or data collected through st and ard data collection techniques . Furthermore , the methods lay the foundation for collaborative community research partnerships Community engagement is an on-going , arduous , and necessary process for developing effective health promotion programs . The challenges are amplified when the particular health issue or research question is not prominent in the consciousness of the targeted community . In this paper , we explore the community-based participatory research ( CBPR ) model as a means to negotiate a mutual agenda between communities and research ers . The paper is focused on the ( perceived ) need for cervical cancer screening in an under-re source d community in Cape Town , South Africa . Cervical cancer is a significant health problem in this community and elsewhere in South Africa . Unlike HIV-AIDS , however , many Black South Africans have not been educated about cervical cancer and the importance of obtaining screening . Many may not consider screening a priority in their lives . Our research included extensive consultations and informal interviews with diverse community and regional stakeholders . Following these , we conducted 27  focus groups and 106 demographic surveys with r and omly selected youth , parents , local health care personnel , educators and school staff . Focus group data were summarized and analyzed cross-sectionally . Community stakeholders were involved throughout this research . Our consultations , interviews , and focus group data were key in identifying the concerns and priorities of the community . By engaging community stakeholders , we developed a research framework that incorporated the community 's concerns and priorities , and stressed the intersecting roles of poverty , violence , and other cultural forces in shaping community members ' health and wellbeing . Community members helped to refocus our research from cervical cancer to ' cervical health , ' a concept that acknowledged the impact on women 's bodies and lives of HIV-AIDS and STDs , sexual violence , poverty , and multiple social problems . We conclude that the research agenda and questions in community-based health research should not be considered immutable . They need to be open to negotiation , creativity , and constant reinvention Background Community consultation is increasingly recommended , and in some cases , required by ethical review boards for research that involves higher levels of ethical risk such as international research and research with vulnerable population s. In design ing a r and omised control trial of a mental health intervention using a wait list control , we consulted the community where the research would be undertaken prior to finalising the study protocol . The study sites were two conflict-affected locations : Grozny in the Chechen Republic and Kitchanga in eastern Democratic Republic of Congo . Methods Group discussion s with a range of community members were held in both study sites . Facilitators used a prepared set of questions to guide the discussion s and to solicit feedback on the value of the research as well as on the study design . Specific questions were asked about enablers and barriers to participation in the research . Results Six groups were held in Grozny and thirteen in Kitchanga . The majority of individuals and groups consulted supported the research , and understood the purpose . In Grozny , the main concern raised was the length of the waiting period . Barriers to both waiting and returning for follow up were identified . In Kitchanga , there was a strong reaction against the wait list control and against r and omisation . The consultations provided information on unanticipated harms to the community , allowing changes to the study design to mitigate these harms and increase acceptability of the study . It also served to inform the community of the study , and through engaging with them early , helped promote legitimacy and joint responsibility . Conclusion Community consultation prior to finalising the study design for a mental health intervention trial in two humanitarian setting s proved feasible . Our experience reinforces the importance of community consultation before the study design is finalised and the importance of broad consultation that includes both community leaders and the potential study participants To determine the prevalence of drug abuse in city neighborhoods in a developing country undergoing rapid urbanization , we performed a household survey on the spread of drug abuse in Vientiane , Lao People 's Democratic Republic . A total of 1497 households from 17 villages were selected by the stratified r and om sampling method from urban districts in the city of Vientiane .  Participatory style research was employed to increase both the sensitivity of detection and the reliability of information gathered . Local key players shared in the participatory process in this study . We worked with national and city officers and community leaders , as well as with neighborhood leaders who had received previous training for this survey , and conducted household surveys using face-to-face interviews . We inquired about the spread of drug abuse by asking if the families interviewed recognized drug abuse problems in their community . To examine the extent of urbanization of individual villages , the urban index was calculated by principle component analysis from the following eight indicators : income , occupation , parents ' educational histories , diffusion of telephones , ownership of livestock , diffusion of plumbing for running water and distance from the Vientiane city center to the village . Distance was calculated by the Geographic Information System . Among the 17 villages included in the study , the average percentage of recognition of drug abuse in the community was 63.2 % . The relationship between recognition of cases of drug abuse in the community and the urban index showed a significant correlation , with a Spearman coefficient of 0.650 ( p < 0.01 ) . The high reliability of participatory style surveys is also discussed . In conclusion , city neighborhoods in a developing country undergoing rapid urbanization showed evidence of the spread of drug abuse , which was associated with the urban index . Participatory style research activity was recommended to help raise awareness of community participation in anti-drug-abuse activities BACKGROUND There is an urgent need to develop effective strategies to improve stroke outcomes in Sub-Saharan Africa ( SSA ) , where use of evidence -based therapies among patients receiving conventional care is poor . Design s of behavioral interventions to improve stroke care in SSA need to be sensitive to both individual and community factors ( including local perceptions and public policies ) contributing to the likelihood of compliance with recommended therapeutic goals . This article presents a community-based participatory research protocol that will evaluate systems and processes affecting the continuum of stroke-preventive care in an SSA country . METHODS Phase 1 of the Tailored Hospital-based Risk Reduction to Impede Vascular Events study will be implemented from 2013 to 2014 at 4 different types of hospital setting s in Nigeria . Six adult stroke survivor focus group discussion s and  six caregiver focus group discussion s , each lasting about 120 minutes will be conducted . Each group will comprise 6 to 8 participants . We will also conduct 22 semi-structured key informant interviews ( informed by the Theoretical Domains Framework ) with several types of providers and hospital administrators . Purposive and maximum variation sampling will be used to identify and recruit participants from participating hospitals . Transcript data will be analyzed by review ers in an iterative process to identify recurrent and unifying themes using a constructivist variant of the grounded theory methodology , and will involve participatory co- analysis with key stakeholders to enhance authenticity and veracity of findings . DISCUSSION On the basis of the results of Tailored Hospital-based Risk Reduction to Impede Vascular Events phase 1 , we intend to develop a culturally sensitive , system-appropriate , multipronged intervention whose efficacy to boost adherence to evidence -based stroke-preventive care will be tested in a future r and omized trial ( phase 2 )
target: The review revealed the most common stage for PPI was in research planning , and the most common level of involvement was collaboration .
  Most studies did not provide evidence of effectiveness or elaborate on the impact of PPI , and they tended to report impact from the research er 's perspective .
  Where impact was mentioned , this generally related to increased relevance to the community , empowerment of participants and alterations in study design .
background: OBJECTIVES Patient and public involvement ( PPI ) is argued to lead to higher quality health research , which is more relatable to and helps empower the public .
  We synthesis ed the evidence to look for examples of PPI in health research in low/middle-income countries ( LMICs ) , looking at levels of involvement and impact .
  Additionally , we considered the impact of who was undertaking the research on the level of involvement and reported impact .