Water Management Priorities in a Post-COVID World

This paper maintains that the growing crisis of water scarcity cannot be addressed from within the paradigm that created the problem. The extractive paradigm which prevails views high economic growth as the main goal of development to be achieved through the increasing extraction of natural resources. Approaches to water management that are based on this paradigm view water as a resource primarily meant for human consumption. In contrast, the paper proposes an ecosystem paradigm in which water is viewed as being embedded within the ecosystem as an essential part of it to be conserved and preserved for future generations. The author identifies five areas of action for water management in the post-COVID context: move away from water-intensive agriculture through crop diversification;sustainable and community-based groundwater management;protection of river systems and wetlands;ensuring water quality and drinking water security and the creation of strong legal frameworks for water governance. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

Community Medicine Clerkship amidst COVID-19 Pandemic: Re-designing, Implementation, and Evaluation

Clerkship on primary care and family medicine is multi-elemental and was very challenging during the COVID-19 pandemic. Some medical students postponed their graduation because the clerkship at the health center could not be carried out in a pandemic situation. This article aims to describe the community medicine clerkship (CMC) module and its implementation amidst the COVID-19 pandemic. This module was delivered by online and offline activities from 10th August to 13th September 2020. A total of forty students, twelve faculty mentors, and fifteen Primary Health Care (PHC) preceptors from ten PHCs in the Tangerang District, Indonesia were involved. Students could carry out activities and fulfil assignments given in the midst of a pandemic with a re-designing of the CMC module. The one-sample t-tests were employed to compare the difference between the study values and the values before the COVID-19 pandemic. The study showed that the scores of students participating in CMC module during the COVID-19 pandemic were significantly different from the scores before the pandemic in terms of both individual and group scores. The findings of the study clearly indicated that all clinical clerkship modules must be redesigned to suit the current conditions. Modifications and variations of various learning methods, guidance techniques, monitoring and coordination are all factors that must be considered in implementing changes to these modules. © 2023 Dwi Tyastuti, Risahmawati Risahmawati, Marita Fadhillah, Fika Ekayanti, Sity Kunarisasia & Ahmad A. Habibi.

Using Community-Based Implementation Frameworks and Strategies to Address Food Insecurity During the COVID-19 Pandemic: A Scoping Review

This scoping review aims to describe the main barriers to food security imposed by the COVID-19 pandemic in low-income U.S. households, identify effective community-based implementation frameworks and strategies, and discuss the lessons learned from implementing community-based approaches during the COVID-19 pandemic. Most cited barriers were categorized into the Community/Society-Policy category of "Social determinants of health in communities." Out of the twelve included studies, only five (42%) adopted an implementation framework in their food-insecurity interventions. This study can guide the development and sustainability of food programming during emergencies with possible transfer of lessons learned to food programs in low-income populations.Copyright © 2022 Taylor & Francis Group, LLC.

COVID-19 and youth violence: views from the frontline

Violent crime tends to be concentrated in economically disadvantaged, racially minoritized communities, particularly among youth. Emerging research suggests that the COVID-19 pandemic may have exacerbated the drivers of violence in these communities but provides limited insight into its effects in a single locale, especially small to mid-size cities, and on those on the frontlines of youth violence (i.e., youth service workers). In the current study, we provide an in-depth, qualitative examination of these dynamics in vulnerable neighborhoods in Lansing, Michigan, centering the voices of those instrumental to violence prevention and community resilience. Specifically, we explore youth service providers' perceptions of how COVID-19 changed youth violence and impacted families, communities, and organizations working to prevent and control youth violence. We use the socioecological model adopted by the public health field to explain and prevent violence to guide our work, as this framework recognizes the interlocking and interactive effects of systemic, community, and relational experiences on youth behavior. As such, it allows us to situate community-based organizations and youth service providers' perceptions within the broader contexts that shape violence. Our findings suggest the need for increased support for community-based prevention and for interventions that rectify structural inequalities.

Reaching city youth with an online summer arts workshop in Los Angeles

The Summer Arts Workshop (SAW) is a community-based art therapy program with a social justice focus. It has been offered through the Helen B. Landgarten (HBL) Art Therapy Clinic at Loyola Marymount University (LMU) since 2007 in partnership with Dolores Mission School in Boyle Heights, a historically under-resourced part of East Los Angeles. In 2020, due to the COVID-19 pandemic and stay-at-home orders in Los Angeles, the SAW leadership team adapted the workshop to an online format. The authors took advantage of the online format to extend the reach of the workshop to several school sites in marginalized communities in Los Angeles County, including a juvenile hall high school, which is a prison for youth in a state youth detention centre. The greatest challenge in adapting to an online format was preserving the core component of the workshop: building trust and healthy attachments through expressive art making. The authors overcame this and other challenges and succeeded in providing connecting experiences for participants and facilitators during a time of social isolation and collective anxiety. This chapter shows how teletherapy can bridge gaps of access, particularly for marginalized populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Caregiving for Older Adults With Dementia During the Time of COVID-19: A Multi-State Exploratory Qualitative Study.

This qualitative semi-structured interview study explores how 64 family caregivers for older adults with Alzheimer's Disease and related dementias across eight states experienced and executed caregiving decisions before and during the COVID-19 pandemic. First, caregivers experienced challenges communicating with loved ones and healthcare workers in all care settings. Second, caregivers displayed resilient coping strategies in adapting to pandemic restrictions, finding novel strategies to balance risks while preserving communication, oversight, and safety. Third, many caregivers modified care arrangements, with some avoiding and others embracing institutional care. Finally, caregivers reflected on the benefits and challenges of pandemic-related innovations. Certain policy changes reduced caregiver burden and could improve care access if made permanent. Telemedicine's increasing use highlights the need for reliable internet access and accommodations for individuals with cognitive deficits. Public policies must pay greater attention to challenges faced by family caregivers, whose labor is both essential and undervalued.

Association between vaccination status and severe health consequences among community-dwelling COVID-19 patients during Omicron BA.1/BA.2 and BA.5-predominant periods in Japan.

BACKGROUND: Many previous studies have reported that COVID-19 vaccine effectiveness decreased over time and declined with newly emerging variants. However, there are few such studies in Japan. Using data from a community-based retrospective study, we aimed to assess the association between vaccination status and severe COVID-19 outcomes caused by the Omicron variant, considering the length of time since the last vaccination dose. METHODS: We included all persons aged ≥12 diagnosed with COVID-19 by a doctor and notified to the Chuwa Public Health Center of Nara Prefectural Government during the Omicron BA.1/BA.2 and BA.5-predominant periods in Japan (January 1 to September 25, 2022). The outcome variable was severe health consequences (SHC) (i.e., COVID-19-related hospitalization or death). The explanatory variable was vaccination status of the individuals (i.e., the number of vaccinations and length of time since last dose). Covariates included gender, age, risk factors for aggravation, and the number of hospital beds per population. Using the generalized estimating equations of the multivariable Poisson regression models, we estimated the cumulative incidence ratio (CIR) and 95% confidence interval (CI) for SHC, with stratified analyses by period (BA.1/BA.2 or BA.5) and age (65 and older or 12-64 years). RESULTS: Of the 69,827 participants, 2,224 (3.2%) had SHC, 12,154 (17.4%) were unvaccinated, and 29,032 (41.6%) received ≥3 vaccine doses. Regardless of period or age, there was a significant dose-response relationship in which adjusted CIR for SHC decreased with an increased number of vaccinations and a longer time since the last vaccination. On the one hand, in the BA.5 period, those with ≥175 days after the third dose had no significant difference in people aged 65 and older (CIR 0.77; 95% CI, 0.53-1.12), but significantly lower CIR for SHC in people aged 12-64 (CIR 0.47; 95% CI, 0.26-0.84), compared with those with ≥14 days after the second dose. CONCLUSION: A higher number of vaccinations were associated with lower risk of SHC against both BA.1/BA.2 and BA.5 sublineages. Our findings suggest that increasing the number of doses of COVID-19 vaccine can prevent severe COVID-19 outcomes, and that a biannual vaccination is recommended for older people.

Development and Modification of a Culturally Tailored Education Program to Prevent Breast Cancer in Korean Immigrant Women in New York City.

Breast cancer (BC) is the most common cancer in Korean American (KA) women. In view of its high prevalence in these women, their low screening rates, and the cultural influence of BC risk factors in their lifestyles, we developed a community-based culturally tailored BC prevention program, the Korean Breast Cancer Risk Reduction Program (KBCRRP). Guided by the PRECEDE-PROCEDE and health belief models, the KBCRRP was developed to achieve four goals: (1) healthy weight, (2) physically active lifestyle, (3) healthy diet, and (4) BC screening and adherence. KBCRRP combines effective multicomponent strategies for BC screening and a group-based lifestyle intervention incorporating traditional Korean health beliefs and is tailored for BC risk reduction. In this paper, we provide an overview of the program, the process of program development, implementation, and evaluation, and modification during the COVID-19 pandemic. The initial program involved 8 weeks of in-person group education sessions led by interdisciplinary healthcare professionals and 16 weeks of follow-up involving smartphone applications, phone calls, and text messaging from trained lifestyle coaches. Participants received opportunities to obtain free mammography during the program. After feasibility testing, the program was modified by incorporating participants' feedback. During the COVID-19 pandemic, we provided the program using the Zoom video platform. Participants' recruitment and retention during the pandemic was successful, reflecting the fact that virtual delivery of group-based education was a feasible and acceptable alternative to in-person sessions. Collaboration with community organizations serving the target population is the key to developing and sustaining a successful community-based educational program.

Developing relevant assessments of community-engaged research partnerships: A community-based participatory approach to evaluating clinical and health research study teams.

Background/Objective: In 2017, the Michigan Institute for Clinical and Health Research (MICHR) and community partners in Flint, Michigan collaborated to launch a research funding program and evaluate the dynamics of those research partnerships receiving funding. While validated assessments for community-engaged research (CEnR) partnerships were available, the study team found none sufficiently relevant to conducting CEnR in the context of the work. MICHR faculty and staff along with community partners living and working in Flint used a community-based participatory research (CBPR) approach to develop and administer a locally relevant assessment of CEnR partnerships that were active in Flint in 2019 and 2021. Methods: Surveys were administered each year to over a dozen partnerships funded by MICHR to evaluate how community and academic partners assessed the dynamics and impact of their study teams over time. Results: The results suggest that partners believed that their partnerships were engaging and highly impactful. Although many substantive differences between community and academic partners' perceptions over time were identified, the most notable regarded the financial management of the partnerships. Conclusion: This work contributes to the field of translational science by evaluating how the financial management of community-engaged health research partnerships in a locally relevant context of Flint can be associated with these teams' scientific productivity and impact with national implications for CEnR. This work presents evaluation methods which can be used by clinical and translational research centers that strive to implement and measure their use of CBPR approaches.

Evaluation of the Spanish-Language Cancer Educational Webinar Series "Vamos a educarnos contra el cáncer" with the RE-AIM Framework.

The COVID-19 pandemic disrupted healthcare for patients with chronic diseases, including cancer. Barriers to healthcare increased, especially for racial and ethnic minorities. While many institutions developed webinars to educate community members, few webinars used a community-based participatory approach, employed a theory-based engagement design, and were evaluated. This manuscript reports the outcomes of "Vamos a educarnos contra el cáncer," a 2021 webinar series. Monthly educational webinars were conducted in Spanish on cancer-related topics. The presentations were delivered by Spanish-speaking content experts from different organizations. Webinars were conducted using the video conferencing platform Zoom. Polls were launched during the webinar to collect data and evaluate each webinar. The RE-AIM model of reach, effectiveness, adoption, implementation, and maintenance was used to evaluate the series. The SAS Analytics Software was used for analysis and data management. Two hundred ninety-seven people participated with over 3000 views of the webinar recordings (Reach); 90% rated the sessions as good or excellent (Effectiveness); 86% agreed to adopt or improve a cancer-related behavior, and 90% reported willingness to adopt or improve a cancer-related action for someone else (Adoption); 92% reported feeling engaged (Implementation). The series has produced a resource library, manual of operations, and agreement of the Hispanic/Latino Cancer Community Advisory Board (CAB) to continue the webinar series in the future (Maintenance). Overall, these results highlight the impact of this webinar series and provide a standard approach to planning, delivering, and evaluating webinars as a strategy for cancer prevention and control in a culturally appropriate manner.

Insights from Drug Checking Programs: Practicing Bootstrap Public Health Whilst Tailoring to Local Drug User Needs.

The year 2021 was the most deadly year for overdose deaths in the USA and Canada. The stress and social isolation stemming from the COVID-19 pandemic coupled with a flood of fentanyl into local drug markets created conditions in which people who use drugs were more susceptible to accidental overdose. Within territorial, state, and local policy communities, there have been longstanding efforts to reduce morbidity and mortality within this population; however, the current overdose crisis clearly indicates an urgent need for additional, easily accessible, and innovative services. Street-based drug testing programs allow individuals to learn the composition of their substances prior to use, averting unintended overdoses while also creating low threshold opportunities for individuals to connect to other harm reduction services, including substance use treatment programs. We sought to capture perspectives from service providers to document best practices around fielding community-based drug testing programs, including optimizing their position within a constellation of other harm reduction services to best serve local communities. We conducted 11 in-depth interviews from June to November 2022 via Zoom with harm reduction service providers to explore barriers and facilitators around the implementation of drug checking programs, the potential for integration with other health promotion services, and best practices for sustaining these programs, taking the local community and policy landscape into account. Interviews lasted 45-60 min and were recorded and transcribed. Thematic analysis was used to reduce the data, and transcripts were discussed by a team of trained analysts. Several key themes emerged from our interviews: (1) the instability of drug markets amid an inconsistent and dangerous drug supply; (2) implementing drug checking services in dynamic environments in response to the rapidly changing needs of local communities; (3) training and ongoing capacity building needed to create sustainable programs; and (4) the potential for integrating drug checking programs into other services. There are opportunities for this service to make a difference in overdose deaths as the contours of the drug market itself have changed over time, but a number of challenges remain to implement them effectively and sustain the service over time. Drug checking itself represents a paradox within the larger policy context, putting the sustainability of these programs at risk and challenging the potential to scale these programs as the overdose epidemic worsens.

Effectiveness of an Online Dementia Prevention Program on Cognitive Function and Depression in Community-Dwelling Older Adults during the COVID-19 Pandemic in Korea.

(1) Background: Continuous participation in a comprehensive dementia prevention program is important for community-dwelling older adults during the coronavirus disease (COVID-19) pandemic, as limitations on their communities and social participation have increased and participation in daily tasks has decreased. These factors can negatively affect their cognitive function and symptoms of depression. This study aimed to introduce an evidence-based online dementia prevention program in the South Korean context and to identify its effect on cognitive function and symptoms of depression in community-dwelling older adults during the COVID-19 pandemic. (2) Methods: One hundred and one community-dwelling older adults without dementia participated in twelve sessions of an online dementia prevention program designed by occupational therapists. Cognitive function and symptoms of depression were assessed before and after the program. Cognitive function was tested using the Cognitive Impairment Screening Test and symptoms of depression were assessed using the Korean version of the Short Geriatric Depression Scale. The participants' opinions were gathered using open-ended questions. (3) Results: After the program, according to the raw score, orientation was maintained and attention, visuospatial function, executive function, memory, and language function increased. The memory and total cognitive score was improved significantly. Symptoms of depression significantly decreased. The program's benefits according to the participants were participation in new activities, boredom reduction, online communication, and reminiscence. (4) Conclusions: An online dementia prevention program is effective in maintaining and increasing cognitive function and preventing depression in community-dwelling older adults. An online dementia prevention program is a useful method in providing opportunities to participate in cognitive training and continuous daily activities during the COVID-19 pandemic.

Three-year evaluation of a program teaching social determinants of health in community-based medical education: a general inductive approach for qualitative data analysis.

BACKGROUND: Social determinants of health (SDH) are intricately intertwined with various social and economic factors. Reflection is essential for learning about SDH. However, only a few reports have focused on reflection in SDH programs; most were cross-sectional studies. We aimed to longitudinally evaluate a SDH program in a community-based medical education (CBME) curriculum that we introduced in 2018 based on the level of reflection and content on SDH in students' reports. METHODS: Study design: General inductive approach for qualitative data analysis. Education program: A 4-week mandatory clinical clerkship in general medicine and primary care at the University of Tsukuba School of Medicine in Japan was provided to all fifth- and sixth-year medical students. Students underwent a 3-week rotation in community clinics and hospitals in suburban and rural areas of Ibaraki Prefecture. After a lecture on SDH on the first day, students were instructed to prepare a structural case description based on encounters during the curriculum. On the final day, students shared their experiences in a small group session and submitted a report on SDH. The program was continuously improved and faculty development was provided. STUDY PARTICIPANTS: Students who completed the program during October 2018-June 2021. ANALYSIS: Levels of reflection were categorized as reflective, analytical, or descriptive. The content was analyzed based on the Solid Facts framework. RESULTS: We analyzed 118 reports from 2018-19, 101 reports from 2019-20, and 142 reports from 2020-21. There were 2 (1.7%), 6 (5.9%), and 7 (4.8%) reflective reports; 9 (7.6%), 24 (23.8%), and 52 (35.9%) analytical reports; and 36 (30.5%), 48 (47.5%), and 79 (54.5%) descriptive reports, respectively. The others were not evaluable. The number of Solid Facts framework items in reports were 2.0 ± 1.2, 2.6 ± 1.3, and 3.3 ± 1.4, respectively. CONCLUSIONS: Students' understanding of SDH deepened as the SDH program in the CBME curriculum improved. Faculty development might have contributed to the results. Reflective understanding of SDH might require more faculty development and integrated education of social science and medicine.

Introduction to health information exchange

To support health care and public health in managing the array of information available about patients and populations, health systems have adopted a variety of information and communications technologies (ICT). Examples include electronic health record systems that document patient symptoms, diseases, and medications as well as health care processes. Yet, many ICT systems operate as islands unto themselves, unable to connect or share information with other ICT systems. Such fragmentation of data and information is an impediment to achieving the goal of efficient, coordinated health care delivery. It was further a major challenge during the COVID-19 pandemic when information was rapidly needed yet challenging to access. Health information exchange (HIE) seeks to address the challenges of connecting disparate ICT systems, enabling information to be available when and where it is needed by clinicians, administrators, and public health authorities. This chapter robustly defines HIE, including its core components and various forms. This chapter further discusses the role of HIE in supporting care delivery and public health. © 2023 Elsevier Inc. All rights reserved.

Collective Healing to Support Design Futures: Building Community and Exploring Methods

This workshop explores the role of healing ourselves as a key aspect for transformative social change. It brings together social justice and community based work in HCI that engages with healing and joy to expand on current methodologies such as autoethnography, somaesthetics, and embodied design which aim to describe different ways of knowing and describing and living experiences as inputs for design futuring. Our concern of interest is the ways in which all of us have lived through continuous community grief and loss due to the ongoing COVID-19 pandemic and a continued climate crisis;and the resulting symptoms like anxiety, depression, body pain, and scattered focus. We believe that we must acknowledge these experiences and feelings about these events in order to effectively work towards more optimistic futures. This workshop takes the space and time to consider our recent collective traumas and explore how to integrate them into futures that support the development of futures that fit our emotional, ethical, social and physical needs. Our aim is to build a greater understanding of how the CHI community can integrate healing in support of social change. © 2023 Owner/Author.

Modeling COVID-19 with big mobility data: Surveillance and reaffirming the people in the data

To better understand the COVID-19 pandemic, public health researchers turned to "big mobility data”—location data collected from mobile devices by companies engaged in surveillance capitalism. Publishing formerly private big mobility datasets, firms trumpeted their efforts to "fight” COVID-19 and researchers highlighted the potential of big mobility data to improve infectious disease models tracking the pandemic. However, these collaborations are defined by asymmetries in information, access, and power. The release of data is characterized by a lack of obligation on the part of the data provider towards public health goals, particularly those committed to a community-based, participatory model. There is a lack of appropriate reciprocities between data company, data subject, researcher, and community. People are de-centered, surveillance is de-linked from action while the agendas of public health and surveillance capitalism grow closer. This article argues that the current use of big mobility data in the COVID-19 pandemic represents a poor approach with respect to community and person-centered frameworks. © The Author(s) 2023.

Monitoring the Temporal Trajectory of Sars-Cov-2 in Hong Kong - Daily Antigen Rapid Testing Surveillance (Darts) System

Intro: The number of PCR-confirmed cases may serve poorly as a surveillance data for a representative disease activity, due to its bias towards symptomatic cases or people having an identifiable risk exposure, and the high dependency on changing testing policy. We reported a large-scale ad-hoc community surveillance initiative, Daily Antigen Rapid Testing Surveillance (DARTS) System, using self-performed rapid antigen tests(RAT). Method(s): A representative cohort of 10000+ individuals was enrolled over the territory. Participants were divided into 7 sub-cohorts to achieve a rolling schedule with 1400+ individuals on a daily basis. Participant performed the RAT regularly irrespective of symptom or exposure history, with a self-sampled throat-and-nasal swab. RAT result and photo were reported on the same day of testing through an online platform. Daily point prevalence was disseminated on a real-time dashboard to inform the situation awareness(https://covid19.sph.hku.hk/dashboard). Finding(s): Since its launch during the peak of the fifth wave in March 2022, the system has tracked the changing trajectory of different phases of the Omicron pandemic, including the rapidly subsiding daily prevalence from an initial high value of 12.7% (8.4-18.7) in early March to a baseline of 0.6% (0.2-1.4) in early April, maintained with a non-zero baseline (0.1-0.3%) over May, and subsequent stepwise increase to 0.5% (0.2-1.2) in June. The reproduction number increased from 0.66(0.63,0.70) to 1.23(1.14,1.33) from March to June, signifying the gradual increase of residual Omicron transmission. Conclusion(s): Our DARTS system has demonstrated the feasibility of a participatory surveillance system using self-performed RAT, and its utility as an ad-hoc surveillance to timely reflect the rapidly changing epidemic trajectory. Regular testing irrespective of symptom and exposure risk helps to give more representative picture, including subclinical cases who also carried an implication of disease transmission. The use of RAT also helps to avoid the constraint of manpower and testing capacity, and has been quickly adopted for case definition.Copyright © 2023

ASHAs in India – The Unsung Corona Warriors

This case study outlines the struggle that Accredited Social Health Activists (ASHAs) encountered at the grassroots level in India while combating the spread of the corona virus. Due to misinformation and a lack of specific knowledge, rural communities began to mistrust government workers attempting to track the spread of the pandemic, resulting in instances of physical and verbal abuse. The impact on many ASHAs, who provided a vital frontline health service, was very negative. A communication strategy had to be adopted to avoid a worsening situation. Seema Barma (Block ASHA coordinator) had the job of providing a sustainable solution for managing the uncertainty in an effective manner and to rebuild public trust in authorities, and health workers including ASHAs. Students will learn how to formulate an effective communication strategy for dealing with such a pandemic crisis situation in a developing nation with specific reference to India. © 2022 NeilsonJournals Publishing.

Developing a peer-led intervention to promote COVID-19 testing in low-income housing settings.

Background: The Housing Collaborative project at Eastern Virginia Medical School has developed a method of adapting public health guidance from public housing communities, which face tremendous health challenges in cardiometabolic health, cancer, and other major health conditions. In this paper, we describe how academic and community partners in the Housing Collaborative came together to do this work with a focus on COVID-19 testing in the context of the emerging pandemic. Methods: The academic team used virtual community engagement methods to interact with the Housing Collaborative Community Advisory Board (HCCAB) and a separate cohort of research participants (N = 102) recruited into a study of distrust in COVID-19 guidance. We conducted a series of 44 focus group interviews with participants on related topics. Results from these interviews were discussed with the HCCAB. We used the collaborative intervention planning framework to inform adaptation of public health guidance on COVID-19 testing delivered in low-income housing settings by including all relevant perspectives. Results: Participants reported several important barriers to COVID-19 testing related to distrust in the tests and those administering them. Distrust in housing authorities and how they might misuse positive test results seemed to further undermine decision making about COVID-19 testing. Pain associated with testing was also a concern. To address these concerns, a peer-led testing intervention was proposed by the Housing Collaborative. A second round of focus group interviews was then conducted, in which participants reported their approval of the proposed intervention. Conclusion: Although the COVID-19 pandemic was not our initial focus, we were able to identify a number of barriers to COVID-19 testing in low-income housing settings that can be addressed with adapted public health guidance. We struck a balance between community input and scientific rigor and obtained high quality, honest feedback to inform evidence-based recommendations to guide decisions about health.

A System-Oriented Dialogue Model to Design Community Partnerships for More Effective Sars-Cov-2 Prevention in Schools: The Case of Spain.

Objectives: The European Centre for Disease Control (ECDC) COVID-19 guidelines for non-pharmaceutical interventions (NPI) identify safety, hygiene and physical distancing measures to control SARS-Cov-2 transmission in schools. Because their implementation requires complicated changes, the guidelines also include "accompanying measures" of risk communication, health literacy and community engagement. Although these are considered crucial, their implementation is complex. This study aimed to co-define a community partnership that a) identifies systemic barriers and b) designs recommendations on how to implement the NPI to improve SARS-Cov-2 prevention in schools. Methods: We designed and piloted a System-Oriented Dialogue Model with the participation of 44 teachers and 868 students and their parents from six Spanish schools during 2021. The results were analysed using thematic analysis. Results: Participants identified 406 items addressing issues related to system characteristics, which is indicative of the complexity of the challenge. Using a thematic analysis, we defined 14 recommendations covering five categories. Conclusion: These findings could help in developing guidelines for initiating community engagement partnerships in schools to provide more integrated prevention interventions.