Community-Based Work and Participatory Budgeting.

Participatory budgeting (PB) works best if this activity is viewed to be part of a trend that is referred to as community-based work. But this connection is not often made. As a result, many PB projects tend to drift away from their home communities. Although working in communities is thought to be a very practical endeavor, philosophy should not be ignored, particularly if the aim is to be community-based. Some examples are supplied in this paper that illustrate how this community-based philosophy alters, and improves, some traditional phases of PB projects. The overall result is to keep these budgeting projects informed by local knowledge and under community control.

Piloting a Flexible Solicited Diary Study With Marginalized Latina Women During the COVID-19 Pandemic.

Little is known about the experiences of minority stress among Latina women who have sex with both women and men (WSWM), a sexual and gender minority group situated at the intersection of multiple marginalized identities. The current article presents an exploratory study aimed at addressing this knowledge gap. The research utilized a flexible diary-interview method (DIM) to investigate stress-related experiences among Mexican American WSWM residing in an economically disadvantaged community in the U.S. during the third wave of the COVID-19 pandemic. A detailed description of the study is provided, including information on the background, methodology, participants' experiences, and how the project was managed remotely by a virtual research team. Twenty-one participants were asked to maintain a diary for a 6-week period spanning from March to September 2021. They submitted weekly entries in diverse formats (visual, audio, typed, and handwritten) through a user-friendly website or via mail while communicating regularly with researchers over the phone. Following the diarizing period, in-depth semi-structured interviews were conducted to clarify pertinent information within the entries and validate researchers' preliminary interpretations. Out of the initial 21 enrollees, 14 participants stopped diarizing at different stages, and nine completed the entire study. Despite facing challenges exacerbated by the pandemic, participants reported the diary-keeping process as a positive experience that offered an authentic outlet to share parts of their lives they seldom reveal. The implementation of this study highlights two significant methodological insights. Firstly, it emphasizes the value of employing a DIM to explore intersectional narratives. Secondly, it underscores the importance of adopting a flexible and sensitive approach in qualitative health research, particularly when engaging individuals from minoritized groups.

Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community.

South Florida agricultural regions, home to Latinx immigrant farmworkers, report higher rates of late-stage breast cancer diagnosis than national, state, and county-level averages. We conducted a community-based qualitative study on the needs, health knowledge gaps, barriers to breast cancer screening, and the role of community health workers (CHWs) in supporting the community's access to early detection services. We conducted three CHW focus groups (FGs) (n = 25) and in-depth interviews (n = 15), two FGs (n = 18) and in-depth interviews (n = 3) with farmworker community members, and informal interviews with cancer clinicians (n = 7). Using a grounded theory approach, five core themes regarding the community's barriers to accessing health care services emerged: (a) lack of information; (b) social and economic barriers; (c) cultural factors; (d) fears and mistrust; and (e) psychosocial concerns. Findings yield implications for community health practice, the potential impact of CHWs, and the production of breast cancer education to improve health equity along with the care continuum.

Community-based participatory design of a community health worker breast cancer training intervention for South Florida Latinx farmworkers.

OBJECTIVE: Community health worker (CHW)-led education is an important strategy to increase awareness and access to breast cancer screening in medically-underserved communities. This study aimed to develop a context-specific, culturally-appropriate training intervention for South Florida CHWs to educate Latinx immigrant farmworkers on breast cancer and early detection. METHODS: A community-based participatory research (CBPR) study, conducted 2017-2019, informed the design of a training curriculum for CHWs and educational dissemination materials. Twenty-two CHWs were trained and knowledge gains were measuring using a one-group pre-and post-test design. Triangulated evaluation consisted of field observations of CHW-client interactions, CHW self-reports, and rapid assessment surveys of community members. RESULTS: A community stakeholder-informed breast cancer training curriculum resulted in significant, sustained breast cancer knowledge gains among CHWs when comparing pre-, post-, and 4-6 month post-training follow-up test scores. Field observations of educational material dissemination, CHW self-reported evaluations, and community rapid assessment surveys at three health fairs demonstrated this was an effective strategy to engage female Latinx farmworkers in breast cancer education. CONCLUSIONS: Community and key stakeholder participation in the development of a breast cancer educational intervention allowed for tailored design priorities around knowledge-based content, comprehensiveness, relevance, appropriateness, and ease of dissemination to community members. This model of participatory CHW training intervention design can enable future train-the-trainer approaches to disseminate and scale-up evidence-based health education interventions.

Self-identity, lived experiences, and challenges of breast, cervical, and prostate cancer survivorship in Mexico: a qualitative study.

BACKGROUND: Qualitative research on cancer patients' survivor-identity and lived experiences in low- and middle-income countries is scarce. Our study aimed at exploring the concept and experience of survivorship for Mexicans living with breast, cervical, and prostate cancer. METHODS: We conducted a qualitative study in Mexico City, Morelos, Nuevo León, and Puebla. The participants were breast, cervical, and prostate cancer patients ≥18 years of age with completed primary cancer treatment. Data were collected via in-depth interviews and analyzed using an inductive thematic approach. RESULTS: The study included 22 participants with a history of breast, 20 cervical, and 18 prostate cancer. Participants accepted the term "cancer survivor" as a literal interpretation of being alive, medical confirmation of treatment completion, or achievement of a clinical result possibly indicative of cure. The majority of respondents perceived that the future is out of their control and under God's will. They linked cure to divine intervention and did not demonstrate the sense of empowerment that is often associated with the survivorship term. The principal themes of their narratives encompass: 1) adverse physical and sexual experiences; 2) emotional problems; 3) cancer-related stigma; 4) challenges to obtaining health-related information; 5) financial hardship; and 6) experience of strengthening family ties in order to provide them with support. In addition, women with breast cancer reported distress caused by changes in body image and positive experience with support groups. CONCLUSION: In Mexico, cancer patients report complex survivorship experiences that demand post-treatment follow-up and support. There is the need to implement comprehensive, culturally-relevant survivorship programs focused on emotional, informational, and in-kind support and empowerment of cancer patients.