Strengths, challenges, and strategies for implementing pragmatic multicenter randomized controlled trials (RCTs): example of the Personalized Citizen Assistance for Social Participation (APIC) trial.

BACKGROUND: Randomized controlled trials (RCTs) are rigorous scientific research designs for evaluating intervention effectiveness. However, implementing RCTs in a real-world context is challenging. To develop strategies to improve its application, it is essential to understand the strengths and challenges of this design. This study thus aimed to explore the strengths, challenges, and strategies for improving the implementation of a pragmatic multicenter, prospective, two-arm RCT evaluating the effects of the Personalized Citizen Assistance for Social Participation (Accompagnement-citoyen Personnalisé d'Intégration Communautaire: APIC; weekly 3-h personalized stimulation sessions given by a trained volunteer over a 12-month period) on older adults' health, social participation, and life satisfaction. METHODS: A multiple case study was conducted with 14 participants, comprising one research assistant, seven coordinators, and six managers of six community organizations serving older adults, who implemented the APIC in the context of a RCT. Between 2017 and 2023, qualitative data were extracted from 24 group meetings, seven semi-directed interviews, emails exchanged with the research team, and one follow-up document. RESULTS: Aged between 30 and 60 (median ± SIQR: 44.0 ± 6.3), most participants were women from organizations already offering social participation interventions for older adults and working with the public sector. Reported strengths of this RCT were its relevance in assessing an innovative intervention to support healthy aging, and the sharing of common goals, expertise, and strategies with community organizations. Challenges included difficulties recruiting older adults, resistance to potential control group assignments, design complexity, and efforts to mobilize and engage volunteers. The COVID-19 pandemic lockdown and health measures exacerbated challenges related to recruiting older adults and mobilizing volunteers and complicated delivery of the intervention. The strategies that mostly overcame difficulties in recruiting older adults were reducing sample size, simplifying recruitment procedures, emphasizing the health follow-up, extending partnerships, and recognizing and supporting volunteers better. Because of the lockdown and physical distancing measures, the intervention was also adapted for remote delivery, including via telephone or videoconferencing. CONCLUSION: Knowledge of the strengths and challenges of pragmatic RCTs can contribute to the development of strategies to facilitate implementation studies and better evaluate health and social participation interventions delivered under real-life conditions. TRIAL REGISTRATION: NCT03161860; Pre-results. Registered on May 22, 2017.

Evaluation of a Conference on Cancer-Related Financial and Legal Issues: A Potential Resource to Counter Financial Toxicity.

This study describes the conception, development, and growth of the Triage Cancer Conference hosted by Triage Cancer, a national nonprofit organization providing free legal and financial education to the cancer community. We conducted a retrospective analysis of post-conference participant surveys. Descriptive statistics were calculated for participant demographics, and acceptability, feasibility, and appropriateness were evaluated. From 2016-2021, 1239 participants attended the conference and completed post-conference surveys. Participants included social workers (33%), nurses (30%), and cancer patients/survivors (21%), with representation from over 48 states. Among those who reported race, 16% were Black, and 7% were Hispanic. For acceptability, more than 90% of participants felt that the conference content, instructors, and format were suitable and useful. For feasibility, more than 90% of participants felt that the material was useful, with 93-96% reporting that they were likely to share the information and 98% reporting that they would attend another triage cancer event. Appropriateness was also high, with >80-90% reporting that the sessions met the pre-defined objectives. Triage Cancer fills an important gap in mitigating financial toxicity, and formal evaluation of these programs allows us to build evidence of the role and impact of these existing resources. Future research should focus on adding validated patient-reported outcomes, longer-term follow-up, and ensuring inclusion and evaluation of outcome metrics among vulnerable populations.

Community Health Builders Program: A Collaborative Model Connecting National Health Thought Leaders With Community-Level Champions.

Make Well Known Foundation (MWKF), a nonprofit organization focused on supporting the health of minoritized and underserved populations, piloted the Community Health Builders (CHB) program. This connected MKWF Steering Committee members-national thought leaders in health-with leaders of underserved populations in Greensboro, NC, with the goal of translating research into practice. Steering Committee members provided education, instruction, and resources to community leaders that could then be transferred to area residents to cultivate better health. A roundtable meeting was first organized to allow community leaders to share insights into the highest priority needs of Greensboro's Black residents. Four topics resulted that became the focus of the training modules (called "accelerator forums") that formed the core of the CHB program. Each accelerator forum was led by Steering Committee members and local-level topic experts to educate and share resources with community leaders. The program concluded with a local health and resource fair, which exposed Greensboro residents to the resources shared during CHB program trainings. Overall, the CHB program pilot demonstrated success in the collaborative engagement between national- and community-level leaders based on measures of increased knowledge and self-efficacy in supporting Greensboro residents in the four accelerator forum topics. In a final debrief session, CHB participants shared their perspective that the progress achieved in the community needed to be sustained through continued national- and community-level collaboration and ongoing community training. This key insight and the need for sustained engagement will be incorporated into all future programs.

A Needs Assessment Approach for Adolescent and Young Adult Sexual and Gender Diverse Cancer Survivors.

Sexual and gender diverse (SGD) adolescent and young adult (AYA) cancer survivors are an increasing and vulnerable group with unique needs that often remain unmet in the healthcare system. This paper describes the conceptualization and development of a community-based organization dedicated to serving SGD AYAs, in addition to reporting on the results of a community-led needs assessment. A total of 56 SGD AYA community members completed the online survey. Most participants were between the ages of 26 to 33, identified as white, cisgender, bisexual women, and had hematologic malignancies. Identified unmet needs of SGD AYAs included the following: sexual health and family planning; gender affirmation; financial stability; and emotional support. Areas within the community organization were identified as gaps, areas of expansion, and assets. Results highlight the role of community and academic partnerships in improving cancer care delivery for SGD AYA cancer survivors.

Food Parenting Practices Promoted by Childcare and Primary Healthcare Centers in Chile: What Influences Do These Practices Have on Parents? A Qualitative Study.

Chile, like many other countries in the world, is experiencing a high prevalence of childhood overweight. Among the factors influencing children's eating behaviors are the food parenting practices promoted by community organizations. More information is needed on the influences of these recommendations on the parenting practices of parents of preschoolers. This study examined what types of food parenting practices are promoted in childcare and primary healthcare centers and how these recommendations influence subsequent parental behavior. Interviews using photo-elicitation were conducted with 25 parents of Chilean preschoolers. The interviews were analyzed using inductive thematic analysis. Five themes were identified to describe food parenting practices promoted by community organizations and the influences that these practices had on parents of preschoolers. Healthcare centers were found to educate parents and provided a structured feeding. However, parents found their advice regarding dietary restriction challenging to follow. Childcare centers also provided information about healthy diet, food monitoring, and diversifying the child's diet in a way that was perceived as adequate. While childcare centers encouraged structured and autonomous food parenting practices in a positive and supportive manner, healthcare centers tended to provide more restrictive guidance that posed challenges for parents struggling with preschool nutritional care.

Lights, Facts, and Goals: A Novel Framework to Enhance Community Health Messaging Campaign Design, Implementation, and Assessment.

The spread of health misinformation has made the task of health communicators more difficult. However, the success of health messaging hinges not only on meaningful message content but also on the credibility of who is delivering the message. "Trusted messengers," like local leaders and community-based organizations, have a greater ability to influence improvements in community health, due to their shared cultural experience with their communities. Health communication agencies should empower trusted messengers with the tools they need to succeed in health communication. One tool critical for their success is a succinct health messaging framework to plan and implement health messaging. Marketing has "See, Think, Do"-a simple, practical framework used to influence consumer purchases. As a more trustworthy corollary, we propose the "Lights, Facts, and Goals" framework, a concise, authentic, and transparent method for planning, implementing, and assessing health messaging campaigns that influence health improvements. "Lights" refers to different methods of reaching communities like trusted messengers, advertisements, and text messages. "Facts" refers to key sourced scientific information relevant to a specific aspect of community health. "Goals" refers to actions community members can take to improve their health in connection with the communicated health facts. This article describes how the "Lights, Facts, and Goals" framework both simplifies the creation and communication of scientifically sound health messaging and strengthens the partnership between health agencies and trusted messengers in the community. Through "Lights, Facts, and Goals," community-based organizations, community leaders, and their partners will be more effective at improving community health through messaging.

The Mauli Ola Study: A Unique Academic-Community Partnership With MA'O Organic Farms to Understand and Address Health Inequities Among Native Hawaiians and Other Pacific Islanders in Hawai'i.

Indigenous peoples, including Native Hawaiians and Pacific Islanders (NHPIs), experience significant cardiometabolic health disparities arising in large part from rapid changes to their diets and food systems. Innovative food sovereignty initiatives led by NHPIs are needed to address these disparities. This article describes a community-based participatory research study that incorporates social and biological measures to examine the impact of an Indigenous-led land-based food sovereignty youth leadership program on health disparities among NHPI youth in Hawai'i. Grounded in the Indigenous knowledge that holistic health and wellbeing of people is inseparable from that of the environment and to counter rampant food insecurity in their community of Wai'anae, O'ahu, MA'O Organic Farms developed a Youth Leadership Training (YLT) program that offers education, nutrition, physical activity, and access to health care. The program also engages YLT interns and their social networks in health education and research in the ongoing Mauli Ola study. Preliminary data from this study affirm the need to address the disproportionately high rates of obesity, type 2 diabetes mellitus (T2D), and poor mental health conditions among young NHPIs in the Wai'anae community, and how the YLT program may provide an effective approach to address this need. Our unique academic-community partnership underscores the importance of social and biomedical research to understand health disparities in the NHPI population, which present novel avenues to enable disease prevention. The outcomes of the Mauli Ola study may serve as a valuable model for health disparities research while leveraging ongoing social programs that support Indigenous food sovereignty.

Health Behaviors Before and After the Implementation of a Health Community Organization: Gangwon's Health-Plus Community Program.

OBJECTIVES: Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon's Health-Plus community program, implemented from 2013 to 2019 on residents' health behaviors. METHODS: This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted. RESULTS: HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables. CONCLUSIONS: The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed.

Community organization guides standardization, adaptability, and innovation: lessons from peer support in the Shanghai Integration Model.

Although there is broad evidence for the value of peer support (PS) in preventing and managing diabetes and other chronic diseases, identifying approaches to stage, scale, and adapt PS interventions is a challenge. Community organization may provide a process for such adaptation of standardized PS and diabetes management to individual communities. This community organization approach was used to develop PS in 12 communities in Shanghai, China. Through a convergent mixed methods design, project records, semi-structured interviews, and an implementation assessment characterized processes of adaptation of standardized materials, examined the extent to which the program was implemented, and identified key success factors and challenges. Findings from both interviews and the implementation assessment indicated that communities adapted standardized intervention components to meet the needs of their communities and assumed responsibility for implementation of different components of the program based on their community's available capacity. Additionally, community innovations occurring as part of the project were reported and standardized for dissemination in future iterations of the program. Key success factors identified included cooperation and collaboration among varied partners within and across communities. Two challenges illustrate the resilience of the community organization model in response to COVID-19 and the need for further adaptation in rural communities. Community organization provided a useful approach to standardization, adaptation, innovation, and reporting of PS interventions for diabetes management.

The Pre-Implementation Phase of a Project Seeking to Deliver a Community-Based CVD Prevention Intervention (SPICES-Sussex): A Qualitative Study Exploring Views and Experience Relating to Intervention Development.

BACKGROUND.: Community-led health care interventions may be an effective way to tackle cardiovascular disease (CVD) risk factors, especially in materially deprived communities where health care resources are stretched and engagement with institutions is often low. To do so effectively and equitably, interventions might be developed alongside community members through community engagement. OBJECTIVES.: The aim of this project was to carry out stakeholder mapping and partnership identification and to understand the views, needs, experiences of community members who would be involved in later stages of a community-based CVD prevention intervention's development and implementation. METHODS.: Stakeholder mapping was carried out to identify research participants in three communities in Sussex, United Kingdom. A qualitative descriptive approach was taken during the analysis of focus groups and interviews with 47 participants. FINDINGS.: Three themes were highlighted related to intervention design (a) Management: the suitability of the intervention for the community, management of volunteers, and communication; (b) Logistics: the structure and design of the intervention; and (c) Sociocultural issues, the social and cultural expectations/experiences of participants and implementers. CONCLUSIONS.: Study participants were open and willing to engage in the planned community-based intervention, particularly in elements of co-design and community-led delivery. They also highlighted the importance of sociocultural factors. Based on the findings, we developed recommendations for intervention design which included (but were not limited to): (a) a focus on a bottom-up approach to intervention design, (b) the recruitment of skilled local volunteers, and (c) the importance of fun and simplicity.

De la caracterización de la población moradora al acompañamiento en la construcción de experiencias de resistencia al despojo, en la conflictividad urbana de la ciudad de Medellín

Se sistematizan algunas iniciativas y experiencias de organización comunitaria, en proceso de construcción de territorialidad como lo son las de los participantes de la "población moradora", inmersa en los escenarios del despojo, provocado por las alianzas público-privadas del urbanismo neoliberal en el Valle de Aburrá, que al lograr convertirse en sujetos organizativos consolidan apuestas por el trabajo colectivo de transformación social. La reflexión en modo IAP da cuenta de la forma como en medio de las adversas problemáticas de su mundo de la vida, por medio del trabajo con herramientas formativas, la "población moradora" se constituye como subjetividad erguida y de resistencia, en permanente construcción de un proyecto de incidencia política.

In the midst of the advance of the urban intervention of the alliances between the officialdom and the financial guilds for the benefit of the private sector, which took place in the first two decades of the 21st century in the city of Medellín, some considerations are made on the contextual conditions in which the phenomenon of resistance of the population named dweller in the city of Medellín and the metropolitan area emerges. Thus, some initiatives and experiences of community organization are systematized, whose social subjects overcome the bets of collective work, in the midst of the adversities of the problems of their world of life of the subjectivity that lives from the dispossession by urbanism.

Una experiencia con ellas: una actividad comunitaria en el barrio de Carabanchel Alto / An experience with them: a community activity in the neighbourhood of Carabanchel Alto

Introducción y objetivos: Una experiencia con las mujeres de la Asociación Cultural de Carabanchel Alto (ACCA) sobre los activos y recursos de salud de Carabanchel Alto.Métodos. Actividad dinamizada por distintas entidades del barrio, impartida en un aula del Centro de Educación Infantil y Primaria (CEIP) República Dominicana y basada en el conocimiento de los recursos y activos del barrio y la lectura como herramienta de reflexión.Resultados. Nos acercamos a la población mayor del barrio y conocimos su historia. Se creó un ambiente de confianza donde compartimos experiencias y reflexiones.Conclusiones. El contacto con distintos profesionales de la salud fuera del ámbito del trabajo permite establecer un vínculo de confianza para una futura atención en estas entidades. (AU)

Introduction and aims: An experience with ACCA women on Carabanchel Alto health assets and resources.Methods. This activity, organised by different organisations in the neighbourhood, took place in a CEIP República Dominicana classroom and based on knowledge of the neighbourhood’s resources and assets and reading as a tool of reflection.Results. We approached the neighbourhood's older population and got to know their story. A climate of trust was fostered where we shared experiences and reflections.Conclusions. Contact with different health professionals outside the work setting enables a bond of trust to be established for future care in these entities. (AU)

Barriers to Meeting Community Needs in New York State during COVID-19: Results From a Pilot Survey of Nongovernmental Population and Community Health Professionals.

Capacity building and training help empower the community and population health organizations to partner with local health departments and collaboratively design multisectoral interventions that account for the complexity of public health and health promotion challenges in the era of COVID-19 and beyond. Ideally, training programs should be informed by an understanding of the needs and priorities of the professionals for whom they are intended. This brief report focuses on the results of a pilot online survey conducted as part of a larger pilot study by the New York State Association of County Health Officials and the Region 2 Public Health Training Center among population and community health professionals (n = 27) from four counties in New York State during the COVID-19 pandemic. Survey participants included a diverse group of staff members from various large and small nonprofit organizations, federally qualified health centers, academic institutions, hospitals, and insurers. Survey findings provide preliminary insights into the extent to which these organizations have been involved in the COVID-19 response in partnership with LHDs, barriers they faced in responding to the needs of the populations they serve and adjusting their work routines/operations to COVID-19 guidelines, and their top emerging organizational and training needs. Lessons learned from conducting an online survey during a public health emergency and implications for future training interventions for population and community health professionals are also discussed within the context of promoting multisectoral collaboration with local health departments, solving complex public health problems, and advancing health equity.

Implementation Strategies to Support Built Environment Approaches in Community Settings.

BACKGROUND: Built environment approaches are recommended to improve population physical activity levels. Implementation strategies are needed to improve uptake, but little is known about effective strategies to translate research to practice in community settings. PURPOSE: Inform implementation strategies through understanding delivery agents' perceptions of (1) built environment approaches, (2) a toolkit developed to support implementation, and (3) other required implementation strategies. METHOD: A toolkit was developed to detail the process of partnering to change the built environment and provide examples of built environment approaches (e.g., walking paths, traffic calming). Data were collected through focus groups (N = 3) with Extension Agents (n = 46) in 2020. The semi-structured focus group script was based on the Consolidated Framework for Implementation Research and the Technology Acceptance model. Rapid content analysis techniques and a deductive, grounded theory approach were used to interpret the data. Results. Focus groups generated meaning units coded into themes of perceptions of the intervention (subthemes: barriers, resources needed, and facilitators) and perceptions of the toolkit (subthemes: components to add, positive perceptions, and helpful components). The most common resources needed were coalition guidance and funding. CONCLUSION: Agents experience barriers and facilitators to implementing built environment approaches and have specific needs for support. Based on the results, we created implementation strategies: (1) Places for Physical Activity toolkit, (2) Coalition Coaching, and (3) Mini-Grants. Future work is needed to investigate the effectiveness of these implementation strategies.

Development of a Nudge Program at One Alaska Food Pantry.

Food pantry clients experience many health disparities, including elevated incidence of diabetes, heart disease, and other nutrition-related conditions. Nutrition education interventions in the form of a nudge can be an effective method to increase nutrition knowledge and healthy pantry food selection. Currently there is no nutrition education program at the largest food pantry in Alaska. The goal of this project was to develop a nutrition intervention in the form of a nudge to increase the selection of nutritious foods by pantry clients. Methods included the development of nudges, or environmental cues, within the pantry as well as client education handouts and recipes for clients to take home. Implications for practice include the potential to increase staff and client knowledge and nutrition education, as well as for impacting the overall health and food security of the clients and their families. Additional implications include the availability of the program and resources for other food pantries across the state to customize for use in their facilities. After the program has been implemented, it can be evaluated across each site and its efficacy determined to implement into policy.

Impacts of community-level grassroots organizations on household food security during the COVID-19 epidemic period in China.

Purchasing food via community-level grassroots organizations was a new pattern of food patronage for Wuhan residents during the COVID-19 lockdown in 2020, but little attention was paid to it. The study examined the relationship between community-level grassroots organizations and household food insecurity based on an online survey of household food insecurity in Wuhan in March 2020. The study found that problems in all three domains of food insecurity including food anxiety, insufficient quality and inadequate quantity existed but were uneven. Community-level grassroots organizations played an important role in promoting food security including reducing worries about food supply and providing enough food intake, but did not ensure households had adequate food quality due to increasing food prices, fewer varieties of food and decreased food freshness. Compared to other grassroots organizations, the community committee had actually become an extension of the government to run administrative grassroots affairs before the epidemic, so its tight relationship with local government made it become the major grassroots power in ensuring household food security at the residential community level.

"More than just checking the box": community-based organizations on their role in Medicaid redesigns.

New York and Massachusetts 1115 Medicaid demonstration waivers aimed to prioritize social determinants of health and engage community-based organizations to improve health outcomes. This is an evaluation of community-based organizations' public comments regarding their participation in social services delivery within the 1115 waivers. Both states solicited public comments on waiver implementation to date and potential improvements. The research team extracted all publicly available comments (n = 359) made by direct service providers between November 2016 and April 2019. The sample was then limited to only comments that discussed social service provision and health care-social service partnerships (n = 58). Findings are presented in 2 stages: (1) concerns regarding delivery system reform incentive payments funding levels, timing, and flow and (2) perspectives on how states and Medicaid administrators could improve health care-community organization relationships. Resource-dependent, community-based organizations protested insufficient funding. Additional comments identified specific design, structure, and implementation aspects of the 1115 waiver that could improve partnerships. Despite 1115 waivers prioritizing social service integration, community-based organizations still feel underfunded and disenfranchised. Aligning with health care standards requires significant time and effort. Given resource constraints, the state must facilitate these investments. Community organizations' feedback can also offer guidance on waiver strategies in other states.

To address Medicaid enrollees' social needs, New York and Massachusetts have led the way in aiming to integrate community-based organizations into Medicaid policy and financing. In an evaluation examining public comments submitted by community-based organizations to state Medicaid offices, perspectives on participating in 1115 Medicaid demonstration waivers revealed 2 themes (1) financial concerns about funding, timing, and flow of payments and (2) nonfinancial suggestions for enhancing health care and community-based organization partnerships through standardized partnership standards, enhanced governance, and tailored metrics to better address social determinants of health.

Addressing HIV and Homelessness During COVID-19: A Community-Based Demonstration Project.

People experiencing homelessness are at increased risk for HIV, and people with HIV (PWH) experiencing homelessness are more likely to experience suboptimal HIV health outcomes than PWH with stable housing. Within Alabama, a state prioritized in the Ending the HIV Epidemic initiative, Jefferson County consistently has the highest number of new HIV diagnoses as well as a high percentage of the state's homeless population. To address the twin epidemics of both HIV and homelessness within the high-priority setting of Jefferson County, Alabama, this 1-year community-based project, Ending the HIV Epidemic: Addressing HIV Health and Homelessness (AH3), sought to increase HIV testing and linkage to care among this population by placing a full-time case manager trained in HIV testing and case management at a homeless shelter. Results demonstrated that HIV testing was highly acceptable: 733 individuals were offered a test, and only 2.7% (n = 20) declined. Nine previously diagnosed, out of care PWH and one newly diagnosed PWH were identified through AH3 testing efforts. Of these, five (50%) were linked to care at a local HIV clinic. The remaining five PWH left the shelter before they could be linked to care. Just 10 shelter guests expressed interest in taking PrEP (just 1.4% of guests who tested negative for HIV), and only one of these linked to PrEP care. Future health promotion programs are needed to address mental health and other ancillary needs among this population, as well as programs that provide access to PrEP and other HIV prevention services.

Decreasing Missed Appointments at a Community Health Center: A Community Collaborative Project.

Introduction: Missed appointments are a problem for health care systems, causing lost revenue and concern for poor health outcomes. This is particularly true at Community Health Centers (CHCs), where clients may already face substantial barriers to optimal care and outcomes. Identified solutions to this problem are limited, and often focus on reminder calls and messages to clients. Methods: This project utilized a unique academic/CHC collaboration to investigate and initiate solutions to their high missed appointment rates. Client phone calls to determine clinic specific needs, monthly team meetings to brainstorm and choose initiatives, engaging stake holders, and phased implementation were the tools used to address the high missed appointment rates within the limitations of the clinic resources available. Results: Within one quarter, missed appointment rates at the clinic dropped by 6%-17% for different appointment types. Conclusion: While the project was interrupted due to the pandemic, early outcomes were promising and the model may be helpful to other CHCs with similar concerns.

Barriers to the Provision of Preventive Care to People Living with Mental Health Conditions: Self-Report by Staff Working in an Australian Community Managed Organisation.

People living with mental health conditions experience a reduced life expectancy largely due to a higher prevalence of chronic diseases. Addressing health risk behaviours, including tobacco smoking, inadequate nutrition, harmful alcohol consumption, and physical inactivity (SNAP), through the provision of preventive care, is recommended to reduce this burden. Community Managed Organisations (CMOs) may play an important role in providing preventive care to consumers with mental health conditions, however, few studies have examined preventive care provision in CMO settings; and no studies have comprehensively assessed barriers to the provision of this care using a tool such as the Theoretical Domains Framework (TDF). To fill this research gap, we conducted an online survey among staff (N = 190) from one CMO in Australia to (1) identify barriers to preventive care provision (ask, advise, assist, connect) to address SNAP behaviours among consumers; and (2) explore associations between barriers and preventive care provision. Results demonstrate that while staff reported knowing how to provide preventive care and believed it would positively impact consumers; barriers including confidence in providing this care and consumer uptake of referrals, were identified. Further research among multiple CMOs is needed to identify care provision and associated barriers in the sector more widely.