Harnessing the potential of community-based participatory research approaches in bipolar disorder

BACKGROUND: Despite the rapid growth in the sophistication of research on bipolar disorder (BD), the field faces challenges in improving quality of life (QoL) and symptom outcomes, adapting treatments for marginalized communities, and disseminating research insights into real-world practice. Community-based participatory research (CBPR)-research that is conducted as a partnership between researchers and community members-has helped address similar gaps in other health conditions. This paper aims to improve awareness of the potential benefits of CBPR in BD research. METHODS: This paper is a product of the International Society for Bipolar Disorders (ISBD) Taskforce on Community Engagement which includes academic researchers, healthcare providers, people with lived experience of BD, and stakeholders from BD community agencies. Illustrative examples of CBPR in action are provided from two established centres that specialize in community engagement in BD research: the Collaborative RESearch Team to study psychosocial issues in BD (CREST.BD) in Canada, and the Spectrum Centre for Mental Health Research in the United Kingdom. RESULTS AND DISCUSSION: We describe the philosophy of CBPR and then introduce four core research areas the BD community has prioritized for research: new treatment approaches, more comprehensive outcome assessments, tackling stigma, and enhanced understanding of positive outcomes. We then describe ways in which CBPR is ideal for advancing each of these research areas and provide specific examples of ways that CBPR has already been successfully applied in these areas. We end by noting potential challenges and mitigation strategies in the application of CBPR in BD research. CONCLUSIONS: We believe that CBPR approaches have significant potential value for the BD research community. The observations and concerns of people with BD, their family members, and supports clearly represent a rich source of information. CBPR approaches provide a collaborative, equitable, empowering orientation to research that builds on the diversity of strengths amongst community stakeholders. Despite the potential merits of this approach, CBPR is as yet not widely used in the BD research field, representing a missed opportunity.

Promoting community capacity through university-community engagement: the Deakin University / Department of Human Services (Barwon South West) Partnership

The formal Partnership between Deakin University and the Victorian Department of Human Services (Barwon-South Western Region), based in Geelong, aims to bring together the knowledge, experience and resources of the Department and Deakin University for the benefit of the people living in that region, as well as for the mutual benefit of both organisations. A recent review process featured stakeholder interviews and focus groups. A special workshop on university-community engagement was also held for interested stakeholders in late 2006. This was facilitated by Prof. Judith Ramaley, President of Winona State University, during her visit to Deakin University as a Fulbright Visiting Senior Specialist. Visioning and strategic planing have continued throughout 2007.

This paper will describe the efforts and achievements of the Partnership through the complementary lenses of Healthy Cities, health-promoting universities and community capacity. This framework will be used to describe how the Partnership coordinators have used Prof Ramaley’s insights to establish a draft Business Plan that espouses a more mature form of collaboration and embraces shared, transformative goals. The paper will describe how the notion of community capacity is being used to evaluate the Partnership’s overall contribution to community engagement.

Building capacity for rural health : the role of boundary crosser and the impact of their behaviours on community readiness partnerships

The concept of partnership has entered policy rhetoric and is urged as good practice in a variety of domains including health. Rural communities tend to have fewer resources available for the provision of services such as health than their metropolitan counterparts, and so could be expected to benefit from partnerships with external agencies. Indicators of coalition maturity for working in partnership with external agents in order to build stronger communities are distilled from the group development and partnership research literature and considered in the light of the experiences of the University Department of Rural Health in community engagement. The chapter draws on experiences of two rural community coalitions working to plan and negotiate health service provision. The coalitions were analysed against the indicators. A key indicator of maturity and readiness for working in partnership with external agents is related to the behaviour of ‘boundary crossers’. Boundary crossers are defined as people who move freely between two or more domains and who understand the values, cultures and language, and have the trust, of both. Domains can be within a community or be the community and an external sector. Community health professionals, especially those in senior positions, often act as boundary crossers between the community and broader domains such as regional/state health services or policy, although other community members can fill the role. Other key indicators of coalition maturity for working in partnership with external agents include local leadership that empowers the community, a willingness of community coalitions to take risks and mould opportunities to meet their vision, and a culture of critical reflection and evaluation of past actions.

This chapter analyses the impact of boundary crossing behaviour on community readiness and partnerships with external agents that are intended to build rural community capacity to plan and negotiate health service provision. It is argued that the characteristics and modus operandi of boundary crossers who are members of rural community coalitions affect the level of maturity of the coalitions and community readiness to work with external agents. An understanding of the characteristics and modus operandi of boundary crossers provides valuable insights for external agents in designing their approach to partnerships that build rural community capacity for health.

Embracing rigour : developing a community engagement framework for strategic urban planning

Local governments are increasingly seeking new ways to engage with communities through a variety of productive avenues. Yet strategic planning lags behind with an accepted method to consult and engage with communities about proposed policy changes. When engagement methods are used which go beyond those which are legislated for, the process often involves members of communities who are familiar with planning processes, or have time to participate, thereby excluding large sections of the community. In addition, consultation methods often lack rigour in data collection upon which major strategic decisions are based, thereby undermining government's capacity to make quality and informed planning decisions. The aim of this paper is to assist local government urban planners with their community engagement practice in order to form policies which are acceptable to the affected communities. The paper proposes a community engagement framework which introduces rigour within the community engagement process by drawing on research methods from psychology and political science.

Pedagogy of oppressed community engagement : socially inclusive visioning of urban change

It is generally accepted that good practice in policy making and urban change initiatives requires community engagement, where community-based approaches are emphasised as a means of socially inclusive visioning. Communities expect greater transparency, accountability and engagement. This expectation is not always met, with many studies focusing on the perceived tickbox effect - where engagement is a process that has to be undertaken rather than being welcomed and embraced as an integral part of planning for urban change. This paper explores multi-disciplinary concepts and looks at ways these can be linked to community engagement in planning, particularly in larger urban Councils. In this brief glimpse at the wide variety of disciplines that could be drawn on, the paper uses information systems, teaching models, organisational theory and public policy to highlight the potential for altering concepts of community engagement. It concludes that, from these particular examples: the use of double-loop learning could help to empower the community (from organisational theory), collaboration and participation necessitate the co-ordination and exchange of information and knowledge within and between organisations (information systems), the preconception that the authority holds all the knowledge ready to be handed out to the community (teaching models) needs to be challenged, and partnerships are important in empowering people (public policy).

Advancing community engagement practice for strategic urban planning : learning from allied and remote disciplines

Urban planning has the potential to draw on allied and remote disciplines to improve community consultation processes for strategic planning projects. Urban design and landscape architecture have quantitative and qualitative methods which can be utilised to visualise different options of urban intensification which may fit within communities’ expectations of change. Furthermore political science has long used scientifically established psychometric techniques to collect data from broad sections of the population, analysing demographic profiles of communities and understanding their perceptions and attitudes. By appropriating quantitative and qualitative methods from other disciplines, urban planning policies can be developed which may reflect communities’ aspirations of amenity and neighbourhood character. The aim of this paper is to assist local government urban planners with their community engagement practice in order to form policies which are acceptable to the affected communities. The paper draws on Victoria as a case study of community engagement practice, examines research methods from allied and remote disciplines and proposes a community engagement framework which introduces rigour within the community engagement process.

The OPtimising HEalth LIterAcy (Ophelia) process: study protocol for using health literacy profiling and community engagement to create and implement health reform

Health literacy is a multi-dimensional concept comprising a range of cognitive, affective, social, and personal skills and attributes. This paper describes the research and development protocol for a large communities-based collaborative project in Victoria, Australia that aims to identify and respond to health literacy issues for people with chronic conditions. The project, called Ophelia (OPtimising HEalth LIterAcy) Victoria, is a partnership between two universities, eight service organisations and the Victorian Government. Based on the identified issues, it will develop and pilot health literacy interventions across eight disparate health services to inform the creation of a health literacy response framework to improve health outcomes and reduce health inequalities.

Facebook content analysis: a study into Australian banks' social media community engagement

Understanding the motives that encourage users to adopt social media to communicate with businessesis very important. This research study was conducted with Australian banks and adds to the developmentof empirically tested social media adoption model consisting of technological and social communicationaspects (Senadheera, 2015). This chapter presents the findings of the research study based on analysisof wall posts gathered from Australian banks’ Facebook presence in the year 2013. The research studyinvolves a thematic analysis of frequently used words by Australian banks in their respective Facebookwall posts following an outcome of a word frequency test conducted using NVivo. This analysis wasconducted with the proposed adoption model as the basis to determine whether banks’ Facebook contentaddresses the basic user requirements driving them to adopt social media to communicate with Australianbanks. The results strengthens the robustness and the applicability of the social media adoption model.

Leveraging the Commonwealth Games in Melbourne for community engagement: an examination of Equal First and the Adopt-a-Second-Team program

Event leverage provides information about what outcomes occur as a result of an event. Unlike event impact studies, event leverage analysis identifies why particular outcomes occurred, and the processes that can be used to optimise desired event outcomes. While research has been directed towards understanding how events can be leveraged to provide optimal economic outcomes for host communities, there is little research that examines social leverage within the context of events. The research presented in this paper is part of a larger study that investigated social leverage within the context of the 2006 Commonwealth Games, held in Melbourne, Australia. This paper presents preliminary results relating to two Victorian regions with regard to one the over-arching social policy, Equal First, and a subsidiary program called, Adopt-a-Second-Team. Participant observations and stakeholder interviews were employed to explore the development, operationalisation, implementation and outcomes of Equal First and Adopt-a-Second-Team. The results suggest that although each region achieved outcomes that were consistent with the directions of Equal First, each implemented the Adopt-a-Second-Team differently. The two case studies presented in this paper highlight that the model of implementation developed by the City of Port Phillip may provide a benchmark in social leverage of events. Implications for leveraging social impacts and managing social legacies of events through an approach that includes consideration of policy development and operationalisation from the event organising body and program implementation from the perspective of local community event organisers are discussed.

Entropy-based collaborative detection of DDOS attacks on community networks

A community network often operates with the same Internet service provider domain or the virtual network of different entities who are cooperating with each other. In such a federated network environment, routers can work closely to raise early warning of DDoS attacks to void catastrophic damages. However, the attackers simulate the normal network behaviors, e.g. pumping the attack packages as poisson distribution, to disable detection algorithms. It is an open question: how to discriminate DDoS attacks from surge legitimate accessing. We noticed that the attackers use the same mathematical functions to control the speed of attack package pumping to the victim. Based on this observation, the different attack flows of a DDoS attack share the same regularities, which is different from the real surging accessing in a short time period. We apply information theory parameter, entropy rate, to discriminate the DDoS attack from the surge legitimate accessing. We proved the effectiveness of our method in theory, and the simulations are the work in the near future. We also point out the future directions that worth to explore in the future.

Community engagement and working with government

Community engagement in health care can occur from policy to local community levels. It is consistent with democracy. A systems perspective can see consumers engaged to legitimise government agendas. Often community participation is via consultation instead of partnership or delegation. A community development approach to engagement can empower communities to take responsibility for their own health care. Understanding rural place facilitates alignment between health programs and community, assists incorporate community resources into health care and provides information about health needs. Rural communities, health services and other community organisations need skills in working together to develop effective partnerships that transfer some power from health systems. Rural engagement with national/state agendas is a challenge. Community engagement takes time and resources, but can be expected to lead to better health outcomes for rural residents.

Multi-level rural community engagement in health

Community participation in health is consistent with notions of democracy. A systems perspective of engagement can see consumers engaged to legitimise government agendas. Often community participation is via consultation instead of partnership or delegation. A community development approach to engagement can empower communities to take responsibility for their own health care. Understanding rural place facilitates alignment between health programs and community, assists in incorporating community resources into health care and provides information about health needs. Rural communities, health services and other community organisations need skills in working together to develop effective partnerships that transfer some power from health systems. Rural engagement with national/state agendas is a challenge. Community engagement takes time and resources, but can be expected to lead to better health outcomes for rural residents.