Owusua Yamoah

Context: Community coalitions in 9 Ohio counties implementing the Communities that Heal (CTH) intervention to reduce opioid overdose deaths in the HEALing Communities Study (HCS). Objective: To evaluate 9 Ohio HCS coalition network structures using social network analyses to assess organizational positionality (eg, connectedness, centrality, density), perceptions of value and trust, and associations between positionality and trust and value. Design: With Visual Networks Lab (VNL), cross-sectional data were collected during the early intervention from August 31, 2022, to November 8, 2022, using a validated survey tool and Program to Analyze, Record, and Track, Networks to Enhance Relationships (PARTNER) to measure organizational connections and attributes. Setting: Nine counties located throughout Ohio that were randomized into the second wave of the HCS. Participants: 153 member organizations from across the 9 Ohio coalitions. Coalition size ranged from 16 to 27 member organizations. No organization served on more than one coalition. Main outcome measures: Count of organizational partnerships (ties), perceived value, and trust scores. Results: Coalition structure varied across counties, displayed in network maps indicating the number and type of connections by organization. At the coalition level, the mean number of ties ranged from 2.94 to 7.13. Coalition connectedness (density) ranged from low (0.17) to moderate (0.31). Mean trust scores were higher: 3.25 to 3.53 (of 4) while mean value scores ranged from lower to fair: 2.61 to 3.07 (of 4). Degree centrality (most connections) ranged from 0.3 to 0.6; closeness centrality (shorter connections) ranged from 0.2 to 0.5. Trust and value were correlated in 8 coalitions; associations among centrality, trust, and value scores varied considerably. Conclusion: Variations in coalition structures likely reflect differences in community context. Understanding coalition structure, including by sector, and perceptions of trust and value, may enhance coalition leadership's ability to improve collaboration and enhance coalition capacity to meet objectives.

The use of Photovoice methods to identify and address public health challenges has evolved since this participatory action research method’s inception in the 1990s. However, there is a notable lack of research on the dissemination of Photovoice findings to promote community action and change. This study evaluates audience and Photovoice participants’ experiences of dissemination events presenting the results of 21 Photovoice projects that supplemented the HEALing Communities Study (HCS), a multistate community-based study of strategies to reduce opioid overdose deaths. The Photovoice projects captured the perspectives of people with lived experience of substance use disorder and front-line providers regarding their communities’ responses to the opioid epidemic. This article describes the multiple artifact types and dissemination formats co-created by HEALing Communities Study researchers and Photovoice project participants to share photographs, captions, and insights. In addition, the study reports the evaluation results from attendees of more than 24 local, state, and national events that exhibited and presented on the Photovoice projects. These evaluations assessed whether attendees’ experiences at the events influenced their critical consciousness of and intention to act to address their communities’ concerns with substance use disorder. Respondents encouraged continued efforts to educate community members, especially policymakers, from the perspective of those most impacted by substance use disorder. Findings from the study suggest Photovoice dissemination events may encourage attendees to engage more deeply in public health topics such as the opioid addiction crisis, which supports the critical consciousness model for assessing community health change initiatives.

Community engagement is considered essential in addressing community health problems. This paper details lessons learned from community engagement efforts implemented to reduce opioid overdose deaths in nine Ohio communities participating in Wave 2 of the HEALing (Helping to End Addiction Long-term) Communities Study (HCS). We describe community engagement strategies implemented during the Wave 2 intervention period, including coalition-building, fostering community collaboration, prioritizing health equity and policy advocacy, stigma reduction education, and elevating voices of people with lived experience (PWLE). We provide reflections from the perspective of Community Engagement Facilitators (CEFs) on how these strategies informed the implementation of evidence-based practices (EBPs) within communities. Our community engagement approaches and reflections highlight three key lessons for future community engagement efforts: 1) An intentional and constant focus on community collaboration is a necessary and essential ingredient for successful community engagement; 2) introducing opportunities to define and discuss equity within the local community can lead to recognition of subgroups for directed intervention; 3) Engaging persons with lived experience (PWLE) can foster trust around stigmatizing issues.

Background: Fruit and vegetable consumption is lower than national trends among people receiving Supplemental Nutrition Assistance Program (SNAP) benefits due to economic and physical access barriers. Monetary nutrition incentive programs at farmers markets aim to reduce these barriers to improve diet quality among SNAP consumers. We leveraged community-engaged methods to collaboratively design a mobile app to increase the use of both nutrition incentive programs and farmers markets among SNAP households with children. This population represents about 35% of all SNAP households providing the dual benefit of improving diet for both adults and children. Objective: In this paper, we share the iterative, community-engaged development process used to design a technology intervention that encourages the integration of farmers markets into the food shopping routines of SNAP consumers with children. Methods: Our qualitative community-engaged approach was informed by human-centered design, following the inspiration and ideation phases of this framework. In the “inspiration” phase, we worked with community nutrition experts to define both the goal of and target audience for the app (ie, SNAP households with children). In the subsequent “ideation” phase, we completed 3 stages of data collection. We developed 2 interface prototypes and received feedback from end users on design and usability preferences before selecting a baseline model. Additional feedback gathered from qualitative interviews with 20 SNAP consumers with children was incorporated into the app’s version 1 (V1) development. We then shared V1 with SNAP consumers, children, and farmers market managers to test the app’s functionality, design, and utility. Results: In the “inspiration” phase, the community nutrition partners identified SNAP consumers with children younger than 18 years as the target population for the app. In the “ideation” phase, we successfully created V1 through 3 stages of a qualitative, community-engaged process. First, about 75% (n=3) of SNAP consumers and all farmers market managers selected a grocery shopping design option for the layout of the app. Second, we integrated features identified by SNAP consumers with children into the app design, such as market information (ie, location with GPS address links, hours, website), likely available market inventory, market events, and grocery shopping checklists. Finally, we obtained recommendations for future versions of the app, including real-time changes in market hours, additional notification options, and grocery list personalization during a demonstration of V1. Both SNAP consumers and farmers market managers expressed interest in the app’s launch and utility. Conclusions: It is feasible for community nutrition researchers to successfully design a community-engaged mobile app with the assistance of software developers. The community-engaged approach was key to us integrating potential end users’ preferences in the design of V1. Future work will assess the app’s impact on low-income families’ use of local farmers markets and nutrition incentive programs, as well as fruit and vegetable consumption.

Commonly used measures for assessing local food systems, such as food security or healthy food access, do not provide guidance into the series of actions involved in transforming these outcomes. To address this gap, our research brief presents lessons learned from a community action research project about implementation mechanisms (i.e., series of linked actions) involved in community-led efforts to transform urban food systems to achieve goals of nutrition equity. Our data are derived from the perceptions of 18 community leaders identify­ing as Black, Indigenous, and People of Color (BIPOC) planning to implement food justice initia­tives in Cleveland, Ohio, United States. Content analysis revealed 10 themes and related indicators reflecting mechanisms of implementation and impact of community-led food justice initiatives. Findings underscore the importance of implemen­tation mechanisms that influence changes in com­munity power, food culture and norms, and healthy food retail while mitigating risks of gentrification. Future research is needed to operationalize these mechanisms of implementation to provide guid­ance for action planning, decision-making, and accountability within urban food systems.

We analyzed county food pantry use data for 2019 and 2020 (n = 1,169,568 pantry visits) to explore differences in pantry use among four types of households determined by the presence of seniors and/or children. Our results show that household composition had a significant (p < .001) impact on food pantry utilization, with multi-generational families with children's pantry reliance per year higher than any other group in both 2019 and 2020. The constant high pantry usage of these families suggests chronic food need among families with seniors and children including grandfamilies and highlights the need for tailored interventions.

Routine activity (Cohen & Felson, 1979) and crime patterns theory (Brantingham & Brantingham, 1995) emphasize that individual characteristics and daily routine interactions command the number, severity, spatial distribution, and patterns of criminal events and victimization. The crime patterns theory postulates that offenders and targets usually intercept during everyday non-criminal activities (Brantingham & Brantingham, 1995). During everyday routines, a potential offender and a suitable target converge in space and time without a capable guardian.