University College London, Institute of Global Health, London, UK.
Herd International, Thapathali, Kathmandu, Nepal.
Public Health. 2021 Apr;193:23-25. doi: 10.1016/j.puhe.2021.01.012. Epub 2021 Mar 10.
The World Health Organization estimates that 422 million people have diabetes, three-quarters of whom live in low- and middle-income countries. Global action plans to address non-communicable diseases (NCDs) recognise the centrality of community engagement to create an enabling environment within which to address risk factors.
In this article, we describe and critically reflect on a cocreated community engagement approach to address type 2 diabetes in the southern plains of Nepal. We coproduced the engagement approach with 40 artists from the Janakpur Women's Development Centre to create an environment for dialogue about diabetes and NCD risk between artists and the general public.
We used participatory action research to produce contextually relevant interactive methods and materials. Methods included artists' peer research to inform creative workshops, a drama performed in 19 villages and a two-day funfair in a public park. We used qualitative and participatory methods to analyse the effect of this engagement and reflect on lessons learned.
Around 2000 people saw the drama, and around 4000 people attended the funfair. Community dialogue about prevention of diabetes was facilitated by drama and through games and songs at the funfair. Artists grew confident to interact with their peers and drama audiences about the causes of diabetes and prevention strategies. Despite crowds at the funfair, it was difficult to reach women because the venue was often used by men and boys, and patriarchal norms prevent women from free movement. Village interactions were able to engage a more mixed audience.
Innovative, asset-based community engagement about diabetes and other NCDs at scale is possible through locating, building on and strengthening community resources to address local health issues. Engagement could be enhanced by considering the gendered nature of community engagement spaces and by increasing opportunities for interaction between artists and the general public through more intimate and large-scale events.
世界卫生组织估计有 4.22 亿人患有糖尿病，其中四分之三生活在中低收入国家。解决非传染性疾病（NCD）的全球行动计划认识到社区参与的核心作用，以便在其中创造有利环境来解决风险因素。
在本文中，我们描述并批判性地反思了在尼泊尔南部平原解决 2 型糖尿病的共创社区参与方法。我们与来自 Janakpur 妇女发展中心的 40 名艺术家共同创作了参与方法，以创造一个关于糖尿病和 NCD 风险的艺术家与公众之间对话的环境。
我们使用参与式行动研究来产生具有上下文相关性的互动方法和材料。方法包括艺术家的同行研究，以告知创意工作坊，在 19 个村庄进行的戏剧表演以及在公共公园举行的为期两天的游乐会。我们使用定性和参与性方法来分析这种参与的效果，并反思所学到的经验教训。
大约有 2000 人观看了戏剧，大约有 4000 人参加了游乐会。戏剧和游乐会的游戏和歌曲促进了社区关于预防糖尿病的对话。艺术家们变得更加自信，可以与同龄人以及戏剧观众就糖尿病的病因和预防策略进行互动。尽管游乐会人潮涌动，但由于该场地经常被男性和男孩使用，而且男尊女卑的规范阻止女性自由活动，因此很难接触到女性。村庄互动能够吸引更多不同的观众。
通过定位、利用和加强社区资源来解决当地健康问题，可以实现针对糖尿病和其他 NCD 进行创新、基于资产的大规模社区参与。通过考虑社区参与空间的性别性质，并通过更多亲密和大规模的活动增加艺术家与公众之间的互动机会，可以增强参与度。
