Russell Kirsten, Rosenbaum Simon, Varela Sharon, Stanton Robert, Barnett Fiona
Murtupuni Centre for Rural and Remote Health, PO Box 2572, Mount Isa, Qld 4825, Australia
School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
Rural Remote Health. 2023 Mar;23(1):7438. doi: 10.22605/RRH7438. Epub 2023 Mar 26.
Poor mental health is an under-recognised burden in rural locations. This is evident in suicide rates that are 40% higher in rural communities than in urban ones, despite a similar prevalence of mental disorders. The level of readiness and engagement of rural communities to adapt or even acknowledge poor mental health can impact effective interventions. For interventions to be culturally appropriate, community engagement should include individuals, their support networks and relevant stakeholders. Community participation guides people living in rural communities to be aware of and take responsibility for community mental health. Community engagement and participation foster empowerment. This review examines how community engagement, participation and empowerment were used in the development and implementation of interventions aimed at improving mental health of adults residing in rural communities.
Databases CINAHL, EmCare, Google Scholar, Medline, PsychInfo, PubMed and Scopus were systematically searched from database inception to July 2021. Eligible studies included adults living in a rural cohort where community engagement was used to develop and implement a mental health intervention.
From 1841 records identified, six met the inclusion criteria. Methods were both qualitative and quantitative, including participatory-based research, exploratory descriptive research, community-built approach, community-based initiative and participatory appraisal. Studies were located in rural communities of the USA, UK and Guatemala. Sample size ranges was 6-449 participants. Participants were recruited using prior relationships, project steering committee, local research assistants and local health professionals. All six studies underwent various strategies of community engagement and participation. Only two articles progressed to community empowerment where locals influenced one another independently. The underlying purpose of each study was to improve community mental health. The duration of the interventions ranged from 5 months to 3 years. Studies on the early stages of community engagement discovered a need to address community mental health. Studies where interventions were implemented resulted in improved community mental health.
This systematic review found similarities in community engagement when developing and implementing interventions for community mental health. Community engagement should involve adults residing in rural communities when developing interventions - if possible, both with a diverse gender representation and a background in health. Community participation can include upskilling adults living in rural communities and providing appropriate training materials to do so. Community empowerment was achieved when the initial contact with rural communities was through local authorities and there was support from community management. Future use of the strategies of engagement, participation and empowerment could determine if they can be replicated across rural communities for mental health.
农村地区的心理健康问题负担未得到充分认识。这在自杀率上体现得很明显，尽管农村和城市社区精神障碍的患病率相似，但农村社区的自杀率比城市高40%。农村社区适应甚至认识到心理健康问题的准备程度和参与度会影响有效的干预措施。为使干预措施符合文化特点，社区参与应包括个人、其支持网络和相关利益攸关方。社区参与引导农村社区居民认识并对社区心理健康负责。社区参与和参与促进赋权。本综述探讨了社区参与、参与和赋权在旨在改善农村社区成年人心理健康的干预措施的制定和实施中是如何运用的。
从数据库建立到2021年7月，系统检索了CINAHL、EmCare、谷歌学术、Medline、PsychInfo、PubMed和Scopus数据库。符合条件的研究包括居住在农村队列中的成年人，其中社区参与被用于制定和实施心理健康干预措施。
从识别出的1841条记录中，有6条符合纳入标准。方法包括定性和定量，包括基于参与的研究、探索性描述性研究、社区建设方法、基于社区的倡议和参与性评估。研究地点位于美国、英国和危地马拉的农村社区。样本量范围为6 - 449名参与者。参与者通过先前的关系、项目指导委员会、当地研究助理和当地卫生专业人员招募。所有六项研究都采用了各种社区参与和参与策略。只有两篇文章涉及社区赋权，即当地人相互独立地产生影响。每项研究的根本目的都是改善社区心理健康。干预措施的持续时间从5个月到3年不等。关于社区参与早期阶段的研究发现有必要解决社区心理健康问题。实施干预措施的研究使社区心理健康得到改善。
本系统综述发现，在为社区心理健康制定和实施干预措施时，社区参与存在相似之处。在制定干预措施时，社区参与应包括居住在农村社区的成年人——如果可能的话，要有不同性别的代表且具备健康背景。社区参与可以包括提升农村社区居民的技能并提供适当的培训材料。当与农村社区的初步接触是通过地方当局进行且有社区管理的支持时，就实现了社区赋权。未来对参与、参与和赋权策略的运用可以确定它们是否能在农村社区中复制以促进心理健康。
