{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:39:41Z","timestamp":1790638781996,"version":"4.1.0"},"reference-count":50,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3_Suppl","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Community engagement is a strategy commonly used in health and development programming. Many disease eradication programs engage with communities through different structures and mechanisms to detect, report, contain, and respond to the diseases they target. Qualitative operational research was conducted in a district of Chad co-endemic for both dracunculiasis (i.e., Guinea worm disease) and circulating vaccine-derived poliovirus to reveal factors influencing community engagement behavior in the context of eradication-related programming. Women and men from six communities and stakeholders from the local, district, and central levels were recruited to participate in focus group discussions and semi-structured in-depth interviews. A thematic analysis was performed to identify barriers and facilitators of community engagement. Barriers to community engagement included mistrust in exogenously established health program initiatives (i.e., initiatives designed by partners external to targeted program communities) resulting from negative past experiences with external entities and community groups and the lure of profit-motivating community engagement. Subgroup and intersectionality analyses revealed that gender and other identities influence whether and to what extent certain members of the community engage in a meaningful way. Facilitators of community engagement included leadership and the influence of authorities and leaders in community participation, perceived benefits of being engaged with community-based initiatives, and use of incentives to enhance community participation. Study findings may be used to inform the refinement of community engagement approaches in Chad and learning agendas for other \u201clast mile\u201d disease eradication programs.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0635","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T13:37:30Z","timestamp":1720532250000},"page":"36-48","source":"Crossref","is-referenced-by-count":3,"title":["Factors Influencing Community Engagement during Guinea Worm and Polio Eradication Endgames in Chad: Recommendations for \u201cLast Mile\u201d Programming"],"prefix":"10.4269","volume":"111","author":[{"given":"Maryann G.","family":"Delea","sequence":"first","affiliation":[{"name":"The Carter Center, Guinea Worm Eradication Program, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalique","family":"Browne","sequence":"additional","affiliation":[{"name":"The Carter Center, National Guinea Worm Eradication Program \u2013 Chad, N\u2019Djamena, Chad;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severin","family":"Kaji","sequence":"additional","affiliation":[{"name":"The Carter Center, National Guinea Worm Eradication Program \u2013 Chad, N\u2019Djamena, Chad;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Weiss","sequence":"additional","affiliation":[{"name":"The Carter Center, Guinea Worm Eradication Program, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ouakou","family":"Tchindebet","sequence":"additional","affiliation":[{"name":"Minist\u00e8re de la Sante Publique, Programme National d\u2019Eradication de Ver du Guin\u00e9e \u2013 Tchad, N\u2019Djamena, Chad"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","author":"Morgan","year":"2006"},{"key":"b2","series-title":"BMC Public Health","first-page":"944","article-title":"Narratives of community engagement: A systematic review-derived conceptual framework for public health interventions","volume":"17","author":"Brunton","year":"2017"},{"key":"b3","series-title":"Declaration of Alma-Ata. Alma-Ata, USSR","year":"1978"},{"key":"b4","series-title":"Vaccine","first-page":"D7","article-title":"The eradication of smallpox\u2013An overview of the past, present, and future","volume":"29","author":"Henderson","year":"2011"},{"key":"b5","series-title":"Vaccine","first-page":"D86","article-title":"Dracunculiasis eradication and the legacy of the smallpox campaign: What\u2019s new and innovative? What\u2019s old and principled?","volume":"29","author":"Richards","year":"2011"},{"key":"b6","series-title":"Vaccine","first-page":"D135","article-title":"From smallpox eradication to contemporary global health initiatives: Enhancing human capacity towards a global public health goal","volume":"29","author":"Tarantola","year":"2011"},{"key":"b7","series-title":"Am J Trop Med Hyg","first-page":"1","article-title":"Community engagement, ownership, and civil society organizations in polio eradication","volume":"101","author":"Andrus","year":"2019"},{"key":"b8","series-title":"BMJ Open","first-page":"e048694","article-title":"Assessing community engagement in Nigeria polio eradication initiative: Application of the Consolidated Framework for Implementation Research","volume":"11","author":"Akinyemi","year":"2021"},{"key":"b9","series-title":"Glob Public Health","first-page":"1138","article-title":"Listening to the rumours: What the northern Nigeria polio vaccine boycott can tell us ten years on","volume":"8","author":"Ghinai","year":"2013"},{"key":"b10","series-title":"The Causes and Impacts of Neglected Tropical and Zoonotic Diseases: Opportunities for Integrated Intervention Strategies","first-page":"604","author":"Hopkins"},{"key":"b11","year":"2020"},{"key":"b12","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1129","article-title":"Progress toward polio eradication\u2014Worldwide, January 2019\u2013June 2021","volume":"70","author":"Bigouette","year":"2021"},{"key":"b13","series-title":"Educ Psychol","first-page":"314","article-title":"Volunteerism as purpose: Examining the long-term predictors of continued community engagement","volume":"33","author":"Barber","year":"2013"},{"key":"b14","year":"2022"},{"key":"b15","series-title":"Implement Sci","first-page":"42","article-title":"The behaviour change wheel: A new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","year":"2011"},{"key":"b16","series-title":"Int J Qual Methods","article-title":"The central role of theory in qualitative research","volume":"17","author":"Collins","year":"2018"},{"key":"b17","series-title":"J Community Psychol","first-page":"1645","article-title":"Personal and community factors as predictors of different types of community engagement","volume":"47","author":"Zanbar","year":"2019"},{"key":"b18","series-title":"Curr Opin Psychol","first-page":"85","article-title":"Risk perceptions and health behavior","volume":"5","author":"Ferrer","year":"2015"},{"key":"b19","series-title":"J Environ Manage","first-page":"132","article-title":"Evaluation of the role of risk perception in stakeholder engagement to prevent lead exposure in an urban setting","volume":"184","author":"Harclerode","year":"2016"},{"key":"b20","series-title":"PLoS Negl Trop Dis","first-page":"e0008153","article-title":"Gender norms and mass deworming program access in Com\u00e9, Benin: A qualitative assessment of gender-associated opportunities and challenges to achieving high mass drug administration coverage","volume":"14","author":"Geyer","year":"2020"},{"key":"b21","series-title":"Dev Change","first-page":"435","article-title":"Resources, agency, achievements: Reflections on the measurement of women\u2019s empowerment","volume":"30","author":"Kabeer","year":"1999"},{"key":"b22","series-title":"White Paper: A Conceptual Model of Women and Girls\u2019 Empowerment","author":"Van Eerdewijk","year":"2017"},{"key":"b23","series-title":"Dev Change","first-page":"1010","article-title":"Measuring women\u2019s empowerment: Gender and time-use agency in Benin, Malawi and Nigeria","volume":"53","author":"Eissler","year":"2022"},{"key":"b24","series-title":"PLoS One","first-page":"e0201710","article-title":"Enhancing the sample diversity of snowball samples: Recommendations from a research project on anti-dam movements in Southeast Asia","volume":"13","author":"Kirchherr","year":"2018"},{"key":"b25","series-title":"Handbook of Research Methods in Health Social Sciences","first-page":"1431","author":"Quinlan"},{"key":"b26","series-title":"Qual Res Psychol","first-page":"77","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006"},{"key":"b27","series-title":"CAM Journal.","first-page":"31","article-title":"Codebook development for team-based qualitative analysis","volume":"10","author":"MacQueen","year":"1998"},{"key":"b28","series-title":"Int J Qual Methods","article-title":"Thematic analysis: Striving to meet the trustworthiness criteria","volume":"16","author":"Nowell","year":"2017"},{"key":"b29","series-title":"BMC Med Res Methodol","first-page":"45","article-title":"Methods for the thematic synthesis of qualitative research in systematic reviews","volume":"8","author":"Thomas","year":"2008"},{"key":"b30","author":"Jordan","year":"2008"},{"key":"b31","series-title":"DiGeSt Journal of Diversity and Gender Studies.","first-page":"39","article-title":"Intersectionality as method","volume":"2","author":"Helma","year":"2015"},{"key":"b32","series-title":"Des Stud","first-page":"417","article-title":"Personas and user-centered design: How can personas benefit product design processes?","volume":"32","author":"Miaskiewicz","year":"2011"},{"key":"b33","series-title":"Malar J","first-page":"245","article-title":"What is community engagement and how can it drive malaria elimination? Case studies and stakeholder interviews","volume":"18","author":"Baltzell","year":"2019"},{"key":"b34","series-title":"PLOS Glob Public Health.","first-page":"e0001643","article-title":"Facilitators and barriers to community engagement in the Global Polio Eradication Initiative: A mixed methods study","volume":"3","author":"Agrawal","year":"2023"},{"key":"b35","series-title":"Am J Trop Med Hyg","first-page":"4","article-title":"The CORE Group Polio Project: An overview of its history and its contributions to the Global Polio Eradication Initiative","volume":"101","author":"Losey","year":"2019"},{"key":"b36","series-title":"PLoS One","first-page":"e0253318","article-title":"Perceived enablers and barriers of community engagement for vaccination in India: Using socioecological analysis","volume":"16","author":"Dutta","year":"2021"},{"key":"b37","series-title":"Am J Trop Med Hyg","first-page":"85","article-title":"Use of social mobilization and community mobilizers by non-governmental health organizations in Malawi to support the eradication of polio, improve routine immunization coverage, and control measles and neonatal tetanus","volume":"101","author":"Chimpololo","year":"2019"},{"key":"b38","series-title":"Malar J","first-page":"47","article-title":"Evaluating a community engagement model for malaria elimination in Haiti: Lessons from the community health council project (2019\u20132021)","volume":"22","author":"Bardosh","year":"2023"},{"key":"b39","series-title":"Trop Med Int Health","first-page":"312","article-title":"Community-directed interventions strategy enhances efficient and effective integration of health care delivery and development activities in rural disadvantaged communities of Uganda","volume":"10","author":"Katabarwa","year":"2005"},{"key":"b40","series-title":"Am J Trop Med Hyg","first-page":"59","article-title":"Trust, communication, and community networks: How the CORE Group Polio Project community volunteers led the fight against polio in Ethiopia\u2019s most at-risk areas","volume":"101","author":"Stamidis","year":"2019"},{"key":"b41","series-title":"Am J Trop Med Hyg","first-page":"1345","article-title":"Understanding factors influencing polio vaccine uptake in Ghana\u2014Developing meaningful community mobilization and engagement strategies in collaboration with religious leaders","volume":"107","author":"Lohiniva","year":"2022"},{"key":"b42","series-title":"PLoS Negl Trop Dis","first-page":"e0007861","article-title":"How community engagement strategies shape participation in mass drug administration programmes for lymphatic filariasis: The case of Luangwa District, Zambia","volume":"13","author":"Silumbwe","year":"2019"},{"key":"b43","series-title":"Dev Pract","first-page":"750","article-title":"Donors and exogenous versus endogenous development","volume":"24","author":"Holcombe","year":"2014"},{"key":"b44","series-title":"J Clin Transl Sci","first-page":"e87","article-title":"Co-designing to advance community health and health equity in Wisconsin: Building the Neighborhood Health Partnerships Program","volume":"5","author":"Bonham-Werling","year":"2021"},{"key":"b45","series-title":"BMJ","first-page":"h3267","article-title":"Evidence based community mobilization for dengue prevention in Nicaragua and Mexico (Camino Verde, the Green Way): Cluster randomized controlled trial","volume":"351","author":"Andersson","year":"2015"},{"key":"b46","series-title":"Action Learning and Action Research: Genres and Approaches","first-page":"193","author":"Wood"},{"key":"b47","series-title":"Emerging Theories In Health Promotion Practice And Research","first-page":"451","author":"Flay"},{"key":"b48","series-title":"Health Psychol","first-page":"379","article-title":"A taxonomy of behavior change techniques used in interventions","volume":"27","author":"Abraham","year":"2008"},{"key":"b49","series-title":"Hum Commun Res","first-page":"148","article-title":"Social norms, behavioral payment programs, and 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