Bridging a gap between community and the research institution via a youth advisory group on health and health research in rural Cambodia

Engaging young people in health research has been promoted globally. In May 2021, the Mahidol Oxford Tropical Medicine Research Unit (MORU), a global health research network partnered with a local health centre and a secondary school in Siem Pang, Cambodia, to establish a youth engagement group. Ten students aged 16 to 22 years old underwent training and led health engagement activities in schools and communities and are referred to as the youth advisory group on health and research engagement (YAGHRE) members. These YAGHRE members were trained on wide spectrum of health topics raised and deemed priority concerns by them or their community.  

We reflected on engagement activities with YAGHRE members using a theory of change following a logic of inputs, pathways, outputs and outcomes (Figure 3 in the article). This figure illustrates how and why the change occurs through various steps. Briefly, input refers to the engagement activities, pathway means the mechanism of how the input might have led to an expected output while outcomes are longer term impacts of the activities. 

Five major outcomes were identified: 

1. Increased respect towards individuals, communities, and stakeholders
2. Increased trust and relationships
3. Improved health and research literacy
4. Improved uptake of health and research interventions
5. Improved community health

The first activity included ‘training on health topics suggested by YAGHRE members and promotional measures from MORU researchers’—input. This seems to demonstrate a receptiveness of MORU researchers for the YAGHRE members who wish to learn new health topics (health promotion)—pathway. As a result of this, the YAGHRE members may have felt a sense of recognition and increased understanding of community’s health concerns —output. Reflecting further on these outputs, we explored the pathways and longer-term outcome that could be relevant for our engagement activities. The overall process of co-designing the health education materials and tools based on the suggestions from YAGHRE members (pathway) may have garnered a sense of respect towards their priorities ultimately supporting one of the goals of community engagement (outcome). 

The second activity entailed observation and interaction of YAGHRE members at MORU’s research facilities and laboratory. This opportunity of a new experience may have increased the familiarity of the laboratory set-up, and the core of the research activities. Such a participatory nature of engagement can enhance both formal and informal relationships, transparency (on research processes) and ultimately increase the trust between the YAGHRE members and the researchers. 

The third activity was preparing health education materials (e.g. posters, leaflets and videos). The preparation of these health education materials was supported by MORU’s researchers who developed their skills and capacities to use computers, software, and tools to prepare audio-visual materials. Development of these key skills may have enhanced their understanding of the health topics and the process of research ultimately improving health and research literacy. 

The fourth activity was involvement in health campaigns such as the COVID-19 vaccination in the district. Such an opportunity to participate in a vaccination campaign can enhance a sense of responsibility and enthusiasm to learn and lead such activities. The responsibility of being involved in the vaccination campaign could have promoted members’ sense of recognition, achievement, and confidence. Although difficult to prove, the youth group members’ involvement in vaccination campaigns may have contributed to the improved uptake of vaccine and research interventions.

The fifth activity was youth group members’ continuous exploration of community behaviours related to health and the local disease burden. Findings from this formative exploration may have helped guide research and interventions in the community such as tailored (community-informed) health promotional campaigns. Beyond the complete attributability (ceiling of accountability) of such activities, the consequent development of tailored health promotional interventions could promote healthy community behaviour, reducing health burdens and thus can ultimately improve the community’s health.

Download the article here.