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Co-design of a Community-based Rehabilitation Program to Decrease Musculoskeletal Disabilities in a Mayan-Yucateco

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    Community-based participatory research (CBPR) enabled co-design of a community-based rehabilitation (CBR) program for chronic musculoskeletal diseases in Mexico. The program integrates local needs and knowledge to improve healthcare access and quality for the Mayan community.

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    Area of Science:

    • Public Health
    • Community Health
    • Rehabilitation Science

    Background:

    • Chronic musculoskeletal (MSK) diseases cause significant disability in the Mayan community of Chankom, Yucatán, Mexico.
    • Addressing MSK disease burden requires culturally relevant and community-driven interventions.

    Purpose of the Study:

    • To elucidate a community-based participatory research (CBPR) strategy for designing a community-based rehabilitation (CBR) program.
    • To develop a CBR program tailored to the needs of individuals with MSK diseases in Chankom.

    Main Methods:

    • Qualitative descriptive thematic analysis of ethnographic data collected from 2014 to 2017.
    • Implementation of a CBPR strategy involving academic and community partners.

    Main Results:

    • Key CBPR processes included alliance building, prioritizing community needs, integrating local and global knowledge, and shared decision-making.
    • The designed CBR program comprises six interventions: health services coordination, personal support, community blood sampling, specialized services, health promotion, and transportation.
    • The program interventions are culturally sensitive and aim to enhance healthcare quality, availability, accessibility, and acceptability.

    Conclusions:

    • Co-designing a CBR program for chronic MSK diseases in Chankom was achieved through extensive community engagement and CBPR principles.
    • The developed CBR program addresses the health component of the WHO-CBR matrix.
    • Future CBPR cycles are recommended following program implementation and evaluation to ensure sustained impact.