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

Co-design of a Community-based Rehabilitation Program to Decrease Musculoskeletal Disabilities in a Mayan-Yucateco Municipality Edgar Villarreal-Jimenez, Jose Antonio Lores-Peniche, Ingris Pelaez-Ballestas, MD, MSc, PhD, Gabriela Cruz-Martín, MSc, Daniela Flores-Aguilar, Hazel García, Arturo Velazco Gutiérrez, Hugo Ayora-Manzano, PT, Kenia López, and Adalberto Loyola-Sanchez, MD, MSc, PhD What Is the Purpose of This Study? • This manuscript describes the process of a community-based participatory research strategy implemented in a Mayan community to design a community-based rehabilitation program for people living with chronic musculoskeletal diseases. What Is the Problem? • Many people living in the Mayan community of Chankom have a musculoskeletal disease that limits their function and participation in community life. Therefore, there is a need to develop a rehabilitation program that decreases the disabling effects of these conditions, considering their specific sociocultural needs. What Are the Findings? • The community-based participatory research strategy was formed by four main processes: 1) forming and maintaining an alliance between academia and community representatives, 2) clarifying community needs, 3) integrating local and global knowledge, and 4) conducting shared-decision making efforts, all of which include the basic principles of community-based participatory research. • We co-designed a community-based rehabilitation program formed by six main components: 1) coordination of services, 2) provision of personal support, 3) provision of blood sampling services, 4) provision of specialized rheumatology and rehabilitation services, 5) implementation of health promotion strategies, and 6) provision of transportation, which mainly address the Health Component of the World Health Organization–community-based rehabilitation program matrix. Who Should Care Most? • This study is relevant for anyone trying to design a community-based rehabilitation program in Indigenous and other underserved communities with full engagement and participation of community members. Recommendations for Action • Community-based rehabilitation programs aimed at improving functioning of people living with disabilities in Indigenous contexts should be co-designed with the community, following a community-based participatory research strategy. [End Page e7] • Community members who contribute with working hours to the participatory effort should be adequately financially compensated for their time. • The future implementation of the six components of the co-design community-based rehabilitation program will likely improve the quality of services provided to this Mayan community and hence the function and quality of life of people living with chronic musculoskeletal diseases in this Indigenous community. [End Page e8] Edgar Villarreal-Jimenez Universidad Marista de Mérida Jose Antonio Lores-Peniche Universidad Marista de Mérida Ingris Pelaez-Ballestas Rheumatology Unit, Hospital General de México "Dr. Eduardo Liceaga" Gabriela Cruz-Martín Universidad Nacional Autónoma de Mexico Daniela Flores-Aguilar Universidad Autónoma de Yucatán Hazel García Department of Rheumatology, Hospital Amerimed Arturo Velazco Gutiérrez Department of Internal Medicine, Hospital Amerimed Hugo Ayora-Manzano Universidad Autónoma de Yucatán Kenia López Chankom Municipality Adalberto Loyola-Sanchez Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Department of Clinical Neurosciences, Alberta Health Services Copyright © 2023 Johns Hopkins University Press