Increasing local capacity to lead policy and program solutions for reducing dengue incidence in 24 de Diciembre, Panamá: A novel community-based participatory research framework for fostering community engagement in planning and implementing dengue prevention, surveillance, and control activities

Background.  Dengue and other vector-borne diseases are endemic to Panamá, representing 17% of the total annual environmental disease burden.  National dengue prevention and control initiatives include mosquito abatement and public health education campaigns.  Although these initiatives have been implemented locally, significant economic and sociopolitical barriers to adopting preventive practices in the home, insufficient capacity and resources at the community health center, and lack of coordination and cooperation among stakeholders have hindered their effectiveness in reducing dengue incidence. 

Objectives.  To propose a theory-grounded, sustainable, and scalable community-based participatory research framework for planning and implementing integrated community-based dengue prevention, surveillance, and control policies and activities. 

Methods.  The framework includes nine domains: (1) equitable partnership-building; (2) needs assessment, ethnographic exchange, environmental scan; (3) epidemiological data collection and analysis; (4) dissemination of progress and findings; (5) bidirectional elicitation of policy and programmatic priorities and solutions; (6) feasibility, efficacy, and impact assessment; (7) integrated policy and program development; (8) program testing, piloting, evaluation; (9) continuous monitoring and quality improvement. 

Results.  A community-based promotora model and policy recommendations for coordinating dengue prevention and control efforts were realized within this framework through a partnership between health center staff, researchers from a locally-based international research foundation, visiting public health graduate students, and key community informants.   

Conclusions.  This framework provides multidisciplinary researchers and communities with guidance on coordinating the planning and implementation of dengue prevention and control programs and policies.  The framework attempts to empower communities to build capacity, optimize resource capabilities, and integrate efforts to reduce dengue incidence.