Learning from the wisdom of community: Applying a community based participatory multiple case study methodology to understand families living in adversity

Highlights • Social isolation and community connectedness are core to wellness and resilience • Participatory urban planning can enhance inclusion and health • Systems navigation designed for specific groups will maximize access to services • Poverty and material deprivation modify all aspects of family resilience • Stake’s multiple case study methods can be adapted for CBPAR Abstract Adverse Childhood Experience and Adverse Community Environments (the “pair of ACEs”) make up family and community level factors that prevent families and communities from reaching their full potential. Using Community Based Participatory Action Research (CBPAR) methods, involving a team of community and academic researchers, this study applies Stake’s multiple case study methods to explore factors leading to or impeding resilience among families with the pair of ACEs in an area of South Eastern Ontario using visual timelines, in depth interviews, focus groups, and Photovoice methodology. The research team completed intracase analyses for each of 10 cases, followed by a collective intercase analysis of all research data. Twelve assertions or themes were identified through the intercase analysis, highlighting areas that need intervention to improve child and family resilience for families experiencing the pair of ACEs. These include anti-discrimination, community safety, human rights, substance use treatment, healthy communities, impacts of COVID-19, Indigenous community needs, integration of newcomers, material deprivation, health and social system service navigation, social support networks, and family supports. Despite differences between the cases, there was a remarkable degree of overlap between the experiences and perspectives of the families (cases) in our study. Each of the twelve areas identified (assertions) as important by families have important practical implications for community-informed program and policy development. Specifically, findings highlighted the need for interventions to decrease social isolation and community connectedness, urban planning to enhance inclusion and health, support for systems navigation, and poverty reduction strategies.