Currently accepted at: JMIR Research Protocols
Date Submitted: Jul 7, 2026
Date Accepted: Oct 30, 2026
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/106484
The final accepted version (not copyedited yet) is in this tab.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Participatory Action Research for Change: A protocol for collaborating with FSM youth to develop a multilevel intervention approach to HIV/STI prevention in Guåhan (Guam)
ABSTRACT
Background:
Background People from the Federated States of Micronesia (FSM) who move to the US territory of Guam (indigenously known as Guåhan) suffer disproportionately poor health outcomes, including high rates of HIV and STIs. Adolescents and young adults (AYA), aged 15-24, are the most impacted.
Objective:
Objectives This protocol describes an exploratory study which will employ the theory of structural vulnerability to explore factors that influence HIV and STI prevention, testing, and treatment in FSM diaspora AYA, including migrants and U.S. born children of Guåhan, through a participatory action research (PAR) approach and transform findings into a testable intervention with a multilevel approach. Participatory Action Research (PAR) is a model that recognizes community participants not just as givers of knowledge, but as producers and partners in the entire research process.
Methods:
Methods The proposed study will engage Micronesian AYA, community partners, and undergraduate university students to assess, through lived experience, individual, social, and structural determinants of HIV/STI prevention and develop an intervention with a three-aim approach: (1): Develop a community-based research partnership to research individual, community, and structural factors that shape HIV and STI prevention, testing, and treatment in FSM diaspora youth of Guåhan; (2): Develop a multi-level theory-informed intervention to address factors; and (3): Test, evaluate and adapt the intervention for expansion.
Results:
Results The study was funded in September 2026. Preparation for Aim 1 began in October 2025; the research team has been formed; partners and participants are presently being trained with culturally adapted PAR curriculum. Formative research (data collection and analysis) will occur Year 2 (September 2026-August 2027). Aim II intervention development will occur in Years 2 and 3 (March 2027-February 2028). Aim III is projected to occur from March 2028 to August 2029. Analysis and dissemination activities will begin in December 2027 and be ongoing.
Conclusions:
Conclusions This study will be the first of its kind to examine determinants and correlates of HIV and STI prevention through community-centered research in action-oriented migrant-focused organizations in Guåhan, where resources are limited due to its territorial status. It will address an important health inequity issue in a Guåhan community using a theory-based, mixed-methods collaborative approach, and lead to a community-centered intervention design.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.