BACKGROUND AND OBJECTIVE<p>Due to disasters and calamities, the number of internally displaced persons (IDPs) in the country is steadily increasing. With their disadvantaged situation, this population is prone to experiencing powerlessness and poor health outcomes. However, there is limited information on how these communities can gain control over their health and well-being. While community empowerment is a crucial process in the health sciences, this concept remains understudied. Hence, this study aimed to explore the process of community empowerment in health and develop a theory grounded on the experiences of displaced communities.p>METHODS<p>This study utilized the classic grounded theory (CGT), primarily aimed at discovering a conceptual theory anchored on the experiences of internally displaced persons. Particularly, this GT variant sought to explicate a social process of community empowerment in health through the participants’ lenses. A total of 45 individuals from six towns of Bulacan province, Philippines were purposively recruited to participate in focus group discussions and key informant interviews. Data analysis employed the constant comparison method, which involved concept development, reduction, and refinement to derive the emerging theory from the gathered information.p>RESULTS<p>he 5 C's Grounded Theory of Community Empowerment in Health depicts marginalization as the main context of internal displacement, where participants’ experiences of resource deprivation and social neglect made them vulnerable to poor health outcomes. The theory further explicates five processes involved in the empowerment of IDPs, namely: consciousness-raising, collaborating, capacity building, carrying out responsibilities, and continuing work. Particularly, the key steps involve (1) raising the community’s awareness on the importance of gaining control over their health and well-being; (2) establishing collaborative relationships within and outside communities; (3) developing competencies on various health-related domains; (4) assuming multiple roles and implementing programs; and (5) continuing efforts to train more people, sustain partnerships, and expand community involvement. These steps lead to the study’s core variable of self-sufficiency, where communities are anchored on the philosophy of communal unity (bayanihan) in managing their own health needs, promoting healthcare access, and addressing other social determinants of health. Moreover, study findings highlight the unique contribution of women, spirituality, and multisectoral engagement in facilitating the process of community empowerment.p>CONCLUSION<p>This is one of the first few studies to explore the process of community empowerment in health, which guided the development of a theory based on the experiences of internally displaced communities. The theory emphasizes that community empowerment is an iterative and continuous process that involves interactions among community members and other stakeholders. Holistic social preparation and capacity building, together with the integration of local culture and philosophy, could support the successful transition of IDPs into their new lives. Hence, multisectoral collaboration involving government agencies, private offices, higher education institutions, healthcare facilities, and faith-based organizations is crucial in promoting the movement of IDPs from marginalization towards gaining control over their health.p>
Human ; Grounded Theory ; Vulnerable Populations ; Community Participation

: One of the most commonly used tools by clinicians to identify cases of anxiety and depression in medically ill patients is the Hospital Anxiety and Depression Scale, or the HADS Filipino version. However, there were some “gray areas” with its use, particularly for those who are in the non-psychiatric setting. Some translated items may pertain to something else which could influence patients' responses. Furthermore, local studies showed differences in the conception, understanding, and expression of depression unique to Filipino culture and could be potentially missed during the assessment. This paper determined the validity and reliability of the Anxiety and Depression Symptom Assessment Guide or ADSAto a sample of 91 adult cardiac Filipino patients in the in-patient setting. In addition to the 29-item ADSAtool that was generated from HADS, the review of literature and other sources was also reviewed by experts from two rounds of Delphi Survey. It was written in a yes-or-no format and available in both English and Filipino versions. The tool was tested for internal consistency, intra-class and inter-item reliability. Another test used was criterion-based validity utilizing HADS to identify cases of anxiety and depression. The results showed that ADSAis highly reliable with Cronbach's alpha of 0.97, poor-to-moderate intra-class correlation (0.670 for anxiety, 0.440 for depression), and consistent/acceptable interitem correlation (0.528 for anxiety, 0.382). Both HADS and ADSAwere positively correlated with correlation coefficients of 0.667 and 0.391 (p-value<0.5) for anxiety and depression respectively. Using a cut-off score of 5, ADSA has moderate sensitivity and specificity of 72.5% and 78.4% for anxiety, and 66.7% and 64.3% for depression. Further research is needed to strengthen ADSA's validity by increasing the sample size and the multi-center sites.
Anxiety ; Depression