O-24 Enablers, challenges, and benefits of multilevel intersectional collaboration for NCD Prevention: The Kalinago in Dominica

Methods: Partnerships included local primary care, Kalinago Leaders, Church Leaders, and central government agencies. CONTACT implemented nature gardening, screening for NCD risk factors and health education over 10 months. Evaluation used pre- and post-implementation longitudinal qualitative interviews (n=52, 28 females, 24 males) with Kalinago health advocates, Kalinago congregants, primary care nurses and religious leaders. Interviews were analysed using thematic analysis. 

Results: There were 13 themes and 28 sub-themes. Ena- blers: (i) motivations of RHAs - altruism, community health improvement, enhance knowledge and skills; (ii) value of community engagement- research and primary healthcare partnerships; (iii) community-centeredness- church as a trusted institution and community support; (iv) cultural centeredness - shared cultural identity; (v) faith-based approach-aligning religious teachings with health mes- sages. Challenges: (i) lack of professional recognition for RHAs -  professional  scepticism  and  reluctance  to share personal information; (ii) resource limitations- insufficient health education materials, insufficient gardening resources, financial & time constraints; (iii) accessiblity to programme sites - lack of transportation; (iv) environmental challenges- poor soil quality and lack  of  water; (v)  COVID-19. Benefits (i) strengthening the healthcare system-reduced nurses workload , increased access to screenings and referrals for specialst care; (ii) promoting a healthy lifestyle - improved health education, encouraged physical activity, provided access   to  fresh   vegetables,   increased   vegetable intake (iii) community diffusion-community dialogues, communal sharing, adoption of backyard home gardens.

Conclusion: It is possible to successfully implement multi- sectoral collaboration for NCD prevention with Indigenous communities in the Caribbean. This study highlights potential transformative strategies for NCD prevention in the Kalinago community, which are relevant to both Indigenous and non-Indigenous contexts.