title: Developing Community-Based Rehabilitation Programs for Musculoskeletal Diseases in Low-Income Areas of Mexico: The Community-Based Rehabilitation for Low-Income Communities Living With Rheumatic Diseases (CONCORD) Protocol.
abstract: BACKGROUND
  The negative impact of musculoskeletal diseases on the physical function and quality of life of people living in developing countries is considerable. This disabling effect is even more marked in low-socioeconomic communities within developing countries. In Mexico, there is a need to create community-based rehabilitation programs for people living with musculoskeletal diseases in low-socioeconomic areas. These programs should be directed to prevent and decrease disability, accommodating the specific local culture of communities.
  
  
  OBJECTIVE
  The objective of this paper is to describe a research protocol designed to develop, implement, and evaluate culturally sensitive community-based rehabilitation programs aiming to decrease disability of people living with musculoskeletal diseases in two low-income Mexican communities.
  
  
  METHODS
  A community-based participatory research approach is proposed, including multi and transdisciplinary efforts among the community, medical anthropology, and the health sciences. The project is structured in 4 main stages: (1) situation analysis, (2) program development, (3) program implementation, and (4) program evaluation. Each stage includes the use of quantitative and qualitative methods (mixed method program).
  
  
  RESULTS
  So far, we obtained resources from a Mexican federal agency and completed stage one of the project at Chankom, Yucatán. We are currently receiving funding from an international agency to complete stage two at this same location. We expect that the project at Chankom will be concluded by December of 2017. On the other hand, we just started the execution of stage one at Nuevo León with funding from a Mexican federal agency. We expect to conclude the project at this site by September of 2018.
  
  
  CONCLUSIONS
  Using a community-based participatory research approach and a mixed method program could result in the creation of culturally sensitive community-based rehabilitation programs that promote community development and decrease the disabling effects of musculoskeletal diseases within two low-income Mexican communities.
authors.affiliation: School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada. loyolaa@mcmaster.ca.
authors.forename: Adalberto
authors.identifier: http://orcid.org/0000-0002-0082-2907
authors.initials: A
authors.lastname: Loyola Sánchez
authors.forename: Julie
authors.identifier: http://orcid.org/0000-0001-6356-0492
authors.initials: J
authors.lastname: Richardson
authors.forename: Ingris
authors.identifier: http://orcid.org/0000-0001-5188-7375
authors.initials: I
authors.lastname: Peláez-Ballestas
authors.forename: John N
authors.identifier: http://orcid.org/0000-0001-7917-3657
authors.initials: JN
authors.lastname: Lavis
authors.forename: Seanne
authors.identifier: http://orcid.org/0000-0001-9536-1578
authors.initials: S
authors.lastname: Wilkins
authors.forename: Michael G
authors.identifier: http://orcid.org/0000-0002-5383-2471
authors.initials: MG
authors.lastname: Wilson
authors.forename: Jacqueline
authors.identifier: http://orcid.org/0000-0001-5019-3603
authors.initials: J
authors.lastname: Rodríguez-Amado
authors.forename: José
authors.identifier: http://orcid.org/0000-0002-5499-5280
authors.initials: J
authors.lastname: Alvarez-Nemegyei
authors.forename: Rebeca T
authors.identifier: http://orcid.org/0000-0002-2942-1592
authors.initials: RT
authors.lastname: Martínez-Villarreal
authors.forename: Dora J
authors.identifier: http://orcid.org/0000-0003-1214-9761
authors.initials: DJ
authors.lastname: Onofre-Rodríguez
authors.forename: Raquel
authors.identifier: http://orcid.org/0000-0001-5113-4250
authors.initials: R
authors.lastname: Benavides-Torres
keywords: Mexico; community-based participatory research; musculoskeletal diseases; rehabilitation; social change