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BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Narratives of community engagement: a systematic review-derived conceptual framework for public health interventions

Authors: Ginny Brunton, James Thomas, Alison O’Mara-Eves, Farah Jamal, Sandy Oliver, Josephine Kavanagh

Published in: BMC Public Health | Issue 1/2017

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Abstract

Background

Government policy increasingly supports engaging communities to promote health. It is critical to consider whether such strategies are effective, for whom, and under what circumstances. However, ‘community engagement’ is defined in diverse ways and employed for different reasons. Considering the theory and context we developed a conceptual framework which informs understanding about what makes an effective (or ineffective) community engagement intervention.

Methods

We conducted a systematic review of community engagement in public health interventions using: stakeholder involvement; searching, screening, appraisal and coding of research literature; and iterative thematic syntheses and meta-analysis. A conceptual framework of community engagement was refined, following interactions between the framework and each review stage.

Results

From 335 included reports, three products emerged: (1) two strong theoretical ‘meta-narratives’: one, concerning the theory and practice of empowerment/engagement as an independent objective; and a more utilitarian perspective optimally configuring health services to achieve defined outcomes. These informed (2) models that were operationalized in subsequent meta-analysis. Both refined (3) the final conceptual framework. This identified multiple dimensions by which community engagement interventions may differ. Diverse combinations of intervention purpose, theory and implementation were noted, including: ways of defining communities and health needs; initial motivations for community engagement; types of participation; conditions and actions necessary for engagement; and potential issues influencing impact. Some dimensions consistently co-occurred, leading to three overarching models of effective engagement which either: utilised peer-led delivery; employed varying degrees of collaboration between communities and health services; or built on empowerment philosophies.

Conclusions

Our conceptual framework and models are useful tools for considering appropriate and effective approaches to community engagement. These should be tested and adapted to facilitate intervention design and evaluation. Using this framework may disentangle the relative effectiveness of different models of community engagement, promoting effective, sustainable and appropriate initiatives.
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Literature
1.
National Institute for Health and Clinical Excellence. NICE public health guidance 9: community engagement to improve health. London: NICE; 2008.
2.
Department of Health. Commissioning and system management - PPE. Real involvement: working with people to improve health services. London: Department of Health; 2008.
3.
Gough D, Thomas J, Oliver S. Clarifying differences between review designs and methods. Syst Reviews. 2012;1(1):28.CrossRef
4.
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O, Peacock R. Storylines of research in diffusion of innovation: a meta-narrative approach to systematic review. Soc Sci Med. 2005;61(2):417–30.CrossRefPubMed
5.
O'Mara-Eves A, Brunton G, McDaid D, Oliver S, Kavanagh J, Jamal F, et al. Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis. Public Health Res. 2013;1(4):548.
6.
Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. London: Sage; 1994.
7.
Kneale D, Thomas J, Harris K. Developing and optimising the use of logic models in systematic reviews: exploring practice and good practice in the use of programme theory in reviews. PLoS One. 2015;10:1–26.CrossRef
8.
O'Mara-Eves A, Brunton G, McDaid D, Kavanagh J, Oliver S, Thomas J. Techniques for identifying cross-disciplinary and ‘hard-to-detect’ evidence for systematic review. Research Synthesis Methods. 2014;5(1):50–9.CrossRefPubMed
9.
Brunton G, Stansfield C, Thomas J. Finding relevant studies. In: Gough D, Oliver S, Thomas J, editors. An introduction to systematic reviews. London: Sage; 2012.
10.
Patton M. Qualitative evaluation and research methods. 2nd ed. Newbury Park: Sage Publications; 1990.
11.
Ritchie J, Lewis J, McNaughton Nicholls C, Ormston R. Qualitative research practice: a guide for social science students and researchers. London: Sage; 2014.
12.
Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess R, editors. Analyzing qualitative data. London: Routledge; 1994.
13.
Thomas J, Brunton J, Graziosi S. EPPI-reviewer 4.0: software for research synthesis. London: EPPI-Centre software, social science research unit, institute of Education; 2010.
14.
Bradshaw J. A taxonomy of social need. In: McLachlan G, editor. Problems and progress in medical care seventh series Nuffield Provisional Hospitals Trust: Open University Press; 1972.
15.
Anastacio J, Gidley B, Hart L, Keith M, Mayo M, Kowarzik U. Reflecting realities: participants’ perspectives on integrated communities and sustainable development. York: Joseph Rowntree Foundation; 2000.
16.
Beresford P, Hoban M. Participation in anti-poverty and regeneration work and research: overcoming barriers and creating opportunities. York: Joseph Rowntree Foundation; 2005.
17.
Birchall J, Simmons R. User power: the participation of users in public services. National Consumer Council; 2004.
18.
Darbas T, Smith T, Hall C. Case studies of community engagement: enhancing community engagement for NRM in the SEQ western catchment. Queensland: CSIRO; 2007.
19.
Office of the Deputy Prime M. National evaluation of local strategic partnerships: formative evaluation and action research programme 2002–2005. London: Office of the Deputy Prime Minister; 2006.
20.
Office of the Deputy Prime M. Neighbourhood wardens scheme evaluation. London: Office of the Deputy Prime Minister; 2004.
21.
Office of the Deputy Prime M. Evaluation of the residents' consultancy pilots initiative. London: Office of the Deputy Prime Minister; 2004.
22.
Barnes M, Newman J, Knops A, Sullivan H. Constituting ‘the public’ in public participation. Public Adm. 2003;81(2):379–99.CrossRef
23.
Barnes M, Sullivan H, Matka E. The development of collaborative capacity in health action zones: a final report from the national evaluation. Birmingham: University of Birmingham; 2003.
24.
Newman J, Barnes M, Sullivan H, Knops A. Public participation and collaborative governance. J Soc Policy. 2004;33(02):203–23.CrossRef
25.
Taylor M. Community participation in the real world: opportunities and pitfalls in new governance spaces. Urban Stud. 2007;44(2):297–317.CrossRef
26.
Simonsen-Rehn N, Ovretveit J, Laamanen R, Suominen S, Sundell J, Brommels M. Determinants of health promotion action: comparative analysis of local voluntary associations in four municipalities in Finland. Health Promot Int. 2006;21(4):274–83.CrossRefPubMed
27.
Bandura A. Social learning theory. New York: General Learning Press; 1977.
28.
Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health. 1998;13:623–49.CrossRef
29.
30.
Stokols D. Translating social ecological theory into guidelines for community health promotion. Am J Health Promot. 1996;10(4):282–98.CrossRefPubMed
31.
Hawley A. Human ecology: a theory of community structure. New York: Ronald Press; 1950.
32.
O'Neill M, Lemieux V, Groleau G, Fortin J-P, Lamarche PA. Coalition theory as a framework for understanding and implementing intersectoral health-related interventions. Health Promot Int. 1997;12(1):79–87.CrossRef
33.
Greenhalgh T, Bate P. Diffusion of innovations in health service organisations. London: BMJ Books; 2005.CrossRef
34.
35.
Griffiths J, Blair-Stevens C, Thorpe A. Social marketing for health and specialised health promotion, stronger together: weaker apart, shaping the future. London: RSPH, NSMC; 2008.
36.
Audrey S, Holliday J, Parry-Langdon N, Campbell R. Meeting the challenges of implementing process evaluation within randomized controlled trials: the example of ASSIST (a stop smoking in schools trial). Health Educ Res 2006;21(3):366-377.
37.
Campbell R, Starkey F, Holliday J, Audrey S, Bloor M, Parry-Langdon N, et al. An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial. Lancet. 2008;371(9624):1595–602.CrossRefPubMedPubMedCentral
38.
Fisher E, Auslander W, Sussman L, Owens N, Jackson-Thompson J. Community organization and health promotion in minority neighborhoods. Ethn Dis. 1992;2(3):252–72.PubMed
39.
Jemmott LS, Brown EJ, Dodds S. Building community partnerships to improve HIV prevention efforts: implications for nurses. J Assoc Nurses AIDS Care. 1998;9(3):29–40.CrossRefPubMed
40.
Starkey F, Moore L, Campbell R, Sidaway M, Bloor M. ASSIST. Rationale, design and conduct of a comprehensive evaluation of a school-based peer-led anti-smoking intervention in the UK: the ASSIST cluster randomised trial [ISRCTN55572965]. BMC Public Health. 2007;7(1):301.CrossRefPubMedCentral
41.
Treno A, Holder H. Community mobilization: evaluation of an environmental approach to local action. Addiction. 1997;92(Suppl 2):S173–87.CrossRefPubMed
42.
Weinehall L, Hellsten G, Boman K, Hallmans G. Prevention of cardiovascular disease in Sweden: the Norsjö community intervention programme—motives, methods and intervention components. Scand J Public Health. 2001;29(56 suppl):13–20.
43.
Kegler MC, Swan DW. Advancing coalition theory: the effect of coalition factors on community capacity mediated by member engagement. Health Educ Res. 2012;27(4):572–84.CrossRefPubMed
44.
Matthews H. Citizenship, youth councils and young People's participation. J Youth Stud. 2001;4(3):299–318.CrossRef
45.
Flowers P, Hart GJ, Williamson LM, Frankis JS, Der GJ. Does bar-based, peer-led sexual health promotion have a community-level effect amongst gay men in Scotland? Int J STD AIDS. 2002;13(2):102–8.CrossRefPubMed
46.
Russell H. National evaluation of local strategic partnerships: issues paper: voluntary and community sector engagement in local strategic partnerships. Office of the Deputy Prime Minister: London; 2005.
47.
Boote J, Telford R, Cooper C. Consumer involvement in health research: a review and research agenda. Health Policy. 2002;61(2):213–36.CrossRefPubMed
48.
Cornish F, Ghosh R. The necessary contradictions of ‘community-led’ health promotion: a case study of HIV prevention in an Indian red light district. Social science &amp. Medicine. 2007;64(2):496–507.
49.
Hamer M, Box V. An evaluation of the development and functioning of the Boscombe network for change, a health alliance or partnership for health in Dorset. Health Educ J. 2000;59:238–52.CrossRef
50.
Ritchie D. Breathing space’: reflecting upon the realities of community partnerships and workers’ beliefs about promoting health. Health Educ J. 2001;60(1):73–92.CrossRef
51.
Ritchie D, Parry O, Gnich W, et al. Issues of participation, ownership and empowerment in a community development programme: tackling smoking in a low-income area in Scotland. Health Promot Int. 2004;19(1):51–9.CrossRefPubMed
52.
53.
Tan EJ, Xue QL, Li T, Carlson MC, Fried LP. Volunteering: a physical activity intervention for older adults--the experience corps program in Baltimore. J Urban Health. 2006;83(5):954–69.CrossRefPubMedPubMedCentral
54.
Kim YH, Sarna L. An intervention to increase mammography use by Korean American women. Oncol Nurs Forum. 2004;31(1):105–10.CrossRefPubMed
55.
Holder HD, Moore RS. Institutionalization of community action projects to reduce alcohol-use related problems: systematic facilitators. Subst Use Misuse. 2000;35(1–2):75–86.CrossRefPubMed
56.
Bickerstaff K, Walker G. Shared visions, unholy alliances: power, governance and deliberative processes in local transport planning. Urban Stud. 2005;42(12):2123–44.CrossRef
57.
Duffy B, Rose J, Butler S, Vince J. Views of new deal for communities - focus group report. London: MORI; 2005.
58.
Blamey A, Ayana M, Lawson L, Mackinnon J, Paterson I, Judge K. Final report:the independent evaluation of have a heart paisley. Glasgow: University of Glasgow; 2004.
59.
Rogers PJ. Using Programme theory to evaluate complicated and complex aspects of interventions. Evaluation. 2008;14(1):29–48.CrossRef
60.
Educe L. Seeking the lessons: skills and knowledge Programme evaluation. Research report 19. London: Office of the Deputy Primer Minister; 2005.
61.
Sridharan S, Gnich W, Moffat V, Bolton J, Harkins C, Hume M, et al. Independent evaluation of have a heart paisley phase 2. Edinburgh: Research Unit in Health, Behaviour and Change, University of Edinburgh; 2008.
62.
McInroy N, MacDonald S. From community garden to Westminster: active citizenship and the role of public space. Centre for Local Economic Strategies: Manchester; 2005.
63.
Goodlad R, Burton P, Croft J. Effectiveness at what? The processes and impact of community involvement in area-based initiatives. Environ Plann C Gov Policy. 2005;23(6):923–38.CrossRef
64.
Bolam B, McLean C, Pennington A, Gillies P. Using new media to build social capital for health: a qualitative process evaluation study of participation in the CityNet project. J Health Psychol. 2006;11(2):297–308.CrossRefPubMed
65.
South J, Meah A, Bagnall A, Kinsella K, Branney P. People in public health: a study of approaches to develop and support people in public health roles. London: Queen’s Printer and Controller of HMSO. National Institute of Health Research (NIHR) Service Delivery and Organisation (SDO) Programme; 2010.
66.
Rees R, Oliver S. Stakeholder perspectives and participation in reviews. In: Gough D, Oliver S, Thomas J, editors. An introduction to systematic reviews. London: Sage; 2012.
67.
Frick KD, Carlson MC, Glass TA, McGill S, Rebok GW, Simpson C, et al. Modeled cost-effectiveness of the experience corps Baltimore based on a pilot randomized trial. J Urban Health. 2004;81(1):106–17.CrossRefPubMedPubMedCentral
68.
Swainston K, Summerbell C. The effectiveness of community engagement approaches and methods for health promotion interventions. Teeside: University of Teeside; 2008.
69.
Wilcox D. Community participation and empowerment: putting theory into practice. RRA. Notes. 1994;21:78–82.
70.
Popay J, Attree P, Hornby D, Milton B, Whitehead M, French B, et al. Community engagement in initiatives addressing the wider social determinants of health: a rapid review of evidence on impact, experience and process. University of Lancaster: Lancaster; 2007.
71.
NHS Dudley Primary Care Trust. Your NHS Dudley. Dudley: Dudley Primary Care Trust; 2013.
72.
Harden A, Oliver S. Who’s listening? Systematically reviewing for ethics and empowerment. In: Oliver S, Peersman G, editors. Using research for effective health promotion. Buckingham: Open University Press; 2001.
73.
Morgan LM. Community participation in health: perpetual allure, persistent challenge. Health Policy Plan. 2001;16(3):221–30.CrossRefPubMed
74.
Barnes K, Friedman SM, Brickner N, Honig J. Impact of community volunteers on immunization rates of children younger than 2 years. Arch Pediatr Adolesc Med. 1999;153(5):518–24.CrossRefPubMed
75.
Popay J. Community engagement for health improvement: questions of definition, outcomes and evaluation. A background paper prepared for NICE. London: NICE; 2006.
76.
Reijneveld SA, Westhoff MH, Hopman-Rock M. Promotion of health and physical activity improves the mental health of elderly immigrants: results of a group randomised controlled trial among Turkish immigrants in the Netherlands aged 45 and over. J Epidemiol Community Health. 2003;57(6):405–11.CrossRefPubMedPubMedCentral
77.
Richardson G, Kennedy A, Reeves D, Bower P, Lee V, Middleton E, et al. Cost effectiveness of the expert patients Programme (EPP) for patients with chronic conditions. J Epidemiol Community Health. 2008;62(4):361–7.CrossRefPubMed
78.
Secker-Walker RH, Holland RR, Lloyd CM, Pelkey D, Flynn BS. Cost effectiveness of a community based research project to help women quit smoking. Tob Control. 2005;14(1):37–42.CrossRefPubMedPubMedCentral
79.
Davis SM, Clay T, Smyth M, Gittelsohn J, Arviso V, Flint WH, et al. Pathways curriculum and family interventions to promote healthful eating and physical activity in American Indian schoolchildren. Prev Med. 2003;37:S24–34.CrossRefPubMedPubMedCentral
80.
Davis SM, Going SB, Helitzer DL, Teufel NI, Snyder P, Gittelsohn J, et al. Pathways: a culturally appropriate obesity-prevention program for American Indian schoolchildren. Am J Clin Nutr. 1999;69(4 Suppl):796S–802S.PubMedPubMedCentral
81.
Davidson LL, Durkin MS, Kuhn L, O'Connor P, Barlow B, Heagarty MC. The impact of the safe kids/healthy neighborhoods injury prevention program in Harlem, 1988 through 1991. Am J Public Health. 1994;84(4):580–6.CrossRefPubMedPubMedCentral
82.
Petticrew M, Rehfuess E, Noyes J, Higgins JPT, Mayhew A, Pantoja T, et al. Synthesizing evidence on complex interventions: how meta-analytical, qualitative, and mixed-method approaches can contribute. J Clin Epidemiol. 2013;66(11):1230–43.CrossRefPubMed
83.
Woodall JR, Warwick-Booth L, Cross R. Has empowerment lost its power? Health Educ Res. 2012;27(4):742–5.CrossRefPubMed
84.
Draper AK, Hewitt G, Rifkin S. Chasing the dragon: developing indicators for the assessment of community participation in health programmes. Social science &amp. Medicine. 2010;71(6):1102–9.
85.
O'Mara-Eves A, Brunton G, Oliver S, Kavanagh J, Jamal F, Thomas J. The effectiveness of community engagement in public health interventions for disadvantaged groups: a meta-analysis. BMC Public Health. 2015;15(1):129.CrossRefPubMedPubMedCentral
Metadata
Title
Narratives of community engagement: a systematic review-derived conceptual framework for public health interventions
Authors
Ginny Brunton
James Thomas
Alison O’Mara-Eves
Farah Jamal
Sandy Oliver
Josephine Kavanagh
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4958-4

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