Chapter 8. Summary
Donna Jo McCloskey, RN, PhD, and Mina Silberberg, PhD
This primer presents the case for community engagement in health promotion and research and provides guidelines for its practice. It emphasizes the need to articulate the purpose and goals of the engagement initiative, assess community capacity and one’s own capacity for community engagement, and build or leverage community assets for health improvement. Community engagement, like any other initiative, needs to be implemented with a plan of action that is goal and context based. The stakeholders engaged, the strategy and approach used to gain their involvement, and the resources needed all depend on the purpose and outcomes desired and on knowledge of the community and the partners.
Community engagement may or may not be a new way of doing business for a given individual or entity. If it is new, it may mean changing the way organizations, individuals, and practices make decisions about programs and resource allocation. It may also mean developing partnerships, coalitions, and collaborative efforts with new people and organizations. Before action can occur, engagement leaders need to consider and develop a management strategy.
- The values of the organization: Does it perceive involving the community in identifying community health issues and developing programs as important? Does it recognize the importance of partnering and collaborating with other groups or community-based organizations?
- The intent of the organization: What does the organization want to accomplish? What is the best way to establish its position and select strategies to begin community action?
- The operations of the organization: Is it already working with the community on specific programs or issues? How? Are there existing collaborations with other institutions or agencies? Are community leaders or representatives already involved in decision making related to program planning, implementation, and evaluation?
- The resources and expertise available to support an engagement effort: What mechanisms will be in place to ensure that relevant data on community needs will be used? What financial resources will be required? Which staff are most skilled or already have strong ties to the community?
- Know what is of interest and what community involvement is expected to accomplish. For example, is the goal a broad one, such as engaging the community in assessing its health status, identifying concerns, and developing and implementing action plans, or is it more narrow, such as engaging the community around specific health objectives?
- Have an idea about how the community should be involved. Will they be advisors or co-decision makers or both? What might the structures and process be for their involvement?
- Be clear on the community to be engaged, at least initially. Is it a geographic community, including all of those who live within its boundaries, or is it a community that is defined in some other way?
- Know the extent to which the focus of the community engagement efforts is flexible. As more is learned about the community and issues of interest, it might be more effective or appropriate to focus engagement efforts on other populations or communities. Similarly, goals may need to be modified based on community input.
- Talk with stakeholders, attend community meetings, read community newspapers, and obtain information that is relevant to the engagement process.
- Establish relationships and build trust.
Potential partners will be more likely to become involved in a community engagement effort, such as collaborative health promotion or research projects, if they understand what it means to become involved and believe their participation will be meaningful. Using a community-engaged approach and working within communities requires a continual effort to balance costs and benefits and sustain cooperation and accountability among participating groups. All interested individuals, groups, and organizations must feel they can join a community engagement effort and influence it. This is the foundation for trust among collaborators. If trust is not present, relationships are guarded and commitments tentative. Therefore, relationships must be built that are inclusive of the entire community of interest.
Being inclusive can create some organizing challenges. However, successfully overcoming these challenges will provide a greater return on the investment made by engagement leaders through the greater involvement of partners and the assets they bring to the process. One key challenge is managing the decision-making process. When formal governance of the collaboration is needed, the community should be given an opportunity to shape the governance process and provide input on decisions to be made by the governing structure. Another important approach to creating and maintaining a sense that participation is worthwhile is to use collaborative strategies that can achieve a small success quickly and reinforce the benefit of participation. With time, collaborations may evolve from these “small beginnings” and grow into more ambitious efforts. Over time, it may be appropriate for an entity to move away from a position as a lead stakeholder to become simply one of many partners in a broader effort. In addition, stakeholders may find that they no longer need to reach out to involve a community because that community is now coming to them. Over time, engagement leaders may also need to reexamine and revise the purpose, goals, and strategies of the collaborative. Engagement leaders may find that it is time to broaden the participation and engage new communities on new issues while nurturing existing collaborations.
The contributors to this second edition of Principles of Community Engagement hope that it will provide all stakeholders with greater insight into the science and practice of community engagement and the implementation of community-engaged initiatives. These insights should help prepare those interested in community engagement to practice in the diverse situations that communities face. Most importantly, the insights provided in this primer should help prepare engagement leaders to make decisions that improve health, reduce disparities, and enhance quality of life.