Engaging communities in non-communicable disease research and interventions in low- and middle-income countries: a realist review protocol

Abstract

IntroductionEngaging communities and intended beneficiaries at various stages of health research is a recommended practice. The contribution of community engagement to non-communicable disease research in low- and middle-income countries has not yet been extensively studied or synthesised. This protocol describes the steps towards generating an understanding of community engagement in the context of non-communicable disease research, prevention and health promotion using a realist review approach. A realist lens enables a rich explanatory approach to causation while capturing complexity, and an openness to multiple outcomes, including unintended consequences. The review will thus develop an understanding of community engagement without assuming that such practices result in more ethical research or effective interventions.Methods and analysisWe propose a realist approach aiming to examine how, why, under what circumstances and for whom community engagement works or does not work. The iterative review steps include clarifying the review scope; searching for evidence; appraising studies and extracting data; synthesising evidence and drawing conclusions; and disseminating, implementing and evaluating the findings. Principles of meta-narrative review (pragmatism, pluralism, historicity, contestation, reflexivity and peer review) are employed to ensure practicable and contextualised review outputs. The proposed review will draw on theoretical and empirical literature beyond specific diseases or settings, but with a focus on informing non-communicable disease research and interventions in low- and middle-income countries. The synthesis of existing literature will be complemented by qualitative realist interviews and stakeholder consultation. Through drawing on multiple types of evidence and input from both experts and intended beneficiaries, the review will provide critical and pragmatic insights for research and community engagement in low- and middle-income countries.Ethics and disseminationEthical approval has been obtained from the University of the Witwatersrand. Dissemination will include traditional academic channels, institutional communications, social media and discussions with a wide range of stakeholders.

Participatory mental health interventions in low-income and middle-income countries: a realist review protocol

“…To counter the western hegemonic knowledge structures that shape much of the peer-reviewed literature,38 we have added specific stakeholder consultations in our review, to combine and include embodied knowledges held by people with mental health difficulties, carers and community members. Consulting stakeholders as part of the review is consistent with the realist methodology 30 32. We assess their views of participation and involvement as it relates to mental health, at two stages in the review .…”

“…Our investigation applies a realist methodology, which has a similar interest in ‘what works for these particular people in particular contexts’ 30 33. Realists reviews combine theory and empirical observation and seek to understand how and why change is facilitated 30 32–34. This review will be used to identify mechanisms of change and their related contexts, which will support the development of theory to further our understandings of how participation is used in the design and implementation of mental health interventions.…”

“…To date, there have been reviews of community engagement and participatory health approaches in LMICs 30 31 including an ongoing realist review on community engagement in non-communicable disease interventions and research 32 ; however, to the authors’ knowledge, there has been no specific review that interrogates participatory approaches to mental health across LMICs. The current review seeks to address this gap exploring the following questions: In LMIC settings, what is the nature of participatory approaches for mental health improvement?…”

The unreachable doorbells of South Texas: community engagement in colonias on the US-Mexico border for mosquito control

“…We employ this design to provide an account of the issues we faced with community engagement during our different projects, and try to provide causes of the problem, solutions we undertook, the outcomes of the solutions, lessons learned, and the broader theories/concepts relevant to our experience [ 40 ]. We are analyzing how gradual changes in community engagement, from minimal outreach with limited involvement from stakeholders to consultation with some input from stakeholders to researchers [ 41 ], allowed us to improve participation and retention of community members in the framework of a mosquito ecology and control research program. We kept records on the total number of occupied houses in the communities, the number of visits needed to engage community members during the house-to-house recruitment, number of dropouts for each community, and community members’ suggestions during meetings and flyer development.…”

Community engagement for malaria elimination in the Greater Mekong Sub-region: a qualitative study among malaria researchers and policymakers

“…Over recent years, community engagement has received increasing attention in health research and programme interventions [ 1 , 2 ]. What constitutes community and engagement is however debated, particularly because of differences in overall aims [ 3 ].…”