Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review

Abstract

BackgroundAlthough community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness of CE, and components of CE that are acceptable, feasible, and effective when used among disadvantaged populations.DesignThe systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out methodological assessments of the included studies using rating scales. The analysis focussed on model synthesis to identify the key CE components linked to positive study outcomes and comparative analysis between positive study outcomes, processes, and quality indicators of CE.ResultsOut of 24 studies that met our inclusion criteria, 21 (87.5%) had positively impacted health behaviours, public health planning, health service access, health literacy, and a range of health outcomes. More than half of the studies (58%) were of good quality, whereas 71% and 42% of studies showed good community involvement in research and achieved high levels of CE, respectively. Key CE components that affected health outcomes included real power-sharing, collaborative partnerships, bidirectional learning, incorporating the voice and agency of beneficiary communities in research protocol, and using bicultural health workers for intervention delivery.ConclusionsThe findings suggest that CE models can lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation. We also found several gaps in the current measurement of CE in health intervention studies, which suggests the importance of developing innovative approaches to measure CE impact on health outcomes in a more rigorous way.

Advancing Nursing Science Through Community Advisory Boards

“…These include incorporating real power-sharing structures between academic and community partners, ensuring true collaborative partnerships, engaging the voice and agency of the target community in the research protocol, nurturing bidirectional learning processes, and incorporating bicultural health workers for intervention delivery. 11 These components help ensure partnerships within CABs result in constructive community-academic relationships and processes and positive health outcomes. These principles also have broad applications, regardless the health outcome and population of interest.…”

“…1 In fact, community health workers (CHWs), lay individuals from the community of interest that are trained to address health issues in their own community, have been identified as being integral to CBPR, demonstrating a positive impact on health outcomes. 11 CHWs work to improve outcomes of interventions by overcoming cultural barriers to the targeted community, helping to provide access to the community, encouraging participant engagement, improving the quality of health promotion messages included in interventions, and improving health behaviors. Additionally, from the community’s perspective, CHWs and other people that help bridge the culture of the community and the culture of the research team help engender trust with the group being studied.…”

“…10 Recently Cyril and colleagues conducted a systematic review to address the gap in knowledge regarding the methods and components of CBPR that maximize positive health outcomes among vulnerable populations. 11 Twenty-four studies that evaluated community-engaged methods were identified, and 21 (87.5%) documented positive effects on health outcomes. The key community-engaged components that had a positive impact on health outcomes included: (1) real power-sharing between academic and community partners, (2) collaborative partnerships, (3) incorporating the voice and agency of the target community in the research protocol, (4) bidirectional learning between community members and researchers, and (5) incorporating bicultural health workers that reflects the cultural identity of the community for intervention delivery.…”

Role of health care professionals in preventative activities and vaccination programs during outbreaks

“…Research increasingly shows the importance of public engagement in pandemic planning. The community-based participatory approach can aid in understanding community perspectives and values, helps accept recommended actions by the public and execute at the community level [15,16].…”

Exploring the potential role of community engagement in evaluating clinical and translational science grant proposals

“…Community engagement is posited to engender better quality research, expand the applicability of research, empower patients, improve dissemination and uptake of results, and respond to a moral imperative to include a broad community of stakeholders in research processes. 6,7 Typically, however, patients, the public, and advocacy stakeholders are neither conceptualized to be engaged, nor actually engaged, in the early phases of the translational continuum. 8,9 To date, the majority of community engagement efforts have focused on informing patient-centered health initiatives, recruiting and soliciting participation in clinical studies or interventions, or facilitating the dissemination of health information.…”