Public participation and marginalized groups: the community development model

Abstract

OBJECTIVES: To develop ways of reaching house-bound people and enabling them to give their views in planning and monitoring health and social care. STRATEGY: HealthLINK - a project based in a community health council - explored ways of involving older house-bound people in the London Borough of Camden, in planning and monitoring health and social care using community development techniques. RESULTS: HealthLINK set up an infrastructure to enable house-bound people to have access to information and to enable them to give their views. This resulted in access for health and local authorities to the views of house-bound older people and increased the self esteem and quality of life of those who became involved. CONCLUSIONS: Community development approaches that enable an infrastructure to be established may be an effective way of reaching marginalized communities. However, there are tensions in this approach between the different requirements for public involvement of statutory bodies and of users, and between representation of groups and listening to individual voices.

Can the patient be on our team? An operational approach to patient involvement in interprofessional approaches to safe care

“…Cultural marginalization can hinder people from ''speaking up'' (O'Keefe & Hogg, 1999), as can a culture of public passivity (Arnstein, 1969). Professional defensiveness is a major cultural barrier to patient empowerment -professional resistance, emotional distancing, and negative attitudes can significantly reduce the effectiveness of patients' involvement.…”

An Examination of Opportunities for the Active Patient in Improving Patient Safety

“…20,21 Cultural disparities may exist among health care professionalsVfor example, preliminary evidence suggests that physicians may be culturally averse to increasing patient involvement because of the negative psychological impact that discussion of risk may have to the patient. Research indicates, however, that both patients and physicians vary in their ability to do this.…”

Hand Hygiene

“…1129 Cultural factors such as cultural marginalization, caused by social pressure, can have a significant impact on "speaking up". 1130 In addition to these barriers, a significant factor often perceived by the patient is the fear of a negative impact/response from their HCWs. 1131 This barrier was explored in an acute care rehabilitation unit where patients are often dependent on their HCWs for activities of daily living.…”