Diverse Community Engagement and Involvement (CEI) is required to address, and avoid perpetuating, health inequities, but approaches to CEI tend to be based on how things are done within academia and limit work with under-represented groups.
The research
Embedded reflective evaluation and action research were used to obtain insights on a number of projects using culturally tailored approaches.
Turning discovery into new approaches
We identified that culturally-tailored, relationship-focussed and community-led public involvement builds trust, strengthens social capital, supports wellbeing, increases research participation, develops community leadership, builds health literacy and improves how research teams deliver.
Evaluations highlighted that engagement requires granular, culturally specific approaches, partnership working and whole team commitment in addition to operational needs including good facilities, secure funding, staffing, training, communication systems, and include community models of reward and recognition.
Impacts
Impacts reflected the 3 shifts, emphasising that inclusive models required movement into culturally safe community spaces, inclusion of remote/online engagement and importantly that impacts included prevention of ill-health and reduced health inequities.
Good practice insights were shared through academic publications and development of accessible good practice guidance for the Learning for Involvement website. Impacts were wide ranging and included:
- Increased trust and research participation.
CEI that implemented good practice helped build trust, making research accessible, relevant and “for us”. It helped people get involved in planning research, take part in studies and consider research as a career. - Improved health knowledge and health-positive cultures.
CEI created opportunities for people to access health information, discuss sensitive topics, reflect and consider changes in relation to lifestyle.
This empowered people to deliver community-led health action including blood pressure checks, stroke awareness and mental health talks, and supporting peers. People used health science information to deliver health improvement. - Wellbeing benefits.
Projects provided enjoyable physical activity and dedicated self-care time. - Reduced isolation and stronger relationships.
Engagement built friendships, motivation, accountability, encouragement and peer support extending impact into communities. This growth of social capital.
helped participants access information, gain confidence and build trust with research and health systems and helped resource community-led health action. - Empowerment and ownership.
Participants described feeling a sense of ownership, equality and “give and take” with researchers. Engagement was strongest where it moved towards co-production and community-led delivery. - Practice change among researchers.
Practice moved towards reflective evaluation, incorporating theory, embedding involvement across teams and governance, and using online platforms to increase reach and accessibility.
For more on our public involvement work, visit our pages: Our approach to Public Involvement – NIHR Biomedical Research Centre Leicester