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Centre for Health Promotion

Community-centred approaches to health and well-being

Bringing together findings from key stakeholders in public health, in particular lay-workers and local communities, to underpin policy and strategy in community-based approaches to health and wellbeing, for Public Health England and NHS England.

Community-centred approaches to health and well-being

the challenge

For any public health policy to be successful requires the engagement of the targeted beneficiaries in the process. The field of community engagement and empowerment in health covers a diverse range of approaches. Longstanding barriers to the development and application of an evidence base include:

  • the absence of common terminology
  • the lack of recognition around community assets, and
  • the need for local adaption

This has resulted in a fragmented evidence base. Work by the Centre for Health Promotion Research (CHPR) at Leeds Beckett University (LBU) led by Professor Jane South, has directly addressed this challenge through a portfolio of underpinning research that has (i) unpacked the nature of community interventions and underlying mechanisms, and (ii) produced evidence- based frameworks to guide policy, commissioning and practice.

The Approach

The first phase was a major NIHR-funded study entitled “People in Public Health”, which focussed on lay people in public health roles. This work incorporated a systematic scoping review, deliberative methods, qualitative research and multiple case study assessments. Outputs from this broad NIHR study informed and significantly contributed to the understanding of the range of health-improvement roles that members of the public could successfully take on and how problematic issues like remuneration could be managed.

The second phase broadened the portfolio of research and widened the scope to all community engagement approaches used to improve health and wellbeing. Our co-produced mode of working led to the establishment of an emergent issue ‘think tank’ that linked policy makers, national organisations, practitioners, communities and academics. This network identified key research questions to be addressed to improve the evidence base relating to community engagement.

Subsequently, Professor South was seconded to Public Health England and led a joint knowledge translation project on community engagement since 2014 that informed the direction of the underpinning research. The underpinning research consisted of mixed methods approaches to identify current policy and practice in the UK for encouraging community engagement and a systematic review to identify barriers and facilitators for increasing community engagement. This research met the challenges of a fragmented evidence base that had hindered advancement in this area by:

  1. Developing a conceptual framework linking theory with practice, using the notion of community-centred approaches
  2. Identifying and mapping international and national evidence on community-based interventions

This work resulted in a taxonomy, ‘the family of community-centred approaches’ and was a significant contribution in developing community-engagement strategies within public health sectors. The two extensive NICE-commissioned reports presented in the underpinning research were part of a collaboration between LBU and University of East London (UEL). The key findings of the underpinning research have been summarised and condensed into the PHE/NHSE report “A guide to community-centred approaches for health and wellbeing”, which has acted as the conduit to stakeholders in translation of the underpinning research into driving changes in public health policy and practice.

The Impact

The CHPR body of research has driven an evidence-led decision process that has changed policy and practice in the design and delivery of community-centred approaches to health and wellbeing. Impactful change has occurred in the UK at national governmental, local governmental, local provider and practitioner levels and internationally with the adoption of these research findings by the Spanish public healthcare system. The ultimate beneficiaries of the impact of this research are the general public, through improvement in government policy and societal practice in relation to ownership of one’s health. Changes in societal practice relating to public health is far-reaching, both from the perspective of a general improvement in health and wellbeing throughout society to the subsequent financial savings to public health services such as the NHS.

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