Abstract

Introduction: Community engagement is increasingly recognized as a critical aspect of global health. Recent years have seen an expansion of community engagement activities linked to health research, but debates and inconsistencies remain about the aims of different types of engagement, mechanisms underpinning their implementation and impact, and influential contextual factors. Greater commitment to and consistency around community engagement by health research programs, implementers and funders requires a more coherent evidence base. This realist review is designed to improve our understanding of how and why community engagement contributes to intended and unintended outcomes (including research and ethical outcomes) in different contexts. Given the breadth and diversity of the literature on community engagement in health research, the review will initially focus on malaria research in low- and middle-income countries (LMICs) and draw on wider global health literature where needed. Methods and analysis: Community engagement in practice is often a complex set of interventions. We will conduct a realist review - a theory driven approach to evidence synthesis - to provide explanations for how and why community engagement with health research produces the pattern of outcomes observed across different contexts of application. We will consolidate evidence from a range of documents, including qualitative, quantitative and mixed method studies. The review will follow several stages: devising an initial programme theory, searching evidence, selecting appropriate documents, extracting data, synthesizing and refining the programme theory, and reiteration of these steps as needed. Ethics and dissemination: A formal ethics review is not required for this literature review. Findings will be disseminated in a peer reviewed journal, through national and international conferences, and through a set of short briefings tailored for audiences with an interest in community engagement. Outputs and presentations will be informed by and feed into our network of community engagement experts. PROSPERO registration number: CRD42019125687.

Highlights

  • Community engagement is increasingly recognized as a critical aspect of global health

  • We have provided a definition of what a realist programme theory is, and clarified the status and provisional nature of the initial programme theory visualisations (Figure 3 and Figure 4) included in the paper

  • Background Community engagement is increasingly recognized as a critical element of global health research, recommended by ethicists, funders and international ethics guidelines, such as the 2016 Council for International Organization of Medical Sciences (CIOMS) guidelines[1,2,3]

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Summary

Introduction

Background Community engagement is increasingly recognized as a critical element of global health research, recommended by ethicists, funders and international ethics guidelines, such as the 2016 Council for International Organization of Medical Sciences (CIOMS) guidelines[1,2,3]. Our review aims to focus on CE in large research programmes in LMICs in order to understand how community engagement works in practice in such settings and assess claims made for contributions to research related and ethical outcomes. Review aim This review aims to improve our understanding of the ways in which (i.e. how, why and in what contexts) community engagement interventions contribute to (or do not contribute to) reported outcomes (both explicitly aimed for and unintended), including the range of research related and ethical outcomes highlighted above under the section ‘Goals and outcomes’, and the roles of context and mechanisms in each case. Given that outcomes are not always clearly articulated in reports of community engagement, the review will consider revealed outcomes, again attempting to understand the influence of particular mechanisms and context

Methods
Strengths and limitations
Clinical and Translational Science Awards Consortium
12. Lavery JV
27. Wallerstein N
45. Pawson R
58. Adhikari B
A more explicit focus on LMIC contexts
Taking unintended outcomes seriously
The need for prioritization
Interrogating the theory of change
Towards deeper understanding of the multiple shades of community engagement
The need to more explicitly focus on values
Findings
Full Text
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