An inter-sectoral map of UK policy promoting community engagement and empowerment in health

Abstract

Issue: Strengthening community action, as proposed in the Ottawa Charter, is key to achieving public health goals within a whole-of society approach to health. Community engagement is not a simple intervention as it is shaped by community contexts and policy agendas that can either constrain or enable local action. This has implications for developing an evidence base. Description of problem: Changes in UK policy and programme funding have led to a fragmented evidence base and many participatory models not achieving sustainability. To inform an update of public heath guidance, the National Institute for Health and Care Excellence commissioned an independent, systematic scoping review to understand UK community engagement policy and practice. This paper presents findings from the documentary analysis of policy themes and concepts. Results: After systematic searching and screening, 40 policy and 30 conceptual publications were included and extracted data then mapped onto a matrix. We found that UK policy interest in community engagement in health threads through multiple sectors including health, local government and volunteering. Policy focus was not static; new concepts (eg social action) have emerged since 2000, while others (eg health inequalities) have less prominence. Local government was identified as a key policy actor. Community empowerment was a common theme but concepts were not used consistently. Lessons: Community engagement in health has policy significance but can lack visibility because it is applied across multiple policy areas and is cross referenced to different concepts. This is important for promoting intersectoral action involving communities and for building healthy public policy. Our conclusions are that community engagement is best used as a broad organising concept as it covers a range of policy areas and terms. This needs to be accounted for in building an evidence base for participatory methods within and between countries. Message 1 A mapping of UK policy since 2000 shows that community engagement in health can be promoted through a range of policy initiatives and sectors; however there is change through policy cycles Message 2 The evidence base on community engagement can appear fragmented, results from this policy analysis help identify related concepts and terms.