Abstract
BackgroundIn the light of the existence of social inequalities in health, a CBPR (Community Based Participatory Research) programme for health promotion started in Malmö, Sweden, in 2017. The programme was based on a penta-helix structure and involved a strategic steering group with representatives from academia, voluntary organisations, the business sector, the public sector, and citizens from the community where the programme took place. The aim of this study was to explore how the penta-helix collaboration worked from the perspectives of all partners, including the citizens.MethodsIndividual interviews, that were based on a guide for self-reflection and evaluation of CBPR partnerships, were conducted with the representatives (N = 13) on three occasions, during the period 2017–2019. A qualitative content analysis was used to analyse the interviews.ResultsSix themes emerged from the analysis, including Challenges for the partners in the penta-helix collaboration; Challenges for the professionals at the local level; Citizen-driven processes are important for the penta-helix collaboration; Health promoters are essential to build trust between different sectors of society; Shift of power; and System changes take time. The analysis shows that the penta-helix collaboration worked well at the local level in a governance-related model for penta-helix cooperation. In the overall cooperation it was the citizen-driven processes that made the programme work. However, the findings also indicated an inflexibility in organisations with hierarchical structures that created barriers for citizen involvement in the penta-helix collaboration.ConclusionThe main issue uncovered in this study is the problem of vertically organised institutions where discovery and innovation processes flow down from the top, thereby eliminating the essential input of the people and community that they are supposed to serve. The success of the programme was based on an interprofessional cooperation at a local level, where local professions worked together with voluntary organisations, social workers, CBPR researchers from the university, citizens and local health promoters.
Highlights
In the light of the existence of social inequalities in health, a CBPR (Community Based Participatory Research) programme for health promotion started in Malmö, Sweden, in 2017
The six themes – Challenges for the partners in the pentahelix collaboration; Challenges for the professionals at the local level; Citizen-driven processes are important for the penta-helix collaboration; Health promoters are essential for building trust between different sectors of society; Shift of power; and System changes take time – were identified and considered to reflect the perspectives of the partners
The partners from academia stated that the main challenge for the partnership was to find cross-border solutions in the collaboration that would persist over time
Summary
In the light of the existence of social inequalities in health, a CBPR (Community Based Participatory Research) programme for health promotion started in Malmö, Sweden, in 2017. The existence of social inequalities in health is well established in the world To reduce these inequalities, it is essential to take action on the social determinants of health in a broader perspective and improve the conditions in which people live and work [1]. A multisectoral approach (MSA), involving various stakeholders from different sectors in the society, is important for solving complex societal challenges such as inequalities in health [3]. The challenge in such collaboration is to engage the stakeholders to work with intersectoral actions in order to create sustainability solutions. We argue that the community needs to be a more active partner in such multisectoral collaboration to create sustainability solutions in socially vulnerably areas
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