Opportunities and Barriers to Embedding Community Development Approaches in Local Systems

Abstract

Background: Community development is a multi-faceted process which generates individual and community empowerment and can contribute towards reducing health inequalities, particularly in marginalised communities. Community development approaches refer to interventions, frameworks and programmes which work with communities to help them to identify their collective needs and challenges, and mobilises them to utilise available assets to generate long term change within the community. Funding for community development is typically provided on a short term ‘one off’ basis which limits its potential benefits. Continued investment, so that community development becomes normalised, is needed. Embedding community development within local systems, such as primary health care, local authorities and housing associations, is one way to achieve continued investment and to maximise benefits. However, there is little research on how to embed community development approaches within such systems. The research presented is part of a PhD project which aims to address this research gap. 
 Methods: Semi-structured interviews with Key Informants, who have experience embedding community development approaches within systems, are currently being conducted and shall be completed in December 2022. Participants are being recruited through purposive sampling. The interview topic guides were reviewed by a Public and Patient Involvement (PPI) panel in June 2021 and were developed around the Consolidated Framework for Implementation Research (CFIR). Data analysis is being undertaken also using the five domains of the CFIR (intervention characteristics, outer setting, inner setting, individual characteristics and intervention processes) in NVivo.
 Results: Preliminary results have shown that all five domains of the CFIR impact the embedding process. Funding is frequently described as a barrier to implementation, but some participants believe that funding is incorrectly identified as a barrier, with only limited funds needed to embed this way of working. It is frequently mentioned that a strong belief in the purpose of the project and key individuals driving systemic change within the organisation are key to long term implementation. Other current emerging themes include the significance of the political setting at both a local and national level, as well as a multidisciplinary and inter-sectoral approach being adopted being a facilitator to change.
 Future Implications: The results of this research will be collated with other parts of the PhD research project on embedding community development approaches in systems to improve health and reduce inequalities, to generate guidelines on how systems can embed community development approaches into their way of working. A panel of community members will contribute towards the generation of these guidelines, which will be made available to any local system considering adopting a community development approach.