The strengths, gender, and place framework: a new tool for assessing community engagement

Despite a recent increase in community engagement in health initiatives during the COVID-19 pandemic, health inequalities and health inequities remain a serious problem for society, often affecting those in underserved communities the most. Often individualised incentives such as payment for vaccinations have been used to increase involvement in health initiatives but evidence suggests that these do not always work and can be ineffective. This paper addresses the real world problem of a lack of involvement of communities in health programmes and subsequent health inequalities. Using data from nine workshops with community members evaluating a large community health programme, we develop a socio-ecological model [SEM] of influences on community engagement in health programmes to identify holistic and systemic barriers and enablers to such engagement. To date SEM has not been used to develop solutions to improve community engagement in health programmes. Such an approach holds the potential to look beyond individualised conceptualisations of behaviour and instead consider a multitude of social and cultural influences. This knowledge can then be used to develop multi-faceted and multi-layered solutions to tackle the barriers to community engagement in health programmes. Our SEM highlights the overarching importance of the socio-cultural environment in influencing community engagement. Within the socio-cultural environment were factors such as trust, social support and community mindedness. We also found that other factors affecting community engagement fall within individual, economic, technological, political and physical environments. Such factors include engagement in community organisation governance and processes, access to and ability to use technology and access to safe outdoor spaces. We propose further testing our socioecological model in other communities.

Despite a recent increase in community engagement in health initiatives during the COVID-19 pandemic, health inequalities and health inequities remain a serious problem for society, often affecting those in underserved communities the most. Often individualised incentives such as payment for vaccinations have been used to increase involvement in health initiatives but evidence suggests that these do not always work and can be ineffective. This paper addresses the real world problem of a lack of involvement of communities in health programmes and subsequent health inequalities. Using data from nine workshops with community members evaluating a large community health programme, we develop a socio-ecological model [SEM] of influences on community engagement in health programmes to identify holistic and systemic barriers and enablers to such engagement. To date SEM has not been used to develop solutions to improve community engagement in health programmes. Such an approach holds the potential to look beyond individualised conceptualisations of behaviour and instead consider a multitude of social and cultural influences. This knowledge can then be used to develop multi-faceted and multi-layered solutions to tackle the barriers to community engagement in health programmes. Our SEM highlights the overarching importance of the socio-cultural environment in influencing community engagement. Within the socio-cultural environment were factors such as trust, social support and community mindedness. We also found that other factors affecting community engagement fall within individual, economic, technological, political and physical environments. Such factors include engagement in community organisation governance and processes, access to and ability to use technology and access to safe outdoor spaces. We propose further testing our socioecological model in other communities.

This project employed community researchers as a means of improving community engagement around their Private Water Supplies (PWS) in rural Scotland. In this paper, we reflect on working with community researchers in terms of the benefits and challenges of the approach for future rural research that seeks to improve community engagement. The paper (1) critiques the involvement of community researchers for rural community engagement, drawing on the experiences in this project and (2) provides suggestions for good practice for working with community researchers in rural communities’ research. We offer some context in terms of the role of community members in research, the importance of PWS, our approach to community researchers, followed by the methodological approach and findings and our conclusions to highlight that community researchers can be beneficial for enhancing community engagement, employability, and social capital. Future community researcher approaches need to be fully funded to ensure core researchers can fulfil their duty of care, which should not stop when data collection is finished. Community researchers need to be supported in two main ways: as continuing faces of the project after the official project end date and to transfer their newly acquired skills to future employment opportunities.

Over the last decade excellent progress has been made globally in HIV management thanks to antiretroviral therapy (ART) rollout and international guidelines now recommending immediate initiation of ART in people living with HIV. Despite this, advanced HIV disease (CD4 less than 200 cells/mL) and opportunistic infections remain a persistent challenge and contribute significantly to HIV-associated mortality, which equates to 23,000 deaths in Uganda in 2018 alone. Our Meningitis Research Team based in Uganda is committed to conducting clinical trials to answer important questions regarding diagnostics and management of HIV-associated opportunistic infections, including tuberculosis and cryptococcal meningitis. However, clinical research is impossible without research participants and results are meaningless unless they are translated into benefits for those affected by the disease. Therefore, we held a series of community engagement events with the aims of 1) giving research participants a voice to share their experiences of clinical research and messages of hope around advanced HIV disease with the community, 2) dispelling myths and stigma around HIV, and 3) raising awareness about the complications of advanced HIV disease and local clinical research and recent scientific advances. The purpose of this Open Letter is to describe our community engagement experience in Uganda, where we aimed to give clinical research participants a greater voice to share their experiences. These activities build upon decades of work in HIV community engagement and lays a platform for future research and engagement activities.

Community engagement in higher education has been promoted as critical to fulfilling higher education’s responsibility to the public good through teaching, learning, and knowledge generation. Reciprocity and mutual benefit are key principles of community engagement that connote a two-way exchange of knowledge and outcomes. However, it is not clear from existing literature whether community engagement impacts communities in positive ways. The problem addressed through this study was how campus-community partnership stakeholders define impact. Using grounded theory, the ways community and campus partners defined, measured, and understood community impact in a diverse set of campus-community partnerships at two U.S. urban, Jesuit universities that employ place-based approach to community engagement were explored. Relationships as facilitators of impact and as impacts in and of themselves emerged as central themes. Themes from the data led to the development of the Justice-Centering Relationships Framework which includes two paradigms for understanding community impact in higher education community engagement – Plug-and-Play and Justice-Centering Relationships – that are bridged by a Reframing process. The Framework contributes to and informs the “how” of taking a place-based community engagement approach that leads to positive benefits for community impact, student learning and formation, and institutional change.

BackgroundMass anti-malarial administration has been proposed as a key component of the malaria elimination strategy in South East Asia. The success of this approach depends on the local malaria epidemiology, nature of the anti-malarial regimen and population coverage. Community engagement is used to promote population coverage but little research has systematically analysed its impact. This systematic review examines population coverage and community engagement in programmes of mass anti-malarial drug administration.MethodsThis review builds on a previous review that identified 3049 articles describing mass anti-malarial administrations published between 1913 and 2011. Further search and application of a set of criteria conducted in the current review resulted in 51 articles that were retained for analysis. These 51 papers described the population coverage and/or community engagement in mass anti-malarial administrations. Population coverage was quantitatively assessed and a thematic analysis was conducted on the community engagement activities.ResultsThe studies were conducted in 26 countries: in diverse healthcare and social contexts where various anti-malarial regimens under varied study designs were administered. Twenty-eight articles reported only population coverage; 12 described only community engagement activities; and 11 community engagement and population coverage. Average population coverage was 83% but methods of calculating coverage were frequently unclear or inconsistent. Community engagement activities included providing health education and incentives, using community structures (e.g. existing hierarchies or health infrastructure), mobilizing human resources, and collaborating with government at some level (e.g. ministries of health). Community engagement was often a process involving various activities throughout the duration of the intervention.ConclusionThe mean population coverage was over 80% but incomplete reporting of calculation methods limits conclusions and comparisons between studies. Various community engagement activities and approaches were described, but many articles contained limited or no details. Other factors relevant to population coverage, such as the social, cultural and study context were scarcely reported. Further research is needed to understand the factors that influence population coverage and adherence in mass anti-malarial administrations and the role community engagement activities and approaches play in satisfactory participation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1593-y) contains supplementary material, which is available to authorized users.

Introduction Community engagement is critical in promoting awareness, dispelling myths, and strengthening outbreak preparedness and response. In Nigerian communities, private sector providers, particularly Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) serve as the first point of healthcare contact. The IntegratE project, implemented by Society for Family Health, has trained and supported them to deliver quality family planning (FP) and primary healthcare (PHC) services. This study explores how lessons from the IntegratE private sector model can be adapted to empower communities in preventing and responding to Lassa fever and other viral hemorrhagic fevers outbreak. Methods The IntegratE project adopted a multi-layered approach involving capacity building, demand generation, and strategic community engagement in 11 Nigerian States from 2017 to 2024. Over 5,200 CPs and PPMVs were trained in interpersonal communication, counseling, referral, health promotion and data reporting, particularly in FP and maternal-child health services. This abstract proposes the adaptation of these methodology particularly the role of trusted CPs and PPMVs to Lassa fever prevention through early warning systems, community-based surveillance, counselling and targeted risk communication. Results Evidence from the IntegratE project indicates increased FP awareness and uptake, improved health-seeking behavior, reduced misconceptions and growing trust in private sector healthcare providers among underserved populations. Over 834,523 women accessed FP through these trained providers with about 33% (274,013) being new clients, who may not have accessed FP if the providers were not trained. Also, over 551,306 children seen for various PHC services including malaria, pneumonia, diarrhea, tuberculosis and malnutrition. Conclusion The IntegratE project demonstrates that empowering trusted private sector providers can improve community health outcomes. Integrating CPs and PPMVs into Lassa fever response frameworks can enhance early detection, promote timely disease reporting, encourage behavioral change, improve community engagement, reduce Lassa fever myths and stigma and contribute to more resilient health systems.

The fast pace of urban life, the high cost of living, and the complexity of interpersonal relationships are triggering social isolation among urban residential youths in China. Furthermore, online demand is causing social isolation due to a lack of physical human interactions which leads to poorer mental and physical health. Therefore, there is a need to get the youth generation to go offline to enjoy natural living and live healthily in society. A desktop survey was conducted as part of a larger study to improve community engagement in urban residential outdoor environments for youth. The results found offline community engagement could improve the well-being of young residents by taking advantage of its positive physical and mental effects. Using visual tools for exploring the functional and aesthetic landscape needs and motivation for co-creating personalized spaces in a residential community is proposed. After the introduction of the background problem, this proposal will present the literature survey results on youth generation in China, urban residential outdoor environment, and improved community engagement. This study contributes to the development of an offline community engagement model for youths in residential communities. The proposed model is expected to alleviate the current social isolation situation for the youth generation. Future studies are recommended to include the identification of key characteristics of the youth generation and the lifestyles they prefer, applications of the new co-design mode in the design phase, and application of new visual technology in landscape design practice.

Over the last decade excellent progress has been made globally in HIV management thanks to antiretroviral therapy (ART) rollout and international guidelines now recommending immediate initiation of ART in all HIV-positive people. Despite this, advanced HIV disease (CD4 less than 200 cells/mL) and opportunistic infections remain a persistent challenge and contribute significantly to HIV-associated mortality, which equates to 23,000 deaths in Uganda in 2018 alone. Our Meningitis Research Team based in Uganda is committed to conducting clinical trials to answer important questions regarding diagnostics and management of HIV-associated opportunistic infections, including tuberculosis and cryptococcal meningitis. However, clinical research is impossible without research participants and results are meaningless unless they are translated into benefits for those affected by the disease. Therefore, we held a series of community engagement events with the aims of giving clinical research participants a voice in sharing their experiences of clinical research and messages of hope around advanced HIV disease with the community, dispelling myths and stigma around HIV, raising awareness about the complications of advanced HIV disease and local ongoing clinical research and recent scientific advances. The purpose of this Open Letter is to describe our community engagement experience in Uganda, which we hope will lay the foundation for further clinical research public engagement activities, giving research participants a greater voice to share their experiences.

Engaging communities in tuberculosis research

Significant efforts have been undertaken to address the challenges in Mindanao. Given the complexity of issues in the region, a top-down approach must be complemented by grassroots-level initiatives. In this context, micro-empowerment is key to fostering positive community transformation. This article explores the motivations and work of twelve (12) women leaders in Mindanao who have advanced community empowerment through education, micro- entrepreneurship, and peace-building initiatives. These efforts have amplified marginalized voices and enhanced the visibility of women’s participation in addressing issues of peace and social justice, contributing to the broader cause of women’s empowerment in Mindanao. Moreover, their community engagement has fostered personal growth, offering a nuanced understanding of empowerment. Using narrative analysis, the study evaluates the motivations and fundamental practices behind these leaders’ grassroots efforts. Findings reveal that the women’s activism arises from intersecting factors such as contextual influences, ingrained social activities, and experiences of marginalization, which shape their unique perspectives on community concerns. Their activism is not coincidental, but a reflexive response to their lived experiences, inspiring them to drive change. By integrating the concepts of situated knowledges and intersectionality, the study highlights how these women’s consciousness and worldviews have informed their community engagement, transforming personal narratives into political action. By amplifying women’s narratives, the study underscores the importance of inclusive narratives in addressing gender inequalities, aligning with the United Nations Sustainable Goals focused on gender equality and women’s empowerment.

Community Radio (CR) stations are short range radio stations that serve the local media needs of their surrounding communities. Community participation by way of helping set the station agenda, airing of people's voices, and providing them with a local communication medium, is the defining feature of CR. But this philosophy has been hard to execute in practice because of logistical difficulties, with station staff not being able to reach out to a listenership-base spread across several hundreds of square kilometers. In today's context though, the high penetration of mobile phones has made it easier for listeners to participate in the running of radio stations, but the potential of telephony and radio integration has been exploited only minimally. In this paper, we explore the use of PhonePeti, an automated answering machine system in a community radio station based in Gurgaon, India. Answering machines are one of several ways to bring together the radio and telephony mediums. We show that this alone has the potential to considerably improve community engagement, but it also opens up many interesting issues on usability. Through quantitative and content analysis of 758 calls from 411 callers over two iterations of PhonePeti, combined with telephonic interviews of several callers, we show that significant challenges arise in being able to explain the concept of an answering machine to people who have not been exposed to a similar system in the past. We then show, through call statistics, that PhonePeti has increased community engagement by enabling more listeners to reach the station. Finally, we show that an answering machine system can be used to collect useful information from the callers.

Efforts to contain the spread of Ebola in the eastern Democratic Republic of the Congo (DRC) during the 2018-2020 epidemic faced challenges in gaining community trust and participation. This affected implementation of community alerts, early isolation, contact tracing, vaccination, and safe and dignified burials. To quickly understand community perspectives and improve community engagement, collaborators from the DRC Red Cross, the International Federation of the Red Cross, and the U.S. Centers for Disease Control and Prevention explored a new method of collecting, coding, and quickly analyzing community feedback. Over 800 DRC Red Cross local volunteers recorded unstructured, free-text questions and comments from community members during community Ebola awareness activities. Comments were coded and analyzed using a text-coding system developed by the collaborators. Coded comments were then aggregated and qualitatively grouped into major themes, and time trends were examined. Communities reported a lack of information about the outbreak and the response, as well as concerns about the Ebola vaccination program and health care quality. Some doubted that Ebola was real. The response used the feedback to revise some community engagement approaches. For example, 2 procedural changes that were followed by drops in negative community responses were: using transparent body bags, which allayed fears that bodies or organs were being stolen, and widening the eligibility criteria for Ebola vaccination, which addressed concerns that selectively vaccinating individuals within Ebola-affected communities was unfair. This system is unique in that unstructured feedback collected by local volunteers in the course of their work was rapidly coded, analyzed, and given to health authorities for use in making course corrections throughout the response. It provides a platform for local voices to be heard throughout an emergency response and provides a mechanism for assessing the effects of program adjustments on community sentiments.

BackgroundCommunity engagement in maternal and perinatal death surveillance and response (MPDSR) could support health systems in providing people-centred care and ensure accountability for the prevention of maternal and perinatal deaths. Although community engagement activities in MPDSR have been described, the literature does not adequately explain which community engagement in MPDSR strategies succeed, the contexts in which they work, the outcomes they produce, and for whom.MethodsWe conducted a realist review, which involved the identification and refinement of programme theories. An initial literature search identified four initial programme theories (IPTs) that explain how community engagement works in the different parts of the MPDSR cycle.Six databases (Medline, Embase, Scopus, Global Health, CINAHL Plus and Web of Science) and Google were searched for papers and grey literature published between 2004 and August 2022. We used retroductive analysis on included articles to support the identification of generative causation using the heuristic of ‘context-mechanism-outcome configuration’ (CMOCs), which explained what mechanisms were triggered in different contexts and the outcomes that were produced. The findings were then used to refine the IPTs and produce final programme theories.ResultsForty-five articles from 40 studies reported some form of community engagement in MPDSR. We identified 20 CMO configurations that were synthesised into five programme theories:Fear of blame demotivates community members and health professionals from engaging in MPDSR.Dialogue between health professionals and community members improves collaboration and empowers community members to propose innovative solutions.Trusted social connections between bereaved families and community volunteers enables them to identify and report deaths.Financial and non-financial incentives motivate community members and health professionals to engage in MPDSR.Community engagement is more sustainable when it is routinised and integrated into the health system.ConclusionImplementing community engagement in MPDSR requires a systems approach that addresses the five Programme Theories collectively, rather than implementing community engagement in specific parts of the MPDSR cycle as our initial programme theories had suggested. Establishing conducive participatory spaces that promote dialogue, trust and minimise blame culture is critical for the success of community engagement in MPDSR programmes. Community members can be engaged in MPDSR processes in health facilities and community settings and high- and low-income countries.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12884-025-08183-x.

High tuberculosis (TB) prevalence in Papua New Guinea (PNG) is a serious public health concern. The epidemic in this region is exacerbated by the presence of drug-resistant TB strains as well as HIV infection. This presents a public health threat not only locally but also to Australia due to the high potential for cross-border transmission between PNG’s Western Province and the Australian Torres Strait Islands. We present two mathematical models of TB in the Western Province: a simple model of the underlying TB dynamics, and a detailed model which accounts for the additional effects of HIV and drug resistance. The detailed model is used to make quantitative predictions about the impact of expanding the TB case detection rate under the Directly Observed Treatment, Short-course treatment regimen. This paper provides a framework for future investigation into the economic costs and public health benefits of potential TB interventions in this region, with the eventual aim of providing recommendations to guide policy makers in both PNG and Australia. doi:10.1017/S1446181111000587