JULIE TROCCHIO, BSN, MS
"Knowing is not enough; we must apply. Willing is not enough; we must do."
— Johann Wolfgang von Goethe
Engaging community members who need and use community benefit services can improve how we assess needs, plan to meet community needs and implement pro-grams. Health care organizations may think they are connecting with their community, but do community members think they are engaged? This topic was explored by a National Academy of Medicine (NAM) initiative to assess the extent and impact of community engagement.1
NAM developed a new model for assessing community engagement after analyzing public health and other literature and consulting experts. The model, "Achieving Health Equity and Systems Transformation Through Meaningful Community Engagement," is also known as "Assessing Community Engagement."
The model is built on the core principles that community engagement must be:
- Grounded in trust.
- Designed for information to flow to and from the community and its partners.
- Culturally centered.
The model also says that participants should be equal and that relationships should be ongoing, continuing beyond specific projects.
The Assessing Community Engagement model will help assess the goals of community engagement, which are: strengthened partnerships and alliances, expanded knowledge, improved health and health care programs and policies, and thriving communities.
Strengthened Partnerships and Alliances
To examine whether community engagement is strengthening partnerships, the NAM model suggests looking at these indicators:
- Diversity and inclusivity: Partnerships should be intentionally diverse, including persons and groups not traditionally invited or involved in improving community health.
- Partnerships and opportunities: All engaged in partnerships and alliances should fully benefit from their participation. This could include gaining new information or skills, or financial opportunities.
- Acknowledgment, visibility and recognition: Community partners should be recognized as contributors, experts and leaders. This would include public acknowledgement of participants' contributions.
- Mutual value: The community should benefit from the partnership, not just contribute to the effort. The value gained could be financial or nonfinancial.
- Trust: Trust is a core component of community engagement. It requires showing up authentically and following through with commitments.
- Shared power: Partnerships should demonstrate that community participants are involved in leadership activities and decision-making.
- Structural supports for community engagement: Partnerships need an infrastructure that includes adequate financing and policies on board composition, management and decision-making.
Another area to examine when assessing community engagement is expanded knowledge. Partnership should create new insights and resources for participants. They can create new thinking and cover new ground, revealing information not recognized outside of the community.
The model identifies three indicators of expanded knowledge:
- New curricula, strategies and tools that can be disseminated, accessed, replicated and scaled.
- Bidirectional learning, when participants gain knowledge about the culture and practices in the community, including stories and information about the lived experience.
- Community-ready information and recommendations that the community can understand and use.
Improved Health and Health Care Programs and Policies
The goal of community benefit partnerships is to create programs that the community can use to improve health. An indicator of success in this area is that the solutions align with the community priorities. This happens when partnerships work on community-identified programs, using shared decision-making and agreement on metrics of success.
Partnerships aimed at improving health should come up with solutions that are implemented with and endorsed by community members. They should build on community assets and show measurable growth.
Another assessment factor is sustained relationships. Partnerships should extend beyond initial support by having an infrastructure and resources that can sustain programs and permit adjustment or refinement over time.
While there may be various definitions of thriving communities, the NAM model identifies these five indicators to evaluate the success of partnerships and alliances.
- Physical and mental health, including awareness of health and health-related activities and self-efficacy in managing well-being and chronic conditions.
- Community capacity and connectivity, including how engaged community members are and development of new community leaders.
- Community power, meaning that health improvement programs are favored, initiated and guided by the community. This might also include greater expectations that the community will be involved in all aspects of the partnership's programs.
- Community resiliency, which involves assessing the overall strength of the community and its capacity to self-manage.
- Life quality and well-being, including improvements in the following drivers of health: education, racial justice, economics and housing.
CONCLUSION AND NEXT STEPS
The NAM community engagement model is based on the premise that community engagement does not supplement community health improvement activities, but rather, is foundational. It posits that the processes needed to engage communities are essential to achieving equity and that only by assessing and evaluating engagement will we be able to understand program impact and know where to focus efforts. "Health and health care stakeholders," it says, "must measure what matters — community engagement — and ensure that it is meaningful."2
As next steps, the committee that developed the model will be publishing stories and assessment instruments for users who want to measure community engagement. CHA's community benefit staff will watch for these next steps and share resources as they are available so CHA members can consider ways to build more purposeful community engagement.
JULIE TROCCHIO, BSN, MS, is senior director of community benefit and continuing care for the Catholic Health Association, Washington, D.C.
- Sergio Aguilar-Gaxiola et al., "Assessing Meaningful Community Engagement: A Conceptual Model to Advance Health Equity through Transformed Systems for Health," NAM Perspectives, February 14, 2022, https://doi.org/10.31478/202202c.
- Aguilar-Gaxiola et al., "Assessing Meaningful Community Engagement."
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