A realist review of community engagement with health research

Abstract

Introduction: Community engagement is increasingly recognized as a critical aspect of global health. Recent years have seen an expansion of community engagement activities linked to health research, but debates and inconsistencies remain about the aims of different types of engagement, mechanisms underpinning their implementation and impact, and influential contextual factors. Greater commitment to and consistency around community engagement by health research programs, implementers and funders requires a more coherent evidence base. This realist review is designed to improve our understanding of how and why community engagement contributes to intended and unintended outcomes (including research and ethical outcomes) in different contexts. Given the breadth and diversity of the literature on community engagement in health research, the review will initially focus on malaria research in low- and middle-income countries (LMICs) and draw on wider global health literature where needed. Methods and analysis: Community engagement in practice is often a complex set of interventions. We will conduct a realist review – a theory driven approach to evidence synthesis – to provide explanations for how and why community engagement with health research produces the pattern of outcomes observed across different contexts of application. We will consolidate evidence from a range of documents, including qualitative, quantitative and mixed method studies. The review will follow several stages: devising an initial programme theory, searching evidence, selecting appropriate documents, extracting data, synthesizing and refining the programme theory, and reiteration of these steps as needed. Ethics and dissemination: A formal ethics review is not required for this literature review. Findings will be disseminated in a peer reviewed journal, through national and international conferences, and through a set of short briefings tailored for audiences with an interest in community engagement. Outputs and presentations will be informed by and feed into our network of community engagement experts. PROSPERO registration number: CRD42019125687

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“… 15 17 Insights from micro-level and meso-level are important for informing change at the macro-level where policies are formulated and decided 16 ; and for generating community awareness and ownership of solutions for improving healthcare access. 17 …”

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“…Inter-personal trust can be fostered through building relationships between community members and research staff, which are built over time through day-to-day interactions, sharing of food and participating in local events (Adhikari et al, 2018;Adhikari et al, 2019;Geissler et al, 2008;Sahan et al, 2017). In contexts where reciprocity and conformity are social norms, these relationships can inadvertently influence the voluntariness of consent (Adhikari et al, 2018).…”

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“…Without the buy-in of the target population the coverage of mass drug administration can lead to disappointment has been trialled and evaluated. Health education, drama performance, and incentives (for individuals and communities) appear to have been successful, suggesting that the engagement modalities have to be adapted to the requirements of each community [46][47][48][49][50][51][52].…”