Benefits arising from lay involvement in community-based public health initiatives: The experience from community nutrition

Kennedy, Leonard A.

doi:10.1177/1757913910369090

Cited by 8 publications

(20 citation statements)

References 20 publications

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“…Boundary spanning to improve performance and uptake of health services was used to increase participation rates in clinical services [ 39 – 42 , 45 , 48 , 49 , 52 , 63 ] or to achieve a change in health behaviours and outcomes [ 27 , 44 , 47 , 51 , 53 , 55 , 58 – 61 ]. In the former, boundary spanners have a stronger organisational orientation, and in the latter, health services use boundary spanners because of their community orientation.…”

Section: Resultsmentioning

confidence: 99%

Community boundary spanners as an addition to the health workforce to reach marginalised people: a scoping review of the literature

2018

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BackgroundHealth services in high-income countries increasingly recognise the challenge of effectively serving and engaging with marginalised people. Effective engagement with marginalised people is essential to reduce health disparities these populations face. One solution is by tapping into the phenomenon of boundary-spanning people in the community—those who facilitate the flow of ideas, information, activities and relationships across organisation and socio-cultural boundaries.MethodsA scoping review methodology was applied to peer-reviewed articles to answer the question: “How do health services identify, recruit and use boundary spanners and what are the outcomes?” The review was conducted in seven databases with search terms based on community-based boundary spanning, marginalised people and health services.FindingsWe identified 422 articles with the screening process resulting in a final set of 30 articles. We identified five types of community-based boundary spanning: navigators, community health workers, lay workers, peer supporters and community entities. These range from strong alignment to the organisation through to those embedded in the community. We found success in four domains for the organisation, the boundary spanner, the marginalised individuals and the broader community. Quantifiable outcomes related to cost-savings, improved disease management and high levels of clinical care. Outcomes for marginalised individuals related to improved health knowledge and behaviours, improved health, social benefits, reduced barriers to accessing services and increased participation in services. We identified potential organisational barriers to using boundary spanners based on organisational culture and staff beliefs.ConclusionsCommunity boundary spanners are a valuable adjunct to the health workforce. They enable access to hard to reach populations with beneficial health outcomes.Maintaining the balance of organisational and community alignment is key to ongoing success and diffusion of this approach.

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Section: Resultsmentioning

confidence: 99%

Community boundary spanners as an addition to the health workforce to reach marginalised people: a scoping review of the literature

2018

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“…They constitute an untapped resource whose potential has been evidenced in the USA. Kennedy and colleagues 314,315 have explored the benefits arising from lay involvement in community-based nutrition programmes in poor neighbourhoods. These include increased service coverage and the ability to reach populations, personal development and enhanced social support.…”

Section: Community Participationmentioning

confidence: 99%

“…[310][311][312][313][314][315] For example, Daykin and Naidoo 310 explored the views of health professionals on promoting health in areas of poverty with low-income clients. They questioned the assumption that primary health care is the best setting for health promotion; several constraints are identified as limiting its effectiveness.…”

Section: Community Participationmentioning

confidence: 99%

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Peckham

Falconer

Gillam

et al. 2015

Health Serv Deliv Res

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BackgroundThis project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities.AimsThe aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice.MethodsWe undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff.FindingsMany of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely.Future ResearchFuture research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…Prior work has shown that TB health education can be effective if health promotion practitioners create a supportive environment and understand the cultural barriers [8]. The use of community lay workers is vital at increasing screening coverage and reaching the hard to reach black communities [27]. Community-based programs help people become active participants in improving their health and wellbeing, rather than acting as passive recipients of professional efforts [28].…”

Section: Discussionmentioning

confidence: 99%

Lay Perceptions about Tuberculosis among Non-UK-Born Black Africans in the United Kingdom

Asiimwe¹,

Cross²,

Haberer³

2015

JTR

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Background: Tuberculosis among non-UK-born Black Africans has been gradually recognized as a public health problem in the UK despite the various interventions implemented. Objectives: To explore the perceptions of non-UK-born Black Africans about TB health risk; to explore the health seeking behavior of the non-UK-born Black Africans in relation to TB and to explore lay views on TB health education and screening as opportunities for health promotion. Methodology and Study Design: A qualitative methodology was used on a purposively selected sample of 12 non-UK-born Black Africans living in Leeds. Face-to-face interviews were conducted to explore the lay perceptions about TB. Thematic analysis was used to derive important themes in accordance to the study objectives. Ethical approval was provided by Leeds Metropolitan University. Setting: Community setting of non-UK-born Black Africans in Leeds, UK. Results: This population holds mixed views and perceptions about tuberculosis, few facilitators and many barriers existed to current TB prevention efforts. The barriers included: language barriers, barriers related to services and systems, immigration status and stigma despite the benefits involved. The potential for black African communities to readily increase the likelihood of behavior change was found as an important finding for this study. Conclusions: Tuberculosis is a preventable public health problem. Involvement of the non-UK-born black Africans communities in the TB prevention may be beneficial for reducing and tackling TB rates in this population. Such an approach is potentially inexpensive and more readily implementable than other suggested strategies such as changes to immigration policies.

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Benefits arising from lay involvement in community-based public health initiatives: The experience from community nutrition

Cited by 8 publications

References 20 publications

Community boundary spanners as an addition to the health workforce to reach marginalised people: a scoping review of the literature

Community boundary spanners as an addition to the health workforce to reach marginalised people: a scoping review of the literature

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Lay Perceptions about Tuberculosis among Non-UK-Born Black Africans in the United Kingdom

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