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Abstract Community participation is a central concept for health promotion, covering a breadth of approaches, purposes and activities. This paper reports on a national knowledge translation project in England, UK, which resulted in a conceptual framework and typology of community-based approaches, published as national guidance. A key objective was to develop a conceptual framework linked to sources of evidence that could be used to support increased uptake of participatory methods across the health system. It was recognized that legitimacy of community participation was being undermined by a scattered evidence base, absence of a common terminology and low visibility of community practice. A scoping review, combined with stakeholder consultation, was undertaken and 168 review and conceptual publications were identified and a map produced. A ‘family of community-centred approaches for health and wellbeing’ was then produced as way of organizing the evidence and visually representing the range of intervention types. There are four main groups, with sub-categories: (i) strengthening communities, (ii) volunteer and peer roles, (iii) collaborations and partnerships and (iv) access to community resources. Each group is differentiated using key concepts and theoretical justifications around increasing equity, control and social connectedness. An open access bibliography is available to accompany the framework. The paper discusses the application of the family of community-centred approaches as a flexible planning tool for health promotion practice and its potential to be used as a framework for organizing and synthesizing evidence from a range of participatory methods.

Practice-based case studies that describe learning from implementation are a useful source of evidence for policy makers, practitioners and researchers. Despite the value of narratives developed in context as a form of experiential or applied evidence, little is known about appropriate qualitative review and synthesis methods to deal with multiple practice-based case studies. This paper reports on a methodological study to develop and pilot a synthesis method using a sample of community wellbeing case studies focused on interventions to improve community infrastructure. The study was conducted in four interlinked phases: (i) literature review to scope synthesis methods (ii) piloting search and selection methods to identify a sample of relevant practice-based case studies that reported experiential learning (iii) undertaking cross case analysis and qualitative synthesis based on framework analysis methods (iv) review and reflection to produce a summative account of the method and agreed definition. The main output from the study was a staged approach to qualitative synthesis of practice-based case studies based on seven steps, which move from identification of a conceptual framework through to producing a narrative report. The potential transferability of this approach and its application in research and policy are critically discussed. Synthesis of case studies derived from community-based interventions could address knowledge gaps in the formal evidence base. While further methodological development is warranted, it is argued that study results form a credible qualitative framework for synthesising practice-based evidence.

Background Peer-research is steered and conducted by people with lived experience of the issues being researched. This paper explores the value of peer-research in two complex public health intervention evaluations in the UK. Methods Reports from 18 peer research projects, completed by residents from 12 communities in the UK taking part in two community empowerment interventions, were analysed using cross-case analysis. Results Undertaking peer research helped to build the evaluation and research skills within individual projects as well as providing data on other outcomes related to the programmes Theory of Change. Some peer researchers, however, felt unprepared for the activity despite support from the academic team and were unsatisfied with project outcomes. While peer research projects provided more opportunities for local residents to engage with the overall evaluations, there was an overreliance on people closely connected to the programmes to be peer researchers. The peer research projects explored topics that were broader than the aims and objectives of the overall programme evaluations. All provided insight into the context in which projects occurred, while some also informed understanding of programme change mechanisms. Conclusions Including peer research as part of complex public health intervention evaluations can help uncover important contextual and ecological details beyond the reach of more traditional evaluation data collection. Peer research can also empower and build research/evaluation capacity within communities, which is particularly pertinent for community empowerment interventions.

Background Delivery of health and care services using a combination of remote and/or in-person channels and digital and/or traditional tools (Hybrid Service Delivery, HSD) is increasingly seen as a way of improving quality and affordability, improving access, personalisation and sustainability, and reducing inequalities. Across the voluntary, community and social enterprise sector (VCSE), using a combination of remote and/or in-person channels and digital and/or traditional tools (HSD) has enabled the essential provision of services for people who have learning disabilities and/or autistic (LDA). However, it is unclear how different tools and channels have been used, what worked well or not well, for whom, and in what circumstances. The aim of this realist review is to explore how VCSE organisations can effectively use digital technologies alongside or instead of in-person activity to provide social care services to adults with learning disabilities and/or autism. This review protocol is presented in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P). Methods We will conduct a participatory realist review. Following realist review methodology, and involving people with LDA and organisations who deliver services to them, we will define the scope of the review/theory development, search for and appraise evidence, extract and synthesise findings, and develop the narrative. Using a developed strategy, electronic databases (Academic Search Complete, CINAHL, MEDLINE, PsycInfo, SCOPUS, Social Science Citation Index and Social Policy and Practice) will be searched. A data extraction table will be used to assist in sifting, sorting and organising relevant information from identified studies. For each proposition statement, relevant data from the identified literature will be synthesised and compared with the proposed theory to develop an understanding of how, why and when hybrid delivery works in different settings with different populations. Discussion This review aims to collate and synthesise evidence relating to hybrid service delivery in VCSE organisations to provide social care services to LDA adults. By conducting a participatory realist review, we anticipate that the findings will lead to a greater understanding of contextual factors and therefore more relevant recommendations. Systematic review registration PROSPERO CRD42024457161.

‘Low-level’ support is championed to support adults with high functioning autism spectrum disorder (HFASD) to achieve good quality health and social care, yet research in the area is sparse. Drawing on semi-structured interview data, this paper considers the efficacy of an intervention to provide low-level support to adults with HFASD with little or no funded support. The intervention led to a number of perceived positive outcomes for adults with HFASD, their families, and service providers in the city, including increased access to education, volunteering, support and information, socialising, improved health and wellbeing, and managing day-to-day. Although many of life’s difficulties still persisted, the intervention helped service users overcome barriers to availing further support, possibly leading to beneficial outcomes down the line.

Despite volunteering being a feature of community life in the UK, differences as to who volunteers are evident. Reporting on a rapid review of the evidence on volunteering and inequalities, the aim of this paper is to provide an overview of the breadth and interconnectedness of barriers to volunteering for potentially disadvantaged groups. Sixty-seven articles were identified, to produce a map of factors affecting volunteer participation. Findings suggest that whilst different demographic groups experience specific barriers to volunteering, there are areas of commonality. Analysis shifts the onus of volunteering away from the level of individual choice (a dominant emphasis in policy and practical discussions around promoting volunteering) and towards the influence of structural factors related to broader exclusionary processes. Those who potentially have the most to gain from volunteering are the least likely to participate. Whilst the benefits of volunteering are increasingly documented by research and championed by policy, there are questions about the success of this approach given that the underlying social inequalities present substantive barriers to volunteering and must be addressed to promote greater access.

Participatory research appeals to notions of community empowerment and of generating more valid data grounded in the lived experiences of communities. For research-degree students, however, implementing such an approach can complicate an already challenging endeavour. Participatory research may juxtapose the institutional mechanisms surrounding a research degree and provide practical barriers to research-degree students. Reflecting on my own experience attempting to conduct a piece of participatory research for my doctoral research, this article concludes that participation should be viewed as an expansive concept and that any meaningful attempt to progress along a continuum of participation should be recognized and encouraged.

BackgroundLiving in an area experiencing economic and social deprivation is a known risk factor to poor mental health and wellbeing. There is considerable need to prevent poor mental health outcomes through action on the social determinants of health. This paper is concerned with how some communities experiencing disadvantage appear to be more resilient to poor mental health and wellbeing (community resilience).MethodsA qualitative case study approach was used to carry out an in-depth exploration of what factors support community resilience in four communities experiencing disadvantage in the United Kingdom.74 semi-structured interviews were undertaken remotely with 39 residents and 35 VCSE groups, community leaders and other local stakeholders. Interviews explored resilience narratives, assets and protective factors, and local challenges. Community analysis workshops and resilience mapping workshops in each site further explored insights from interviews. Data analysis was undertaken using cross-case, thematic analysis.ResultsCommunities experiencing disadvantage encounter a range of daily and enduring challenges to good mental health and wellbeing. Four overlapping and interacting themes support community resilience: (i) Community hubs and local VCSE networks enable a community to support one another and respond effectively to challenges; (ii) Opportunities to participate and make connections within communities strengthens social connections, builds local capacity and empowers people; (iii) Open and supportive environments to talk about mental health and wellbeing help reduce stigma and gives people the tools to help one another; and (iv) Community identities and collective narratives that establish a shared sense of belonging help people to feel secure and connected.ConclusionCommunity resilience can be understood in terms of the amount of resources – articulated in terms of capital (e.g. financial, social, cultural, human, natural, physical/built) – that communities can draw on in response to challenges and how well they are mobilised. VCSE organisations and networks play a significant role both building and mobilising different capitals in communities experiencing disadvantage. However, communities experiencing disadvantage face enduring challenges (e.g. poor housing, insecure employment, Covid-19). While VCSE organisations can directly support communities at a local level, their ability to affect structural change is limited to campaigning and advocacy. Responsibility for addressing these issues lie with local and national government. A thriving VCSE sector is important for community resilience in communities experiencing disadvantage as a mechanism for both sustainably building and mobilising community resources in the face of daily and enduring challenges.

BackgroundThis paper reflects on different stakeholders’ perspectives on how voluntary, community and social enterprise (VCSE) organisations in the UK, particularly those embedded in communities (‘community anchors’) supported responses to the Covid-19 pandemic and the potential implications for how these organisations are valued and supported for their contribution to local health and care systems in the UKMethodsA review of ‘grey’ literature using a rapid review methodology was completed. Websites of 30 organisations known to be active in producing documents and reports concerning the role of the VCSE in health and care systems were searched. Data were extracted by one reviewer into an Excel spreadsheet under the headings: title, author, type of evidence, population, actions, impacts, enablers/challenges, and other. Results were combined into a narrative synthesis.ResultsThirty-four reports were included. Unsurprisingly, the VCSE sector itself has the keenest insight and understanding of what they have been doing during the pandemic, of the complexities of the sector, and what their role could be in the recovery. In contrast, government perspectives, particularly at a national level, are fewer and more distant. They demonstrate a less detailed understanding of the complexity of the response and the importance of the long-term relationships between VCSE organisations and communities. Actions tend to focus on narrow areas of policy (e.g. volunteer passports), which can feel like rather simplistic responses to the complex relationships and challenges at a local level.ConclusionThe most comprehensive description and analysis of the contribution that VCSE organisations made to the pandemic response in the UK comes from the VCSE itself. However, it is important that a deeper understanding of what happened at a local level is carried forward into local and national governmental policy.

Community empowerment interventions, which aim to build greater individual and community control over health, are shaped by the community systems in which they are implemented. Drawing on complex systems thinking in public health research, this paper discusses the evaluation approach used for a UK community empowerment programme focused on disadvantaged neighbourhoods. It explores design choices and the tension between the overall enquiry questions, which were based on a programme theory of change, and the varied dynamic socio-cultural contexts in intervention communities. The paper concludes that the complexity of community systems needs to be accounted for through in-depth case studies that incorporate community perspectives.