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Community-based participatory research has a long-term commitment to principles of equity and justice with decades of research showcasing the added value of power-sharing and participatory involvement of community members for achieving health, community capacity, policy, and social justice outcomes. Missing, however, has been a clear articulation of how power operates within partnership practices and the impact of these practices on outcomes. The National Institutes of Health–funded Research for Improved Health study (2009-2013), having surveyed 200 partnerships, then conducted seven in-depth case studies to better understand which partnership practices can best build from community histories of organizing to address inequities. The diverse case studies represented multiple ethnic–racial and other marginalized populations, health issues, and urban and rural areas and regions. Cross-cutting analyses of the qualitative results focus on how oppressive and emancipatory forms of power operate within partnerships in response to oppressive conditions or emancipatory histories of advocacy within communities. The analysis of power was conducted within each of the four domains of the community-based participatory research conceptual model, starting from how contexts shape partnering processes to impact short-term intervention and research outputs, and contribute to outcomes. Similarities and differences in how partnerships leveraged and addressed their unique contexts and histories are presented, with both structural and relational practices that intentionally addressed power relations. These results demonstrate how community members draw from their resilience and strengths to combat histories of injustice and oppression, using partnership principles and practices toward multilevel outcomes that honor community knowledge and leadership, and seek shared power, policy, and community transformation changes, thereby advancing health equity.

Empower yourself in today's highly connected, socially conscious world as you learn how to wield your passions, digital tools, and the principles of social entrepreneurship to affect real change in your schools, communities, and beyond. Contains profiles of successful projects, step-by-step guides to applied changemaking, and a variety of resources.

A long-standing challenge in community-based participatory research (CBPR) has been to anchor practice and evaluation in a relevant and comprehensive theoretical framework of community change. This study describes the development of a multidimensional conceptual framework that builds on social movement theories to identify key components of CBPR processes. Framework synthesis was used as a general literature search and analysis strategy. An initial conceptual framework was developed from the theoretical literature on social movement. A literature search performed to identify illustrative CBPR projects yielded 635 potentially relevant documents, from which eight projects (corresponding to 58 publications) were retained after record and full-text screening. Framework synthesis was used to code and organize data from these projects, ultimately providing a refined framework. The final conceptual framework maps key concepts of CBPR mobilization processes, such as the pivotal role of the partnership; resources and opportunities as necessary components feeding the partnership's development; the importance of framing processes; and a tight alignment between the cause (partnership' s goal), the collective action strategy, and the system changes targeted. The revised framework provides a context-specific model to generate a new, innovative understanding of CBPR mobilization processes, drawing on existing theoretical foundations.

The legacy of Community Action for Health (CAH) in India traces back to the global momentum for primary health care galvanized by the Alma Ata Declaration and post–World War II social movements. In 2024, the World Health Assembly endorsed a resolution on institutionalising CAH and other forms of social participation as a core pillar of health reform. The Indian experience of institutionalising CAH under its erstwhile National Rural Health Mission offers an example of sustained national-scale implementations of CAH globally, yet its lessons—both successes and blind spots—remain under-analysed. This paper aims to fill that gap by critically examining the trajectory of CAH since 2005 and exploring its implications for the operationalization of the SPH Resolution. In 2021, two virtual Witness Seminars and four in-depth interviews were conducted with leaders of Civil Society Organizations (CSOs), program implementers, and policy decision-makers involved in the institutionalization of Community Action for Health (CAH) under the National Rural Health Mission (NRHM). Participants included. Seminars and interviews explored key events, actors, processes, and contextual factors that shaped the evolution of CAH. All sessions were fully transcribed and analysed using ATLAS.ti (version 22). Our analysis of the evolution of CAH in India suggests four phases – leading to and flowing away from governmentality. While initially communitization involved collaborative dialogue, debate and system redesign, pilots of CAH rolled out across Indian states with varying strategies, ownership, and stakeholdership. Roles of community began to shift into that of agents and providers as part of “sarkarikaran” or governmentalization of community processes. A final phase suggests that like flowing water, CAH may continue to reconfigure state-society relations in the wake of emerging challenges, less formalised, more embedded interactions. This suggests that institutionalising, standardizing and centralising CAH is neither lasting, nor desirable. Highlights Community action for health has a vaunted legacy and remains highly relevant across contexts today. Witness seminar methodology can help understand how community action for health models have evolved in a decentralized social democratic context like India’s. Analysis reveals four (nautical) phases in the evolution of community action for health in India: building the ship, setting sail, floundering waters, and flowing where there’s space (or even when there’s not). In the current context, where institutionalization of social participation for health is being called for, understanding these histories and trajectories offers many insights.

Background The People’s Planning Campaign (PPC) in the southern Indian state of Kerala started in 1996, following which the state devolved functions, finances, and functionaries to Local Self-Governments (LSGs). The erstwhile National Rural Health Mission (NRHM), subsequently renamed the National Health Mission (NHM) was a large-scale, national architectural health reform launched in 2005. How decentralisation and NRHM interacted and played out at the ground level is understudied. Our study aimed to fill this gap, privileging the voices and perspectives of those directly involved with this history. Methods We employed the Witness Seminar (WS), an oral history technique where witnesses to history together reminisce about historical events and their significance as a matter of public record. Three virtual WS comprised of 23 participants (involved with the PPC, N(R)HM, civil society, and the health department) were held from June to Sept 2021. Inductive thematic analysis of transcripts was carried out by four researchers using ATLAS. ti 9. WS transcripts were analyzed using a realist approach, meaning we identified Contexts, Mechanisms, and Outcomes (CMO) characterising NRHM health reform in the state as they related to decentralised planning. Results Two CMO configurations were identified, In the first one, witnesses reflected that decentralisation reforms empowered LSGs, democratised health planning, brought values alignment among health system actors, and equipped communities with the tools to identify local problems and solutions. Innovation in the health sector by LSGs was nurtured and incentivised with selected programs being scaled up through N(R)HM. The synergy of the decentralised planning process and N(R)HM improved health infrastructure, human resources and quality of care delivered by the state health system. The second configuration suggested that community action for health was reanimated in the context of the emergence of climate change-induced disasters and communicable diseases. In the long run, N(R)HM’s frontline health workers, ASHAs, emerged as leaders in LSGs. Conclusion The synergy between decentralised health planning and N(R)HM has significantly shaped and impacted the health sector, leading to innovative and inclusive programs that respond to local health needs and improved health system infrastructure. However, centralised health planning still belies the ethos and imperative of decentralisation – these contradictions may vex progress going forward and warrant further study.

Federal and state health data sets often lack the granularity needed for medically underserved small towns. To address this, we conducted two community health assessment surveys in Knights Landing (KL), a rural agricultural town in California, to identify local healthcare strengths, barriers, and needs. Utilizing a Community‐Based Participatory Action Research (CBPAR) framework, our project centered on a collaboration between academic‐researchers and promotora‐researchers: community leaders who evolved from activists to empowered research partners over a decade. Data from an initial randomized survey in 2013 (N = 88) informed the design of a follow‐up survey in 2018 (N = 100). For the 2018 survey, promotora‐researchers made the executive decision to shift to snowball sampling, which provided a deeper understanding of the health experiences of the clinic's most vulnerable and historically underrepresented populations. Both surveys produced actionable community‐owned data that stimulated significant community organizing, led to expanded services at the student‐led clinic (KLOHC), and cultivated public health investments for Knights Landing. This study demonstrates how a decade‐long partnership, grounded in shared power and evolving into a Community‐Owned and ‐Managed Research (COMR) model, can generate a robust and adaptive health assessment tool. Ultimately, this work highlights the transformative power of community involvement in health research for creating impactful and enduring change. Plain Language Summary Federal and state government agencies manage health data to understand regional health needs, but this information is less helpful to understand needs at a small‐town scale. In Knights Landing, CA, residents decided to identify local health needs and barriers to accessing and affording medical care by administering surveys in their agricultural rural town. Healthcare promoters and local leaders worked alongside academic scholar‐activists and nonprofits to design the surveys, recruit participants, conduct surveys, and interpret survey findings. Local leadership began owning and managing the research project in the 2018 survey after the academic‐led 2013 survey. The survey results led to real changes in Knights Landing like community organizing and new investments. These surveys also helped the local student‐run health clinic offer more services and respond to the needs of residents. This manuscript documents over a decade of teamwork between local resident leaders and academic scholar‐activists based on sharing trust and sharing power while creating a survey that can be customized and serve local priorities. Key Points Community health surveys informed community organizing and the actions of a student‐led nonprofit clinic in Knights Landing, California Promotora‐researchers partnered with academic researchers and nonprofits to conduct this Community‐Based Participatory Action Research Over a decade of collaborative research produced a survey tool that gave rise to localized data based on community‐identified health need