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Community health and wellbeingAction research on health inequalities$

Steve Cropper, Alison Porter, and Gareth Williams

Print publication date: 2007

Print ISBN-13: 9781861348180

Published to Policy Press Scholarship Online: March 2012

DOI: 10.1332/policypress/9781861348180.001.0001

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Engaging with communities

Engaging with communities

Chapter:
(p.105) Five Engaging with communities
Source:
Community health and wellbeing
Author(s):

Bronwen Bermingham

Alison Porter

Publisher:
Policy Press
DOI:10.1332/policypress/9781861348180.003.0005

Abstract and Keywords

This chapter discusses the lessons that can be learned from the Sustainable Health Action Research Programme (SHARP) in Wales about the character of communities and strategies for engaging with communities. It considers community engagement as a continuing process, and one in which initial engagement and re-engagement offer particular challenges to both communities and to the SHARP partnerships. The chapter evaluates the extent to which communities engaged with the various SHARP projects and suggests that the experience of all the projects within SHARP is at odds with unitary conceptions of community and community leadership.

Keywords:   SHARP, communities, Wales, community engagement, community leadership

Introduction

This chapter sets out learning from the Sustainable Health Action Research Programme (SHARP) about the character of communities, strategies for the development of relationships with communities, and the difficulties encountered in those relationships. It also considers the outcomes – more and less tangible – that may survive as meaningful resources for continuing community–agency relations. We consider community engagement as a continuing process, and one in which initial engagement and re-engagement offer particular challenges to both communities and to the SHARP partnerships.

Engagement of the SHARP projects with the communities within which they were working has been a fundamental criterion of their success. There are two reasons for this. First, the projects needed to engage with communities in order to give themselves academic credibility: it is no good basing a project on what communities perceive as their own health needs if you cannot demonstrate that community members themselves have defined and articulated those needs. Second, by its very nature, action research is based on engagement and cannot function without it. Engagement with communities is necessary both to identify needs but also to convert understandings of needs into interventions, resources and practices that may bring about change.

The terms ‘engagement’, ‘involvement’ and ‘participation’ are all used to discuss the processes by which organisations and their users, or the broader community, can work together on the planning, design, delivery and monitoring of services. These processes are seen as essential to ensuring that public services are appropriate in nature and delivered in an appropriate way; and community involvement, community strategies and community leadership have become key building blocks of New Labour’s approach to public policy and public service delivery. The Health Development Agency (HDA) has defined the ‘new’ public health agenda as focusing on community-based frameworks to affect the underlying determinants of health inequalities (Rogers and Robinson, (p.106) 2004), while the Department of Health has commissioned the Nuffield Institute for Health to produce a series of guides to community involvement for providers of health and social care in England (Emmel, 2004; Emmel and Conn, 2004). However, as was pointed out in work for the Audit Commission, the concept of community involvement is both slippery and potentially troublemaking:

Community and neighbourhood involvement…remains a vague concept and outcomes are ill-defined. Finding a satisfactory description of what it is and why it is done involves an exploration of all the ways in which communities are involved in public affairs.

(Smyth, 2001, p 1)

While ‘involvement’ is a concept that encompasses these broad themes of power and control, the term ‘engagement’ may be thought of as referring more specifically to the actual process of interaction between a community and, in this case, a SHARP project. It implies reciprocity: the project engages with the community and the community engages with the project, a model that is unfamiliar to traditional social research (see Chapter Seven). It also emphasises the fact that there is a process going on that may change through time, and that requires action, management and maintenance. For this reason, ‘engagement’ has been chosen as the theme of this chapter.

Processes of engagement work in more than one direction, since they are about how groups who may have very different starting points, expectations and agendas meet and interact. This chapter will consider the extent to which communities engaged with the various SHARP projects, and the extent to which this was on the projects’ terms. It will also consider how successful projects were at engaging with communities on communities’ own terms – which may, of course, be many different sets of terms according to the layering and grouping within a community. Within the SHARP programme, there was also a third set of processes in operation – that concerned with smoothing the mutual engagement of communities and service providers. The skill with which SHARP projects oiled the wheels of these sometimes troubled relationships is considered in more detail in Chapter Eight.

The experience of all the projects within SHARP is at odds with unitary conceptions of community, community leadership and voice, and we reflect on how a variety of relationships with communities can be established and maintained. We explore the ways in which communities can be understood as stratified, sometimes deeply, and discuss strategies to enable not only initial contact to take place, but also the deepening of engagement. The roles of community members (p.107) and ‘accepted outsiders’ in promoting engagement are central to the discussion of strategies for engagement. Many of the SHARP communities have been weakly linked to service agencies, have had poor experiences of consultation and few community resources; trust in statutory agencies is commonly low.

The chapter concludes with a discussion of how progress in engagement can be judged, considers ways in which community capacity becomes defined and articulated, and explores the release of power to communities and the management of risk by both communities and agencies in that process. It examines how engagement and the depth of engagement is acknowledged, recorded and experienced; and it considers the extent to which this is an integral part of evaluating the success and impact of a project or programme, and the extent to which it might be considered as a separate process.

The nature of communities

Geographical communities and communities of interest

If the process of engagement takes place between the project and the community, the obvious question is: what is the community? Should it be considered in this context as a place, a set of people with common interest, a mode of activity or as a mechanism for giving collective legitimacy to individual perspectives? At a pragmatic level, should the focus for defining a ‘community’ be a set of shared problems that can provide a focus for shared action? In this case, what are the implications of identifying a community by a sense of shared problems or need?

Among those working in the field of community initiatives for health improvement, there is little agreement about what a community is (Jewkes and Murcott, 1996; Emmel and Conn, 2004; Barnes et al, 2007). Yet definition of the community (or communities) is needed not just for conceptual clarity but also for practical reasons. The SHARP projects have needed to define the communities with which they would be working in order to target their activities, to limit the scale of their work, and to give them some framework against which they can measure what they have achieved. Inevitably, the definitions applied were diverse.

The seven projects can be broadly divided into two types: communities of identity and communities of place (Carlisle et al, 2004). ‘Communities of identity’ are those where members are perceived to have common attributes or characteristics, and may be assumed to have some degree of common outlook or experience. ‘Communities of place’ are identified with a particular neighbourhood or location; (p.108) this sounds straightforward, but in fact raises all sorts of questions about the size of area people identify with, diversity or cohesion within a geographical area, and the role of place itself in promoting or harming health. Table 5.1, taken from the overarching evaluation, shows how the SHARP projects may be clustered both in terms of type of community with which they were working, and in terms of how intensive or extensive were the processes of engagement that took place with those communities.

Table 5.1. SHARP project clusters

Communities of place

Communities of identity

Intensively focused action research

Holway House project

BeWEHL HYPP R2R

Extensively focused action research

Pembrokeshire SHARP Triangle project

‘Barefoot’ Health Workers project

Source: Carlisle et al (2004).

The definitions of ‘community of place’ and ‘community of identity’ are not absolutely mutually exclusive. For example, Barefoot, while working within specific city wards, also stated the precise minority ethnic groups with which it would engage. BeWEHL (Bettws Women’s Education, Health and Lifestyle) defined its community as being women from the Bettws estate in Newport; this was both a community of place and a community of presumed shared interest and outlook. The BeWEHL project reveals another complexity, in that there were two different types or levels of engagement taking place with two differently targeted communities. One level of engagement was with the relatively small group of socially isolated women who took part in adult education courses. These women then acted as the bridge to another level of engagement with the wider community, through research projects into community health needs.

How communities get to be defined

Definitions of community do not just exist; they have to be created by someone and, to an extent, maintained and reinforced in a continuous process. In some cases, the selection of the community of interest was part of the development of a research question. The HYPP (Health of Young People in Powys) project, for example, wanted to investigate (p.109) what difference it makes to work with different types of community within the population of young people in Powys. ‘Community’ was defined by HYPP in a number of different ways: in the OASIS initiative, it was about the school community, while in Llanwrtyd Wells it was a community of young people, and in the New Deal project it was the community of service users.

In some cases, the definition of the targeted community was refined and developed during the course of the project. Right 2 Respect, for example, worked in its first phase with just one group of young women, from one school. The second phase of the project broadened this to six more groups, with a wider age range and from different communities, not just deprived areas. At the same time, as the project progressed, the interests of young men became evident and their specific needs, including, by implication, their need for engagement, were acknowledged by the project.

Definitions of community created and used by community members may be very different from those that originate with outsiders, such as health development workers (Cohen, 1985; Jewkes and Murcott, 1996). The process of definition of communities can lead to tensions when externally defined identities are not readily accepted by community members. Some definitions, such as ‘an area of deprivation’, carry negative connotations that may cause distress or embarrassment, or simply be rejected by those living there (Popay et al, 2003). Awareness of these issues was apparent from many comments made by project workers working closely with the communities. For example, BeWEHL’s workers were reported in the overarching evaluation as being keenly aware that conventional ways of representing and speaking about people living in positions of socioeconomic disadvantage could be inappropriate and unworkable. They viewed the term ‘socially isolated’ as meaningless, and said that community members found the term ‘socially excluded’ offensive (Carlisle et al, 2004).

The rural community of Llanychaer in north Pembrokeshire was part of the SHARP Pembrokeshire project. Here, as in BeWEHL, there was resistance from community members, in this case to being incorporated into what they saw as an ‘experiment’, unsuited to this relatively prosperous location. Confident and articulate members of the Llanychaer local forum, set up as part of the project, were willing and able to question – with some success – the terms of the ‘experiment’ in which they were being asked to participate. The forum also successfully challenged the partnership’s initial ideas of how ‘the community’ should be defined, requiring it to broaden its original research boundaries. This resistance to the process of definition evolved into an active and (p.110) productive role for the forum in refining the plans for the project’s engagement with the wider community (Carlisle et al, 2004).

Layers within communities

Guidance from the UK government about community involvement and engagement is largely based on an implicit assumption that communities have a solidarity that can be expressed as a single voice (ODPM, 2003), with shared ‘views’, ‘wants’ and ‘needs’ (Wilmott and Thomas, 1984). Jewkes and Murcott (1996), in their work on community participation in health promotion, have explored how the metaphor of community as person is used, identifying the community as an entity with the capacity to think and make decisions, and with its own expertise and agenda.

By contrast, the SHARP experience highlighted the layers and multiple networks, and the fractures and feuds within communities. The engagement process in the SHARP programme took place on many different layers, with different players establishing their own particular forms of engagement with different layers or strata within the different targeted communities. Some projects found that their original ambitions of engaging with a whole community were unrealistic, and that more success came when they targeted their attentions on groups within a community. Importantly, these smaller groups were not interpreted as ‘representing’ the community as a whole; instead, the scale of both action and research was adjusted to reflect the engagement.

Within any community, some groups may be more ready to engage than others. The Barefoot project, for example, found that, to a large extent, the route into communities was through the women. They tended to be highly motivated by a desire for advancement and jobs and, indirectly, for a more independent position within their own communities. In addition, the Women in Action swimming project, jointly initiated by Barefoot and Triangle, gave the women an opportunity to socialise and exercise with female members of their families. Meanwhile, the Holway project struggled to engage a small core of hard-to-reach unemployed men. But there was some success – 10 of the men became involved in a summer Youth Challenge, and two of these subsequently went on to education and training.

Some of the SHARP projects reported that they were aware of the ways in which techniques for engagement might produce a natural bias, which will have implications for any information gathered from them. For example, the Triangle project set up a consultation activity that involved handing out free kettles, and found that it brought in a (p.111) disproportionate number of middle-aged and older people, particularly women. The activity was used as a social event within which basic data could be collected about community views, and these indicated considerable anxiety about the behaviour of children and young people that may have been a reflection of inter-generational distance and conflict.

The Holway project involved working in a single, tightly bounded estate, which might be thought to present a straightforward opportunity for engagement with a relatively uniform community. In fact, the project team found that the Holway estate had different ‘zones’, some of which were seen as more problematic than others. In addition, some resentment was expressed by people within the estate who felt that too much was being done by SHARP for ‘less deserving’ people. For example, there were conflicts over the use of the community hall – the bingo club was unwilling to give up bookings to allow use by the summer youth project. Criticism was also levelled by some community members against the Holway project because it was seen to be doing too little for implicitly ‘deserving’ older people.

In many ways, the task of working with complex communities was easier for those SHARP projects that worked with communities that were more clearly divided geographically as well as in social or economic terms. Both the Pembrokeshire and the Triangle projects, for example, worked with three communities, geographically isolated from one another, and with quite distinct characteristics and local cultures. Both projects handled this by managing their respective interventions in three quite distinct parts, Triangle going so far as to have three, locally recruited, project workers, one for each area. In this way, processes of research and action were tailor-made for the three different communities within each project.

Processes of engagement

Building on existing links

To a greater or lesser degree, all of the projects built on existing links and partnerships to help in the task of bringing about engagement. The overarching evaluation team observed that engagement was most effective where groundwork had already been done: links made, trust established and support structures put in place for the sometimes fragile relationships established through the SHARP projects’ processes of engagement. By building on existing links, the projects gained a number of benefits. The most straightforward was where existing organisations provided a structure within which the action and the (p.112) research could take place. This is one aspect of the partnership work discussed in Chapter Four. In some cases, the existing organisations provided more than just a framework: the HYPP project, for example, used existing structures such as a drop-in information service in a school and a Healthy Communities project in Llanwrtyd Wells as the basis of the ‘action’ component of the action research. In the Holway project, the existing community-based activity in the area, such as a youth club, community workers and so on, provided more of a backdrop to the SHARP work. It also may have helped to introduce residents to the idea of community-based activity of a sort that was strikingly lacking in some other locations, such as the rural Pembrokeshire site of Llanychaer, or among the Yemeni community with which Barefoot was working in Cardiff.

An additional benefit to building on existing links was seen where groundwork had already begun in terms of identifying community needs. For example, even before the SHARP project began, some residents of the Holway project were active in identifying goals on which they wanted action – fly-tipping, speeding, antisocial behaviour and so on. The SHARP project came into a receptive environment, and was able to act as a catalyst for change, in this case the installation of CCTV.

Relationships with organisations already working in a community may not be straightforward, however. One of the communities with which Barefoot was working, for example, already had a strong voluntary sector women’s organisation. Developing work with this community meant that the SHARP project worker had to handle some difficult power issues with the group. A relationship that suited both the group and the project was established when a joint exercise class was set up, with publicity material acknowledging the input of both organisations as equal partners.

Spaces of engagement

Engagement does not take place in the abstract, but is acted out in the real world. Thinking about what might be called the spaces of engagement brings a focus to the actual processes that take place. Spaces of engagement may be read as territory – theirs, yours or ours – and the various ways in which community members respond to those spaces may facilitate or block engagement. On a small scale, a space of engagement may be somewhere such as Holway House (described in the box opposite) where community members could come without feeling alienated. On a larger scale, the idea of spaces of engagement (p.113) brings a focus to the issue of how neighbourhoods are defined and ‘owned’ by the people who live in them, and where the geographical boundaries of a neighbourhood are drawn. People’s willingness to engage may be directly affected by their sense of connectedness with the place where they live.

The Holway project was unusual in being so tightly focused on one intervention, in one place. Other projects were much more diverse in terms of their spaces of engagement, but still had experience of creating spaces where community members would feel a sense of belonging.

Right 2 Respect went out to six diverse communities and found spaces of engagement in each. For example, in Glyn Ceiriog (a rural community) the group met in the community centre and, when this was unavailable, in the local pub. Project workers reported feeling accepted and supported by the people who managed these spaces. In another Right 2 Respect location, the semi-rural community of Gresford, the young women designed and fitted out their own room in a youth (p.114) centre, for use for meetings, peer support and quiet discussion. They chose décor and furnishings to create the right kind of atmosphere. In Llay (a suburb of Wrexham), Right 2 Respect struggled when the only available venue was a dilapidated youth centre, and even more so once that was demolished. But when, in its place, was built a brand new lifelong learning centre the project really took off – especially as the centre manager was very supportive.

Where suitable spaces were lacking, engagement processes were hampered. Barefoot project workers in Cardiff ’s Butetown tried to avoid engaging community members in private spaces such as people’s homes, preferring to find places that were more neutral and less intrusive, without any risks to safety. But many of the more public meeting spaces in the area were seen as partisan or unacceptable: many Muslim people were reluctant to go into church halls, for example. There were similar issues in Riverside, where Barefoot worked with Triangle to support the Women in Action group: at a community planning event, Women in Action members talked of their dream of a building for their needs, with a hall, kitchen, prayer room and crèche. It would be a space they could call their own that would validate the group’s existence.

Changing engagement over time

The engagement of a community in action research is not a one-off event, but a dynamic process that has to be maintained throughout the life of the projects. It can be broken down into four broad stages – initial engagement, on-going engagement, re-engagement and disengagement. At each of these stages, which do not necessarily unfold in a simply linear fashion, engagement may be based on a different mix of people, and different levels of trust, enthusiasm, suspicion and conflict. At the same time, the role of individuals involved in the process may evolve and develop.

All the projects found that building relationships of trust with communities was a slow process that had to take place at the start of the involvement before any overt action research activities could take place. The experience of the Triangle project, described in the box opposite, provides another illustration of how work was designed to allow for this. (p.115)

Transition through the phases of engagement did not always go at the pace that might have been expected. In Pembrokeshire, the project found that initial engagement was established with relative ease. However, in the absence of external investment or resources, community groups lacked the capacity and confidence to take the work further, and the credibility of the project in the wider community was undermined by local experiences of little or no change. In the rural community, by contrast, the Pembrokeshire project struggled to make the initial engagement, but once this was established, there was a remarkable degree of local commitment to action research. Holway project workers observed a change over time in the nature of people’s engagement, in that they became more analytical. They also observed how residents’ capacity to participate in the formal structures of engagement – their ability to manage orderly meetings and so on – developed during the course of the project.

At an individual level, some people involved with the SHARP projects went through substantial changes in the nature of their engagement as part of a personal progress of change of role and change (p.116) of relationship with the project. In Right 2 Respect, young people in the Brynteg group became so engaged with the project that they took part in interviews for new youth workers joining the team. In the Barefoot project, one key community member who started out as a member of the women’s swimming initiative also became a regular catering supplier to the project. She experienced a change of relationship from receiving assistance, both in capacity and financial terms, to negotiating a professional fee for a service provided to the organisation. This indicates a power shift in the relationship from one of initial dependence to one of greater equality.

Another example of this is provided by the BeWEHL project. The project, which worked with 160 women over five years, aimed to increase health and confidence in women who would be considered excluded. The initial intake of students ‘graduated’ from their involvement in the Making a Difference volunteering programme to studentship as part of Further Education Development. With the move from one group to another, the relationship between the members and the project changed.

The nature of engagement between project and community can be affected by changes in the individual people involved. The Right 2 Respect groups experienced turnover as some young people grew out of them and new, younger girls joined. These changes seemed to be fairly smooth. By contrast, changes in staff members resulted in serious disruption to engagement in a number of projects, including Barefoot. Two community researchers departed during the lifetime of the project, leaving vacancies that took many months to fill. This resulted in loss of engagement and a need to re-engage after the recruitment of the new community researchers.

Barriers and motivations to engagement

Perspectives and expectations

Engagement may be helped or, more likely, hindered by the perspectives and expectations of any of the parties involved. The very word ‘health’ proved off-putting in some contexts. Some – though not all – projects found that presenting ‘health’ as the theme of the projects could actually be counter-productive. Instead, it needed to be viewed in terms of broader wellbeing and quality of life, since that is how most people see the issue.

More than one of the SHARP projects discovered how names and titles can saddle projects with unexpected baggage, which in turn inhibits engagement. Though most local people seemed happy with (p.117) the title ‘Right 2 Respect’, a few felt it conveyed a threatening image, one that could be read as un-female or anti-male. The title of the Barefoot project was chosen to reflect a concept from international development work, where ‘barefoot’ describes skilled health workers ‘of the people’. However, many people, particularly in the Somali and Yemeni communities, found the expression ‘barefoot’ offensive, since they felt it implied that it was they who were barefoot, poor and unsophisticated. Project workers with these communities quietly dropped the name in their dealings with the community, and described the project instead as the Health Promotion project.

Differences in perspectives and expectations can work in both directions, and there are examples of academics’ lack of understanding of community members’ agendas, as well as the other way round. The example from Pembrokeshire, in the box below, illustrates one of the risks to the engagement processes posed by interaction between people with widely different perspectives.

(p.118) As much as possible, the projects made efforts to be sensitive to the perspective of community members in terms of the barriers they were experiencing to taking part in project activities. Wherever possible, these were addressed by structuring activities in a way that minimised those barriers. For example, barriers may be presented by other demands on the time of potential participants. In Right 2 Respect, a lot of the young women were responsible for babysitting younger siblings, as parents worked in the evenings, or they had evening jobs themselves. Meetings were therefore held at teatime – straight after school or college. Similarly, in BeWEHL, childcare was one of the biggest barriers to engagement, particularly for women who were on low incomes but were not eligible for state benefits. In the Barefoot project, there were different issues: meetings were held during the daytime at weekends, to allow people who worked in the restaurant trade to attend. However, people will choose what activities they are interested in taking part in. In both Holway and Pembrokeshire, for example, project workers struggled to involve community members in preparing written reports.

Research fatigue and initiative fatigue

A common theme across the whole SHARP programme was that communities had grown used to being the subject of research or regeneration activities that ultimately made little difference, except perhaps to confirm the stigmatising label of deprivation. Several of the projects were sited in areas that had been heavily researched in the past, often on the ‘parachute model’: researchers dropped in from outside, gathered their data and disappeared, with no long-term change resulting for the community. This had led to a high degree of scepticism among local residents that acted as an immense barrier, at least in the beginning, to successful engagement between projects and communities.

(p.119) While some projects reported a sense of hostility to research from sections of their communities, this was not universal; there seemed to be little objection to the research activities in Right 2 Respect and BeWEHL. Community rejections of research are underreported in the literature: negative views may be unknown to senior academic practitioners, as fieldwork is normally the responsibility of research assistants (Boutilier et al, 1997). At local level, therefore, conventional research may have a ‘bad press’ and the potential for action has, beyond any doubt, been the main stimulus for the broader community involvement achieved by these projects.

In Pembrokeshire participants tended to perceive research as a high-status activity, enhanced through its links in this programme with the national government of Wales, but did express a certain fatigue with development initiatives and projects with short-term funding. The Monkton group lacked confidence about what the group could achieve. Members felt that vocal pessimists could drag it down. The community had seen initiatives, project workers and funding streams come and go, with little result on the ground. An action plan had been prepared in 2000, yet the same sorts of issues emerged during the SHARP interviews. The situation was succinctly described by one of the action researchers in Pembrokeshire:

They [that is, communities/community groups] get thrown the most difficult circumstances to work with. People go and see them with all these expectations, and all these grants (p.120) come out, and this or that scheme is here, and out comes someone to work with them for a couple of years. And then they disappear. And then, ‘ooh, there’s this new funding stream’. And these communities don’t know whether they’re coming or going.

(Carlisle et al, 2004, p 34)

Reciprocity

While those involved in running the various SHARP projects had engagement high on their agendas, the people living in the communities where the projects were working may have felt very differently. People may reject engagement for perfectly valid reasons, the strongest of which is simply because they cannot see any potential benefit from taking part. Community members have limited reserves of time and energy;in order to engage them, the SHARP projects had to find ways of conveying that that time and energy would be well spent on the project.

The Triangle project (see box below) tackled this at a very practical level. Other projects also emphasised the social aspects of research and action events. Barefoot put great emphasis on providing free lunch, as well as offering the chance for long-term personal development and ultimately the prospect of employment.

(p.121) Community members know that they are working in a situation of inequality. In the Pembrokeshire SHARP project, community members commented on the contrast between the financial resources held by the project and the fact that they ‘got nothing’. As in Holway, money was made available by the Pembrokeshire project as a ‘community chest’ for local groups to access, but there was no direct reward for individuals taking part in the engagement process, except for the small number who received a fee for carrying out interviews.

Leadership and ‘gatekeepers’ in the communities

Not all members of a community play equal roles in the processes of engagement. In any community, certain members may take on the role of speaking on behalf of others, sometimes with the overt consent of their peers, sometimes without. The various projects discovered that the role of community leaders may be a complex one, with authority assumed or granted in many different ways. Community leaders may take on the role of gatekeepers, with the ability either to facilitate or to block engagement between project workers and the community. In both Pembrokeshire and Triangle, for example, researchers discovered that a community may contain one powerful individual – unelected, unofficial – whose tacit blessing is required before other community members are willing to participate in the project. One of the action researchers in Pembrokeshire described his experience of trying to initiate engagement in the rural area:

“One of the very interesting things that happened when I came into this community to try and get this project going, get this process started, was it was very obvious there was one individual in the village that was what I would term the ‘gatekeeper’. And that person had a huge amount of respect from others in the community, and it didn’t really matter who I spoke to in the community, they wanted me to speak to this one individual and they wanted to see what the outcome of that was. So it was very difficult to get things moving and get things going forward without having the full engagement of the gatekeeper. Which finally when that happened the project, it just flew.”

(Welsh Assembly Government, 2006)

The Barefoot project confronted a particularly complex set of gatekeepers. The project aimed to set up a Bangladeshi Reference Group with which the project could liaise and that would be representative of (p.122) the whole community. However, there were already a number of groups operating within the Bangladeshi community in Cardiff. The conflicts and differences in opinion between these groups made it harder for the community to come together and to voice their common concerns collectively. Traditionally, certain sections of the community, such as women and young people, had not been involved or represented by these groups. Outside organisations and service providers looking to access the Bangladeshi community often approach these groups as a way into the community. This approach has often led to the information being left in the hands of the ‘gatekeepers’ with little or no access to the grass-roots level.

Measuring engagement and assessing its impact

The process of engagement may initially be viewed as an end in itself, but ultimately it has to be measured by the success achieved in bridging the differences and making connections between the various parties to the engagement. Engagement is seen as an essential part of the action research process, but it is worth asking whether it is the case that ‘the more engagement the better’ and whether there is a threshold level of engagement that is required for a project to be successful.

Engagement in the context of the SHARP programme can be considered in relation to Arnstein’s (1969) ‘ladder of participation’ model, which considers the relationship between community members and organisations. In the ‘ladder’ model, each rung from the bottom to the top represents an increasing level of participation of members of the public in the design and running of services or interventions; it was introduced by Arnstein in her work looking at the relationship between citizens and planners, but the ideas are transferable to any public service activity. A simplified version of Arnstein’s ladder is presented in the box opposite. (p.123)

Arnstein’s ladder presents a static or ‘snapshot’ view of the relationship between communities and organisations, glossing over the dynamic nature of the processes of engagement. However, it is useful because it throws into relief two issues at the heart of engagement, namely power and control. Moving from the bottom to the top of the ladder reflects a transfer of power from the organisation to the service user or citizen. Citizens involved in processes higher up the ladder gain power and control as an outcome of the involvement.

Although Arnstein argued powerfully that involvement should be taking place on the highest rungs of the ladder, she acknowledged that even there the outcomes may not be a pure or entirely effective form of citizen control. Community organisations taking over control (p.124) can develop their own bureaucracies and internal politics and end up replicating the organisations they have replaced. The ‘ladder of involvement’ shows how shifts in the balance of power and control are – or should be – one of the intended outcomes of the engagement process. In SHARP, engagement has been an integral part of the action research process, a means to the end of bringing about change in communities’ health and circumstances. This impact is summed up in the final project report on HYPP:

The progress made by HYPP has been a testimony to the energy, enthusiasm and creativity of the children, who when given a platform and forum, have been able to articulate and develop ways of meeting their own needs and requirements. The overwhelming lesson to be drawn is that children themselves are a key resource when examining and promoting health-enhancing behaviour.

(Goodwin and Armstrong-Esther, 2005, p 21)

In addition, engagement has shown its value as a process in its own right, contributing to increased confidence and the building of social capital (to be discussed in more detail in Chapter Eight). The overarching evaluation team described the valuable role of engagement in the Barefoot project, where both workers and stakeholders believed that the greatest impact of the project has been its:

success in working collaboratively with people of all ages from particular groups, who have rarely been successfully engaged by other means or services. This inclusive but indirect approach to community health improvement has taken several years to build, pointing to the real difficulties of expecting short-term change from action research with marginalised social groups. Equally important, these new networks remain fragile relationships in need of nurturing.

(Carlisle et al, 2005, p 67)

A third way in which the processes of engagement that took place through SHARP have, in many cases, made a difference is through their lasting impact on the structures of engagement that allow interaction between communities and public sector organisations of all types. In HYPP, children of all ages, and from different social, cultural and linguistic communities, came together to establish and run a youth council, Dyfodol Llanwyrtyd Future, and were invited to address town council meetings in order to express their requirements concerning local services and activities. They have also managed to connect (p.125) themselves to ‘influential others’, locally, regionally and even nationally – in addition to their invitations to Cardiff Bay and Westminster, a member of Dyfodol now sits on the council of Funky Dragon, the Welsh Assembly’s consultation group for young people across Wales.

This outcome is similar to that achieved by the Women in Action group facilitated by both the Triangle and Barefoot projects. The group has now succeeded in positioning itself in a role that has high-profile and meaningful connection with the local authority, the Local Public Health Team of the National Public Health Service and all levels of the National Assembly for Wales. Evidence of this was the list of those who attended a seminar in which Women in Action set out its background, achievements and future aspirations.

Conclusion

The various SHARP projects revealed the complexities of the processes of engagement between projects and communities. Their experiences highlighted the ways in which engagement is integral to action research. They showed that engagement with a community can only ever be partial and, to some degree, partisan, and that a degree of pragmatism must shape the projects’ ambitions for engagement. They demonstrated the ways in which ‘depth’ of engagement – intensively, with a small number of people – can be a more realistic and effective ideal than ‘breadth’ of engagement with a larger number of people, but at a more superficial level.

Engagement may need to be managed carefully, and expectations limited. Working on community engagement may entail dealing with and resolving conflicting values and priorities. There may be differences of priorities held by different members within a community. There may be values held by some community members that are at odds with the values of the service planners, providers or funders. Engagement does not automatically lead to the outcomes people hope for. It can raise hopes that, if they are not met, can lead to disillusionment. The SHARP projects demonstrated that engagement, and community members’ expectations of it, had to be carefully managed. In the Holway project, for example, the single most important issue identified by residents at the start of the project was the state of pre-cast concrete houses on the estate. Only at the end of the project – four years down the line – was the council beginning to address this.

Three of the projects (Triangle, Barefoot, Pembrokeshire)took a very particular approach to tackling engagement, by choosing to recruit local community researchers to act as links between the communities, the (p.126) projects and the respective organisations within which each project was based. The next chapter goes on to discuss these workers, and their roles as key players making links between projects and communities and also negotiating with gatekeepers in the communities.

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