Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis

Article

O'Mara-Eves, A, Brunton, Ginny, McDaid, G, Oliver, Sandy, Kavanagh, Josephine, Jamal, F., Matosevic, T, Harden, A. and Thomas, James 2013. Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis. Public Health Research. 1 (4).
AuthorsO'Mara-Eves, A, Brunton, Ginny, McDaid, G, Oliver, Sandy, Kavanagh, Josephine, Jamal, F., Matosevic, T, Harden, A. and Thomas, James
Abstract

Overall, community engagement interventions are effective in improving health behaviours, health consequences, participant self-efficacy and perceived social support for disadvantaged groups. There are some variations in the observed effectiveness, suggesting that community engagement in public health is more likely to require a
‘fit for purpose’ rather than ‘one size fits all’ approach. We identified trends in the evidence that could provide useful directions for future intervention design and evaluation.
Although there is a trend to suggest that there is greater effectiveness of peer-/lay-delivered interventions
than interventions that take an empowerment approach or those that involve community members in the design of the intervention, this finding was not statistically significant. We cannot, therefore, conclude that one particular model of community engagement or theory of change is clearly more effective than any other.
Albeit from a small number of studies, there also appear to be gains to human and social capital. There is evidence of benefits for engagees, including skills acquisition and future employment. Also, there is evidence that interventions improve participants’ perceived social support.
There is weak but inconsistent evidence that different types of community engagement interventions can be
cost-effective, and that implementation factors may affect intervention success. The new conceptual framework and the identification of three main theories of change can be used in intervention design and evaluation. Community engagement interventions need evaluations to include long-term assessment; the full range of potential beneficiaries; rigorous process evaluation; and collection of costs and resources data. We anticipate that these additions will help to disentangle the relative effectiveness of different models of community engagement and encourage sustainable initiatives with a lasting health legacy for the community.

JournalPublic Health Research
Journal citation1 (4)
Year2013
PublisherNational Institute for Health Research
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Web address (URL)http://www.journalslibrary.nihr.ac.uk/phr/volume-1/issue-4
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PrintNov 2013
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Deposited05 Dec 2013
FunderNational Institute of Health Research
Copyright information© Queen’s Printer and Controller of HMSO 2013. This work was produced by O’Mara-Eves et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.
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