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What does it mean to do research within a community?

Some researchers do studies in a lab. Some do studies in a clinic. Some do studies in hospitals. And some do studies within a community. You might be thinking, what does it mean to do research within a community? What do researchers even mean when they say “community”? Why do they want to do research with a community? How do they learn about communities? These are all great questions! 

“Community” can mean a lot of different things when it comes to research. Researchers think about communities in many different ways. A community could be people who live in the same area. It could be people who are in the same age group (like children, or older adults). It could be people who share the same identities, speak the same languages, work the same jobs, experience the same health issues, join the same social media groups, enjoy doing the same activities…or people who feel connected to each other for any of these reasons, and others!    

Just like there are many different types of communities, there are a lot of reasons why researchers might be interested in doing research with communities. Some researchers want to find out about how people live their lives within their communities to help improve everyday health. Some want to figure out what the most important health issues are in a community. And others want to see if a new program might help make communities healthier.     

How do researchers learn about communities?  

Imagine you just moved to a new town – how would you try to learn about your new home? Would you go to some events? Try to meet new people? Talk to your neighbors? Find groups that do activities you like? Now, if you were a researcher, how would you try to learn about a community you wanted to work with? If your answers seem similar, that’s because…well…they are. When researchers want to learn about communities, the best thing they can do is (you guessed it) get out there! As a researcher tries to learn more about a community, they might go to events, volunteer with community groups, or meet with people who are interested in the same health topics as they are. They might try to find out what research projects are already going on in a community by talking to other researchers. They might try to find out what health topics are most important to community members by looking at community health reports, or maybe even by trying to organize a listening session where community members come and share their thoughts and feelings about a research topic. The more time a researcher can spend learning about a community, the better their research can be! If you see a researcher out in your community before a research project starts, they might be trying to:  

• Build trust and relationships with community members  
• Choose a research topic that the community is interested in  
• Pick a type of study that the community wants to take part in  
• Learn what results community members want to see from the research   
• Figure out what might make it hard for community members to join a research study and what might make it easier  
• Learn if the community wants to help plan, do, or share the research  

How can researchers work with a community on a research project?  

One of the most important things a researcher can learn when they want to work with communities is how much a community wants to help plan, do, and share the research. Sometimes research projects happen  in  communities. Research that happens  in  communities is called  community-based research . You might also think of research as happening  on  communities (research should not feel like it is happening on you!). Well, research can happen  with  communities, too. Working  with  communities on a research project is called  community-engaged research .   

Even though community-engaged research is one type of research, these projects can all look really different. There are many ways to “engage” with communities on a research project. This is why it is so important for researchers to talk with communities about how involved they want to be in planning, doing, and sharing the research. Researchers can work with community members to…  

Researchers can work with communities on one part of a research project (like PLAN), or all parts of a research project (PLAN, DO, and SHARE). And sometimes researchers will work with the same communities on many different research projects! It all depends on the researcher, the study, and what the community wants.  

What if researchers really want to put the community in the driver’s seat?  

Sometimes, when communities are really involved with research, it is called  community-based participatory research or CBPR . In community-based participatory research projects, communities aren’t just doing research  with  a researcher – they are leading the research! Community-based participatory research is done through a true and equal partnership of community members and a researcher or research team. The ideas, research topic, study design…pretty much everything about the research…is driven by community members. They have the power to make decisions about all parts of the study and how the research is done. Community-based participatory research studies usually try to understand big issues impacting communities (maybe something like access to healthcare or poverty within a community) and try to find solutions through policy and social change. This type of research takes a lot of time, strong relationships, and trust between community partners and researchers.    

So, to wrap it all up…      

There are many researchers out there who work with communities on research. Working with communities to do research takes time, trust, and effort – but it makes the research so much better for everyone!   

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• v.11(2); 2021 Feb

Strategies of community engagement in research: definitions and classifications

Vetta l sanders thompson.

1 Washington University in St. Louis, Brown School, St. Louis, MO, USA

Nicole Ackermann

2 Washington University in St. Louis School of Medicine, St. Louis, MO, USA

Kyla L Bauer

Deborah j bowen.

3 University of Washington, Department of Bioethics and Humanities, Seattle, WA, USA

Melody S Goodman

4 New York University, School of Global Public Health, New York, NY, USA

Engagement activities are defined along a continuum that analyzes and represents nonacademic stakeholder activities and interactions with academic researchers. Proposed continua begin with none to limited stakeholder inclusion and input into research and continue with descriptions of increasing presence, input, and participation in decision-making. Despite some agreement in the literature, development of consistent terminology and definitions has been recommended to promote the common understanding of strategies in engaged research. This paper sought to develop and understand classifications and definitions of community-engaged research that can serve as the foundation of a measure of engaged research that permits comparisons among engagement strategies and the outcomes that they produce in health- and healthcare-related research studies. Data on academic and stakeholder perceptions and understandings of classifications and definitions were obtained using Delphi process ( N = 19) via online and face-to-face survey and cognitive response interviews ( N = 16). Participants suggested the need for more nuanced understanding of engagement along portions of the continuum, with active involvement and decision-making as engagement progressed. Cognitive interview responses suggested that outreach and education is a more advanced level of engagement than previously discussed in the literature and viewed consultation negatively because it required work without guaranteeing community benefit. It is possible to define a continuum of patient- and community-engaged research that is understood and accepted by both academic researchers and community members. However, future research should revisit the understanding and depiction of the strategies that are to be used in measure development.

Implications

Practice: It is possible for researchers and stakeholders to clarify terminology so that roles, participation, and benefits are clear at each level of community engagement along the continuum.

Policy: Policymakers who want to encourage community-engaged research must consider similarities and differences that may emerge in community and academic perceptions of community-engaged research.

Research: Future research is needed to clarify the understanding and depiction of community engagement activities and strategies that guide measure development.

INTRODUCTION

As the scientific community increasingly focuses on translation and implementation of scientific discoveries [ 1–3 ], stakeholder engagement is receiving increased attention in research as a key component in the process of tailoring best practices for specific populations [ 4–6 ]. However, as ongoing research and analysis indicate [ 7 ], there continues to be a need to reach agreement on the terminology and definitions used in the field of engaged research. To examine critical issues in the field, a consortium was formed, composed of individuals from the USA, Canada, UK, and Australia who recognized the importance and potential impact of funder advancement of patient- and stakeholder-engaged research. One of the issues that the consortium members undertook was an examination of definitional issues in engaged research. The group recognized variation in the terminology used [ 7 ]. Thus, the authors recommended that consistent terminology and definitions be generated to promote the common understanding of strategies in engaged research. At the same time, the authors remained flexible, encouraging continued growth and innovation in the field. The recommendations included use of the term engagement as opposed to participation and involvement , which were deemed either overly narrow or too broad. The consortium proposed the definition of research engagement as “an active partnership between stakeholders and researchers in production of new healthcare knowledge and evidence” [ 7 ] (p. 7). The field’s acceptance of this foundational definition would suggest the need to clarify definitions of classifications and the continua of engagement.

In terms of engagement, the literature has consistently divided academic research into that which is considered nonengaged, advisory, symbolic, collaborative, or full engagement [ 8–11 ]. Engagement activities are defined along a continuum that analyzes and represents nonacademic stakeholder activities and interactions with academic researchers. In the continuum of engagement, engagement may represent an effort to share education and information with the community, but at another point on the continuum, engagement may involve shared decision-making throughout the research process. There seems to be agreement in the literature on the trajectory of the continua and what activities and strategies represent the endpoint of authentic engagement [ 5 , 8–11 ]. The continua proposed begin with none to limited stakeholder inclusion and input into research, and continue with descriptions of progressively increasing presence, input, and participation in decision-making. There seems to be less agreement on how stakeholder engagement strategies are defined and positioned along the continua proposed as researchers and stakeholders form collaborations and partnerships. For example, the number of strategies included and described varies, as does the inclusion of strategies such as education, outreach, and informational strategies. In addition, whether outreach and education, as well as informative and consultative strategies are combined varies in descriptions of the stakeholder engagement continua.

Fundamental to classifications of strategies for engaged research are the questions of whether, how, and when stakeholder voices are heard and carry weight and whether the voices of academic researchers overpower those of the nonacademic stakeholders [ 7 , 9–11 ]. If stakeholders are allowed to advise but the researchers have the ultimate decision-making power, stakeholder presence may give the appearance of engagement although the stakeholders may not be meaningfully engaged. Several scholars contend that meaningful engagement requires some shared decision-making [ 9–11 ]. Previously research suggested a classification system that moved from nonengaged to engaged participation [ 9 ]. Nonparticipation is represented by outreach and education , with researchers developing, implementing, and evaluating strategies to reach the community of interest and with researchers providing education to try to educate nonacademic stakeholders about a particular topic [ 9 ]. The continuum continues with symbolic participation , which includes the following: (a) coordination with researchers in which researchers gather community stakeholders together to assess important elements of a project or activity and in which community members provide feedback to academic researchers and (b) cooperation where researchers ask community members for help with a project, instead of just asking for advice. The final category on the continuum is collaboration , with two categories that reference researchers and community members being actively involved in the design and implementation of the project and in the interpretation of the findings. One of the two types of collaboration is patient-centered collaboration , with patients, caregivers, and advocacy groups determining the priority setting for research choices and controlling the design and implementation of the project activities in addition to the interpretation and publication of findings. The other type of collaboration is community-based participatory research (CBPR), which is a population health approach to the patient-centered engagement model [ 9 , 12 ].

In this paper, we report on efforts to subject our engagement classifications and definitions to researcher and stakeholder scrutiny and feedback. This paper seeks to understand the changes in classification and definition that were required to achieve agreement among researchers and stakeholders. Classifications and definitions that are agreed upon can serve as the foundation of a measure of engaged research that might allow comparisons among engagement strategies and the outcomes that they produce in a variety of health- and healthcare-related research studies.

The study and consent procedures described received institutional review board approval.

Development of definitions for stakeholder-engaged research classifications

The Disparities Elimination Advisory Committee (DEAC) of the Program for Elimination of Cancer Disparities (PECaD) of a comprehensive cancer center [ 12 ] worked collaboratively with study investigators to develop a standardized measure of stakeholder engagement [ 13 ]. In addition, this measurement development group sought a way to classify strategies of engaged research and, specifically, how programs and projects adhered to community engagement principles. The team initiated discussion using the definition of stakeholder-engaged research provided by the CDC [ 13 ] and the principles outlined in the work of Israel [ 10 , 11 ]. The process began in April 2014 with DEAC members ( n = 15) participating in a focus group on perceptions of the implementation of CBPR principles used in each PECaD project and by each PECaD cancer partnership. The DEAC members consisted of 3 (20%) men, 12 (80%) women, 8 (53%) Black, 5 (33%) White, and 2 (13%) Native American participants.

As work proceeded, the DEAC members and the academic researchers used the definition of patient-engaged research —as offered by the Patient-Centered Outcomes Research Institute (PCORI) [ 14 ]—to develop definitions for the strategies included on the continuum of stakeholder-engaged research: coordination, cooperation, patient-centered collaboration, and CBPR collaboration [ 9 ]. PCORI defines patient-engaged research as, “The meaningful involvement of patients, caregivers, clinicians, and other healthcare stakeholders throughout the entire research process—from planning the study, to conducting the study, and disseminating study results” [ 14 ]. In the spring of 2017, the research team conducted an extensive literature review on measures of community engagement, which led to revised definitions.

The final iteration of the effort involved additional input from the DEAC members and the Patient Research Advisory Board (PRAB) at a mid-western school of medicine [ 15 ]. The PRAB includes the alumni of a program that provided a 15-week training program on research methods, who are certified to conduct research with human subjects by the university human research protections office. The PRAB is designed to help investigators with community-engaged or community-based research proposals/projects by having community members review proposals and give feedback. The additional interaction with DEAC and PRAB resulted in the addition of a fifth category of engagement: outreach and education [ 9 ]. In the spring of 2017, study investigators reviewed PCORI-funded projects for definitions and examples of engagement that were used in patient-centered outcomes research and activities. The definitions were presented to the DEAC members for comment in April 2017. To obtain more in-depth input and feedback, volunteers were solicited; six members (DEAC or PRAB members) agreed to provide feedback on the definitions in June 2017.

Delphi panel process

As CBPR practitioners, the research team believed that it was important that a measure of stakeholder-engaged research be developed in a way that was consistent with CBPR principles, particularly the inclusion of stakeholder input into the classification of engagement and their definitions. A modified Delphi process was designed to fulfill this goal; thus, the Delphi panel was convened. The Delphi method uses structured communication among individuals with expertise on a topic, with the goal of reaching agreement on a designated outcome [ 16 ]. The process involves administration of multiple rounds of individual surveys (online and in-person), with aggregation of responses and participant receipt of feedback on the group response for each round until reaching majority agreement.

Nineteen participants, composed of academic researchers and nonacademic members (see Table 1 ) with expertise in community engagement in research, were recruited through the authors’ networks and were asked to participate in a panel for a study on developing and validating a quantitative measure of community engagement in research [ 17 ]. The panel purposefully consisted of both stakeholders/community partners (57.9%) and academic researchers (42.1%). Most panelists did not focus on a specific disease or health condition in their work (57.9%). For the other panelists, the health conditions of focus included HIV/AIDS, hepatitis C, mental illnesses, respiratory illnesses, health behaviors and prevention, breast cancer, sickle cell, cancer in general, or hypertension. One panelist dropped after completing the first of the five rounds of the Delphi process, leaving 18 panelists remaining engaged throughout the entire process.

Demographics of Delphi panel ( N = 19)

CBPR community-based participatory research.

a Not all Delphi panel members were providers; nine were current or past service providers.

An introductory webinar was held to inform the panel members about the Delphi process. The introductory webinar was followed by three computer rounds, one face-to-face round, and a final computer round. In each round, panelists were asked whether they agreed or disagreed with the definitions for the classifications of stakeholder engagement research, and they were asked to suggest modifications. The goal of the process was to reach agreement (>80%).

Round 1 was focused on items that might measure strategies of stakeholder-engaged research. The stakeholder engagement classifications and definitions were presented to panelists in October 2017, during Round 2 of the Delphi process. The stakeholder engagement classifications and their definitions had been determined by the DEAC-PRAB working group. Input and refinement continued through Round 5 (August 2018). Rounds 2, 3, and 5 of the Delphi process were online surveys (via Qualtrics platform) that allowed for feedback. Round 4 was an in-person meeting conducted over 2 days [ 17 ]. Three polling activities took place at the in-person meeting during Round 4. There were eight people who could not attend the in-person meeting, but were able to participate by using an online meeting platform (GoToMeeting) or by submitting a premeeting survey before the first day. Three of the six panelists who completed the premeeting survey attended the in‐person meeting virtually at varied times throughout the 2‐day meeting. All but two panelists were able to participate in some format for Round 4. During the in-person meeting, notes were taken by the research team and a professional editor to explain key changes and areas of disagreement. The professional editor also checked for grammar and consistency issues.

The definitions for the proposed DEAC-PRAB stakeholder engagement classifications were based on a literature review and synthesis first presented by the research team [ 9 ]. The original strategies of engagement and their definitions, as informed by CDC/ATSDR [ 13 ], Israel [ 10 , 11 ], and the DEAC team [ 12 ], were the following:

• Outreach: Researchers develop, implement, and evaluate strategies to reach the target population. Key members of the target population (gatekeepers) can be engaged as advisors and can make key connections.
• Education: Researchers are trying to educate stakeholders about a particular topic. This is usually combined with outreach efforts to gain audiences for education sessions and/or materials.
• Coordination: Researchers gather community health stakeholders together to assess important elements of a project or activity. Community members give feedback, and this feedback informs researchers’ decisions. However, it is the researchers’ responsibility to design and implement the study with no help expected from the community members. Research and related programs are strengthened through community outreach, and results are disseminated through community groups and gatekeepers.
• Cooperation: Researchers ask community members for help with a project, instead of just asking for advice. There is some activity on the part of community members in defined aspects of the project, including recruitment, implementation of interventions, measurement, and interpretation of outcomes. Community health stakeholders are ongoing partners in the decision-making for the project. Community health stakeholders’ understanding of research and its potential importance are enhanced through participation in activities.
• Collaboration: Both researchers and community members are actively involved in the design and implementation of the project and in the interpretation of the findings. In addition, all stakeholders benefit in some way from working together, including increased capacity of community groups to engage in research implementation. Community health stakeholders collaborate in decision-making and resource allocation with an equitable balance of power that values input from the community health stakeholders.
• Patient-centered: Patients, caregivers, and advocacy groups dictate the priority setting for research choices and control the design and implementation of the project activities in addition to the interpretation and publication of findings. Researchers use their expertise to move these components along, but community health stakeholders make all major decisions about research approaches. Systems are in place for patient participation in research at all points of the engagement continuum. Community health stakeholders have the capacity to engage in partnerships with an equitable balance of power for governance and a strong level of accountability to the public or community.
• Community-based participatory research: CBPR is the population health approach to the patient-centered engagement model. The principles of CBPR highlight trust among partners, respect for each partner’s expertise and contributions, mutual benefit among all partners, and a community-driven partnership with equitable and shared decision-making [ 9 ] (p. 487).

Cognitive response interviews

Cognitive response interviews were conducted to identify problems with survey items and definition wording and to help us modify the definitions to improve their use in community-engaged research [ 18 ]. Cognitive response interviewing is an evidence-based method of examining participant understanding and interpretation of survey items. Participants are asked to answer questions about their interpretation of items, paraphrase items, and identify words, phrases, or item components that are problematic [ 18 ], after each individually present item.

A purposive sample of 16 individuals (see Table 2 ) was recruited to complete one-on-one cognitive response interviews in November of 2018. Eligibility criteria for the cognitive response interviews were that participants had to be adults (18 years or older) and that they had to have experience partnering with researchers on patient- or community-engaged research. Participants were recruited through a database of alumni who had completed the Community Research Fellows Training (CRFT) program in a mid-western city [ 19 ] and through referral by CRFT alumni. CRFT was established in 2013 and maintains an opt-in database of graduates of four cohorts ( n = 125), 94 (75%) of whom are active alumni and have updated contact information.

Demographics of cognitive interview participants ( N = 16)

GED general education diploma; HS high school.

Interviewer training and interviews

The lead author of the manuscript trained the project manager and two research assistants ( n = 4 interviewers, including the lead author) on how to conduct in-depth cognitive interviewing to ensure consistent interview and data collection procedures. The training also provided an orientation to the interview guide and protocol. The project manager provided interviewers instruction on the use of tablets to administer the cognitive response interview to assure consistency and ease of administration. Although tablets were used during the interview to capture responses to survey items and quantitative questions, computer-assisted personal interview software was not used, and participant qualitative responses were captured using a digital recorder.

The one-on-one, semistructured interviews were completed in person. In order to assure that respondents understood their role in the cognitive response interviews, interviewers explained that the purpose of the interview was to identify problems with survey items and definition wording and to help us modify the definitions to improve their use in community-engaged research. The interviews lasted 90–120 min, and each session’s digital recording was professionally transcribed. Each individual received a $50 gift card for participation. Each participant completed 16 (50%) of 32 items on the quality and 16 (50%) of 32 items quantity scales. Interviews were conducted using verbal probing after participant responses.

The primary means of administering survey questions was by tablet, participants were provided with the option to use a paper version if preferred. Participants were then presented with six classifications of stakeholder-engaged research definitions, which were presented in pairs, and the participants were asked to explain the difference between them for a total of three separate comparisons. To minimize the impact that the order of questions had on the overall results, we used four different versions of the questionnaire, which listed definition comparisons in different orders, and we randomly assigned the questionnaires to participants.

Coding and analysis

After reviewing the project goals, the content of the interviews, and the existing literature, the first author developed a defined coding guide that prescribed rules and categories for identifying and recording content. The coding was completed in three phases. In the first phase, the study investigator and one research assistant coded the transcripts based on the participant’s discernment (understood or misunderstood) for definitions. Additional codes were developed to note if participants’ explanations included certain keywords or themes (e.g., control/power, decision-making). The coders read and coded the interview transcripts individually, identifying text units that addressed the participants’ understanding of engagement definitions and rationale for differentiating between the classifications of stakeholder-engaged research.

In the second phase of coding, the two coders (the senior investigator and the research assistant) met to reach agreement on the definitions and examples used to code the interview transcripts. Finally, on completion of coding and development of agreement, the coders reconvened to formulate core ideas and general themes that emerged from each interview.

Results of polling and discussion on Delphi panel definitions

The Delphi panel provided input and voted on three iterations of engagement strategies and definitions during Rounds 2 through 5 (see Figure 1 ) to reach agreement (94.4%–100.0%; Table 3 ). At the end of Round 2 of the Delphi process, nonacademic researchers reached strong agreement on definitions of the engaged research classification: outreach and education (80%), coordination (100%), cooperation (90%), patient-centered collaboration (100%), and CBPR collaboration (100%). However, academic stakeholders did not reach strong agreement on any of the definitions: outreach and education (75%), coordination (75%), cooperation (75%), patient-centered collaboration (75%), and CBPR collaboration (75%). In Round 3, academic researchers reached strong agreement only on the definition for cooperation (88%, ranged from 63% to 75% for all others), while nonacademic researchers reached strong agreement on all definitions, 80%–100% (80% agreement for collaboration, 90% for outreach and engagement, 100% for both cooperation and consultation). Also, collaboration, which had been of two types previously, was classified as one category in Round 3 and coordination was renamed consultation. A fifth classification of engaged research, partnership, was added in Round 4 and remained in Round 5. The in-person meeting and discussion (Round 4) made a substantial difference in reconciling divergent perspectives on classification definitions (see Table 3 ), reaching 80% agreement among participants. However, lower and variable participation (no participation, presurvey/on and off virtual, presurvey only) may have influenced the flow and direction of the discussion, affecting the validity of the Round 4 process. Because some panelists did not vote and to assure that everyone’s input was incorporated, a final online round, Round 5, was completed. Only one dissenting opinion was recorded in the last online survey (Round 5), and this was for the collaboration definition (see Table 3 ).

Agreement of Delphi panel in online surveys on definitions in the community-engaged research continuum

CBPR community-based participatory research; PC patient centered.

a Delphi panel members voting on the Round 4 surveys (present or online); N = 13 for Day 2 voting on partnership (due to the number of virtual participants differing throughout the day).

b Collaboration–CBPR and Collaboration–PC were combined as a classification during the first revision and changed to Collaboration in Round 3.

Change of categories in continuum of community-engaged research, Rounds 2–5 of Delphi panel.

On the basis of the Round 2 survey feedback, academic researcher members of the Delphi panel wanted definitions to be more concise, and they expressed concerns about terminology used to categorize the strategies of engagement. In particular, their concerns were related to differences in how the categories were represented in the community-based participatory and patient-centered research literatures. Community members seemed most concerned that definitions state exactly how community members would be provided services (e.g., provision of culturally appropriate education) and how they would be involved in research (i.e., in outreach efforts). In the Round 3 definitions, academic researchers, again, called for concise terms to improve applicability, while community members had fewer suggestions and mostly small edits (e.g., do not use the word “target” when referring to community members).

Community stakeholders and academic researchers had extended discussions about how to classify who was on the research team (e.g., what happens when “researchers are the community and not ‘academic researchers’”) and about using the right language to be as inclusive as possible (e.g., using “community members/patients” vs. “patients, caregivers, partner organizations, etc.”; see Table 4 ). Community stakeholders and academic researchers also wanted stronger wording. An academic researcher suggested describing and highlighting what constitutes equity in engaged research, and one community stakeholder suggested a category that represented long-term relationships between community stakeholders and researchers to be the gold standard (i.e., partnership). In the third and fourth rounds, strong agreement existed, and few definitional modifications were developed (see Table 4 ).

Delphi panel’s changes in key terms in community engagement definitions, Rounds 2–5

Results from cognitive response interviews

The discussion and recommendations of the Delphi panel resulted in a final set of engagement strategies and definitions that were examined using cognitive response interviews of a purposive sample of 16 interviewees. The terms and definitions tested were the following:

• 1.Outreach and Education
• Definition: Research team members develop, implement, and evaluate strategies to reach the population of interest. Organizational partners can be engaged as advisors and can make key connections. In some instances, researchers are trying to educate community residents and/or patients about a particular topic. In these cases, outreach efforts are used to gain audiences for education sessions and/or materials.
• 2.Consultation
• Definition: Researchers ask community residents and/or patients for advice on important elements of a project or activity. The provided feedback informs the research, but the researchers are responsible for designing and implementing projects with no help expected from the people who were consulted.
• 3.Cooperation
• Definition: Researchers ask community residents and/or patients for advice and help with a project. Such help may include activity in defined aspects of the project, including recruitment, activities related to doing the intervention, the creation of study questions and measures, and the interpretation of outcomes. Researchers and community residents and/or patients work together to make decisions throughout the project.
• 4.Collaboration
• Definition: Patients, caregivers, clinicians, researchers, and/or community members partner in every aspect of the research, including setting priorities, study design, implementation, analysis/interpretation, and dissemination. Collaborations are built on mutual respect and trust. All partners are valued, benefit from the research, and share decision-making, power, and resources.
• 5.Partnership
• Definition: A strong, bidirectional relationship exists among patients, caregivers, clinicians, researchers, and community members (or a combination of these categories) regarding every aspect of the research, including setting priorities, study design, implementation, analysis/interpretation, and dissemination. The relationship is built on trust and mutual respect. All partners are valued, benefit from the research, and share decision-making, power, and resources. Strong partnership processes exist for how resources are shared, how decisions are made, and how ownership of the work is determined and maintained. Partnerships are the result of long-term relationships and have moved beyond working on a single project. Partners have a history of collaboration, having worked together previously.

Participants in the cognitive response interviews considered two strategies of community engagement at a time and the underlying rationale for both in order to distinguish their differences. Overall, 85% of cognitive response interviewees agreed on such distinctions. The most misunderstood difference was between the outreach and education level and the consultation level (37.5% misunderstanding). Participants seemed to confuse the strategies because they thought the outreach and education level was a higher form of community-engaged research than cooperation. Cognitive interview responses suggest that 37.5% of participants found strong similarities between cooperation and collaboration and that 50% of participants did so between collaboration and partnership. Despite the perceived similarities, most participants (87.5%) agreed on the distinctions. A key distinction that participants made between cooperation and collaboration was related to decision-making, control, or power. Involvement in decision-making, control, or power was an important feature of collaboration. A key distinction between collaboration and partnership was the number of projects researchers and community members had collaborated on. All of the eight participants who completed the collaboration/partnership comparison used the words long-term , ongoing , or history to describe the important features of partnership.

Over the rounds of review for the Delphi panel, the categorization of community members and researchers shifted toward more common vernacular (i.e., community residents and/or patients ) than research language (i.e., stakeholders ). Whereas the outreach and education category was initially defined using specific ideas such as “staff members who are similar to target population” or “people with relevant lived experience,” in the final definition, the category was defined in broad terms like “organizational partners” or “community residents and/or patients.” Definitions of strategies of engagement further along the continuum, such as collaboration, were described in broad terms (e.g., “the community”) at the beginning of the process but in specific groups (e.g., “patients, caregivers, clinicians, and community members”) by the end. Also regarding categories further along the continuum, such as collaboration and partnership, Delphi and interview participants desired that the terms reflect community members’ active involvement and decision-making influence in the research process. In these stages of engagement, researchers are not expected to merely make the attempt to have a respectful and equal relationship with community members; they are expected to actually have a respectful and equal relationship. Trust and a strong relationship should be in place to achieve a high level of engagement.

Participants seemed to believe that outreach and education is a more advanced level of community engagement than has been discussed in the historical literature, where it has been described as ranging from nonparticipation to the lowest level of tokenism [ 8 , 9 ]. Some participants negatively described consultation because it required the most work from them without guaranteeing anything in return. This deficit in giving was a major problem, and the idea that their efforts may not even influence the research project was an additional injury. In contrast, with outreach and education, participants receive something, and participants assumed that this stage naturally incorporated feedback, as respondents talked about community members being needed for outreach and actively engaging in education sessions.

Because cognitive response participants judged outreach and education as being an advanced stage of engagement, we looked back at comments from the Delphi panel when discussing outreach and education. In the first round of definition changes from the Delphi panel, one academic researcher commented that the definition for outreach and education seemed more involved than what the researchers had seen before. At the same time, two community members wanted the definition to involve community members more in outreach activities and producing appropriate educational materials. It was a difference in perception of outreach and education projects that continued to show up during cognitive interviews and participant surveys predominantly with community member participants. Explanations from the cognitive response interviews and comments on comparisons of category definitions and position within the continuum suggested the need to rethink the presentation of outreach and education in comparison to consultation.

The PCORI Compensation Framework states:

Research and other research-related activities funded by the Patient-Centered Outcomes Research Institute (PCORI) should reflect the time and contributions of all partners. Fair financial compensation demonstrates that patients, caregivers, and patient/caregiver organizations’ contributions to the research, including related commitments of time and effort, are valuable and valued. Compensation demonstrates recognition of the value, worth, fairness of treatment with others involved in the research project, and contributes to all members of the research team being valued as contributors to the research project [ 20 ].

Compensation was not discussed directly, but the principles selected and the discussion of these during cognitive interviews allude to the issues noted in the PCORI framework. The Delphi panel discussion and cognitive response interviews suggest an expectation that community resources and contributions be valued and compensated. These resources might include compensation for the use of organizational space, staff or community contributions to recruitment, data collection, or other research-related projects and activities, but might also include appropriate compensation of research participants. Hence, means for compensation may include financial, along with other kinds of intellectual and community investment.

It is possible that the standard single-axis approach to describing community-engaged research continua does not adequately depict community contributions and benefits for each engagement strategy. We developed the framework shown in Figure 2 as an alternative for consideration. This depiction seems to adequately capture community understanding of the contributions from researchers and benefits to communities regarding outreach and education compared to consultation.

Recommended portrayal of continuum of community-engaged research interactions.

Limitations

These findings should be interpreted cautiously due to the small sample size. However, cognitive response interviewing provides in-depth insight into how participants are thinking about and interpreting surveys, the factors that affect their interpretation and responses, and how comfortable they feel with the language, options, and coverage of topics important to an issue. In addition, the Delphi process allows a diverse group of stakeholders to consider issues of importance until agreement has been reached. The findings and recommendations presented require quantitative assessment and discussion in the literature.

CONCLUSIONS

The results of Delphi panel and cognitive response interviews indicate that it is possible to define a continuum of patient- and community-engaged research that is understood and accepted by both academic researchers and community members. However, responses from the cognitive response interviews suggest the need to revisit the understanding and depiction of the strategies that are to be used in measure development. Cognitive response data also indicate that terminology matters in the ability to adequately convey roles, participation, and benefits at each level of community engagement along the continuum.

This research was funded by the Patient Centered Outcome Research Institute (PCORI), ME-1511-33027. The funder had no role in the study design, data collection, analysis, interpretation, or drafting of this article.

Compliance with Ethical Standards

Conflict of Interest: The authors declare that they have no conflicts interests.

Authors’ Contributions: V.S.T. conceived of the study, participated in the design of the study, completed interviews, assisted with interview coding and analysis. In addition, V.S.T. wrote the draft version and revisions of the manuscript. N.A. participated in the study design, performed interviews, completed quantitative data analysis and assisted with manuscript revision. D.B. participated in the study design and revision of the manuscript. M.G. conceived of the study, directed the design and coordination of the study and helped to draft the manuscript. All authors read and approved the final version of the manuscript.

Ethical Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The institutional review boards at Washington University in St. Louis and at New York University approved this study.

Informed Consent: Informed consent was obtained from all individual participants included in the study. The institutional review boards at Washington University in St. Louis and at New York University approved the consent procedures used in this study.

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• Published: 28 November 2022

Community-engaged research is stronger and more impactful

• Gabrielle Wong-Parodi   ORCID: orcid.org/0000-0001-5207-7489 1  

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Based on her own experience, Gabrielle Wong-Parodi describes how a community-engaged approach has the potential to strengthen research and increase its impact.

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Clinical and Translational Science Awards Consortium Community Engagement Key Function Committee Task Force on the Principles of Community Engagement. Principles of Community Engagement (NIH publication no. 11-7782) (Department of Health and Human Services USA, 2011).

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The OCOB project was developed under assistance agreement no. 84024001 awarded by the US Environmental Protection Agency (EPA) to G.W.-P. (Stanford University) and S.-H. Cho (RTI International). This World View has not been formally reviewed by the EPA. The views expressed in this document are solely those of G.W.-P. and do not necessarily reflect those of the agency. The EPA does not endorse any products or commercial services mentioned in this World View. OCOB is also supported by a National Science Foundation CAREER award (SES-2045129), Stanford Center for Population Health Sciences award and United States Parcel Service Endowment Fund at Stanford award to G.W.-P., and by a Stanford Impact Labs award to J. Suckale.

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Effective engagement and involvement with community stakeholders in the co-production of global health research

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• Correction for vol. 372, p. - March 10, 2021
• Doreen Tembo , senior research manager patient and public involvement and external review 1 ,
• Gary Hickey , senior public involvement manager 1 2 ,
• Cristian Montenegro , assistant professor 3 ,
• David Chandler , chief executive 4 ,
• Erica Nelson , research fellow 5 ,
• Katie Porter , assistant research manager, patient and public involvement 1 ,
• Lisa Dikomitis , professor of anthropology and sociology of health 6 ,
• Mary Chambers , head of public engagement with science 7 8 ,
• Moses Chimbari , professor of public health 9 ,
• Noni Mumba , head of community engagement 10 ,
• Peter Beresford , emeritus professor of citizen participation 11 ,
• Peter O Ekiikina , public contributor low and middle income countries 12 ,
• Rosemary Musesengwa , senior researcher 13 ,
• Sophie Staniszewska , professor of health research (patient and public involvement and experiences of care) 14 ,
• Tina Coldham , public adviser and research fellow 15 16 ,
• Una Rennard , public contributor to health and social care research 17
• 1 Wessex Institute, Faculty of Medicine, University of Southampton, Southampton, UK
• 2 School of Health Sciences, University of Brighton, Brighton, UK
• 3 School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
• 4 The Psoriasis and Psoriatic Arthritis Alliance, St Albans, Hertfordshire, UK
• 5 London School of Hygiene and Tropical Medicine, London, UK
• 6 School of Medicine, Keele University, Staffordshire, UK
• 7 Oxford University Clinical Research Unit, Vietnam
• 8 Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK
• 9 University of KwaZulu-Natal, School of Nursing and Public Health, South Africa
• 10 KEMRI Wellcome Trust Research Programme, Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Kenya
• 11 School of Health and Social Care, University of Essex, Colchester, UK
• 12 Foundation for Open Development, Tororo, Uganda
• 13 Department of Psychiatry, University of Oxford, Oxford, UK
• 14 Warwick Medical School, Division of Health Sciences, University of Warwick, Coventry, UK
• 15 National Institute for Health Research Centre for Engagement and Dissemination, London, UK
• 16 School for Social Care Research, National Institute for Health Research, London, UK
• 17 Oxfordshire, UK
• Correspondence to: D Tembo d.tembo{at}soton.ac.uk

Doreen Tembo and colleagues argue that small changes as well as larger system-wide changes can strengthen citizens’ contribution to knowledge in health research

Involving a broad range of individual and collective perspectives in global health research outside of academic research is gaining increasing recognition as a mechanism for achieving a greater impact. This activity goes by many names ( box 1 ). In the global north or a high income country, it is commonly called “patient and public involvement,” “engagement,” or “participation.” In low and middle income countries or the global south, these participatory processes are termed “community engagement,” “participation,” and “community engagement and involvement.” 1 2 3 Co-production, a core feature of community engagement and involvement, is common to health research in both the global north and south, with a range of potential benefits. It helps to ensure that health research contributes to building knowledge and generating innovations that benefit users of research. 4 For research that drives change and reduces the waste of resources, 5 co-production should start from the earliest stages, when problems are identified and priorities defined. 6 Such an approach supports research that is ethical, specific, and appropriate to the local community. 7 8 9 10 11 12 Involvement of end users in the design of projects has also been shown to improve recruitment of participants and research methods, making implementation and the impact of the research results more likely. 9 13

Terminology for partnering with communities

Many terms are used to describe how researchers form partnerships with non-academic communities. The lack of universally agreed and defined terms can lead to a lack of clarity about shared values and scope of activities, and relevance to other researchers and communities. It can also hamper discovery and synthesis of evidence from the literature.

The UK National Institute for Health Research (NIHR) distinguishes between terminologies by defining involvement as an active partnership with patients and the public, participation as participants providing data for research, and engagement as researchers sharing research outputs with stakeholders, including patients. 14 Internationally these terms are generally used interchangeably, and other terms, such as user or consumer involvement and citizen participation , are also used. In the context of global health, community engagement encompasses many different levels of the consultation-collaboration/partnership/co-production-control continuum of involvement. 15 Organisations such as Unicef, however, use the term community participation in a similar way to patient and public involvement, to indicate a more active form of partnership with communities. 16 The NIHR has adopted the term community engagement and involvement to encompass the full spectrum and levels of partnership with communities. 2

Various challenges exist to the effective adoption of co-production in global health research. 17 18 There can be no one size fits all approach. Nevertheless, there are some common challenges and enablers related to citizen centred co-production. These barriers and facilitators when co-producing research, centre on problems of politics, finance and resourcing, access and inclusion, relationship building, and community disengagement ( table 1 ). We will refer to these challenges and enablers when we discuss the co-production principles in the following section.

Practical elements to consider when co-producing research

• View inline

The UK National Institute for Health Research (NIHR) co-production guidance and the closely related Unicef Minimum Standards for Community Engagement 16 19 ( table 2 ) provide best practice guidance for research teams to navigate these key common challenges and enablers. In addition to step changes, which can be made by adopting the principles of power sharing, building relationships, acknowledging diverse perspectives, reciprocity, and respecting different knowledge bases, structural changes are also needed to better embed co-production in global health research.

Principles and minimum standards for co-production in research

Sharing power

Sharing power is a key facet of co-production ( table 2 ). Global health research is shaped by power asymmetries or imbalances between funding bodies, research institutions, professional bodies, policy makers, and communities. 20 The exercise of power often depends on who has the resources, the decision making power, and knowledge. These power dynamics and inequalities depend on whose knowledge is valued in interactions both within research teams, and between those teams and the communities with whom they engage. 21 22 A co-production framework seeks to redistribute knowledge based power and replace it with mutual learning between all participants in a collaboration.

Because such approaches to research are still new and may cause uneasiness among both researchers and communities, it is the responsibility of research teams to create mutual adaptive learning processes, thus allowing research questions and designs or plans to be amended. Such changes depend on emerging learning and skills building, and ensure researchers include divergent perspectives in their research. 23 Communities, on the other hand, can act alone by using existing constitutional and institutional structures to lobby for more power and influence within the co-production processes. 24 When such structures do not exist, or when there is political interference, researchers can work with local leaders and political stakeholders to identify and build on local priorities. The Sonagachi project in Kolkata, India is a good example of aligning project priorities with the priorities of those in power (local politicians) and involving local gatekeepers as project team members, to access, involve, and ultimately empower marginalised female sex workers. 25

Some funders and organisations, such as the Canadian International Development Research Centre and the UK NIHR, use mechanisms to level out power differentials in global health research. Their methods include supporting communities and civil society, such as non-governmental, user led, or community based organisations, by providing flexible budgets or funding, which communities and user groups can use to ensure culturally appropriate and user led research design and practice. The World Health Organization special programme for research and training in tropical diseases Malaria and Bilharzia in Southern Africa (Mabisa) study, for example, demonstrates how communities were encouraged to set up community advisory boards, which were given funding to cover research costs for community engagement. 25

Building and maintaining relationships

Building relationships of trust with communities is a time, resource, and labour intensive process. 26 27 Key facets of building sustainability and trust include establishing responsive mutual communication with communities and building capacity for research by encouraging participatory approaches, such as citizen science. An example of a programme which builds local research and community capacity is the Kenya Medical Research Institute Wellcome Trust research programme in Kilifi, which works to build up familiarity with research in the surrounding communities, and involve them in various projects. 28

Much research funding is limited to five years or less, resulting in involvement of communities on a project by project basis instead of developing long term relationships with researchers. Encounters are often transactional and focus on getting a project completed. Such short term interactions, especially if there is no lasting benefit to the community, can be counterproductive or exploitative, 29 leading to community disengagement, especially if researchers do not share their results. 30 31 Future researchers wishing to engage these communities will need to determine why they are disengaged and work with them to develop joint research.

Although some research centres in the UK successfully build relationships with communities, it is more usual for researchers to recruit a small group of people who can provide insights from their own experience. 32 33 34 When views of the community are sought, a representative from a civil society organisation is sometimes involved. This approach saves time and cost, but presents only one perspective on research. 35 When such a representative is necessary—for example, on a funding or ethics committee, it is crucial to ensure that the concerns of marginalised groups are included, by regular meetings with them. For example, the NIHR piloted a community of practice of public members who discussed what research should be prioritised, with a rotating representative from this community attending the prioritisation committee. The pilot was evaluated by NIHR and learning was shared and discussed with the community of practice members.

Research organisations have a key role in ensuring that the development of relationships with communities, and civil society organisations more broadly, becomes a valued, and professionally rewarded academic activity. 36 37 For example, some universities have introduced community engagement and involvement as a criterion for career progression. 38 Effective communication of opportunities for community members to learn more about research into their health condition, and building their research and professional skills, contributes to community engagement.

Including all perspectives and skills

A major concern for health research is that educated older, often retired, middle class individuals, or more organised groups are most likely to be involved. Co-production becomes more inclusive when a plan is established for dealing with communities in culturally acceptable ways, taking into account local needs and capabilities. The research team needs to identify and communicate with all relevant stakeholders, including vulnerable and marginalised groups. 39 Such approaches will minimise resistance, distrust, and unrealistic expectations from the community.

A specialist with knowledge of co-production processes will always be needed within health research teams. Many funders advocate transdisciplinary research teams so that together with the usual disciplines, such as clinical or public health research, epidemiology, health economics, and statistics, a broader range of social sciences, humanities, non-academic disciplines, and communities are also included. 40 For example, the research team for the Malaria and Bilharzia in Southern Africa (Mabisa) study had diverse disciplinary backgrounds, including non-academic members. Community members used their knowledge of the local area to assist scientists in generating sophisticated maps, which acted as a starting point for designing environmental adaptation strategies for reducing vulnerabilities to vectorborne diseases. 40 The inclusion of such expertise will ensure that the cultural and societal factors that might influence the (dis)engagement of communities are taken into account. Nevertheless, to ensure culturally appropriate community engagement, all members of a research team should be trained to carry this out.

Researchers need to be mindful of the jargon sometimes used in academia and health and how it can create barriers to collaboration. Meeting places that are welcoming to all should be used. Community members might not feel comfortable meeting in institutional environments, which might exacerbate the power imbalance between communities and academics or professionals. A positive consequence of the current coronavirus pandemic has been “digital democratisation”—the ability to allow people to co-produce research regardless of location, albeit subject to the availability of equipment and connectivity. That said, we also recognise that some people are digitally excluded, and researchers need to find ways of bridging this divide.

Reciprocity and respecting and valuing different knowledge bases

Reciprocity is essential to co-produced research. 41 Funders of global health research need to reconsider the rewards and impact of co-production. 37 42 Communities which devote their time, effort, and knowledge to shaping a research study should determine what benefits they receive and should be empowered by the processes. For example, benefits that empower communities might range from remuneration, skills training with certificates, access to research institution facilities, learning more about research and particular health conditions, and networking. The community can also be involved in determining what outputs of research are produced. Thus, the community might favour dissemination through methods such as plays, puppet shows, or comics, rather than purely through peer reviewed papers. The Planet DIVOC-91 comic is a key example of how the researchers worked with youth and other community stakeholders in low and middle income countries to provide information about covid-19 and research. 43

Methodological hierarchies in global health research tend to favour quantitative rather than qualitative approaches, and yet it is qualitative approaches that often are used. 44 45 Furthermore, experiential knowledge continues to be considered anecdotal, while the values of expert knowledge are increased within health research. Research teams need to place equal value on different types of knowledge, particularly the lived experiences and contextually specific knowledge of community partners. 37

The funders of most global health research do not yet mandate community engagement and involvement, despite the plethora of guidance to enable researchers to achieve co-production. 46 47 A number of funders, including NIHR, insist on community engagement and involvement in research proposals and consider it a key criterion for funding. This approach might lead to a generational shift in the global health sector, making co-production the norm.

Where we can go from here: recommendations for action

Radical action is needed to embed co-production. It is worrying that during the current pandemic, the level of community engagement and involvement has reduced despite clear guidance on how to carry out ethical and valuable work in an emergency. 48 49 This illustrates the tenuous position of co-production. 50 Within emergency responses, co-production can be achieved by setting up rapid response community panels, strengthening existing community relationships, and developing contingency plans for alternative methods of engagement during future outbreaks.

By expanding current practice and recognising the fundamental change in research culture that is required, leaders, funders, and institutions can do much to raise the profile, and demonstrate the effect, of co-production. They can recommend, or even better, mandate co-production of research, and develop mechanisms to make funding directly available to civil sector organisations. 51 As discussed, reward mechanisms should be determined together with communities, and research ethics frameworks need to be more flexible to allow communities to be fairly paid for their involvement.

Funders and researchers also need to ensure that research priorities are determined with or by communities, are culturally appropriate and adapted to local settings, and that a wide range of community members are involved throughout the research process. Figure 1 , adapted from an NIHR course for public reviewing, 52 shows the various stages in the research process, from identifying and prioritising research through to monitoring and evaluating research, and the ways in which communities can be involved at each stage.

Points of influence for co-production

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Academic journals can follow the lead of The BMJ , the NIHR Journals Library, and others, which require reporting on patient and public involvement. Journals could encourage the publication of research results on co-production, including the use of new methodological approaches, or by encouraging co-authorship by non-academic community members.

To achieve change, we need to think internationally about how the quality of research in universities and in health ecosystems in the global north and south is assessed. In the UK, the Research Excellence Framework is the mechanism whereby the impact of universities’ research is assessed, forming the basis for the allocation of funding. 53 This framework could incorporate a mechanism that values and rewards the outputs of co-production (for example, the total number of peer reviewed articles that are single authorship or lead authored with community partners; evaluating how the research contributed to strengthening local community participation, skills building, research literacy, or creative engagement) and measures the effect of research on people’s lives.

Universities can better align their reward and recognition mechanisms to encourage co-production. Academia and research funders also need to value transdisciplinary and team science, and the inclusion of skills that foster co-production. The curriculums for research methods need to embed the development of knowledge and skills for co-production.

Currently, government use of science and evidence in responding to the pandemic, and the spread of disinformation and mistrust, is being debated globally. 54 Citizens and communities increasingly disseminate knowledge. On the one hand, the pandemic has uncovered underlying systemic health and socioeconomic inequities and, on the other, created a new set of possibilities for global health research that decentralises power and values co-production.

Key messages

Co-production of research is key to achieving more equal relationships in global health research and to delivering positive benefits to a wide range of stakeholders

Co-production requires investment in time and resources and a commitment to building trust between researchers and communities

To deal with the power imbalance between researchers and communities, and within research collaborations, it is important to include experiential knowledge and participatory methodologies

Global health research funders and institutions based in the global north can better support co-production by embedding best practices in their funding criteria and systems for career progression and reward

Acknowledgments

We thank the UK National Institute for Health Research (NIHR) and Department of Health and Social Care staff who provided input into the paper based on their personal views. These included Katalin Torok, senior research manager for patient and public involvement and engagement, UK NIHR; Patrick Wilson, head of global health communications and stakeholder engagement, UK NIHR; and Aaronjay Tidball, global health research programme officer, science, research and evidence directorate, Department of Health and Social Care, UK). We are also grateful to Pippa Coutts, policy and development manager, Carnegie Trust, UK, who was also involved in the roundtable discussion which informs this paper. The roundtable focused on approaches and challenges when engaging end users in the co-production of global health research.

Contributors and sources:DT and GH co-wrote the article, and collaborated on the production of the UK NIHR guidance on co-producing a research project, and practical resources demonstrating how research can be co-produced. DT and GH have facilitated several co-production events, which have all involved public contributors. The paper draws on the discussions at these co-production events and the expert and experiential knowledge of all the authors, who also participated in these events. All authors contributed to, and commented on, this article.

Competing interests: We have read and understood BMJ policy on declaration of interests and declare: SS sits on the editorial board of this series of articles on co-production of knowledge in health research. She is part funded by NIHR Applied Research Collaboration, West Midlands; NIHR Health Protection Research Unit in gastrointestinal infections; and NIHR Health Protection Research Unit in genomics and enabling data. SS will not be involved in the editorial processes for this paper.

Patient and public involvement: Patients and members of the public have been involved in two roundtable events and in a conference that discussed co-production enablers and barriers from which we draw the data for this article. PB, DC, TC, and UR provide patient, public, and community voices from a high income country and POE from a low and middle income country. They were invited based on their history of involvement in health and social care research, and PE, for his involvement in development work in low and middle income countries. TC is a co-author of the NIHR guidelines on co-production.

Provenance and peer review: Commissioned; externally peer reviewed.

This article is part of a series produced in conjunction with WHO and the Alliance for Health Policy Systems and Research with funding from the Doris Duke Charitable Foundation. The BMJ peer reviewed, edited, and made the decision to publish.

This is an Open Access article distributed under the terms of the Creative Commons Attribution IGO License (https://creativecommons.org/licenses/by-nc/3.0/igo/), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited.

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Article Contents

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Alan Barr, The contribution of research to community development, Community Development Journal , Volume 40, Issue 4, October 2005, Pages 453–458, https://doi.org/10.1093/cdj/bsi091

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In this article I consider the relationship between different types and methods of conducting research in the context of community development. In particular I will consider the degree to which different approaches contribute to core objectives of community development to empower communities and promote social justice by engaging the most excluded. The contents will draw on a dialogue within my own agency, the Scottish Community Development Centre (SCDC).

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How to Engage Communities in Research

• First Online: 01 January 2020

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• Emmanuel M. Ngui 2  

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Interest in community engagement has grown enormously over the past several decades. Although community-engaged scholarly work does not get the priority it deserves, it is increasingly being embraced by academic and funding institutions. Community engagement, however, remains a challenge for many academics, especially those who work in cross-cultural settings or with marginalized populations. This chapter examines the concept of community engagement and its complexities and describes some frameworks of community engagement and how academics can engage communities in research. It concludes with a brief overview of key ingredients and ethical considerations in the community engagement process.

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Main Issues and Perspectives: An Introduction

Balancing Research Expectations with Community Realities

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Ngui, E.M. (2020). How to Engage Communities in Research. In: Roberts, L. (eds) Roberts Academic Medicine Handbook. Springer, Cham. https://doi.org/10.1007/978-3-030-31957-1_38

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• Section 15. Qualitative Methods to Assess Community Issues

Chapter 3 Sections

• Section 1. Developing a Plan for Assessing Local Needs and Resources
• Section 2. Understanding and Describing the Community
• Section 3. Conducting Public Forums and Listening Sessions
• Section 4. Collecting Information About the Problem
• Section 5. Analyzing Community Problems
• Section 6. Conducting Focus Groups
• Section 7. Conducting Needs Assessment Surveys
• Section 8. Identifying Community Assets and Resources
• Section 9. Developing Baseline Measures
• Section 10. Conducting Concerns Surveys
• Section 11. Determining Service Utilization
• Section 12. Conducting Interviews
• Section 13. Conducting Surveys
• Section 14. SWOT Analysis: Strengths, Weaknesses, Opportunities, and Threats
• Section 16. Geographic Information Systems: Tools for Community Mapping
• Section 17. Leading a Community Dialogue on Building a Healthy Community
• Section 18. Creating and Using Community Report Cards
• Section 19. Using Public Records and Archival Data
• Section 20. Implementing Photovoice in Your Community
• Section 21. Windshield and Walking Surveys
• Section 22. Using Small Area Analysis to Uncover Disparities
• Section 23. Developing and Using Criteria and Processes to Set Priorities
• Section 24. Arranging Assessments That Span Jurisdictions
• Main Section

What are qualitative methods of assessment?

Why use qualitative methods of assessment, when would you use qualitative methods of assessment, how do you use qualitative methods of assessment.

Using qualitative assessment methods rather than purely data-based information is crucial to understanding many community issues and needs. Numbers work well to show comparisons, progress, an statistics of community efforts, but they cannot express motives, opinions, feelings, or relationships. This section discusses how to use qualitative assessment methods and when to implement them into communtiy planning.

Qualitative methods of assessment are ways of gathering information that yield results that can’t easily be measured by or translated into numbers. They are often used when you need the subtleties behind the numbers – the feelings, small actions, or pieces of community history that affect the current situation. They acknowledge the fact that experience is subjective – that it is filtered through the perceptions and world views of the people undergoing it – and that it’s important to understand those perceptions and world views.

There are two major scientific ways of gathering information: quantitative methods and qualitative methods. Quantitative methods are those that express their results in numbers. They tend to answer questions like “How many?” or “How much?” or “How often?” When they’re used to compare things – the results of community programs, the effects of an economic development effort, or attitudes about a community issue – they do it by subjecting all of the things or people they’re comparing to exactly the same tests or to the same questions whose answers can be translated into numbers. That way, they can compare apples to apples – everything or everyone is measured by the same standard. Quantitative measures are often demanded by policy makers; they are considered trustworthy because their results can be measured against one another, and because they leave less room for bias.

Qualitative methods don’t yield numerical results in themselves. They may involve asking people for “essay” answers about often-complex issues, or observing interactions in complex situations. When you ask a lot of people for their reactions to or explanations of a community issue, you’re likely to get a lot of different answers. When you observe a complex situation, you may see a number of different aspects of it, and a number of ways in which it could be interpreted. You’re not only not comparing apples to apples, you may be comparing apples to bulldozers or waterfalls. As a result, researchers and policymakers sometimes see qualitative methods as less accurate and less legitimate than quantitative ones. That can be true, but, as we’ll see, if qualitative methods are used with care, they can also yield reliable information.

Qualitative and quantitative methods are, in fact, complementary. Each has strengths and weaknesses that the other doesn’t, and together, they can present a clearer picture of the situation than either would alone. Often, the most accurate information is obtained when several varieties of each method are used. That’s not always possible, but when it is, it can yield the best results.

There are a number of qualitative methods that can be used in assessment of issues or community needs. We’ll list the major ones here, and look at them in more detail later in the section.

They include:

• Individual interviews . These may be structured interviews, where the questions are determined beforehand, or unstructured conversations that are allowed to range wherever the interviewee wants to go in relation to the general topic. Even in structured interviews, there may be room for both interviewers and interviewees to pursue topics that don’t relate directly to answering the original questions. The difference, however, is that in a structured interview, all those questions are formally asked, and the interviewer does her best to make sure they’re answered.
• Group interviews . These are similar to individual interviews, but involve two or more interviewees at a time, rather than one. (Sometimes, these are unexpected – the interviewee’s mother and sister are present, and insist on being part of the conversation.) Group interviews have some advantages, in that interviewees can act as a check on one another (I remember that happening in a different way…), and stimulate one another’s thinking. At the same time, the interviewer has to be somewhat of a facilitator, making sure that no one person dominates, and that everyone gets a reasonable chance to speak.

A special case of group interviewing is a focus group . This is a group of about 6-10 people, led by a trained facilitator, assembled to answer a specific question or questions. An effort is sometimes made to make sure that group members don’t know one another, so that social pressures won’t influence them. If trained facilitators are available, focus groups can be a good way to get accurate information about an issue.

• Observation . Here, someone actually goes and looks at a place or event, watches situations or interactions, or takes part in the life of the community or a population while recording what he finds as a result.
• Community or other large meetings . These meetings allow a range of people a chance to express their opinions and react to others’. They can draw on a large pool of opinions and knowledge at one time, and uncover disagreements or differences that can then be discussed.
• Interpretation of records, transcripts, etc. This can range from qualitative analysis of quantitative data (like the assumption of the researcher in the introduction to this section that people who are doing well won’t be interested in an adult education program), to using quantitative data as a jumping-off point for qualitative assessment, to case studies (detailed examinations of individual cases). The last are not always useful in assessing community issues or needs, but they can be very effective in convincing policymakers or funders of the importance of those issues and needs.

Many types of qualitative information are turned into numerical results, although not always accurately. The transformation may miss important details, or the information may simply be too complex to fit easily into numerical constraints, unless you can create a computer model or similar number-based framework that has the capacity to take in an enormous amount of variety. There are many software programs – NVivo and Atlas.ti are fairly well-known, but there are many others, including some freeware – that are intended expressly for analyzing qualitative data.

Since qualitative methods give you results that are not always easy to compare, or even to check for accuracy, people who want hard and fast evidence often see them as suspect. In fact, both quantitative and qualitative measures are important and necessary, depending on the situation. When you’re assessing community issues, as we’ve discussed, you’ll often get closest to the complete picture by using both. The problem is convincing those who need to be convinced – policymakers, funders, etc. – that your qualitative measures are reliable.

There is a debate in the research community about how to judge qualitative methods. Some say they should be evaluated by the same standards as quantitative methods. Others maintain that, because they are intrinsically different from quantitative methods, qualitative methods need a set of standards that take into account their philosophical base and the kind of information they yield.

The British government, for instance, has developed a framework for demonstrating qualitative reliability, which includes a set of 18 questions that a qualitative assessment or study should be subjected to (see Tool #1 ).

Guidelines that can help you argue for the reliability of your qualitative assessment include:

• Report accurately and completely . Whether you’re interviewing, observing, or engaging in some other technique, you should faithfully record such details as the time and place of your activity, who was involved, what the situation was, etc. In that way, you can see similarities and differences, and make comparisons where they’re appropriate. The recording of interviews, observations, and other information should be as accurate and nearly complete as possible (e.g., word-for-word for interviews).
• Frame the right questions, and direct them appropriately . Occasionally, it works to go fishing for information, i.e. to start without any idea of what you want to find out In most instances, however, you should know what the important questions are, and where you need to look for answers. The clearer you can be – and the clearer it is that the questions you’re asking will lead to real understanding and effective action – the more credibility your inquiry will have.
• Use qualitative methods specifically to gain information you can’t easily get from quantitative methods . You can quantify how many members of a specific minority live in a particular neighborhood. It’s much harder to quantify a clear understanding of how well they get along with their neighbors, and why.
• Use the method(s) that can best help you answer the questions you’re asking . If you want to know the state of vacant lots in a city, you’re less likely to determine it by asking people than you are by going and looking at the lots themselves. On the other hand, you usually can gain more information about people’s opinions through talking to them than you can from observation.
• Sort out your own and others’ subjective feelings and comments from objective reality, and try to make sure that your findings are objective . It’s easy to get caught up in the passion of interviewees’ opinions, or in your own response to particular conditions. If you want your findings to be reliable, you have to screen out as much of the subjective as possible from what you find and record. (One way to approach this issue is to have more than one person record and analyze each interview or observation, and then to check on how well they agree, both in their recording of the data and in their interpretation.)

Something that’s objective – an observation, statement, opinion, research finding, etc. – is based on reality as it actually is. Scientists, for instance, aim to be objective, and to understand the way things really are, rather than the way the scientists or others want them to be, or think they might be. A subjective observation, statement, opinion, or research finding, on the other hand, is based on the thoughts and assumptions of the person issuing it. A researcher may be so appalled by the conditions in neighborhoods where violence is rampant that she may begin to feel that violence is in fact the only rational response, and slant her research in that direction. Especially in community assessment, objectivity is vitally important. Objectivity in looking at the community will help you understand how to most effectively address issues, maximize and use assets, and solve problems. Understanding your own subjective reactions – to difficult conditions, to particular individuals, to cultural practices – will help you to screen them out, thereby increasing the reliability of your findings.

The basic reason to use qualitative methods is that there are some kinds of questions and some dimensions of community assessment that can be better addressed by them than by quantitative methods. The methods you use should be determined by the questions you’re asking. Since it may be hard to convince policymakers and others that qualitative methods are useful, however, why bother to use them at all? Some of the major reasons:

• They answer some questions that quantitative measures can’t. Quantitative methods may tell you how many people do a certain thing, but they’re unlikely to tell you how or why they do it. Qualitative methods can better answer the how and why questions, and also provide other information in the process.
• They connect directly with the population and the community with which you’re concerned. In assessment, the best sources of information are those closest to what’s being assessed: they experience it more than anyone else. Qualitative methods generally go directly to those sources with more complex questions than quantitative methods.
• They can get at certain underlying realities of the situation. Once again, quantitative methods often don’t answer “why?” questions, while qualitative methods can tell you about the history of the community or issue, who the significant supporters and opponents of various ideas are, whom people in the community listen to, etc. In an assessment situation, these can be crucial pieces of information.
• They can involve the population of interest, or the community at large, in helping to assess the issues and needs of the community. This participation fosters a sense of ownership and support for the efforts.
• They often allow for a deeper examination of the situation or the community than quantitative methods do. Quantitative methods, although helpful, can tend to put people or events in specific categories, ask for yes-no or multiple-choice answers, often eliminating complexity. Qualitative methods allow for following promising directions (“Why do you say that?”), and can lead to the discovery of important information that quantitative results wouldn’t have touched on.
• They allow for the human factor. While the information obtained through qualitative methods is often subjective, it is also often identified as such, and can be analyzed accordingly.

Clearly, there are times when quantitative research will give you the information you need. So when do you use qualitative methods? It depends to a great extent on the question you’re asking. (The first four situations below are based on a USAID guide to using rapid appraisal methods, Performance Monitoring and Evaluation Tips .)

• When what you need is qualitative, descriptive information . Particularly in an assessment situation, what you’re often looking for is descriptive or analytical information that has little to do with quantitative measures. The type of information provided by qualitative methods is often exactly what you’re looking for in community assessment to decide on next steps.
• When you’re trying to understand the reasons and motivations for people’s behavior, or how they operate in particular situations . Why don’t people take advantage of human service programs for which they’re eligible? What are the differences in the ways people of different cultural backgrounds respond to services? These are the kinds of questions you’re likely to want to answer in a community assessment, and they often can’t be answered quantitatively.
• When you’re analyzing quantitative data. As mentioned above, much quantitative data can be analyzed using qualitative methods.

An odd set of numbers – a community that’s decidedly low-income, but where a vast majority of people own their own homes, for instance – might be the springboard for a qualitative examination of why this is so. A number of reasons are possible: The community is largely elderly, and people are living in long-since-paid-for houses they bought 40 or more years ago, when their income was higher and housing was less expensive. One or more local banks have made it a priority to help people buy houses, and provide low-interest mortgages and other subsidy programs to further that goal. While they may be low-income, the members of the community nonetheless scrimp on everything else in order to put away money for a house. This is often the case among immigrants from certain cultures, where people are willing to live very simply for many years in order to save for property and education. The community has been “written off” because of its substandard housing, dangerous streets, and lack of services, and houses as a result are ridiculously cheap. A combination of factors, some of which may not be listed here. By and large, quantitative methods won’t easily tell you the reasons for this unusual situation, but qualitative methods will.

• When you’re trying to develop suggestions and recommendations . Again, this is often the primary purpose of community assessment. How should you design a program or initiative to accomplish a major community goal or deal with an issue? What will people respond to? Qualitative data may give the best information here, or may be used in addition to qualitative information to provide a complete picture on which to base your strategy.
• When you want to involve the community in assessment as directly as possible . Involving community members directly leads to ownership and support of initiatives, and is also likely to generate the best and most effective solutions. Qualitative assessment methods, for the most part, collect information directly from community members themselves, and allow them to fill in the details as much as they can. By and large, being interviewed is more likely to leave someone feeling like part of the process than filling out a survey.
• When you’re doing community-based participatory research (i.e., involving the community directly in planning and implementing assessment). Community-based participatory research often relies greatly on qualitative assessment methods.
• When quantitative data are unavailable or unobtainable.
• When you don’t have the capacity to use quantitative methods . You may not have the proper training, the software or hardware that will make quantitative assessment useful for you, or the time to use quantitative methods properly.

Now that you’re convinced of the importance of using qualitative methods of assessment, how are you going to do it? There’s seldom one right way to do anything, but we’ll offer some steps to take in using qualitative methods, including some guidelines for doing interviews and observations, the two most common methods. (Most of these guidelines hold equally for using quantitative methods as well.)

Start by deciding what it is you want to know.

You may remember that this is also one of the guidelines for qualitative reliability. It may seem elementary, but it doesn’t happen anywhere near as often as it ought to. The importance of deciding what you want to know is that it determines the character of your assessment – what kinds of questions you ask, whom you ask them of, how you’ll go about it, etc. Without that minimal amount of structure, you’re likely to wind up with a confused and unorganized mass of information.

There are many ways to approach a community assessment, and, consequently, many questions you might choose to start your assessment with. You might even use more than one, but it’s important to be clear about exactly what you’re looking for.

Some possibilities:

• What is the most serious issue – either general or specific – the community faces (i.e., what should we turn our attention to?
• What services are most needed in the community? Who most needs them?
• Are people taking advantage of services that currently exist?
• What are the community’s significant assets? How can they be strengthened?
• Are there forces working against the good of the community that should be opposed? (You probably wouldn’t be asking this question unless you thought there were, and had some idea who or what they might be.)
• Who ought to be involved in a prospective coalition or initiative?

Choose the method best suited to finding the information you’re looking for.

If you want to learn about people’s public behavior, you would probably use direct observation. Observing mothers and children in a clinic waiting room, for example, might give you information about the mothers’ anxiety levels or child-rearing practices.

If you want to know people’s opinions or how they feel about issues, some type of interview would be appropriate.

Once you’ve chosen the right method, it’s important to carry it out properly. Be aware of what you can do with the resources you have. You can’t conduct thousands of interviews in a large city, for instance, without considerable money. If you’re a cash-strapped nonprofit, you might look for a grant to fund your interviews, or you might confine your assessment to one neighborhood. Perhaps you’d mobilize volunteers to conduct interviews, or interview groups rather than individuals. It’s better to do a limited community assessment well than a large one badly. In choosing your method, be aware also that, in some cases, quantitative methods may be more appropriate and more likely to tell you what you want to know.

Choose the people who will gather the information, and, if necessary, train them.

With qualitative methods, where contact is often personal, the question of who carries them out can be very important. Academics or others who are perceived by community members as “the other,” whether because of their behavior, their speech, or simply because they’re outsiders, may find it hard to gather accurate and complete information from a population that’s very conscious of class or cultural differences. Often, it makes more sense to train members of the population or others who are known and trusted by – or at least familiar to, in their behavior, dress, and speech –those who are being asked to contribute their opinions and observations.

Data collectors should be fluent in the language and culture of those they are interviewing. If you’re assessing commercial activity in a Hispanic neighborhood, you’ll miss most of what’s really happening unless you understand both the Spanish language and the normal ways in which Hispanic (or Dominican or Mexican or Puerto Rican) customers and merchants relate to one another.

If you recruit members of the community or of a specific population to do qualitative information gathering – because they relate to the population better, because they speak the language, because you’re engaged in a participatory effort, or simply because you think they’ll be good at it – you should provide them with training to make sure that the results they come up with are reliable. Depending on what kinds of methods they’ll be using, some of the elements of a training might be:

• What to record and how : It may not be obvious how important it is to record the time, place, details, and circumstances of an interview, observation, focus group, or larger meeting It may also be necessary, depending on a trainee’s experience, to learn to use a recorder or video camera, and/or to learn how to take efficient notes without losing the thread of the conversation or missing important points in an observation.
• Interview techniques , as well as exactly what purpose an interview serves, and how it fits into the larger assessment picture. The more clearly an interviewer understands not just what to do and how, but why she’s doing it, the better she’s likely to be at drawing out the information she’s seeking.
• Observation techniques : As with an interview, an observation will be far more useful if the observer understands not just what to do and how to do it, but exactly why he’s doing it, and how it will be used.
• Training in other methods : Focus groups, for instance, require specific skills and techniques.
• Training in how to think of themselves as researchers : Like those engaged in community-based participatory research , information gatherers should understand how researchers operate. Objectivity, attention to detail, curiosity, and the continuous processing of information in order to generate the next question or observation are all part of the investigative mindset, which they should be encouraged to develop.

Determine from whom or from where you need to gather information.

It may be that you want to hear from all sectors of the community, but some issues or circumstances demand more specific informants. Some possible interview subjects may be public officials, members of a specific population or cultural group, people from a particular geographic area, or people with certain characteristics (parents of young children, individuals with disabilities, males 18-24, people with high blood pressure).

Knowing whom you need to ask extends to any method in which you talk directly to people – focus groups, large community meetings, etc. Focus groups used by marketers are chosen extremely carefully, for example, with age, gender, income, place of residence, and even such factors as favored leisure activities considered.

Observation may or may not involve people. If it does, the question may not be whom you want to observe, but rather what activity or situation you want to observe. If it’s general – what kinds of street activity take place in various neighborhoods, how people use a public park – it’s not necessary to focus on a particular population, but rather on the place. If it’s more specific – back to commercial activity in that Hispanic neighborhood – you’ll need to be in the right place at the right time.

Gather the information.

Now it’s time for you or the people you’ve chosen to go out and collect the qualitative information you need.

As mentioned above, interviews can be structured or unstructured. In a strictly structured interview, the same questions in the same order are asked of everyone, with relatively little room for wandering off the specific topic. Semi-structured interviews may also be based on a list of specific questions, but – while trying to make sure that the interviewee answers all of them – the interviewer may pursue interesting avenues, or encourage the interviewee to talk about other related issues. An unstructured interview is likely to be more relaxed – more like a conversation than a formal interview.

There are advantages and disadvantages to each approach. A structured interview may make the interviewee focus in on the questions and the interview process, take it more seriously, and thus provide excellent information. Because everyone is interviewed in the same way, a structured interview may be – or at least may look – reliable. It may also make an interviewee nervous, emphasize the differences between him and the interviewer, and lead to incomplete or less-than-truthful answers.

A semi- or unstructured interview may allow the interviewee to be more relaxed, and thus more forthcoming. It also leaves room for pursuing a topic that’s not directly related to the formal list of questions, but that might be important or even crucial. At the same time, because it can be far-ranging, a semi- or unstructured interview – particularly one that doesn’t start with a list of questions – is, or appears, less reliable than a structured one. It also, in the hands of an inexperienced or indecisive interviewer, may allow an interviewee to get sidetracked and never get back to the original questions.

What kind of interview you use depends on the nature of the information you’re looking for, the needs of the people you’re interviewing (e.g., whether comfort is more important than structure), and your own comfort. The author has conducted all three types of interviews, and has found that semi-structured interviews – having clear questions and goals for the interview, but conducting it in an informal way, with room for pursuing tangents and some simple friendly conversation – is generally productive. The following guidelines for interviewing reflect that view.

• Ask the interviewee to choose the space . You might give him a range of suggestions – his home or workplace, the office of a human service agency, a neutral space, such as a café or a park – and go with his choice. The more comfortable he is, the better and more informative the interview is likely to be.
• Choose your clothes for the comfort of the interviewee . In general, your clothes and hers should be similar: if she’s in jeans and a t-shirt, you shouldn’t be in a suit; if you’re interviewing a business executive at her office, you should be wearing a suit. Clothes send powerful messages, and the message you should be sending here is “We’re from the same planet; you can talk to me.”
• Talk beforehand with the interviewee if you’re planning to record or photograph the interview . Get permission before you show up with equipment It’s common courtesy, and it’s less likely to start the interview off awkwardly .

If the results of the interview are likely to be published, even if the interviewee will be anonymous, you might want to get a signed “informed consent” form, indicating that the interviewee understands the purpose of the interview, and gives permission for the material to be published or used in other ways.

• Record carefully the time, place, circumstances, and details of the interview . This includes a description of the location (the neighborhood as well as the space, if you’re interviewing a community member), other people present, any distractions (kids, pets, TV), other factors influencing the interview or the situation. Include a general description of the interviewee (married Hispanic woman, age 25, three children aged 6, 4, and 1).
• Think out and frame your questions carefully, and ask directly for the information you’re seeking . Memorize your basic questions (not necessarily word-for-word, but know what they are), so that you refer to notes as little as possible. Make your questions clear and unambiguous, so that questions aren’t vague or difficult to understand.
• Ask open-ended questions . These are questions that require an "essay" answer, rather than a yes-no response. For example, instead of asking "Did you enjoy being in the program?" you might ask "What was participating in the program like?" Try to give people the chance to answer as fully and thoughtfully as possible.
• Probe . Ask follow-up questions to get at what people are really saying, or to keep them talking about a topic. ("Why did you like it when the teacher asked your opinion?") Don't be afraid to pursue what may seem to be a sidetrack. Sometimes the best or most important information lies off the beaten path.

Some interviewees can manage one-word answers to nearly any question. They might answer "What was participating in the program like?" with “Good.” Don’t be afraid to probe these answers. “What does that mean?” or “How was it good?” might get you a flood of information. If it gets you another one-word answer, keep probing, unless you sense that the person is getting angry or frustrated. Then it’s probably time to move on to the next question, and hope that there’ll be an opportunity to return to this one for a fuller explanation. But be aware that some people are simply quieter – or less reflective – than others. You may never get much more than one-word answers from them.

• Don't cut people off too quickly . Their stories, or what you can read between the lines, may give you information as important as what they tell you directly.

At the same time, be aware when they’ve strayed too far from the topic. There’s a Mark Twain story that consists of the voice of a man telling an anecdote about a three-legged dog. Every other word reminds him of something else – another story – and he gets continually sidetracked, never finishing the story of the dog, or any of the others, either. Beware the Curse of the Three-Legged Dog: gently but firmly direct people back to the topic if they get too far afield.

• Confirm what you're told by checking with others to the extent that you can . Remember that you're getting people's perceptions, which aren't always the same as objective reality. In Rashomon, a film by the great Japanese director Akira Kurosawa, an incident is described from the perspectives of four participants, each of whom sees it totally differently. In fact, the phenomenon of Rashomon lurks everywhere; get everyone's side of the story.

Group interviews are both similar to and different from individual ones. The basic guidelines – being clear what you’re asking, open-ended questions, probing, etc. – still hold, but the group brings its own dynamic to the situation. The interview becomes more of a group discussion , and the interviewer’s concerns must extend to making sure that everyone gets heard, reining in individuals who dominate the discussion, and keeping the focus on ideas and information, rather than personalities. As with other methods, group interviews have advantages and disadvantages. The former include using the energy of the group to generate more information than might otherwise be forthcoming. Members may stimulate one another to come up with more and more useful material, as their thinking is prodded by the memories and conclusions of others. They can also act as a check on the accuracy of the information provided. In addition, the presence of other, often familiar, interviewees may help to break down shyness or nervousness, and create a relaxed atmosphere in which everyone feels comfortable talking. (The skills of the interviewer at making people comfortable – at least partially by being comfortable herself – are important here.) With these potential positives come the possible negatives of conflict, antagonism, or dislike among group members, as well as other negative feelings or history that can disrupt or twist discussion and make an interview all but useless. There are also problems that can arise from members of the group being too friendly: they may spend too much time in chit-chat, and have trouble focusing on the questions at hand. Group interviews may be useful when resources – and, as a result, interviewers – are limited, or when there are a large number of people who should be, or would like to be, interviewed. Groups probably shouldn’t be much larger than five or six, and interviewers should have, or be trained in, basic group facilitation skills .

Observation

What do we mean by “observation?” For our purposes, there are essentially two kinds: direct and participant observation.

Direct observation is the practice of examining or watching places, people, or activity without interfering or taking part in what’s going on. The observer is the proverbial fly on the wall, often unidentified, who does nothing but watch and record what she sees and/or hears. A direct observation to see how people use a public park, for instance, might consist of one or more observers simply sitting in one place or walking around the park for several hours, or even several days. Observers might come back at different times of day, on different days, or at different times of year, in order to understand as much as possible of what goes on in the park. They might occasionally ask questions of people using the park, but in as low-key and unobtrusive a way as possible, not identifying themselves as researchers.

Some kinds of direct observation – those where people are observed in situations they think are private – have the potential of violating privacy. In these instances, ethics generally demands that the observer obtain the permission of those being observed . In laboratory schools, for instance, where teachers are trained and new educational ideas tested, classes are often observed from behind one-way mirrors. In such cases, both the teachers and the parents of the students are generally informed that such observation may happen, and are asked to sign consent forms. They don’t know exactly when observation is taking place, but they understand that it’s part of the laboratory school environment, and are willing to allow it in order both to improve individual teachers’ skills and to foster the development of better educational methods.

Participant observation involves becoming to some extent part of the life of the people you’re observing – learning and taking part in their culture, their celebrations and rituals, and their everyday activities. A participant observer in the park above might introduce himself into the activities he observes – a regular volleyball game, winter cross-country skiing, dog walking, in-line skating – and get to know well the people who engage in those activities. He would also monitor his own feelings and reactions to using the park, in order to better understand how its users feel about it. He would probably ask lots of questions, and might well identify himself as a researcher.

An effective participant observer may take a long time (in some cases, years) to establish himself in this way. There are exceptions to this rule, of course. Some marketing firms and corporations employ trend-spotters as participant observers. Young, hip, and stylish themselves, these observers are able to identify and mingle with adolescent and young adult trend-setters in brief interactions, and determine what products, styles, and behaviors are likely to catch on soon with young people in general. You may able to do something similar, but it helps greatly if you’re already part of the group that you’re interested in observing, or if the group, like public park users, can include anyone.

Both direct and participant observation can be useful in community assessment. A participant observer in that situation is likely to be a member of the group being observed, because of the length of time it can take to establish an outsider as a participant observer. Direct observation is probably more common as an assessment tool.

Regardless of its type, your observation should be conducted so as to be reliable.

Some guidelines for reaching that goal:

• Think carefully about the questions you want your observation to answer . You may be looking at people’s behavior or interactions in a given place or situation, or the nature of social, physical, or environmental conditions in a particular place or circumstance. If you’re clear about what you want to find out, you can structure your observation to get the best information.
• Where and whom should you observe to answer these questions ? You wouldn’t normally look for evidence of homelessness in the wealthiest neighborhood in town, nor would you observe the residents of an Asian neighborhood to find out something about the Hispanic population.
• When and for how long should observation take place ? Observing commercial activity downtown on Sunday morning won’t get you a very accurate picture of what it’s actually like. You’d need to observe at both busy and slow times, and over a period of time, to get a real idea of the amount, intensity, and character of commercial activity.

What should you observe and record? That depends on the questions you’re trying to answer, but some basics include:

• The physical characteristics of the setting(s), including weather, if outdoors.
• The time of day, week, and year.

Clothing reflects the way people choose to present themselves to the world. A mohawk haircut, piercings, and black clothes represent an attitude and, to some extent, a world view, not just a fashion statement. The same is true for an expensive suit, or for an outfit of jeans, wool shirt, and hiking boots. Paying attention to such details can increase both your understanding and the reliability of your observation.

• The activities, events, and/or places or circumstances observed, and a description of each.
• The nature of interactions among people.
• People’s apparent attitudes toward a place, situation, activity, or event – positive or negative, happy, confused, angry, disappointed, etc.

At a neighborhood festival, for instance, an observer could be watching from a window high above the street, from a position just at the edge of the crowd, from within the crowd and the festival goings-on, as a participant in a festival activity, or even as a festival volunteer or organizer. What she would see and hear, what she would experience, and the information she would obtain would be different from each of these viewpoints.

• The observer’s own responses and attitudes, including the physical and psychological comfort of the observation. This should be separate from the recording of the observation itself, and, in the ideal, should not influence the objective recording of what was observed.

How do you record observations? That depends on the nature of the observation and on your resources. Video recording, unless it’s done from a concealed spot, or in a situation where such recording is expected (a tourist site, or that street festival, for example), can change people’s behavior or put the observer under some suspicion. Audio recording is much less obvious, but also provides less information, unless it’s specifically sound information that you’re seeking. In most cases, recording would be done with a notebook and pencil or with a laptop computer. If recording during the observation would be disruptive or out of place, you’d probably wait till after you had left the situation – but as soon after as possible, so as not to forget or confuse details.

Analyze the information.

Once you’ve gathered information by whatever qualitative method, you have to figure out what it tells you . Some of that will be obvious: if you’ve been interested in who uses that public park we were talking about earlier, and your observation tells you that it’s mostly young people, you have an answer to your initial question . Your next questions may be why other groups don’t use the park as much , and whether the fact that it’s largely used by young people keeps others away. When you’ve answered those questions, you may have generated others , or you may have a basis for planning a campaign to get more people using the park.

Make and carry out a plan to address the issue or problem you’ve identified or were concerned with.

The final step here is to use the information and analysis that came from your use of qualitative methods to change the community for the better. All the assessment in the world is useless if it doesn’t lead to some action that’s meant to create positive change.

Qualitative methods of gathering information – methods such as interviews, observation, focus groups, and community meetings that don’t always yield results that can be reduced to numbers, or that are used to capture a level of information difficult to get with quantitative methods – are often extremely useful in community assessment, especially when used together with quantitative methods, which do give numerical results. Qualitative methods can get at the things that numbers don’t, such as the reasons for people’s actions, or community history. They can help to identify community issues and needs, and provide a basis for planning community efforts that lead to long-term change.

Online Resources

The Action Catalogue is an online decision support tool that is intended to enable researchers, policy-makers and others wanting to conduct inclusive research, to find the method best suited for their specific project needs.

Chapter 6: Research Methods in the "Introduction to Community Psychology" describes the ecological lens in community research, the role of ethics, the differences between qualitative and quantitative research, and mixed methods research.

Harnessing Qualitative Data to Advance Health Equity is a presentation on how data has the potential to both paint an accurate picture of what sexual and intimate partner violence prevention practitioners and advocates know is happening on the ground  and  convey that reality to policymakers.

Qualitative assessment of the Washington State Department of Social and Health Services goals provides a summary of the results of focus groups conducted to explore the public's perception of relevant issues. This is a summary, but you can also download a PDF of the full report.

Qualitative Methods  provides brief descriptions of four standard qualitative research methods: participant observation, direct observation, unstructured interviews, and case studies.

Qualitative Research Methods  is a compendium of sites with papers, links, etc. to qualitative research methods.

Print Resources

Berg, B. (2007),  Qualitative Research Methods for the Social Sciences  (6th edn.) Boston: Allyn and Bacon.

Berkowitz, W. (1982).  Community impact . Cambridge, MA: Schenkman Publishing Company, Inc.

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Problem Solving for Real Change and Empowerment

Community-Based Participatory Research (CBPR), is a relatively recent innovation in problem solving and knowledge creation. CBPR addresses issues and solves problems of social, political, and health disparities where traditional research methods fail because it works with rather than for communities, taking into account specific social realities that often cause the disparities.

The creation of a fully participatory partnership between community members and technically trained experts and investigators is the critical component in any CBPR project; evidence from many sources suggests that what guarantees the production of good science is in fact the promotion of community-defined problem solving.

In the SCRC’s view community-based participatory research must include the following elements:

• Community Defined: the problem under investigation is defined by the community itself, or in collaboration with the formally trained researchers
•  Equitable Collaboration: power and decision-making are shared in all phases of the research and intervention processes
• Action Outcome: the project must include a component that enables direct action on the problem set under investigation

Grassroots communities and research agencies use CBPR to conduct equitable, transparent, and ethically sound research on community-defined problems. By undertaking research projects with community-defined questions, CBPR allows researchers to undertake only those research projects which are most relevant to a community in question, creating stakeholder relationships and buy-in that is otherwise often absent.

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What Is Community Anyway?

Our understanding of community can help funders and evaluators identify, understand, and strengthen the communities they work with.

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By David M. Chavis & Kien Lee May 12, 2015

“Community” is so easy to say. The word itself connects us with each other. It describes an experience so common that we never really take time to explain it. It seems so simple, so natural, and so human. In the social sector, we often add it to the names of social innovations as a symbol of good intentions (for example, community mental health, community policing, community-based philanthropy, community economic development).

But the meaning of community is complex. And, unfortunately, insufficient understanding of what a community is and its role in the lives of people in diverse societies has led to the downfall of many well-intended “community” efforts.

Adding precision to our understanding of community can help funders and evaluators identify, understand, and strengthen the communities they work with. There has been a great deal of research in the social sciences about what a human community is (see for example, Chavis and Wandersman, 1990 ; Nesbit, 1953 ; Putnam, 2000 ). Here, we blend that research with our experience as evaluators and implementers of community change initiatives.

It’s about people.

First and foremost, community is not a place, a building, or an organization; nor is it an exchange of information over the Internet. Community is both a feeling and a set of relationships among people. People form and maintain communities to meet common needs.

Members of a community have a sense of trust, belonging, safety, and caring for each other. They have an individual and collective sense that they can, as part of that community, influence their environments and each other.

That treasured feeling of community comes from shared experiences and a sense of—not necessarily the actual experience of—shared history. As a result, people know who is and isn’t part of their community. This feeling is fundamental to human existence.

Neighborhoods, companies, schools, and places of faith are context and environments for these communities, but they are not communities themselves.

People live in multiple communities.

Since meeting common needs is the driving force behind the formation of communities, most people identify and participate in several of them, often based on neighborhood, nation, faith, politics, race or ethnicity, age, gender, hobby, or sexual orientation.

Most of us participate in multiple communities within a given day. The residential neighborhood remains especially important for single mothers, families living in poverty, and the elderly because their sense of community and relationships to people living near them are the basis for the support they need. But for many, community lies beyond. Technology and transportation have made community possible in ways that were unimaginable just a few decades ago.

Communities are nested within each other.

Just like Russian Matryoshka dolls, communities often sit within other communities. For example, in a neighborhood—a community in and of itself—there may be ethnic or racial communities, communities based on people of different ages and with different needs, and communities based on common economic interests.

When a funder or evaluator looks at a neighborhood, they often struggle with its boundaries, as if streets can bind social relationships. Often they see a neighborhood as the community, when, in fact, many communities are likely to exist within it, and each likely extends well beyond the physical boundaries of the neighborhood.

Communities have formal and informal institutions.

Communities form institutions—what we usually think of as large organizations and systems such as schools, government, faith, law enforcement, or the nonprofit sector—to more effectively fulfill their needs.

Equally important, however, are communities’ informal institutions, such as the social or cultural networks of helpers and leaders (for example, council of elders, barbershops, rotating credit and savings associations, gardening clubs). Lower-income and immigrant communities, in particular, rely heavily on these informal institutions to help them make decisions, save money, solve family or intra-community problems, and link to more-formal institutions.

Communities are organized in different ways.

Every community is organized to meet its members’ needs, but they operate differently based on the cultures, religions, and other experiences of their members. For example, while the African American church is generally understood as playing an important role in promoting health education and social justice for that community, not all faith institutions such as the mosque or Buddhist temple are organized and operate in the same way.

Global migration has led to an assortment of communities based on people’s needs and desire for that sense of trust, belonging, safety, and caring for each other. For example, one group of new immigrants may form a community around its need to advocate for better treatment by law enforcement. Another group may form a community around its need for spiritual guidance. The former may not look like a community, as we imagine them, while the latter likely will.

The meaning of community requires more thoughtfulness and deliberation than we typically give it. Going forward, researchers, practitioners, and policymakers must embrace this complexity—including the crucial impact communities have on health and well-being—as they strive to understand and create social change.

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What Can Research Do In Your Community?

Research takes place in many different settings.

Some research is done in clinical settings like a hospital or doctor’s office. Some may take place on a university campus. Other research happens in community settings where community members themselves may play a variety of roles in the research. This unit will present ideas about how you can get involved in research and work with researchers to improve the health and well-being of your community.

"It's going to take a community to really deal with these kinds of issues." - Dr. John Ruffin, Founding Director of the National Institute on Minority Health and Health Disparities (NIMHD)

Below are examples of how communities and researchers have been able to work together in the United States.

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King County Healthy Homes, Seattle, WA

The King County Healthy Homes project was an intervention research project to help prevent asthma and encourage healthy indoor environments in Seattle.

The indoor home environment presents a range of health risks, including asthma triggers and exposures to toxics such as lead, pesticides, and volatile organics. Minority and low income populations are at increased risk for many of these exposures and children are most sensitive to their effects. Asthma is an important health consequence of these exposures, and its incidence and mortality appear to be steadily increasing, especially among low-income children.

The Seattle-King County Healthy Homes Project addressed these concerns. Paraprofessional Community Home Environmental Specialists (CHES) provided a comprehensive package of educational materials to reduce the total exposure burden of indoor environmental health risks. CHES conducted an initial home environmental assessment in low-income households with asthmatic children age 4-12. The home environmental specialists offered education and social support, encouraged behavior changes, provided materials to reduce exposures (bedding covers, vacuums, door mats, cleaning kits). This initial assessment was followed by five to nine visits over the next 12 months in which CHES worked with tenants, offering continued education and social support.

Community participation was an important component of this project. The project was developed by a partnership of community agencies, a tenant’s union, an environmental justice organization, the local health department, the CDC-sponsored Seattle Partners for Healthy Communities and the University of Washington. Primary funding was provided by the National Institute of Environmental Health Sciences with additional support from the Nesholm Foundation, the Seattle Foundation, and the Seattle-King County Department of Public Health. The project ran from 1997-2005 and found that the homes receiving the educational materials and supports had lower rates of development and severity of asthma in their children and higher awareness of how to prevent asthma.

Source  http://www.kingcounty.gov/healthservices/health/partnerships/sphc/projects.aspx

• King County Homes Project
• Healthy Mothers on the Move
• Vietnamese-American Cervical Cancer Screening
• Weact Northern Manhattan Food Survey

Questions to think about and discuss when reviewing the four examples.

• Who did the study aim to help?
• What problem was the study trying to address?
• When did the study take place?
• How did researchers and community groups work together?
• How did the study make a difference in the community?

Healthy Mothers on the Move, Detroit, MI

The Healthy Mothers on the Move project aimed to demonstrate the effectiveness of a social support healthy lifestyle intervention designed to reduce risk factors for Type 2 diabetes among pregnant and postpartum women. The project worked with Latina and African American pregnant and post-partum women in Detroit. Two intervention programs were offered. One intervention was a Healthy Lifestyle Program with education and support for a healthy diet and exercise. A second intervention was a Pregnancy Control Program that taught stress management and provided general care support but did not include information or support for diet and exercise. Women’s Health Advocates from the community interacted with the study participants. 

Among Latinas, there was almost 90% retention through pregnancy and more than 80% retention through six weeks postpartum. There was also high participant, Women’s Health Advocate, and host site satisfaction. Vegetable consumption in the Healthy Lifestyle group increased significantly. Other analyses are still ongoing.

Preliminary results suggest significant decrease in diabetes risk factors for the healthy lifestyle group. The Community Women’s Health Advocates were instrumental in conducting home visits and working with the women.

Source  http://www.detroiturc.org/index.php?option=com_content&view=article&id=15&Itemid=28

Cervical cancer screening, santa clara, ca.

Vietnamese-American women are five times more likely to develop cervical cancer than other American women. In Santa Clara, CA a REACH 2010 project aimed to increase Pap smear screening for early detection and prevention.  The researchers ran a media campaign on the importance of screening in the community. The University of California also worked with the Vietnamese REACH Health Coalition and lay health workers to encourage Vietnamese Americans to get screened for cervical cancer. The study concluded that the women who spoke with the community health workers were more likely to get screened than the women who were exposed to the media campaign alone.

An evaluation of coalition programs showed that 47.7% of participants who had never had a Pap test received one after meeting with a lay health worker. The evaluation also showed that 17.9% of participants received a mammogram and 27.9% received a clinical breast exam after meeting with a lay health worker, compared with 3.9% and 5.1%, respectively, of women who did not meet with a lay health worker. In addition, 52.1% of participants had a repeat Pap test within 18 months, and 4,187 women enrolled in a reminder system. The study took place from 2004-2007 and involved 105,000 Vietnamese-American women.

Source  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1494888/

Weact food justice initiative, new york, ny.

The goals of the Food Justice Initiative are to understand the challenges and opportunities that children, parents, school officials and residents face regarding healthy food choices in school and at home through research. The WEACT Food Justice Initiative works with community residents in Northern Manhattan grassroots groups and other New York organizations to help influence and develop programs, laws and policies that affect access to healthy food in Northern Manhattan. WEACT has conducted surveys with community residents and schools. They are currently investigating the supply chain of public school lunches to better understand the ingredients and nutritional makeup of the food purchased by the New York City Public School system. One key portion of the Food Justice Initiative is educating policy makers on food justice issues and providing recommendations for improved policies at the City, State and Federal levels.

In addition, WEACT works at the community level to involve parents, students, teachers, the school board, school administrators, and the public in development of the local wellness policies at several Northern Manhattan schools. Since nearly all Northern Manhattan public school students are low-income, this is a critical window of opportunity to empower the community work together to influence policy for greater equality.  WEACT educates and mobilizes the public school community to advocate for healthier policies at the NYC Board of Education, City Council, NYS Legislature and NYS Departments of Education and Health.

WEACT for Environmental Justice is a Northern Manhattan community-based organization whose mission is to build healthy communities by assuring that people of color and/or low-income participate meaningfully in the creation of sound and fair environmental health and protection policies and practices.

Source  http://www.weact.org/Programs/EnvironmentalHealthCBPR/NorthernManhattanFoodJusticeInitiative/tabid/206/Default.aspx

Additional resources, cdc healthy homes, community engaged scholarship 4 health, community-campus partnerships for health, developing and sustaining community-based participatory research partnerships: a skill building curriculum, healthy homes ii asthma project, king county healthy homes project, seattle, wa, reach cdc success stories, reach: the power to reduce health disparities, the community toolbox (university of kansas), important question.

What could research do in your community?

Please take some time to think about and discuss this question with your group or others.

to review Unit 2: Informed Decision-Making

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So why is research important to social work?

As social workers, we train to be able to see the multitude of invisible lines within the systems that hold our lives together, or divide us. We learn to recognize the disconnects, and to help our clients figure out how to reconnect the dots. We view the world through a lens of person-in-environment, that is to say, we seek to understand the context in which our clients live.

The social sciences have an inherent obligation not only to keep abreast of current relevant research, but also to be competent enough to apply new treatments and insights within their practice. Social workers are truly dedicated professionals who have to complete a minimum number of continuing education credits to continue practicing. We don’t get to pick and choose the individuals we help, which is why we have to constantly develop our cultural competencies to identify the strengths of those we are helping. So, research is important to social work because it helps us be effective!

According to the NASW, research in social work helps us:

• Assess the needs and resources of people in their environments
• Evaluate the effectiveness of social work services in meeting peoples needs
• Demonstrate relative costs and benefits of social work services
• Advance professional education in light of changing contexts for practice
• Understand the impact of legislation and social policy on the clients and communities we serve (Retrieved from http://www.socialworkpolicy.org/research)

I still do not know what my research question will be for my senior thesis, but I am beginning to pare down some topics that interest me such as:

• Effects of childhood trauma
• The school-to-prison pipeline
• Trauma-informed therapies within prisons
• Effectiveness of prison diversion programs

8 thoughts on “ So why is research important to social work? ”

try explaining in detail

article quite informing for an amateur in research

In doing any of interventions;evidence based is needed. Not intuition,you need to do assessment of the problem before intervention.Then again you need to to evaluation on the service you provided if has positive impact to your client.

It is a very informative piece of work

try explaining in detail the points listed as to where the nexus between Research and Social work lie

are there means to conduct dual research projects with your institutions?

Akulu muziika zithu zonse ap tisamachiteso kuvutika iyayi 😏😏

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The Power of Parks to Strengthen Community: A Special Report

Primary Author: Lisa W Foderaro , Senior Writer and Researcher, Trust for Public Land

Published May, 2024

High-quality park systems possess the transformative power to help mend America’s fraying social fabric.

• Executive Summary

Americans’ sense of community is being sorely tested. Studies show that people are experiencing extreme levels of loneliness, polarization, and division. Places that historically brought people of different backgrounds together have faded in importance or have themselves become battlegrounds, from houses of worship to social clubs to school boards of education. Parks remain a neutral public gathering place where community members can meet, collaborate, and become empowered. Park leaders can foster those connections through a variety of approaches, programs, and partnerships.

Dakai Brown of Bridgeport, Connecticut, like children around the country, benefits tremendously from communities where social connections are strong. High-quality parks are a contributing factor to social capital, which can deliver lower mortality, reduced depression, and increased economic mobility.

The Findings: Parks can strengthen communities and help bridge divides

Recommendations: Parks departments can deploy strategies to build community

It is no longer enough for cities to create high-quality green spaces. To create strong connections with the community and between residents, parks departments must activate those spaces with culturally representative programs. Photo: Andy Richter

Sherry Taylor, a participant in Raleigh’s On Common Ground program, attended an outdoor viewing party for the Women’s Soccer World Cup at the city’s Moore Square and met several neighbors, including one who has since become a good friend. Photo: Paul Atkinson

THE PROBLEM: America’s Declining Social Capital

“My daughter fell in love with women’s soccer that night,” Taylor recalls. And Taylor, herself, forged a new and critical friendship with a woman she might never have met otherwise. Also a single mother, the other woman and Sherry have grown close and now regularly carpool and help each other with childcare.

“I’m able to pick her daughter up if she can’t, whether because of work or a medical appointment, and vice versa,” Taylor explained. “It’s hard being a single parent, and it’s just good to have someone else to lean on and bond with.”

This kind of neighborly camaraderie is known as social capital , “the ways in which our lives are made more productive by social ties.” Many studies, including Social Capital and Health and Social Capital and Economic Development: A Neighborhood Perspective , show that it’s associated with several significant community-wide benefits, including improved health, social resilience, civic participation, environmental volunteering, and economic well-being. Communities with more social connections see numerous positive outcomes, including lower mortality, reduced depression, and increased economic mobility, and are more resilient to disasters.

But studies also show that social capital has declined in recent decades and that Americans confront polarization along political , economic , ideological , racial and ethnic lines.

THE HYPOTHESIS: Parks Can Help Community Cohesion

At a time when Americans’ trust in many public institutions has sunk to disturbing levels, parkgoers report more positive attitudes.

For example, almost two-thirds of American adults express little to no confidence in the future of our political system. By contrast, people who live near parks are more likely to be satisfied with their local government .

In the Assembly Civic Engagement Survey of over 5,000 people in 26 U.S. communities, those living near popular public parks reported 29 percent greater satisfaction with their parks and recreation departments, 14 percent greater satisfaction with their police, and 13 percent greater satisfaction with their mayor, compared with to people not living near parks—an effect that was even stronger when parks were well-maintained and easily accessible. The findings were controlled for age, Hispanic origin, number of children, political party affiliation, health status, and other factors.

So in 2024 TPL endeavored to explore and expand the existing body of evidence that suggests a link between high-quality park systems and measures of social connectivity.

Parks departments are increasingly creating programming within their green spaces to attract community participation. Free or low-cost exercise programs, like the one at Denver’s Mestizo-Curtis Park, are a great way to get community members moving while fostering social connection.

Students at The Pacific School in Brooklyn, New York, explore the new plants in the renovated Community Schoolyard® garden during the ribbon cutting ceremony in June 2023. These spaces are not just for students. The schoolyards are open to the public after school hours and on weekends to ensure that neighbors have close-to-home access to high-quality park space. Photo: Alexa Hoyer

AN EXPLORATION: Methodology

First, TPL’s annual ParkScore® index ranks parks systems in the 100 most populous U.S. cities based on five factors: access, equity, acreage, investment, and amenities. Additional information on the methodology can be found at tpl.org/parkscore/about .

Second, this year TPL surveyed all public and private organizations managing publicly accessible parks across the 100 most populous U.S. cities to learn how they’re activating their systems to bridge divides between groups that, at best, have little contact with each other and, at worst, experience tension or hostility. A total of 868 examples were submitted from 208 different organizations. Additional details on this survey of park agencies, including methodology and additional findings, can be found here .

Third, data scientists at TPL’s Land and People Lab investigated the association between cities’ ParkScore index rankings and their social capital, as measured by two indicators from the Social Capital Atlas : economic connectedness and rates of volunteering. The researchers behind the Social Capital Atlas developed these indicators by analyzing billions of Facebook relationships for the 72 million U.S. adults aged 25–44 who use Facebook (84% of all U.S. adults aged 25–44). Economic connectedness, or “cross-group” relationships, measures the percentage of friendships between low- and high-income individuals in a given geography, while the volunteering rate measures the percentage of people who are affiliated with a volunteering group. The statistical analysis evaluated the association between a city’s park system quality and social capital while controlling for other factors such as race/ethnicity, urbanicity, transiency, poverty, education, and family structure.

Fourth, with support from the Walmart Foundation, TPL collaborated with nine smaller cities to field-test several tactics for activating park systems and programs in order to strengthen social capital. The Walmart Foundation’s Caring and Connected Communities grant program focuses on bringing people together for meaningful encounters and giving them the skills to build trust and empathy.

“Parks and public spaces are part of that focus,” said Melissa Rhodes Carter, the Walmart Foundation’s senior manager for Community Resilience. “They can play an important role in providing opportunities for people to form relationships that have the potential to help us all live better.”

A Caring and Connected Communities grant helped TPL launch its On Common Ground program in 2023. That program began with the release of “ The Common Ground Framework: Building Community Power Through Park and Green Space Engagement, ” a paper that presented a theoretical three-part model for building community relationships, community identity, and community power.

Following the paper, TPL launched an intensive effort to engage park agencies in nine communities across the United States to test methods of uniting residents of different socioeconomic, racial, ethnic, and generational backgrounds.

“We want to learn from the projects and then share data, tools, and best practices with a wide swath of practitioners,” said Cary Simmons, director of Community Strategies at TPL, who is leading the On Common Ground program. “Essentially, we’re field-testing activities that we hypothesize will have broad applications.” Trust for Public Land is currently evaluating and plans to publish the results of each city’s efforts, but early case studies from several communities are included in the next section.

Mariano Rodriguez (left) and Collin McSpirit stroll on the boardwalk in Bridgeport, Connecticut’s Seaside Park. At a time when Americans express feelings of loneliness, isolation, and disconnection from neighbors, shared public spaces are important in helping people form and maintain relationships. Photo: Kristyn Miller

THE RESULTS: Key Strategies & Case Studies

Table 1 Data source: TPL analysis comparing two measures of social capital from the Social Capital Atlas (https://socialcapital.org/), economic connectedness (‘cross-group’ relationships) and volunteering rate, with TPL’s measure of park system quality—the ParkScore Index.

In the top 25 ParkScore cities, for example, there were, on average, 26 percent more social connections between low- and high-income individuals (“cross-group” relationships) than in lower-ranked cities.

Also in the top 25 ParkScore cities, people were 60 percent more likely to volunteer than those living in lower-ranked cities.

These patterns held after controlling for race/ethnicity, education, poverty, urbanicity, family structure, and transiency.

In layering those findings with TPL’s 2024 survey responses and with reports from the nine On Common Ground communities, four key strategies for building social connections emerged. They are:

Each of these strategies is discussed in the subsections that follow, accompanied by illustrative case studies from ParkScore and On Common Ground cities.

Dr. Hahrie Han, a professor of political science at Johns Hopkins University who studies democracy and civic engagement, said that over the past half-century, American society has seen a withering of the sorts of common spaces that allow people to engage with one another.

“The audacious, beautiful, and exciting promise at the heart of democracy is the idea that putting people into community with each other creates opportunities to learn the capacities, skills, and motivations needed to forge a common life together,” she said. “So it’s ever more important that we have places like parks where people naturally encounter other people. It’s through those encounters that common interests can emerge that are grounded in, but also transcend, self-interest. I see things like parks as an integral part of our civic infrastructure. When we don’t have a multiplicity of those spaces, we know that people can revert back to more parochial tendencies that can create the kind of divisiveness we see in some parts of our society.”

This idea—that parks are an integral part of our civic infrastructure—is more than an accidental by-product. In the ParkScore survey, nearly all cities (91 of 100) reported they’re actively developing civic infrastructure, such as hosting voter registration drives and polling sites in their park systems (Table 2). Other examples include training community members in civic engagement, allowing public protests at park facilities, and welcoming community organizers. These efforts engage people as citizens and thereby revive the democratic ideal of the public square.

Table 2 Data source: 2024 TPL City Park Facts Survey of all public and private park organizations across the 100 most populous cities. The counts reflect the number of cities with at least one organization reporting the given activity.

The 15 advisory council members reflect the city’s rich racial and ethnic diversity. Using some of their On Common Ground funds, BREC compensated committee members with $1,000 stipends, hired a consultant to lead conversations, and paired up the council members to plan community engagement events.

“It was really important for us to introduce the council to [the issue of racism] as soon as possible,” said Andrea Roberts, BREC’s chief operating officer. “We have an unfortunate history here in Baton Rouge, where segregation was a thing even after the federal government said it was illegal. This continued in our community for years. So people are hurting from that and there’s resentment. Those things need to be talked about.”

The work of the community advisory council, which met every month for a year, included a series of community events, each hosted by two council members from different geographic areas and different racial or ethnic backgrounds. BREC provided a budget and guidance, but the teams were given creative freedom. Events ranged from a party for children to make mini-Mardi Gras floats to a Martin Luther King Jr. Day celebration in a local park.

In most ParkScore cities, park agencies’ primary community engagement tools are public meetings. This can result in a top-down approach in which the community is only superficially engaged.

Some parks departments employ the International Association for Public Participation’s (IAP2) “ Spectrum of Public Participation ” model, which features a continuum of citizen engagement: inform, consult, involve, collaborate, empower. In the 2024 TPL survey of the nation’s 100 largest cities, public park agencies were nearly five times more likely to inform the public (“always” or “most of the time”) than to empower the public (Table 3). Only 18 percent of responding cities said they empower the local residents by placing final decision-making in the hands of the public.

Table 3: When planning park projects, systems, and recreation programs, how often does your agency inform, consult, involve, collaborate, and/or empower local residents? Data source: 2024 TPL City Park Facts Survey of all public and private park organizations in the 100 most populous cities. The percentages in this table reflect only each city’s primary park and recreation agency. Sample size = 81 unique cities.

According to TPL data, these trends are on the upswing as park officials actively engage resident collaborators. TPL’s research suggests that cities that shift their efforts toward the right end of the spectrum are more likely to move the needle on measures of social capital.

Across the country, about two-thirds of ParkScore cities are investing in community engagement, either paying community members for their input or hiring full-time community engagement staff (55). Park leaders are hiring and training community organizers and activators to pro- gram their green spaces as hubs for community connection.

“If you show up and say, ‘Here is your brick box of a rec center,’ for example, and the community says they hate it, you won’t get any buy-in to whatever it is you’re building,” he explains. “If you include the community from the outset, you build in participation, volunteerism, advocacy, and stewardship.”

Baltimore City Recreation and Parks now includes the community at every stage. It holds periodic “participatory urbanism” forums, giving residents an opportunity to weigh in on big-picture issues like policy and capital programs. It also invites community members to charrettes—design workshops with park professionals and landscape architects to brainstorm ideas for new green spaces or park renovations. Increasingly, Baltimore is asking children what they think, too.

“When we did playground designs, there was a roomful of adults,” Almaguer says of past projects. “But what do the kids want?” For two new playgrounds at Leon Day Park and Alhambra Park, the department held charrettes at a local rec center for 5- to 12-year-olds. The children designed and built their own playgrounds using popsicle sticks, pipe cleaners, marshmallows, and gumdrops. “We gave them dot stickers to place on things they wanted, like swings and tall towers for climbing,” he added, “and they also voted.”

Baltimore is also taking steps to strengthen its network of park friends groups—and to nurture new ones. The parks department invites 30 such groups to quarterly “Grow” workshops. Each meeting has a different theme—permits, say, or maintenance. “Even though we have a topic, we leave it open for cross-pollination between the groups,” Almaguer added. “So they might say, ‘Hey, what do you do about insurance?’ or ‘How do you write a grant or run an event?’ It’s an opportunity for peer-to-peer conversations.”

Since 2019, the department has also helped three under-resourced neighborhoods start new friends groups. “We all cherish and love parks,” he said. “It is your place of social capital; it’s your respite; it’s your oasis.

TPL has sought to elevate community in all its projects, whether large-scale land protections or small city parks. Community engagement—in public meetings, at farmers markets, in classrooms, and elsewhere—begins long before a formal park design is created or a shovel goes in the ground. It often endures—to propel programming and stewardship—after officials snip the ribbon on opening day. Increasingly, TPL is identifying resident experts in the communities where it works, compensating them for conducting surveys, assisting in workshops, or serving as a liaison with fellow residents.

A little more than half of ParkScore cities (51) are responding to division and polarization by activating their parks—creating programs or facilitating events—with a heavy focus on bringing unlikely groups together, through a series of creative and culturally specific programs that engage new audiences and park user groups. The data suggest that creating high-quality, accessible parks isn’t enough. If cities want to improve and grow social cohesion, they need to create opportunities for residents to come together, and those opportunities should reflect the cultures, interests, and priorities unique to that community.

Tulsa’s weekly Global Gatherings, which drew nearly 4,500 people, highlighted traditions from around the country and the world, including Native American dress and dancing in order to immerse community members in the many rich cultures present throughout the city. Photo: Courtesy of Gathering Place

One of the 100 cities evaluated by TPL’s ParkScore® index, Tulsa developed its five-year-old Gathering Place park with the goal of uniting Tulsans of all backgrounds. The 66-acre park, which had a $465 million price tag, may well be the most expensive local park in U.S. history. (About $200 million of the cost was covered by the George Kaiser Family Foundation, while the city, as well as other foundations and businesses, picked up the rest.)

All programs are free. Chief among them is Global Gatherings, a 13-week program that last year featured weekly events highlighting traditions from more than a dozen regions of the world—Southeast Asia, Africa, the Caribbean, Native America, and others. The program drew nearly 4,500 people and involved more than 80 community partners in activities that featured food, music, dance, traditional attire, storytelling, and crafts.

“Global Gatherings is a collaborative celebration of cultures, and we were ecstatic with the community’s response to the multi-week program,” said Julio Badin, executive director of Gathering Place. “Tulsans of all global backgrounds gathered at the park to share and highlight their traditions to immerse other community members in their rich cultures through art, storytelling, food, music, and dance.”

Jacque Riggs, a jewelry designer and silversmith, arrived in Tulsa from Peru in 2002. Last summer, Riggs and her daughter, Zadith Rodriguez, a 28-year-old printmaker, participated in Global Gatherings. Riggs, 50, helped children make bracelets from brightly colored huayruro seeds. Such bracelets are considered protective amulets, given to newborns to ward off evil spirits. Zadith, for her part, showed children how to make prints of llamas and mountain scenes using paper and inks. There was even a map of Peru.

“It’s always nice to be able to talk a bit about your culture,” Riggs said. “The children were excited and seemed really interested in what we were doing. I also took some bracelets to people at the festival who were from Brazil and Venezuela and said, ‘Hey, I want to give this to you for good luck.’” Building Partnerships In 2023, TPL celebrated its 50th anniversary, and CEO Diane Regas reflected on the organization’s earliest days and earliest partnerships in the San Francisco Bay Area. The organization’s founders, she noted, partnered with the Black Panthers to reclaim vacant lots to create dozens of miniparks throughout the city. “Those early efforts in Oakland were more than just creating parks and green spaces,” she said. “They were about building community, fostering collaboration, and shaping a legacy of hope that continues to influence our work to this day.”

Park leaders across the country report employing partnerships with organizations that deliver park stewardship (74), arts and culture (61), public health (55), and literacy (45) programming. But partnerships that leverage green spaces to address underlying community- level challenges like housing stability (15) and immigrant inclusion (22) are relatively scant (Table 4).

Trust for Public Land examined the connection between a city’s ParkScore ranking and two key indicators of social capital, including volunteerism rates . Parks systems that create and facilitate opportunities for residents to volunteer in their communities can contribute to greater cohesion among neighbors . Photo: Justin Bartels

Table 4 Data source: 2024 TPL City Park Facts Survey of all public and private park organizations across the 100 most populous cities. The counts reflect the number of cities with at least one organization reporting the given activity.

Trust for Public Land research indicates that parks departments should engage residents at every phase of park development, from design to programming. Such was the case at San Geronimo Commons, a former golf course turned community green space in California. Photo: Kevin Quach

CONCLUSION: Community on the Cusp — What Can Be Done

Parks hold tremendous potential for repairing our frayed social fabric, making it incumbent upon the entire parks and recreation field, as well as nonprofit and philanthropic organizations, government agencies, the private sector, and private citizens, to lean into funding and programming opportunities.

The following strategies can optimize the power of parks to elevate social connectedness.

At the local level: Prioritize community engagement. This must be a priority, included in master plans and set forth in local park policy. The process of reaching out to residents and cultivating relationships takes time and intention, so local governments need to dedicate adequate resources in the form of staff, money, and training.

Parks departments should engage residents at every phase of park development, from the spark of an idea for a new park to the creation of park-based programming. This can happen through a one-time design workshop, for example, or through an advisory council or planning committee that meets for months or years. Park professionals should also make full use of friends groups and help establish new ones in under-resourced neighborhoods. And they should consider compensating resident liaisons.

The TPL survey found evidence that there’s a strong public will for funding these efforts. Parks budgets were up across the board in the past year. Total public and private spending on parks and recreation in the 100 most populous cities climbed to $11.2 billion, up from $9.7 billion in 2022 and $8.7 billion five years ago. In fact, after adjusting for inflation, it was the most spent annually on local parks in the largest U.S. cities since before the Great Recession in 2007. This year’s record high was primarily driven by increased capital funding for park renovations and acquisitions from a one-time infusion of federal funds via COVID-19 stimulus money and the Inflation Reduction Act. More cities are investing in their park systems, too, as an outcome of the pent-up demand for green space witnessed during the pandemic.  Private philanthropies, such as the Walmart Foundation and others, have also stepped in and should continue to help towns and cities heal divides and strengthen community.

At the federal level: Park advocates, administrators, and users can support the Outdoors for All Act (O4A). Among other things, O4A would improve the Outdoor Recreation

Legacy Partnership (ORLP), a grant program run by the National Park Service that provides funding for communities that need parks the most.  Specifically, the legislation, which TPL is championing in Congress, would make ORLP permanent, avoiding the need to renew the program annually. If passed, the bill would also allow federally recognized tribes to apply to the funding program for the first time, while letting tribes, cities, and nonprofits apply directly to the National Park Service (instead of having to go through their state governments). Finally, the legislation would lower the population requirement to 25,000, meaning smaller cities and towns would be eligible for funding.

Trust for Public Land is working in close collaboration with several partners, city officials, and community groups on a new park on a former brownfield in San Francisco. When completed, the 10-acre India Basin Waterfront Park , in the Bayview-Hunters Point neighborhood, will offer boat access, as well as walking and bike paths, an extensive picnic area, basketball courts, playgrounds, restrooms, a food pavilion, a history museum and community center, lawns, piers, and a floating dock. The park also features restoration of wetlands, expansion of wildlife habitat, and naturalization of the waterfront edge. The park was designed with extensive community input and will protect residents from sea level rise, as well as offer needed resources.

The park is emerging in an area that, from the 1850s to the 1900s, thrived as its shoreline was used as a civilian and military shipyard and slaughterhouse. Those industries, now defunct, left significant environmental damage, however, impacting the land and cutting off residents from the waterfront. The neighborhood, which is one of the few remaining historically Black neighborhoods in San Francisco, has also suffered from deep neglect of basic infrastructure and generations of social injustice.

The goal in developing the new park is as much to create a spectacular new green space as it is to strengthen the neighborhood—economically, socially, and politically. To achieve that, an Equitable Development Plan informs every aspect of the project and was developed by the community and the four project partners: TPL, the San Francisco Parks Alliance, the San Francisco Recreation and Parks Department, and the A. Philip Randolph Institute. Local residents receive training in construction jobs through a robust workforce development program. And a tech hub within the park is now providing free Wi-Fi, loaner laptops, and tech support, even before the park’s official opening.

Get The Power of Parks to Strengthen Community

Contributors Tim Almaguer , Baltimore City Department of Recreation and Parks, Community Engagement and Strategic Partnership Division | Julio Badin , Gathering Place | Melissa Rhodes Carter , Walmart Foundation | Howard Frumkin | Dr Hahrie Han , Johns Hopkins University | Will Klein | Hannah Kohut | Keith Maley | Kevin Niu |  Cary Simmons | Sherry Taylor | Diane Regas | Jacque Riggs | Andrea Roberts , East Baton Rouge Parish Parks and Recreation Department (BREC) | Levar Robinson , BREC Community Advisory Council | Zadith Rodriguez | Geneva Vest | Šárka Volejníková | Dan Walsh | Deborah Williams

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Asking for help is hard, but others want to help more than we often give them credit for, says Stanford social psychologist Xuan Zhao .

Xuan Zhao (Image credit: Anne Ryan)

We shy away from asking for help because we don’t want to bother other people, assuming that our request will feel like an inconvenience to them. But oftentimes, the opposite is true: People want to make a difference in people’s lives and they feel good – happy even – when they are able to help others, said Zhao.

Here, Zhao discusses the research about how asking for help can lead to meaningful experiences and strengthen relationships with others – friends as well as strangers.

Zhao is a research scientist at Stanford SPARQ , a research center in the Psychology Department that brings researchers and practitioners together to fight bias, reduce disparities, and drive culture change. Zhao’s research focuses on helping people create better social interactions in person and online where they feel seen, heard, connected, and appreciated. Her research, recently published in Psychological Science ,  suggests that people regularly underestimate others’ willingness to help.

This fall, Zhao will be co-teaching a two-session workshop Science-Based Practices for a Flourishing Life through Stanford’s well-being program for employees, BeWell.

Why is asking for help hard? For someone who finds it difficult to ask for help, what would you like them to know?

There are several common reasons why people struggle to ask for help. Some people may fear that asking for help would make them appear incompetent, weak, or inferior – recent research from Stanford doctoral student Kayla Good finds that children as young as seven can hold this belief. Some people are concerned about being rejected, which can be embarrassing and painful. Others may be concerned about burdening and inconveniencing others – a topic I recently explored.  These concerns may feel more relevant in some contexts than others, but they are all very relatable and very human.

The good news is those concerns are oftentimes exaggerated and mistaken.

What do people misunderstand about asking for help?

When people are in need of help, they are often caught up in their own concerns and worries and do not fully recognize the prosocial motivations of those around them who are ready to help. This can introduce a persistent difference between how help-seekers and potential helpers consider the same helping event. To test this idea, we conducted several experiments where people either directly interacted with each other to seek and offer help, or imagined or recalled such experiences in everyday life. We consistently observed that help-seekers underestimated how willing strangers – and even friends – would be to help them and how positive helpers would feel afterward, and overestimated how inconvenienced helpers would feel.

These patterns are consistent with work by Stanford psychologist Dale Miller showing that when thinking about what motivates other people, we tend to apply a more pessimistic, self-interested view about human nature. After all, Western societies tend to value independence, so asking others to go out of their way to do something for us may seem wrong or selfish and may impose a somewhat negative experience on the helper.

The truth is, most of us are deeply prosocial and want to make a positive difference in others’ lives. Work by Stanford psychologist Jamil Zaki has shown that empathizing with and helping others in need seems to be an intuitive response, and dozens of studies , including my own, have found that people often feel happier after conducting acts of kindness. These findings extend earlier research by Stanford Professor Frank Flynn and colleagues suggesting that people tend to overestimate how likely their direct request for help would be rejected by others. Finally, other research has even shown that seeking advice can even boost how competent the help-seeker is seen by the advice-giver.

Why is asking for help particularly important? 

We love stories about spontaneous help, and that may explain why random acts of kindness go viral on social media. But in reality , the majority of help occurs only after a request has been made. It’s often not because people don’t want to help and must be pressed to do so. Quite the opposite, people want to help, but they can’t help if they don’t know someone is suffering or struggling, or what the other person needs and how to help effectively, or whether it is their place to help – perhaps they want to respect others’ privacy or agency. A direct request can remove those uncertainties, such that asking for help enables kindness and unlocks opportunities for positive social connections. It can also create emotional closeness when you realize someone trusts you enough to share their vulnerabilities, and by working together toward a shared goal.

It feels like some requests for help may be harder to ask than others. What does research say about different types of help, and how can we use those insights to help us figure out how we should ask for help?

Many factors can influence how difficult it may feel to ask for help. Our recent research has primarily focused on everyday scenarios where the other person is clearly able to help, and all you need is to show up and ask. In some other cases, the kind of help you need may require more specific skills or resources. As long as you make your request Specific, Meaningful, Action-oriented, Realistic, and Time-bound (also known as the SMART criteria ), people will likely be happy to help and feel good after helping.

Of course, not all requests have to be specific. When we face mental health challenges, we may have difficulty articulating what kind of help we need. It is okay to reach out to mental health resources and take the time to figure things out together. They are there to help, and they are happy to help.

You mentioned how cultural norms can get in the way of people asking for help. What is one thing we can all do to rethink the role society plays in our lives?

Work on independent and interdependent cultures by Hazel Markus , faculty director of Stanford SPARQ , can shed much light on this issue. Following her insights, I think we can all benefit from having a little bit more interdependency in our micro- and macro-environments. For instance, instead of promoting “self-care” and implying that it is people’s own responsibility to sort through their own struggles, perhaps our culture could emphasize the value of caring for each other and create more safe spaces to allow open discussions about our challenges and imperfections.

What inspired your research?

I have always been fascinated by social interaction – how we understand and misunderstand each other’s minds, and how social psychology can help people create more positive and meaningful connections. That’s why I have studied topics such as giving compliments , discussing disagreement , sharing personal failures, creating inclusive conversations on social media , and translating social and positive psychology research as daily practices for the public . This project is also motivated by that general passion.

But a more immediate trigger of this project is reading scholarly work suggesting that the reason why people underestimate their likelihood of getting help is because they don’t recognize how uncomfortable and awkward it would be for someone to say “no” to their request. I agree that people underestimate their chance of getting help upon a direct ask, but based on my personal experience, I saw a different reason – when people ask me for help, I often feel genuinely motivated to help them, more than feeling social pressure and a wish to avoid saying no. This project is to voice my different interpretation on why people agree to help. And given that I’ve seen people who have struggled for too long until it was too late to ask for help, I hope my findings can offer them a bit more comfort when the next time they can really use a helping hand and are debating whether they should ask.

Social Life

How to improve your mental health through community, the benefits of community involvement, plus tips and ideas for cultivating it..

Updated May 24, 2024 | Reviewed by Jessica Schrader

• Community involvement and a strong social network positively impact mental health with far-reaching benefits.
• Benefits of community include hope, opportunity, and resources, plus friendship and a sense of fulfillment.
• To help you decide how to get involved, consider your interests and passions, and consult with trusted others.

By Kimberly Nelson , MA, with Becky Shipkosky

Have you ever felt alone in the world? Isolated? If you have, can you think back to the state of your mental health at that time? Now, try to think of a time when you had a strong support network—maybe a job with the very best co-workers, your crew of friends in high school or college, or an especially cohesive group of roommates. Research indicates that these times in our lives are likely to be characterized by relatively good mental health (Park et al., 2023).

Why is a strong sense of community correlated with better mental health? For some—the more extroverted among us—this may seem perfectly natural. But introverts might find this counterintuitive. In fact, being in community offers benefits beyond the basic extrovert-recharge effect, including:

• Social support: Someone to talk to when the going gets tough.
• Purpose: Something bigger than yourself that inspires you to get out of bed and “do the day.”
• Hope: Others who believe in you and help you believe in yourself.
• Inspiration: Seeing people who look like you do great things and being reminded that you can do great things too.
• Accountability: “We’re counting on you, and we miss you when you’re not here.”
• Appreciation: Being seen for your strengths and having your best qualities reflected back to you.
• Empowerment: Community can give you a voice in a way that would be hard to accomplish alone.
• Opportunity: Your community network is the best source for job opportunities and so much more.
• Cultural connection: Whether it’s those with your same diagnosis, race, orientation, language, socio-economic background, or all of the above, being with your village can be so affirming.
• Resources: Who steps in to help when we’re struggling? Community does!

What Is Mental Health Recovery?

The recovery model is a newer paradigm in mental health care that emphasizes a person’s strengths, personal wisdom , and autonomy. It seeks to support individuals in living fulfilling lives with all the parts of themselves fully integrated, including their lived experience of mental illness. To learn more, see our post that fully defines the mental health recovery model.

Community + Mental Health Recovery

Within the recovery model, community is one of the four dimensions that underpin a fulfilling life (SAMHSA, 2024). Our Chief Program Officer, Dr. Lisa Schactman, emphasizes the role of community in the self-integration process: “Part of the recovery experience is reconnection. Some of the reconnection is to yourself…and some of the connection is to our loved ones and people in our community.”

At the end of the day, for better or worse, so much of who we are is in context of community. Like nearly everything else in our lives, “a recovery process is something that’s done in relationship, in community,” Schactman points out.

How to Cultivate Community That Fosters Recovery

Seeking out community may be new to some people. In our busy lives, we may only engage with the people and places we must. Stop by the coffee shop in the morning, say hello and goodbye to the barista. Go to work and talk shop with coworkers. Not all community provides the benefits we’ve talked about. Work may not be a bountiful hub of deep connection, after all. So, how do you even begin to intentionally build community for yourself?

• Start with the knowledge that you are enough. You don’t have to bring anything to the table other than yourself and what you naturally do well or love to do. This centeredness will help you quickly identify what is a good fit and what isn’t.
• Think about what captures your interest, passion, or curiosity. If no current interests or passions come to mind, think back to what you were most interested in as a child. This exercise may not lead you to just the right thing immediately, but it will absolutely move you in the right direction.
• Ask loved ones or care providers, like a therapist, to suggest ideas based on their understanding of you. This is great because it can provide perspectives you hadn’t thought of.

Where to Find Community

What types of spaces, events, and activities can we intentionally seek out to create a healthful and supportive environment that nurtures our mental health? Here are a few suggestions:

• Volunteer work: Volunteer for efforts you care about. Here are a few ideas: community garden, literacy or tutoring program for adults or children, peer support, animal shelter, food bank, senior center, crisis hotline.
• Workshops or classes: Look for workshops or classes that focus on personal development, mindfulness , or skill building. This could be anything from yoga to carpentry to non-violent communication.
• Support group: Find local or online support groups that resonate with you. Actively participate in meetings and discussions.
• Advocacy: Get involved in advocacy for issues you care about.
• Hobby group: Join or create a group based on a shared hobby or interest, such as a book club, gaming squad, or exercise group.
• Community events: Attend local events, fairs, and festivals.
• Online community: Use social media platforms or apps designed to connect people who have common interests or are seeking support.
• Faith-based: If you’re spiritual , join faith-based groups or activities. You can even begin by simply showing up for regular prayer or worship, which will undoubtedly open up opportunities for other events and programs.
• Exercise group: Join a local running club or yoga class, start going to the skate park or roller rink, or join a box gym.

You don’t have to choose just one opportunity. It’s a great idea to try a few or several totally different things to see what feels best to you. And once you settle on something, try to establish a schedule with it. Your regular involvement is what will help you form and strengthen relationships. These relationships can lead to friendships that are based on common interests, and the more you you are, the higher quality those relationships can be.

Park, E. Y., Oliver, T. R., Peppard, P. E., & Malecki, K. C. (2023). Sense of community and Mental Health: A cross-sectional analysis from a household survey in Wisconsin. Family Medicine and Community Health , 11(2). https://doi.org/10.1136/fmch-2022-001971

Recovery and recovery support . SAMHSA. (2024, March 26). https://www.samhsa.gov/find-help/recovery

Shipkosky, B., & Schactman, L. (2024, March 22). Recovery Model of Mental Health. personal.

CooperRiis is a non-profit residential healing community for adults with mental health challenges.

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How do community first responders help in an emergency?

Health and Social Care Services Research

doi: 10.3310/nihrevidence_62850

This is a plain English summary of original publications from a research project . The views expressed are those of the author(s) and reviewer(s) at the time of publication.

This study describes the role of community first responders in England: their activities, organisation, cost and impact on care outcomes. It found that responders:

• arrive ahead of ambulances in 1 in 11 of the most serious calls
• provide reassurance to people waiting for an ambulance
• help ambulance services to meet their response time targets for the most urgent calls.

Rules and policies relating to community first responders vary between ambulance services. The researchers are working with policy teams to standardise responders’ responsibilities and training, and to improve recruitment and retention.

Further information is available on the website of the Association of Ambulance Chief Executives .

What do community first responders do?

More than 12,000 people in the UK volunteer as community first responders. They include members of the public and off-duty healthcare professionals; they are all trained to administer life-saving skills. Ambulance services send responders to people who have called 999; their goal is to arrive ahead of the ambulance crew and can provide emergency care, for example, to someone whose heart has stopped beating (cardiac arrest).

Responders are an increasingly important part of emergency services. They were first introduced to help ambulance services in rural areas, where access to emergency care might be delayed. But evidence is lacking on their contribution to medical outcomes, what care they provide, how it could be improved, and how much the role costs.

What’s new?

Researchers examined routine electronic records covering 4.5 million incidents in 2019 from 6 ambulance services in England . They reviewed policies and guidelines from 7 ambulance services. The researchers interviewed 47 people (including responders, commissioners, ambulance staff, patients and their relatives).

The study found that responders typically took on 1 shift per week (on-call for 7 hours). They attended calls for many health issues, including breathing difficulties, choking and seizures. They shared information such as blood pressure and temperature with ambulance crews on arrival.

Overall, community first responders arrived before ambulance crews in 2% (86,880) of all calls made. They were most likely to arrive first:

• in rural areas (4%) compared with urban areas (1.5%)
• for the most serious calls (9%) and for slightly less serious calls (5%)
• for neurological conditions including stroke and endocrine problems such as low blood sugar (6.5%)
• for heart and breathing problems (almost 6%).

Responders are assigned to calls according to their location when the call is made. The study suggested that wealthier, less diverse areas were best served by community first responders. Callers who were less likely to be seen by a community first responder ahead of an ambulance were:

• from minority ethnic backgrounds (0.07% calls compared with 2.0% calls made by white people)
• from lower income areas (0.8% calls compared with 1.1% calls in high-income areas).

The impact of the service was mixed. Community first responders:

• enabled a faster prehospital response time and helped services meet response time targets
• led to 870 fewer ambulance call-outs for people who had fallen at home in 28 months in Lincolnshire where they were commissioned to provide a falls service.

The data did not show a direct impact on survival rates in cardiac arrest. This is because the arrival of community first responders is only one among many factors that influence survival.

The research team found that rules, standards and procedures (to ensure the safety of responders, patients and the public) varied between services . The numbers of responders across ambulance services, and the training, varied widely. Costs were incompletely recorded and reported but estimates ranged from £40,000 to over £800,000 per service per year .

In interviews , responders said they had made a proactive and positive decision to take on the role. Some were motivated by the first aid training. Patients and the public were often unaware of the responder role. Despite this, the arrival of a responder provided reassurance as well as assistance.

Why is this important?

The study highlights the value of community first responders to emergency medical services and the people they care for. Responders help ambulance services meet their target response time. They sometimes reach people faster than ambulances (particularly in rural settings) and provide emergency care before paramedics arrive.

When the role was introduced, responders were only called out to people whose hearts had stopped outside of hospital. They are now called for a range of emergencies, and the role is expanding (to attend people who have long-term conditions, or who have fallen at home, for example).

The study raised concerns about the accuracy of ambulance services’ records of costs, including training for responders and out of pocket expenses such as fuel. The incomplete nature of the records partly explains the large cost differences in services’ estimates; better record-keeping is needed to establish whether first responders are cost-effective.

What’s next?

In collaboration with policymakers, the researchers are developing recommendations to develop the responder role. Recommendations include standardisation of training and of the responsibilities of the role .

At meetings with people from 8 ambulance services (regional and national), they called for ambulance services to standardise training and responsibilities . Stakeholders suggested a nationally recognised certificate for all responders. These discussions informed the future National Ambulance Volunteering Strategy .

Some ambulance services are trialling falls programmes for community first responders , in which emergency calls are fielded to responders instead of ambulance crews. Using responders for potentially non-urgent call-outs could reduce ambulance call-outs, save ambulance crews’ time and reduce NHS spending.

You may be interested to read

This is a summary of a research project. All outputs are on the project web page: https://www.cahru.org.uk/research/peqo/community-first-responders-role-in-the-current-and-future-rural-health-and-care-workforce/

Papers include:

Botan V, and others. Community first responders’ contribution to emergency medical service provision in the United Kingdom . Annals of Emergency Medicine 2023; 81: 176 – 183.

Patel G, and others. “It's like a swan, all nice and serene on top, and paddling like hell underneath”: community first responders’ practices in attending patients and contributions to rapid emergency response in rural England, United Kingdom—a qualitative interview study . Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2023; 31: 7.

Hosseini SMP, and others. PP47 Effectiveness of falls response partnership in emergency medical services in Lincolnshire, UK: an economic evaluation

Patel G, and others. Common hierarchies, varied rules – the problem of governing community first responders in prehospital care for quality standards: documentary discourse analysis . BMC Health Services Research 2023; 23: 38.

An article published on the Lincoln Policy Hub about this research: Policy engagement towards informing the current and future role of Community First Responders’ in the United Kingdom . January 2024.

If you are interested in volunteering for the ambulance service, as a community first responder or in another role, visit the Association of Ambulance Chief Executives website.

Funding:  This study was funded by the NIHR Health and Social Care Delivery Research programme.

Conflicts of Interest:  No relevant conflicts were declared. Full disclosures are available on the original papers.

Disclaimer:  Summaries on NIHR Evidence are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that the views expressed are those of the author(s) and reviewer(s) at the time of publication. They do not necessarily reflect the views of the NHS, the NIHR or the Department of Health and Social Care.

NIHR Evidence is covered by the creative commons, CC-BY licence. Written content may be freely reproduced provided that suitable acknowledgement is made. Note, this license excludes comments made by third parties, audiovisual content, and linked content on other websites.

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Vice President for Research

Utah awarded $62m grant to help increase access to solar power for traditionally underserved communities.

By Lisa Potter, Research Communications Specialist, University of Utah Communications

The U.S. Environmental Protection Agency has selected the Utah Office of Energy Development (OED) to receive $62.45 million through EPA Solar For All , a federal program to increase access to the benefits of solar power for traditionally underserved communities. Utah is one of 60 recipients chosen from a competitive review process thanks to a months-long effort of the Utah Solar for All Coalition.

Led by the OED , the Utah Solar for All Coalition brought together experts from the University of Utah, Utah Clean Energy, Utah Department of Environmental Quality/Division of Air Quality, Salt Lake City Department of Sustainability and Salt Lake County to develop the initiative that harnesses Utah’s abundant sunshine to help vulnerable communities gain energy independence and resiliency and access to Utah’s thriving solar workforce.

“The University of Utah has a strong dedication to sustainability and community well-being in the state, so we are thrilled to be part of an initiative to bring this clean energy resource to the people who need it most,” said Marian Rice, associate director of the Energy Futures Research Engine at the U, Utah Solar For All Coalition member and chair of the coalition’s community benefits committee. “We are excited to collaborate with Solar for All Coalition, state and local government, NPOs and community groups on projects that benefit Utah’s people, economy and ecosystem.”

The Office of the Vice President for Research (VPR) Energy Futures Research Engine led the U’s significant contributions to the Utah Solar for All proposal. In addition to Rice, Elizabeth Gerhard of the Large Infrastructure Funding Team (LIFT), consultant Kimberly Johnson, Kimberly Schmit of University Neighborhood Partners and Kody Powell of Intermountain Industrial Assessment Center supported the proposal.

Funded by the Inflation Reduction Act’s Greenhouse Gas Reduction Fund, Utah Solar for All adheres to the reduction fund’s three objectives: reducing climate and air pollution, delivering benefits to low-income and disadvantaged communities and mobilizing financing to spur additional deployment of low-cost solar energy.

“We’ll be leveraging these funds to supply grants and low-cost financing for those who would normally find the cost of installing solar power prohibitive,” said Greg Todd, director of OED. “In turn, funded projects will improve grid resiliency, lower emissions across the state and lower monthly utility bills for program participants. Our office sees this as a win for our utilities, our air and, most importantly, our consumers.”

Utah’s initiative will support rooftop solar through inclusive financing alternatives, robust community engagement, workforce development and innovative partnerships with proven capabilities to accelerate renewable energy across the state. The formative stages will prioritize Utahns who are at risk from a lack of electricity and/or unplanned power outages that may affect life-essential medical devices.

“The U is honored to be a part of Utah Solar for All, a project that exemplified the U’s values to promote sustainability and community well-being,” said Erin Rothwell, vice president of research at the U. “As the flagship institution for the state, it is important we support and collaborate on important initiatives that translate into improving economic stability and energy security.”

The EPA estimates that the 60 Solar for All recipients will enable more than 900,000 households in low-income and disadvantaged communities to deploy and benefit from distributed solar energy. This $7 billion investment will generate over $350 million in annual savings on electric bills for overburdened households. The program will reduce 30 million metric tons of carbon dioxide equivalent emissions cumulatively, from over four gigawatts of solar energy capacity unlocked for low-income communities over five years. Solar and distributed energy resources help improve electric grid reliability and climate resilience, which is especially important in disadvantaged communities that have long been underserved.

Note: This story was originally published on @theU .

How citizen scientists help koala conservation efforts, and what you can do to contribute

Science How citizen scientists help koala conservation efforts, and what you can do to contribute

Before Jackson Cass, 27, was organising citizen science projects and monitoring koalas in western Victoria, he was working in construction with his father.

"The environment was something I was always interested in and passionate about, but I didn't really understand how I could get involved in that space," he says.

So he left construction and started studying a diploma in conservation and ecosystems management at uni.

"From there I started doing a lot of volunteering with some local landcare groups," Mr Cass, who has now been the coordinator of the Moorabool Catchment Landcare Group for almost four years, says.

"I think it's a valuable thing to contribute, and being a younger person, it's good to have young people represented in that space as well."

Mr Cass is one of hundreds of citizen scientists collecting information on koala populations across Australia as part of a national koala monitoring program .

The monitoring program is led by quantitative biologist and CSIRO senior research scientist Andrew Hoskins, who says koalas can be "quite cryptic" as they sit quietly high up in trees, particularly during the day. 

"Everybody knows what a koala looks like — they're really easy to identify, but they're really hard to spot," Dr Hoskins says.

"This makes monitoring them even harder."

So the more eyes out looking for them, the better.

Dr Hoskins says it is the first time citizen science has been used Australia wide to collect data on koala numbers, habitat and health.

"It's super exciting to work on a national-scale program that allows people to provide information in a useful and usable way that then we as scientists can make best use of to inform conservation of such an iconic species," he says.

"[Working with citizen scientists] is efficient and it's also really inclusive because it lets anybody access and contribute information to the program in a meaningful way."

What do latest data tell us about koala populations?

Koalas ( Phascolarctos cinereus ) typically live in eucalyptus forests along southeastern and eastern Australia.

Historical data suggests that national koala populations "have declined quite severely in recent years", Dr Hoskins says.

With only two years of data in the program, he says it is still too early to determine if the koala populations are continuing to decline or have stabilised.

"What we are still working out is: how many were there to begin with? And how many do we have now?" Dr Hoskins says.

"We don't have enough points through time to really give a good estimate at that national scale of trend yet … [but] we are confident that we will get there."

The most at-risk populations — those considered "vulnerable" and protected under national environment law — are in parts of Queensland, New South Wales, and the Australian Capital Territory. As of March 2024, the estimated size of these endangered populations was between 95,000 and 238,000 animals.

Koalas in Victoria and South Australia, on the other hand, are not considered endangered and are even over-abundant in some areas, with their populations estimated between 129,000 and 286,000 animals.

Dr Hoskins says habitat loss is a significant contributor behind koala declines at a national level, as is the bacterial infection that causes chlamydia.

"Whether it be by bushfires, or whether it be by land clearing, or urban expansion, which is another habitat loss challenge," he says.

"Chlamydiosis is widespread and extensive throughout the koala population, and can cause quite severe reproductive issues, particularly with female koalas."

Data back up local stories

Before koala monitoring started in the Moorabool region, Mr Cass says there had been a general chatter about declining numbers, "but it was all anecdotal".

Older farmers told him stories about koalas walking through their paddocks, while bush residents spoke about hearing koalas calling throughout the summer, but they hadn't seen or heard the animals in years.

But Mr Cass says hard data on local koala numbers was "lacking", which meant there wasn't "anything to back those claims up as correct as they may be". 

So the landcare group decided to make monitoring a priority and signed up to the national program.

"We had a really terrific response for the community to come out and help collect some more data on koalas," Mr Cass says.

"There's definitely been a growing interest from landholders to be engaged in citizen science activities over the past 10 years."

The Moorabool landcare group also works closely with members of the Wadawurrung Traditional Owners Aboriginal Corporation, such as biodiversity project officer Kelly Ann Blake to monitor ngaambulmum (koala).

"The translation of ngaambulmum actually means 'rump in fork of tree', or 'bottom in fork of tree', which makes perfect sense because you're looking at a big fluffy backside in the tree," she explains.

Ms Blake says it is imperative First Nations voices and perspectives are taken seriously, adding that by doing so, this also provides a deeper understanding of the animals.

"We use a two-way learning approach where we encourage everyone to learn from Country and listen to what Country is teaching us," she says.

"We use all of our senses: looking, listening, smelling and feeling. We will use our past and current knowledge of koalas to see where they are and if they are healthy."

While Victoria overall has many koalas, Mr Cass says monitoring over the past two years backs up stories of declining numbers in some parts of the Moorabool area.

Only two koalas were spotted across 39 monitoring sites this year following a total of three koala sightings in 2023.

He says habitat loss and climate change are probably the biggest two impacts on local koala populations in the area. 

How does koala monitoring work?

The monitoring program has a network of sites that have been "carefully selected and chosen throughout the landscape" to reflect the koalas' range, Dr Hoskins says.

He says a common challenge scientists face when monitoring a species such as the koala is: "How much of you not seeing a species in an area has to do with the fact that the species isn't there, or that you haven't just been able to see it?" 

Scratch marks on a tree or koala droppings are some of the visual indicators used by citizen scientists to assess whether a koala may be nearby. 

If it wasn't for this citizen science project with the Moorabool community and CSIRO, Mr Cass says he wouldn't know as much as he does now about koalas, including the best ways to monitor them.

One of the more "scientifically rigorous" methods is a double line transect, a type of systematic survey used to estimate the population size of a species, or to detect changes in that size over time.

This involves two people starting at opposite ends of a mapped-out line or path through a section of habitat and walking from one end to the other as they search for koalas.

Since late 2021, Mr Cass has conducted more than 70 koala surveys in the Moorabool region, but has only seen five koalas in total.

"Koalas are very tricky things to spot in a tree when you have looked at a thousand trees that day.

"There's many times where I haven't spotted something and somebody else has."

The citizen science observations are combined with other methods such as koala detection dogs and drones, which help locate and map out the presence of koalas in an area.

How can I get involved?

Dr Hoskins encourages anyone who wants to undertake systematic surveys to get in contact with the program, and check out the  NKMP website  for guidelines and information sessions.

Around 618 citizen scientists have directly engaged with the koala monitoring program so far, which includes local communities, vets and wildlife carers, and First Nations people.

The CSIRO has also released an app called Koala Counter designed for citizen scientists to record survey data. 

"They might want to collect koala information in a way that we as scientists also collect that information, which helps us get better information to understand how many koalas there are, not just where koalas are," Dr Hoskins says.

But you don't need to do a survey to help. 

Other apps, such as Koala Spotter and iNaturalist, feed into the CSIRO project too. They're set up for citizen scientists who may be out on a walk and want to record a koala sighting, or collect information about koala health.

"We've been working closely with the University of Sunshine Coast who have developed Bluetooth ear tags for koalas," Dr Hoskins says.

The tags can identify individual koalas in some areas via the Koala Spotter app, and allow community members to develop a personal relationship with their local koalas, as well as learn about some of the issues facing koalas in their area.

"You'll get its name, how old it is. If it potentially encountered humans — why did it get caught? Did it end up in veterinary care? Did it get hit by a car?" Dr Hoskins says.

The monitoring program is also systematically collecting information about other species that people may encounter when spotting koalas. One is the endangered greater glider.

"Greater gliders are quite topical at the moment as well, and interestingly, they occupy very similar regions to koalas," Dr Hoskins says.

"We've been joking that it's not just the national koala monitoring program — it's also the national greater glider monitoring program."

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