Community Engagement Guide, Study notes of Public Health

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Community

Engagement

Guide

SharePoint/C4PA/

Community_Engagement

Contents

• Introduction
• Engaging Governmental Public Health System Partners
• Ethical Research and Engagement
• Community Participation Continuum
• Community Engagement Checklist
• Key Principles
• Methods of Engagement
• Common Barriers
• Evaluating Your Community Engagement Efforts
• Closing
• Additional Resources
• Definitions
• A. Identifying the Community Worksheet Appendices
• B. Methods to INFORM
• C. Methods to CONSULT
• D. Methods to INVOLVE
• E. Methods to COLLABORATE
• F. Methods to EMPOWER

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What do we mean by community?

A community is a group of people who are brought together by something in common. This can include things like cultural background, shared experience, and geographic location. One person can belong to many different communities.

DOH engages communities on many different levels. Sometimes programs collaborate directly with community members. Oftentimes, we seek community participation through our collaborations with partners, organizations, and other agencies. The chart below includes examples of the types of communities and partners the department has engaged in the past.

When to do community engagement?

You should engage our customers and communities who will be most impacted by your work Even internal-facing work can affect members of the general public. Think about our external customers and community members who may be effected directly or indirectly.

Community Members

Groups of individuals who have something in common

• Parents
• People living with HIV/AIDS
• Pregnant women
• Latino/Hispanic youth

Community Partners

Organizations, agencies, or community groups

• P arent/Teacher Association
• Gay City
• March of Dimes
• El Centro de la Raza

Developing policy Bill analysis | Legislative agenda | Budget requests | Revisions to Washington Administrative Code | Changes in partner funding | Rule making Communicating information or changing communication tools Developing standards, guidance documents, protocols Making changes to internal systems or structures Applying for or posting funding opportunities Creating materials or publications Project planning Grant writing

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Engaging Governmental Public Health System Partners

Engaging Tribes

DOH respects the unique government-to-government relationship that exists between Tribes as sovereign nations, the federal government, and the state. Policies, programs, and projects that will impact Tribes or Tribal communities very likely require a formal consultation process. Information about how to engage Tribal governments and leaders is outside the scope of this guide. If you are interested in engaging with Tribal communities, please contact DOH’s Tribal Relations Director.

Engaging Local Health Jurisdictions

The relationship between DOH and LHJs are multi-faceted. At times, LHJs are our partners on an important project or program. They also serve as important stakeholders for policy efforts, serve on our advisory boards and committees, and collaborate with us on new initiatives. LHJs are also our sub-recipients, which creates a contractor relationship with the agency. LHJs should always be engaged whenever your activity includes engaging communities in their jurisdiction. For more information about how to engage or communicate with LHJs, please contact DOH’s Local Health Liaison.

Ethical Research and Engagement

Some community engagement activities may be considered research. Per DOH Policy 03.001, programs are responsible for getting approval from the Washington State Institutional Review Board prior to conducting research or research-related activities. For more information, review DOH’s Human Subjects and Public Health Practice Guidelines.

Additionally, add DOH employees should review relevant ethics policies and laws before planning their community engagement activities.

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Community Engagement Checklist

☐ Review the Key Principles of community engagement. and reflect on any biases, assumptions, or privileges you have.^ Learn about the community

Key Principles, p.

☐ Identify the and reach out as early as possible.^ community^ partners, members, or stakeholders you wish to engage,^ Worksheet,p. 12-

☐

Notify Local Health Jurisdictions touched by your effort, and involve them as appropriate.

Engaging LHJs, p. 3

☐

Choose a method , place, date, and time of engagement that are culturally and linguistically appropriate.

Methods, p. 6, 14-

☐ Review state ethics laws processes.^ and ethical research guidelines and follow any applicable

Additional Resources, p. 11

☐

Create an evaluation plan with the community or partners based on how they would measure or define success.

Evaluation, p. 10

☐ Get feedback from community leaders^ on your method, questions, and approach.^ Methods, p. 6

☐

Identify potential barriers and make a plan to mitigate them to ensure equal opportunity for participation.

Common Barriers, p. 7-

☐

Intentionally listen , give value to all voices and perspectives, and provide space for those impacted by injustices.

Key Principles, p. 5

☐

Only make promises you can keep. Be honest and forthcoming about what you can do with the feedback you receive.

Key Principles, p. 5

☐

Evaluate the effectiveness of your partnership or community engagement effort during the project and make adjustments as needed to structure, membership, and processes.

Evaluation, p. 10

☐

Gather feedback from the community or partners about how the project went, and use their perspectives to inform your evaluation.

Evaluation, p. 10

☐ Share the results programs.^ and next steps with the community, partners, and other DOH

Key Principles, p. 5

☐ Reflect on what can be improved^ for your future community engagement efforts.

Key Principles, p. 5

☐ Stay connected^ in order to maintain a long-term relationship.

Key Principles, p. 5

Before

During

After

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Key Principles

Community engagement can be complex. To be effective, we need to recognize and respect the di- versity and assets of the communities we are engaging. It takes a long time to build strong relationships, and it takes even longer to repair relationships that have been damaged. Approach all groups with humility and anticipate learning about the subtle nuances of each community. Following these key principles can help you build trusting relationships with community members, leaders, and partners.

Do your research about the community

It’s important to understand the community’s culture, norms, values, power and political structures, economic conditions, social networks, demographic trends, and history. Addi- tionally, become aware of the community’s history of collaborating with other programs at DOH, other agencies, and our partners, including the barriers they have faced in engaging with us.

Do your research about yourself

Before engaging with a community or potential partner, check your own biases, privileges, and limitations.

• What assumptions or stereotypes do you hold about this community?
• How could your assumptions negatively impact your interactions or efforts?
• How do your cultural norms and values align with those of the community?
• Are you the most effective person to be leading this engagement effort, or should you work with or through partners?

Allow community members to self- identify

Remember that our cultural identities are dynamic, how people identify is a personal choice, and that the people we engage are both individuals and members of various groups. Some communities and individuals we strive to reach may have intersectional identities, which means they are members of more than one group that has been historically marginalized or oppressed.

Prioritize unheard perspectives

Give space and power to the perspectives of those whose voices are least heard. Listen with the intent to take action on the needs expressed by the community. Recognize that indivi- duals have different perspectives and no perspective should be valued more than another.

Value others’ time We should never expect community members to volunteer their time or expertise. Show that you value what they bring to your project through compensation, reimbursement, or support for one of their priorities.

Avoid tokenism Individuals should never be expected to speak on behalf of, or represent, an entire community.

Recognize strengths and assets

Even communities that experience the greatest health and economic inequities have strengths, assets, and resources that should be acknowledged and leveraged.

Be proactive If you are working on a specific project or trying to address certain health issues, reach out to potential partners and community members as early as possible.

Ensure communi- cation is ongoing

Collaboration requires continual opportunities for conversation and sharing. Use two-way communication methods that partners or community members are familiar with using.

Be transparent Be honest and forthcoming about the purpose of your project and how you will use the input you receive. Only make promises you can keep and make sure to follow through on your commitments. Not following through can erode the trust you have worked hard to build.

Meet people where they are

Be flexible in your approach. Go to the community—where members gather—and work to build relationships and trust. Look for opportunities to immerse yourself in the community you are trying to reach by attending community events and groups.

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Common Barriers

Community members and partners may face barriers to collaborating with us. To be successful in engaging the community, ensure your community engagement approach addresses their barriers.

Language

Community members who prefer to communicate in a language other than English or have unique vision or hearing needs, will need language assistance services to participate.

• Identify the linguistic needs of your community by talking to community leaders and key informants, and by reviewing language data.
• Translate all meeting materials and announcements into the top languages spoken within the area or community.
• Let people know ahead of time that interpretation services will be available for the event or meeting.
• Arrange for free interpretation services, including sign language and real-time translation services.

Resource

Culturally and linguistically appropriate services

Common Barriers Potential Solutions

Culture

You may need to accommodate certain cultural values to ensure all members are able to participate. For example, should you meet with men and women separately? Would you be more effective in engaging youth with or without their parents present?

• Be mindful of cultural and religious observances and events when choosing a meeting date and time.
• Ask community leaders or key informants about the most culturally appropriate way to engage community members and then adapt your approach.

Resource

Cultures Connecting 2017-2018 Diversity Calendar

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Geographic Location

It may be difficult for rurally-isolated communities to attend in- person engagement activities.

• Meet people where they are at (physically). Hold your event at a location the community regularly meets or gathers.
• Choose a location that is accessible by public transportation.
• Offer travel reimbursement and lodging.
• If you are organizing multiple events or meetings, consider holding them in different locations.

Common Barriers Potential Solutions

Intercommunity

Dynamics

It may be inappropriate to bring all the members of one community together in a shared space because of inter-community relationships, power structures, or other norms.

• Do your research ahead of time to learn about any potential intercommunity dynamics that may create barriers for some members to engage.
• Talk with community leaders and other partners to get their perspective.
• Consider what part of the community is disempowered within status-quo power structure.
• Learn from other organizations and DOH programs who have worked with the same community in the past.

Our Own Implicit Bias

Implicit bias refers to the associations, stereotypes, and assumptions that we make about people. Our biases can affect how we interact with others and our relationships with community members.

• Do your research about yourself before engaging with any community you are not a member of.
• Commit to continuous, critical self-reflection.
• Be humble, respectful, and honest. Admit mistakes when you make them.

Resource

Project Implicit, Harvard University

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Stigma

Stigma can prevent some communities from participating, especially within certain populations, such as people living with HIV/AIDS.

• Be mindful of how stigma may impact those you’re trying to reach.
• Consult with an agency or community expert on stigma reduction strategies

Time

Some of the more logis- tical aspects of community engagement take time. Plan accordingly and adapt your timeframe as needed to meet the needs of the community.

• Think about the daily schedules of the people you’re trying to engage.
• If you will be hiring a vendor for your project, allow three months for the contracting process.
• If your project qualifies as research, allow two months to seek approval from the Institutional Review Board.

Common Barriers Potential Solutions

Government Jargon

and Process

Government has its own language and way of doing things that may create unintentional barriers for people outside our agency.

• Use simple, clear language in all communications and be cognizant of overusing acronyms.
• Check your assumptions about what aspects of the way we do our work is common knowledge.

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Competing Priorities

Do not expect that community members will be able to drop everything else in their lives to participate in a DOH project. They have full lives with many responsibilities and commitments that may take priority. You may be able to mitigate some of these competing priorities through thoughtful planning.

• Family: If you plan to engage parents or caregivers in person, consider needs for childcare or provide options for remote engagement.
• Food: The sharing of food to bring people together is common across cultures. If possible, bring healthy and culturally appropriate snacks or meals when holding community meetings or focus groups. Make sure to ask community members about dietary restrictions and preferences ahead of time.
• Work: Often, community members are not reimbursed for their time whereas partners who work for other agencies and organizations may be able to participate during work time. Look into options for providing incentives and travel reimbursement to decrease barriers for participation. Additionally, people who work full- time may prefer evenings or weekends.
• School: If engaging students or those within the academic community, consider the time of year and school schedules. It may be difficult to engage during school hours, the start of the school session, exam times, or school breaks.

Resource

DOH’s Heathy Nutrition Guidelines for Meetings and Events

Technological Barriers

Remote and online engagement can work really well for some communities, but you may lose some community members due to technological barriers.

• Choose a platform your participants are familiar with.
• Review information about the technological requirements ahead of time to make sure they are clear, straightforward, and not overly burdensome.
• Ensure technological support is available before and during the event.

Common Barriers Potential Solutions

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Closing

Thank you for using DOH’s Community Engagement Guide, and for contributing to our agency’s efforts to build meaningful relationships with the communities we serve and advancing health equity. The following references and appendices provide additional resources. If you need any other assistance, please contact the Center for Public Affairs, Community Relations & Equity quadrant.

Additional Resources

Internal

• Evidence-based Approach to Improving the Health and Safety of the Population
• Health Equity Review Planning Tool
• Guide for Health Promotion and Health Education Activities
• Well Crafted: The PCH style guide for design and communication best practices
• Human Subjects and Public Health Practice Guidelines
• Ethics policies and laws

External

• King County Health Equity Assessment Tool
• Messaging Guide for Policy Advocates
• CDC’s Principles of Community Engagement, Chapter 7: Program Evaluation and Evaluating Community Engagement
• IMPACT: A Practical Guide to Evaluating Community Information Projects

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Definitions

Community

A diverse group of individuals who interact with one another and may have overlapping traits, cultures, beliefs, tendencies, needs, geographic proximity, or shared histories. Individuals self- identify with their communities, can belong to more than one community, and may prioritize a community more than others.

MacQueen et al., 2001

Community Engagement

The process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the wellbeing of those people. It is a powerful vehicle for bringing about environmental and behavioral changes that will improve the health of the community and its members. It often involves partnerships and coalitions that help mobilize resources and influence systems, change relationships among partners, and serve as catalysts for changing policies, programs, and practices.

Centers for Disease Control and Prevention, 1997

Health Equity

Exists when all people can attain their full health potential and no one is disadvantaged from achieving this potential because of the color of their skin, ancestry, level of education, gender identity, sexual orientation, age, religion, the job they have, the neighborhood in which they live, socioeconomic status, or whether they have a disability.

DOH Health Equity Workgroup, 2016

Cultural Humility

Being open to and respecting the self-identified cultural and personal factors of an individual’s life. This involves ongoing reflection and self-awareness of one’s own biases to avoid perpetuating cultural assumptions. True cultural humility requires an appreciation for the richness and complexity of the concept of culture.

Foronda et al., 2016

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ppendices

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