Chapter 2. Part 3. For Engagement to Succeed . . .

"Partnering with the community is necessary to create change and improve health."

A partnership is a relationship between individuals/groups characterized by mutual cooperation and responsibility, for the achievement of a specified goal. Many of the organizing concepts, models, and frameworks in Chapter 1 speak to the relationship between community partnerships and positive change. CBPR and current approaches to translational research recognize community engagement significantly enhances the potential for research to lead to improved health.

The individuals and groups involved in a partnership must identify opportunities for co-learning and feel that they each can meaningfully contribute. At the same time, partners should identify something to gain from the pursuit of improved health. Every party in such a relationship also holds important responsibility for the final outcome of an effort.

"All aspects of community engagement must recognize and respect the diversity of the community. Awareness of the various cultures of a community and other factors affecting diversity must be paramount in planning, designing, and implementing approaches to engaging a community."

Diversity may be related to economic, educational, employment, or health status. It may also include differences in culture, language, race, ethnicity, age, gender, mobility, literacy, or personal interests. These elements of diversity may affect individuals' and communities' access to

• health care delivery,
• their health status, and
• their response to community engagement efforts.

The processes, strategies, and techniques used to engage the community must be respectful of and complement cultural traditions. Another element of community diversity is the roles that different people and organizations play in the functioning of a community. Engaging these diverse populations will require the use of multiple engagement strategies.

"Community engagement can only be sustained by identifying and mobilizing community assets and strengths and by developing the community's capacity and resources to make decisions and take action."

Community assets include the interests, skills, and experiences of individuals and local organizations. It also includes the networks of relationships that connect them. Individual and institutional resources such as facilities, skills, and economic power can be mobilized for community health decision making and action. In brief, community members and institutions should be viewed as resources to bring about change and take action. Chapter 1 highlights the need to offer an exchange of resources to ensure com-munity participation.

The literature stresses that engagement is more likely to be sustained when new resources and capacities are developed. Engaging the community in making decisions about health and taking action in may involve the provision of experts and resources. This may help communities develop the necessary capacities (e.g., through leadership training) and infrastructure to

• analyze situations,
• make decisions, and
• take action.

"Organizations that wish to engage a community as well as individuals seeking to effect change must be prepared to release control of actions or interventions to the community and be flexible enough to meet its changing needs."

As mentioned in Chapter 1, engaging the community is ultimately about facilitating community-driven action. Community action should include the many elements of a community that are needed for the action to be sustained. All while still creating a manageable process. Community engagement will create changes. Changes in relationships and in the way institutions and individuals demonstrate their capacity and strength to act on specific issues.

"Community collaboration requires long-term commitment by the engaging organization and its partners."

Communities and community collaborations differ in their stage of development. As noted earlier, community engagement sometimes occurs around a specific, time-limited initiative. More commonly, however, community participation and mobilization need nurturing over the long term. Moreover, long-term partnerships have the greatest capacity for making a difference in the health of the population.

Building trust and helping communities develop the capacity and infrastructure for successful community action takes time. Individuals and organizations may need additional resources, knowledge, and skills to become players and partners in decision making for community health. For example, partners might need long-term technical assistance and training related to

• developing an organization,
• securing resources,
• organizing constituencies to work for change,
• participating in partnerships and coalitions, resolving conflict, and
• other technical knowledge necessary to address issues of concern.

Furthermore, strategies must be developed for sustaining efforts. The probability of sustained engagement and effective programming increases when community participants are active partners in the process.