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Table 4 Summary of guiding principles and corresponding supportive interventions, contextual factors and mechanisms leading to successful CE interventions

From: Achieving successful community engagement: a rapid realist review

Interventions

Enabling contextual factors

Enabling mechanisms

Relevant citations

Guiding principle 1: Ensure staff provide supportive and facilitative leadership based on transparency

Provide citizens access to all relevant resources

Implement two-way communication with citizens

Facilitate citizens’ understanding of key topics

Accessible points of connection between communities & local services

Supportive organisational structures

Unique points of connection between communities and local services

Staff’s support and facilitation makes citizens feel valued

Professionals openly listening to citizens’ problems and ideas, improves professionals’ understanding of communities’ needs

Transparency about limited resources can prevent communities from feeling frustrated

Chan & Benecki [30]

Durey et al. [32]

Tenbensel et al. [37]

Yoo et al. [40]

Guiding principle 2: Foster a safe & trusting environment to enable citizens to provide input

Invest resources in the building of trusting relationships with communities

Tailor strategies to citizens’ needs and preferences

Hold meetings outside organisational sphere

Adjust meetings and activities to citizens’ needs (e.g. language, timetable)

Citizens to (co)chair boards, steering groups

Hire demographically and culturally diverse staff in order to better reflect and connect with the communities

Accessible organisational structures

Community members included in governance and leadership of intervention and engaged in decision-making processes

Pre-established trusting relationships with communities

Culturally safe spaces build communities’ confidence to discuss their needs

Staff who create safe environments and address citizens’ supportive needs help build trust and cohesion

De Freitas & Martin [16]

Durey et al. [32]

Kegler et al. [41]

Kelaher et al. [33]

Luluquisen & Pettis [34]

Montesanti et al. [35]

Schoch-Spana et al. [42]

Veronesi & Keasey [39]

Guiding principle 3: Ensure citizens’ early involvement

Discuss with citizens the stage at which they want to be involved

Align organisational and citizens’ health definitions and priorities

Include citizens in needs assessments and identification of priorities

Financial or quality related organisational crises highlighting need for far-reaching change

Pre-established collaborative relationships

Early involvement motivates and enables all stakeholders to bring about change

Early involvement of some citizens can trigger others to become involved as well

Carlisle (2010)

Clark et al. [31]

Lang et al. [12]

Tenbensel et al. [37]

Veronesi & Keasey [39]

Guiding principle 4: Share decision-making and governance control with citizens

Adjust decision-making methods by having multiple professionals from the same organisation share one vote on decision-making committees, thus levelling out the vote share

Place citizens in leadership and decision-making positions

Share relevant resources and tools with engaged citizens

More in-depth collaboration between partners

Interventions initiated by citizens themselves

Organisations willing to address power imbalances

Citizens’ willingness to join intervention depends on extent to which organisations are ready to share control

Satisfaction rates of CE forums increases with number of involved citizens

Increasing citizens’ input during strategic and decision-making stages is valued by citizens and helps prevent feelings of disempowerment

Carlisle (2010) [9]

Clark et al. [31]

Durey et al. [32]

Kelaher et al. [33]

Lang et al. [12]

Luluquisen & Pettis [34]

Guiding principle 5: Acknowledge and address citizens’ experiences of power imbalances

Invest in communities with low levels of readiness to build their capacity

Adjust organisational approaches, structures, processes by privileging citizens

Allow citizens to shape their own role

Inclusive organisational structures

Equal number of citizens and professionals in leadership and decision-making positions

Clear remits for professionals and citizens

Clear recognition of citizens’ valuable contributions, legitimises initiatives

Equal presence of citizens on forums prevents citizens from experiencing being at the lower end of the power spectrum

Carlisle (2010) [9]

Kelaher et al. [33]

Lewis [17]

Luluquisen & Pettis [34]

Renedo & Marston [18]

Guiding principle 6: Invest in citizens who feel they lack the skills and confidence to engage

Provide professional or leadership training, e.g. in chairing meetings, conducting support-group sessions

Provide learning opportunities highlighting causes of citizens’ disadvantage and tools to alleviate these

Citizens motivated to improve their neighbourhoods and services they access

Improved awareness helps citizens to develop greater sense of control, self-confidence, skills

Being involved in direct peer recruitment can lead to service-users recognising their own entitlement to participation

Crondahl & Eklund Karlsson [10]

De Freitas & Martin [16]

Durey et al. [32]

Lang et al. [12]

Renedo & Marston [18]

Guiding principle 7: Create quick and tangible wins

Offer short-term mobilisation activities, e.g. neighbourhood clean-ups

Ensure citizens’ input is actually used

Use local media to share quick win stories

Pressing and visible health and socio-economic needs combined with significant community support for change

Early successes provide momentum, creates trust in CE processes and inspires other citizens to become involved

Short-term concrete improvements can maintain citizens’ dedication to CE processes when problems arise

Durey et al. [32]

Hamamoto et al. [11]

Kegler et al. [41]

Luluquisen & Pettis [34]

[40])

Guiding principle 8: Take into account both citizens’ and organisations’ motivations

Be flexible and allow citizens to focus only on those issues that interest them

Use crises situations to catalyse citizen engagement

Be transparent about organisational motivations and requirements

Be open and receptive to citizens’ negative service-usage experiences

Pressing and visible health and socio-economic needs and significant community support for change

Service-users and carers wanting to increase level of social interactions, and to upskill

Catering to citizens’ motivations helps maintain momentum

Building on citizens’ emotional links to neighbourhood or services can connect citizens

Crises situations can mean organisations are forced to change their traditional patterns

De Freitas & Martin [16]

Hamamoto et al. [11]

Lang et al. [12]

Lewis [17]

Pennel et al. [36]

Schoch-Spana et al. [42]

Van Eijk & Steen [38]

Veronesi & Keasey [39]