The goal of the Community Voices for Health (CVH) initiative is to build strong, inclusive community engagement infrastructure so that a broad range of people—especially those from marginalized and underserved communities—have a voice in health policymaking, are supported in efforts to solve community challenges, and benefit from community networks.
This section offers resources for planning comprehensive community engagement, building team understandings of equity-centered community engagement approaches, and understanding the role of power in building engagement.
More on Community Engagement
Why is engagement important?
Engagement matters. In fact, it has a direct effect on physical health. Research shows our physical health depends a great deal on whether we are connected to family, friends, neighbors, and health professionals. Public health improves when people work together to solve problems, by gathering information, volunteering, or collaborating with decision makers and health professionals. Engagement can prompt citizen action in the form of volunteer activities and initiatives focused either on health directly or on social determinants of health, such as promoting safety or encouraging people to exercise.
At the state level, helping people understand health issues while giving them a meaningful voice in health policy decisions will increase the likelihood that policies benefit the people they are intended to serve. The CVH approach helps people build, step by step, a comprehensive, multilevel infrastructure for engagement.
How does engagement impact health and policy outcomes?
- People become more informed about public issues. The CVH Pennsylvania team held 35 virtual or in-person conversations across the state (with participants from 27 counties) around health issues important to residents.
- Relationships between citizens and public officials are strengthened. The CVH Georgia team supported community health workers (CHWs) in hosting a virtual CHW Advocacy Day at the Georgia State Capitol. The event highlighted the special knowledge of clients’ lives held by CHWs and showed how CHWs can serve as a valuable resource for policymakers—particularly in identifying disparities and improving health outcomes in marginalized communities.
- People come up with ideas for new activities or initiatives. The CVH Nevada team created a PhotoVoice project for high school- and college-aged youth across the state. The initiative culminated in larger community discussions that illuminated deeply rooted issues now on the table for future policy advocacy. Topics examined by Nevada’s youth included the disrepair of Nevada’s rural highways, grocery store deserts, climate change, and rising rents. Of particular interest among youth in both Northern and Southern Nevada was the issue of homelessness.
- The CVH New Mexico team developed community-based participatory research tools with county and tribal health councils (piloted in six high-need areas of the state). This empowered community leaders to address urgent needs in public health, primary care, behavioral health, and social determinants of health. After being informed, people move to action. The CVH Colorado team developed a six-week curriculum for a cohort of African American Denver residents to develop their skills in community engagement, community-based participatory research, and base building to increase their issue-based knowledge around youth violence, behavioral and mental health, and equitable housing. Participants “graduated” from the training with the knowledge required to co-create programs and initiatives around health equity and health-equity policy.
- People find the resources and build the relationships they need to implement their ideas. The CVH Indiana Team partnered with other key organizations on the Community Health Improvement Plan (CHIP) process. Together, they combined data sources (health data from CVH, the Department of Health, Indiana University Health, and secondary sources) to identify the top 10 priority needs of the state. They then designed two community-wide think-tank sessions to inform the work of the CHIP over the next three years.
- New leaders emerge. From each of the diverse approaches across the country emerged new individual and organizational leaders who inspired direction, innovation, and action.
How does it work?
The Community Voices for Health initiative employs a holistic approach to health. Change is driven by a network of individuals and community-based organizations focused on community health and well-being, such as consumer-advocacy groups, organizations serving recent immigrants, and affordable-housing advocates. These networks work in partnership with public health departments and leaders, healthcare systems, researchers, university-based centers, social service providers, and many others.
The network-based approach leverages each stakeholder’s specific expertise, unique perspective, and set of connections. It builds upon the existing assets of each individual, organization, and community.
Frameworks To Support Community Engagement Efforts
For a deeper dive into the types of community engagement, best practices, and frameworks for building networks, explore the following guides:
- Community Voices for Health Planning Guide: For building networks and community engagement infrastructure to make health systems and policies better serve all people—especially marginalized and underserved communities. The guide provides context on different types of engagement, including state-specific examples of the impact of community engagement on health, and strategies for engaging and amplifying the voice of marginalized populations (e.g., rural communities, people who are homeless, immigrants).
- Guide for Building Coalitions and Networks: For recruiting participants, communicating about engagement, providing information and options about solutions for challenges, managing discussions, helping participants generate ideas and make group decisions, and supporting action efforts
- Strengthening and Sustaining Public Engagement: A Planning Guide for Communities: For helping residents design systems of engagement and strategies for ensuring sustainability
Activities: Setting The Foundation For Equitable Community Engagement
Strong internal team dynamics set the foundation for partnership with external stakeholders. It is essential for lead organizations to develop trust, shared definitions, and understanding that will enable collective impact. The resources below provide suggestions and activities to build a strong foundation.
Set community agreements
Community agreements are ground rules jointly developed by the facilitator and participants to ensure that meetings are productive and that there is a plan for addressing conflicts. They offer a framework for collective ownership and accountability.
Here are some examples of common community agreements include:
- challenge the idea not the person
- take space, make space
- operate with courage and a willingness to look at oneself
- listen for understanding
- take care of yourself
Once the agreements have been identified, the facilitator will ask participants for agreement around the ground rules. Should any disagreement arise, the facilitator and participants can refine the ground rules. This practice builds the muscle needed to work through difficult group dynamics.
Considerations for equitable meeting design
- Create a participatory, inclusive meeting design. Carefully craft agendas for online and in-person meetings to give participants time to interact with each other and deliberate over key concepts.
- Give people a chance to tell their stories. When people have a chance to relay their experiences, they are much more likely to learn from each other, be civil toward one another, form stronger relationships, and make the connection between their individual interests and the public good.
- Build trust among residents and between residents and decision makers. Sharing stories and experiences builds relationships not just among residents but also between residents and decision makers, especially when those decision makers are involved in building the engagement infrastructure.
- Provide factual information—as much as people want. In an era when information—and disinformation—circulates more quickly and widely than ever, providing user-friendly basic information about public problems, budget expenditures, public services, and other data is an essential component of engagement. Information can be shared in numerous ways, including through printed handouts, information briefs, infographics, interactive online maps, machine-readable datasets, presentations, discussion, issue guides, and access to subject-matter experts. Some kinds of engagement, such as community-engaged research, rely on citizens to help gather and analyze the data.
- Make engagement convenient and accessible. Most people are busy and value engagement opportunities that fit easily into their schedules. Create opportunities that eliminate barriers to participation, such as language barriers and a lack of transportation or child care. Consider offering stipends to participants that cover costs for participating and compensate them for their time.
- Continually center equity and pay attention to power dynamics. In each meeting, revisit questions of inclusion, accessibility, and the locus of power.
- Centering equity: Exercises and resources for centering equity in community engagement, building relationships with marginalized and underserved communities, and shifting power toward the communities. Learn more.
- Understanding power: Activities for developing a shared understanding of what power is, how it currently exists, and how to use it in the context of a social challenge. Learn more.
Build on existing strength through engagement scans
Conducting an engagement scan is an asset-mapping activity that provides information on existing community engagement efforts, leadership, and other resources that can serve as building blocks for the strategic development of engagement infrastructure. The Pennsylvania Health Access Network’s state engagement scan demonstrates the power of scans to dramatically increase the number of people involved in health policy—especially people from marginalized communities whose voices are rarely heard—by identifying gaps in opportunities for community voice.
The goal of the Community Voices for Health (CVH) initiative is to build strong, inclusive community engagement infrastructure so that a broad range of people—especially those from marginalized and underserved communities—have a voice in health policymaking, are supported in efforts to solve community challenges, and benefit from community networks.
This section offers resources for planning comprehensive community engagement, building team understandings of equity-centered community engagement approaches, and understanding the role of power in building engagement.
Why is engagement important?
Engagement matters. In fact, it has a direct effect on physical health. Research shows our physical health depends a great deal on whether we are connected to family, friends, neighbors, and health professionals. Public health improves when people work together to solve problems, by gathering information, volunteering, or collaborating with decision makers and health professionals. Engagement can prompt citizen action in the form of volunteer activities and initiatives focused either on health directly or on social determinants of health, such as promoting safety or encouraging people to exercise.
At the state level, helping people understand health issues while giving them a meaningful voice in health policy decisions will increase the likelihood that policies benefit the people they are intended to serve. The CVH approach helps people build, step by step, a comprehensive, multilevel infrastructure for engagement.
How does engagement impact health and policy outcomes?
- People become more informed about public issues. The CVH Pennsylvania team held 35 virtual or in-person conversations across the state (with participants from 27 counties) around health issues important to residents.
- Relationships between citizens and public officials are strengthened. The CVH Georgia team supported community health workers (CHWs) in hosting a virtual CHW Advocacy Day at the Georgia State Capitol. The event highlighted the special knowledge of clients’ lives held by CHWs and showed how CHWs can serve as a valuable resource for policymakers—particularly in identifying disparities and improving health outcomes in marginalized communities.
- People come up with ideas for new activities or initiatives. The CVH Nevada team created a PhotoVoice project for high school- and college-aged youth across the state. The initiative culminated in larger community discussions that illuminated deeply rooted issues now on the table for future policy advocacy. Topics examined by Nevada’s youth included the disrepair of Nevada’s rural highways, grocery store deserts, climate change, and rising rents. Of particular interest among youth in both Northern and Southern Nevada was the issue of homelessness.
- The CVH New Mexico team developed community-based participatory research tools with county and tribal health councils (piloted in six high-need areas of the state). This empowered community leaders to address urgent needs in public health, primary care, behavioral health, and social determinants of health. After being informed, people move to action. The CVH Colorado team developed a six-week curriculum for a cohort of African American Denver residents to develop their skills in community engagement, community-based participatory research, and base building to increase their issue-based knowledge around youth violence, behavioral and mental health, and equitable housing. Participants “graduated” from the training with the knowledge required to co-create programs and initiatives around health equity and health-equity policy.
- People find the resources and build the relationships they need to implement their ideas. The CVH Indiana Team partnered with other key organizations on the Community Health Improvement Plan (CHIP) process. Together, they combined data sources (health data from CVH, the Department of Health, Indiana University Health, and secondary sources) to identify the top 10 priority needs of the state. They then designed two community-wide think-tank sessions to inform the work of the CHIP over the next three years.
- New leaders emerge. From each of the diverse approaches across the country emerged new individual and organizational leaders who inspired direction, innovation, and action.
How does it work?
The Community Voices for Health initiative employs a holistic approach to health. Change is driven by a network of individuals and community-based organizations focused on community health and well-being, such as consumer-advocacy groups, organizations serving recent immigrants, and affordable-housing advocates. These networks work in partnership with public health departments and leaders, healthcare systems, researchers, university-based centers, social service providers, and many others.
The network-based approach leverages each stakeholder’s specific expertise, unique perspective, and set of connections. It builds upon the existing assets of each individual, organization, and community.
Frameworks To Support Community Engagement Efforts
For a deeper dive into the types of community engagement, best practices, and frameworks for building networks, explore the following guides:
- Community Voices for Health Planning Guide: For building networks and community engagement infrastructure to make health systems and policies better serve all people—especially marginalized and underserved communities. The guide provides context on different types of engagement, including state-specific examples of the impact of community engagement on health, and strategies for engaging and amplifying the voice of marginalized populations (e.g., rural communities, people who are homeless, immigrants).
- Guide for Building Coalitions and Networks: For recruiting participants, communicating about engagement, providing information and options about solutions for challenges, managing discussions, helping participants generate ideas and make group decisions, and supporting action efforts
- Strengthening and Sustaining Public Engagement: A Planning Guide for Communities: For helping residents design systems of engagement and strategies for ensuring sustainability
Activities: Setting The Foundation For Equitable Community Engagement
Strong internal team dynamics set the foundation for partnership with external stakeholders. It is essential for lead organizations to develop trust, shared definitions, and understanding that will enable collective impact. The resources below provide suggestions and activities to build a strong foundation.
Set community agreements
Community agreements are ground rules jointly developed by the facilitator and participants to ensure that meetings are productive and that there is a plan for addressing conflicts. They offer a framework for collective ownership and accountability.
Here are some examples of common community agreements include:
- challenge the idea not the person
- take space, make space
- operate with courage and a willingness to look at oneself
- listen for understanding
- take care of yourself
Once the agreements have been identified, the facilitator will ask participants for agreement around the ground rules. Should any disagreement arise, the facilitator and participants can refine the ground rules. This practice builds the muscle needed to work through difficult group dynamics.
Considerations for equitable meeting design
- Create a participatory, inclusive meeting design. Carefully craft agendas for online and in-person meetings to give participants time to interact with each other and deliberate over key concepts.
- Give people a chance to tell their stories. When people have a chance to relay their experiences, they are much more likely to learn from each other, be civil toward one another, form stronger relationships, and make the connection between their individual interests and the public good.
- Build trust among residents and between residents and decision makers. Sharing stories and experiences builds relationships not just among residents but also between residents and decision makers, especially when those decision makers are involved in building the engagement infrastructure.
- Provide factual information—as much as people want. In an era when information—and disinformation—circulates more quickly and widely than ever, providing user-friendly basic information about public problems, budget expenditures, public services, and other data is an essential component of engagement. Information can be shared in numerous ways, including through printed handouts, information briefs, infographics, interactive online maps, machine-readable datasets, presentations, discussion, issue guides, and access to subject-matter experts. Some kinds of engagement, such as community-engaged research, rely on citizens to help gather and analyze the data.
- Make engagement convenient and accessible. Most people are busy and value engagement opportunities that fit easily into their schedules. Create opportunities that eliminate barriers to participation, such as language barriers and a lack of transportation or child care. Consider offering stipends to participants that cover costs for participating and compensate them for their time.
- Continually center equity and pay attention to power dynamics. In each meeting, revisit questions of inclusion, accessibility, and the locus of power.
- Centering equity: Exercises and resources for centering equity in community engagement, building relationships with marginalized and underserved communities, and shifting power toward the communities. Learn more.
- Understanding power: Activities for developing a shared understanding of what power is, how it currently exists, and how to use it in the context of a social challenge. Learn more.
Build on existing strength through engagement scans
Conducting an engagement scan is an asset-mapping activity that provides information on existing community engagement efforts, leadership, and other resources that can serve as building blocks for the strategic development of engagement infrastructure. The Pennsylvania Health Access Network’s state engagement scan demonstrates the power of scans to dramatically increase the number of people involved in health policy—especially people from marginalized communities whose voices are rarely heard—by identifying gaps in opportunities for community voice.
