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Improving the health of communities through participation

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Introduction to the Project

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The partnership between the La Trobe Rural Health School and rural health services involves a three year program to engage with local communities. The program supports the facilitation, production and exchange of information between all stakeholders to generate sustainable health services and approaches that positively impact on the health of the community. Central to the program are the PhD students who will complete a PhD by publication that documents the community process, outcomes and outputs. The doctoral projects will be based on collaborative and participatory research methodology and will have clear outcomes for the community; as well as cross cutting research projects focused on evaluation of community engagement processes from an international perspective, evaluation of inclusion and evaluation of health literacy.

The program provides the opportunity to explore some of the unanswered questions that relate to community involvement including: • What is the role of communities in the design and implementation of a regional health system? • What models of services do communities design when given a range of data, information and research evidence? • What models of community engagement and enablement are appropriate? • Can community engagement lead to changes in health literacy?

Meet the Academic Team

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Introduction to each of the academics with links to their uni profiles

Meet the Health Services

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Heathcote Heath

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“Heathcote Health is committed to the development and implementation of an effective community engagement and participation program and this project will greatly assist us in understanding how best to partner with the Heathcote community to achieve positive health and wellbeing outcomes.”Dan Douglas, CEO Heathcote Health

Rochester and Elmore District Health Service

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“This project provides a great opportunity for REDHS to build on connections with the communities we provide services to. This research with La Trobe University will lead to short and long term outcomes and will provide a meaningful way for people in our catchment to have a greater say in the services REDHS provides.”Matt Sharp, CEO Rochester and Elmore District Health Service

Rural Northwest Health

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Rural Northwest Health “We believe that this research project will enable us to engage and talk to local community members about what health topics are important for them. Outcomes achieved will be a community that will have improved knowledge about the local health services and what they can do to develop their health.” Catherine Morley, CEO Rural Northwest Health

The Lastest News From the Communities

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Heathcote News

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Introduction from Elena and updates

Rochester/Elmore News

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Introduction from Mary and regular updates

Warracknabeal News

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Introduction from John and regular inputs

The Latest News from the PhD Fishbowl

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The International Scene

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Introduction from Nerida and regular updates Link to her Wiki page

The Inclusion Corner

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Introduction from Emma and regular updates

Enhancing Health Literacy

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Introduction from Diana and regular updates

The Latest News from the Academics

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4 April 2013

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Assoc. Professor Amanda Kenny recently presented at the Taking the Pulse Conference held in Brisbane, outlining eight simple lessons learnt from the community participation projects undertaking to date. We thought these lessons are too good not to share more widely.

The eight things we’ve learnt

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Through all of the projects we have been engaged in, there are some simple things that we have learnt.

1.Engaging citizens in health decision-making is important but there must be different ways for people to engage and they must be supported with development opportunities.

2. You need to be clear what you are engaging about. You need to think about where you sit on the ladder of participation and the best way to achieve what it is that you want to achieve.

3. There must be clear and transparent processes around participation. It is important that people understand the purpose of their participation, how much power they have in decision making, whether decisions have already been made and whether their views will fundamentally change or influence decisions.

4. Power is a fundamental consideration. The tokenistic consumer on a program advisory group – the risk with these approaches is that a genuine intention to empower can serve to further marginalise and disempower. Engaging people on a committee or steering group can serve to neutralise criticism and can ensure that we can say that we have consulted, however, the benefits for those involved may be limited. One of the questions to ask is who decides what gets decided? How are the agenda and the process of participation decided? Have we confronted and discussed the power relationships that exist within the groups that we establish?

5. Personally, I don’t believe that all participation should aim at engaging all people. The risk is that it becomes managerialist participation, an exercise to simply tick boxes. One of the questions that we ask is who is included who is excluded and does it matter? What processes are used to engage people and are these the best processes for these groups?

6. Ensuring people have access to information is important to ensure that input and decisions can be based on evidence. This must include access to financial and cost data. When people are given costs, policies, and constraints and can include these in their deliberations, participation rises. True participation is not just about listening. The assumption that whatever a local community says is true must be true works directly against meaningful participation. Communities must be informed. Holding an open public meeting and asking people what they want without any parameters is a dangerous thing to do and serves to promote individual agendas and leave people feeling devalued and frustrated.

7. Higher levels of participation take time. There is an enormous amount of work in building trust, discussing power and developing meaningful conversations.

8. The word empowering is a really interesting and overused one. We often talk about giving people a voice but I believe that it is far more. There is enormous opportunity for communities to develop solutions, to come up with creative ways of addressing the issues that they encounter rather than waiting for solutions to be imposed from the top down. A really simple but great example of this was a presentation that I gave in a community about the health reform agenda. An older woman came up to me afterwards and said that her biggest fear was that she would die alone and would be in her house without being found. A couple of young women standing there reassured her that they could help. By the end of the conversation they had set up a simple process where they would call her regularly.

To read the full presentation go to: Crikey Website