Using an asset-based approach to explore the benefits of involvement in community-centred initiatives

Purpose:
To explore with community groups, using an asset-based approach, what local individual and community assets exist in a deprived English Local Authority area;

To reflect with participants on how these assets might be utilised to improve health and wellbeing;

To consider how such assets might be used to promote public health (PH) as part of changes to PH provision in the context of austerity measures and local authority budget cuts.

Background:
Effective community engagement is essential if local government is to achieve public health goals (NICE, 2014). However, despite widespread acceptance of the need to enable individuals and communities to take more control over their health and lives, ‘the invaluable contributions and experiences of citizens actively involved in their own communities are rarely considered as part of the evidence base’ (Public Health England, 2015).

There has been a recent shift in UK PH policy towards an ‘asset approach’, balancing the evidence base on health deficits (identifying problems and needs) with an equal focus on health assets (resources for creating health and wellbeing). An asset approach seeks to identify and mobilise the capacity, skills, knowledge, connections and potential in individuals, communities and organisations to create positive health and cultivate resilience.

Methods:
The study used principles of action research, seeking to engage with diverse groups in the locality (professionals and community members) in a process of reflective inquiry. An initial inquiry using ‘knowledge café’ workshops with statutory and voluntary services informed the research focus. Activities included reflective group discussion, photo elicitation and interactive question and answer sessions. Focus groups were held with members of 12 diverse community initiatives, focusing on how the activities and processes involved in community group participation facilitated the health and wellbeing of community members. Data were analysed using Template Analysis.

Conclusions:
Findings are organised in relation to three main areas: (i) Assets at a community level; (ii) Assets at an individual level; (iii) Making the most of assets: collaborative working between communities and others. Findings provide important insights to inform possibilities for how communities can play a more active role in responding to PH issues.

As autonomous and independent entities, community groups described themselves as better able than public sector services to devote the time needed to really understand and respond to their community members. Professionals are seen as offering advice; peers are seen as offering choices. Traditionally ‘hard to reach’ groups may respond better to peer rather than professional assistance. Participants identified numerous mental and physical health benefits from taking part in community groups. Professionals can play an important role supporting community members to develop their own health and wellbeing initiatives. Holistic community based solutions to public health improvement may require the development of an alternative set of indicators to monitor and evaluate change focusing for example on resilience, levels of individual community involvement and peer support rather than more conventional indicators such as decrease in smoking or healthy eating. There is an important role for qualitative research in the development and evaluation of such initiatives.