LEEDS BECKETT UNIVERSITY

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1 Natioal Istitute for Health ad Care Excellece Review 4: Commuity egagemet approaches to improve health: map of the literature o curret ad emergig commuity egagemet policy ad practice i the UK Ae-Marie Bagall 1, Jae South 1, Joae Trigwell 1, Karia Kisella 1, Judy White 1, Agela Harde 2 1 Cetre for Health Promotio Research, Leeds Beckett Uiversity 2 Istitute for Health ad Huma Developmet, Uiversity of East Lodo Versio rd July 2015 Cotact for further iformatio Dr Ae-Marie Bagall Reader i Evidece Sythesis (Health Iequalities) Cetre for Health Promotio Research Istitute for Health ad Wellbeig Leeds Beckett Uiversity Calverley Lae Leeds LS1 3HE t: +44(0) e: a.bagall@leedsbeckett.ac.uk LEEDS BECKETT UNIVERSITY 1

2 Ackowledgemets We would like to ackowledge our collaborative parters i this Stream 2 work (Reviews 4, 5 ad Primary Research Report 1) at the Istitute of Health ad Huma Developmet, Uiversity of East Lodo: Agela Harde, Kevi Sherida, Alex McKeow, Ifeosa Da- Ogosi ad Farah Jamal, who have worked closely with us at every stage. We would also like to ackowledge the thoughtful discussio ad help provided by colleagues producig Stream 1 work (Reviews 1, 2 ad 3) at the EPPI-Cetre, Istitute of Educatio, Uiversity of Lodo: Giy Bruto, James Thomas, Jey Caird, Gillia Stokes, Claire Stasfield, Dyla Keale, Michelle Richardso, ad by the NICE project team: Tracey Shield, Peter Shear, James Jagroo ad Atoy Morga. Fudig This is a idepedet report commissioed ad fuded by the Natioal Istitute for Health ad Care Excellece (NICE). The views expressed are ot ecessarily those of NICE. Coflicts of iterest Professor Jae South was a member of the NICE Public Health Advisory Committee PHAC developig the commuity egagemet guidelie ad was secoded to Public Health Eglad to develop the family of commuity cetred approaches durig developmet of the guidelie. There were o other coflicts of iterest i the writig of this report. Cotributios The opiios expressed i this publicatio are ot ecessarily those of Leeds Beckett Uiversity or of the fuders (NICE). Resposibility for the views expressed remais solely with the authors. This report should be cited as: Bagall AM, South J, Trigwell J, Kisella K, White J, Harde A (2015) Commuity egagemet approaches to improve health: Map of the literature o curret ad emergig commuity egagemet policy ad practice i the UK. Leeds: Cetre for Health Promotio Research, Istitute for Health ad Wellbeig, Leeds Beckett Uiversity. Copyright 2015 The authors of this report hold the copyright for the text of the report. The authors give permissio for readers of the report to display ad prit the cotets for their ow ocommercial use, provided that the source is cited clearly followig the citatio details provided. 2

3 Cotets Glossary... 4 Abbreviatios... 7 Executive summary Itroductio Methodology Fidigs Discussio Coclusio ad recommedatios Refereces APPENDIX A Sample search strategy from O Mara-Eves et al Appedix B Sample search strategy from Stream 1 update Appedix C Sample search strategy from PHE mappig review APPENDIX D Bibliography of icluded studies APPENDIX E Bibliography of excluded studies APPENDIX F List of Systematic Reviews mied for relevat studies APPENDIX G Table of icluded studies/ projects APPENDIX H The family of commuity-cetred approaches (South 2014) APPENDIX I Studies by type of commuity egagemet approach (South 2014; South 2015)

4 Glossary Asset-based approaches A asset based approach makes visible ad values the skills, kowledge, coectios ad potetial i a commuity. It promotes capacity, coectedess ad social capital (Glasgow Cetre for Populatio Health, 2011). Commuity egagemet The direct or idirect process of ivolvig commuities i decisio makig ad/ or i the plaig, desig, goverace ad delivery of services, usig methods of cosultatio, collaboratio ad/ or commuity cotrol (O Mara-Eves et al. 2013) Commuity mobilisatio/ actio A capacity buildig process, through which commuities pla, carry out ad/ or evaluate activities o a participatory ad sustaied basis to achieve a agreed goal. Icludes commuity developmet ad asset based approaches. Commuity developmet A process where commuity members come together to take collective actio ad geerate solutios to commo problems (Uited Natios ) Commuity orgaisatios New ad existig service developmet; coectig people to commuity resources ad iformatio. Extet of commuity egagemet Take from Stream 1 (Bruto et al. 2014): HIGH if level of CE = HIGH i all 3 of desig, delivery ad evaluatio; MODERATE if level of CE = HIGH i 2 out of 3 of desig, delivery ad evaluatio; LOW if level of CE = HIGH i 0 or 1 out of 3 of desig delivery or evaluatio. Level of commuity egagemet Take from Stream 1 (Bruto et al. 2014), for each of desig, delivery ad evaluatio: Commuity members leadig or collaboratig = HIGH; Commuity members cosulted or iformed = LOW Miig 1 d ?opedocumet 4

5 I this review, this refers to screeig referece lists of relevat systematic reviews to fid further primary studies that may meet the review iclusio criteria. These are the retrieved as full text ad screeed for iclusio. Mixed methods evaluatio A evaluatio that uses both quatitative methods (e.g. questioaires) ad qualitative methods (e.g. iterviews). No-peer health advocacy Possible roles are similar to those uder peer ivolvemet but ivolve members of the commuity that are ot peers of the target participats. Peer ivolvemet Peers are defied as people sharig similar characteristics (e.g. age group, ethicity, health coditio) who provide advice, iformatio ad support ad/ or orgaise activities aroud health ad wellbeig i their or other commuities. Ca iclude bridgig roles (e.g. health traiers, avigators) or peer-based itervetios (e.g. peer support, peer educatio ad peer metorig). Public health All orgaized measures (whether public or private) to prevet disease, promote health, ad prolog life amog the populatio as a whole. Its activities aim to provide coditios i which people ca be healthy ad focus o etire populatios, ot o idividual patiets or diseases (World Health Orgaisatio) Social capital The dispositio to create, develop ad maitai etworks that may be used for the purpose of social itegratio (The Social Capital Foudatio) Social exclusio Social exclusio is a complex ad multi-dimesioal process. It ivolves the lack or deial of resources, rights, goods ad services, ad the iability to participate i the ormal relatioships ad activities, available to the majority of people i a society, whether i ecoomic, social, cultural or political areas. It affects both the quality of life of idividuals ad the equity ad cohesio of society as a whole' (Levitas et al., 2007) Social etworks Explicit use of the term i study reports. Commuity mobilisatio/ actio approaches could use social etworks (e.g. timebaks). Targeted approaches 5

6 Eligibility ad access to services are determied by selectio criteria, such as icome, health status, employmet status or eighbourhood (Natioal Collaboratig Cetre for Determiats of Health, 2013). Uiversal approaches Eligibility ad access are based simply o beig part of a defied populatio such as all wome, all childre uder age six, or all people livig i a particular geographic area, without ay further qualifiers such as icome, educatio, class, race, place of origi, or employmet status (Natioal Collaboratig Cetre for Determiats of Health, 2013). Voluteers Used whe this term is explicitly used i study reports. Peer ad o-peer roles could ivolve voluteers but may ot be explicitly labelled as such. 6

7 Abbreviatios CE CBPR CRD DARE DOPHER TROPHI CPH NICE PHAC PPI HTA NIHR Commuity egagemet Commuity based participatory research Cetre for Reviews ad Dissemiatio, Uiversity of York Database of Abstracts of Reviews of Effects Database of Public Health Effectiveess Reviews Trials of Public Health Itervetios database Cetre for Public Health Natioal Istitute of Health ad Care Excellece Public Health Advisory Committee Patiet ad Public Ivolvemet Health Techology Assessmet Natioal Istitute of Health Research EPPI-Cetre Evidece for Policy ad Practice Iformatio ad Co-ordiatig Cetre PCT RCT C2 LTC Primary Care Trust Radomised Cotrolled Trial Coectig Commuities Log term coditio 7

8 Executive summary Backgroud Commuity egagemet has bee defied as the direct or idirect process of ivolvig commuities i decisio makig ad/or i the plaig, desig, goverace ad delivery of services, usig methods of cosultatio, collaboratio, ad/or commuity cotrol (O Mara- Eves et al. 2013). Commuity egagemet for health was defied i the scope for this work ((Natioal Istitute for Health ad Care Excellece, 2014) as beig about people improvig their health ad wellbeig by helpig to develop, deliver ad use local services. It is also about beig ivolved i the local political process. Commuity egagemet ca ivolve varyig degrees of participatio ad cotrol: for example, givig views o a local health issue, joitly deliverig services with public service providers (co-productio) ad completely cotrollig services. The more a commuity of people is supported to take cotrol of activities to improve their lives, the more likely their health will improve (Popay et al., 2007). Sice the publicatio of The Natioal Istitute for Health ad Care Excellece s guidace o commuity egagemet i 2008 (Natioal Istitute for Health ad Care Excellece, 2008) there has bee cosiderable research activity i this topic area. A recet NIHR review (O Mara-Eves et al., 2013) which focused o commuity egagemet for health iequalities foud 319 relevat studies, ad cocluded that commuity egagemet itervetios are effective i improvig health behaviours, health cosequeces, participat self-efficacy ad perceived social support for disadvataged groups. The Cetre for Public Health at NICE are ow updatig the 2008 guidace, ad this update icludes three streams of evidece: Stream 1 (Reviews 1, 2 ad 3): Commuity egagemet: a report o the curret effectiveess ad process evidece, icludig additioal aalysis. Stream 2 (Reviews 4 ad 5 ad Primary Research Report 1): Commuity egagemet: UK qualitative evidece, icludig oe mappig report ad oe review of barriers ad facilitators. Stream 3: A ecoomic aalysis (Reviews 6 ad 7). Stream 2 icludes three compoets: Review 4: a map of the literature o curret ad emergig commuity egagemet policy ad practice i the UK. Primary Research Report 1: a map of curret UK practice based o a case study approach. This cosists of a series of six case studies of curret or recet commuity egagemet projects; 8

9 Review 5: Evidece review of barriers to, ad facilitators of, commuity egagemet approaches ad practices i the UK. Figure 1 demostrates how Reviews 4 ad 5 ad Primary Research Report 1 are related to each other ad to the evidece from Reviews 1-3. Figure 1: Relatioship of Stream 2 compoets with each other ad with Stream 1. This report is of Review 4: Commuity egagemet approaches to improve health: map of the literature o curret ad emergig commuity egagemet policy ad practice i the UK. Aims ad objectives This mappig review provides a syopsis of the key fidigs from documetary aalysis (icludig grey literature) of the curret evidece base for UK local ad atioal policy ad practice for commuity egagemet. It aims to idetify, describe ad provide isight ito curret ad emergig commuity egagemet policy ad practice i the UK. 9

10 I additio to the mai aim above, the review set out to address ay or all of the followig research questios, from the fial NICE Guidace scope: Questio 3: What processes ad methods help commuities ad idividuals realise their potetial ad make use of all the resources (people ad material) available to them? Questio 4: Are there uiteded cosequeces from adoptig commuity egagemet approaches? Questio 5: What barriers ad facilitators affect the delivery of effective commuity egagemet activities particularly to people from disadvataged groups? I terms of the research questios, as this is ot a review of effectiveess, this compoet o its ow is uable to aswer ay of the review questios fully. Questio 3 is aswered i part by Reviews 1-3, ad more specific UK-focused aswers will be provided by Primary Research Report 1 (case studies) ad Review 5 (evidecereview of barriers ad facilitators). Primary Research Report 1 ad Review 5 will also seek to aswer review questios 4 ad 5. Methods a) Search strategy Our search strategy was desiged i collaboratio with our cosortium parter, the EPPI- Cetre, who carried out the systematic review of effectiveess for Stream 1. Give the difficulties of idetifyig studies via traditioal electroic database searches we focused our search efforts o Specialised research registers ad websites; The pool of icluded ad excluded studies from the recet NIHR review (O Mara- Eves et al., 2013); A update of the searches from the recet NIHR review (O Mara-Eves et al., 2013) carried out for Stream 1 which icluded a search of specialist systematic review websites ad databases (DoPHER; DARE; the Cochrae Database of Systematic Reviews, the Campbell Library, the HTA programme website) ad a search of the TRoPHI database of studies i health promotio ad public health; The results of searches carried out for a recet review of commuity based itervetios for Public Health Eglad (South, 2015); Miig of the referece lists of relevat systematic reviews obtaied from ay of these sources; Website searches of relevat orgaisatios; Direct calls for evidece by NICE ad by Leeds Beckett Uiversity via etworks of cotacts with commuity practitioers ad groups. 10

11 b) Screeig Records idetified from all searches were assessed by hierarchical iclusio screeig. Iclusio criteria covered populatios, itervetios, outcomes, study desig, coutry, date ad laguage. 1 DATE: studies published before (or for policy ad coceptual papers, before 2006) 3 were excluded. 2 COUNTRY: UK oly. Studies of o-uk projects or commuities or policies were excluded. 3 INTERVENTION: oly studies of commuity egagemet i public health topics were icluded (see glossary ad Chapter 2 for workig defiitios) 4 STUDY DESIGN: Empirical or theoretical research, or practice descriptios, or policy documets were icluded. Secodary research (e.g. systematic reviews) ad discussio or commetary papers that did ot preset empirical or theoretical research were excluded. The referece lists of systematic reviews were mied for relevat studies. Records were first screeed o title ad abstract. The iclusio criteria were tested ad refied after pilotig them o a radom sample of 10% of the titles ad abstracts. All reviewers idepedetly screeed these records ad ay differeces were resolved by discussio ad where ecessary, iformed by the advice of the NICE CPH team. Further pilot screeig was coducted util at least 80% agreemet betwee reviewers was reached. Oce this level of reliability was reached the remaiig records were radomly divided betwee reviewers for sigle screeig. All icluded records were marked for full text retrieval. Ay disagreemets were discussed or if ecessary resolved by the lead researcher. All full text studies were screeed by oe reviewer usig the agreed iclusio criteria, with a radom sample of 30% beig double screeed. Ay disagreemets were resolved by discussio ad recourse to a third reviewer. Those documets that passed the iclusio criteria o the basis of full text screeig were icluded i the review. 2 *Search date of 2000 owards would capture relevat ad appropriate records related to commuity egagemet as coceived i the scopig documet. The date rage is iformed by various legislatio (e.g. The Health & Social Care Act, Sectio 11: Public Ivolvemet & Cosultatio; Local Govermet Act) published at this time which geerated research activity. 3 Date chose to avoid duplicatio of effort with a previous review commissioed by NICE (Popay et al. 2007) to iform the previous NICE guidace o commuity egagemet (Natioal Istitute of Health ad Care excellece 2008). Searches for that review eded i 2007; we icluded articles from 2006 to allow for ay delays i articles beig idexed o electroic databases. 11

12 c) Codig As this was a mappig review, which ecompasses a wide rage of evidece rather tha focussig i depth o a arrower topic, data extractio was limited to codig withi categories, with limited explaatory text. Quality assessmet was ot udertake. Icluded studies were coded by oe reviewer ad a radom selectio of 20% checked by a secod reviewer, usig piloted pre-agreed forms. Ay disagreemets were resolved by discussio with referece to the full paper ad, where ecessary, a third reviewer. Codig categories icluded: Documet type, summarised i this report as o o S = research (research or evaluatio studies), or D = o-research (coceptual papers, policy documets or practice descriptios); Study desig (if research/ evaluatio study); Type of commuity egagemet (see glossary); Level ad extet of commuity egagemet (low, medium, high: see below); Name of iitiative; Lead orgaisatio; Type of activity; Settig; Targeted or uiversal approach; Health or wellbeig issues; Populatio group(s) (PROGRESS-Plus categories (Kavaagh et al., 2008)) 4 ; Outcomes reported (for research/ evaluatio studies oly): 4 The PROGRESS-plus framework highlights several social ad persoal dimesios that may affect health iequalities i.e.: Place of residece; Race/ ethicity; Occupatio; Geder; Religio; Educatio; Socio-ecoomic positio; Social capital; Other (e.g. age, disability, sexual orietatio, beig looked after, etc.). Recommeded by the Cochrae/Campbell Health Equity Group (Kavaagh J et al. 2008) 12

13 Level of commuity egagemet i desig, delivery or evaluatio: Take from Reviews 1-3 (Bruto et al., 2014), for each of desig, delivery ad evaluatio: Commuity members leadig or collaboratig = HIGH; Commuity members cosulted or iformed = LOW. Extet of commuity egagemet: HIGH if level of CE = HIGH i all 3 of: desig AND delivery AND evaluatio. MODERATE if level of CE = HIGH i 2 out of 3 of: desig, delivery ad evaluatio. LOW if level of CE = HIGH i 0 or 1 out of: desig, delivery ad evaluatio. d) Sythesis The key fidigs of the mappig review were summarised arratively i the first istace, with frequecies ad proportios of documets i certai categories also beig preseted. The literature was mapped, groupig papers usig categories from the codig process. Areas where there were multiple papers, or coversely, limited research were oted. Ay fidigs that related directly to the research questios were oted. Further arrative sythesis was udertake of policy ad coceptual documets. 13

14 Mai fidigs 4441 (91% of total) records were idetified through searches of electroic databases, ad 448 records (9% of total) were idetified from additioal sources (see below), makig 4897 records for iitial screeig. After screeig, 577 full text articles, 316 articles (6.5% of iitial umber) were icluded i the map. Source: Less tha half (39%, =123) of the 316 icluded articles came from electroic database searches. 108 (34%) came from miig the referece lists of idetified systematic reviews ad other secodary research articles, 37 (12%) came from website searches (icludig our ow istitutios), 20 (6%) came from NICE s call for evidece, 21 (7%) from the Register of Iterest, three (<1%) from citatio searches carried out for Compoet 2 (Harde et al., 2015) ad four (1.3%) came directly from Reviews 1-3 (Bruto et al., 2014). Documet type: 227 of the 316 icluded articles (72%) were coded as research or evaluatio, 77 (24%) were coded as practice descriptio, 40 (13%) as policy-related documets, ad 30 (9%) as coceptual or theoretical papers. Articles could be coded i more tha oe of these categories, most commoly policy combied with practice descriptio or research/ evaluatio. Study desig: Of the 227 research or evaluatio documets, the majority were coded as either mixed methods evaluatio (=90, 40%) or qualitative studies (=88, 39%). Sevetee studies (7%) were coded as questioaires or surveys, fiftee (7%) were radomised cotrolled trials, seve (3%) were before ad after studies ad five (2%) were oradomised cotrolled trials. Twety studies (9%) were coded as other : the majority of these were case studies, or the methods were ot described. There was some overlap betwee these categories, with some studies beig coded as more tha oe study desig. Policy: There are a umber of cosistet themes relatig to the UK policy cotext for commuity egagemet ad health, based o aalysis of 40 policy publicatios* Firstly, policy documets, reviews ad commetary cocerig commuity egagemet ad health ca be mapped across a wide rage of policy areas ad sectors. These iclude: health policy ad the NHS, local govermet policy ad regeeratio, third sector ad voluteerig ad also health iequalities as a cross cuttig policy issue. Very few publicatios were focused exclusively o commuity egagemet ad public health, but all related to i some way to the active participatio of idividuals ad commuities as a mechaism to improve health, commuity life or quality of local services or alteratively to reduce iequalities ad area disadvatage. Secodly, sice 2006 there are cosistet themes across govermet policy relatig to the sigificace of commuity egagemet ad empowermet. The review has highlighted a umber of specific policy iitiatives from both Labour govermet ad the Coservative-Liberal Democrat Coalitio govermet of These iclude chages i patiet ad public ivolvemet (PPI) structures ad public ivolvemet mechaisms affectig health plaig ad services; eighbourhood maagemet, Localism aimed at devolutio of power to local commuities ad health iequalities policy. There are also 14

15 relevat policies from the devolved assemblies (Scottish Govermet, 2013, Welsh Assembly Govermet, 2008). Overall, publicatios relatig to iequalities ad commuity empowermet, whether origiatig from govermet or from idepedet sources, like the Marmot review (Marmot, 2010), called for ew relatioships betwee services ad commuities that give more power to commuities, eablig idividuals to play a greater part i local decisios that affect their health ad lives. Thirdly, the review has idetified a cosistet theme aroud the cotributio of idividuals ad commuities to health ad to society i geeral. Discussio ad commetary cluster roud various cocepts which are frequetly cross-refereced to each other. These iclude asset-based approaches, co-productio ad voluteerig. *(Atkiso, 2012, Bauld et al., 2005a, Blak et al., 2007, Boydell ad Rugkåsa, 2007, Bridge, 2006, Cabiet Office, 2011, Commuities ad Local Govermet, 2007, Departmet for Commuities & Local Govermet, 2006b, Departmet for Commuities & Local Govermet, 2007a, Departmet of Health, 2004, Departmet of Health, 2006b, Departmet of Health, 2007a, Departmet of Health, 2008b, Departmet of Health, 2008a, Edwards, 2002, Keedy, 2006, Lawless et al., 2007, Local Govermet Iformatio Uit, 2012, Marmot, 2010, Nesta, 2013, Office of the Deputy Prime Miister, 2006, Scottish Commuity Developmet, 2013, Scottish Commuity Developmet Cetre, 2013, Scottish Govermet, 2013, Sustaiable Developmet Commissio, 2010, Thraves, 2013, Wait ad Nolte, 2006, Wallace, 2007, Waless, 2002, Waless, 2004, Welsh Assembly Govermet, 2008, Whitehead ad Dahlgre, 2007) Cocepts: 30 articles explored cocepts ad theories related to commuity egagemet**. A diverse rage of cocepts are used to explai ad critique aspects of power ad participatio. There is o commo termiology ad a umber of papers poit to the challeges of defiig what are complex sets of ideas. Oly four papers specifically dealt with commuity egagemet as a defied topic (Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Sherida ad Tobi, 2010, South ad Phillips, 2014). Empowermet cotiues to be a sigificat theme both how it ca be achieved ad what it meas. Sice 2006, other relevat cocepts, such as co-productio ad voluteerig, have gaied some promiece i public health literature. The implicatios are that commuity egagemet, as proposed i the earlier NICE guidace (Natioal Istitute for Health ad Care Excellece, 2008), is best see as a umbrella term that covers a rage of cocepts relatig to participatio ad empowermet. **(Joes, 2004, Attree et al., 2011, Beresford, 2007, Boydell ad Rugkåsa, 2007, Boyle et al., 2010, Browlie et al., 2006, Burto et al., 2006, Cabiet Office, 2011, Chadderto et al., 2008, Chirewa, 2012, Commuities ad Local Govermet, 2007, Departmet of Health, 2006b, Draper et al., 2010, Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Hardill et al., 2007, Keedy, 2006, Laverack, 2006, Local Govermet Iformatio Uit, 2012, Mahoey et al., 2007, McDaid, 2009, Nesta, 2013, Office of the Deputy Prime Miister, 2006, Scottish Govermet, 2013, Sherida ad Tobi, 2010, Specer, 2014, Truma ad Raie, 2001, Wait ad Nolte, 2006, Wallace, 2007, South ad Phillips, 2014) 15

16 Commuities: The largest group of articles (=112, 36%), both research (=89, 39%) ad o-research (=28, 31%), looked at iitiatives i urba settigs. A large umber (=90, 29%) also looked at iitiatives i both urba ad rural settigs. Oly 11 articles (4%) looked at iitiatives i rural settigs aloe (Bromley, 2014, Davis, 2008, Dickes Ady et al., 2011, East Midlads Regioal Empowermet Partership, 2009a, Elliott et al., 2007, Halliday ad Asthaa, 2005, Hoddiott et al., 2006a, Hoddiott et al., 2006b, Osbore et al., 2002, Starkey et al., 2005, Stutely, 2002). I 43 studies, the settig was ot clear. As this was a mappig review, we did ot udertake detailed data extractio o the populatios other tha to code for idicators of health iequalities usig the PROGRESSplus tool (see Health Iequalities below). However, the UK map icludes articles o commuities of place (e.g. Well Lodo (Phillips et al., 2012)), commuities of culture (e.g. Roma support group (Roma Support Group, 2009)), ethicity, age (e.g. Youth.com (Craig, 2010); MAC UK (Metal Health Foudatio, 2013); Parterships for Older People (Williamso et al., 2009, Widle et al., 2009) or health ad wellbeig issues (e.g. log term coditios (Hills et al., 2007)). The health ad wellbeig issues addressed most frequetly by UK commuity egagemet iitiatives were commuity level or wellbeig outcomes, rather tha idividual behaviour chage outcomes: social capital or social cohesio (=129, 41%) e.g. improved social etworks (Burgess 2014), reductio i crime (Stutely ad Cohe 2004); commuity wellbeig (=110, 35%) e.g. commuity resiliece (Ciderby et al. 2014), empowermet (Hothi et al. 2007) ; persoal wellbeig (=82, 26%) e.g. positive metal health (IRISS 2012, Tuariu et al. 2011), quality of life (Nazroo ad Matthews 2012); geeral health persoal (=99, 31%) e.g. weight maagemet (Jeigs et al. 2013), healthy lifestyle promotio (Robiso et al. 2010; ad geeral health commuity (=95, 30%) e.g. settig up group activities (Woodall et al. 2012), reducig health iequalities (Race for Health 2010). This seems to be a differet patter from iitiatives icluded i the systematic reviews of effectiveess (Reviews 1-3 (Bruto et al. 2014)), which have focused o idividual health issues such as physical activity ad healthy eatig. Health Iequalities: Idicators of potetial health iequality observed most frequetly i the icluded articles were socioecoomic (=89 S; 35 D) ad other idicators of disadvatage (= 95 S, 28 D) these icluded a rage of groups such as: people with disabilities (e.g. Edwards 2002, iclusio i regeeratio); people with learig difficulties (LD) (e.g. McCaffrey 2008, commissioig from the perspective of people with LD); older people (e.g. Williamso et al. 2009, Parterships for Older People); 16

17 offeders (e.g. Dooris et al. 2013, health traier service); people with log term health coditios (e.g. Hills et al. 2007, healthy livig cetres); people with substace use disorders (e.g. Elliott et al. 2001, ivolvig peer iterviewers i research); Gay Lesbia Bisexual or Trasgeder groups (e.g. Flowers et al. 2002, bar-based peer-led sexual health promotio with gay me); metal health service users (e.g. O Brie et al. 2011, voluteerig i ature); Refugees ad asylum seekers (e.g. Bhavai ad Newbur 2014, NCT peer support). Other idicators of iequality were race/ ethicity (= 53 S, 16 D), lack of social capital or social exclusio (= 37 S, 9 D). This demostrates that commuity egagemet iitiatives i the UK go beyod the approach of targetig the most obvious idicators of iequality (i.e. those that are icluded i health equity profiles such as ethicity, geder ad occupatioal or socioecoomic status) ad seek to egage some of the most margialised, disadvataged or excluded populatio groups. This is true of both research ad o-research articles. Commuity egagemet iitiatives for populatios with Other idicators of disadvatage were more likely to use peer (45S (47%), 6D (21%)) or voluteer (34S (36%), 4D (14%)) ivolvemet approaches tha those for populatios coded as havig socioecoomic idicators of disadvatage (Peer ivolvemet 31S (34%), 6D (17%); Voluteers 11S (12%), 3S 11%)), which were similar to the percetages give across the rage of UK iitiatives i this mappig review (see Approaches below). Iitiatives targetig populatios with ay idicators of health iequalities were more likely to use a targeted tha a uiversal approach (other tha populatios with low social capital, where a uiversal approach was more likely to be used). As for all iitiatives icluded i this map, iitiatives for populatios with other idicators of disadvatage were also most likely to address social capital or cohesio issues (46S (48%), 11D (39%)), but idividual issues such as physical activity (24S (25%), 1D (4%)), healthy eatig (28S (29%), 1D (4%)), metal health (28S (29%), 4D (14%)) ad substace use (23S (24%), 2D (7%)) were also commoly targeted. Persoal assets was a health ad wellbeig category that was more commoly addressed i this group tha ay other (14S (15%), 1D (4%)) Examiatio of treds over time (from 2000 to 2014) revealed that socioecoomic idicators ad other idicators of disadvatage were cosistetly the most targeted idicators of health iequality i the UK commuity egagemet literature o policy ad practice. Approaches to commuity egagemet: The mappig review foud a wide rage of approaches to commuity egagemet i the 316 icluded articles, which were grouped ito seve types: Commuity mobilisatio/ actio; Commuity parterships/ coalitios; Peer ivolvemet; Commuity orgaisatios; No-peer health advocacy; Social etworks; Voluteers (see Glossary for defiitios). Commuity mobilisatio/ actio (138 articles, 89S, 49D; 44%) ad commuity parterships/ coalitios (180 articles, 113S, 67D; 57%) were the most commoly used approaches i both research ad o-research articles. Peer 17

18 ivolvemet (=97, 82S, 15D; 31%) ad voluteers (=64, 50S, 14D; 20%) were commo approaches i research articles, but less so i o-research articles. I more tha half of these articles, peer ivolvemet approaches were combied with other commuity egagemet approaches. Differet approaches seemed to be used to target differet types of health or wellbeig issues, for example peer ivolvemet was most ofte see i itervetios targetig idividual behaviour chage (e.g. physical activity, healthy eatig, substace use), whereas commuity mobilisatio/ actio or partership/ coalitio approaches were more ofte see i iitiatives that focused o commuity wellbeig, social capital or commuity assets. Most icluded iitiatives reported a low (=141 (45%), 110S (48%), 31D (35%)) or moderate (=124 (39%), 85S (37%), 39D (44%)) extet of commuity egagemet, with oly 33 iitiatives (10%, 17S (7%), 16D (18%)) reportig a high extet of CE (defied as commuity leadig or collaboratig i all three of: desig; delivery; evaluatio). Most of the iitiatives with a high extet of CE took a commuity mobilisatio/ activatio approach (=21 (64%)), ad/ or a collaboratio/ partership approach (=26 (79%)) to commuity egagemet. The comparatively high proportio of these iitiatives which were reported i the o-research literature (20% of all o-research articles, compared to 8% of research articles) may be idicative of a gap betwee the types of orgaisatios which usually write ad publish research articles (e.g. academics ad health professioals), ad the types of orgaisatios which usually ivolve commuity members i the evaluatio process (e.g. commuity-based, o-academic), ad/or may idicate challeges i the evaluatio or publicatio process of high egagemet iitiatives. It is worth otig due to the potetial for publicatio bias if oresearch articles had ot bee icluded i this map of UK practice. Examiatio of treds over time (from 2000 to 2014) revealed that there has bee a icrease i approaches usig peer ivolvemet sice 2009 ad that o-peer health advocacy approaches (such as health traiers) see to have bee icreasig i frequecy sice Outcomes: I the 227 research ad evaluatio studies, the most frequetly reported outcome type was process outcomes (=187 S (82%)) such as recruitmet of lay workers, followed by wellbeig outcomes (=116 S (51%)) such as cofidece, self-efficacy ad quality of life, ad health outcomes (=102 S (45%)) such as icreased awareess ad uptake of cacer screeig. Commuity level outcomes (=92 S (41%)) were reported more frequetly tha outcomes at the idividual level (=83 S (37%)). Harmful or uiteded effects (=12 S (5%)) ad ecoomic outcomes (=11 S (5%)), such as uit costs ad fudig, were reported less frequetly. Effects: Directio of effect was ot routiely coded for i this systematic mappig review, so we are uable to commet o effectiveess. Uiteded or harmful effects: There is some evidece i this compoet 1a to cotribute to review questio 4, with 12 studies (5%) coded as reportig uiteded or harmful cosequeces. Evidece from these 12 studies suggests that uiteded effects ca be positive (e.g. improved metal health i commuity members deliverig itervetios) but may also be egative or harmful, either to commuity deliverers (e.g. voluteers feelig overburdeed), to orgaisatios or parterships (e.g. tesios betwee lay ad professioal 18

19 role boudaries), or to the wider commuity (e.g. commuity members becomig so attached to projects that there are o places left for ewer members). Examiatio of treds over time (from 2000 to 2014) revealed that reportig of metal health ad wellbeig outcomes have icreased i frequecy sice Structure ad focus of existig evidece base: There is a substatial amout of iformatio i the followig topic areas: Urba or mixed settigs (i.e. both urba ad rural); socioecoomically deprived groups or areas; socially excluded or isolated groups; areas that lack social cohesio; other potetially disadvataged groups (e.g. older people; people with disabilities; people i poor physical or metal health); black or miority ethic groups; iitiatives targetig health behaviours (physical activity, healthy eatig, substace use), metal health, persoal ad commuity wellbeig, geeral health (persoal ad commuity), social capital or cohesio; iitiatives with low or moderate extet of CE; process, wellbeig, health ad commuity level outcomes. There seems to be little iformatio i the followig areas: rural settigs; uiteded or harmful effects; cultural adaptatio; iitiatives with a high extet of CE; populatio groups that may experiece health iequalities due to religio, culture or educatioal reasos. 19

20 Summary Statemets Summary statemet 1: Coceptual A umber of overlappig terms are used to cover cocepts ad approaches that relate to the active participatio of people i decisios about their health ad lives (based o 30 coceptual/ theoretical papers *). This icludes commuity egagemet (4 papers: Foutai et al. 2007; Glasgow Cetre for Populatio Health 2007; Sherida ad Tobi 2010; South ad Phillips 2014), commuity participatio (2 papers: Mahoey et al. 2007; Draper et al. 2010), commuity or public ivolvemet (4 papers: Burto et al. 2006; Chadderto et al. 2008; Departmet of Health, 2006;Wait ad Nolte 2006) ad empowermet: 3 papers: (Commuities ad Local Govermet, 2007, Laverack, 2006, Specer, 2014)). Empowermet is a complex cocept that has differet dimesios both relatig to process ad outcomes (Laverack, 2006, Specer, 2014). The review of coceptual papers suggests that commuity egagemet also relates to social actio by commuities through voluteerig ad buildig social capital (based o 11 coceptual/ theoretical papers (Cabiet Office, 2011, Commuities ad Local Govermet, 2007, Dobbs ad Moore, 2002, Nesta, 2013, Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Hardill et al., 2007, Laverack, 2006, Local Govermet Iformatio Uit, 2012, Sherida ad Tobi, 2010, Wallace, 2007)). *(Joes, 2004, Attree et al., 2011, Beresford, 2007, Boydell ad Rugkåsa, 2007, Boyle et al., 2010, Browlie et al., 2006, Burto et al., 2006, Cabiet Office, 2011, Chadderto et al., 2008, Chirewa, 2012, Commuities ad Local Govermet, 2007, Departmet of Health, 2006b, Draper et al., 2010, Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Hardill et al., 2007, Keedy, 2006, Laverack, 2006, Local Govermet Iformatio Uit, 2012, Mahoey et al., 2007, McDaid, 2009, Nesta, 2013, Office of the Deputy Prime Miister, 2006, Scottish Govermet, 2013, Sherida ad Tobi, 2010, Specer, 2014, Truma ad Raie, 2001, Wait ad Nolte, 2006, Wallace, 2007, South ad Phillips, 2014) Summary statemet 2: Policy Policy iterest i commuity egagemet ad health ca be mapped across a wide rage of policy areas ad sectors (based o 38 policy related articles**). These iclude: health policy ad the NHS, local govermet policy ad regeeratio, third sector ad voluteerig ad also health iequalities as a cross cuttig policy issue. Commuity egagemet i public health cotiues to be supported through these various policy drivers (4 publicatios: (Departmet of Health, 2010, Departmet of Health, 2012a, Departmet of Health, 2012b, HM Govermet, 2010b)); however, there appears to be a greater policy emphasis o patiet ad public ivolvemet (PPI) structures i relatio to the NHS (6 publicatios: (Departmet of Health, 2006b, Departmet of Health, 2006a, Departmet of Health, 2007a, Departmet of Health, 2010, HM Govermet, 2012, NHS Eglad, 2013)). The key role of local govermet i leadig commuity egagemet ad supportig public participatio i local decisio makig has bee a major policy theme throughout the period covered by the review (based o 4 publicatios: (Departmet for Commuities & Local Govermet, 2006b, Departmet for Commuities & Local Govermet, 2007a, Departmet for Commuities & Local Govermet, 2007b, HM Govermet, 2007)). Commuity 20

21 egagemet ad empowermet have bee cosistetly liked to strategies to address health iequalities (3 publicatios: (Departmet of Health, 2008b, Departmet of Health, 2008a, Departmet of Health, 2009a), with emphasis give to eablig idividuals to play a greater part i local decisios that affect their health ad lives. Two specific policy iitiatives idetified i the review were New Deal for Commuities (Lawless et al., 2007, Wallace, 2007) ad Neighbourhood Maagemet/parterships (Blak et al., 2007, Office of the Deputy Prime Miister, 2006, Sustaiable Developmet Commissio, 2010). The cotributio of idividuals ad commuities to health ad to society i geeral is a policy theme, with the importace of social actio o health beig edorsed i govermet documets ad policy commetary. Iterrelated cocepts foud i the map of policy iclude asset-based approaches, co-productio, voluteerig ad peer support, ad a umber of (o-govermetal) documets advocate for methods that draw o commuity stregth ad build o the lay cotributio. **(Atkiso, 2012, Bares et al., 2008a, Blak et al., 2007, Boydell ad Rugkåsa, 2007, Boyle et al., 2010, Bridge, 2006, Commuities ad Local Govermet, 2007, Departmet for Commuities & Local Govermet, 2006b, Departmet for Commuities & Local Govermet, 2007a, Departmet for Commuities & Local Govermet, 2007b, Departmet of Health, 2006a, Departmet of Health, 2006b, Departmet of Health, 2007a, Departmet of Health, 2008b, Departmet of Health, 2008a, Departmet of Health, 2009a, Departmet of Health, 2010, Departmet of Health, 2012a, Departmet of Health, 2012b, HM Govermet, 2007, HM Govermet, 2010b, HM Govermet, 2010a, HM Govermet, 2011, HM Govermet, 2012, Keedy, 2006, Lawless et al., 2007, Local Govermet Iformatio Uit, 2012, Mauger ad et al., 2010, Nesta, 2013, NHS Eglad, 2013, Office of the Deputy Prime Miister, 2006, Public Health Eglad, 2013, Scottish Commuity Developmet, 2013, Scottish Commuity Developmet Cetre, 2013, Scottish Govermet, 2013, Sustaiable Developmet Commissio, 2010, Thraves, 2013, Wait ad Nolte, 2006, Wallace, 2007, Welsh Assembly Govermet, 2008, Whitehead ad Dahlgre, 2007). Summary Statemet 3: Commuities Most commuity egagemet activity i the UK takes place i urba or mixed (urba ad rural) settigs (based o 209 articles). The health ad wellbeig issues addressed most frequetly by UK commuity egagemet iitiatives were commuity level or wellbeig outcomes, rather tha idividual behaviour chage outcomes: social capital or social cohesio (=129, 41%) e.g. improved social etworks (Burgess 2014), reductio i crime (Stutely ad Cohe 2004); commuity wellbeig (=110, 35%) e.g. commuity resiliece (Ciderby et al. 2014), empowermet (Hothi et al. 2007) ; persoal wellbeig (=82, 26%) e.g. positive metal health (IRISS 2012, Tuariu et al. 2011), quality of life (Nazroo ad Matthews 2012); geeral health persoal (=99, 31%) e.g. weight maagemet (Jeigs et al. 2013), healthy lifestyle promotio (Robiso et al. 2010; ad 21

22 geeral health commuity (=95, 30%) e.g. settig up group activities (Woodall et al. 2012), reducig health iequalities (Race for Health 2010). Summary Statemet 4: Health iequalities Much UK practice i commuity egagemet is directly relevat to health iequalities (based o 124 studies coded as socioecoomic idicators (=89 S; 35 D) e.g. deprivatio (Greee 2007; Hills et al. 2013) ad 123 studies coded as other idicators of disadvatage (= 95 S, 28 D) these icluded a rage of characteristics such as: people with disabilities (e.g. Edwards 2002, iclusio i regeeratio); people with learig difficulties (LD) (e.g. McCaffrey 2008, commissioig from the perspective of people with LD); older people (e.g. Williamso et al. 2009, Parterships for Older People); offeders (e.g. Dooris et al. 2013, health traier service); people with log term health coditios (e.g. Hills et al. 2007, healthy livig cetres); people with substace use disorders (e.g. Elliott et al. 2001, ivolvig peer iterviewers i research); Gay Lesbia Bisexual or Trasgeder groups (e.g. Flowers et al. 2002, bar-based peer-led sexual health promotio with gay me); metal health service users (e.g. O Brie et al. 2011, voluteerig i ature); refugees ad asylum seekers (e.g. Bhavai ad Newbur 2011, NCT peer support). This demostrates that commuity egagemet iitiatives i the UK go beyod the approach of targetig the most obvious idicators of iequality (i.e. those that are icluded i health equity profiles such as ethicity, geder ad occupatioal or socioecoomic status) ad seek to egage some of the most margialised, disadvataged or excluded populatio groups. Peer- ad voluteer-based approaches to commuity egagemet were more commo i populatios with other idicators of disadvatage tha i ay other group (based o 51 articles o peer approaches (45S (47%), 6D (16%)), such as peer educatio for prevetig falls i older people (Alle 2004) ad 38 articles o voluteer approaches (34S (36%), 4D (14%)), such as voluteerig for metal health (Istitute for Voluteerig Research 2003). Summary statemet 5: Approaches to commuity egagemet The mappig review foud a wide rage of approaches to commuity egagemet i the 316 icluded articles. Approaches aliged to commuity developmet ad empowermet ad/ or participatory priciples are commoly used i the UK, with peer ad voluteer ivolvemet also beig promiet approaches. Differet approaches seem to be 22

23 appropriate to address differet health ad wellbeig issues, for example peer, voluteer or lay ivolvemet for targetig idividual behaviour chage; commuity mobilisatio/ actio or commuity parterships/ coalitios for targetig commuity level outcomes, such as wellbeig, commuity assets or social capital. Most of the iitiatives with a high extet of CE took a commuity mobilisatio/ activatio approach (=21 (64%))*, ad/ or a collaboratio/ partership approach (=26 (79%))** to commuity egagemet. Health or wellbeig issues most frequetly addressed were commuity wellbeig (=15 (45%) 8D, 7S), social capital/ cohesio (=14 (42%) 6D, 8S), geeral health persoal (=8 (24%) 5D, 3S), geeral health commuity (=11 (33%) 7D, 4S). A comparatively high proportio of these iitiatives were reported i the o-research literature (=16 (20%) compared to =17 (8%) i research literature). * Aastacio et al. 2000; Boyle et al. 2006; Christie et al. 2012; Phillips et al. 2012; Platt et al. 2003; Qui ad Kifto 2012; Reeve ad Peerbhoy 2007; Roma Support Group 2011; Specer 2014; Webster ad Johso 2000; Coulter 2010; Coulter 2014; Foutai et al. 2007; GCPH 2007; Joes 2014; Laverack 2006; Nesta 2012; Scottish Govermet 2009; Stuteley 2014; Sherida & Tobi 2010; Specer 2014) ** Aastacio et al. 2000; Boyle et al. 2006; Christie et al. 2012; JRF 2011; Marais 2007; Murray 2010; Phillips et al. 2012; Qui ad Kifto 2012; Race for Health 2010; Reeve ad Peerbhoy 2007; Roma Support Group 2011; NHS Greater Glasgow & Clyde 2010; Baies et al. 2006; Webster ad Johso 2000; Beresford 2007; Boyle et al. 2010; Browlie et al. 2006; Coulter 2010; Coulter 2014; Foutai et al. 2007; GCPH 2007; Mahoey et al. 2007; McDaid 2009; Nesta 2012; Stutely 2014; Sherida & Tobi 2010; Specer 2014) Summary statemet 6: Outcomes I the 227 research ad evaluatio studies, the most frequetly reported outcome type was process outcomes (=187 S (82%)) such as recruitmet of lay workers (e.g. Chapma 2010), followed by wellbeig outcomes (=116 S (51%)) such as cofidece, self-efficacy ad quality of life (e.g. White et al. 2010), ad health outcomes (=102 S (45%)) such as icreased awareess ad uptake of cacer screeig (Curo 2014). Commuity level outcomes (=92 S (41%) e.g. Bares et al (Health Actio Zoes)) were reported more frequetly tha outcomes at the idividual level (=83 S (37%) e.g. Platt et al (smokig cessatio)). Harmful or uiteded effects (=12 S (5%)) ad ecoomic outcomes (=11 S (5%)), such as uit costs ad fudig, were reported less frequetly. Uiteded or harmful effects: Evidece from 12 studies (Adrews et al., 2003, Ball ad Nasr, 2011, Boydell ad Rugkåsa, 2007, Bridge Cosortium, 2002, Lawless et al., 2007, Lorec ad Wills, 2013, McLea ad McNeice, 2012, Muscat, 2010, New Ecoomics Foudatio, 2002, Skidmore et al., 2006, Steve ad Priya, 2000, Ward ad Baks, 2009) o uiteded or harmful effects suggests that these ca be positive (e.g. improved metal health i commuity members deliverig itervetios) but may also be egative or harmful, either to commuity deliverers (e.g. voluteers feelig overburdeed), to orgaisatios or parterships (e.g. tesios betwee lay ad professioal role boudaries), or to the wider commuity (e.g. commuity members becomig so attached to projects that there are o places left for ewer members). 23

24 Summary statemet 7: Structure ad focus of existig evidece base There is a substatial amout of iformatio i the followig topic areas: Urba or mixed settigs (i.e. both urba ad rural); socioecoomically deprived groups or areas; socially excluded or isolated groups; areas that lack social cohesio; other potetially disadvataged groups (e.g. older people; people with disabilities; people i poor physical or metal health); black or miority ethic groups; iitiatives targetig health behaviours (physical activity, healthy eatig, substace use), metal health, persoal ad commuity wellbeig, geeral health (persoal ad commuity), social capital or cohesio; iitiatives with low or moderate extet of CE; process, wellbeig, health ad commuity level outcomes. There is very little iformatio, either from research, or from other sources, o what is beig doe i terms of commuity egagemet i rural settigs (=11 (3%) 7 S, 4 D), or i commuities that may experiece health iequalities due to religio/ culture (= 12 (4%) 6 S, 6 D) or educatioal reasos (= 17 (5%) 14 S, 3 D). There is little iformatio o harmful or uiteded effects of commuity egagemet iitiatives ( = 12 S (5%)), or o ecoomic outcomes ( = 11 S (5%)). Coclusios This mappig review foud a substatial evidece-base o curret ad emergig UK policy ad practice i commuity egagemet, ecompassig a diverse rage of populatios ad approaches to commuity egagemet. The use of commuity egagemet as a umbrella term to ecompass differet approaches ad activities for differet populatio ad health or wellbeig issues seems to fit well with the UK perspective. The key role of local govermet i leadig commuity egagemet ad supportig public participatio i local decisio makig has bee a major policy theme throughout the period covered by the review. Commuity egagemet ad empowermet have bee cosistetly liked to strategies to address health iequalities, with emphasis give to eablig idividuals to play a greater part i local decisios that affect their health ad lives. Domiat cocepts iclude asset-based approaches, co-productio, voluteerig ad peer support. There was a high volume of evidece from: qualitative ad mixed methods studies; iitiatives targetig health iequalities via socioecoomically deprived areas ad groups, ad via hard to reach groups (such as people with disabilities, substace users, homeless people). Commuity level outcomes (e.g. improved housig) ad wellbeig outcomes (e.g. improved self-esteem) were most commoly addressed, ad commuity mobilisatio/ actio ad commuity parterships/ coalitios were the types of commuity egagemet most commoly employed. Recommedatios for practice: A varied toolbox of approaches to commuity egagemet i the UK is eeded i order to egage with a wide rage of populatios ad health ad wellbeig issues. 24

25 Commuities targeted by CE iitiatives i the UK iclude a substatial proportio who are at risk of health iequalities (such as people with metal health issues, offeders, homeless people, Gay, Lesbia, Bisexual or Trasgeder), but who are ot routiely fully represeted i health equity profiles/ audits, which ted to focus o age, geder, ethicity ad deprivatio idices. Cosideratio should cotiue to be give to these margialised groups, i terms of both iitial egagemet ad measuremet of impact. Recommedatios for research: The lack of iitiatives foud i rural settigs, ad the lack of evidece o cultural adaptatio, groups at risk of health iequalities due to religio/ culture or lack of educatio suggests that it would be beeficial to explore commuity egagemet i practice for these groups. Future research studies should report ay harmful or uiteded effects. 25

26 1. Itroductio 1.1 Review cotext The Cetre for Public Health (CPH) at the Natioal Istitute for Health ad Care Excellece (NICE) is developig a guidelie o Commuity egagemet approaches to improve health. The guidelie is beig developed by a Public Health Advisory Committee (PHAC) i i lie with the fial scope for this work. The guidelie is expected to be published i Jauary 2016 ad will cotai recommedatios based o the evidece cosidered by the PHAC. There are three streams of work associated with the guidelie s developmet that the CPH has commissioed: Stream 1 (Reviews 1-3): Commuity egagemet: a report o the curret effectiveess ad process evidece, icludig additioal aalysis. Stream 2 (Reviews 4 ad 5, ad Primary Research Report 1): Commuity egagemet: UK qualitative evidece, icludig oe mappig report ad oe review of barriers ad facilitators. Stream 3: A ecoomic aalysis (Reviews 6 ad 7). Compoet 1 of Stream 2 comprises a mappig report (Review 4, ad Primary Research Report 1) to idetify, describe ad provide isight ito curret ad emergig commuity egagemet policy ad practices i the UK. Compoet 2 (Review 5) is a systematic review of barriers ad facilitators to commuity egagemet. The mappig review (compoet 1) cosists of the followig two parts: (a) Review 4: map of the literature o curret ad emergig commuity egagemet policy ad practice i the UK. This provides a syopsis of the key fidigs from documetary aalysis (icludig grey literature ad practice surveys) of the curret evidece base for UK local ad atioal policy ad practice for commuity egagemet, as well as a assessmet of the extet to which relevat scope questios ca be aswered by the evidece base. (b) Primary research report 1: Map of curret practice based o a case study approach. This cosists of a series of six case studies of curret or recet commuity egagemet projects to improve health ad reduce health iequalities. The focus will be o processes of commuity egagemet ad barriers ad facilitators to these, ad will iclude: practitioer ad commuity members views o iclusio, ivolvemet ad decisio makig; structures ad processes; backgroud (local culture, resources, eeds ad priorities);; outcomes (perceived beefits/ disbeefits ad impacts o idividuals ad wider commuity); uaticipated effects; measures of success idetified by commuities ad professioals; wider coectios. Case studies were idetified ad selected to reflect differet approaches of curret commuity egagemet withi the UK, i particular those approaches targeted at disadvataged groups or commuities, ad other evidece gaps idetified i Reviews 1-5. Figure 1 demostrates how Reviews 4 ad 5, ad primary research report 1 are related to each other ad to the evidece from Reviews 1-3. The work was etered ito as part of a 26

27 cosortium, with the EPPI-Cetre (Uiversity of Lodo) deliverig Reviews 1-3 ad Leeds Beckett Uiversity ad the Uiversity of East Lodo deliverig Reviews 4 ad 5, ad Primary Research Report 1. As such there has bee a commo approach ad sharig of evidece betwee the two Streams. Figure 1: Relatioship of Stream 2 compoets with each other ad with Stream Aims ad objectives of the review This mappig review provides a syopsis of the key fidigs from documetary aalysis (icludig grey literature) of the curret evidece base for UK local ad atioal policy ad practice for commuity egagemet. It aims to idetify, describe ad provide isight ito curret ad emergig commuity egagemet policy ad practice i the UK. 1.3 Research questios. I additio to the mai aim above, the mappig review set out to address ay or all of the followig research questios, from the fial Guidace scope: Questio 3: What processes ad methods help commuities ad idividuals realise their potetial ad make use of all the resources (people ad material) available to them? 27

28 This questio could iclude sub-questios to explore the impact o the effectiveess ad acceptability of differet itervetios coferred by: those deliverig the itervetio; commuity represetatives or groups; health topic; settig; timig; or theoretical framework. Questio 4: Are there uiteded cosequeces from adoptig commuity egagemet approaches? Questio 5: What barriers ad facilitators affect the delivery of effective commuity egagemet activities particularly to people from disadvataged groups? Questio 5 will ecompass the followig overarchig questios: Q5.1 To what extet do these barriers ad facilitators vary accordig to key differeces i commuity egagemet approaches ad practices, the health outcomes ad populatios to which they are targeted, ad the cotext i which they are delivered? Q5.2 How ca the barriers ad challeges be overcome? 1.4 Operatioal defiitios The scope of the evidece covered by this project is outlied i the fial Guidace scope documet ( Commuity egagemet is used as a umbrella term coverig commuity egagemet ad commuity developmet. It is about people improvig their health ad wellbeig by helpig to develop, deliver ad use local services. It is also about beig ivolved i the local political process. Commuity egagemet ca ivolve varyig degrees of participatio ad cotrol: for example, givig views o a local health issue, joitly deliverig services with public service providers (co-productio) ad completely cotrollig services. For this map, we have used the defiitio of commuity egagemet from a recet NIHRfuded systematic review (O Mara-Eves et al., 2013), i lie with the work carried out for Reviews 1-3 as part of this guidace (Bruto et al., 2014): direct or idirect process of ivolvig commuities i decisio makig ad/or i the plaig, desig, goverace ad delivery of services, usig methods of cosultatio, collaboratio, ad/or commuity cotrol (O Mara-Eves et al. 2013). The eligible populatio is commuities defied by at least 1 of the followig, especially where there is a idetified eed to address health iequalities: geographical area or settig, iterest, health eed, disadvatage ad/or shared idetity. The eligible itervetios/ activities are defied as : activities to esure that commuity represetative are ivolved i developig, deliverig or maagig services to promote, 28

29 maitai or protect the commuity s health ad wellbeig. A example of a commuity egagemet activity is commuity-based participatory research. Examples of where this might take place iclude: care or private homes, commuity or faith cetres, public spaces, cyberspace, leisure cetres, schools ad colleges ad Sure Start cetres. Examples of commuity egagemet roles iclude: commuity (health) champios; commuity or eighbourhood committees or forums; commuity lay or peer leaders. Eligible activities also iclude local activities to improve health by supportig commuity egagemet. Examples iclude (ca be delivered separately or i combiatio): raisig awareess of, ad ecouragig participatio i, commuity activities, evaluatio ad feedback mechaisms, fudig schemes ad icetives, programme maagemet, resource provisio, traiig for commuity members ad professioals ivolved i commuity egagemet. The guidelie will ot cover commuity egagemet activities that: do ot aim to reduce the risk of disease or health coditio, do ot aim to promote or maitai good health, do ot report o primary or itermediate health outcomes, focus o the plaig, desig, delivery or goverace of treatmet i healthcare settigs, target idividual people (rather tha commuity). The eligible outcomes are defied as: improvemet i idividual ad populatio level health ad wellbeig. Other expected itermediate outcomes may iclude: positive chages i health related kowledge, attitudes ad behaviour, improvemet i process outcomes, icrease i the umber of people ivolved i commuity activities to improve health, icrease i the commuity s cotrol of health promotio activities, improvemet i persoal outcomes, improvemet i commuity s ability ad capacity to make chages ad improvemets to foster a sese of belogig, views o the experiece of commuity egagemet (icludig what supports ad ecourages people to get ivolved ad how to overcome barriers to egagemet). 1.5 Idetificatio of possible equality ad other equity issues This mappig review of UK practice icludes commuity egagemet i all cotexts ad is ot limited to commuities experiecig health iequalities. However, much of the idetified literature ad practice does target disadvataged groups ad those groups experiecig health iequalities. The PROGRESS-Plus tool (Kavaagh et al., 2008)was used to categorise articles i terms of which disadvataged groups were targeted 5. 5 The PROGRESS-plus framework highlights several social ad persoal dimesios that may affect health iequalities i.e.: Place of residece; Race/ ethicity; Occupatio; Geder; Religio; Educatio; Socio-ecoomic positio; Social capital; Other (e.g. age, disability, sexual orietatio, beig looked after, etc.). Recommeded by the Cochrae/Campbell Health Equity Group (Kavaagh J et al. 2008) 29

30 1.6 Review team The review team comprised researchers led by Dr Ae-Marie Bagall at the Cetre for Health Promotio Research at Leeds Beckett Uiversity, workig i partership with a team of researchers led by Professor Agela Harde at the Istitute for Health ad Huma Developmet, Uiversity of East Lodo. The Cetre for Health Promotio Research has a log history of research that has commuity egagemet at its heart. The team, uder the leadership of Jae South, Professor of Healthy Commuities, has recetly delivered two high quality NIHR-fuded systematic reviews o the roles of lay people i public health (South et al. 2010), ad o peer itervetios i priso settigs (South et al., 2014). We also delivered a series of rapid evidece reviews for Altogether Better, o: Commuity Health Champios ad Older People; Empowermet ad Health ad Wellbeig (see: The CHPR team members ad their roles for the curret review were as follows: Ae- Marie Bagall is a Reader i Evidece Sythesis (Heath Iequalities), actig as pricipal ivestigator, lead ad project maager for the review, developig codes ad udertakig screeig, codig ad overall arrative sythesis. Jae South is Professor of Healthy Commuities, who is a co-ivestigator with a specific role i the sythesis of the coceptual ad policy documets. Joae Trigwell is a Research Fellow whose role icluded acquisitio, screeig ad codig of articles. Karia Kisella is a Research Assistat whose role icluded acquisitio, screeig ad codig of articles. Judy White is a Seior Lecturer i Health Promotio ad Director of Health Together her role icluded likig to practice to acquire grey literature ad advertise the Register of Iterest. Each team member, apart from Jae South, has declared o coflict of iterest. Jae South is a member of the NICE Public Health Advisory Committee ad has declared this. 30

31 2. Methodology 2.1 Search Strategy Our search strategy was desiged i collaboratio with our cosortium parter, the EPPI- Cetre, who carried out the systematic reviews of effectiveess (Reviews 1-3) (Bruto et al., 2014). Give the difficulties of idetifyig studies via traditioal electroic database searches (terms for commuity egagemet are ot well idexed or applied i uiform)(o Mara-Eves et al., 2013, O'Mara-Eves et al., 2014) we focused our search efforts o specialised research registers ad websites. We searched the followig sources: 1. The pool of studies (both icluded ad excluded studies) that were idetified withi the recet NIHR fuded review o commuity egagemet (O Mara-Eves et al., 2013). The searchig for this review idetified may potetially relevat UK studies. The search sytax origially used for these searches (icludig date of searches) is preseted i Appedix A. 2. Updatig the origial searches that were carried out for the O Mara-Eves et al. (2013) review. This part of the search strategy had the followig two elemets. The search sytax that was used i updatig the search process is preseted i Appedix B: a) A systematic search for existig systematic reviews which iclude studies of commuity egagemet through specialist websites ad databases dedicated to systematic reviews: DoPHER (the Database of Promotig Health Effectiveess Reviews developed ad maitaied by the EPPI-Cetre); the Cochrae Database of Systematic Reviews (CDSR); Database of abstracts of reviews of effects (DARE); the Campbell Library; the NIHR Health Techology Assessmet (HTA) programme website; ad Health Techology Assessmet (HTA) database hosted by CRD. b) A systematic search of the EPPI-Cetre database of studies i health promotio ad public health that the EPPI-Cetre has built up over may years as a result of carryig out systematic reviews (kow as TRoPHI). The studies i this database are the product of systematic searches i core NICE databases ad have already bee systematically classified. Both of these elemets were ru from Jauary 2011 owards. 3. The results of searches that were carried out i April 2014 for a Public Health Eglad mappig review of commuity-based itervetios (South, 2015) were rescreeed for primary research (oly secodary sources were icluded i the PHE review). The search strategy for this review is preseted i Appedix C. 4. Systematic reviews idetified from ay of the above sources were mied for relevat primary studies. 31

32 a. The followig iteret sources were searched: Natioal orgaisatios Ope Grey healthevidece.org UK govermet (gov.uk) portal NICE Evidece (icludig NICE website ad former Health Developmet Agecy documets) Public health observatories ESRC research ivestmets: health ad wellbeig ( Local govermet associatio health ( Local govermet associatio ad Departmet of Health From trasitio to trasformatio i public health ( /joural_cotet/56/10180/ ) NICE support for local govermet ( NHS Scotlad ( NIHR public health research programme ( NIHR school for public health research ( Policy research uit i commissioig ad the healthcare system ( Public health agecy (for Norther Irelad) - Health ad social wellbeig improvemet ( Public health Eglad ( Royal Society for Public Health ( The Kig s Fud public health ad iequalities ( Cetre for Traslatioal Research i Public Health ( UCL Istitute of Health Equity ( UK Faculty of Public Health ( UK Healthy Cities Network ( Welsh Govermet Health ad social care ( World Health Orgaisatio Europe Health 2020:the Europea policy for health ad wellbeig ( 32

33 Altogether Better evidece resources Associatio of public health observatories ( BIG Lottery wellbeig evaluatio Cetre for Public Scrutiy ( Charities evaluatio service ( Commuity developmet exchage ( Commuity developmet foudatio ( Departmet of commuities ad local govermet Commuity empowermet divisio ( Commuity Health Exchage ( Federatio of commuity developmet learig ( Health lik ( Improvemet foudatio healthy commuity collaborative ( Improvemet ad developmet agecy for local govermet ( NHS Ivolve ( Natioal coucil for volutary orgaisatios ( NHS Cetre for ivolvemet ( Natioal social marketig cetre ( Natioal support team for health iequalities ( NESTA people powered health New ecoomics foudatio ( Pacesetters programme ( sprogramme/idex.htm) Patiet ad public ivolvemet specialist library ( Picker istitute Europe ( Turig poit ( Joseph Rowtree Foudatio Academy for Sustaiable Commuities ( Local orgaisatios Bradford ad Airedale PCT ( Bromley by Bow Cetre ( Commuity Health Actio partership ( East Midlads commuity dialogue project ( Heart of Birmigham PCT ( Herefordshire PCT ( Liverpool PCT ( Murray Hall Commuity Trust ( St. Mathews Project, Leicester ( 33

34 NHS Tower Hamlets ( Orgaisatio with a specific focus o ethic miority commuities Apee Sehat ( Black ad ethic miority commuity care forum ( Commuities i Actio Eterprises ( Commuity Health Ivolvemet ad Empowermet Forum ( Delivery Race Equality i metal health ( Social Actio for Health ( Uiversities Oxford uiversity Departmet of Social policy ad social work ( Uiversity of Cetral Lacashire Iteratioal school for commuities, rights ad iclusio ( Lodo School of Ecoomics Persoal Social Services Research Uit ( Bath Uiversity School for Health ( Durham Uiversity School of Applied Social Sciece ( Lacaster Uiversity School of Health ad Medicie ( Liverpool Uiversity School of populatio, Commuity ad Behavioural Scieces ( York Uiversity Social Policy Research Uit ( Uiversity of Warwick Health Together NIHR School for Public Health Research Citizes/public experieces Healthtalk olie ( Ivolve ( 10,000 voices ( Amazig Stories ( Our Stories ( Our Commuities ( locality.org.uk Well Lodo People s Health Trust 34

35 5. Cotact was made with commuity practitioers ad groups, ad other academics, via established etworks (People i Public Health database; Health Together database; Puttig the Public back ito Public Health database; Voluteerig Fud database of projects; CHAIN; Healthwatch Leeds; CommUNIty; locality) ad local authority, academic ad practice mailig lists, to request published literature, grey literature, practice surveys ad details of emergig practice. A olie Register of Iterest was placed o the Health Together website to ivite ad facilitate iterested parties to submit evidece. 6. There was a call for evidece to the project stakeholders made by NICE (17 Jue - 15 July 2014). 2.2 Iclusio/exclusio criteria for review The followig iclusio criteria were used for screeig titles ad abstracts. Defiitios reflect the eligibility criteria of populatios, activities, outcomes as outlied i sectio 1.4 ad the fial guidace scope ( Iclusio (Titles ad abstracts): Populatio: UK oly. Commuities ivolved i itervetios to improve their health; health or social care practitioers or other idividuals ivolved i developig, deliverig or maagig relevat itervetios. Studies which target idividuals rather tha a specific commuity (icludig self-maagemet e.g. expert patiet) were excluded. Itervetio: Focus o commuity egagemet of ay kid (for example, activities that esure commuity represetatives are ivolved i developig, deliverig or maagig or evaluatig services; or local activities that support commuity egagemet) WITHIN PUBLIC HEALTH; or local or atioal policy or practice. See below for workig defiitios of commuity egagemet ad public health. Studies which do ot aim to reduce the risk of a disease or health coditio, or which do ot aim to promote or maitai good health (by tacklig, for example, the wider determiats of health) were excluded. Studies which focus o the plaig, commissioig, desig, delivery or goverace of treatmet i healthcare/ cliical care settigs were excluded. Outcomes: improvemet/ chage i idividual ad populatio-level health ad wellbeig; positive chages i health-related kowledge, attitudes ad behaviour; improvemet/ chage i process outcomes (e.g. service acceptability, uptake, efficiecy, productivity, partership workig); icrease/ chage i the umber of people ivolved i commuity activities to improve health; icrease i the commuity s cotrol of health promotio activities; improvemet i persoal wellbeig outcomes such as self-esteem ad 35

36 idepedece; improvemet i the commuity s capacity to make chages ad improvemets to foster a sese of belogig; adverse or uiteded outcomes; ecoomic outcomes; chages i social capital, social iclusio ad social determiats of health such as housig, employmet. Study desigs: Empirical research: either quatitative, qualitative or mixed methods outcome or process evaluatios. To iclude grey literature ad practice descriptios or surveys. Relevat policy documets ad theoretical/ coceptual models or frameworks were also icluded. Published i Eglish. Discussio articles or commetaries ot presetig empirical or theoretical research or policy were excluded. Workig defiitios Commuity egagemet: We have used the same defiitio as Reviews 1-3 (Bruto et al., 2014) direct or idirect process of ivolvig commuities i decisio makig ad/or i the plaig, desig, goverace ad delivery of services, usig methods of cosultatio, collaboratio, ad/or commuity cotrol (O Mara-Eves et al., 2013). Whilst screeig titles ad abstracts for iclusio, ad followig discussio with NICE, with our Stream 2 parters at UEL ad with the EPPI-Cetre team producig Reviews 1-3, we added the followig clarificatios: What Commuity Egagemet is: People champioig the public health eeds ad iterests of local commuities ad citizes; Activities aimed at redesigig, recofigurig or deliverig public health care services; Effective participatio of the public i the commissioig process of public health services that reflect the eeds of the local populatio; Expert patiet groups of patiets with a coditio/diagosis where the purpose is to improve health ad wellbeig ad/or protect agaist other health coditios (i.e. public health itervetios). What Commuity Egagemet is t: Activities aimed at redesigig, recofigurig or deliverig cliical care services; 36

37 Effective participatio of the public i the commissioig process of cliical health services that reflect the eeds of the local populatio; Patiets ad carers participatig i plaig, maagig ad makig decisios about their ow care ad treatmet; Expert patiet groups where the purpose is to improve a idividual s experiece of maagig their treatmet / care. Public health: NOT cliical health services, ot social care. Itervetios delivered at commuity level, outcomes measured at populatio level. Public health icludes health protectio ad health improvemet (both prevetio of illess ad promotio of health). 2.3 Study Selectio Process Records were first screeed o title ad abstract. The iclusio criteria were tested ad refied after pilotig them o a radom sample of 10% of the titles ad abstracts. All reviewers idepedetly screeed these records ad ay differeces were resolved by discussio ad where ecessary, iformed by the advice of the CPH team. Further pilot screeig was coducted util a good level of reliability was reached. (A good level of reliability was defied as 80% agreemet betwee reviewers assigig exclusio/iclusio codes. The percet agreemet was calculated as the umber of agreemet scores divided by the total umber of scores). Oce this level of reliability was reached oe reviewer screeed all the remaiig titles ad abstracts, with a secod reviewer screeig a radom selectio of 5%. Ay disagreemets were discussed or if ecessary resolved by the lead researcher. Full text studies for those records that met the iclusio criteria were retrieved. All full text studies were radomly allocated betwee the review team members ad screeed usig the agreed iclusio criteria, with a radom sample of 30% beig double screeed. Ay disagreemets were resolved by discussio ad recourse to a third reviewer. Those documets that passed the iclusio criteria o the basis of full text screeig were icluded i the review. Records idetified from all searches were assessed by hierarchical iclusio screeig. Iclusio criteria covered populatios, itervetios, outcomes, study desig, coutry, date ad laguage. 37

38 5 DATE: studies published before (or for policy ad coceptual papers, before ) were excluded. 6 COUNTRY: UK oly. Studies of o-uk projects or commuities or policies were excluded. 7 INTERVENTION: oly studies of commuity egagemet i public health topics were icluded (see above for workig defiitios) 8 STUDY DESIGN: Empirical or theoretical research, or practice descriptios, or policy documets were icluded. Secodary research (e.g. systematic reviews) ad discussio or commetary papers that did ot preset empirical or theoretical research were excluded. Systematic reviews were mied for relevat studies (see Search Strategy). We used EPPI-Reviewer 4 (ER4) (Thomas et al., 2010) to support the maagemet ad aalyses of the refereces ad the data extractio for all compoets. 2.4 Data extractio/ codig Icluded studies were coded by oe reviewer ad a radom selectio of 20% checked by a secod reviewer, usig piloted pre-agreed forms o EPPI-Reviewer 4. Ay disagreemets were resolved by discussio with referece to the full paper ad, where ecessary, a third reviewer. Codig differed depedig o the type of documet beig coded e.g. for research/ evaluatio articles, codes o the type of outcomes preseted were used. Quality assessmet was ot udertake, as this is a mappig review. Codig categories were: Bibliographic details; Coder; Year of publicatio; Documet type (evaluatio/research; practice descriptio; policy documet; coceptual or theoretical paper) Articles may be classified as: 6 *Search date of 2000 owards would capture relevat ad appropriate records related to commuity egagemet as coceived i the scopig documet. The date rage is iformed by various legislatio (e.g. The Health & Social Care Act, Sectio 11: Public Ivolvemet & Cosultatio; Local Govermet Act) published at this time which geerated research activity. 7 Date chose to avoid duplicatio of effort with a previous review commissioed by NICE (Popay et al. 2007) 38

39 o o Studies (S) papers that iclude origial data. These may be trials, surveys, meta- aalyses, service audits or qualitative studies. S papers may be cited for their data, but also for issues flagged up i the discussio of the fidigs or implemetatio. Discussios (D) papers which do ot preset ay ew data but cosist of descriptios of curret practice, discussios of issues, policy documets, coceptual or theoretical papers or reviews of or commetaries o other papers. Study desig (if evaluatio or research): RCT; Cotrolled trial; Before ad after study; Qualitative study; Mixed methods evaluatio; Survey/ questioaire; Type of commuity egagemet: Commuity actio/ mobilisatio; Commuity parterships/ coalitios; Peer roles; Commuity orgaisatios; No-peer lay advocacy; Voluteers; Social etworks; Cultural adaptatio; Level of commuity egagemet i desig, delivery ad evaluatio; Extet of commuity egagemet (low, medium, high); Name of iitiative; Lead orgaisatio; Type of activity; Settig; Targeted or uiversal; Health or wellbeig issues; Populatio group(s) (PROGRESS-Plus categories) 8 ; Outcomes reported (for research/ evaluatio studies oly): o o o o o o health outcomes reported? wellbeig outcomes reported? Effects o social determiats reported? Effects at idividual level reported? Effects at commuity level reported? Harmful/ uiteded outcomes reported? 8 The PROGRESS-plus framework highlights several social ad persoal dimesios that may affect health iequalities i.e.: Place of residece; Race/ ethicity; Occupatio; Geder; Religio; Educatio; Socio-ecoomic positio; Social capital; Other (e.g. age, disability, sexual orietatio, beig looked after, etc.). Recommeded by the Cochrae/Campbell Health Equity Group (Kavaagh J et al. 2008) 39

40 o o o o Process or service delivery outcomes reported? Ecoomic outcomes reported? Uptake outcomes reported Overall effectiveess outcome (if relevat); markers for relevace to other streams Further workig defiitios for type, level ad extet of commuity egagemet: Level of commuity egagemet i desig, delivery or evaluatio: Take from Reviews 1-3 (Bruto et al., 2014), for each of desig, delivery ad evaluatio: Commuity members leadig or collaboratig = HIGH; Commuity members cosulted or iformed = LOW. Extet of commuity egagemet: HIGH if level of CE = HIGH i all 3 of: desig AND delivery AND evaluatio. MODERATE if level of CE = HIGH i 2 out of 3 of: desig, delivery ad evaluatio. LOW if =level of CE = HIGH i 0 or 1 out of: desig, delivery ad evaluatio. Type of commuity egagemet: For type of commuity egagemet, the typology developed i the NIHR systematic review of effectiveess (O Mara-Eves et al., 2013) was used to esure cosistecy betwee stream 1 (Reviews 1-3)_ad stream 2 (Reviews 4 ad 5, ad Primary Research Report 1, Figure 2), although the defiitios were the expaded usig a ew typology that was developed i parallel with this work, for Public Health Eglad (South 2014, South 2015, ad see Appedix H). Figure 2: A typology of commuity egagemet (adapted from O Mara-Eves et al., 2013) 40

41 Type of Commuity Egagemet Defiitio* Commuity mobilizatio/actio Commuity parterships/coalitios Peer ivolvemet Commuity orgaisatios ew ad existig service developmet No-peer health advocacy Social Networks Voluteers Cultural adaptatio A capacity buildig process, through which commuities pla, carry out ad/or evaluate activities o a participatory ad sustaied basis to achieve a agreed goal. Icludes commuity developmet ad asset based approaches Workig i partership with commuities to desig ad/or deliver services ad programmes. Parterships/ coalitios may be i the form of forums; committees; advisory groups, task forces Peers defied as people sharig similar characteristics (e.g. age group, ethicity, health coditio) who provide advice, iformatio ad support ad/or orgaise activities aroud health ad wellbeig i their or other commuities. Ca iclude bridgig roles (e.g. health traiers, avigators) or peer-based itervetios (e.g. peer support, peer educatio ad peer metorig) Coectig people to commuity resources ad iformatio (e.g. social prescribig ad other types of o-medical referral systems; commuity hubs, such as healthy livig cetres; commuity-based commissioig) Possible roles are similar to those uder peer ivolvemet but ivolve members of the commuity that are ot peers of the target participats Explicit use of the term i study reports. Commuity mobilizatio/actio approaches could use social etworks (e.g. timebaks) Used whe this term is explicitly used i study reports. Peer ad o-peer roles could ivolve voluteers but may ot be explicitly labeled as such Usig kowledge of a commuity's orms, values ad prefereces to make a itervetio more appropriate. Note: simply traslatig a itervetio ito the relevat laguage is ot cosidered cultural adaptatio, as this ca potetially require o commuity egagemet *Defiitios expaded usig South (2015) family of commuity-based itervetios (South, 2015) 41

42 2.5 Methods of sythesis ad data presetatio. The fidigs of the review were summarised arratively, groupig papers usig categories i the codig process, with frequecies ad proportios of documets i certai categories beig preseted as bar charts. Topic areas where there were multiple papers, or alteratively, limited research were oted. A separate sythesis was udertake of policy, theoretical ad coceptual documets. We have used the Reviews 1-3 typology of commuity-cetred approaches as a iitial framework to begi to explore the spread of itervetio approaches used i the UK ad how this has chaged over time, together with summaries of which disadvataged groups have bee targeted, whether these are related to itervetio approaches, what types of outcomes have bee reported, ad whether this has chaged over time. The summary of policy, theoretical ad coceptual documets feeds i to this aalysis by idetifyig sigificat periods of chage, ad by highlightig the curret cotext, withi which we ca idetify where we are ow. Evidece statemets have bee produced which summarise fidigs ad the overall stregth of the evidece with regard to the umber ad type (but ot quality) of studies as per NICE guidace o systematic reviews. 42

43 3. Fidigs 3.1 Results of literature searches 4441 (91% of total) records were idetified through searches of electroic databases, ad 456 records (9% of total) were idetified from additioal sources (see below), makig 4897 records for iitial screeig. After the first screeig stage, 4321 records were excluded ad 577 full text articles were obtaied ad screeed agai. 234 articles were excluded at this stage: 13 were from before 2000 (or before 2006 if policy or coceptual articles), 43 were o-uk, 96 were ot about commuity egagemet or ot about public health, ad 82 were ot primary research, policy or practice descriptio pieces. We were uable to obtai 27 articles. This left 316 articles that were icluded i the map (Figure 3). See Appedix D for a list of icluded studies, ad Appedix E for lists of excluded studies, with reasos for exclusio. Figure 3: Flow chart of study selectio process Titles ad abstracts idetified through database searchig ( = 4441) O Mara-Eves et al (=685) Stream 1 update (=28) PHE map (=3728) Additioal records idetified through other sources ( = 456) NICE call for evidece (=44) Leeds Beckett call for evidece (=34) Website searches (=64) From mied SRs (=128) From mied PHE articles (=170) Authors ow work (=13) C2 backward & forward citatios (=3) Records screeed ( = 4897) Records excluded ( = 4320) Full-text articles assessed for eligibility ( = 577) Full-text articles excluded ( = 234) Date (=13) Coutry (=43) Topic (=96) Study type (=82) Uable to obtai (=27) Studies icluded i map ( = 316) 43

44 3.2 Overview of icluded articles See Appedix G for a table of icluded study characteristics. Source (Figure 4): Less tha half (123 = 39%) of the 316 icluded articles came from electroic database searches. 108 (34%) came from miig the referece lists of idetified systematic reviews ad other secodary research articles, 37 (12%) came from website searches (icludig our ow istitutios), 20 (6%) came from NICE s call for evidece, 21 (7%) from the Leeds Beckett Uiversity Register of Iterest, three (1%) from citatio searches from compoet 2 (Harde et al., 2015) ad four (1.3%) came directly from Reviews 1-3 (Bruto et al., 2014). Figure 4: Sources of evidece Database searches SR miig Websites NICE call Register Stream 1 Citatio searches 108 Documet type (Figure 5): 227 of the 316 icluded articles (72%) were coded as research or evaluatio, 77 (24%) were coded as practice descriptio, 40 (13%) as policy-related documets, ad 30 (9%) as coceptual or theoretical papers. Articles could be coded i more tha oe of these categories, most commoly policy combied with practice descriptio or research/ evaluatio. 44

45 Figure 5: Documet type Cocept/ theory Policy Evaluatio/ reasearch Practice descriptio Study desig (Figure 6): Of the 227 research or evaluatio documets, the majority were coded as either mixed methods evaluatio (=90, 40%) or qualitative studies (=88, 39%). Sevetee studies (7%) were coded as questioaires or surveys, fiftee (7%) were radomised cotrolled trials, seve (3%) were before ad after studies ad five (2%) were o-radomised cotrolled trials. Twety studies (9%) were coded as other : the majority of these were case studies, or the methods were ot described. There was some overlap betwee these categories, with some studies beig coded as more tha oe study desig. Figure 6: Study desig

46 3.3 Policy ad coceptual cotext Cocept map Commuity egagemet, as defied by NICE Guidace i 2008, is the process of ivolvig commuities i decisios that affect them through egagemet i service plaig ad developmet or health improvemet activities (Natioal Istitute for Health ad Care Excellece, 2008). This aligs the term with commuity participatio, which has bee a cetral cocept i the historical developmet of public health ad health promotio (World Health Orgaisatio, 2009). The Ottawa Charter, which cotiues to be ifluetial as a framework for practice (Laverack ad Mohammadi, 2011), has stregtheig commuity actio as oe of five areas for health promotio actio. I the mappig review, 30 coceptual/theoretical publicatios from the UK were idetified (Joes, 2004, Beresford, 2007, Boydell ad Rugkåsa, 2007, Boyle et al., 2010, Browlie et al., 2006, Burto et al., 2006, Cabiet Office, 2011, Chadderto et al., 2008, Chirewa, 2012, Commuities ad Local Govermet, 2007, Departmet of Health, 2006b, Draper et al., 2010, Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Hardill et al., 2007, Keedy, 2006, Laverack, 2006, Local Govermet Iformatio Uit, 2012, Mahoey et al., 2007, McDaid, 2009, Nesta, 2013, Office of the Deputy Prime Miister, 2006, Scottish Govermet, 2013, Sherida ad Tobi, 2010, Specer, 2014, Truma ad Raie, 2001, Wait ad Nolte, 2006, Wallace, 2007, South ad Phillips, 2014, Attree et al., 2011). These icluded policy documets, research papers ad discussios of commuity egagemet theory or practice. Two publicatios focused specifically o the cocept of commuity participatio (Draper et al., 2010, Mahoey et al., 2007), oe with a iteratioal perspective (Draper et al., 2010) ad the other discussig participatio i Health Impact Assessmet (Mahoey et al., 2007). Four publicatios focused o commuity or public ivolvemet (Burto et al., 2006, Chadderto et al., 2008, Departmet of Health, 2006b, Wait ad Nolte, 2006) ad four o the topic of commuity egagemet (Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Sherida ad Tobi, 2010, South ad Phillips, 2014). The publicatios o commuity egagemet all discussed the sigificace of commuity egagemet for health with two presetig frameworks to support egagemet (Foutai et al., 2007, Sherida ad Tobi, 2010). Empowermet is aother edurig cocept that describes the process ad/or outcome of idividuals ad commuities realisig more cotrol over their health ad lives (Woodall et al., 2010). Empowermet requires active participatio as it caot be coferred by others. Most theoretical frameworks reflect the sigificace of shifts i power as a sigificat dimesio of participatio (Corwall, 2008). I the mappig review, three coceptual publicatios focused o the topic of empowermet (Commuities ad Local Govermet, 2007, Laverack, 2006, Specer, 2014), oe of these takig a iteratioal perspective (Laverack, 2006). Specer s paper, which focused o empowermet ad youg people, preseted a coceptual framework for uderstadig the differet dimesios of power that affect youg people. Laverack s paper similarly preseted a coceptual framework based o ie domais of empowermet: improves participatio; develops local leadership; icreases problem assessmet capacities; ehaces the ability to ask why ; builds empowerig orgaizatioal structures; improves resource mobilizatio; stregthes liks to other orgaizatios ad people; creates a equitable relatioship with outside agecies; icreases 46

47 cotrol over programme maagemet. These ad other publicatios focusig o other aspects of egagemet, reflect the importace of empowermet as both a process ad a valued outcome i relatio to health ad wellbeig. Commuity egagemet cocers social relatioships withi a wider ecology or social settig (Trickett et al., 2011) ad therefore other cocepts, such as commuity cohesio, are of relevace (Elliott, 2012). Four coceptual publicatios covered aspects of social capital/social cohesio ad seve covered aspects of commuity wellbeig. Other cocepts idetified i the mappig review icluded commuity resiliece (Cabiet Office, 2011), voluteerig (Hardill et al., 2007) ad co-productio (Boyle et al., 2006, Local Govermet Iformatio Uit, 2012). Voluteerig describes a specific feature of participatio, that is time give freely by people to aid others. The theoretical paper by Hardill et al (Hardill 2007) o voluteerig discussed how voluteerig is associated with labour market policies. A publicatio by NESTA o Peer support (Nesta, 2013)(NESTA) liked the cocept of peer support to voluteerig. Summary I summary, the map of UK literature shows that a diverse rage of cocepts are used to explai ad critique aspects of power ad participatio. There is o commo termiology ad a umber of papers poit to the challeges of defiig of what are complex sets of ideas. Oly four papers specifically dealt with commuity egagemet as a defied topic (Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Sherida ad Tobi, 2010, South ad Phillips, 2014). Empowermet cotiues to be a sigificat theme both how it ca be achieved ad what it meas. Sice 2006, other relevat cocepts, such as coproductio ad voluteerig, have gaied some promiece i public health literature. The implicatios are that commuity egagemet, as proposed i the earlier NICE guidace, is best see as a umbrella term that covers a rage of cocepts relatig to participatio ad empowermet. Map of UK policy from 2006 owards I total, 40 publicatios related to UK policy ad commuity egagemet; these were a mix of govermet documets, policy commetary ad a small umber of policy evaluatios. Together they give a overview of domiat policy themes aroud commuity egagemet from 2006 owards. This covers the period of the Labour govermet ad the Coservative-Liberal Democrat Coalitio govermet of (see Table 1). Cocepts referred to i govermet documets iclude commuity egagemet, empowermet ad participatio. Of particular sigificace is the Coalitio heath reforms which moved public health from NHS to local govermet. The mappig review shows that health policy uder both govermets has edorsed the active ivolvemet of commuities ad the wider public i local health plaig ad commissioig (see Table 1). The term patiet ad public ivolvemet (PPI) is used to describe the participatio of service users ad the wider public i health service ad public health plaig ad decisio makig. 47

48 I total, six govermet publicatios (Departmet of Health, 2006b, Departmet of Health, 2006a, Departmet of Health, 2007a, Departmet of Health, 2010, HM Govermet, 2012, NHS Eglad, 2013) relatig to PPI were idetified. Oe of the coceptual publicatios focused o the ivolvemet of miority ethic commuities i both research ad cosultatio (Foutai et al., 2007), while aother focused o metal health ad reported o a participatory actio research project with metal health service users to overcome barriers to participatio (McDaid, 2009). Public ivolvemet is also used to describe the active ivolvemet of members of the public i research, icludig public health research. Three coceptual papers published durig discussed public or user ivolvemet i research (Beresford, 2007, Browlie et al., 2006, Foutai et al., 2007), with oe focused o the ivolvemet of childre ad youg people as researchers (Browlie et al 2006). Papers o public ivolvemet i research discussed the value of ivolvig people ad the challeges of iclusio, with two describig approaches for practice (Browlie et al., 2006, Foutai et al., 2007). The review fidigs show how public ivolvemet structures have udergoe sigificat chage i the last te years. I 2006, the Labour govermet itroduced ew PPI structures icludig the creatio of Local Ivolvemet Networks (LINks) (Departmet of Health, 2006b). As part of the Coalitio health reforms, Health ad Wellbeig Boards were created as local structures overseeig public health strategy ad also Healthwatch as oe of the primary mechaisms for PPI (Departmet of Health, 2010, HM Govermet, 2012). The review idetified four Coalitio govermet documets relatig to commuity egagemet ad public health (Departmet of Health, 2010, Departmet of Health, 2012a, Departmet of Health, 2012b, HM Govermet, 2010b) see Table 1, icludig the public health strategy Healthy Lives, Healthy People which called for a ew approach to empower idividuals ad commuities (HM Govermet, 2010b). The most recet govermet publicatios idetified i the review were NHS Eglad s Trasformig participatio i health ad care (NHS Eglad, 2013)ad Public Health Eglad s 2013/4 priorities (Public Health Eglad, 2013). Overall the review shows that there has bee cosistet policy iterest i commuity egagemet i health ad i healthcare services from 2006 to the preset day. There are some differeces of emphasis betwee healthcare ad public health policy. Policy o PPI has resulted i establishmet of differet ivolvemet mechaisms, such as Healthwatch, uderpied by legislatio (HM Govermet, 2012). I cotrast, policy statemets o commuity egagemet i public health documets from the Coalitio govermet sigal the value of idividuals ad commuities beig empowered to make healthy choices, but there are o govermet proposals for the establishmet of specific structures or public health programmes to effect those aspiratios. The key role of local govermet i leadig commuity egagemet ad supportig public participatio i local decisio makig has bee a cosistet policy theme throughout the period covered by the review. Four policy publicatios betwee were idetified that focused o commuity empowermet ad local govermet liked to the White paper Strog ad prosperous commuities produced by the Departmet of Commuities ad Local Govermet i 2006 (Departmet for Commuities & Local Govermet, 2006b, Departmet for Commuities & Local Govermet, 2007a, Departmet for Commuities & Local Govermet, 2007b, HM Govermet, 2007). The Coalitio govermet has pursued a policy of localism, with the Localism Act of 2011 devolvig powers ad resposibilities to local authorities to egage with their commuities ad gratig citizes various rights to 48

49 participate ad to challege a local coucil (HM Govermet, 2011) (ad see Departmet for Commuities ad Local Govermet, 2011(Departmet for Commuities ad Local Govermet, 2011)). The review idetified a further seve policy publicatios that provided policy commetary i relatio to public participatio i local plaig ad decisio makig; two of these focused o commuity egagemet/empowermet i public health (Bridge, 2006, Wait ad Nolte, 2006) ad six o broader themes aroud public participatio, goverace ad localism (Bares et al., 2003, Boydell ad Rugkåsa, 2007, Local Govermet Iformatio Uit, 2012, Mauger ad et al., 2010, Sustaiable Developmet Commissio, 2010, Thraves, 2013). Commuity egagemet ad empowermet have bee cosistetly liked to strategies to address health iequalities. The review idetified three Labour govermet documets relatig to health iequalities ad commuity egagemet published betwee (Departmet of Health, 2008b, Departmet of Health, 2008a, Departmet of Health, 2009a) (see Table 1). The period of the Labour govermet also saw a focus o area based iitiatives, resultig i much public health activity beig targeted o disadvataged eighbourhoods through regeeratio iitiatives ad later through spearhead primary care trusts. Three coceptual (Burto et al., 2006, Office of the Deputy Prime Miister, 2006, Wallace, 2007) ad four policy publicatios discussed the critical part commuity egagemet plays i relatio to area disadvatage ad regeeratio iitiatives (Office of the Deputy Prime Miister, 2006, Sustaiable Developmet Commissio, 2010, Wallace, 2007). The key iitiatives were New Deal for Commuities(Wallace, 2007) ad Neighbourhood Maagemet/ parterships (Blak et al., 2007, Office of the Deputy Prime Miister, 2006, Sustaiable Developmet Commissio, 2010). Actio o iequalities was give further promiece with the publicatio of the Marmot strategic review of iequalities i Eglad post The Marmot review made a explicit lik betwee iequalities ad commuity empowermet. Creatig ad sustaiig healthy ad sustaiable commuities was oe of six recommeded policy objectives (The Marmot Review, 2010). The mappig review idetified four coceptual (Attree et al., 2011, Beresford, 2007, Chirewa, 2012, Scottish Govermet, 2013) ad three policy publicatios (Atkiso, 2012, Bridge, 2006, Whitehead ad Dahlgre, 2007) - oe o childre ad youg people (Atkiso, 2012) - that explicitly discussed commuity egagemet as a meas to address health iequalities. The most recet govermet documet o commuity egagemet ad health iequalities is the Scottish Govermet s Equally Well review 2013 (Scottish Govermet, 2013) - a report of the Miisterial taskforce o Health Iequalities. Echoig some of the themes of Marmot review, it argues for radical chages i the way public services work with commuities ad a eed to build those local services aroud people ad commuities. Curretly, the Coalitio govermet is pursuig a policy of austerity which icludes major cuts i govermet spedig ad restructurig of the public sector aimed at brigig the deficit uder cotrol. Local govermet, ad particularly the larger urba authorities, have see cuts i their fudig of up to 40%. No publicatios i the review focused o commuity egagemet ad iequalities i cotext of austerity. Voluteerig is a importat cocept for commuity egagemet ad from 2006, there has bee a icreasig emphasis o social actio ad voluteerig withi health (Departmet of Health, 2011). Oe coceptual paper discussed voluteerig i relatio to disadvataged 49

50 areas(hardill et al., 2007). The Coalitio govermet itroduced the cocept of a Big Society which emphasises a icreased role for civil society. Two policy publicatios discussed the Big Society i depth, oe cocered with co-productio(boyle et al., 2010) ad oe from the Cabiet office outliig the roles of idividual citizes, commuities ad third sector orgaisatios(cabiet Office, 2010). There has bee a growig iterest i lay ad peer roles durig the review period. I 2004, the White paper Choosig health itroduced health traiers as a ew cadre of lay health worker recruited from, ad workig withi, disadvataged commuities (Departmet of Health, 2004). Oe coceptual paper discussed the health traier iitiative i relatio to health iequalities (Attree et al., 2011) ad oe further publicatio provided a aalysis of lay health ad food worker roles (Keedy, 2006). Peer support was the focus of a publicatio by NESTA (Nesta, 2013). Sice 2006, ew sets of ideas have emerged that have geerated iterest ad iformed practice. Oe of these is co-productio, which describes approaches that seek to build equal ad reciprocal relatioships betwee service users, carers ad professioals i the desig ad delivery of services (Boyle et al., 2010). Co-productio has bee particularly liked to maagemet of log term coditios ad the persoalisatio ageda withi the social care sector. Two publicatios were idetified that discussed co-productio (Boyle et al., 2010, Local Govermet Iformatio Uit, 2012). Aother emerget theme relates to the cocept of health assets. While the otio of buildig o commuity stregths to promote positive health has a log history i iteratioal literature, there has bee growig iterest i the UK i asset-based approaches to health (Morga, 2014). Asset-based approaches are described as place-based, relatioshipbased, citize-led ad therefore ivolve some degree of commuity egagemet (Foot, 2012). The review idetified oe policy publicatio by the Scottish Commuity Developmet Cetre focused o asset based approaches to health improvemet. This argued that assetbased approaches are a itegral part of commuity developmet ad liked this to Scottish health policy (Scottish Commuity Developmet Cetre, 2013). The NHS Eglad publicatio Trasformig Participatio i health ad care (NHS Eglad, 2013) also argued for a asset-based approach to health. The NESTA publicatio o peer support (Nesta, 2013) ad a report o co-productio (Boyle et al., 2010) liked to ideas about idividual ad commuity assets. Summary I summary, there are a umber of cosistet themes relatig to the UK policy cotext for commuity egagemet ad health, based o aalysis of 40 policy publicatios from 2006 owards. Firstly, policy documets, reviews ad commetary cocerig commuity egagemet ad health ca be mapped across a wide rage of policy areas ad sectors. These iclude: health policy ad the NHS, local govermet policy ad regeeratio, third sector ad voluteerig ad also health iequalities as a cross cuttig policy issue. Very few publicatios were focused exclusively o commuity egagemet ad public health, but all related to i some way to the active participatio of idividuals ad commuities as a 50

51 mechaism to improve health, commuity life or quality of local services or alteratively to reduce iequalities ad area disadvatage. Secodly, sice 2006 there are cosistet themes across govermet policy relatig to the sigificace of commuity egagemet ad empowermet. The review has highlighted a umber of specific policy iitiatives from both Labour govermet ad the Coservative-Liberal Democrat Coalitio govermet of These iclude chages i PPI structures ad public ivolvemet mechaisms affectig health plaig ad services; eighbourhood maagemet, Localism aimed at devolutio of power to local commuities ad health iequalities policy. There are also relevat policies from the devolved assemblies (Welsh Assembly 2008; Scottish Govermet2013). Overall, publicatios relatig to iequalities ad commuity empowermet, whether origiatig from govermet or from idepedet sources, like the Marmot review, called for ew relatioships betwee services ad commuities that give more power to commuities, eablig idividuals to play a greater part i local decisios that affect their health ad lives. Thirdly, the review has idetified a cosistet theme aroud the cotributio of idividuals ad commuities to health ad to society i geeral. Discussio ad commetary cluster roud various cocepts which are frequetly cross-refereced to each other. These iclude asset-based approaches, co-productio ad voluteerig. 51

52 Table 1: Policy documets idetified i mappig review Year Health policy Other policy Departmet of Health (2006). Our Health, our care, our say: a ew directio for commuity services. - - Departmet of Health (2006). A stroger local voice: a framework for creatig a stroger local voice i the developmet of health ad social care services Departmet of Health (2007). Commissioig framework for health ad well-beig. - Departmet for Commuities ad Local Govermet (2006). Strog ad prosperous commuities: The Local Govermet White Paper. - - Office of the Deputy Prime Miister (2006). Neighbourhood maagemet At the turig poit? Programme review HM Govermet (2007). Local Govermet ad Public Ivolvemet i Health Act Commuities ad Local Govermet (2007). A Actio Pla for Commuity Empowermet: Buildig o Success. - - Departmet for Commuities ad Local Govermet (2007). Local Govermet ad Public Ivolvemet i Health Bill: statemet of itet - statutory guidace. Commuity empowermet Departmet of Health (2008). Tacklig Health Iequalities: 2007 status report o programme for actio. - Departmet of Health (2008). Health iequalities: Progress ad ext steps. - Welsh Assembly (2008). Desiged to add value: a third dimesio: a strategic directio for the volutary ad commuity sector i supportig health ad social care Departmet of Health (2009). Tacklig Health Iequalities: 10 Years O A review of developmets i tacklig health iequalities i Eglad over the last 10 years Departmet of Health (2010). Equity ad excellece: liberatig the NHS. - HM Govermet (2010). Healthy lives, healthy people: Our strategy for public health i Eglad. - HM Govermet (2010). Buildig a stroger civil society: A strategy for volutary ad commuity groups, charities ad social eterprises. - HM Govermet (2010). Equality Act HM Govermet (2011). Localism Act Departmet of Health (2012). Improvig outcomes ad supportig trasparecy. Part - 52

53 Year Health policy Other policy - 1A: A public health outcomes framework for Eglad, 2013 to Departmet of Health (2012). Improvig outcomes ad supportig trasparecy. Part 2: Summary of techical specificatios of public health idicators. - - HM Govermet (2012). Health ad Social Care Act Public Health Eglad (2013). Public Health Eglad: our priorities for 2013/14 - NHS Eglad (2013). Trasformig Participatio i health ad care. - Scottish Govermet (2013). Equally well: review report of the Miisterial Task Force o Health Iequalities. 3.4 Commuities Place (Figure 7): The largest group of articles (=117, 37%), both research (=89, 39%) ad o-research (=28, 31%), looked at iitiatives i urba settigs. A large umber (=92, 29%) also looked at iitiatives i both urba ad rural settigs. Oly 11 articles (3.5%) looked at iitiatives i rural settigs aloe (Bromley, Davies, 2009, Dickes Ady et al., 2011, East Midlads Regioal Empowermet Partership, 2009a, Elliott et al., 2007, Halliday ad Asthaa, 2005, Hoddiott et al., 2006a, Hoddiott et al., 2006b, Osbore et al., 2002, Starkey et al., 2005, Stutely, 2002). I 43 articles (14%), the settig was ot clear. As this was a mappig review, we did ot udertake detailed data extractio o the populatios other tha to code for idicators of health iequalities usig the PROGRESSplus tool (see below). However, the UK evidece base o commuity egagemet icludes articles o commuities of place (see above ad e.g. Well Lodo), commuities of iterest, such as culture (e.g. Roma support group) or situatio (e.g. NCT peer support traiig for refugees ad asylum seekers), ethicity, age (e.g. Youth.com; MAC UK; Parterships for Older People), or health ad wellbeig issues (e.g. log term coditios). 53

54 Figure 7: Place Urba Rural Both Ca't tell Research/ eval No-research Iequalities: Icluded articles were coded o PROGRESS-Plus (Kavaagh et al., 2008) idicators of health iequalities targeted by iitiatives. I Figure 8, it ca be see that the idicators coded for the most frequetly were socioecoomic idicators (=124, 40%) ad other idicators of disadvatage (=123, 39%) these icluded a rage of characteristics such as disability; older people; metal health service users (see Table 2 for a full breakdow of groups icluded i this category). Other sigificat idicators of iequality targeted by icluded iitiatives were race/ ethicity (=69, 22%), lack of social capital or social exclusio (=46, 15%) ad iitiatives targetig a specific geder (=39, 13%). This demostrates that commuity egagemet iitiatives i the UK go beyod the approach of targetig the most obvious idicators of iequality (i.e. those that are icluded i health equity profiles such as ethicity, geder ad occupatioal or socioecoomic status) ad seek to egage some of the most margialised, disadvataged or excluded populatio groups, such as offeders, homeless people, people with poor physical or metal health, disabilities or learig difficulties, ad older people (at risk of social isolatio). This is true of both research ad o-research articles. Commuity egagemet iitiatives for populatios coded as beig i the category Other idicators of disadvatage were more likely to use peer (45S (47%), 6D (16%)) or voluteer (34S (36%), 4D (14%)) ivolvemet approaches tha those for populatios coded as havig socioecoomic idicators of disadvatage (Peer ivolvemet 31S (34%), 6D (17%); Voluteers 11S (12%), 3S (11%)), which were similar to the percetages give across the rage of UK iitiatives i this mappig review (see Approaches below). 54

55 Number of iitiatives Figure 8: Populatio PROGRESS-Plus idicators Research/ eval No-research Figure 9 displays treds i the targetig of groups at risk of health iequalities over time. It ca be see that socioecoomic status ad the other idicators of disadvatage categories were cosistetly the most targeted idicators of iequalities. Figure 9: Treds over time i CE iitiatives targetig groups at risk of health iequalities Ethicity Occupatio Geder Religio Educatio Socioecoomic status Social capital Other 0 Year 55

56 Table 2 Plus Group Groups coded as Other idicators of disadvatage i PROGRESS- Number of studies/ iitiatives Older people 36 Disability or learig difficulties 22 Poor health/ LTCs 20 Childre ad youg people 20 Metal health difficulties 19 disadvataged or deprived 18 Poor housig/ homeless 16 Offeders 9 Loe parets 9 Substace abuse 8 Social isolatio/ exclusio 8 Carers 6 LGBT 5 Refugees/ asylum seekers 8 Hard to reach 4 Crime 4 High rates of teeage pregacy 6 Low literacy 4 Margialised 2 Low access to health or social care services 2 Gypsies, Travellers or Roma 2 vulerable 2 Domestic violece 2 Sex workers 1 56

57 Group Number of studies/ iitiatives Looked after childre 1 Complex eeds 1 Road accidets affectig mostly childre 1 Fear & mistrust 1 Lack of access to good quality food Health & Wellbeig issues The issues addressed most frequetly by the iitiatives i the icluded articles were social capital or social cohesio (=129, 41%), commuity wellbeig (=110, 35%), persoal wellbeig (=82, 26%), geeral health persoal (=99, 31%) ad geeral health commuity (=95, 30%). There were o strikig differeces i the health ad wellbeig issues looked at by research or o-research articles, as ca be see i Figure 10. As for all iitiatives icluded i this map, iitiatives for populatios with other idicators of disadvatage were also most likely to address social capital or cohesio issues (46S (48%), 11D (39%)), but idividual issues such as physical activity (24S (25%), 1D (4%)), healthy eatig (28S (29%), 1D (4%)), metal health (28S (29%), 4D (14%)) ad substace use (23S (24%), 2D (7%)) were also commoly targeted. Persoal assets was a health ad wellbeig category that was more commoly addressed i this group tha ay other (14S (15%), 1D (4%)) 57

58 Figure 10 Health ad wellbeig issues Research/ eval No-research 3.6 Approaches to commuity egagemet: The mappig review foud a wide rage of approaches to commuity egagemet i the 316 icluded articles, which were grouped ito seve types (see Glossary). Commuity mobilisatio/ actio (138 articles, 89S, 49D; 44%) ad commuity parterships/ coalitios (180 articles, 113S, 67D; 57%) were the most commoly used approaches to commuity egagemet i both research ad o-research articles (Figure 12). Peer ivolvemet (=97, 82S, 15D; 31%) ad voluteers (=64, 50S, 14D; 20%) were commo approaches i research articles, but less so i o-research articles. Differet approaches seemed to be used to target differet types of health or wellbeig issues (Figure 13), for example peer ivolvemet was most ofte see i itervetios targetig idividual behaviour chage (e.g. physical activity, healthy eatig, substace use), whereas commuity mobilisatio/ actio or partership/ coalitio approaches were more ofte see i iitiatives that focused o commuity wellbeig, social capital or commuity assets. 58

59 Physical activity Healthy eatig Metal health Disease prevetio STIs Substace use Prevetio violece/ abuse/ crime Persoal wellbeig Commuity wellbeig Social capital/ cohesio Persoal assets Commuity assets Other Childre ad Youg People/ Geeral health (persoal) Geeral health (commuity) Safety/ accidet prevetio Figure 12 Type of commuity egagemet Research/ eval No-research Figure 13 Health or wellbeig issue by type of CE Commuity mobilisatio/ actio Commuity parterships/ coalitios Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social etworks Voluteers Cultural adaptatio 59

60 Table 3 displays the iitiatives coded i each of the seve types of approach to CE, for years 2006 to Further descriptio of the key iitiatives i each approach is give below, although may of these have bee coded uder more tha oe type of approach (see Table 3, ad Appedix G for full details of icluded articles). Commuity mobilisatio/ actio: 138 articles were coded as icludig commuity mobilisatio/ actio, defied as a capacity buildig process, through which idividuals, groups ad families as well as orgaisatios, pla, carry out ad evaluate activities o a participatory ad sustaied basis to achieve a agreed goal. Some iitiatives used iovative methods such as art, music ad photography to egage with commuity members (Callard 2005, Curo 2011, Metal Health Foudatio 2013). Examples iclude: Altogether Better - a five-year programme fuded through the BIG Lottery that aimed to empower people across the Yorkshire ad Humber regio to improve their ow health ad that of their families ad their commuities. The regioal programme was made up of a learig etwork ad sixtee commuity ad workplace projects with a emphasis o three themes: physical activity, healthy eatig ad metal health & well-beig. Altogether Better was based o a empowermet model ad at the heart of this model was the cocept that commuity health champios ca be equipped with the kowledge, cofidece ad skills to make a differece i their commuities. This model was based o three elemets: buildig cofidece, buildig capacity ad system challege. (Altogether Better, 2010, White ad Woodward, 2013, Woodall et al., 2012a). Well Lodo Alliace: partership headed by the Lodo Health Commissio ad fuded through the BIG Lottery s (BIG) Well-beig fud (Chapma, 2010, Craig, 2010, Phillips et al., 2014, Phillips et al., 2012, Sadare, 2011, Tuariu et al., 2011, Well Lodo ad NHS Hammersmith &Fulham, 2011). The Well Lodo program used a commuity egagemet ad co-productio approach to desig ad deliver a suite of commuity-based projects with the aim of icreasig physical activity, healthy eatig, ad metal health ad wellbeig i 20 of the most deprived eighbourhoods i Lodo. The projects ivolved a mix of traditioal health promotio itervetios, commuity egagemet activities, ad chages to the physical eighbourhood eviromet. Other iitiatives that used a health champios approach icluded: Life is Precious (Curo) Health Literacy improvemet (Liverpool Joh Moore's Uiversity, 2012) Sheffield All Beig Well Cosortium (Reece ad Flit, 2012) Commuity Champios Fud (Watso et al., 2004). Health Improvemet Programmes (Arora et al., 2000) these were govermetled three-year actio plas, developed i each health authority district, aimed at improvig the health of the local populatio. Healthy Livig Cetres (Bridge Cosortium 2002, Hills 2007, Platt 2005) which aimed to address health iequalities ad social exclusio targetig people i deprived areas, via a umber of differet methods icludig various health based 60

61 activities. Fuded by the New Opportuities Fud, which became the Big Lottery Fud. Natioal Empowermet Partership Programme (Seder 2011): The NEP programme aimed to empower citizes ad commuities, ad to demostrate the differece that commuity empowermet ca make to idividuals, commuity groups, commuities ad public agecies, develop effective methods of quality assurace for commuity empowermet, promote good practice. To achieve these aims, the programme: supported idividuals ad commuities i egagig ad takig up opportuities to be ivolved i ad ifluece local decisios; built the capacity of local authorities ad other public agecies to egage ad empower commuities; ad esured a coordiated approach to empowermet activity across the volutary ad commuity sector (VCS) ad public agecies. Neighbourhood Maagemet Pathfiders Programme (Brow 2002, DCLG 2007, East Midlads Regioal Empowermet Partership, ODPM 2006) - commuity ivolvemet i iovative ways of deliverig diverse projects/ services, by: -(i) establishig ad supportig a wide rage of local groups ad activities, especially for childre ad youg people; (ii) creatig opportuities for people from differet backgrouds ad commuities to come together ad work towards commo goals (e.g. a local radio statio); (iii) givig residets more of a sese of local idetity through festivals, commuity cetres ad through reclaimig local public spaces; (iv) tacklig egative stereotypes of the eighbourhood ad of particular groups withi it. Assets-based approaches (IRISS 2012: asset mappig project to discover commuity assets i Kirkitilloch that were useful ad available for positive metal health ad well-beig, but also to help others idetify their ow persoal assets, McLea 2012: illustratig asset based approaches for health improvemet i commuities i Scotlad, Scottish Commuity Developmet Cetre 2013) Co-productio iitiatives o Boyle 2006: Rushey Gree Time Bak, Cares of Life project, Rhymey Time Bak, Blaegarw Time Cetre, Dias Time Bak, Gorbals Time Bak, Peer tutorig project, Patch, Seal, Peer advocacy project, Roots. o Hatzidimitriadou 2012: offerig Improved Access to Psychological Therapies (IAPT) services i the locality o Hough 2014: co-producig Cardiovascular health i Wadsworth Metal health iitiatives: o Natioal Istitute for Metal Health i Eglad Commuity Egagemet Project (Foutai 2010): The commuity egagemet strad of the DRE actio pla is a sigificat aspect of the work of DRE. As oe of the three buildig blocks of the actio pla ad programme which developed to implemet it, the work o commuity egagemet is a good barometer to gauge at a grassroots level the extet to which people from Black ad miority ethic (BME) commuities feel egaged; feel that their views are take o board by commissioers ad providers of 61

62 services; ad feel that there is real improvemet i how they access ad experiece metal health services. o Positive Metal Attitudes (Qui 2005, Qui 2010) te year metal health iequalities programme i Scotlad usig commuity developmet priciples. Local commuity projects developed for specific populatios (Badesha 2005; Christie 2012, Dickes 2011, Ewles 2001, Healthy Commuities 2010, Hothi 2007, Kimberlee 2008, MacKio 2006, Power 2001) or specific health issues e.g. Breathig Space for smokig cessatio (Ritchie 2001, Ritchie 2004,). Commuity projects developed for specific cultures e.g. Roma Support Group 2009) which used Actio Research i order to idetify the barriers ad eablers faced by the Roma refugee ad migrat commuity whe egagig i maistream empowermet mechaisms. Health Actio Zoes (Bares 2004, Bares 2005, Bauld 2005, Bezeval 2003, Boydell 2007, Cole 2003) these area-based iitiatives aimed to reduce the effects of persistet disadvatage, by idetifyig ad addressig the public health eeds of the local area, icreasig the effectiveess, efficiecy ad resposiveess of services, ad developig parterships for improvig people s health ad relevat services, addig value through creatig syergy betwee the work of differet agecies. Commuity Participatio Programmes (Taylor 2005): The Commuity Empowermet Fud (CEF), Commuity Chests (CCs) ad Commuity Learig Chests (CLCs). These were desiged to: ecourage more people to become ivolved i the regeeratio of their eighbourhoods; help residets gai the skills ad kowledge they eed to play a active role i Neighbourhood Reewal; ad support the ivolvemet of the local commuity ad volutary sector as a equal parter i local strategic parterships (LSPs). Commuities that Care (Crow 2004, Frace 2001)- This early itervetio programme targets childre livig i commuities ad families that are deemed to put them at risk of developig social problems. The CTC approach focuses o specific geographical areas ad ivolves brigig together local commuity represetatives, professioals workig i the area ad seior maagers resposible for service maagemet. Area regeeratio programmes. The most well -kow of these is the New Deal for Commuities (Blak 2007, Diham 2007, Lawless 2004, Lawless 2007, Muscat 2010, ODPM 2005, Stafford 2008), a area-based iitiative that aims to improve coditios i some of the most deprived eighbourhoods i Eglad ad reduce the gap betwee them ad the rest of the coutry. There are 39 NDC areas, each with a budget of approximately 50 millio with which to address five specific outcome areas (health, uemploymet, educatio, crime ad the physical eviromet) over 10 years. I order to be cosidered for NDC fudig, commuity parterships ivolvig local residets, local authorities, public service providers, commuity ad volutary orgaisatios ad busiesses had to prepare a proposal for regeeratio. Other smaller regeeratio programmes were also icluded (Aastacio 2000, Berkeley 2011, Callard 2005, Cidersby 2014, CHEX 2014, Lawso 2009, Stutely 2004 Sigle Regeeratio Budget Parterships (Office of the Deputy Prime Miister 2002); Residets Cosultacy Pilot (ODPM 2004). The outcomes for regeeratio programmes teded to 62

63 be at commuity level ad focused o social determiats of health, social capital ad wellbeig, rather tha idividual health. Commuity parterships/ coalitios: 180 articles were coded as icludig commuity parterships/ coalitios. Commuity members ca be partered with ay combiatio of service providers, academics, govermet members, or idustry. Examples iclude: Wirral Healthy Homes (Seymour 2014): holistic respose to improvig the health ad wellbeig of vulerable residets ad improvig the property coditio. Referrals to the etwork of parters Healthy Homes has established ca help achieve positive health outcomes for residets ad reduce health iequalities. Sure Start (Aig 2007, Bagley 2006, ): multi-agecy/ multi-discipliary paretig ad early years support; health, play ad learig. Commissioig services ad support for people with learig disabilities ad complex eeds (David 2008, McCaffrey 2008): supportig people with learig disabilities ad complex eeds to live their lives fully through the activities of commissioig. Have a Heart Paisley (Blamey 2004): The log-term aim of HaHP was to reduce the total burde ad levels of iequality of Coroary Heart Disease (CHD) i the tow of Paisley through a itegrated programme of secodary ad primary prevetio. The combied itervetios were to be delivered i partership ad i a maer that egaged the commuity at all levels of the programme. It was hoped that this itegrated approach would be capable of saturatig the tow of Paisley with improved ad ew services, projects ad opportuities that would, over the log term, reduce ad prevet CHD amogst the Paisley populatio. Timebaks (Burgess 2014, Cambridge Cetre for Housig Plaig Research 2013)): a exchage system i which time is the pricipal currecy. For every hour participats deposit i a timebak, perhaps by givig practical help ad support to others, they are able to withdraw a hour of support whe they are i eed. Social Exclusio Parterships (Chapma 2001): commuity participatio i multiagecy parterships to improve social iclusio. Citize s Juries (Gooberma-Hill 2008): public ivolvemet: ivolvig members of the public i citize's jury settig priorities for health research. Boscombe Network for Chage (Hamer 2000): a health-related forum of statutory ad volutary agecy employees, voluteers ad local residets, set up i 1996, bor out of a cocer to promote chage i the deprived ward of Boscombe. Govahill Equally Well test site (Harkis 2012): a localised partership approach (ivolvig public ad third sectors as well as commuity members) which aims to improve all aspects of life ad coditios i the area. Healthy Weight Commuities (Rocket Sciece Ltd 2011): The purpose of the Healthy Weight Commuities Programme was to demostrate the ways i which egagig commuities i healthy eatig, physical activity ad healthy weight activities as part of a sigle coheret programme may have a greater impact o health outcomes tha curret discrete activities. Health Impact Assessmet (Mahoey 2007; Kearey 2004; Elliott et al. 2007; Chadderto et al. 2008): HIA is iteded to support decisio-makig i choosig 63

64 betwee optios by predictig the future cosequeces of implemetig the differet optios. Rural regeeratio parterships (Osbore 2002): commuity ivolvemet i rural regeeratio parterships. Parterships for Older People Projects (PSSRU 2009): aims to create a sustaiable shift i the care of older people, movig away from a focus o istitutioal ad hospital based crisis care toward earlier ad better targeted itervetios withi commuity settigs. Mosaics of Meaig (NHS Greater Glasgow & Clyde 2010): a partership to research ad the address stigma relatig to metal health problems with the four largest settled BME groups i Glasgow: Pakistai, Chiese, Idia ad Africa ad Caribbea. Peer ivolvemet 97 articles were coded as icludig peer ivolvemet, defied as ay peer ivolvemet, e.g. peer cousellig, peer educatio, peer leaders, peer leadership, role models, peer support. Examples iclude: Breastfeedig ad paretig peer support (Alexader 2003, Curtis 2007, Hoddiott 2006, Igram 2005, Igram 2013, Jolly 2012, MacPerso 2010, MacArthur 2009, McIes 2000, Newbur 2013, Raie 2003): various models both group ad idividual support eg.birth ad Beyod commuity supporters programme (NCT), desiged to recruit ad trai commuity voluteers to work as peer supporters for parets who are refugees or asylum seekers, with the aim of reducig isolatio, stress ad low mood durig pregacy ad the first two years after birth. A Stop Smokig I Schools Trial (ASSIST) (Audrey 2006, Audrey 2008, Campbell 2008, Starkey 2005): Peer supporters i secodary schools ecourage stoppig smokig. Peer-led sex educatio (Stepheso 2008) Activity Frieds (Corbi 2006): Activity Frieds is a voluteer programme for the over 50s desiged to help people achieve a healthier lifestyle through icreasig physical activity ad befriedig to alleviate social isolatio. Health Traiers (Dooris 2013) health traiers i the crimial justice settig Peer Power (Duffy 2012): Peer support group for people with metal illess. Peer educatio popular oio leader diffusio of iovatio model (Elford 2001, Flowers 2002, Kelly 2004): aimed at gay me, prevetig HIV trasmissio. Active at 60 Commuity Aget Programme (Hatamia 2012): Commuity agets (commuity groups ad their voluteers) to help people approachig ad post retiremet to stay or become more active ad positively egaged with society, i particular those at risk of social isolatio ad loeliess i later life. 64

65 Commuity orgaisatios 51 articles were coded as icludig commuity orgaisatios (ew or existig). Most of the iitiatives i this sectio were also coded uder at least oe of the other types of CE. Examples iclude: Imagie East Greewich (Callard 2005): a series of arts/health projects developed as part of a regeeratio programme o two housig estates i a Lodo borough. Peer Power (Duffy 2012): peer support group for people with metal illess. Healthy Livig Cetres (Hills 2007, Platt 2005): The Healthy Livig Cetre (HLC) programme was set up i 1998 to fud commuity level itervetios to address health iequalities ad improve health ad wellbeig i iovative ways. The programme fuded 351 HLCs, which i tur geerated a wide rage of differet activities, tailored to the eeds of their local commuities. These operated o a umber of differet models some based maily withi oe cetral buildig, while others fuctioed as parterships or etworks of activities ru by differet orgaisatios at a umber of differet sites. Some HLCs focused o specific health-related services, but i keepig with the broad, holistic visio of the programme, may have sought to address the wider determiats of health iequalities, such as social isolatio, uemploymet ad poverty. Natural Choices for health ad wellbeig (Wood 2013): a joit veture betwee Liverpool PCT ad The Mersey Forest which aimed to promote health ad wellbeig i Liverpool residets usig atural eviromets ad thus create a city focused upo atural choices for health ad wellbeig. No-peer health advocacy 45 articles were coded as icludig o-peer health advocacy for members of the commuity that are NOT peers of the target participats, where peer is defied as sharig the same age group or health risk/coditio or similar i key aspects (e.g. race/ethicity). Examples iclude: Health Traiers (Gree 2012, Ward 2009, Lorec 2013, South 2007): a atioal programme itroduced by the Departmet of Health i The aim of the programme is to recruit people from local commuities with a good uderstadig of local issues who ca offer tailored advice, motivatio ad practical support to idividuals who wat to adopt a healthier lifestyle ad act as message bearers betwee professioals ad commuities. A atioal package of accredited traiig has bee developed to support the work of the health traiers ad develop their skills as part of the healthcare workforce. Lay food ad health workers (Keedy 2008, Keedy 2010) Ay lay health worker: idigeous to the commuities beig served, carryig out fuctios related to commuity-based public health iitiatives desiged to prevet disease or promote health ad wellbeig, with specific focus o food ad public health; traied i some way i the cotext of the itervetio; but havig o formal professioal or paraprofessioal qualificatios. 65

66 Lay led walkig programmes (Lamb 2002): commuity-based lay led walkig scheme. Roy Castle fag eds stop smokig service (Owes 2006): adult smokig-cessatio service across Liverpool. Uique aspects are that the service is provided by traied lay advisors with a omedical backgroud ad there is o waitig list cliets ca self-refer by callig a helplie or walkig ito a meetig. Social etworks 28 articles were coded as icludig social etworks (explicit use of the term). Most of these articles were also coded uder at least oe of the other types of CE. Examples iclude:timebaks (Burgess 203, Cambridge Cetre for Housig Plaig 2014, NEF 2002): a exchage system i which time is the pricipal currecy. For every hour participats deposit i a timebak, perhaps by givig practical help ad support to others, they are able to withdraw a hour of support whe they are i eed Commuity Participatio Programmes (Taylor 2005): desiged to ecourage more people to become ivolved i the regeeratio of their eighbourhoods, help residets gai the skills ad kowledge they eed to play a active role i Neighbourhood Reewal; ad support the ivolvemet of the local commuity ad volutary sector as a equal parter i local strategic parterships (LSPs). Voluteers 61 articles were coded as icludig voluteers (explicit use of the term). Examples iclude: Befriedig schemes (Adrews 2003): volutary sector local home visitig befriedig service; Chagig Mids (Cawley 2011): metal health awareess traiig; Walkig for Health (Howlett 2000): a iitiative to icrease the health ad fitess of sedetary people by promotig regular ad brisk walkig withi local commuities.. 66

67 Table 3 Iitiatives by type of commuity egagemet approach (Bruto et al. 2014) Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig 2006 Commuity developmet icludig people with learig difficulties (Keedy et al., 2006); Co-productio (Boyle et al., 2006) Roy Castle fag eds stop smokig service (Owes ad Sprigett, 2006); Pathfider programme (eighbourhood maagemet) (Office of the Deputy Prime Miister, 2006, Departmet for Commuities & Local Govermet, 2006a); Co-productio (Boyle et al., 2006); Public ivolvemet i plaig health care (Aderso et al. 2006); Sure Start (Bagley ad Ackerley, 2006); Cityet project (Bolam et al. 2006); Commuity food iitiatives (Pritchard et al. 2006) ASSIST (peer-led smokig cessatio i schools) (Audrey et al., 2006a, Audrey et al., 2006b); Breastfeedig peer support i rural Scotlad (Hoddiott et al., 2006b, Hoddiott et al., 2006a); Activity Frieds: peer metor physical activity programme for over 50s (Corbi, 2006); Co-productio (Boyle et al., 2006) Sure Start (Bagley ad Ackerley, 2006); Commuity based peer educatio utritio itervetio (Hylad et al. 2006) Cityet project: buildig social capital ad improvig ICT access for disadvataged groups i Nottigham, UK.(Bolam et al., 2006); Sure Start (Bagley ad Ackerley, 2006); Commuity food iitiatives (Pritchard et al., 2006); Co-productio (Boyle et al., 2006) Cityet project (Bolam et al. 2006); Roy Castle fag eds stop smokig service (Owes ad Sprigett, 2006); Lay food ad health workers (Keedy, 2006); Health Traiers(Visram et al., 2006); Cityet project (Bolam et al. 2006); Co-productio (Boyle et al., 2006); Sure Start (Bagley ad Ackerley, 2006); Voluteerig (Bowers et al., 2006, Baies et al., 2006); Co-productio (Boyle et al., 2006) Sure Start (Bagley ad Ackerley, 2006); Commuity food iitiatives (Pritchard et al. 2006) 67

68 Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig 2007 Healthy Futures (CE model) (Glasgow Cetre for Populatio Health, 2007); Local Wellbeig Project (empowermet) (Hothi et al., 2007); Healthy Livig Cetres (Hills et al., 2007); Commuity developmet traiig course(clay Christopher et al., 2007); Sure Start (Aig et al., 2007); New Deal for Commuities (eighbourhood regeeratio) (Blak et al., 2007, Diham, 2007, Wallace, 2007, Lawless et al., 2007); JRF Neighbourhood Reewal Programme (Taylor et al., 2007); Commuity based participatory research (Marais, 2007); Breastfeedig peer support (Curtis et al., 2007) Healthy Livig Cetres (Hills et al. 2007); Health Traiers (South et al., 2007); Breastfeedig peer support (Curtis et al., 2007); Healthy Livig Cetres (Hills et al. 2007); New Deal for Commuities (eighbourhood regeeratio) (Blak et al., 2007, Diham, 2007, Wallace, 2007, Lawless et al., 2007); Health Impact Assessmet (Elliott et al. 2007; Mahoey et al. 2007); Healthy Livig Cetres (Hills et al. 2007); Health Impact Assessmet (Elliott et al., 2007, Mahoey et al., 2007); Pathfiders programme (eighbourhood maagemet) (Departmet for Commuities & Local Govermet, 2007b); Public ivolvemet i policy ad practice (U. K. Coalitio Agaist Poverty, 68

69 Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig 2007); Healthy Livig Cetres (Hills et al. 2007); 2008 Commuity developmet ad metal health (Seebohm ad Gilchrist, 2008); Streets Ahead O Safety: Youg people & road safety (Kimberlee, 2008); Egagig heard to reach families (Barrett 2008); Health Impact Assessmet (Chadderto et al. 2008); Health Impact Assessmet (Chadderto et al., 2008); New Deal for Commuities (eighbourhood regeeratio) (Stafford et al., 2008); Ivolvemet i commissioig for people with LD ad complex eeds (Davis, 2008, McCaffrey, 2008); Citizes juries (Gooberma-Hill et al 2008); ASSIST (peer-led smokig cessatio i schools) (Audrey et al., 2008, Campbell et al., 2008); RIPPLE (Peer-led sex educatio i schools) (Stepheso et al., 2008); Sure Start ad coproductio (Pemberto ad Maso, 2008) Citizes Juries (Gooberma-Hill et al., 2008) Lay food ad health workers (Keedy et al., 2008); Voluteerig (Commuity Service Voluteers (CSV), 2008); Egagig heard to reach families (Barrett 2008); New Deal for Commuities Streets Ahead O Safety: Youg people & road 69

70 Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig (eighbourhood regeeratio) (Stafford et al., 2008); safety (Kimberlee, 2008); 2009 Healthy Livig Cetres (Taylor, 2009); Health/ Commuity Champios (Davies, 2009, East Midlads Regioal Empowermet Partership, 2009a); Coomuity developmet (East Midlads Regioal Empowermet Partership 2009b); Commuity-led health improvemet (Taylor 2009); Participatory Actio Research (McDaid, 2009); Parterships for Older People Programme (Widle et al., 2009, Williamso et al., 2009); Well Lodo (World café) (Bertotti et al., 2009); Pathfider programme (eighbourhood maagemet) (East Midlads Regioal Empowermet Partership, 2009b); Neighbourhood regeeratio (Lawso ad Kears, 2009); ASSIST (peer-led smokig cessatio i schools) (Starkey et al., 2009); Social support for ifat feedig (Watt et al., 2009); Breastfeedig peer support (MacArthur et al., 2009); Health/ Commuity Champios (Davies, 2009, East Midlads Regioal Empowermet Partership, 2009a) Improvig CE with Roma Commuity (Roma Support Group, 2009); Co-productio & Sure Start (Pemberto & Maso 2009); Commuity-led health improvemet (Taylor 2009); Health/ Commuity Champios (Davies, 2009, East Midlads Regioal Empowermet Partership, 2009a); Health traiers (Ward ad Baks, 2009); Voluteers (home start) (Bares et al., 2009); Parterships for Older People Programme (Widle et al., 2009, Williamso et al., 2009); Commuity-led health improvemet (Taylor 2009); Co-productio & Sure Start (Pemberto & Maso 2009); 70

71 Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig Commuity-led health improvemet (Taylor 2009); 2010 Empowermet (Take Part approach) (Neumark, 2010) Empowermet (West Johstoe Digital Iclusio Project; Hearts of Salford) (Smith et al., 2010); Health Champios (Altogether Better) (Yorkshire & Humber Empowermet Project, 2010, White et al., 2010); Well Lodo (youth.com & Youg Ambassadors; Commuity Activators; World Cafe) (Craig, 2010, Chapma, 2010, Sherida et al., 2010); Assets approaches (Foot & Hopkis 2010); Co-productio (Boyle et al., 2010); Social Iclusio Parterships (Carlisle, 2010); New Deal for Commuities (eighbourhood regeeratio)(muscat, 2010); Regeeratio (Lawso 2010); The Black ad Miority Ethic (BME) Health Forum (commuity participatory research) (Race for Health, 2010); Natioal Istitute for Metal Health i Eglad Commuity Egagemet Project (Foutai ad Hicks, 2010); Well Lodo (youth.com & Youg Ambassadors; Commuity Activators; World Cafe) (Craig, 2010, Chapma, 2010, Sherida et al., 2010); The Black ad Miority Ethic (BME) Health Forum (commuity participatory research) (Race for Health, 2010); Healthy lifestyle programme (Sefto me s health project) (Robiso et al., 2010); Addressig stigma related to metal health problems with BME groups (NHS Greater Glasgow ad Clyde, 2010); Natioal Istitute for Metal Health i Eglad Commuity Egagemet Project (Foutai ad Hicks, 2010); Lay food ad health workers (Keedy, 2010); Health traiers (Bpcssa, 2010, Carlso et al., 2010); Well Lodo (youth.com & Youg Ambassadors; Commuity Activators; World Cafe) (Craig, 2010, Chapma, 2010, Sherida et al., 2010); Health Champios (Altogether Better) (Yorkshire & Humber Empowermet Project, 2010, White et al., 2010); Health Champios (Altogether Better) (Yorkshire & Humber Empowermet Project, 2010, White et al., 2010); Voluteers (home start) (MacPherso et al., 2010); Natioal Istitute for Metal Health i Addressig stigma related to metal health problems Health Champios (Altogether Better) 71

72 Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig Eglad Commuity Egagemet Project (Foutai ad Hicks, 2010); Commuity empowermet (Gregso & Court 2010); Regeeratio (Lawso 2010); with BME groups (NHS Greater Glasgow ad Clyde, 2010); Well Lodo (youth.com & Youg Ambassadors; Commuity Activators; World Cafe) (Craig, 2010, Chapma, 2010, Sherida et al., 2010); Assets approaches (Foot & Hopkis 2010); (Yorkshire & Humber Empowermet Project, 2010, White et al., 2010); Commuity empowermet (Gregso & Court 2010); Co-commissioig (Mauger et al. 2010); Patiet public egagemet (PPE) i sexual ad reproductive health ad HIV/ AIDS (SRHH) services (Robiso ad Lorec, 2010); Healthy lifestyle programme (Sefto me s health project) (Robiso et al., 2010); 72

73 Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig 2011 Natioal Empowermet Partership Programme (Seder et al., 2011); NHS Health Empowermet Leverage Project (HELP) (Chaa, 2011); Health champios (Well Lodo) (Well Lodo ad NHS Hammersmith &Fulham, 2011, Cawley ad Berzis, 2011, Sadare, 2011, Tuariu et al., 2011); Localism housig associatios (Place Shapers Group 2011); Natioal Empowermet Partership Programme (Seder et al., 2011); NHS Health Empowermet Leverage Project (HELP) (Chaa, 2011); Neighbourhood regeeratio (Jarvis et al., 2011); Neighbourhood approaches to loeliess (JRF 2011); Healthy Weight Commuities (Rocket Sciece Ltd 2011); Actio Research (Roma Support Group 2011); Health champios (Well Lodo) (Well Lodo ad NHS Hammersmith &Fulham, 2011, Cawley ad Berzis, 2011, Sadare, 2011, Tuariu et al., 2011); Commuity Metorig service for older people (Dickes Ady et al., 2011); Localism housig associatios (Place Shapers Group 2011); Youth health champios (RSPH 2011); Healthy Weight Commuities programme (Rocket Sciece Ltd, 2011); Social Housig (Roseburg, 2011); Housig Associatios (Place Shapers Group, 2011) Health Traiers (Attree et al., 2011, Ball ad Nasr, 2011, Istitute for Crimial Policy Research, 2011, North West Public Health Observatory, 2011, Royal Society for Public Health, 2011); Health champios (Well Lodo) (Well Lodo ad NHS Hammersmith &Fulham, 2011, Cawley ad Berzis, 2011, Sadare, 2011, Tuariu et al., 2011); Localism housig associatios (Place Shapers Group 2011); Natioal Empowermet Partership Programme (Seder et al., 2011); NHS Health Empowermet Leverage Project (HELP) (Chaa, 2011); Voluteerig (O'Brie et al., 2011); Big Lottery Fud atioal wellbeig programme (CLES Cosultig, 2011); Localism housig associatios (Place Shapers Group 2011); NHS Health Empowermet Leverage Project (HELP) (Chaa, 2011); Actio Research (Roma Support Group 2011); Social Housig (Roseburg, 2011); Public agecies ad faith 73

74 Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig Youth health champios (RSPH 2011); commuities parterships (SCDC 2011); 2012 Asset-based approaches (McLea ad McNeice, 2012, Iriss, 2012); Commuity developmet ad metal health (Seebohm et al., 2012); Equally Well (Harkis ad Ega, 2012); Well Lodo (coproductio/ health champios) (Phillips et al., 2012); Health Champios (Sheffield All-Beig Well Cosortium, Woodall et al. 2012) (Reece ad Flit, 2012); Health Champios (health literacy) Co-productio (people powered health) (Nesta, 2012b, Nesta, 2012a, Local Govermet Iformatio Uit, 2012, Hatzidimitriadou et al., 2012); Well Lodo (coproductio/ health champios) (Phillips et al., 2012); Service user ivolvemet i social care (Beresford & Carr 2012); Participatory Actio Research (Chirewa 2012); Social marketig, road safety (Christie et al., 2012); Equally Well (Harkis ad Ega, 2012); Wome i Gova fightig Well Lodo (coproductio/ health champios) (Phillips et al., 2012); Commuity agets (Active at 60 programme) (Hatamia et al., 2012); Breastfeedig peer support (Jolly et al., 2012); Peer power for people with metal illess (Duffy, 2012); Social marketig, road safety (Christie et al., 2012); Positive Metal Attitudes (metal health iequalities programme)(qui ad Kifto, 2012); Traiig course: Health Issues I the commuity (Commuity Health Exchage, 2012a); Positive Metal Attitudes (metal health iequalities programme)(qui ad Kifto, 2012); Service user ivolvemet i social care (Beresford & Carr 2012); Participatory Actio Research (Chirewa 2012); Wome i Gova fightig iequality (Mackitosh 2012); Well Lodo (coproductio/ health champios) (Phillips et al., 2012); Health Champios (Sheffield All-Beig Well Cosortium 2012; Woodall et al. 2012) (Reece ad Flit, 2012); Health Champios (health literacy) (Liverpool Joh Moore's Uiversity, 2012); Health traiers (White et al., 2012, Cook ad Wills, 2012, Data Collectio Reportig System, 2012, Garder et al., 2012, Gree, 2012); Voluteerig (Nazroo ad Matthews, 2012); Commuity agets (Active at 60 programme) (Hatamia et al., 2012); 74

75 Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig (Liverpool Joh Moore's Uiversity, 2012); Social marketig, road safety (Christie et al., 2012); iequality (Mackitosh 2012); Positive Metal Attitudes (metal health iequalities programme)(qui ad Kifto, 2012); Commuity developmet ad metal health (Seebohm et al., 2012); Co-productio ad metal health (Hatzidimitriadou 2012); Wome i Gova fightig iequality (Mackitosh 2012); Positive Metal Attitudes (metal health iequalities programme)(qui ad Kifto, 2012); 2013 Assets based approaches (SCDC 2013a, b; Feto 2013); Equally Well (Scottish Timebaks (Cambridge Cetre for Housig ad Plaig Research 2013); Assets-based approaches Health traiers (Dooris 2013); Breastfeedig peer support (Igram 2013); Localism (Thraves 2013); Advocacy for pedestria safety (Hills et al. 2013); Health traiers (Jeigs et al. Timebaks (Cambridge Cetre for Housig ad Plaig Voluteerig i health ad care (Naylor et al. 2013); 75

76 Commuity mobilisatio/ actio Collaboratios & parterships Peer ivolvemet Commuity orgaisatios No-peer health advocacy Social Networks Voluteerig Govermet 2013); Music ad Chage metal health ad youg people i gags (MHF 2013); Localism (Thraves 2013); Health champios (White & Woodward 2013); (SCDC 2013a, b);: Equally Well (Scottish Govermet 2013); Localism (Thraves 2013); Natural Choices for Health ad Wellbeig (Wood 2013) NCT peer support (Newbur 2013,Bhavai 2013, McCarthy 2013) Music ad Chage metal health ad youg people i gags (MHF 2013); Peer support (NESTA 2013); Health champios (White & Woodward 2013); 2013; Lorec & Wills 2013; Shircore 2013); Health champios (White & Woodward 2013); Research 2013) 2014 Commuity resiliece: the good life iitiative (Ciderby et al. 2014); Assets-based ed of life care (Matthiese et al. 2014); Well Lodo (Phillips et al. 2014); Timebaks (Burgess 2014); Commuity resiliece: the good life iitiative (Ciderby et al. 2014); Assets-based ed of life care (Matthiese et al. 2014); NCT peer support (Newbur 2014, Bhavai 2014) Assets-based ed of life care (Matthiese et al. 2014); Well Lodo (Phillips et al. 2014); Co-productio i Wadsworth (Hough 2014) 76

77 77

78 Number of studies Targeted vs uiversal approaches Figure 14 shows treds over time i targeted versus uiversal approaches. It ca be see that the popularity of targeted approaches peaked i 2005 ad agai i Uiversal approaches were relatively rare before Iitiatives targetig populatios with ay idicators of health iequalities were more likely to use a targeted tha a uiversal approach (other tha populatios with low social capital, where a uiversal approach was more likely to be used). Figure 14 Treds over time i use of targeted ad uiversal approaches Targeted Uiversal Year Figure 15 shows treds i types of CE over time. It ca be see that there has bee a icrease i approaches usig peer ivolvemet sice 2009, ad that o-peer health advocacy approaches (e.g. health traiers) seem to have bee icreasig i frequecy sice

79 Number of studies Figure 15: Treds i types of CE over time N studies CE type1 CE type2 CE type3 CE type4 CE type5 CE type6 CE type7 5 0 Year CE type 1 = commuity mobilisatio/ actio; CE type 2 = commuity parterships; CE type 3 = peer ivolvemet; CE type 4 = commuity orgaisatios; CE type 5 = o-peer health advocacy; CE type 6 = social etworks; CE type 7 = voluteers Extet of commuity egagemet (Figure 16): Most icluded iitiatives reported a low (=141 (45%), 110S (48%), 31D (35%)) or moderate (=124 (39%), 85S (37%), 39D (44%)) extet of commuity egagemet, with oly 33 iitiatives (10%, 17S (7%), 16D (18%)) reportig a high extet of CE (defied as commuity leadig or collaboratig i all three of: desig; delivery; evaluatio). Most of the iitiatives with a high extet of CE took a commuity mobilisatio/ activatio approach (=21 (64%)), ad/ or a collaboratio/ partership approach (=26 (79%)) to commuity egagemet (Table 4). The comparatively high proportio of these iitiatives which were reported i the o-research literature (20% of all o-research articles, compared to 8% of research articles) may be idicative of a gap betwee the types of orgaisatios which usually write ad publish research articles (e.g. academics ad health professioals), ad the types of orgaisatios which usually ivolve commuity members i the evaluatio process (e.g. commuity-based, o-academic), ad/or may idicate challeges i the evaluatio or publicatio process of high egagemet iitiatives. It is worth otig due to the potetial for publicatio bias if o-research articles had ot bee icluded i this map of UK practice. 79

80 Figure 16 Extet of commuity egagemet Research/eval No-research Low Moderate High 80

81 Table 4: Type of CE approach used by articles reportig a high extet of CE Type of CE Research No-research Commuity mobilisatio/ actio - Small area regeeratio programmes (Aastacio et al., 2000) - Co-productio approaches (Boyle et al., 2006, Nesta, 2012b); - A road safety awareess project i the local Somali commuity (Christie et al., 2012); - Well Lodo programme RCT (Phillips et al., 2012); - Breathig Space commuity based atismokig programme (Platt et al., 2003); - Positive Metal Attitudes a metal health iequalities iitiative i Glasgow (Qui ad Kifto, 2005, Qui ad Kifto, 2012) - Healthy Livig Cetre project catcho2us! (Reeve ad Peerbhoy, 2007); - Actio Research to idetify barriers ad eablers to empowermet i the Roma commuity (Roma Support Group, 2009); - Ethographic study o empowermet ad youg people s health (Specer, 2014); - Commuity mappig to tackle social exclusio ad food poverty (Webster ad Johso, 2000); - Small area regeeratio programmes (Aastacio et al., 2000) - Co-productio approaches (Boyle et al., 2006, Nesta, 2012b); - Creative cosultatio with childre ad youg people for commuity developmet (Coulter); - Leeds Gypsy ad Traveller Exchage (Joes); - Commuity empowermet policy (Scottish Govermet, 2009); - Coectig Commuities (Stuteley) Commuity parterships/ coalitios - Co-productio approaches (Boyle et al., 2006, Nesta, 2012b); - A road safety awareess project i the local Somali commuity (Christie et al., 2012); - Commuity activity to address loeliess (Joseph Rowtree Foudatio, 2011); - CBPR i TB cotrol (Marais, 2007); - CALL-ME arts ad gardeig projects for older people (Murray); - Well Lodo programme RCT (Phillips et al., 2012); - Positive Metal Attitudes a metal health iequalities iitiative i Glasgow (Qui ad Kifto, 2005, Qui ad Kifto, 2012) - The Black ad Miority Ethic (BME) Health - Co-productio approaches (Boyle et al., 2006, Nesta, 2012b); - User ivolvemet research (Beresford, 2007); - Childre as researchers (Browlie et al., 2006); - Creative cosultatio with childre ad youg people for commuity developmet (Coulter); - Participatory actio research i metal health policy ad plaig (McDaid, 2009); - Coectig Commuities (Stuteley) 81

82 Type of CE Research No-research Forum (Race for Health, 2010); - Healthy Livig Cetre project catcho2us! (Reeve ad Peerbhoy, 2007); - Actio Research to idetify barriers ad eablers to empowermet i the Roma commuity (Roma Support Group, 2009); - Mosaics of Meaig parterships with BME commuities to promote metal health (NHS Greater Glasgow ad Clyde, 2010); - Older people ad voluteerig research (Baies et al., 2006) - Commuity mappig to tackle social exclusio ad food poverty (Webster ad Johso, 2000); Peer ivolvemet - A road safety awareess project i the local Somali commuity (Christie et al., 2012); - Positive Metal Attitudes a metal health iequalities iitiative i Glasgow (Qui ad Kifto, 2005, Qui ad Kifto, 2012) The Black ad Miority Ethic (BME) Health Forum (Race for Health, 2010); - Mosaics of Meaig parterships with BME commuities to promote metal health (NHS Greater Glasgow ad Clyde, 2010); - Older people ad voluteerig research (Baies et al., 2006) - Co-productio (Boyle 2010) - Creative cosultatio with childre ad youg people for commuity developmet (Coulter); Commuity orgaisatios - CALL-ME arts ad gardeig projects for older people (Murray); - Positive Metal Attitudes a metal health iequalities iitiative i Glasgow (Qui ad Kifto, 2005, Qui ad Kifto, 2012) - Healthy Livig Cetre project catcho2us! (Reeve ad Peerbhoy, 2007); - Leeds Gypsy ad Traveller Exchage (Joes); No-peer health advocacy Social etworks - Chagig Mids a metal health awareess project (Cawley ad Berzis, 2011) - Older people ad voluteerig research (Baies et al., 2006) 82

83 Type of CE Research No-research Voluteers - Chagig Mids a metal health awareess project (Cawley ad Berzis, 2011) - Older people ad voluteerig research (Baies et al., 2006) - Commuity mappig to tackle social exclusio ad food poverty (Webster ad Johso, 2000); I additio, some articles used a rage of commuity egagemet ad participatio models (Foutai et al., 2007, Coulter, 2010, Glasgow Cetre for Populatio Health, 2007, Laverack, 2006, Mahoey et al., 2007, Sherida ad Tobi, 2010). 3.7 Type of outcomes reported (research/ evaluatio studies oly): I the 227 research ad evaluatio studies, the most frequetly reported outcome type was process outcomes (=187 S (82%)) such as recruitmet of lay workers, followed by wellbeig outcomes (=116 S (51%)) such as cofidece, self-efficacy ad quality of life, ad health outcomes (=102 S (45%)) such as icreased awareess ad uptake of cacer screeig. Commuity level outcomes (=92 S (41%)) were reported more frequetly tha outcomes at the idividual level (=83 S (37%)). Harmful or uiteded effects (=12 S (5%)) ad ecoomic outcomes (=11 S (5%)), such as uit costs ad fudig, were reported less frequetly (Figure 17). Effects: Directio of effect was ot routiely coded for i this systematic mappig review, so we are uable to commet o effectiveess. 83

84 Figure 17 Types of outcomes reported Series1 Harmful or uiteded effects were reported i twelve studies (Adrews et al., 2003, Ball ad Nasr, 2011, Boydell ad Rugkåsa, 2007, Bridge Cosortium, 2002, Lawless et al., 2007, Lorec ad Wills, 2013, McLea ad McNeice, 2012, Muscat, 2010, New Ecoomics Foudatio, 2002, Skidmore et al., 2006, Steve ad Priya, 2000, Ward ad Baks, 2009). I some studies, the uiteded effect was potetially harmful for commuity members deliverig itervetios, i that voluteers were doig more tha was expected of them (Adrews et al., 2003) or felt a burde of resposibility, havig little time to themselves ad feelig afraid of lettig people dow (Bridge Cosortium, 2002, Steve ad Priya, 2000) I others, the uiteded effects were felt to be potetially harmful to other commuity members, for example becomig depedet o the project ad prevetig ew participats from accessig a place (McLea ad McNeice, 2012). Uiteded effects could also be positive, for example improvemets i metal health were reported by some commuity members deliverig itervetios (New Ecoomics Foudatio, 2002). Some harmful effects were due to orgaisatioal issues e.g. the speed at which oe Health Traier programme developed ad delays aroud some aspects impacted egatively o the morale ad cofidece of health traiers. There were also tesios betwee lay ad professioal workers with regard to role boudaries i relatio to advice givig (Ward ad Baks, 2009). Oe report foud that the key factor ifluecig levels of participatio i goverace was the existig patter of likig social capital those already well coected ted to get better coected (Skidmore et al., 2006). This would ot help to decrease health iequalities ad might have the opposite effect, of icreasig them. Figure 18 shows treds i type of outcomes reported i research/ evaluatio studies over time. It ca be see that metal health or wellbeig outcomes have icreased i frequecy sice

85 Number of iitiatives Figure 18 Treds i types of outcome reported i CE research/ evaluatio studies over time IBC SDH MHWB assets commuity social cohesio geeral health 0 Year IBC = idividual behaviour chage; SDH = social determiats of health; MHWB = metal health ad/ or wellbeig 3.8 Summary This map of curret ad emergig UK practice i commuity egagemet has attempted to draw together all the UK-based research evidece ad theories ad o-research practice descriptios ad policies to give a overview of what is happeig i terms of commuity egagemet i the UK today. The kowledge comes from a wide rage of sources from RCTs to persoal commuicatios from small projects. These vary i depth of descriptio ad i methodological quality, but as this is a mappig review, o formal assessmet of quality was udertake, so we caot commet further o this aspect. I terms of applicability this review is obviously very relevat to the UK settig ad seems to fill i a umber of evidece gaps highlighted by Stream 1, for example, it icludes a high proportio of itervetios aimed at improvig social determiats of health ad a high proportio of articles recordig commuity-based outcomes. A diverse rage of populatio groups are icluded, ad the evidece is domiated by iitiatives that target health iequalities through workig with socioecoomically disadvataged populatios, ad hard to reach groups such as older people ad those with disabilities. 316 articles have cotributed to this review, the majority beig research or evaluatio, with the majority of these beig mixed method evaluatios or qualitative studies. 85

86 Policy There are a umber of cosistet themes relatig to the UK policy cotext for commuity egagemet ad health, based o aalysis of 40 policy publicatios from 2006 owards. Firstly, policy documets, reviews ad commetary cocerig commuity egagemet ad health ca be mapped across a wide rage of policy areas ad sectors. These iclude: health policy ad the NHS, local govermet policy ad regeeratio, third sector ad voluteerig ad also health iequalities as a cross cuttig policy issue. Very few publicatios were focused exclusively o commuity egagemet ad public health, but all related to i some way to the active participatio of idividuals ad commuities as a mechaism to improve health, commuity life or quality of local services or alteratively to reduce iequalities ad area disadvatage. Secodly, sice 2006 there are cosistet themes across govermet policy relatig to the sigificace of commuity egagemet ad empowermet. The review has highlighted a umber of specific policy iitiatives from both Labour govermet ad the Coservative-Liberal Democrat Coalitio govermet of These iclude chages i PPI structures ad public ivolvemet mechaisms affectig health plaig ad services; eighbourhood maagemet, Localism aimed at devolutio of power to local commuities ad health iequalities policy. There are also relevat policies from the devolved assemblies (Scottish Govermet, 2013, Welsh Assembly Govermet, 2008). Overall, publicatios relatig to iequalities ad commuity empowermet, whether origiatig from govermet or from idepedet sources, like the Marmot review, called for ew relatioships betwee services ad commuities that give more power to commuities, eablig idividuals to play a greater part i local decisios that affect their health ad lives. Thirdly, the review has idetified a cosistet theme aroud the cotributio of idividuals ad commuities to health ad to society i geeral. Discussio ad commetary cluster roud various cocepts which are frequetly cross-refereced to each other. These iclude asset-based approaches, co-productio ad voluteerig. Cocepts The map of UK literature foud 30 articles that explored cocepts ad theories related to commuity egagemet. A diverse rage of cocepts are used to explai ad critique aspects of power ad participatio. There is o commo termiology ad a umber of papers poit to the challeges of defiig of what are complex sets of ideas. Oly four papers specifically dealt with commuity egagemet as a defied topic egagemet (Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Sherida ad Tobi, 2010, South ad Phillips, 2014). Empowermet cotiues to be a sigificat theme both how it ca be achieved ad what it meas. Sice 2006, other relevat cocepts, such as co-productio ad voluteerig, have gaied some promiece i public health literature. The implicatios are that commuity egagemet, as proposed i the earlier NICE guidace, is best see as a umbrella term that covers a rage of cocepts relatig to participatio ad empowermet. 86

87 Commuities The largest group of articles (=117, 37%), both research (=89, 39%) ad o-research (=28, 31%), looked at iitiatives i urba settigs. A large umber (=92, 29%) also looked at iitiatives i both urba ad rural settigs. Oly 11 articles (3.5%) looked at iitiatives i rural settigs aloe (Bromley, Davies, 2009, Dickes Ady et al., 2011, East Midlads Regioal Empowermet Partership, 2009a, Elliott et al., 2007, Halliday ad Asthaa, 2005, Hoddiott et al., 2006a, Hoddiott et al., 2006b, Osbore et al., 2002, Starkey et al., 2005, Stutely, 2002). I 43 articles (14%), the settig was ot clear. As this was a mappig review, we did ot udertake detailed data extractio o the populatios other tha to code for idicators of health iequalities usig the PROGRESS-plus tool. However, the UK evidece base o commuity egagemet icludes articles o commuities of place (see above ad e.g. Well Lodo), commuities of iterest, such as culture (e.g. Roma support group) or situatio (e.e. NCT peer support traiig for refuges ad asylum seekers), ethicity, age (e.g. Youth.com; MAC UK; Parterships for Older People), or health ad wellbeig issues (e.g. log term coditios). The health ad wellbeig issues addressed most frequetly by UK commuity egagemet iitiatives were commuity level or wellbeig outcomes, rather tha idividual behaviour chage outcomes: social capital or social cohesio (=129, 41%) e.g. improved social etworks (Burgess 2014), reductio i crime (Stutely ad Cohe 2004); commuity wellbeig (=110, 35%) e.g. commuity resiliece (Ciderby et al. 2014), empowermet (Hothi et al. 2007) ; persoal wellbeig (=82, 26%) e.g. positive metal health (IRISS 2012, Tuariu et al. 2011), quality of life (Nazroo ad Matthews 2012); geeral health persoal (=99, 31%) e.g. weight maagemet (Jeigs et al. 2013), healthy lifestyle promotio (Robiso et al. 2010; ad geeral health commuity (=95, 30%) e.g. settig up group activities (Woodall et al. 2012), reducig health iequalities (Race for Health 2010). This seems to be a differet patter to iitiatives icluded i the systematic review of effectiveess (Stream 1 (Bruto et al. 2014)), which have focused o idividual health issues such as physical activity ad healthy eatig. Iequalities Health iequalities idicators most frequetly observed were socioecoomic idicators (=89 S; 35 D) ad other idicators of disadvatage (= 95 S, 28 D) these icluded a rage of characteristics such as: people with disabilities (e.g. Edwards 2002, iclusio i regeeratio); 87

88 people with learig difficulties (LD) (e.g. McCaffrey 2008, commissioig from the perspective of people with LD); older people (e.g. Williamso et al. 2009, Parterships for Older People); offeders (e.g. Dooris et al. 2013, health traier service); people with log term health coditios (e.g. Hills et al. 2007, healthy livig cetres); people with substace use disorders (e.g. Elliott et al. 2001, ivolvig peer iterviewers i research); Gay Lesbia Bisexual or Trasgeder groups (e.g. Flowers et al. 2002, bar-based peer-led sexual health promotio with gay me); metal health service users (e.g. O Brie et al. 2011, voluteerig i ature).; Refugees ad asylum seekers (e.g. Bhavai & Newbur 2011, NCT peer support) Other idicators of iequality targeted by icluded iitiatives were race/ ethicity (= 53 S, 16 D), lack of social capital or social exclusio (= 37 S, 9 D). This demostrates that commuity egagemet iitiatives i the UK go beyod the approach of targetig the most obvious idicators of iequality (i.e. those that are icluded i health equity profiles such as ethicity, geder ad occupatioal or socioecoomic status) ad seek to egage some of the most margialised, disadvataged or excluded populatio groups, such as offeders, homeless people, people with poor physical or metal health, disabilities or learig difficulties, ad older people (at risk of social isolatio). This is true of both research ad o-research articles. Commuity egagemet iitiatives for populatios coded as beig i the category Other idicators of disadvatage were more likely to use peer or voluteer ivolvemet approaches tha those for populatios coded as havig socioecoomic idicators of disadvatage, which were similar to the percetages give across the rage of UK iitiatives i this mappig review. Iitiatives targetig populatios with ay idicators of health iequalities were more likely to use a targeted tha a uiversal approach (other tha populatios with low social capital, where a uiversal approach was more likely to be used). Approaches to commuity egagemet The mappig review foud a wide rage of approaches to commuity egagemet i the 316 icluded articles, which were grouped ito seve types (see Glossary). Commuity mobilisatio/ actio (138 articles, 89S, 49D; 44%) ad commuity parterships/ coalitios (180 articles, 113S, 67D; 57%) were the most commoly used approaches to commuity egagemet i both research ad o-research articles. Peer ivolvemet (=97, 82S, 15D; 31%) ad voluteers (=64, 50S, 14D; 20%) were commo approaches i research articles, but less so i o-research articles. Differet approaches seemed to be used to target differet types of health or wellbeig issues, for example peer ivolvemet was most 88

89 ofte see i itervetios targetig idividual behaviour chage (e.g. physical activity, healthy eatig, substace use), whereas commuity mobilisatio/ actio or partership/ coalitio approaches were more ofte see i iitiatives that focused o commuity wellbeig, social capital or commuity assets. Oly 33 iitiatives (11%, 17S, 16D) reported a high extet of CE (defied as commuity leadig or collaboratig i all three of: desig; delivery; evaluatio). Most of the iitiatives with a high extet of CE took a commuity mobilisatio/ activatio approach (=21*, 64%), ad/ or a collaboratio/ partership approach (=26**, 79%) to commuity egagemet. The comparatively high proportio of these iitiatives which were reported i the oresearch literature (20% of all o-research articles, compared to 8% of research articles) may be idicative of a gap betwee the types of orgaisatios which usually write ad publish research articles (e.g. academics ad health professioals), ad the types of orgaisatios which usually ivolve commuity members i the evaluatio process (e.g. commuity-based, o-academic), ad/or may idicate challeges i the evaluatio or publicatio process of high egagemet iitiatives. It is worth otig due to the potetial for publicatio bias if o-research articles had ot bee icluded i this map of UK practice. * Aastacio et al. 2000; Boyle et al. 2006; Christie et al. 2012; Phillips et al. 2012; Platt et al. 2003; Qui ad Kifto 2012; Reeve ad Peerbhoy 2007; Roma Support Group 2011; Specer 2014; Webster ad Johso 2000; Coulter 2010; Coulter 2014; Foutai et al. 2007; GCPH 2007; Joes 2014; Laverack 2006; Nesta 2012; Scottish Govermet 2009; Stuteley 2014; Sherida & Tobi 2010; Specer 2014) ** Aastacio et al. 2000; Boyle et al. 2006; Christie et al. 2012; JRF 2011; Marais 2007; Murray 2010; Phillips et al. 2012; Qui ad Kifto 2012; Race for Health 2010; Reeve ad Peerbhoy 2007; Roma Support Group 2011; NHS Greater Glasgow & Clyde 2010; Baies et al. 2006; Webster ad Johso 2000; Beresford 2007; Boyle et al. 2010; Browlie et al. 2006; Coulter 2010; Coulter 2014; Foutai et al. 2007; GCPH 2007; Mahoey et al. 2007; McDaid 2009; Nesta 2012; Stutely 2014; Sherida & Tobi 2010; Specer 2014) Outcomes I the 227 research ad evaluatio studies, the most frequetly reported outcome type was process outcomes (=187 S (82%)) such as recruitmet of lay workers, followed by wellbeig outcomes (=116 S (51%)) such as cofidece, self-efficacy ad quality of life, ad health outcomes (=102 S (45%)) such as icreased awareess ad uptake of cacer screeig. Commuity level outcomes (=92 S (41%)) were reported more frequetly tha outcomes at the idividual level (=83 S (37%)). Harmful or uiteded effects (=12 S (5%)) ad ecoomic outcomes (=11 S (5%)), such as uit costs ad fudig, were reported less frequetly. Effects: Directio of effect was ot routiely coded for i this systematic mappig review, so we are uable to commet o effectiveess. 89

90 Uiteded or harmful effects: There is some evidece i this compoet 1a to cotribute to review questio 4, with 12 studies (5%) coded as reportig uiteded or harmful cosequeces. Evidece from these 12 studies suggests that uiteded effects ca be positive (e.g. improved metal health i commuity members deliverig itervetios) but may also be egative or harmful, either to commuity deliverers (e.g. voluteers feelig overburdeed), to orgaisatios or parterships (e.g. tesios betwee lay ad professioal role boudaries), or to the wider commuity (e.g. commuity members becomig so attached to projects that there are o places left for ewer members). Structure ad focus of existig evidece base There is a substatial amout of iformatio i the followig topic areas: Urba or mixed settigs (i.e. both urba ad rural); socioecoomically deprived groups or areas; socially excluded or isolated groups; areas that lack social cohesio; other potetially disadvataged groups (e.g. older people; people with disabilities; people i poor physical or metal health); black or miority ethic groups; iitiatives targetig health behaviours (physical activity, healthy eatig, substace use), metal health, persoal ad commuity wellbeig, geeral health (persoal ad commuity), social capital or cohesio; iitiatives with low or moderate extet of CE; process, wellbeig, health ad commuity level outcomes. There seems to be little iformatio i the followig areas: rural settigs; uiteded or harmful effects; cultural adaptatio; iitiatives with a high extet of CE; populatio groups that may experiece health iequalities due to religio, culture or educatioal reasos. 3.9 Summary statemets Summary statemet 1: Coceptual A umber of overlappig terms are used to cover cocepts ad approaches that relate to the active participatio of people i decisios about their health ad lives (based o 30 coceptual/ theoretical papers *). This icludes commuity egagemet (4 papers: Foutai et al. 2007; Glasgow Cetre for Populatio Health 2007; Sherida ad Tobi 2010; South ad Phillips 2014), commuity participatio (2 papers: Mahoey et al. 2007; Draper et al. 2010), commuity or public ivolvemet (4 papers: Burto et al. 2006; Chadderto et al. 2008; Departmet of Health 2006b; Wait ad Nolte 2006) ad empowermet (3 papers: Commuities ad Local Govermet 2007; Laverack 2006; Specer 2014). Empowermet is a complex cocept that has differet dimesios both relatig to process ad outcomes (Laverack 2006; Specer 2014). The review of coceptual papers suggests that commuity egagemet also relates to social actio by commuities through voluteerig ad buildig social capital (based o 11 coceptual/ theoretical papers (Cabiet Office, 2011, Commuities ad Local Govermet, 2007, Dobbs ad Moore, 2002, Nesta, 2013, Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Hardill et al., 2007, 90

91 Laverack, 2006, Local Govermet Iformatio Uit, 2012, Sherida ad Tobi, 2010, Wallace, 2007)). *(Joes, 2004, Attree et al., 2011, Beresford, 2007, Boydell ad Rugkåsa, 2007, Boyle et al., 2010, Browlie et al., 2006, Burto et al., 2006, Cabiet Office, 2011, Chadderto et al., 2008, Chirewa, 2012, Commuities ad Local Govermet, 2007, Departmet of Health, 2006b, Draper et al., 2010, Foutai et al., 2007, Glasgow Cetre for Populatio Health, 2007, Hardill et al., 2007, Keedy, 2006, Laverack, 2006, Local Govermet Iformatio Uit, 2012, Mahoey et al., 2007, McDaid, 2009, Nesta, 2013, Office of the Deputy Prime Miister, 2006, Scottish Govermet, 2013, Sherida ad Tobi, 2010, Specer, 2014, Truma ad Raie, 2001, Wait ad Nolte, 2006, Wallace, 2007, South ad Phillips, 2014) Summary statemet 2: Policy Policy iterest i commuity egagemet ad health ca be mapped across a wide rage of policy areas ad sectors. These iclude: health policy ad the NHS, local govermet policy ad regeeratio, third sector ad voluteerig ad also health iequalities as a cross cuttig policy issue. Commuity egagemet i public health cotiues to be supported through these various policy drivers (4 publicatios: (Departmet of Health, 2010, Departmet of Health, 2012a, Departmet of Health, 2012b, HM Govermet, 2010b)); however, there appears to be a greater policy emphasis o patiet ad public ivolvemet (PPI) structures i relatio to the NHS (6 publicatios: (Departmet of Health, 2006b, Departmet of Health, 2006a, Departmet of Health, 2007a, Departmet of Health, 2010, HM Govermet, 2012, NHS Eglad, 2013)). The key role of local govermet i leadig commuity egagemet ad supportig public participatio i local decisio makig has bee a major policy theme throughout the period covered by the review (based o 4 publicatios: (Departmet for Commuities & Local Govermet, 2006b, Departmet for Commuities & Local Govermet, 2007a, Departmet for Commuities & Local Govermet, 2007b, HM Govermet, 2007)). Commuity egagemet ad empowermet have bee cosistetly liked to strategies to address health iequalities (3 publicatios: (Departmet of Health, 2008b, Departmet of Health, 2008a, Departmet of Health, 2009a), with emphasis give to eablig idividuals to play a greater part i local decisios that affect their health ad lives Two specific policy iitiatives idetified i the review were New Deal for Commuities (Lawless, 2004, Lawless et al., 2007, Wallace, 2007) ad Neighbourhood Maagemet/parterships (Office of the Deputy Prime Miister, 2006, Sustaiable Developmet Commissio, 2010). The cotributio of idividuals ad commuities to health ad to society i geeral is a policy theme, with the importace of social actio o health beig edorsed i govermet documets ad policy commetary. Iterrelated cocepts foud i the map of policy iclude asset-based approaches, co-productio, voluteerig ad peer support, ad a umber of (o-govermetal) documets advocate for methods that draw o commuity stregth ad build o the lay cotributio. 91

92 Summary Statemet 3: Commuities Most commuity egagemet activity i the UK takes place i urba or mixed (urba ad rural) settigs (based o 209 articles). The health ad wellbeig issues addressed most frequetly by UK commuity egagemet iitiatives were commuity level or wellbeig outcomes, rather tha idividual behaviour chage outcomes: social capital or social cohesio (=129, 41%) e.g. improved social etworks (Burgess 2014), reductio i crime (Stutely ad Cohe 2004); commuity wellbeig (=110, 35%) e.g. commuity resiliece (Ciderby et al. 2014), empowermet (Hothi et al. 2007) ; persoal wellbeig (=82, 26%) e.g. positive metal health (IRISS 2012, Tuariu et al. 2011), quality of life (Nazroo ad Matthews 2012); geeral health persoal (=99, 31%) e.g. weight maagemet (Jeigs et al. 2013), healthy lifestyle promotio (Robiso et al. 2010; ad geeral health commuity (=95, 30%) e.g. settig up group activities (Woodall et al. 2012), reducig health iequalities (Race for Health 2010). Summary Statemet 4: Health iequalities Much UK practice i commuity egagemet is directly relevat to health iequalities (based o 125 studies coded as socioecoomic idicators (=89 S; 35 D) e.g. deprivatio (Greee 2007; Hills et al. 2013) ad 123 studies coded as other idicators of disadvatage (= 95 S, 28 D) these icluded a rage of characteristics such as: people with disabilities (e.g. Edwards 2002, iclusio i regeeratio); people with learig difficulties (LD) (e.g. McCaffrey 2008, commissioig from the perspective of people with LD); older people (e.g. Williamso et al. 2009, Parterships for Older People); offeders (e.g. Dooris et al. 2013, health traier service); people with log term health coditios (e.g. Hills et al. 2007, healthy livig cetres); people with substace use disorders (e.g. Elliott et al. 2001, ivolvig peer iterviewers i research); Gay Lesbia Bisexual or Trasgeder groups (e.g. Flowers et al. 2002, bar-based peer-led sexual health promotio with gay me); metal health service users (e.g. O Brie et al. 2011, voluteerig i ature); 92

93 Refugees ad asylum seekers (e.g. Bhavai ad Newbur 2011, NCT peer support). This demostrates that commuity egagemet iitiatives i the UK go beyod the approach of targetig the most obvious idicators of iequality (i.e. those that are icluded i health equity profiles such as ethicity, geder ad occupatioal or socioecoomic status) ad seek to egage some of the most margialised, disadvataged or excluded populatio groups. Peer- ad voluteer-based approaches to commuity egagemet were more commo i populatios with other idicators of disadvatage tha i ay other group (based o 57 articles o peer approaches (45S (47%), 6D (16%)), such as peer educatio for prevetig falls i older people (Alle 2004) ad 38 articles o voluteer approaches (34S (36%), 4D (14%)), such as voluteerig for metal health (Istitute for Voluteerig Research 2003). Summary statemet 5: Approaches to commuity egagemet The mappig review foud a wide rage of approaches to commuity egagemet i the 316 icluded articles. Approaches aliged to commuity developmet ad empowermet ad/ or participatory priciples are commoly used i the UK, with peer ad voluteer ivolvemet also beig promiet approaches. Differet approaches seem to be appropriate to address differet health ad wellbeig issues, for example peer, voluteer or lay ivolvemet for targetig idividual behaviour chage; commuity mobilisatio/ actio or commuity parterships/ coalitios for targetig commuity level outcomes, such as wellbeig, commuity assets or social capital. Most of the iitiatives with a high extet of CE took a commuity mobilisatio/ activatio approach (=21 (64%))*, ad/ or a collaboratio/ partership approach (=26 (79%))** to commuity egagemet. Health or wellbeig issues most frequetly addressed were commuity wellbeig (=15 (45%) 8D, 7S), social capital/ cohesio (=14 (42%) 6D, 8S), geeral health persoal (=8 (24%) 5D, 3S), geeral health commuity (=11 (33%) 7D, 4S). A comparatively high proportio of these iitiatives were reported i the o-research literature (=16 (20%) compared to =17 (8%) i research literature). * Aastacio et al. 2000; Boyle et al. 2006; Christie et al. 2012; Phillips et al. 2012; Platt et al. 2003; Qui ad Kifto 2012; Reeve ad Peerbhoy 2007; Roma Support Group 2011; Specer 2014; Webster ad Johso 2000; Coulter 2010; Coulter 2014; Foutai et al. 2007; GCPH 2007; Joes 2014; Laverack 2006; Nesta 2012; Scottish Govermet 2009; Stuteley 2014; Sherida & Tobi 2010; Specer 2014) ** Aastacio et al. 2000; Boyle et al. 2006; Christie et al. 2012; JRF 2011; Marais 2007; Murray 2010; Phillips et al. 2012; Qui ad Kifto 2012; Race for Health 2010; Reeve ad Peerbhoy 2007; Roma Support Group 2011; NHS Greater Glasgow & Clyde 2010; Baies et al. 2006; Webster ad Johso 2000; Beresford 2007; Boyle et al. 2010; Browlie et al. 2006; Coulter 2010; Coulter 2014; Foutai et al. 2007; GCPH 2007; Mahoey et al. 2007; McDaid 2009; Nesta 2012; Stutely 2014; Sherida & Tobi 2010; Specer 2014) 93

94 Summary statemet 6: Outcomes I the 227 research ad evaluatio studies, the most frequetly reported outcome type was process outcomes (=187 S (82%)) such as recruitmet of lay workers (e.g. Chapma 2010), followed by wellbeig outcomes (=116 S (51%)) such as cofidece, self-efficacy ad quality of life (e.g. White et al. 2010), ad health outcomes (=102 S (45%)) such as icreased awareess ad uptake of cacer screeig (Curo 2014). Commuity level outcomes (=92 S (41%) e.g. Bares et al (Health Actio Zoes)) were reported more frequetly tha outcomes at the idividual level (=83 S (37%) e.g. Platt et al (smokig cessatio)). Harmful or uiteded effects (=12 S (5%)) ad ecoomic outcomes (=11 S (5%)), such as uit costs ad fudig, were reported less frequetly. Uiteded or harmful effects: Evidece from 12 studies (Adrews et al., 2003, Ball ad Nasr, 2011, Boydell ad Rugkåsa, 2007, Bridge Cosortium, 2002, Lawless et al., 2007, Lorec ad Wills, 2013, McLea ad McNeice, 2012, Muscat, 2010, New Ecoomics Foudatio, 2002, Skidmore et al., 2006, Steve ad Priya, 2000, Ward ad Baks, 2009) o uiteded or harmful effects suggests that these ca be positive (e.g. improved metal health i commuity members deliverig itervetios) but may also be egative or harmful, either to commuity deliverers (e.g. voluteers feelig overburdeed), to orgaisatios or parterships (e.g. tesios betwee lay ad professioal role boudaries), or to the wider commuity (e.g. commuity members becomig so attached to projects that there are o places left for ewer members). Summary statemet 7: Structure ad focus of existig evidece base There is a substatial amout of iformatio i the followig topic areas: Urba or mixed settigs (i.e. both urba ad rural); socioecoomically deprived groups or areas; socially excluded or isolated groups; areas that lack social cohesio; other potetially disadvataged groups (e.g. older people; people with disabilities; people i poor physical or metal health); black or miority ethic groups; iitiatives targetig health behaviours (physical activity, healthy eatig, substace use), metal health, persoal ad commuity wellbeig, geeral health (persoal ad commuity), social capital or cohesio; iitiatives with low or moderate extet of CE; process, wellbeig, health ad commuity level outcomes. There is very little iformatio, either from research, or from other sources, o what is beig doe i terms of commuity egagemet i rural settigs (=11 (3%) 7 S, 4 D), or i commuities that may experiece health iequalities due to religio/ culture (= 12 (4%) 6 S, 6 D) or educatioal reasos (= 17 (5%) 14 S, 3 D). There is little iformatio o harmful or uiteded effects of commuity egagemet iitiatives ( = 12 S (5%)), or o ecoomic outcomes ( = 11 S (5%)). 94

95 4. Discussio 4.1 Mai fidigs This systematic mappig review foud a substatial evidece-base o curret ad emergig UK policy ad practice i commuity egagemet, ecompassig a diverse rage of populatios ad approaches to commuity egagemet. The key role of local govermet i leadig commuity egagemet ad supportig public participatio i local decisio makig has bee a major policy theme throughout the period covered by the review. Commuity egagemet ad empowermet have bee cosistetly liked to strategies to address health iequalities, with emphasis give to eablig idividuals to play a greater part i local decisios that affect their health ad lives. Domiat cocepts iclude asset-based approaches, co-productio, voluteerig ad peer support. There was a high volume of evidece from: qualitative ad mixed methods studies; iitiatives targetig health iequalities via socioecoomically deprived areas ad groups, ad via hard to reach groups (such as people with disabilities, substace users, homeless people). Commuity level outcomes (e.g. improved housig) ad wellbeig outcomes (e.g. improved self-esteem) were most commoly addressed, ad commuity mobilisatio/ actio ad commuity parterships/ coalitios were the types of commuity egagemet most commoly employed. 4.2 Wider cotext The previous NICE guidace o commuity egagemet (NICE 2008) made 12 recommedatios which covered policy developmet, log-term ivestmet, orgaisatioal ad cultural chage, levels of egagemet ad power, mutual trust ad respect, ifrastructure, partership workig, area-based iitiatives, commuity members as agets of chage, commuity workshops, residet cosultacy ad evaluatio. A recet systematic review of commuity egagemet to reduce iequalities i health (O Mara-Eves et al., 2013) foud solid evidece that commuity egagemet itervetios have a positive impact o health behaviours, health cosequeces, self-efficacy ad perceived social support outcomes, across a wide rage of cotext ad usig a variety of mechaisms. The 2008 guidace o commuity egagemet (NICE 2008) foud that the approach used to ivolve the commuity was ot usually the mai focus of the evaluatio. With this i mid, the other two compoets of Stream 2 (Primary Research Report 1: map of curret practice based o a case study approach (Bagall et al., 2015), ad Review 5: Evidece review of barriers to, ad facilitators of, commuity egagemet approaches ad practices i the UK ((Harde et al., 2015)) will seek to evaluate the process of commuity egagemet, rather tha the delivery of the itervetio or its effects. 95

96 The 2008 guidace also made detailed recommedatios for further research, icludig methodology for future commuity egagemet research studies, impact evaluatio of area-based iitiatives, research ito barriers ad facilitators to commuity egagemet, ad ecoomic evaluatio. Primary Research Report 1 (Bagall et al. 2015) ad Review 5 (Harde et al. 2015) also address the third of these objectives: research ito barriers ad facilitators. The NICE guidace published i 2008 did ot iclude a rage of ewer commuity egagemet approaches, because they had ot yet bee evaluated. These icluded health traiers, collaborative methodology ad citizes juries ad paels. Evaluatios of all of these approaches are icluded i this systematic map. 4.3 Limitatios of the review Protocol deviatios: We had stated i the protocol that we would do forwards ad backwards citatios of all icluded studies, but give the large umber of icluded studies, we did ot do this, or did we cotact authors to ask for more details of icluded studies. This may have led to some iitiatives beig missed out of the map. A delay i publicatio (time lag bias) may also have led to more recet ad emergig practice beig left out of the map, but we sought to avoid this by extesive website searches ad by cotactig practitioers through may differet sources to obtai details of projects that had ot yet (or i some cases ever would be) bee published. Theory: There was some developmet i coceptual thikig aroud commuity egagemet termiology as part of this project, which stemmed from a lack of clarity aroud terms used for commuity egagemet. A similar issue with idetifyig which commuity egagemet approach was used was idetified i the 2008 NICE guidace o commuity egagemet (NICE 2008). There was also debate over whether itervetios were targeted or uiversal with team members fidig it difficult to reach agreemet i some cases. The lack of a stadard set of terms for commuity participatio presets difficulties i iterpretatio of research ad practice. Some phrases are used effectively as syoyms eg commuity ivolvemet ad commuity egagemet, while other terms lack a agreed defiitio. Also theoretical costructs used with some precisio i academic literature may be coceptualised differetly i professioal practice ad also by the public (Yerbury, 2011). Clusters of literature ca occur as a field of practice develops. This review mapped how commuity egagemet ad related cocepts have bee operatioalised i UK policy ad practice. Due to the methodology ad timescale of the systematic map, we could ot extract detailed data o the theoretical uderpiigs of various approaches to commuity egagemet. However, the typology we used was based o the recet NIHR review (O Mara-Eves et al., 2013) which described three coceptualisatios of commuity egagemet: - Theories of chage for patiet/ cosumer ivolvemet: egagemet with commuities or members of commuities i strategies for service developmet, i which empowerig idividuals ehaces their egagemet with service professioals to effect sustaiable chages i services. It ivolves commuity members i the plaig or desig of a itervetio. 96

97 - Theories of chage for peer-/lay-delivered itervetios: services egage commuities or idividuals withi commuities to deliver itervetios, thereby empowerig them by ehacig their skills. This approach aims to effect sustaiable chage amogst idividuals ad their peers. - Theories of empowermet to reduce health iequalities: whe people are egaged i a programme of commuity developmet, a empowered commuity is the outcome sought by ehacig their mutual support ad their collective actio to mobilise resources of their ow ad form elsewhere to make chages withi the commuity. A empowered commuity ca do much to sustai its ow efforts. Aother typology was developed i parallel with the 7 types of commuity egagemet used i Reviews 1-3 (Bruto et al., 2014). This typology was developed as part of a report for Public Health Eglad (South, 2015), ad was also based o the 2013 NIHR review but placed differet types of commuity itervetios ito a family with four mai themes: Stregtheig commuities; Voluteer & peer roles; Collaboratios & parterships; Access to commuity resources (see Appedix H for further details). Arguably, the family of commuity based itervetios (South, 2015) may be more applicable to the UK cotext tha the seve types of commuity egagemet that we have used i this review. For the subsequet compoet 1b (case studies) we have used the South 2015 typology i our samplig frame as it was felt that this was more applicable to UK practice. Appedix I also shows the distributio of the iitiatives i this UK mappig review across the four mai categories i the South 2015 family of commuity based itervetios. What the review does ot cover: The date cut-off of 2000 for research, evaluatio ad practice descriptios, ad of 2006 for policy or coceptual papers may have led to some relevat studies from before these dates beig missed, however as this is iteded to be a map of curret ad emergig practice this is probably ot importat. As this was a systematic mappig review, with may icluded articles, we did ot udertake detailed data extractio ad therefore did ot examie all the icluded articles i as much detail as for a stadard systematic review. This led to difficulties i assigig codig categories to some of the articles, as alluded to above, ad may mea that some of the categories assiged to some of the articles may be subject to discussio ad chage. The lack of time to examie all the articles i detail (may of which were large reports) meas that we are uable to say with certaity that we have detected (for example) all metios of harmful or uiteded effects, ad it is possible that these were icluded i more tha 12 articles. As is appropriate for a systematic mappig review (Gough et al., 2012), ad i order to code all 316 icluded articles withi the short time available, we did ot udertake quality assessmet for icluded research ad evaluatio studies. Because of this limitatio, we did ot routiely code for whether a iitiative had positive effects, as it was felt that without the quality assessmet ad detailed data extractio, ay such fidigs would be relatively meaigless ad potetially misleadig if take out of cotext. This is somethig that could be addressed i future systematic reviews of this topic, which could focus o (for example) the effectiveess of oe type of commuity egagemet approach withi or across certai populatio groups. 97

98 The lack of detailed data extractio meat that the map also lacks detailed descriptios of populatios, settigs, activities etc. ad there is o detail of whether particular approaches were uderpied by particular theories. 4.4 Stregths of the review This systematic map of the UK literature o commuity egagemet policy ad practice i the UK aimed to iclude all the commuity egagemet iitiatives that have bee takig place sice Previous experiece i this field (O Mara-Eves et al. 2013, South et al. 2010) suggests that there is a publicatio bias i that professioally-led (sometimes referred to as top-dow ) iitiatives are more likely to be evaluated ad the published i peer reviewed jourals tha commuity-led ( bottom-up or Grass-roots ) iitiatives, such as those that result i commuity empowermet. We tried to overcome this publicatio bias by makig every effort to fid ad iclude grey literature (reports ad other documets from orgaisatioal repositories ad websites) ad two calls for evidece were made, from NICE to stakeholders, ad from the review teams to etworks of commuity orgaisatios, public health practitioers ad academics. We had 21 relevat projects cotact us via our Register of Iterest, ad 20 via the NICE call for evidece, some of which did ot have ay related publicatios or evaluatio reports, ad would ot have bee picked up eve i our website searches. While we kow of other relevat projects that did ot sig up to the Register, we hope that this map comes closer to presetig a realistic picture of what is happeig i practice tha if we had oly icluded published joural articles. The iclusio of a rage of evidece from o-rct study desigs, which are so ofte excluded from systematic reviews of effectiveess, is a real stregth of this map of practice. It has bee argued that measurig outcomes aloe does ot measure the impact o people s lives or the cotext i which chages (if ay) take place (Lowe 2013), ad that qualitative research is better placed to explore these aspects of effectiveess. It is also ofte oted that hard to reach groups are ofte excluded from traditioal research studies such as RCTs, whether deliberately or by default. The iclusio of other types of iformatio has esured that a wider rage of populatio groups ad approaches to commuity egagemet are represeted i this map ad i fact hard to reach groups together form the largest populatio group. 4.5 Implicatios of the fidigs The diversity of populatios, health ad wellbeig issues, approaches ad activities that are ivolved i recet ad curret commuity egagemet policy ad practice i the UK suggests that the use of commuity egagemet as a umbrella term, as proposed i the 2008 guidace (Natioal Istitute for Health ad Care Excellece, 2008), seems to still be appropriate, as differet approaches fit best with differet populatios ad/ or health ad wellbeig issues. 98

99 Use of the PROGRESS-Plus tool (Kavaagh et al., 2008) i this systematic map has highlighted differeces i the populatios targeted by commuity egagemet iitiatives i the UK compared to those targeted i the iteratioal literature. For example, i the 2013 NIHR review (O Mara-Eves et al., 2013), ethicity was the most frequet PROGRESS-Plus characteristic across all the icluded studies, although for UK studies oly, the most frequet characteristic was socioecoomic status. I our map, the most frequet PROGRESS-Plus characteristic was Other vulerable groups, followed by socioecoomic status. Our review ad the 2013 review of effectiveess (O Mara-Eves et al., 2013) also foud that populatios ofte had more tha oe characteristic of PROGRESS-Plus. The high volume of iitiatives takig place i these Other vulerable groups i the UK deserves recogitio by policy makers ad decisio makers, practitioers, professioals ad researchers, i terms of resources, evaluatio ad opportuities for shared learig. It may also idicate a eed for a specific commuity egagemet add-o to the PROGRESS- Plus tool, so that future research ad evaluatio is more likely to capture the fier details of the commuities ivolved. The map has idicated that there is a high volume of evidece i the followig categories: process evaluatios; qualitative ad mixed methods studies; populatio socioecoomic idicators, other idicators of disadvatage (disability; older people; service users; substace users; homeless; etc.), BME; Issues social capital, commuity wellbeig, commuity health (commuity level outcomes). Types of CE: commuity mobilisatio/ actio; commuity parterships/ coalitios. It may be beeficial to carry out a full systematic review focused o ay of these areas to examie i-depth the effectiveess of UK-based iitiatives. The map has also idicated that there are evidece gaps i the followig areas: rural settigs; Harmful/ uiteded effects; health iequalities related to religio/ culture or educatioal issues. It may be beeficial to focus UK-based primary research ad/ or practice i these areas. 99

100 5. Coclusio ad recommedatios This mappig review foud a substatial evidece-base o curret ad emergig UK policy ad practice i commuity egagemet, ecompassig a diverse rage of populatios ad approaches to commuity egagemet. The use of commuity egagemet as a umbrella term to ecompass differet approaches ad activities for differet populatio ad health or wellbeig issues seems to fit well with the UK perspective. The key role of local govermet i leadig commuity egagemet ad supportig public participatio i local decisio makig has bee a major policy theme throughout the period covered by the review. Commuity egagemet ad empowermet have bee cosistetly liked to strategies to address health iequalities, with emphasis give to eablig idividuals to play a greater part i local decisios that affect their health ad lives. Domiat cocepts iclude asset-based approaches, co-productio, voluteerig ad peer support. There was a high volume of evidece from: qualitative ad mixed methods studies; iitiatives targetig health iequalities via socioecoomically deprived areas ad groups, ad via hard to reach groups (such as people with disabilities, substace users, homeless people). Commuity level outcomes (e.g. improved housig) ad wellbeig outcomes (e.g. improved self-esteem) were most commoly addressed, ad commuity mobilisatio/ actio ad commuity parterships/ coalitios were the types of commuity egagemet most commoly employed. Recommedatios for practice: A varied toolbox of approaches to commuity egagemet i the UK is eeded i order to egage with a wide rage of populatios ad health ad wellbeig issues. Commuities targeted by CE iitiatives i the UK iclude a substatial proportio who are at risk of health iequalities (such as people with metal health issues, offeders, homeless people, Gay, Lesbia, Bisexual or Trasgeder), but who are ot routiely fully represeted i health equity profiles/ audits, which ted to focus o age, geder, ethicity ad deprivatio idices. Cosideratio should cotiue to be give to these margialised groups, i terms of both iitial egagemet ad measuremet of impact. Recommedatios for research: The lack of iitiatives foud i rural settigs, ad the lack of evidece o cultural adaptatio, groups at risk of health iequalities due to religio/ culture or lack of educatio suggests that it would be beeficial to explore commuity egagemet i practice for these groups. Future research studies should report ay harmful or uiteded effects. There is scope for future systematic reviews o commuity egagemet i the UK cotext to examie the effectiveess of each type of commuity egagemet approach. 100

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116 VISRAM, S., GEDDES, L., CARR, S. M. & DRINKWATER, C A evaluatio of the Early Adopter Phase of the Health Traiers Project i the North East. Northumbria Uiversity. WAIT, S. & NOLTE, E Public ivolvemet policies i health: explorig their coceptual basis. Health Ecoomics, Policy, Ad Law, 1, WALLACE, A We have had othig for so log that we do't kow what to ask for : New Deal for Commuities ad the Regeeratio of Socially Excluded Terrai. Social Policy ad Society, 6, WANLESS, D Securig our Future Health: Takig a Log-Term View. Lodo: HM Treasury. WANLESS, D Securig good health for the whole populatio. Fial report. Lodo: HM Treasury. WARD, L. & BANKS, L Evaluatio of Health Traiers i West Sussex. Brighto: Uiversity of Brighto. WATSON, A., OWEN, G., CROWDER, M. & ELLIS, B Evaluatio of the commuity champios fud. Lodo: Departmet for Educatio ad Skills. WATT, R. G., TULL, K. I., HARDY, R., WIGGINS, M., KELLY, Y., MOLLOY, B., DOWLER, E., APPS, J. & MCGLONE, P Effectiveess of a social support itervetio o ifat feedig practices: radomised cotrolled trial. Joural Of Epidemiology Ad Commuity Health, 63, WEBSTER, J. & JOHNSON, V Reachig the parts... Commuity mappig: workig together to tackle social exclusio ad food poverty. Lodo: Sustai. WELL LONDON & NHS HAMMERSMITH &FULHAM Health Champio Project : EVALUATION REPORT. Lodo: Hammersmith ad Fulham NHS. WELSH ASSEMBLY GOVERNMENT Desiged to add value: a third dimesio: a strategic directio for the volutary ad commuity sector i supportig health ad social care, Cardiff, Wales: Welsh Assembly Govermet. WHITE, J., KINSELLA, K. & SOUTH, J Kirklees Health Traier Service. Leeds: Leeds Metropolita Uiversity. WHITE, J., SOUTH, J., WOODALL, J. & KINSELLA, K Altogether Better Thematic Evaluatio - Commuity health champios ad empowermet. Leeds: Leeds Metropolita Uiversity. WHITE, J. & WOODWARD, J Commuity Health Champios i Licolshire. Leeds: Leeds Metropolita Uiversity. WHITEHEAD, M. & DAHLGREN, G Levellig up (part 1): a discussio paper o cocepts ad priciples for tacklig social iequalities i health (Studies o social ad ecoomic determiats of populatio; health o 2). Copehage: WHO Regioal Office for Europe. WILLIAMSON, T., PRASHAR, A., HULME, C. & WARNE, T Evaluatio of Rochdale Parterships for Older People Project (POPP): Buildig Healthy Commuities for Older People. Report: Uiversity of Salford/ Uiversity of Leeds. WINDLE, K., WAGLAND, R., FORDER, J., D'AMICO, F., JANSSEN, D. & WISTOW, G Natioal Evaluatio of Parterships for Older People Programme. Report: Persoal Social services Research Uit. WOOD, C., BRAGG, R. & BARTON, J Natural Choices for Health ad Wellbeig: A Report for Liverpool Primary Care Trust ad The Mersey Forest. Colchester: Uiversity of Essex. WOODALL, J., KINSELLA, K., SOUTH, J. & WHITE, J. 2012a. Commuity Health Champios ad older people: A review of the evidece, Leeds, Altogether Better. WOODALL, J., RAINE, G., SOUTH, J. & WARWICK-BOOTH, L Empowermet ad Health & Well-beig: Evidece Review. Leeds: Cetre for Health Promotio Research, Leeds Metropolita Uiversity. WOODALL, J., WHITE, J. & SOUTH, J. 2012b. Improvig health ad well-beig through commuity health champios: a thematic evaluatio of a programme i Yorkshire ad Humber. Perspectives i Public Health. DOI: /

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118 APPENDIX A 2013 Sample search strategy from O Mara-Eves et al. Search strategy: Database of Promotig Health Effectiveess Reviews Keyword search: Health promotio OR iequalities AND (Aims stated AND search stated AND iclusio criteria stated) Search strategy: Trials Register of Promotig Health Itervetios disadvatage OR disparities OR disparity OR equality OR equity OR gap OR gaps OR gradiet OR gradiets OR health determiats OR health educatio OR health iequalities OR health promotio OR healthy people programs OR iequalities OR iequality OR iequities OR iequity OR prevetive health service OR prevetive medicie OR primary prevetio OR public health OR social medicie OR uequal OR variatio AND chage aget OR citize OR commuity OR champio OR collaborator OR disadvataged OR lay commuity OR lay people OR lay perso OR member OR miority OR participat OR patiet OR peer OR public OR represetative OR residet OR service user OR stakeholder OR user OR voluteer OR vulerable AND capacity buildig OR coalitio OR collaboratio OR committee OR compact OR cotrol OR co-productio OR coucils OR delegated power OR democratic reewal OR developmet OR empowermet OR egagemet OR forum OR goverace OR health promotio OR iitiative OR itegrated local developmet programme OR itervetio guidace OR ivolvemet OR juries OR local area agreemet OR local goverace OR local ivolvemet etworks OR local strategic partership OR mobilisatio OR mobilizatio OR eighbourhood committee OR eighbourhood maagers OR eighbourhood reewal OR eighbourhood wardes OR etworks OR orgaisatio OR paels OR participatio OR participatio compact OR participatory actio OR parterships OR pathways OR priority settig OR public egagemet OR public health OR rapid participatory assessmet OR regeeratio OR relatios OR support Search strategy: Cochrae databases 118

119 CDSR (Cochrae reviews). DARE (other reviews). HTA database (techology assessmets). NHS EED (ecoomic evaluatios). disadvatage OR disparities OR disparity OR equality OR equity OR gap OR gaps OR gradiet OR gradiets OR health determiats OR health educatio OR health iequalities OR health promotio OR healthy people programs OR iequalities OR iequality OR iequities OR iequity OR prevetive health service OR prevetive medicie OR primary prevetio OR public health OR social medicie OR uequal OR variatio AND chage aget OR citize OR commuity OR champio OR collaborator OR disadvataged OR lay commuity OR lay people OR lay perso OR member OR miority OR participat OR patiet OR peer OR public OR represetative OR residet OR service user OR stakeholder OR user OR voluteer OR vulerable AND capacity buildig OR coalitio OR collaboratio OR committee OR compact OR cotrol OR co-productio OR coucils OR delegated power OR democratic reewal OR developmet OR empowermet OR egagemet OR forum OR goverace OR health promotio OR iitiative OR itegrated local developmet programme OR itervetio guidace OR ivolvemet OR juries OR local area agreemet OR local goverace OR local ivolvemet etworks OR local strategic partership OR mobilisatio OR mobilizatio OR eighbourhood committee OR eighbourhood maagers OR eighbourhood reewal OR eighbourhood wardes OR etworks OR orgaisatio OR paels OR participatio OR participatio compact OR participatory actio OR parterships OR pathways OR priority settig OR public egagemet OR public health OR rapid participatory assessmet OR regeeratio OR relatios OR support Search strategy: The Campbell Library disadvatage OR disparities OR disparity OR equality OR equity OR gap OR gaps OR gradiet OR gradiets OR health determiats OR health educatio OR health iequalities OR health promotio OR healthy people programs OR iequalities OR iequality OR iequities OR iequity OR prevetive health service OR prevetive medicie OR primary prevetio OR public health OR social medicie OR uequal OR variatio AND 119

120 chage aget OR citize OR commuity OR champio OR collaborator OR disadvataged OR lay commuity OR lay people OR lay perso OR member OR miority OR participat OR patiet OR peer OR public OR represetative OR residet OR service user OR stakeholder OR user OR voluteer OR vulerable AND capacity buildig OR coalitio OR collaboratio OR committee OR compact OR cotrol OR co-productio OR coucils OR delegated power OR democratic reewal OR developmet OR empowermet OR egagemet OR forum OR goverace OR health promotio OR iitiative OR itegrated local developmet programme OR itervetio guidace OR ivolvemet OR juries OR local area agreemet OR local goverace OR local ivolvemet etworks OR local strategic partership OR mobilisatio OR mobilizatio OR eighbourhood committee OR eighbourhood maagers OR eighbourhood reewal OR eighbourhood wardes OR etworks OR orgaisatio OR paels OR participatio OR participatio compact OR participatory actio OR parterships OR pathways OR priority settig OR public egagemet OR public health OR rapid participatory assessmet OR regeeratio OR relatios OR support 120

121 Appedix B Sample search strategy from Stream 1 update Appedix 1: Sample search strategies Search strategy: Database of Promotig Health Effectiveess Reviews Sca the title ad abstracts of all items published sice Search strategy: Trials Register of Promotig Health Itervetios The search is based o broad terms for Populatio AND Itervetio Free text search of titles ad abstracts, 2011 owards: chage aget* OR citize* OR commuit* OR champio* OR collaborator* OR disadvataged OR lay worker or lay health OR lay people OR lay perso OR member* OR miorit* OR participat* OR patiet* OR peer* OR public OR represetative* OR residet* OR stakeholder* OR user* OR voluteer* OR vulerable AND capacity buildig OR coalitio* OR collaboratio* OR committee* OR compact OR co-productio OR coucil* OR delegated power* OR democratic reewal OR developmet OR empower* OR egag* OR forum* OR goverace OR iitiative* OR itervetio guidace OR ivolve* OR juries OR "jury" OR local area agreemet* OR local goverace OR mobilisatio OR mobilizatio OR eighbourhood committee* OR eighbourhood maager* OR eighbourhood reewal OR eighbourhood warde* OR eighborhood committee* OR eighborhood maager* OR eighborhood reewal OR eighborhood warde* OR etwork* OR orgaisatio* OR orgaizatio* OR pael* OR participatio OR participatory actio OR partership* OR pathway* OR priority settig* OR public egagemet OR public health OR rapid participatory assessmet* OR 121

122 regeeratio OR relatios OR support Search strategy: Cochrae/Cetre for Reviews ad Dissemiatio databases Cochrae Database of Systematic Reviews (Cochrae Library); DARE (CRD); HTA database (CRD); NHS EED (CRD). The search is based o broad terms for Topic AND Populatio AND Itervetio. Search 2011 owards. Search all fields: disadvatage* OR disparities OR disparity OR equalit* OR equit* OR gap OR gaps OR gradiet OR gradiets OR health determiat OR health determiats OR health educatio OR health iequalities OR health promotio OR healthy people program* OR iequalities OR iequality OR iequit* OR prevetive health service* OR prevetive medicie OR primary prevetio OR public health OR social medicie OR uequal OR variatio* AND chage aget* OR citize* OR commuit* OR champio* OR collaborator* OR disadvataged OR lay commuit* OR lay people OR lay perso OR member* OR miorit* OR participat*" OR patiet* OR peer* OR public OR represetative* OR residet* OR service user* OR stakeholder* OR user* OR voluteer* OR vulerable OR "lay worker" OR "lay health" AND capacity buildig OR coalitio* OR collaboratio* OR committee* OR compact OR cotrol OR co-productio OR coucil* OR delegated power* OR democratic reewal OR developmet OR empowermert OR egagemet OR forum* OR goverace OR health promotio OR iitiative* OR itervetio guidace OR ivolvemet OR juries OR "jury" OR local area agreemet* OR mobilisatio OR mobilizatio OR eighborhood committee* OR eighborhood maager* OR eighborhood 122

123 reewal OR eighborhood warde* OR eighbourhood committee* OR eighbourhood maager* OR eighbourhood reewal OR eighbourhood warde* OR etworks OR etwork OR orgaisatio* OR orgaizatio* OR pael* OR participatio OR participatory actio OR partership* OR pathway* OR priority settig* OR public egagemet OR public health OR rapid participatory assessmet OR regeeratio OR relatios OR support Search strategy: Campbell Collaboratio Library All reviews published sice 2011 scaed by title, ad the by title ad abstract. Search strategy: NIHR Health Techology Assessmet (HTA) programme website/jourals library. All reviews published sice 2011 scaed by title, ad the title ad abstract. 123

124 Appedix C Sample search strategy from PHE mappig review Databases searched (from Jauary 2004 to April 2014): MEDLINE, IDOX Iformatio Service; CINAHL, Social Policy ad Practice; Academic Search Complete. The followig search strategy was used: 1. (commuit* or lay or public or citize* or people or empower* or social or emacipat* or volut*or asset-based or peer) 2. (cocept* or framework or defiitio* or theory or theories or model or typolog* or categoris* or categoriz* or dimesio* or domai* or costruct or review or evidece base* or effective* or outcome*) 3. (itervetio* or prevetio* or egagemet or ivolve* or participat* or actio or developmet or mobilisatio or commissioig) 4. ("health promotio" or "health improvemet" or "healthy commuit*" or wellbeig or quality of life or self-care or resiliece) 5. (determiat* N2 (social or health)) or (health N2 (iequality or equity or exclu*)) or (uderserved or hard to reach or seldom heard ) 6. MeSH terms: (MH "Commuity Networks") OR (MH "Commuity-Based Participatory Research") OR (MH "Volutary Health Agecies") OR (MH "Volutary Programs") OR (MH "Voluteers") or (MH "commuity health worker") or (MH "public health practice") Combiatios 6 (MeSH) ad 2 (TI) (1 N2 3) ad 2 ad 4 (1 N2 3) ad 2 (Title oly) (1 N2 3) ad 5 1 ad 2 ad 5 (Title oly) A additioal cross-cuttig search was ru i MEDLINE (Jauary 2004 to April 2014): ((commuit* or citize* or empower* or emacipat* or asset-based or "co-productio") 2 (itervetio* or egagemet)) AND ( health or wellbeig or "well beig" ) (cocept* or framework or defiitio* or theory or theories or theoriz* or typolog*) AND (itervetio* or egagemet or ivolve* or participat*) AND (health or wellbeig or "well beig") 124

125 commuit* ad (empower* or egage* or ivolv* or participat* or emacipat*) ad (health or wellbeig or "well beig") 125

126 APPENDIX D Bibliography of icluded studies. Adams L, Cummig F (2002) Promotio Health policies & practice - Promotig social ad commuity developmet i Sheffield: A reflectio of te years work. I: Amos AM & Muro J (eds.)promotig Health. Alborz A, Wilki D, Smith K (2002) Are primary care groups ad trusts cosultig local commuities? Health & Social Care i the Commuity. (10): Alexader J, Aderso T, Grat M, Saghera J, Jackso D (2003) A evaluatio of a support group for breast-feedig wome i Salisbury, UK. Midwifery. (19): ALLEN, T Prevetig falls i older people: evaluatig a peer educatio approach. British Joural of Commuity Nursig., 9, ALTOGETHER BETTER Altogether Better Programme: Phase 1. Leeds: Cetre for Health Promotio Research, Leeds Beckett Uiversity. Aastacio J, Gidley B, Hart L, Keith M, Mayo M, Kowarzik U (2000) Reflectig realities: Participats perspectives o itegrated commuities ad sustaiable developmet. Bristol, Policy Press. Aderso E, Shepherd M (2005) Takig off the suit : egagig the commuity i primary health care decisio-makig. Health Expectatios, 9, Adrews G J; Gavi N, Begley S, Brodie D (2003) Assistig friedships, combatig loeliess: users' views o a befriedig scheme. Ageig ad Society, 23, Aig A, Stuart J, Nicholls M, Morley A (2007) Natioal Evaluatio Report: Uderstadig Variatios i Effectiveess amogst Sure Start Local Programmes. Lodo: Istitute for the Study of Childre, Families ad Social Issues, Birkbeck. Arora S, Davies A, Thompso S (2000) Developig health improvemet programmes: challeges for a ew milleium. Joural of Iter-professioal Care. 14: Atkiso M (2012) Iequalities i health outcomes ad how they might be addressed. Childre ad Youg People's Health Outcomes Forum. Attree P (2004) 'It was like my little acor, ad it's goig to grow ito a big tree': a qualitative study of a commuity support project. Health Soc Care Commuity. 12(2): Attree P, Clayto S, Karuaithim S, Nayak S, Papay J, Read, D (2011) NHS Health Traiers: A Review of Emergig Evaluatio Evidece.. Critical Public Health, 22: Audrey S, Holliday J, Campbell R (2006) It's good to talk: Adolescet perspectives of a iformal, peer-led itervetio to reduce smokig. Social Sciece ad Medicie. 63(2): Audrey S, Holliday J, Parry-Lagdo N, Campbell R (2006) Meetig the challeges of implemetig process evaluatio withi radomized cotrolled trials: the example of ASSIST (A Stop Smokig i Schools Trial). Health Educ Res. 21(3):

127 Audrey S, Holliday J, Campbell R (2008) Commitmet ad compatibility: Teachers' perspectives o the implemetatio of a effective school-based, peer-led smokig itervetio. Health Educatio Joural. 67(2): Bagley C, Ackerley C (2006) 'I am much more tha just a mum': social capital, empowermet ad Sure Start. Joural of Educatio Policy. 21: BAINES, S., M LIE & WHEELOCK, J Voluteerig, self-help ad citizeship i later life. Newcastle: Age Cocer Newcastle ad Uiversity of Newcastle upo Tye. Ball L, Nasr N (2011) A Qualitative Exploratio of a Health Traier Programme i Two Primary Care Trusts. Perspectives i Public Health, 131, Badesha G, Litva A (2005) Perceptios of commuity participatio ad health gai i a commuity project for the South Asia populatio: a qualitative study. Joural Of Public Health (Oxford, Eglad). 27(3): Bares M, Newma J, Kops A, Sulliva H (2003) Costitutig 'the public' i public participatio. Public Admiistratio. 81: Bares M, Sulliva H, Matka E (2004) The developmet of collaborative capacity i Health Actio Zoes: A fial report from the atioal evaluatio. Birmigham: df Bares J, Seior R, MacPherso K (2009) The utility of voluteer home-visitig support to prevet materal depressio i the first year of life. Child Care Health Dev. 35: Bares M, Bauld L, Bezeval M et al; (2005) Health actio zoes Parterships for health equity. Oxfordshire: Routledge BARNES, M., SKELCHER, C., BEIRENS, H., DALZIEL, R., JEFFARES, S. & WILSON, L. 2008b. Developig citize-cetred goverace. York: Joseph Rowtree Foudatio. Barrett H (2008) Hard to reach families: egagemet i the volutary ad commuity sector. Lodo: Family ad Paretig Istitute. Bauld L, Judge K, Bares M, Bezeval M, Mackezie M, Sulliva H (2005) Promotig social chage: the experiece of health actio zoes i Eglad. Joural of Social Policy. 34(3): Bauld L, Sulliva H, Judge K, Mackio J (2005) Assessig the impact of Health Actio Zoes, i M. Bares, L. Bauld, M. Bezeval, K. Judge, M. Mackezie ad H. Sulliva (eds) Health Actio Zoes: Parterships for health equity: Baxter L, Thore L, Mitchell A (2001) Small voices, big oises. Lay ivolvemet i health research: lessos from other fields. Exeter: Washigto Siger Press. Beavigto J (2014) Health Improvemet Neighbourhood work. Respose to call for evidece from Leeds Beckett Uiveristy. 127

128 Beck A, Majumdar A, Estcourt C, Petrak J (2005) "We do't really have cause to discuss these thigs, they do't affect us": a collaborative model for developig culturally appropriate sexual health services with the Bagladeshi commuity of Tower Hamlets. Sexually Trasmitted Ifectios. 81(2): Bezeval M (2003) The fial report of the tacklig Iequalities i health module: the atioal evaluatio of health actio zoes, A report to the Departmet of Health. Lodo: Departmet of Geography, Quee Mary, Uiversity of Lodo.Olie. Available Bezeval M (2003) Tacklig iequalities i health: Fial Report to Sheffield Health Actio Zoe. Lodo: Departmet of Geography, Quee Mary, Uiversity of Lodo. Beresford P, Carr S (2012) Social care, service users ad user ivolvemet. Jessica Kigsley Publishers Ltd. Beresford P (2007) User ivolvemet, research ad health iequalities: developig ew directios. Health ad Social Care i the Commuity. 15: Bertotti M, Adams-Eato F, Sherida K, Reto A (2009) Key barriers to commuity cohesio: views from residets of 20 Lodo deprived eighbourhoods. GeoJoural, 77: Bhavai V, Newbur M (2013) NCT breastfeedig peer support i East Lacashire. Perspective - NCT s joural o preparig parets for birth ad early parethood. Jue 2013: Bhavai V, Newbur M (2014) Birth ad Beyod Commuity Supporters Programme: Fial Evaluatio Report of the Pilot Project. Lodo: NCT. Blamey A, Ayaa M, Lawso L, Mackio J, Paterso I, Judge K (2004) Fial Report: The Idepedet Evaluatio of Have a Heart Paisley. Glasgow, Uited Kigdom: Uiversity of Glasgow. Blak L, Grimsley M, Goyder E, Ellis E, Peters J (2007) Commuity-based lifestyle itervetios: chagig behaviour ad improvig health. Joural Of Public Health (Oxford, Eglad). 29(3): Bolam B, McLea C, Peigto A, Gillies P (2006) Usig ew media to build social capital for health: a qualitative process evaluatio study of participatio i the CityNet project. Joural of health psychology. 11(2): Bowers H, Macadam A, Patel M, Smith C (2006) Makig a differece through voluteerig: the impact of voluteers who support ad care for people at home. Lodo: CSV. Boydell LR, Rugkåsa J (2007) Beefits of workig i partership: A model. Critical Public Health 17: Boyle D, Clark S, Burs S (2006) Hidde work: Co-productio by people outside paid employmet. York: The ew ecoomics foudatio ad the Joseph Rowtree Foudatio

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147 APPENDIX E Bibliography of excluded studies Reaso for exclusio: DATE (published before 2000, or 2006 for policy or cocept papers) Bauld L, Mackio J, Judge K (2001) Commuity Health Iitiatives: Recet Policy Developmets ad The Emergig Evidece-Base... :. Burto P (2003) Commuity Ivolvemet i Neighbourhood Regeeratio: Stairway to heave or road to owhere?.. :. Carlisle S (2000) Health promotio, advocacy ad health iequalities: a coceptual framework.. Health Promotio Iteratioal. 15:. Departmet for Health; (2003) Tacklig Health Iequalities: a programme for actio. :. Dobbs L, Moore A (2001) Egagig Commuities i Area-based Regeeratio: The role of participatory evaluatio.. :. Foley P, Marti S (2000) A New Deal for the Commuity? Public participatio i regeeratio ad local service delivery. Policy ad Politics. 28:. Jacobs B, Mulroy S, Sime C (2002) Theories of chace ad commuity ivolvemet i North Staffordshire Health Actio Zoe i L. Bauld ad K. Judge (eds) Learig from Health Actio Zoes, Chichester.. : Joes K, Moha J, Health Developmet, Agecy, Barard S, Twigg L (2004) Social capital, place ad health: creatig, validatig ad applyig small-area idicators i the modellig of health outcomes. : Health Developmet Agecy. Kellett M (2005) Childre as active researchers: a ew research paradigm for the 21st cetury?. : ESRC Natioal Cetre for Research Methods. Kuruvilla S (2005) Civil Society Participatio i H ealth Research ad Policy: A Review of Models, Mechaisms ad Measures. : Overseas D evelopmet Istitute. Parry Jaye, Judge Ke (2005) Tacklig the wider determiats of health disparities i Eglad: a model for evaluatig the New Deal for Commuities regeeratio iitiative. America Joural Of Public Health. 95(4): Popay J et al; (2005) Takig Strategic Actio for Egagig Commuities (SAFEC)... :. Seyfag G (2002) Tacklig Social Exclusios with Commuity Currecies: Learig from LETS to Time Baks. :. Reaso for exclusio: COUNTRY (ot UK) Aderse MR, Hagher M, Meischke H, Shaw C, Yasui Y, Urba N (2000) Recruitmet, Retetio, ad Activity of Voluteers Promotig Mammography Use i Rural Commuitites.. :. 147

148 Aou S M; Shahid S, Le L, Packer T L; (2012) The Role ad Ifluece of Champios i a Commuity-Based Lifestyle Risk Modificatio Programme. Joural of Health Psychology. 18:. Balliger M L; Talbot L A; Verrider G K; (2009) More tha a place to do woodwork: a case study of a commuity-based Me's Shed. Joural of Me's Health. 6:. Basu Ambar, Dutta Moha Jyoti; (2008) The relatioship betwee health iformatio seekig ad commuity participatio: the roles of health iformatio orietatio ad efficacy. Health Commuicatio. 23(1): Batte Lesley, Holdaway Mauree (2011) The cotradictory effects of timelies o commuity participatio i a health promotio programme. Health Promotio Iteratioal. 26(3): Berge Jerica M; Medehall Tai J; Doherty William J; (2009) Usig Commuity-based Participatory Research (CBPR) To Target Health Disparities i Families. Family Relatios. 58(4): Bishop C, Earp JA, Eg E, Lych KS (2002) Implemetig a atural helper lay health advisor program: lessos leart from uplaed evets.. :. Brauack-Mayer A, Louise J (2008) The ethics of Commuity Empowermet: tesios i health promotio theory ad practice. Promotio & Educatio. 15(3): 5-8. Burdie James N; McLeroy Keeth, Blakely Craig, Wedel Moica L; Felix Michael R. J; (2010) Commuity-based participatory research ad commuity health developmet. The Joural Of Primary Prevetio. 31(1-2): 1-7. Campbell C, Corish F (2010) Towards a "fourth geeratio" of approaches to HIV/AIDS maagemet: creatig cotexts for effective commuity mobilisatio. AIDS Care. 22 Suppl 2: Cargo M, Mercer SL (2008) The value ad challeges of participatory research: stregtheig its practice. Aual Review of Public Health. 29: Chima Matthew, Early Debee, Ebeer Patricia, Huter Sarah, Imm Pamela, Jekis Pey, Sheldo Jeffrey, Wadersma Abraham (2004) Gettig To Outcomes: a commuity-based participatory approach to prevetive itervetios. Joural Of Iterprofessioal Care. 18(4): Deis CL (2002) Breastfeedig peer support: materal ad voluteer perceptios from a radomized cotrolled trial.. Birth (Berkeley, Calif.). 29(3): Dickso-Gomez J, Weeks M, Martiez M, et al (2006) Times ad places: process evaluatio of a peer led HIV prevetio itervetio. Subst Use Misuse. :. Fadia T Shaya; Aa Gu, Elijah Sauders (2006) For the patiet. Addressig cardiovascular health disparities through commuity itervetios. Ethicity & Disease. 16(1):

149 Grassley J Escheti V; (2007) Two Geeratios Learig Together: Facilitatig Gradmothers' Support of Breastfeedig. Iteratioal Joural of Childbirth Educatio. (22(3)): Graves K (2001) Sheddig the light o me i sheds: Fial report... :. Johso Z, B Molloy et al; (2000) Commuity mothers programme - Seve year follow-up of a radomized cotrolled trial of o-professioal itervetio i paretig. Joural of Public Health Medicie. 22:. Juzag I, Fortue T, Black S, Wright E, Bull S (2011) A pilot programme usig mobile phoes for HIV prevetio. Joural Telemed Telecare. 17: Khodyakov Dmitry, Stockdale Susa, Joes Felica, Ohito Elizabeth, Joes Adrea, Lizaola Elizabeth, Mago Joseph (2011) A Exploratio of the Effect of Commuity Egagemet i Research o Perceived Outcomes of Partered Metal Health Services Projects(). Society Ad Metal Health. 1(3): Kilpatrick Sue (2009) Multi-level rural commuity egagemet i health. The Australia Joural Of Rural Health. 17(1): Labote R Laverack G; (2001) Capacity buildig i health promotio, Part 1: For whom? Ad for what purpose?. Critical Public Health. 11(2): Lasker J et al; (2011) Time Bakig ad Health: The Role of a Commuity Currecy Orgaizatio i Ehacig Well-Beig.. Health Promotio Practice. 12: Latki CA, Sherma S, Kowlto A (2003) HIV prevetio amog drug users: outcome of a etwork-orieted peer outreach itervetio.. :. Laverack G (2001) A idetificatio ad iterpretatio of the orgaizatioal aspects of commuity empowermet. Commuity Developmet Joural. 36(2): Law AV, Shapiro K (2005) Impact of a commuity pharmacist-directed cliic i improvig screeig ad awareess of osteoporosis... :. Ly L DeBar; Margaret Scheider, Kimberly L Drews; Eilee G Ford; Diae D Stadler; Esther L Moe; Mamie White, Arthur E Her; ez, Sara Solomo, A Jessup, Elizabeth M Veditti; (2011) Studet public commitmet i a school-based diabetes prevetio project: impact o physical health ad health behavior.. :. Meurer Lida N; Diehr Sabia (2012) Commuity-egaged scholarship: meetig scholarly project requiremets while advacig commuity health. Joural Of Graduate Medical Educatio. 4(3): Narushima M (2005) Payback time : commuity voluteerig amog older adults.. :. O'Fallo LR, Dearry A (2002) Commuity-based participatory research as a tool to advace evirometal health scieces. Eviro Health Perspect. : Ormsby J, Staley M, Jaworski K (2010) Older me's participatio i commuity-based me's sheds programmes. Health Soc Care Commuity. 18:. 149

150 (2006) Revised evidece-based program list will support commuity-level practice. Metal Health Weekly. 16(15): 1-3. Robiso-Whele S, Hughes R B; Taylor H B; Colvard M, Mastel-Smith B, Nosek M A; (2006) Improvig the health ad health behaviors of wome agig with physical disabilities: A peer-led health promotio program. Womes Health Issues. 16(6): Rya DeForge, Bev Rega, Iris Gutmais (2008) Lea O Me: Buildig Voluteer Capacity to Support Frail Seiors Participatio i Commuity Seiors Cetre Programs: A Pilot Project Evaluatio Report.. :. Thomas GN, Macfarlae DJ, Guo B, Cheug BM, McGhee SM, Chou KL, Deeks JJ, Lam TH, Tomliso B (2010) Health promotio i older Chiese: a 12-moth cluster radomized cotrolled trial of pedometry ad "peer support"... :. Valete T W; Chou C P; Petz M A; (2007) Commuity Coalitio Networks as Systems: Effects of Network Chage o Adoptio of Evidece-Based Prevetio. Am.J.Public Health. :. va der Plaat, M, Barrett G (2006) Buildig commuity capacity i goverace ad decisio makig. Commuity Developmet Joural. 41(1): Wagemakers A, Vaadrager L, Koele M, Saa H, Leeuwis C (2010) Commuity health promotio: a framework to facilitate ad evaluate supportive social eviromets for health. Evaluatio Ad Program Plaig. 33(4): Wallerstei N (2006) What is the evidece o effectiveess of empowermet to improve health?. Copehage: WHO Regioal Office for Europe. WHO (2008) Commuity Ivolvemet i Tuberculosis Care ad Prevetio: Towards Parterships for Health: Guidig Priciples ad Recommedatios Based o a WHO Review. Geeva: WHO Press. Wog Naima T; Zimmerma Marc A; Parker Edith A; (2010) A typology of youth participatio ad empowermet for child ad adolescet health promotio. America Joural Of Commuity Psychology. 46(1-2): World Health Orgasiatio; (2002) Commuity Participatio i Local Health ad Sustaiable Developmet: Approaches ad Teachiques, i Europea Sustaiable Developmet ad Health Series No. 4. :. Youg-joo Lee, Jeffrey L Brudey; (2008) The impact of voluteerig o successful ageig: a review with implicatios for programme desig.. :. Reaso for exclusio: TOPIC (ot commuity egagemet or ot public health) Ede Agela, Lowdes J (2013) Improvig well-beig through commuity health improvemet: a service evaluatio,.. :. 150

151 CHEX (2011) Moey Well Spet: Ecoomic evidece i Commuity-led health.. :. Swa P (2013) Promotig social iclusio through commuity arts. Metal Health ad Social Iclusio. 17 :. Adrews Kathie (2004) Developig a learig etwork to support egagemet with health commuities. Health Expectatios: A Iteratioal Joural Of Public Participatio I Health Care Ad Health Policy. 7(4): Baker Christopher (2013) Moral Freightig ad Civic Egagemet: A UK Perspective o Putam ad Campbell's Theory of Religious-Based Social Actio. Sociology of Religio. 74(3): Bambra C, Smith K E; Garthwaite K, Joyce K E; Huter D J; (2011) A labour of Sisyphus? Public policy ad health iequalities research from the Black ad Acheso Reports to the Marmot Review. Joural of Epidemiology & Commuity Health. 65(5): Caie J (2012) Climbig the walls: priso metal health ad commuity egagemet. British Joural Of Nursig (Mark Alle Publishig). 21(11): 658. Camero A, Lloyd L, Turer W et al; (2009) Workig across boudaries to improve health outcomes: a case study of a housig support ad outreach service for homeless people livig with HIV.. Health Soc Care Comm. (17): Cetre Wome's Resource; (2011) Hidde value: demostratig the extraordiary impact of wome's volutary ad commuity orgaisatios. Lodo: Wome's resource Cetre. Christie Milliga, Athoy Gatrell, Amada Bigley (2004) Cultivatig Health: therapeutic ladscapes i orther Eglad. Social Sciece & Medicie. (58): Collis C (2009) Resiliece i commuity orgaisatio ad its implicatios for commuity developmet i the curret ecoomic crisis: the case of the Clydebak Idepedet Resource Cetre. Cocept. 19:. Craig G (2014) The key to ulock better outcomes (outcomes based commissioig). Health Service Joural. : Creativity works (2013) Creativity works: fial evaluatio report o the NETWORKS project.. :. McCabe A, Davis A (2012) Commuity developmet as metal health promotio: priciples, practice ad outcomes. Commuity Developmet Joural. 47(4): Departmet for Childre; Schools, Families DCSF (2008) The childre's pla: oe year o - progress report.. :. Departmet of Health; (2008) Real ivolvemet: workig with people to improve health services... :. DETR Departmet of the Eviromet, Trasport; the Regios (2000) Natioal strategy for eighbourhood reewal report of Policy Actio Team 18: better iformatio.. :. 151

152 DfES (2005) Sure Start Natioal Evaluatio Report 13: Early impacts of Sure Start Local programmes o childre ad families. :. Docherty I, Goodlad R, Paddiso R (2001) Civic culture, commuity ad citize participatio i cotrastig eighbourhoods.. :. Dowlig B, Powell M, Glediig C (2004) Coceptualisig successful parterships. Health ad Social Care i the Commuity. 12:. East L (2002) Regeeratig health i commuities: voices from the ier city. Critical Social Policy. 22:. Emma Miller (2008) Outcomes importat to people with itellectual disabilities. Joural of Policy ad Practice i Itellectual Disabilities. 5(3): Evas D, Killora A (2000) Tacklig health iequalities through partership workig: learig from a realistic evaluatio. Critical Public Health. 10:. Evas N (2001) Tacklig smokig through parterships: lessos leared from the atioal alliace schemes... :. Fazil Q, et al (2004) Empowermet ad advocacy: reflectios o actio research with Bagladeshi ad Pakistai families who have childre with severe disabilities,. Health ad Social Care i the Commuity. 12: Fieldhouse J (2012) Metal health, social iclusio, ad commuity developmet: lessos from Bristol. Commuity Developmet Joural. 47:. Fieldhouse Jo, Doskoy Ae-Laure (2013) Commuity participatio ad social iclusio i Bristol. Metal Health ad Social Iclusio. 17: Fisher Pamela, Owe Jey (2008) Empowerig itervetios i health ad social care: recogitio through 'ecologies of practice'. Social Sciece & Medicie (1982). 67(12): Force Social Exclusio Task; (2010) Iclusio Health: Evidece Pack, March Lodo: Social Exclusio Task Force. Force Social Exclusio Task; (2010) Iclusio health: improvig the way we meet the primary health care eeds of the socially excluded. Lodo: Social Exclusio Task Force. Gaster L, Crossley R (2000) Commuity developmet: Makig a differece i social housig.. York: Joseph Rowtree Foudatio ad YPS. Gaveta J, Barrett G (2010) So What Differece Does it Make? Mappig the Outcomes of Citize Egagemet. IDS Research Summary of IDS Workig Paper 347. :. Geller R (2001) The first year of Health Improvemet Programmes; views from directors of public health. Joural of Public Health Medicie. 23:. 152

153 Gleibs I et al; (2011) No coutry for old me? The role of a Getleme's Club i promotig social egagemet & psychological well-beig i residetial care. Agig ad Metal Health. :. Gu R (2008) The power to shape decisios? A exploratio of youg people's power i participatio,. Health ad Social Care i the Commuity. 16:. Health Great Britai Departmet of; (2011) No health without metal health: a crossgovermet metal health outcomes strategy for people of all ages: supportig documet: the ecoomic case for improvig efficiecy ad quality i metal health. Lodo: Great Britai: Departmet of Health. Hederso B (2006) Research ito the sustaiability issues facig orgaisatios ivolved i commuity activity ad health improvemet. Ediburgh: NHS Scotlad. Hoddiott P, Britte J, Prescott G J; Tappi D, Ludbrook A, Godde D J; (2008) Effectiveess of policy to provide breastfeedig groups (BIG) for pregat ad breastfeedig mothers i primary care: cluster radomised cotrolled trial.. :. Hore M, Costello J (2003) Health eeds assessmet: Ivolvig older people i health research. Qual Ageig. 4: Housto S (2010) Buildig resiliece i a childre's home: results from a actio research project. Child ad Family Social Work. 15:. Howe A, MacDoald H, Barrett B, Little B (2006) Esurig public ad patiet participatio i research: a case study i ifrastructure developmet i oe UK Research ad Developmet cosortium. Primary Health Care Research ad Developmet. 7(1): Igram J, Ca K, Peacock J, Potter B (2008) Explorig the barriers to exclusive breastfeedig i black ad miority ethic groups ad youg mothers i the UK. Mater Child Nutr.. (4(3)): Igs R, Crae N, Camero M (2011) Be Creative Be Well: A evaluatio. Well Lodo.. :. Ivolve (2009) Seior Ivestigators ad Public Ivolvemet. : Ivolve/NIHR. Ivolve (2010) Examples of traiig ad support for public ivolvemet i research: sharig iovative practice workshop. : Ivolve/NIHR. IRISS Istitute for Research ad Iovatio i Social Services, Ea; (2013) Social assets i actio evaluatio report. Glasgow.. :. Joae McLea, Haah Biggs, Idiya Whitehead, Rebekah Pratt, Margaret Maxwell (2009) Evaluatio of the Deliverig for Metal Health Peer Support Worker Pilot Scheme.. :. Johstoe D, Campbell-Joes C (2003) Skills for regeeratio: Learig by commuity champios. Lodo: Educe ad the Departmet for Educatio ad Skills

154 Johstoe D, Johstoe S, Garrad S, Campbell-Joes C, Fordham G (2005) Neighbourhood Reewal Advisers - Skills ad Kowledge Programme Evaluatio - Backgroud Report 3. :. Jude Caie (2011) Social iclusio ad the priso populatio.. :. Justi Davis Smith ad Pat Gay; (2005) Active ageig i active commuities: Voluteerig ad the trasitio to retiremet. :. Keedy L A; Milto B, Budred P (2008) Lay food ad health worker ivolvemet i commuity utritio ad dietetics i Eglad: defiitios from the field. Joural Of Huma Nutritio Ad Dietetics: The Official Joural Of The British Dietetic Associatio. 21(3): Kig s Fud (2000) Strategic actio programme for healthy commuities: draft report o the expert hearig.. :. Leamy N, Clough R (2006) How older people became researchers: traiig guidace ad practice i actio. : JRF. Lemos G (2006) Steadyig the ladder: social ad emotioal aspiratios of homeless ad vulerable people.. :. Lhussier M et al; (2008) The potetial cotributio of realistic evaluatio to small-scale commuity itervetios. Commuity Practitioer. 81:. Lister G (2010) Assessig the Value for Moey of Health Traier Services... :. Lloyd N, O Brie M, Lewis C (2005) Fathers i Sure Start.. Lodo: Natioal Evaluatio of Sure Start ad Istitute for the Study of Childre, Families, ad Social Issues, Uiversity of Lodo. Lodo Health, Observatory (2012) A review of local actios i the former Lodo Spearhead boroughs to reduce health iequalities through key social determiats: employmet, housig ad icome - executive summary.. :. Mackezie Mhairi, Turer Fioa, Platt Stephe, Reid Maggie, Wag Yigyig, Clark Julia, Sridhara Sajeev, O'Doell Catherie A; (2011) What is the 'problem' that outreach work seeks to address ad how might it be tackled? Seekig theory i a primary health prevetio programme. BMC Health Services Research. 11: Mackezie Mhairi (2012) Reachig the hard-to-reach: coceptual puzzles ad challeges for policy ad practice, IN Joural of Social Policy, Vol 41 No 3 Jul :. Mathorpe J, rews J, Agelik M, Zegers S, Cores M, Smith M, Watso R (2003) Voluteers i Itermediate Care: Flexible Frieds?. Joural of Itegrated Care. (11(6)): Mathorpe J, Cores M (2004) Itermediate Care: Older People's Ivolvemet ad Experieces. Joural of Itegrated Care. (12(6)):

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156 Scottish Executive Cetral Research Uit; (2001) Natioal evaluatio of the former regeeratio programmes.. :. Crook Leae ( ) Talk Cacer. :. Iliffe S et al; (2010) User ivolvemet i the developmet of a health promotio techology for older people: fidigs from the SWISH project. Health ad Social Care i the Commuity. 18:. Louise Rya, Eleoore Kofma, Paulie Aaro (2010) Isiders ad outsiders: workig with peer researchers i researchig Muslim commuities.. :. Social Developmet Direct; (2004) Neighbourhood Wardes Scheme Evaluatio: fial report. Lodo: SD Direct. Spadler H, McKeow M, Roy A (2012) Evaluatio of 'It's a Goal!' Fial Report. :. Sridhara S, Gich W, Moffat V, Bolto J, Harkis C, Hume M, Nakaima A, MacDougall I, Docherty P (2008) Idepedet Evaluatio of Have a Heart Paisley Phase 2. Ediburgh: Uiversity of Ediburgh. Staley K (2009) Explorig Impact: Public ivolvemet i NHS, public health ad social care research. : NIHR. Steviso C, Hickso M (2013) Explorig the public health potetial of a mass commuity participatio evet. Joural Of Public Health (Oxford, Eglad). :. Stredder K, Sumall H, Lyos M (2009) Behaviour chage traiig delivered across Cheshire ad Merseyside: A report mappig programmes ad explorig processes.. :. Taylor S (2006) A ew approach to empowerig older people's forums: idetifyig barriers to ecourage participatio. Practice. 18(2): The Metorig ad Befriedig Foudatio; (2010) Befriedig works: Buildig resiliece i local commuities.. :. Themessl-Huber Markus, Lazebatt Ae, Taylor Julie (2008) Overcomig health iequalities: a participative evaluatio framework fit for the task. The Joural Of The Royal Society For The Promotio Of Health. 128(3): Tustill J, Allock D, Akhurst S, Garbers C (2005) Sure Start local programmes: Implicatios of case study data from the atioal evaluatio of Sure Start. Childre & society. 19(2): Walker P, Lewis J, Ligayah S, Sommer F (2000) Prove it! Measurig the effect of eighbourhood reewal o local people... :. White A, Zwolisky S, Prigle A, McKea J, Daly-Smith A, Robertso S, Berry R (2012) Premier League Health: A Natioal Programme of Me s Health Promotio Delivered i/by Professioal Football Clubs, Fial Report. :. Whittemore R, Raki S, Callaha CD, Leder MC, Carroll DL (2000) The Peer Advisor Experiece Providig Social Support.. :. 156

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165 APPENDIX F studies List of Systematic Reviews mied for relevat Attree P, Frech B, Milto B, Povall S, Whitehead M, Popay J (2011) The experiece of commuity egagemet for idividuals: a rapid review of evidece. Health & Social Care I The Commuity. 19(3): Beth Milto (2012) The impact of commuity egagemet o health ad social outcomes: a systematic review. Commuity Developmet Joural. 47(3): Beva Gillia, Brow Michelle (2014) Itervetios i exclusive breastfeedig: a systematic review. British Joural of Nursig. 23(2): Black ME, Yamada J, Ma V (2002) A systematic literature review of the effectiveess of commuity-based strategies to icrease cervical cacer screeig.. Ca J Public Health. 93(5): : Blak Lidsay, Baxter Susa K; Paye Nick, Guillaume Louise R; Pilgrim Hazel (2010) Systematic review ad arrative sythesis of the effectiveess of cotraceptive service itervetios for youg people, delivered i educatioal settigs. Joural Of Pediatric Ad Adolescet Gyecology. 23(6): Blak Lidsay, Baxter Susa K; Paye Nick, Guillaume Louise R; Squires Hazel (2012) Systematic review ad arrative sythesis of the effectiveess of cotraceptive service itervetios for youg people, delivered i health care settigs. Health Educatio Research. 27(6): Boote Joatha, Baird Wedy, Beecroft Claire (2010) Public ivolvemet at the desig stage of primary health research: a arrative review of case examples. Health Policy (Amsterdam, Netherlads). 95(1): Boote Joatha, Wog Ruth, Booth Adrew (2012) 'Talkig the talk or walkig the walk?' A bibliometric review of the literature o public ivolvemet i health research published betwee 1995 ad Health Expectatios: A Iteratioal Joural Of Public Participatio I Health Care Ad Health Policy. :. Boote J (2012) Patiet ad Public Ivolvemet i Health ad Social Care Research: A Bibliography.. :. Bouzid Maha, Hooper Lee, Huter Paul R; (2013) The effectiveess of public health itervetios to reduce the health impact of climate chage: a systematic review of systematic reviews. Plos Oe. 8(4): e62041-e Bridget Cady (2007) The health impact of policy itervetios tacklig the social determiats of commo metal disorder: a systematic review. Joural of Public Metal Health. 6(2):

166 Burto P, Croft J, Hastigs A, Slater T, Goodlad R, Abbortt J, Macdoald D (2004) What works i commuity ivolvemet i area-based iitiatives?: a systematic review of the literature. Lodo: Great Britai: Home Office. Busch Vicet, de Leeuw, Johaes Rob Josephus; de Harder, Alida, Schrijvers Augustius Jacobus Petrus; (2013) Chagig multiple adolescet health behaviors through school-based itervetios: a review of the literature. The Joural Of School Health. 83(7): Carr S, Lhussier M, Forster N, Geddes L, Deae K, Peigto M, Visram S, White M, Michie S, Doaldso C, Hildreth A (2011) A evidece sythesis of qualitative ad quatitative research o compoet itervetio techiques, effectiveess, costeffectiveess, equity ad acceptability of differet versios of health-related lifestyle advisor role i improvig health. Health Techology Assessmet (Wichester, Eglad). 15(9): iii. Casiday R, Kisma E, Fisher C, Bambra C (2008) Voluteerig ad health; what impact does it really have? Voluteerig Eglad.. :. Coles E, Themessl-Huber M, Freema R (2012) Ivestigatig commuity-based health ad health promotio for homeless people: a mixed methods review. Health Educatio Research. 27(4): Cokli Aalij, Morris Zoë, Nolte Elle (2012) What is the evidece base for public ivolvemet i health-care policy?: results of a systematic scopig review. Health Expectatios: A Iteratioal Joural Of Public Participatio I Health Care Ad Health Policy. :. Coell P, Wolfe C, McKevitt C (2008) Prevetig stroke: a arrative review of commuity itervetios for improvig hypertesio cotrol i black adults. Health & Social Care I The Commuity. 16(2): Dickes Ady P; Richards Suzae H; Greaves Coli J; Campbell Joh L; (2011) Itervetios targetig social isolatio i older people: a systematic review. BMC Public Health. 11: Va Sluijs, M F, McMi A M; Griffi S J; (2007) Effectiveess of itervetios to promote physical activity i childre ad adolescets: systematic review of cotrolled trials. British Medical Joural. 335(7622): Elliott Eva (2012) Coected Comuities. A review of theories, cocepts ad itervetios relatig to commuity-level stregths ad their impact o health ad well beig. Lodo: Coected Commuities. Ford P, Clifford A, Gussy K, Garter C (2013) A systematic review of peer-support programs for smokig cessatio i disadvataged groups. Iteratioal Joural Of Evirometal Research Ad Public Health. 10(11): Fudge N, Wolfe CDA, McKevitt C (2007) Ivolvig older people i health research. Age ad Ageig. (36(5)):

167 Gaa R, Fitzpatrick-Lewis D, Ciliska D, Peirso L (2012) Commuity-based itervetios for ehacig access to or cosumptio of fruit ad vegetables amog five to 18-year olds: a scopig review. BMC Public Health. 12: Garrett Sue, Elley C Raia; Rose Sally B; O'Dea Des, Lawto Beverley A; Dowell Athoy C; (2011) Are physical activity itervetios i primary care ad the commuity costeffective? A systematic review of the evidece. The British Joural Of Geeral Practice: The Joural Of The Royal College Of Geeral Practitioers. 61(584): e125-e133. Gich W (2004) Commuity-based itervetios topromote o-smokig: a systematic review.. :. Gozalez-Suarez C, Worley A, Grimmer-Somers K, Does V (2009) School-based itervetios o childhood obesity: a meta-aalysis. America joural of prevetive medicie. 37(5): Gradiger Felix, Britte Nicky, Wyatt Katria, Froggatt Katherie, Gibso Ady, Jacoby A, Lobba Fioa, Mayes Debbie, Sape Dee, Rawcliffe Tim, Popay Jeie (2013) Values associated with public ivolvemet i health ad social care research: a arrative review. Health Expectatios: A Iteratioal Joural Of Public Participatio I Health Care Ad Health Policy. :. Gustafsso S, Edberg A, Johasso B, Dahli-Ivaoff S (2009) Multi-compoet health promotio ad disease prevetio for commuity-dwellig frail elderly persos: a systematic review. Europea Joural of Ageig. 6(4): Hartma Marieke A; Hosper Kare, Stroks Karie (2011) Targetig physical activity ad utritio itervetios towards mothers with youg childre: a review o compoets that cotribute to attedace ad effectiveess. Public Health Nutritio. 14(8): Heave B, Brow L, White M, Errigto L, Mathers J, Moffatt S (2013) Supportig wellbeig through meaigful social roles: Systematic review of itervetio studies. The Milbak Quarterly. 9(2): Hills D (2004) Evaluatio of commuity-level itervetios for health improvemet: a review of experiece i the UK. Lodo: Health Developmet Agecy. Igram Lucy, MacArthur Christie, Kha Khalid, Deeks Joatha J; Jolly Kate (2010) Effect of ateatal peer support o breastfeedig iitiatio: a systematic review. CMAJ: Caadia Medical Associatio Joural = Joural De L'associatio Medicale Caadiee. 182(16): Jagosh Justi, Macaulay A C; Pluye Pierre, Salsberg J O. N; Bush Paula L; Hederso J I. M; Sirett Eri, Wog Geoff, Cargo Margaret, Herbert Carol P; Seifer Sarea D; Gree Lawrece W; Greehalgh Trisha (2012) Ucoverig the Beefits of Participatory Research: Implicatios of a Realist Review for Health Research ad Practice. Milbak Quarterly. 90(2): Jill Mathorpe, Jo Moriarty (2012) Diversity i older people ad access to services: a evidece review. Lodo: Age UK. 167

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172 APPENDIX G Table of icluded studies/ projects KEY: Extet of CE: + Low; ++ Moderate; +++ High. Type of CE: 1 Commuity mobilisatio/actio; 2 Commuity parterships/coalitio; 3 Peer ivolvemet; 4 Commuity orgaisatios; 5 No-peer health advocacy; 6 Social etworks; 7 Voluteers; 8 Cultural adaptio. Outcomes reported: H Health; WB Wellbeig; SDH Social Determiats of Health; I Idividual level; C Commuity level; P Progress; E Ecoomic; U Uptake. Short Title Type Name of iitiative Type of activity HWB issues Target group Extet of CE Type of CE Outc omes repor ted Curo, P (Curo) Research Life is Precious Life is Precious is a cacer health improvemet project commissioed by Dudley Public Health Commuity Health Improvemet Team. The project used a creative arts approach to egage local people from miority ethic commuities i a dialogue aroud cacer. Icludes commuity health champios. Disease prevetio Persoal wellbeig Race/ ethicity Geder H; WB; I; P Seymour, ()(Seymo ur) Research Mixed methods evaluatio Wirral Healthy Homes Healthy Homes looks at a more holistic respose to improvig the health ad wellbeig of vulerable residets ad improvig the property coditio. Referrals to the etwork of parters Healthy Homes has established ca help achieve positive health outcomes for residets ad reduce health iequalities. Commuity assets Other [Ifo] improvig housig Safety/ accidet prevetio Other idicators of disadvatage [Ifo] vulerable households e.g. childre, older people H, WB, SDH, I Adams, (2002)(A dams ad Cummig, 2002) Practice descriptio Discussio Health promotio usig a social model of health. Essetially there were 3 strads to the model: 5 levels of work icludig workig with commuities ad takig a commuity developmet approach, priciples ad domais Commuity wellbeig Commuity assets Geeral health (commuity) Socioecoomic idicators [Ifo] health iequalities; deprived areas

173 Alborz (2002)(Al borz et al., 2002) Research Mixed methods evaluatio PCG/Trusts are domiated by health professioals, but are resposible for represetig the iterests of the local commuity. This paper assesses how they have iformed ad cosulted local commuities ad the perceived impact of this cosultatio o decisiomakig. Other [Ifo] Cosultatio through ivolvemet with primary care groups ad trusts + 2 P Alexade r (2003)(Al exader et al., 2003) Research Questio aire/ survey Bosom Buddies A support group ru by lay Bosom Buddies, a midwife ad a breast-feedig cousellor Healthy eatig [Ifo] breast feedig Persoal assets [Ifo] wome traied Childre ad Youg People/ Paretig Geder + 3 H, P, U Alle (2004)(All e, 2004) Research Positive Actio o Falls Programme Peer educatio approach to prevetig falls i older people. Peer educatio programme i Bradford gave oe-off sessios to groups of older people providig iformatio about falls prevetio ad demostratig simple balace ad stregth buildig exercises. Physical activity Other [Ifo] falls prevetio Geeral health (persoal) Socioecoomic idicators Other idicators of disadvatage [Ifo] older people + 3 H, WB, I, P Altogethe r Better (2010)(Alt ogether Better, 2010) Research Qualitativ e study Altogether Better-- Health Champios: Commuitybased projects Commuity health champios - aims to empower people across the Yorkshire ad Humber regio to improve their ow health ad that of their families ad their commuities. Physical activity Healthy eatig Metal health Substace use Persoal wellbeig Commuity wellbeig Social capital/ cohesio Persoal assets [Ifo] TRAINING OF HEALTH CHAMPIONS Other [Ifo] 6, employmet; weight, orgaisig evets Geeral health (persoal) Geeral health (commuity) Other idicators of disadvatage [Ifo] commuities ad target groups are geerally those with the poorest health ad who make the least use of prevetive services, for example residets of mobile homes ad elders; disability H, WB, SDH, I, C, P 173

174 Aastacio (2000)(A astacio et al., 2000) Research Qualitati ve study [Ifo] cas e studies commuity participatio Commuity wellbeig Other [Ifo] area-based regeeratio; commuity parterships Occupatio [Ifo] areas of +++ uemploymet Socioecoomic idicators [Ifo] areas of deprivatio WB, P Aderso, (2005)(A derso ad Shepherd, 2005) Research Qualitati ve study public ivolvemet i plaig primary health care public ivolvemet i plaig health services Geeral health (commuity) Socioecoomic idicators [Ifo] deprived areas ++ 2 P Adrews, (2003)(A drews et al., 2003) Research Qualitati ve study ] befriedig service provided by Age Cocer Buckighams hire volutary sector local home-visitig befriedig service Metal health Persoal wellbeig Social capital/ cohesio Occupatio [Ifo] cliets aged 80+ (retired) Geder [Ifo] Most voluteers reported to be female Social capital [Ifo] frail ad isolated older people + 7 WB, I, H, P Davis (2008)(D avis, 2008) Rese Mixed methods evaluatio to uderstad the commissioig process for people with learig disabilities ad complex eeds Other [Ifo] commissioig health services Geeral health (persoal) Geeral health (commuity) people with learig disabilities ++ 2 C, P McCaffre y (2008)(M ccaffrey, 2008) Research Qualitativ e study [Ifo] cas e studies supportig people with learig disabilities ad complex eeds to live their lives fully through the activities of commissioig Persoal wellbeig Social capital/ cohesio Persoal assets Geeral health (persoal) Social capital Other idicators of disadvatage [Ifo] people with learig disabilities ad complex eeds ++ 2 H, WB, SDH, I, P Aig, (2007)(A Research Mixed Sure Start Local program variability study Childre ad Youg People/ + 2 H, WB, 174

175 ig et al., 2007) methods evaluatio Programmes Paretig Socioecoomic idicators I, P Arora, (2000)(Ar ora et al., 2000) Qualitati ve study Health Improvemet Programmes Three-year actio plas, developed i each health authority district, aimed at improvig the health of the local populatio. Geeral health (persoal) Geeral health (commuity) H, I, C, P Assembly Goverme t Wales Coucil for Volutary Actio (2004) Questio aire/ survey Cocept/ theory Evaluatio / research Discussio Voluteerig for Health/ Buildig Strog Bridges voluteerig for health i health ad social care services i parterships betwee the volutary ad health sectors Persoal wellbeig Geeral health (persoal) H, WB, P, U Atkiso, (2012)(At kiso, 2012) Research Policy Discussio Childre & Youg People/ Paretig Other idicators of disadvatage [Ifo] childre & youg people Attree (2004)(At tree, 2004) Qualitativ e study Sure Start Based o a local evaluatio of a Sure Start programme, the preset paper describes the developmet of a commuity support project aimed at egagig local people i supportig the parets ad carers of youg childre. Persoal wellbeig Commuity wellbeig Social capital/ cohesio Commuity assets Childre ad Youg People/ Paretig Geeral health (persoal) Geeral health (commuity) deprived area i the North West - Barrow Other idicators of disadvatage disadvataged commuities; suffers may of the problems associated with ecoomic ad social disadvatage, such as a aboveaverage percetage of families receivig welfare beefits ad +++ rates of teeage pregacy WB, SDH, P Attree (2011)(At tree et Cocept/ theory Health Traiers health iequalities Geeral health (persoal) Other idicators of disadvatage [Ifo] deprived areas

176 al., 2011) Discussio Audrey (2006)(A udrey et al., 2006a) Mixed methods evaluatio ASSIST (A Stop Smokig i Schools Trial) Substace use Childre ad Youg People/ Paretig [Ifo] schools i south-east Wales ad the west of Eglad Other idicators of disadvatage [Ifo] year olds + 3 P Audrey (2006)(A udrey et al., 2006b) Mixed methods evaluatio A Stop Smokig i Schools Trial (ASSIST) Peer supporters i secodary schools ecourage stoppig smokig Substace use [Ifo] smokig Educatio [Ifo] I secodary school + 3 H, C, P Audrey (2008)(A udrey et al., 2008) Mixed methods evaluatio Teachers perspectives o (ASSIST) A Stop Smokig I Schools Trial Stop smokig i schools peer advice Substace use Educatio [Ifo] Year 8 secodary studets + 3 H, C, P Bagley, (2006)(B agley ad Ackerley, 2006) Qualitati ve study Third way iitiative Sure Start study o oe programme give the pseudoym Mazebrook multi-agecy/ multi-discipliary paretig ad early years support; health, play ad learig Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] social exclusio; empowermet Childre ad Youg People/ Paretig Socioecoomic idicators [Ifo] states that the area is classified as a deprived commuity, accordig to Govermet socioecoomic idicators Social capital [Ifo] the area had a traditio of commuity activity ad a pre-existig rage of active groups ad orgaisatios Other idicators of disadvatage [Ifo] described as a disadvataged commuity WB, SDH, I, C, P, E Ball (2011)(B all ad Nasr, 2011) Qualitati ve study [Ifo] iter views ad focus groups health traier service health traier service Physical activity Healthy eatig Metal health Substace use Persoal wellbeig Commuity wellbeig "hard to reach", substace abuse, homeless, deprived commuities + 3 H, WB, SDH, I, H, P 176

177 Social capital/ cohesio Other Geeral health (persoal) [Ifo] weight Geeral health (commuity) Badesh a (2005)(B adesha ad Litva, 2005) Qualitati ve study The Asia Health Developmet Project Physical activity Healthy eatig Social capital/ cohesio Persoal assets Geeral health (persoal) Geeral health (commuity) Race/ ethicity [Ifo] local South Asia commuity WB, SDH, I, C, P Bares (2003)(B ares et al., 2003) Mixed methods evaluatio ESRC democracy ad participatio programme. 4 case studies: The Ward Advisory Board; The Sigle Regeeratio Budget Group (SRB Group); The older people's group; the wome's group; Looks at forums withi which dialogue takes place. 2 case studies defied as locality based iitiatives ad 2 formed aroud presumed commuities of iterest or idetity Social capital/ cohesio [Ifo] citize empowermet Commuity assets [Ifo] Advice ad iformatio source for wome i the city Other [Ifo] eighbourhood reewal Childre ad Youg People/ Paretig Race/ ethicity [Ifo] miority ethic groups; White Europea predomiatly Pakistai Muslim populatio; Black ad white voluteers Occupatio [Ifo] Voluteers; Workig class Geder [Ifo] wome's group Other idicators of disadvatage [Ifo] older people; Older tha the city average; Youth; older ad youger voluteers C, P Bares (2004)(B ares et al., 2004) Qualitati ve study Power, Participatio ad Political Reewal The project ra from ad explored the developmet of deliberative forums through which the state attempts to egage citizes i dialogue about policies ad services: for example area-based forums withi local govermet, user forums i health, seior citizes or youth forums, ad a rage of commuity or idetity-based orgaisatios that the local state draws i Social capital/ cohesio Commuity assets Race/ ethicity [Ifo] icluded miority ethic group forum + 2 P 177

178 to cosultatio exercises. Bares (2004)(B ares et al., 2005, Bares et al., 2004) Mixed methods evaluatio Health Actio Zoes area- based iitiatives to reduce the effects of persistet disadvatage Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] areas of persistet disadvatage H, WB, SDH, C, P Bares (2009)(B ares et al., 2009) RCT Home-start voluteer ustructured home visitig support postatally Metal health Persoal wellbeig Childre ad Youg People/ Paretig Race/ ethicity [Ifo] fewer mothers acceptig home start support were white Occupatio [Ifo] more mothers acceptig home start support were uemployed Geder [Ifo] wome - mothers Educatio [Ifo] mothers acceptig home start support had o average more qualificatios + 7 H, I Bares, (2005)(B ares et al., 2005) Mixed methods evaluatio atioal evaluatio of Health Actio Zoes health actio zoes; area based iitiatives Other [Ifo] social determiats Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators H, I Barrett, (2008)(B arrett, 2008) Qualitati ve study Workig with hard to reach families Childre ad Youg People/ Paretig Socioecoomic idicators [Ifo] 'Hard to reach', parets 1 Bauld (2005)(B auld et al., 2005a) Mixed methods evaluatio Policy Health Actio Zoes area- based iitiatives to reduce the effects of persistet disadvatage Commuity wellbeig Commuity assets Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] areas of persistet disadvatage H, SDH, C, P Bauld, (2005)(B auld et Mixed methods evaluatio Health Actio Zoes to idetify ad address the public health eeds of the local area; - to icrease the effectiveess, efficiecy ad resposiveess of services; - to develop parterships Commuity wellbeig Commuity assets Geeral health (persoal) Socioecoomic idicators [Ifo] areas of persistet disadvatage H, SDH, 178

179 al., 2005b) for improvig people's health ad relevat services, addig value through creatig syergy betwee the work of differet agecies Geeral health (commuity) C, P Baxter (2001)(B axter et al., 2001) Qualitati ve study Small voices, big oises The case studies: 1. Barrow Commuity Gym evaluatio of gym for metal health service users. 2. Fidig Out people with learig difficulties foud out about the experieces of other self-advocacy groups. 3. Briardale Commuity Cetre local people were recruited to carry out a door-to- door survey of people s wishes for facilities i the ew commuity cetre. 4. Presto Road Estate local people used participatory appraisal to fid out what eeded to be doe to improve quality of life o the estate. 5. Holderess Youth Iitiatives youg people used participatory appraisal to ivestigate a umber of issues relevat to them ad their commuity. 6. Totes Traffic Appraisal local people formed a group to try to fid solutios to the local traffic problems. 7. Barriers to Idepedece older people are curretly ivestigatig the barriers to idepedece for people of their age. 8. Alterative Choices a ivestigatio ito alterative strategies of copig with metal health problems. Beavigt o, ()(Beavi gto) Practice descriptio Health Improvemet eighbourho od work Three health improvemet teams work i the deprived areas of Bristol. They take a commuity developmet approach ad work o issues that are importat to the local commuity that will improve health. This icludes work at the idividual ad commuity level. Commuity is egaged by commuity outreach, beig based i the commuity, havig a good reputatio ad kow commitmet i the areas. I additio, a structured approach of commuicatio cetres i the Ier City provide a two way dialogue betwee volutary ad commuity sector orgaisatios i the Ier City. This model is goig to be replicated i other areas of the city. Persoal wellbeig Commuity wellbeig Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] deprived areas Beck (2005)(B eck et al., Qualitati ve study Sexual health STIs [Ifo] Sexual health Race/ ethicity [Ifo] Bagladeshi ++ 2 C, P 179

180 2005) Bezeval (2003)(B ezeval, 2003a) Mixed methods evaluatio Health Actio Zoes (HAZs) Geerally to improve health outcomes ad reduce iequalities. 26 HAZ with differet strategies to address health iequalities Geeral health (commuity) Other idicators of disadvatage [Ifo] HAZ were uiversally deprived, with +++ levels of average ill health ad + levels of iteral iequalities P Bezeval, (2003)(B ezeval, 2003b) Mixed methods evaluatio health actio zoes area based iitiative Disease prevetio [Ifo] reducig health iequalities - assume this refers to the mai idicators such as mortality, cacer etc. Other [Ifo] tacklig health iequalities; raisig the profile of margialised groups Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] socio-ecoomic ad health iequalities betwee differet parts of Sheffield C, P Beresford, (2012)(B eresford ad Carr, 2012) Practice descriptio Discussio user ivolvemet/ service user participatio i social care Substace use Persoal wellbeig Social capital/ cohesio Other [Ifo] older people Childre & Youg People/ Paretig Race/ ethicity Other idicators of disadvatage [Ifo] drug addictio; metal health; older people; life limitig illess; LGBT people Beresford,(2007)(B eresford, 2007) Cocept/ theory user ivolvemet research Other idicators of disadvatage [Ifo] particularly those with learig difficulties, disabilities, metal health service users ad elderly people Bertotti (2009)(B ertotti et al., 2009) Qualitati ve study Well Lodo participatio i World Cafes commuity cohesio- To capture the views of residets Commuity wellbeig Commuity assets Socioecoomic idicators [Ifo] The target areas were idetified o the basis of their rakig withi the 2004 Idex of Multiple Deprivatio ad positio withi the top 13% most deprived LSOAs i Lodo ++ 2 WB, C, P 180

181 Bhavai (2013) (Bhava i ad Newbur, 2013) Practice descriptio NCT breastfeedi g peer support Breastfeedig peer support Childre ad Youg People/ Paretig Healthy eatig Wome (mothers) i East Lacashire + 3,7 /a Bhavai (2014) (Bhava i ad Newbur, 2014) Mixed methods evaluatio Birth ad Beyod Commuity Supporters Programme recruit ad trai commuity voluteers to work as peer supporters, provide a stregths-based, empowerig voluteer peer support service for parets with the aim of reducig isolatio, stress ad low mood durig pregacy ad the first two years after birth Race/ ethicity: 59% idetified themselves as from a Black ad Miority Ethic (BME) group; 48% asylum seekers or refugees; Wome (mothers); + 3,7 WB, SDH, I, P, E Social exclusio Blamey (2004)(Bl amey et al., 2004) Mixed methods evaluatio Have a Heart Paisley The combied itervetios were to be delivered i partership ad i a maer that egaged the commuity at all levels of the programme. It was hoped that this itegrated approach would be capable of saturatig the tow of Paisley with improved ad ew services, projects ad opportuities that would, over the log term, reduce ad prevet CHD amogst the Paisley populatio. The log-term aim of HaHP was to reduce the total burde ad levels of iequality of Coroary Heart Disease (CHD) i the tow of Paisley through a itegrated programme of secodary ad primary prevetio. Physical activity Healthy eatig Disease prevetio STIs Substace use Social capital/ cohesio Persoal assets Commuity assets Childre ad Youg People/ Paretig Other idicators of disadvatage [Ifo] suffered from +++ uemploymet ad socio-ecoomic deprivatio H, WB, SDH, I, P Blak (2007)(Bl ak et al., 2007) Questio aire/ survey Policy New Deal for Commuities New Deal for Commuities: a major UK govermet fuded iitiative Physical activity Healthy eatig Metal health Geeral health (persoal) Socioecoomic idicators [Ifo] deprived Eglish commuities H, WB, I Bolam (2006)(B olam et al., 2006) Qualitati ve study Nottigham City Net project The preset article presets a exploratory qualitative process evaluatio study of Ambassador participatio i City Net, a iovative iformatio commuicatio techology-based (ICT) project that aims to build aspects of social capital ad improve access to iformatio ad services amog disadvataged groups i Nottigham, UK. Commuity wellbeig Social capital/ cohesio Geeral health (commuity) Race/ ethicity [Ifo] youg Africa-Caribbea me with metal health difficulties Occupatio [Ifo] log-term uemployed me Geder Other idicators of disadvatage WB, SDH, I, P 181

182 [Ifo] socially isolated carers ad older people; those livig i deprived wards. Bowers (2006)(B owers et al., 2006) Mixed methods evaluatio objective of idetifyig ad +++lightig the distictive cotributio of voluteers ivolved i providig support to people also receivig differet health ad social care support from statutory services Ð maily withi or coected to home ad itermediate care services. Persoal wellbeig Social capital/ cohesio Geeral health (persoal) Social capital Other idicators of disadvatage [Ifo] older people + 7 WB, I Boydell (2007)(B oydell ad Rugkåsa, 2007) Mixed methods evaluatio Qualitati ve study Policy Cocept/ theory Practice descriptio 2 health actio zoes i Norther Irelad Health actio zoes; parterships. Oe partership ivolved over 30 parters from statutory agecies, volutary ad commuity orgaizatios ad local coucillors, ad met o a six-mothly basis. I additio, most parters met more frequetly i project subgroups. The other partership ivolved a smaller group of parters from statutory ad volutary agecies ad other local area-based parterships, ad met mothly. Both parterships were supported by seior represetatio from member orgaizatios Geeral health (commuity) Socioecoomic idicators [Ifo] deprived areas H, P Boyle (2006)(B oyle et al., 2006) Mixed methods evaluatio [Ifo] 3 case studies Rushey Gree Time Bak, Cares of Life project, Rhymey Time Bak, Blaegarw Time Cetre, Dias Time Bak, Gorbals Time Bak, Peer tutorig project, Patch, Seal, Peer Co-Productio Physical activity Healthy eatig Metal health Substace use Prevetio violece/ abuse/ crime Social capital/ cohesio [Ifo] Peer advocacy project (helpig to welcome ad settle refugees ad asylum seekers i Glasgow) Persoal assets Other [Ifo] Roots (refugee commuity orgaisatio ivolved i a rage of local activities, icludig social Race/ ethicity [Ifo] South-East Lodo is desely populated, multicultural: almost a third of the populatio is Black Africa ad Black Caribbea; Welsh Valleys - As much as 99 per cet of the populatio is white Occupatio [Ifo] Scotlad: There is a substatial group of youg people who are ot i educatio, employmet or traiig o leavig school, ad a +++ proportio of residets o log-term healthor sickess-related beefits Educatio [Ifo] Welsh Valleys - As may as 40 per cet of the workig populatio of Caerphilly have o qualificatios ; Scotlad: There is a substatial group of youg people who are ot H, WB, SDH, I, C, P 182

183 advocacy project, Roots eterprise). Childre ad Youg People/ Paretig Geeral health (persoal) i educatio, employmet or traiig o leavig school, ad a +++ proportio of residets o log-term healthor sickessrelated beefits Other idicators of disadvatage [Ifo] The three study sites were similarly excluded socially ad ecoomically, but their social mix was extremely diverse, though with particular commo issues related to public health; Southwark, Lambeth ad Lewisham the boroughs ivolved are amog the poorest i the UK; Welsh Valleys: Merthyr Tydfil ad Neath have 30 per cet of the populatio with chroic health problems.nearly half of all households have oe or more people livig with a limitig lifelog illess; Scotlad - loe parets; Uemploymet rates have falle sigificatly i recet years (icludig a 50 per cet cut i log-term uemploymet sice 1999) but rates of ecoomic iactivity or worklessess remai a problem; There is a substatial group of youg people who are ot i educatio, employmet or traiig o leavig school, ad a +++ proportio of residets o log-term health or sickess-related beefits; refugees Boyle (2010)(B oyle et al., 2010) Cocept/ theory Policy Discussio co-productio Persoal wellbeig [Ifo] service users BPCSSA (2010)(B pcssa, 2010) Practice descriptio health traiers health traiers: lay workers supportig idividual behaviour chage Physical activity Healthy eatig Metal health Substace use Geeral health (persoal) Race/ ethicity Socioecoomic idicators

184 Bridge (2002)(Br idge Cosortiu m, 2002) Mixed methods evaluatio New Opportuities Fud Healthy Livig Cetres Addressig health iequalities ad social exclusio targetig people i deprived areas, via a umber of differet methods icludig various health based activities. Physical activity Healthy eatig Metal health Disease prevetio Substace use Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] Icreasig opportuities for employmet either directly or idirectly through educatio ad traiig. Childre ad Youg People/ Paretig Geeral health (commuity) Race/ ethicity [Ifo] Cultural ad multi-ethic character is described Occupatio [Ifo] +++ uemploymet was reported i 147of the 200 HLCs; + icome i 156 or the 200 HLCs Socioecoomic idicators [Ifo] 142 out of 200 HLCs curretly etered ito the database are targetig deprived people i urba areas ad 51 out of 200 are targetig deprived people i rural areas. Other idicators of disadvatage [Ifo] Repeated themes cocered the prevalece of poor metal health (three HLCs), poor housig (three HLCs), ad youg sigle paret families (two HLCs) H, WB, C, H, P Bridge (2006)(Br idge, 2006) Policy UK health policy - developmet s relatig to social capital sice 1997 critique of the ifluece of social capital o policy developmet i the UK Social capital/ cohesio Populatio: PROGRESS-Plus Social capital Bromley, ()(Bromle y) Practice descriptio Stroger Commuities Providig support aroud all aspects, especially metal health ad wellbeig ad social isolatio Metal health Persoal wellbeig Social capital/ cohesio Populatio: PROGRESS-Plus Other idicators of disadvatage [Ifo] May, but ot all, of the iitiatives focus o older people Brow, (2002)(Br ow, 2002) Other [Ifo] cas e studies - methods ot reported Workig for Commuities pathfiders commuity ivolvemet/ egagemet i iovative ways of deliverig diverse projects/ services Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] regeeratio Other idicators of disadvatage [Ifo] youg people SDH, C, P 184

185 Browlie (2006)(Br owlie et al., 2006) Cocept/ theory Evaluatio / research Practice descriptio Discussio Qualitativ e study Questio aire/ survey The pricipal aim of this project was, therefore, to explore the problems ad possibilities of icorporatig a childre as researchers perspective ito the ageda of govermet social research i Scotlad. Childre & Youg People/ Paretig Other idicators of disadvatage [Ifo] childre ad youg people Burgess, (2014)(B urgess, 2014) Mixed methods evaluatio 4 timebaks - Cambridgesh ire project, Somersham, Camboure, Littleport ad March. Time bakig - a exchage system i which time is the pricipal currecy. For every hour participats deposit i a timebak, perhaps by givig practical help ad support to others, they are able to withdraw a hour of support whe they are i eed Commuity wellbeig Social capital/ cohesio Social capital WB, SDH, C, P, E Burto, (2006)(B urto et al., 2006) Cocept/ theory commuity ivolvemet i area based iitiatives Commuity wellbeig Other [Ifo] Local ecoomy ad labour market Local housig market Educatio, icludig pre-school provisio Public health Crime ad commuity safety Physical eviromet Delivery of local public services Socioecoomic idicators [Ifo] areas of ecoomic disadvatage 2 Cabiet (2011)(C abiet Office, Cocept/ theory Policy Strategic Natioal Framework o commuity This framework explores the role ad resiliece of idividuals ad commuities before, durig ad after a emergecy. Commuity wellbeig Safety/ accidet prevetio Commuity assets

186 2011) resiliece Callard (2005)(C allard ad Friedli, 2005) Qualitati ve study Imagie East Greewich a series of arts/health projects developed as part of a regeeratio programme o two housig estates i a Lodo borough Metal health STIs Substace use Persoal wellbeig Commuity wellbeig Social capital/ cohesio Persoal assets Childre ad Youg People/ Paretig Geeral health (persoal) Geeral health (commuity) Race/ ethicity [Ifo] racially very diverse, with 23% of the populatio defiig themselves as o-white at the last cesus Socioecoomic idicators [Ifo] sigificat social ad ecoomic iequalities (some of the +++est deprivatio levels are foud i the two estates that were the focus for IEG) H, WB, SDH, P Cambridg e (2013)(C ambridge Cetre for Housig & Plaig Research, 2013) Mixed methods evaluatio [Ifo] cas e studies of 4 projects Time baks Time bakig is a exchage system i which time is the pricipal currecy. For every hour participats deposit i a time bak, perhaps by givig practical help ad support to others, they are able to withdraw a hour of support whe they are i eed Persoal wellbeig Commuity wellbeig Social capital/ cohesio Geeral health (persoal) Race/ ethicity [Ifo] majority are white Occupatio [Ifo] 23% retired; 22% uemployed Educatio [Ifo] 42% have +++er level qualificatio beyod A levels Socioecoomic idicators [Ifo] 58% of members have a icome of less tha 300 per week H, WB, I, P Campbell (2004)(C ampbell et al., 2004) Researc h Qualitati ve study participatio, barriers/ attitudes to Metal health Social capital/ cohesio Race/ ethicity [Ifo] Africa Caribbea Socioecoomic idicators [Ifo] deprived commuity Social capital [Ifo] social capital ++ 2 WB, C, P Campbell (2008)(C ampbell et al., 2008) RCT ASSIST (A Stop Smokig I Schools Trial) school based peer-led itervetio for smokig cessatio i adolescece Substace use Childre ad Youg People/ Paretig + 3 H, I, E, U Carley, (2000)(C Other [Ifo] cas Social capital/ cohesio Other Race/ ethicity [Ifo] ethically diverse + 2 P 186

187 arley et al., 2000) e studies [Ifo] urba regeeratio; commuity safety; commissioig Socioecoomic idicators [Ifo] Birmigham is the fifth most deprived out of 366 districts o the Eglish deprivatio idex, with 25 of its 39 wards raked i the most disadvataged 10% i the coutry Other idicators of disadvatage [Ifo] deprived borough Carlisle (2010)(C arlisle, 2010) Qualitati ve study East Kirklad Social Iclusio Partership (SIP) Scottish Social Iclusio Parterships (SIPs) fuded to tackle local health iequalities ad social exclusio usig a health promotio, partership ad commuityled approach. Metal health Substace use Commuity wellbeig Social capital/ cohesio Geeral health (commuity) Occupatio [Ifo] +++ uemploymet Religio/ culture [Ifo] sectaria divisios betwee Catholic ad Protestat Socioecoomic idicators [Ifo] health iequalities Social capital [Ifo] social exclusio + 2 P Carlso (2010)(C arlso et al., 2010) Mixed methods evaluatio health traiers health traiers: lay workers supportig idividual behaviour chage Physical activity Healthy eatig Substace use Geeral health (persoal) Socioecoomic idicators [Ifo] 61% of cliets reached by the Health Traier Services come from the 40% most deprived social quitiles Social capital [Ifo] I some parts of the service, such as those targetig rural areas, socially isolated idividuals are also beig reached H, I, C, P, E Carr, (2005)(C arr, 2005) Qualitati ve study Family Safety Scheme childhood accidet prevetio i the home. Peer educators called 'safety advisers'. three local mothers were recruited through local advertisig ad traied to take o the role of peer educators Childre ad Youg People/ Paretig Safety/ accidet prevetio [Ifo] accidet prevetio withi the home. Structured aroud four age specific accidet issues; chokig, drowig, falls ad burs. Race/ ethicity [Ifo] multi-ethic commuity Socioecoomic idicators [Ifo] "deprived" Other idicators of disadvatage [Ifo] parets Multiple laguages, a o- Eglish speakig proportio of the populatio, a asylum seeker populatio mobile populatio + 3 I, P Cawley (2011)(C awley ad Qualitati ve study The Chagig Mids Programme metal health awareess traiig Metal health Substace use Prevetio violece/ abuse/ crime Race/ ethicity [Ifo] Black ad Miority Ethic commuities were prioritised +++ [Ifo] Gra duates were 5 7 H, WB, I, P, 187

188 Berzis, 2011) Persoal wellbeig offered opportuit ies to cofacilitate the ext course E, U Cetre (2013) Policy asset based approaches to health improvemet Commuity wellbeig Commuity assets Geeral health (commuity) Other idicators of disadvatage [Ifo] health iequalities Chaddert o (2008)(C hadderto et al., 2008) Cocept/ theory Evaluatio / research Practice descriptio Qualitativ e study health impact assessmet commuity egagemet i health impact assessmet i the UK plaig system Commuity wellbeig Safety/ accidet prevetio [Ifo] waste icieratio 1 Chapma (2010)(C hapma, 2010) Qualitati ve study Commuity Activator Programme The Programme comprised four elemets 1. Recruitmet of Commuity Activators: Recruitig idividuals from the 20 Well Lodo commuities 2. Traiig i Commuity activatio: Delivery of a itesive four-day traiig course. 3. Metor support: Each Activator who completed the traiig course was assiged a persoal metor. 4. A budget: While the Activators gave their time to the programme volutarily (i.e. u-paid) a budget was made available to each Activator who successfully completed the traiig. Physical activity Persoal wellbeig Social capital/ cohesio Race/ ethicity [Ifo] two thirds of participats are from BME groups Occupatio [Ifo] The majority of participats are ot i work or full time educatio or traiig ad do ot have further or +++er educatioal qualificatios. Geder [Ifo] early 3/4 of participats were female Socioecoomic idicators H, WB, I, P Chapma,(2001)(C hapma et al., 2001) Mixed methods evaluatio commuity participatio i multi-agecy parterships to improve social iclusio Social capital/ cohesio Social capital + 2 C, P 188

189 Chau (2007)(C hau, 2007) Qualitati ve study Shared expectatios, shared commitmet a actio-orieted ad older-people-led study which took place from 2003 to 2005 Commuity wellbeig Social capital/ cohesio Geeral health (commuity) Race/ ethicity [Ifo] Chiese older people Other idicators of disadvatage [Ifo] older people P Chirewa (2012)(C hirewa, 2012) Cocept/ theory Participatory actio research. Developmet of a toolkit to support NGOs i tacklig health iequalities. Other [Ifo] "health iequalities" Socioecoomic idicators Other idicators of disadvatage [Ifo] margialised groups Christie, (2012)(C hristie et al., 2012) Qualitativ e study social marketig itervetio to improve road safety awareess i the Somali commuity Safety/ accidet prevetio Race/ ethicity [Ifo] 35% BME Socioecoomic idicators [Ifo] has slightly above average levels of deprivatio compared with other Lodo boroughs ad four of its 20 electoral wards have bee idetified as beig i the 10% most deprived wards i the UK P Cidersb y, (2014)(Ci dersby, 2014) before ad after study Qualitati ve study Questio aire/ survey Other [Ifo] acti o research Good Life iitiative The SEI approach was to develop the Good Life iitiative, which aimed to stimulate commuity buildig i relatio to sustaiability issues, cosiderig improved use of resources, icreased kowledge leadig to +er carbo emissios ad greater commuity coectios ecouragig shared actio Commuity wellbeig Social capital/ cohesio Commuity assets [Ifo] to ehace local skills for self-sufficiecy ad build local resiliece Other [Ifo] sustaiability issues, cosiderig improved use of resources, icreased kowledge leadig to +er carbo emissios ad greater commuity coectios ecouragig shared actio Geeral health (commuity) Other idicators of disadvatage [Ifo] New Earswick is a +-icome commuity that comprises predomiatly social housig owed by the Joseph Rowtree Housig Trust; There have bee chages i its demographics (icludig a icrease i older people) over recet years resultig i some tesios betwee groups WB, SDH, I, P, U Clay, (2007)(Cl ay Christoph er et al., Qualitati ve study Health issues i the commuity (HIIC) Health Issues i the Commuity is a traiig course iformed by a commuity developmet approach to health promotio Physical activity Healthy eatig Prevetio violece/ abuse/ crime Commuity wellbeig Socioecoomic idicators [Ifo] The course ca work with groups who are margialised ad who suffer the egative cosequeces of equality ad discrimiatio + 5 WB 189

190 2007) Social capital/ cohesio Geeral health (commuity) Cole, (2003)(C ole, 2003) Qualitati ve study Health Actio Zoe (Plymouth) HAZs were oe of several area-based iitiatives (ABIs) itroduced ito localities with +++ levels of social ad ecoomic deprivatio. HAZs had two strategic objectives: Idetifyig ad addressig the public health eeds of the local area, i particular trailblazig ew ways of tacklig health iequalities; ad Moderisig services by icreasig their effectiveess, efficiecy ad resposiveess. The HAZ approach was uderpied by seve priciples (achievig equity; egagig commuities; workig i partership; egagig frotlie staff; adoptig a evidece-based approach; developig a perso-cetred approach to service delivery; ad takig a whole systems approach), which miisters asked all HAZs to reflect i their activities ad plas. Healthy eatig Metal health STIs Substace use Social capital/ cohesio Other [Ifo] chages to primary care Childre ad Youg People/ Paretig Geeral health (persoal) Geeral health (commuity) Safety/ accidet prevetio Socioecoomic idicators [Ifo] most deprived ward i Eglad ad Wales. Idex of coditios. Social capital [Ifo] socially excluded Other idicators of disadvatage [Ifo] deprived H, WB, C, P, U Commui ties (2007)(C ommuiti es ad Local Goverm et, 2007) Policy Cocept/ theory Practice descriptio empowermet Commuity wellbeig Commui ty () Other [Ifo] 5 case studies Burfoot Commuity Hub; North Coast Coectio; Health All Roud; PAGES; Steppig Stoes commuity-led health Disease prevetio Commuity wellbeig Social capital/ cohesio Commuity assets Childre ad Youg People/ Paretig Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators Social capital SDH, C, P 190

191 Cosulti g (2011)(C LES Cosulti g, 2011) Mixed methods evaluatio projects from the Wellbeig programme ad two Chagig Spaces award parter programmes Physical activity Healthy eatig Metal health Persoal wellbeig Social capital/ cohesio Childre ad Youg People/ Paretig 7 H, WB, I, C Cook (2012)(C ook ad Wills, 2012) Qualitati ve study health traiers traiers are lay people recruited to egage harder-toreach people from their commuities, offerig oe-tooe support to eable them to make the healthy lifestyle chages of their choice Geeral health (persoal) [Ifo] idividual behaviour chage Other idicators of disadvatage [Ifo] margialised commuities WB, C, P Coote (2004)(C oote et al., 2004) Practice descriptio The Healthy Commuities Collaborative ; The Social Actio Research Project Healthy Commuities Collaborative: This is a model for itroducig structured, evidece-based practice at local level, uder the cotrol of local people. The HCC egages commuities to improve health ad reduce iequalities, ad aims to stregthe their capacity to address health risks.131 So far the collaboratives have focused o prevetig falls amog older people i disadvataged eighbourhoods; The Social Actio Research Project (SARP), Salford, was oe of two actio research projects i Salford ad Nottigham that aimed to deepe uderstadig of how stregtheig commuity capacity ad commuity ivolvemet i local policy ad practice could help to improve health ad reduce health iequalities Safety/ accidet prevetio [Ifo] fall prevetio Social capital/ cohesio Commuity assets Other idicators of disadvatage [Ifo] disadvataged eighbourhoods; older people; 1 Corbi, (2006)(C orbi, 2006) Mixed methods evaluatio Activity Frieds Activity Frieds is a voluteer programme for the over 50Õs desiged to help people achieve a healthier lifestyle through icreasig physical activity ad befriedig to alleviate social isolatio. Physical activity Metal health Persoal wellbeig Social capital/ cohesio Occupatio [Ifo] retired Social capital [Ifo] social isolatio Other idicators of disadvatage [Ifo] older people WB, I, P Coulter (2010)(C Practice Liverpool s Big Health Liverpool PCT orgaised a three stage commuity cosultatio for health strategy; audit of health eeds; Disease prevetio Commuity wellbeig [Ifo] Liverpool; Owto Ward i Hartlepool;

192 oulter, 2010) descriptio Debate; Coected Care i Hartlepool; Apee Sehat; Health Actio Zoes; Apee Sehat (our health) is a social eterprise pathfider project that is tailorig lifestyle programmes to meet the eeds of Britai s South Asia commuity; Health Actio Zoes; Healthy commuities collaborative; NHS Tower Hamlets - lay diabetes educators; Oxfordshire PCT Priorities Forum Social capital/ cohesio Persoal assets [Ifo] traiig of auditors Other [Ifo] health strategy developmet; commuity audit of health eeds; reduce health iequalities Geeral health (persoal) Geeral health (commuity) South Warwickshire; Tower Hamlets; Across the coutry; Oxford Race/ ethicity [Ifo] The views of people from specific priority groups were sought by meas of 13 specially orgaised discussio groups. These icluded people from the Chiese, Sikh, Somali ad Yemei commuities, homeless me, Irish travellers, people with sesory disabilities ad metal health service users. Other idicators of disadvatage [Ifo] The views of people from specific priority groups were sought by meas of 13 specially orgaised discussio groups. These icluded people from the Chiese, Sikh, Somali ad Yemei commuities, homeless me, Irish travellers, people with sesory disabilities ad metal health service users; Owto: The ward is raked as oe of the most deprived atioally, with most residets livig i social housig Coulter, ()(Coulter ) Practice descriptio Somerford Wellbeig Project The mai activity is i two phases: the first is a creative cosultatio with youg people leadig the activity, supported by a commuity developmet worker. A artist experieced i film, aimatio ad audio (digital media) will work with the youg people, developig their skills i iterviewig ad documetatio. Out of the iformatio gathered the youg people will help to devise a phase 2 which will be more focussed itervetios usig the arts for health ad wellbeig outcomes ad to meet CCG eeds. A artist experieced i creative cosultatios will be ivolved alog with the artist workig specifically with digital media. The youg people are from the commuity ad will lead the project. The commuity developmet worker has may years of workig i this commuity ad will provide the leads ito the youg people ad exteded family etworks. Healthy eatig Metal health Disease prevetio [Ifo] maagig log term coditios Substace use Persoal wellbeig Commuity wellbeig Childre & Youg People/ Paretig Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] area of social deprivatio ad health iequalities

193 Craig (2010)(Cr aig, 2010) Qualitati ve study Youth.comU ity Youg Ambassador s programme Recruitig, maagig ad supportig a Youg Ambassador from each of the 20 commuities. Youg Ambassadors help Well Lodo Parters by publicisig their evets ad activities, by itegratig the cocers of youg people ito Well Lodo programmes geerally ad by developig projects i partership with Well Lodo Parters. Uiquely the Youg Ambassadors pla ad deliver their ow projects i their ow commuities ad, as a team, are plaig the Wellet Coferece at City Hall i February (Wellet is a learig etwork coectig all those workig i health ad well-beig promotio across Lodo ad sharig fresh ideas for boostig well-beig through commuityled activities.) Youth Participatio Semiars ad Cofereces Ð Part of the Wellet project, these are desiged to chage attitudes ad idetify orgaisatioal challeges Youth Update Briefigs Ð Policy briefigs aimed at parters, icludig local parters, ad iformig them of youth related issues The Youg Ambassadors Programme is maaged by two Youth.com Workers, each worker recruitig, supportig ad maagig 10 Youg Ambassadors. Commuity wellbeig Geeral health (persoal) Geeral health (commuity) Other idicators of disadvatage [Ifo] youg people P CRESR () Mixed methods evaluatio New Deal for Commuities (NDC) Neighbourhood Reewal- Each NDC is workig with parter agecies ad the local commuity to implemet 10 year programmes to trasform these eighbourhoods. Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Other [Ifo] Neighbourhood reewal Geeral health (commuity) Race/ ethicity [Ifo] the proportio of the o-white populatio across the Programme is about 26 per cet: for Birmigham Asto the equivalet figure is over 80 per cet: for Plymouth ad Kowsley less tha oe per cet Socioecoomic idicators [Ifo] 39 geerally deprived areas: ie would fall withi the most deprived 1,000 of the 32,000 +er level Super Output Areas derived from the 2001 Cesus. The Kowsley NDC area would be the 117th most deprived SOA i Eglad. Other idicators of disadvatage [Ifo] across the Programme 55 per cet of households live i social reted accommodatio: i Southwark it is almost W B, SD H, C, P 193

194 per cet, but i Hartlepool less tha 30 per cet. Crow (2004)(Cr ow et al., 2004) before ad after study Commuitie s that Care (CTC) prevetio iitiative. This early itervetio programme targets childre livig i commuities ad families that are deemed to put them at risk of developig social problems. The CTC approach focuses o specific geographical areas ad ivolves brigig together local commuity represetatives, professioals workig i the area ad seior maagers resposible for service maagemet. Participats are give traiig ad provided with evidece of the levels of risk ad protectio i their commuity. From this they desig a actio pla that seeks to ehace existig services or itroduce ew oes likely to reduce risk Substace use Persoal wellbeig Social capital/ cohesio Other [Ifo] disadvataged eighbourhoods; educatioal achievemet Childre ad Youg People/ Paretig [Ifo] Southside (located i Wales), Westside (West Midlads), Northside (North of Eglad) Race/ ethicity [Ifo] Southside: predom white; The city of Westside has a sigificat ethic populatio (12 per cet), maily of Asia descet Occupatio [Ifo] Uemploymet was the +++est i the city i Westside Other idicators of disadvatage [Ifo] Southside: It was predomiately white, ad the proportio of youg people (uder 18) W B, SD H, C, P Crowley, (2002)(Cr owley et al., 2002) Mixed methods evaluatio [Ifo] cas e study promotig commuity participatio i decisio makig about local services Other [Ifo] ways i which local health services are plaed ad delivered Geeral health (commuity) Race/ ethicity [Ifo] sigificat BME populatio (6%) Other idicators of disadvatage [Ifo] area of social disadvatage; people with disabilities C, P Curtis (2007)(C urtis et al., 2007) Qualitati ve study Breastfrieds scheme breast feedig peer-support project Healthy eatig Childre ad Youg People/ Paretig Geder [Ifo] females, mothers Socioecoomic idicators [Ifo] described as 'workig class' W B, I, P CVS (2008)(C ommuity Service Voluteer s (CSV), 2008) Mixed methods evaluatio Capital Voluteerig Capital Voluteerig is a pa-lodo programme which aims to tackle issues of metal health ad social iclusio, through voluteerig. Metal health Persoal wellbeig Social capital/ cohesio Social capital [Ifo] social iclusio Other idicators of disadvatage [Ifo] metal health service users + 7 H, W B, I Data (2012)(D before ad after Health Traiers Health Traier Service Physical activity Healthy eatig [Ifo] Natioal + 3 H, W 194

195 ata Collectio Reportig System, 2012) study Service Substace use Persoal wellbeig Other [Ifo] weight; 'local issue' Geeral health (persoal) Race/ ethicity [Ifo] sees a strog White British majority - cliets Geder [Ifo] clear female majority - cliets Socioecoomic idicators [Ifo] most cliets live i a area which falls withi the Q1 Most deprived threshold Other idicators of disadvatage [Ifo] clear cosistecy of cliets i the middle age badigs, with beig margially the +++est (19.43%); a sigificat umber of Log term coditio ad Disability/ vulerable group cliets are accessig the service.; offeders B, I, U Davies, (2009)(D avies, 2009) Practice descriptio Discussio commuity health champios commuity empowermet; health champios Physical activity Healthy eatig Metal health Persoal wellbeig Commuity wellbeig Geeral health (persoal) Geeral health (commuity) Other idicators of disadvatage [Ifo] targetig areas where health is curretly poorest DCLG (2006)(D epartme t for Commui ties & Local Goverm et, 2006a) Policy local area agreemets Paper proposes a ew approach to local partership to give local authorities more opportuity to lead their area, work with other services ad better meet the public s eeds. Reshape public services by givig citizes ad commuities a bigger say. a ew framework for strategic leadership i local areas, brigig together local parters to focus o the eeds of citizes ad commuities Stroger local leadership, greater residet participatio i decisios ad a ehaced role for commuity groups ca help all local areas to promote commuity cohesio These reforms will empower citizes ad commuities. Commuity wellbeig Social capital/ cohesio Social capital Dearde- Phillips, (2005)(D earde- Practice descriptio Speakig Up a volutary orgaisatio that has developed the Parliamet model to give people with learig difficulties a strog collective voice. Other [Ifo] commissioig/ ifluecig health services Other idicators of disadvatage [Ifo] people with learig disabilities

196 Phillips ad Foutai, 2005) Discussio Departme t (2004)(D epartme t of Health, 2004) Policy Choosig health health policy Physical activity Healthy eatig Metal health Disease prevetio STIs Substace use Childre & Youg People/ Paretig Socioecoomic idicators [Ifo] health iequalities + 2 Departme t (2006)(D epartme t of Health, 2006b) Policy Cocept/ theory a framework for creatig a stroger local voice i the developmet of health ad social care services. There are five elemets of the ew arragemets: local ivolvemet etworks; overview ad scrutiy committees; more explicit duties o providers ad commissioers of services to ivolve ad cosult; a stroger atioal voice; ad a stroger voice i regulatio Other [Ifo] plaig, developig ad makig decisios about health ad social care services Geeral health (commuity) + 2 Departme t (2007)(D epartme t for Commui ties & Local Goverm et, 2007a) Policy Strog ad Prosperous Commuities - The Local Govermet White Paper The Govermet believes that public services are better, local people more satisfied ad commuities stroger if ivolvemet, participatio ad empowermet is at the heart of public service delivery. 'Strog ad Prosperous Commuities - The Local Govermet White Paper' lays out the Govermet's proposals o how to local authorities ca achieve commuity empowermet. Oe of the ways this will be achieved is through Statutory Guidace, as laid out i the approach to guidace i the White Paper Implemetatio Pla. This paper gives detail o a umber of pieces of Statutory Guidace provided for withi the Bill aimed to support local authorities i commuity empowermet. Commuity wellbeig Other [Ifo] commuity empowermet Departme t (2007)(D Practice descriptio Opportuitie s for Voluteerig Voluteerig i health ad social care services. Physical activity Healthy eatig Metal health Race/ ethicity [Ifo] Mixed ethicities

197 epartme t of Health, 2007b) Scheme 2007 Disease prevetio STIs Substace use Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Other [Ifo] refugees ad asylum seekers Occupatio [Ifo] 70% of voluteers were employed, 30% were uemployed Geder [Ifo] 36% of voluteers were male, 64% were female 7 Departme t (2006)(D epartme t for Commui ties & Local Goverm et, 2006a) Questio aire/ survey Neighbourho od Maagemet Pathfider Programme eighbourhood maagemet/ reewal/ regeeratio Prevetio violece/ abuse/ crime Commuity wellbeig Socioecoomic idicators [Ifo] deprived eighbourhoods ++ 2 SD H, C, P Departme t (2007)(D epartme t for Commui ties & Local Goverm et, 2007b) Qualitativ e study (Neighbourh ood Maagemet ad Social Capital) Neighbourho od Maagemet Pathfiders Programme Neighbourhood maagemet, various methods: - establishig ad supportig a wide rage of local groups ad activities, especially for childre ad youg people. -creatig opportuities for people from differet backgrouds ad commuities to come together ad work towards commo goals examples iclude a local radio statio, work with schools ad faith commuities to icrease cross-cultural uderstadig ad ivolvig youg people ad adults i debates about perceptios of ati-social behaviour; -givig residets more of a sese of local idetity through festivals, commuity cetres ad through reclaimig local public spaces; -tacklig egative stereotypes of the eighbourhood ad of particular groups withi it; Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Childre ad Youg People/ Paretig Race/ ethicity [Ifo] Blaco ad Ovede have a predomiatly white populatio; Leyto is ethically mixed. Social capital Other idicators of disadvatage [Ifo] All three eighbourhoods report problems i relatios betwee adults ad youg people, but while Blaco ad Leyto have a fairly active volutary ad commuity sector, Ovede which has suffered from ecoomic restructurig ad the loss of major local idustries does ot. + 1 W B, SD H, C, P Departme t (2009)(D Policy Practice descriptio Commuities for Health Programme a programme led by local govermet to: work with commuities to help them to improve their ow health; promote partership across local orgaisatios; al+ Social capital/ cohesio Commuity assets Geeral health (persoal) Socioecoomic idicators [Ifo] icludes all the health iequalities

198 epartme t of Health, 2009a) local areas to choose their priorities for health ad provide support from the cetre; ad create a climate for iovatio. Geeral health (commuity) Spearhead areas Derges (2004)(D erges et al., 2004) Qualitati ve study Well Lodo Well Lodo is a multicompoet commuity egagemet ad coproductio programme desiged to improve the health of Lodoers livig i socioecoomically deprived eighbourhoods Physical activity Healthy eatig Metal health Persoal wellbeig [Ifo] Lodo: Eastford, Hartfield ad Moutside Race/ ethicity [Ifo] Ethicity, age ad legth of time i the eighbourhood amog the study populatio were mixed across all three eighbourhoods Other idicators of disadvatage [Ifo] Ethicity, age ad legth of time i the eighbourhood amog the study populatio were mixed across all three eighbourhoods; socioecoomically deprived eighbourhoods H, W B, SD H, I, C, P Dewar (2005)(D ewar, 2005) Qualitati ve study Practice descriptio Iitiatives to support ivolvemet of older people i research ad developmet activity to support older people i partership workig i research ad developmet work Other [Ifo] Empowermet- support older people i partership workig i research ad developmet work Other idicators of disadvatage [Ifo] older people + 3 W B, I, P Dews, ()(Dews) Practice descriptio Commuity Health Champios Providig health iformatio through brief itervetio works ad bridgig programmes, supportig people to access maistream services. Commuity health champios whose primary role is to egage at grassroots level with local commuities, particularly those who are hard to reach with a view to raisig awareess of the beefits of good health ad lifestyle choices ad referrig them ito maistream support. Physical activity Persoal wellbeig Commuity wellbeig Social capital/ cohesio Other [Ifo] wider determiats e.g. employmet; debt maagemet Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] areas of deprivatio DfES (2005)(M elhuish et Mixed methods evaluatio Sure Start Local Programmes (SSLPs) To ehace the life prospects of youg childre i disadvataged families ad commuities. (150 SSLPs icluded i the study) Childre ad Youg People/ Paretig Socioecoomic idicators [Ifo] areas with +++ levels of deprivatio. Other idicators of disadvatage + 2 WB, P 198

199 al., 2005) [Ifo] all childre uder 4 years of age Departme t of Health (2008)(D epartme t of Health, 2008b) Policy Tacklig Health Iequalities: programme for actio policies to tackle health iequalities Disease prevetio Substace use Other [Ifo] child poverty, housig quality, educatioal achievemets, uptake of flu vacciatios Geeral health (persoal) Geeral health (commuity) [Ifo] life expectacy/ mortality Socioecoomic idicators + 2 Dickes (2011)(Di ckes Ady et al., 2011) RCT Commuity Metorig service commuity metorig service for socially isolated older people: Metal health Social capital/ cohesio Other [Ifo] Metorig Geeral health (persoal) Socioecoomic idicators [Ifo] older people, socially isolated Social capital 1 H, WB, C, P Diham, (2007) Qualitati ve study New Deal for Commuities eighbourhood reewal/ regeeratio Persoal wellbeig Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] eighbourhood reewal/ regeeratio Socioecoomic idicators [Ifo] 39 most disadvataged areas targeted by NDC Social capital [Ifo] address issues of social exclusio WB, C, P, U DoH, (2008)(D epartme t of Health, 2008a) Policy Discussio Health iequalities programme Looks at govermet targets of reducig iequalities i health outcomes, what works ad what does ot work, ad what eeds to be doe to carry forward progress. Egagig idividuals, families ad commuities works. A ew primary ad commuity care strategy as part of the NHS Next Stage Review which will move towards persoalised, itegrated ad better quality service. Health Traiers are see as importat ad the DH wats to roll them out to every commuity.report recogises the work third sector orgaisatios do i egagig commuities. Disease prevetio Commuity wellbeig Safety/ accidet prevetio Social capital/ cohesio Other [Ifo] educatio, housig etc. (social determiats) Geeral health (persoal) Geeral health (commuity) [Ifo] health iequalities. Life expectacy/ mortality. Socioecoomic idicators Other idicators of disadvatage + 2 Dooris (2013)(D Mixed methods Offeder Health Offeder Health Traier service Physical activity Healthy eatig Socioecoomic idicators + 3 H, WB, 199

200 ooris et al., 2013) evaluatio Traier service Metal health Substace use Prevetio violece/ abuse/ crime Persoal wellbeig Geeral health (commuity) [Ifo] People o probatio SDH, C, P Draper (2010)(Dr aper et al., 2010) Cocept/ theory Evaluatio / research developig a evaluatio framework that eables a aalysis of the process of participatio ad liks this with health ad programme outcomes 2 Duffy, (2012)(D uffy, 2012) Mixed methods evaluatio Peer Power (the persoalisati o forum group) Peer support group for people with metal illess Metal health H, WB, I, C, P East (2009)(E ast Midlads Regioal Empower met Partersh ip, 2009a) Practice descriptio Bagworth ad Thorto Parish Pla Group, Leicestershir e The Parish Pla group was formed i 2006 to address commuity issues ad brig facilities to the area that would beefit all residets Commuity wellbeig Social capital/ cohesio Commuity assets Socioecoomic idicators Other idicators of disadvatage [Ifo] o facilities ++ 4 East (2009)(E ast Midlads Regioal Empower met Partersh ip, Qualitati ve study Mato Commuity Alliace : Residets Buildig a Better Neighbourho od A Neighbourhood Maagemet Pathfider (NMP) which aims to explore ew ways of workig at a eighbourhood level so that local services are better, more efficiet ad relevat to the locality. Commuity wellbeig Social capital/ cohesio Other [Ifo] Neighbourhood improvemet + 1 WB, C 200

201 2009b) Edwards (2002)(E dwards, 2002) Sigle Regeeratio Budget Drawig o a questioaire set to 200 SRB parterships across Britai, this paper addresses disabled people s ivolvemet i SRB parterships. Commuity wellbeig Social capital/ cohesio [Ifo] The paper explores the extet, form of ad barriers to, disabled people s ivolvemet ad cosultatio i the SRB, ad challeges the otio that SRB parterships are iclusive to all sectors. Other [Ifo] tacklig iequality Other idicators of disadvatage [Ifo] Disability. SRB parterships seek collaboratio betwee public, private ad commuity sectors but, for some miority groups, such iclusioary itetios have proved to be more rhetoric tha reality P, U Eleftheria des, (2005)(El eftheriad es, 2005) Practice descriptio Reto Regeeratio ; Cordale Housig Associatio regeeratio Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] regeeratio Elford (2001)(Elf ord et al., 2001) Cotrolle d trial Questio aire/ survey peer educatio - popular opiio leader "diffusio of iovatio" model STIs [Ifo] prevetio of HIV ifectio Substace use Other idicators of disadvatage [Ifo] gay me ++ 3 H, P Elliott, (2001)(Ell iott et al., 2001) Qualitati ve study paper explores a umber of key issues relatig to the employmet of peer iterviewers by reflectig o a project desiged to explore the views ad experieces of parets who use illegal drugs Substace use Childre ad Youg People/ Paretig Other idicators of disadvatage [Ifo] drug usig parets + 3 H, P Elliott, (2007)(Ell iott et al., 2007) Practice descriptio health impact assessmet (HIA): iformig decisios o the future of a ladfill site i Wales Commuity assets Other [Ifo] Decisios about a ladfill sit Race/ ethicity [Ifo] Welsh ++ 1 Ewles, before the Hartcliffe commuity health developmet project Healthy eatig ++ 1 WB, 201

202 (2001)(E wles et al., 2001) ad after study Health ad Eviromet Actio Group Substace use Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (commuity) Occupatio [Ifo] +++ uemploymet Socioecoomic idicators [Ifo] most families are o a + icome 4 SDH, C, P Exchag e (2012)(C ommuity Health Exchag e, 2012b) Qualitati ve study commuity led health orgaisatios workig to tackle health iequalities at a local level Persoal wellbeig Commuity wellbeig Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] health iequalities P Exchag e (2012)(C ommuity Health Exchag e, 2012a) Mixed methods evaluatio Health Issues I the Commuity (HIIC) Delivery of a course 'Health Issues I the Commuity' (HIIC) Physical activity Healthy eatig Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Geeral health (commuity) [Ifo] Scotlad Socioecoomic idicators [Ifo] disadvataged commuities ad groups traditioally see as beig difficult to reach. Examples iclude I areas of multiple deprivatio Ex-Offeders People with addictios issues More Choices, More Chaces school pupils Older people Youg Homeless people Ethic miority wome s groups Paret s Groups Youg people Teat ad Residet Groups Wome s groups ++ 5 WB, C, P, U Farooqi, (2001)(Fa rooqi ad Bhavsar, 2001) Questio aire/ survey Project Dil Primary Care & Commuity Health Promotio Programme - Reducig Risk Factors of Coroary Heart Disease Amogst the South Asia A CHD traiig ad awareess programme for health care professioals. -A public awareess campaig icludig a peer educatio programme for the South Asia commuity of Leicestershire. Race/ ethicity [Ifo] South Asia Commuity Socioecoomic idicators [Ifo] deprived ier city areas. Other idicators of disadvatage [Ifo] Studies have show some South Asias to have poorer kowledge of risk factors for CHD, ad also poorer access ad uptake of services. This disadvatage is compouded by historically uder-resourced primary care services i ier city areas where South Asias predomiatly live Volut eers WB 202

203 Commuity Feto (2013)(Fe to, 2013) Mixed methods evaluatio assets based approach to health promotio with youg people i Eglad Asset mappig/models Persoal assets Commuity assets Childre ad Youg People/ Paretig F+ers (2002)(Fl owers et al., 2002) Cotrolle d trial a bar-based, peer-led commuity-level itervetio to promote sexual health amogst gay me. The itervetio cosisted of peer educatio withi bars, gay specific geitouriary medicie (GUM) services ad a free-phoe hotlie. Disease prevetio [Ifo] HIV/ AIDS prevetio STIs Other idicators of disadvatage [Ifo] gay me + 3 H, I, P Foot (2010)(Fo ot ad Hopkis, 2010) Practice descriptio Discussi o asset approach Commuity wellbeig Commuity assets Geeral health (commuity) Foutai (2010)(Fo utai ad Hicks, 2010) Mixed methods evaluatio Natioal Istitute for Metal Health i Eglad Commuity Egagemet Project The commuity egagemet strad of the DRE actio pla is a sigificat aspect of the work of DRE. As oe of the three buildig blocks of the actio pla ad programme which developed to implemet it, the work o commuity egagemet is a good barometer to gauge at a grassroots level the extet to which people from Black ad miority ethic (BME) commuities feel egaged; feel that their views are take o board by commissioers ad providers of services; ad feel that there is real improvemet i how they access ad experiece metal health services. The project- 547 commuity researchers, 75 4, 935 Black ad miority ethic curret or ex-metal service users, 344 carers ad 4,472 other commuity members to cotribute to the developmet of metal health policy ad to the plaig ad provisio of services. Metal health Persoal wellbeig Geeral health (persoal) Race/ ethicity Other idicators of disadvatage [Ifo] metal health service users H, WB, I, P Foutai, (2007)(Fo Cocept/ describes the commuity egagemet model developed durig the commuity egagemet programme Commuity wellbeig Social capital/ cohesio Other idicators of disadvatage

204 utai et al., 2007) theory Commuity assets [Ifo] "socially excluded commuities" Frace, (2001)(Fr ace ad Crow, 2001) Mixed methods evaluatio Commuities That Care programme desiged to help childre ad youg people to grow up i safer ad more carig commuities Prevetio violece/ abuse/ crime Childre ad Youg People/ Paretig Other idicators of disadvatage [Ifo] childre ad youg people at risk of offedig ++ 1 H, P Garder (2012)(G arder et al., 2012) before ad after study NHS Health Traier Service Health traier service Physical activity Healthy eatig Persoal wellbeig Other [Ifo] OBESITY Geeral health (persoal) [Ifo] Across Eglad ad Wales Race/ ethicity [Ifo] (17%) were of Asia or Black ethicities; 83.2% White Geder [Ifo] (79%) were female Socioecoomic idicators [Ifo] Nearly, half (1836 cliets; 43.2%) were from the most deprived quitile of the UK populatio, ad a further quarter (1093 cliets; 25.7%) were from the secod most deprived quitile H, WB, I, U Gay, (2007)(G ay, 2007) Mixed methods evaluatio voluteerig Scopig study to ivestigate the ature, practice ad extet of voluteerig i health promotio (i Suffolk) Physical activity Healthy eatig Metal health Substace use Persoal wellbeig Other [Ifo] Support, advice ad iformatio Learig ew skills such as art, laguage ad IT classes Budgetig Childre ad Youg People/ Paretig Geeral health (persoal) Geeral health (commuity) Race/ ethicity [Ifo] BME Other idicators of disadvatage [Ifo] For the most part, orgaisatios existed to support particular groups, for example, MS sufferers, people with metal health difficulties, older people or those with disabilities, youg people, refugees or carers + 4 Volut eers 8 P Glasgow (2007)(Gl asgow Cocept/ theory Healthy Futures commuity egagemet (model) Commuity wellbeig Social capital/ cohesio Commuity assets

205 Cetre for Populatio Health, 2007) Geeral health (commuity) Goddard, (2005)(G oddard, 2005) Mixed methods evaluatio persoal experiece voluteers Persoal wellbeig Other [Ifo] support for people with cacer + Volut eers WB, I Gooberm a-hill (2008)(G ooberma -Hill et al., 2008) Qualitati ve study Bristol Citizes' Jury public ivolvemet: ivolvig members of the public i citize's jury settig priorities for health research Other [Ifo] commissioig; defiig health research priorities Geeral health (commuity) ++ 2 P Govera ce (2012)(Lo cal Goverm et Iformati o Uit, 2012) Policy Cocept/ theory Practice descriptio Discussi o co-productio Commuity wellbeig Geeral health (commuity) ++ 2 Goverm et (2013)(Sc ottish Goverm et, 2013) Policy Cocept/ theory Equally Well uitig policies to reduce health iequalities across Scotlad Physical activity Healthy eatig Metal health Disease prevetio Substace use Prevetio violece/ abuse/ crime Commuity wellbeig [Ifo] social determiats Commuity assets Childre & Youg People/ Paretig

206 Geeral health (persoal) Graffy (2004)(Gr affy et al., 2004) RCT Support from voluteer cousellors for mothers cosiderig breast feedig Healthy eatig Childre ad Youg People/ Paretig Geder [Ifo] Wome- mothers + 7 H, WB, C, P Gree (2012)(Gr ee, 2012) before ad after study Mixed methods evaluatio Health Traier Service Health traier service Physical activity Healthy eatig Substace use Persoal wellbeig Other [Ifo] weight Geeral health (persoal) [Ifo] East of Eglad Race/ ethicity [Ifo] 1/3 of cliets were from miority groups. Occupatio [Ifo] 84 cliets (7.79%) were log term uemployed (over oe year). Other idicators of disadvatage [Ifo] deprived areas; 60.13% of cliets fell withi (ay) oe or more of the followig idicators 1 icome, employmet, health deprivatio threshold, disability, barriers to housig & services + 5 H, WB, I, P, U Greee, (2005)(Gr eee, 2005) Qualitati ve study lookig at factors that ifluece how ad whe youg mothers participate i their commuities as well as the barriers that youg mothers experiece regardig their iclusio i commuity based participatio Persoal assets Geder [Ifo] iterviews with 20 youg mothers betwee the ages of 16 ad 22 Socioecoomic idicators [Ifo] deprived commuities WB, I, P Gregso, (2010)(Gr egso ad Court, 2010) Practice descriptio Discussi o commuity empowermet Persoal wellbeig Commuity wellbeig Commuity assets Other [Ifo] commissioig health services Halliday, (2005)(H alliday ad Asthaa, Practice descriptio Discussi o health actio zoe partership workig Physical activity Persoal wellbeig Social capital/ cohesio Childre & Youg People/ Paretig Socioecoomic idicators

207 2005) Hamer (2000)(H amer ad Box, 2000) Mixed methods evaluatio Boscombe Network for Chage Boscombe Network for Chage, a health-related forum of statutory ad volutary agecy employees, voluteers ad local residets, set up i 1996, bor out of a cocer to promote chage i the deprived ward of Boscombe Social capital/ cohesio Other [Ifo] promote chage [Ifo] Boscombe Socioecoomic idicators [Ifo] The Jarma Idex of Deprivatio Score is 31.4 for the area, ad therefore geeral practitioers receive additioal paymet i recogitio of their populatio s greater health eeds. Other idicators of disadvatage [Ifo] deprived eighbourhoods P Hardill, (2007)(H ardill et al., 2007) Cocept/ theory voluteerig Socioecoomic idicators ++ 7 Harkis, (2012)(H arkis ad Ega, 2012) Mixed methods evaluatio Equally Well (Govahill test site). Equally Well is a key Scottish Govermet policy to reduce the atio s health iequalities Ulike the other Equally Well test sites throughout Scotlad the Govahill test site does ot have a particular health related theme. Rather, the test site ca be described as a localised partership approach (ivolvig public ad third sectors as well as commuity members) which aims to improve all aspects of life ad coditios i the area. Evaluatio evidece idicates that test site parters believe that this complete approach is the correct way to tackle the complexity of issues i the area ad to improve the health ad wellbeig of Govahill residets. Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (commuity) Race/ ethicity Govahill is also a diverse ad trasiet commuity ad is curretly playig host to the highest cocetratio of Easter Europea Roma migrats see i Scotlad Socioecoomic idicators Govahill is a area o Glasgow s Southside facig stark iequalities across a rage of social, ecoomic, health ad evirometal markers. Social capital [Ifo] high levels of atisocial behaviour ++ 2 H, P Harris, ()(Harris) Questio aire/ survey Healthwatch Torbay Healthwatch Torbay is the idepedet cosumer watchdog for health ad social care services i Torbay, esurig the voice of the commuity is used to ifluece ad improve services for local people. Persoal wellbeig [Ifo] support for carers Other idicators of disadvatage [Ifo] carers + 2 P Hatamia, (2012)(H atamia Mixed methods evaluatio the Active at 60 Commuity Aget Commuity agets (commuity groups ad their voluteers) to help people approachig ad post retiremet to stay or become more active ad positively egaged with society, i particular those at risk of social Commuity wellbeig Social capital/ cohesio Geeral health (commuity) Occupatio [Ifo] approachig ad post retiremet Other idicators of disadvatage WB, C, P 207

208 et al., 2012) Programme by Areeay isolatio ad loeliess i later life. [Ifo] those at risk of social isolatio ad loeliess i later life Hatzidimit riadou, (2012)(H atzidimitri adou et al., 2012) Qualitati ve study o ame provided- a commuitybased metal health project offerig Improve Access to Psychological Therapies (IAPT) services i the locality Metal health Commuity wellbeig Social capital/ cohesio Commuity assets Race/ ethicity [Ifo] Aimed at BME commuities. 17 therapists were from BME backgroud ad spoke 7 laguages betwee them WB, C, P Health (2007)(D epartme t of Health, 2007a) Policy Commissioi g framework for health ad wellbeig. Builds o the white paper Our health, our care, our say, providig a framework for actio. Commissioig framework. Commissioig for health ad well-beig meas ivolvig the local commuity to provide services that meet their eeds. Curret reform of public services rests o icreased ivestmet ad o devolvig power to local people so that they ca make the choices that affect their commuities Idividuals ad commuities eed to co-producers of iformatio i order to make effective decisios for idividuals ad groups Persoal wellbeig Commuity wellbeig Geeral health (persoal) Geeral health (commuity) ++ 2 Healthy Commui ties (2010)(H ealthy Commui ties, 2010) Mixed methods evaluatio Other [Ifo] cas e studies Bowmar Wome ad Girls Group; CAMGLEN Commuity Radio; Eyemouth ad District First Respoders; Girva Youth Trust; Healthy Valleys Iitiative; wome ad girls group; commuity radio; first respoders; youth trust; healthy livig cetre; commuity garde; Healthy Commuities Collaborative Physical activity Healthy eatig Metal health STIs Substace use Prevetio violece/ abuse/ crime Persoal wellbeig Social capital/ cohesio Persoal assets Other [Ifo] first respoder traiig, arts Childre ad Youg People/ Paretig [Ifo] Scotlad Race/ ethicity [Ifo] travellers Geder [Ifo] wome ad girls Other idicators of disadvatage [Ifo] travellers people with learig difficulties youg people older people people with disabilities people with metal health issues. There is a +++er rate of people deprived of employmet tha the atioal average, with 23% of childre livig i households where o adults work. There are comparatively +++ umbers of people livig H, WB, SDH, I, P 208

209 Make It Happe Girva s commuity garde; Perth ad Kiross Healthy Commuities Collaborative Geeral health (persoal) Safety/ accidet prevetio with limitig log term illess. Icideces of cacer ad coroary heart disease are sigificatly +++er tha the atioal average, as are the umbers of hospital admissios related to alcohol ad drug misuse. Hederso, (2002)(H ederso et al., 2002) Mixed methods evaluatio Qualitati ve study Sure Start Childre ad Youg People/ Paretig Socioecoomic idicators [Ifo] focused o deprived areas C, P Hills (2007)(Hil ls et al., 2007) Mixed methods evaluatio Healthy Livig Cetres Some HLCs focused o specific health-related services, but i keepig with the broad, holistic visio of the programme, may have sought to address the wider determiats of health iequalities, such as social isolatio, uemploymet ad poverty. Persoal wellbeig Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] wider determiats of health iequalities, such as social isolatio, uemploymet ad poverty Geeral health (persoal) Geeral health (commuity) Race/ ethicity [Ifo] miority ethic groups Occupatio [Ifo] uemployed Geder Other idicators of disadvatage [Ifo] "deprived" commuities those with the poorest health childre ad youg people families those with specific health coditios isolated, vulerable, hard-to-reach or iactive adults disabilities H, WB, SDH, I, C, P, E Hills, (2013)(Ly os et al., 2013) RCT political advocacy approach to reduce pedestria ijuries i deprived commuities Safety/ accidet prevetio Socioecoomic idicators [Ifo] deprived ++ 5 SDH, C Hoddiott (2006)(H oddiott et al., Qualitati ve study peer support for breastfeedig (oe to oe or groupbased) Healthy eatig [Ifo] breastfeedig Childre ad Youg People/ Paretig Geder [Ifo] wome - mothers + 3 H, P, U 209

210 2006a) Hoddiott (2006)(H oddiott et al., 2006b) Cotrolle d trial Questio aire/ survey [Ifo] ad diaries breastfeedig peer coachig iitiative Healthy eatig [Ifo] breastfeedig Childre ad Youg People/ Paretig Geder [Ifo] wome - mothers ++ 3 H, C, P, U Holde, (2002)(H olde ad Craig, 2002) Practice descriptio Discussio The Hull ad East Ridig Health Actio Zoe (HERHAZ) Activity Commuity developmet workers focusig o various health issues. HAZ evaluatio group, smokig cessatio, sexual health promotio, Physical activity Healthy eatig Substace use Commuity wellbeig Social capital/ cohesio Geeral health (commuity) Socioecoomic idicators [Ifo] Areas of deprivatio + 2 Home (2004)(H ome Office, 2004) Leicester City s Multi- Cultural Advisory Group; The REWIND programme; Shoreditch Our Way New Deal for Commuities Programme Leicester City s Multi- Cultural Advisory Group, which acts as a uofficial moitorig body for the city s various iitiatives aimed at tacklig obstacles to commuity cohesio.; REWIND - The project is based o exposig the myths that have bee created aroud issues of race ; Shoreditch NDC partership - The partership is ot cotet with the curret level of egagemet, but actively seeks to icrease the ivolvemet ad support of local residets. Social capital/ cohesio [Ifo] TACKLE RACISM Other [Ifo] regeeratio [Ifo] Leicester; Sadwell Race/ ethicity Other idicators of disadvatage [Ifo] CHILDREN AND YOUNG PEOPLE 2 7 Hothi (2007)(H othi et al., 2007) Mixed methods evaluatio The Local Wellbeig Project The project covers five mai strads: emotioal resiliece for 11 to 13 year olds; wellbeig of older people; guarateed appreticeships; eighbourhoods ad commuity empowermet; ad paretig. Metal health Commuity wellbeig Childre ad Youg People/ Paretig Geeral health (commuity) WB, C, P Hough (2014) (Hough Mixed methods evaluatio Co-producig cardiovascul ar health i three co-produced healthcare projects workig with ethic miority groups at high risk of cardiovascular disease (CVD) i Wadsworth. The three projects Physical activity Race/ ethicity: South Asia ad Somali wome; Africa- Caribbea me ++ 1, 2 H, WB, I, P 210

211 ad Lyall, 2014) Wadsworth icluded two cook ad eat projects for South Asia ad Somali wome, ad a exercise project for Africa- Caribbea me, which met weekly over a six week period. Commuity leaders were ivolved i the project desig ad delivery, ad commuity members coproduced the projects as they evolved over the six weeks Healthy eatig Disease prevetio Geeral health (persoal) Religio: Church etworks ad pastors were ivolved i the WCEN Deprived area, 4, 6, 8 Houghto, ()(Hought o) Practice descriptio The People's Family Project Providig opportuity for local families to atted free family based sessios al+ig opportuity to icrease physical activity, icrease educatio ad awareess about various aspects of health ad sigpost to local services. Physical activity Healthy eatig Metal health Substace use Childre & Youg People/ Paretig Geeral health (persoal) Hylad, (2006)(H ylad et al., 2006) RCT [Ifo] artic le reports o process data Qualitati ve study The Peer- Led Food Club (PLFC) project peer educators i utritio itervetios with older people Physical activity Healthy eatig Metal health Persoal wellbeig Social capital/ cohesio Socioecoomic idicators [Ifo] socially disadvataged areas of ortheast Eglad as appropriate Other idicators of disadvatage [Ifo] service users The study operated i sheltered accommodatio schemes i areas of relative disadvatage idetified usig a idex of multiple deprivatio by UK postcode + 3 H, WB, SDH, I, P Igram (2005)(I gram et al., 2005) Mixed methods evaluatio "Babes" breastfeedi g support iitiative breastfeedig peer support Healthy eatig [Ifo] breastfeedig Childre ad Youg People/ Paretig Geder [Ifo] wome - mothers Socioecoomic idicators [Ifo] area of social ad ecoomic deprivatio i Bristol ++ 3 H, I, P, U Igram (2013)(I gram, 2013) Mixed methods evaluatio Bristol Breastfeedi g Peer Support Service Type of activity Type of activity [Ifo] peer support for breastfeedig Healthy eatig [Ifo] breastfeedig Childre ad Youg People/ Paretig Geder [Ifo] wome - mothers + 3 H, WB, I, P Istitute for Questio aire/ voluteerig for metal voluteerig Metal health Occupatio + 7 H, WB, 211

212 Voluteer ig Research (2003)(I stitute for Voluteer ig Research, 2003) survey health [Ifo] may respodets were uemployed Other idicators of disadvatage [Ifo] people with direct experiece of metal ill health SDH, I Istitute for Crimial Policy Research (2011)(I stitute for Crimial Policy Research, 2011) Mixed methods evaluatio offeder health traier service The team delivers four mai types of work: 1. Helpig offeders register with GPs ad detists. 2. Oe-to-oe work with offeders developig a persoal health pla ad facilitatig health improvemet particularly aroud diet, fitess, smokig cessatio ad alcohol use. 3. Deliverig group work sessios o geeral health ad well-beig issues to offeders attedig the CJDT or participatig i offedig behaviour group work programmes. 4. Participatig i multiagecy health promotio campaigs. Physical activity Healthy eatig Substace use Persoal wellbeig Other [Ifo] registerig with GPs ad other local health services Geeral health (persoal) Other idicators of disadvatage [Ifo] offeders + 3 H, WB, I, P Ivolve (2004)(I volve, 2004) Practice descriptio Discussi o The TRUE project- Traiig for Public Ivolvemet i Research Other [Ifo] Semiar- how to ivolve people i research + 1 IRISS (2012)(Iri ss, 2012) Qualitati ve study Asset mappig project to discover commuity assets i Kirkitilloch that were useful ad available for positive metal health ad well-beig, but also to help others idetify their ow persoal assets. Metal health Persoal wellbeig Commuity wellbeig Persoal assets Commuity assets Other idicators of disadvatage [Ifo] people usig metal health services H, WB, I, C, P Nazroo (2012)(N azroo ad Matthews Other logitudi al aalysis Type of activity [Ifo] voluteerig Persoal wellbeig Occupatio [Ifo] retired Other idicators of disadvatage: older people + 7 WB, I 212

213 , 2012) Jarvis (2011) (Jarvis et al., 2011) Qualitati ve study case study eighbourhood regeeratio Commuity wellbeig Social capital/ cohesio Commuity assets Socioecoomic idicators [Ifo] Caley is i the top 20 % most deprived eighbourhoods i Eglad Other idicators of disadvatage [Ifo] is characterized by: above-average proportios of youg ad older residets; a higher pro- portio of loe parets; lower rates of ecoomic activity ad car owership; ad a higher proportio of social or private-reted accommodatio C, P Jeigs (2013) (Jeigs et al., 2013) Health Traiers Health traier service Physical activity Healthy eatig Other [Ifo] Weight chage Geeral health (persoal) [Ifo] blood pressure [Ifo] Great Yarmouth ad Waveey Geder [Ifo] The majority of participats were female Other idicators of disadvatage [Ifo] their mea age at baselie was 48.2 years; 30% lived i the most deprived quitiles (20%) of atioal deprivatio + 3 H, I Jolly (2012)(Jo lly et al., 2012) RCT peer support worker service for breastfeedig Healthy eatig [Ifo] breastfeedig Childre ad Youg People/ Paretig Race/ ethicity [Ifo] multi-ethic Geder [Ifo] wome - mothers Socioecoomic idicators [Ifo] socioecoomically disadvataged populatio + 3 H, U Joes, ()(Joes) Practice descriptio Leeds Gypsy ad Traveller Exchage (GATE) Commuity led orgaisatio with a rage of projects ad services. Focussig icreasigly o asset based commuity developmet ad co-productio. The overall aim of Leeds GATE is to improve the quality of life for Gypsy ad Irish Travellig people livig i or resortig to Leeds ad we have four objectives: to improve accommodatio provisio; improve health ad well-beig; improve educatio, employmet ad fiacial iclusio; ad to icrease citizeship ad Persoal wellbeig Commuity wellbeig Social capital/ cohesio Persoal assets Commuity assets Other [Ifo] improvig accommodatio, educatio, employmet ad fiacial Race/ ethicity [Ifo] Gypsy ad Irish Travellig People livig i Leeds Religio/ culture Socioecoomic idicators

214 social iclusio. iclusio Geeral health (persoal) Geeral health (commuity) Joseph Rowtree Foudati o (2011)(Jo seph Rowtree Foudati o, 2011) support ad facilitate commuity activity which addresses loeliess amogst people at the eighbourhood level; Persoal wellbeig Social capital/ cohesio Social capital [Ifo] social isolatio/ loeliess Kashefi (2004)(K ashefi ad Mort, 2004) Qualitativ e study The South West Burley citizes jury o health ad social care Citize jury -twelve local people aged betwee 17 ad 70 were recruited to come together for a week to hear evidece, ask questios ad debate what they felt would improve the health ad well-beig of people livig i the area Commuity assets Other [Ifo] Jury steerig group-the jury process acted effectively as a grass-roots health eeds assessmet Socioecoomic idicators [Ifo] A area sufferig itractable health iequalities. Social capital [Ifo] There is a strog sese of commuity i some parts of the area while other parts are fragmeted Other idicators of disadvatage [Ifo] poverty ad + pay; poor housig ad proliferatio of empty properties; high levels of death, illess ad disability; ++ 2 WB, P Kelly (2004)(K elly, 2004) Mixed methods evaluatio Other discusses fidigs of research published i other papers Disease prevetio [Ifo] HIV/ AIDS prevetio STIs Other idicators of disadvatage [Ifo] gay me + 3 H, I, P Keedy Qualitati lay food ad commuity-based food iitiatives Healthy eatig Other idicators of disadvatage + 5 H, I, 214

215 (2008)(K eedy et al., 2008) ve study health worker helpig roles [Ifo] "hard to reach" eighbourhoods C, P Keedy (2010)(K eedy, 2010) Qualitati ve study Lay Food ad Health Workers commuity utritio Healthy eatig Disease prevetio Social capital/ cohesio Geeral health (persoal) Socioecoomic idicators [Ifo] less affluet eighbourhoods Other idicators of disadvatage [Ifo] hard to reach groups H, WB, SDH, P Keedy, (2006)(K eedy, 2006) Qualitati ve study Lay Food ad Health Worker scheme Socioecoomic idicators [Ifo] less affluet eighbourhoods WB, P, U Keedy, (2006)(K eedy et al., 2006) Policy Cocept/ theory Evaluatio / research Sustaiable Dialogues iitiative, Clackmaa shire; Quality Actio Group, commuity developmet icludig people with learig difficulties Healthy eatig Geeral health (persoal) Socioecoomic idicators [Ifo] "less affluet eighbourhoods" + 5 Keedy, (2006)(K eedy et al., 2006) Practice descriptio Lay Food ad Health Worker role lay ivolvemet i commuity utritio Commuity wellbeig Social capital/ cohesio [Ifo] social iclusio Social capital [Ifo] social iclusio/ exclusio Other idicators of disadvatage [Ifo] people with learig difficulties ++ Kimberle e, (2008)(Ki mberlee, 2008) Qualitativ e study Birmigham City Coucil s Streets Ahead o Safety project youg people's participatio i decisio-makig to address the Europea road ijury 'epidemic'. aims to improve road safety ad quality of life i a area of multiple deprivatio Childre ad Youg People/ Paretig Safety/ accidet prevetio Race/ ethicity Religio/ culture [Ifo] 58% Muslim Other idicators of disadvatage [Ifo] oe third of residets are uder 16 years old H, C, P Kirkham, (2000)(Ki Practice descriptio Breastfrie ds peer support for breastfeedig Healthy eatig [Ifo] breastfeedig + 215

216 rkham, 2000) Docaster Childre & Youg People/ Paretig Kriste (2010)(M acpherso et al., 2010) Qualitati ve study Home Start paretal support scheme Social capital/ cohesio Persoal assets [Ifo] traiig provided to mothers Childre ad Youg People/ Paretig -Throughout Eglad Geder- mothers Socioecoomic idicators -Social Disadvatage Idex Other idicators of disadvatage] hard to reach; vulerable families; Participats had all bee idetified i pregacy as likely to have some vulerability WB, I, P Lamb (2002)(La mb et al., 2002) RCT health walks a commuity based lay-led walkig scheme, compared to advice from health care professioal oly Physical activity + 5 Volut eers H, I Laverack (2006)(La verack, 2006) Cocept/ theory Practice descriptio provides a predetermied focus through each of ie empowermet domais : Improves participatio; Develops local leadership; Icreases problem assessmet capacities; Ehaces the ability to ask why ; Builds empowerig orgaizatioal structures; Improves resource mobilizatio; Stregthes liks to other orgaizatios ad people; Creates a equitable relatioship with outside agets; ad Icreases cotrol over programme maagemet Lawless (2004)(La wless, 2004) Mixed methods evaluatio New Deal for Commuities eighbourhood regeeratio Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Commuity assets Other eighbourhood regeeratio Socioecoomic idicators [Ifo] deprived areas Social capital P Lawless, (2007)(La wless et al., 2007) Qualitati ve study [Ifo] 6 case studies New Deal for Commuities eighbourhood reewal, regeeratio Commuity wellbeig Social capital/ cohesio Commuity assets Other Socioecoomic idicators [Ifo] areas of deprivatio Social capital SDH, C, H, P, U 216

217 [Ifo] regeeratio/ reewal Lawso, (2009)(La wso ad Kears, 2009) Qualitati ve study Regeeratio. Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Commuity assets Other- urba regeeratio Race/ ethicity [Ifo] sigificat proportio of asylum seekers ad refugees (up to 40%) C, P Liverpool (2012)(Li verpool Joh Moore's Uiversity, 2012) Mixed methods evaluatio It explores the role ad value of Health Improvemet Practitioers employed by NHS Ashto, Leigh ad Wiga, the traiig they have delivered, ad the impact it has had. The evaluatio also explores the developmet of the Health Champio approach ad the impact it has had o recipiets at a idividual ad orgaisatioal level. Physical activity Healthy eatig Metal health Disease prevetio Substace use Social capital/ cohesio Persoal assets Commuity assets Other Geeral health (persoal) Geeral health (commuity) [Ifo] Ashto, Leigh ad Wiga s Other idicators of disadvatage [Ifo] disadvataged groups, offeders, youg mums, Deprivatio is +++er tha average ad about 12,100 childre live i poverty [Ifo] health cham pios WB, SDH, P Ward (2009)(W ard ad Baks, 2009) Mixed methods evaluatio health traiers health traiers: lay workers to ecourage idividual behaviour chage Physical activity Healthy eatig Metal health Substace use Persoal wellbeig Geeral health (persoal) Socioecoomic idicators [Ifo] deprived commuities Other idicators of disadvatage [Ifo] older people H, WB, P Lorec (2013)(Lo rec ad Wills, 2013) Mixed methods evaluatio Health Traier Case Stories (support aroud; healthy eatig, physical activity, alcohol, smokig ad stress maagemet) Physical activity Healthy eatig Metal health Substace use Geeral health (persoal) H, WB, SDH, C, H, P Rocket Sciece Ltd (2011)(R ocket Sciece Ltd, Qualitati ve study Health Weight Commuities iitiative Pathfiders. The purpose of the Healthy Weight Commuities Programme was to demostrate the ways i which egagig commuities i healthy eatig, physical activity ad healthy weight activities as part of a sigle coheret programme may have a greater impact o health outcomes tha curret discrete activities. Physical activity Healthy eatig Commuity wellbeig Geeral health (persoal) SDH, C, P 217

218 2011) MacArthu r (2009)(M acarthur et al., 2009) RCT [Ifo] Clu ster RCT Iitiatio of breast feedig? Support to iitiate breast feedig Healthy eatig Childre ad Youg People/ Paretig Race/ ethicity [Ifo] multi-ethic- The sample was multiethic, with oly 9.4% of wome beig white British, ad 70% were i the +est 10th for deprivatio. Socioecoomic idicators [Ifo] multi-ethic, deprived populatio. + 3 P, U Mackio (2006)(M ackio et al., 2006) Qualitati ve study commuity based health improvemet Commuity wellbeig Social capital/ cohesio Geeral health (persoal) Geeral health (commuity) 1 2 P Mackito sh, (2012)(M ackitosh, 2012) Practice descriptio GlasGrow project The project aims to improve the health, utritio ad icome-geeratig opportuities for commuities i Gova. As well as offerig utritious meals, the ew PI café will also eable people to buy fresh food locally, from local producers, ad will hopefully geerate a sustaiable icome to help the wome s groups cotiue their vital work. Healthy eatig Persoal wellbeig Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (persoal) Geeral health (commuity) Race/ ethicity Occupatio [Ifo] +++ uemploymet Socioecoomic idicators [Ifo] deprived Mahoey, (2007)(M ahoey et al., 2007) Cocept/ theory Health Impact Assessmet typology of public ivolvemet / commuity participatio i HIA Marais (2007)(M arais, 2007) Mixed methods evaluatio Toward the Improvemet of TB Cotrol ad Participatory Research A multi-method Commuity-based Participatory Research study of TB i migrat Africa commuities Disease prevetio TB Race/ ethicity- Africa H, WB, SDH, C, P Bares (2008)(B Policy Practice citizecetred Reflects o how to create flexible ad effective orgaisatios for deliverig public services that also Commuity wellbeig Social capital/ Socioecoomic idicators

219 ares et al., 2008b) descriptio Discussi o goverace reflect the values of local democracy. cohesio Commuity asset [Ifo] areas of disadvatage Marmot (2009)(D epartme t of Health, 2009b) Policy Discussio Natioal health iequalities strategy, the Programme for Actio policies to tackle iequalities; workig i partership Disease prevetio Substace use Social capital/ cohesio Other [Ifo] life expectacy/ mortality; educatio; child poverty; housig etc. Childre & Youg People/ Paretig Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators + 2 Kearey (2004)(K earey, 2004) Qualitati ve study HIA of the Castlefields Regeeratio Masterpla Health Impact Assessmet; The aim of the curret study, coducted before the Masterpla was completed, was to assess how commuity participatio i the HIA would be affected by the attitudes ad experieces of key stakeholders Other [Ifo] regeratio Geeral health (commuity) [Ifo] Impact of regeeratio work [Ifo] The Castlefields estate i Rucor Other idicators of disadvatage [Ifo] The Castlefields estate i Rucor is i the top 2% most deprived wards i Eglad + 2 P Matthiese (2014)(M atthiese et al., 2014) Practice descriptio Discussio Cumbria Coversatio s for Life Egagig 6 commuities across oe regio Merseyside ad Cheshire Cumbria Coversatios for Life: developmet of a public health campaig Egagig 6 commuities: used a facilated asset based approach to egage 6 commuities to lead their ow awareess iitiative, facilitatig commuity-led awareess iitiatives cocerig ed-of-life coversatios ad care by idetifyig ad coectig existig skills ad expertise. Commuity assets Other [Ifo] ed of life issues Mauger (2010)(M auger Policy Discussi user ivolvemet "thik piece" o the process of user ivolvemet Geeral health (persoal) Other idicators of disadvatage [Ifo] Older people

220 ad et al., 2010) o McDaid, (2009)(M cdaid, 2009) Cocept/ theory participatory actio research i metal health policy ad plaig Metal health Other idicators of disadvatage [Ifo] metal health service users McIes (2000)(M cies et al., 2000) Cotrolle d trial Questio aire/ survey peer cousellig to promote breastfeedig i the ateatal ad postatal periods. breastfeedig promotio programme comprisig persoal peer cousellig of pregat wome, post-atal support ad local awareess raisig activities over a period of 2 year Healthy eatig [Ifo] breastfeedig Childre ad Youg People/ Paretig Geder [Ifo] wome - mothers Socioecoomic idicators + 3 McLea (2012)(M clea ad McNeice, 2012) Qualitative study [Ifo] case studies illustratig asset based approaches for health improvemet Physical activity Metal health Persoal wellbeig Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] Peer metorig, crafts, homemakig, recyclig, gardeig Geeral health (persoal) Geeral health (commuity) Other idicators of disadvatage [Ifo] prisoers; ex-offeders; uemployed; people from disadvataged backgrouds; older people; people with poor metal health; childre ad youg people; youg dads; homeless H, WB, SDH, I, C, H, P, E Mellaby, (2001)(M ellaby et al., 2001) Mixed methods evaluatio A PAUSE experimet programme of sex educatio for secodary schools STIs Other [Ifo] sex educatio Childre ad Youg People/ Paretig Occupatio [Ifo] school pupils + 3 H, I, P Metal Health Foudati o Mixed methods evaluatio Music ad Chage MAC-UK developed a iovative model Itegrate which provides metal health ad geeral support i a youth-led way, ad cosiders youg people experts i their ow experiece. Metal health promotio is at the Metal health Other [Ifo] Youg people ivolved i gags Educatio-absece of formal educatio Other idicators of disadvatage-youg people ivolved i gags. By takig metal health services ito the commuity, they reach youg people who WB, SDH, I, P 220

221 (2013)(M etal Health Foudati o, 2013) cetre of the model which aims to: (1) reduce serious youth violece ad reoffedig; (2) promote the treatmet ad metal health eeds of youg people; (3) egage youg people i traiig, educatio ad/or employmet; ad (4) bridge youg people ito appropriate existig services. Childre ad Youg People/ Paretig ormally would ot seek help, but preset with a umber of complex issues such as homelessess, domestic violece, leavig care, absece of formal educatio, poverty ad uemploymet. Marmot (2010)(M armot, 2010) Policy Marmot Review: Fair Society, Healthy Lives Achievig health ad wellbeig policy goals will ot be achievable without actio from local ad atioal govermet, the NHS, the third ad private sectors ad commuity groups. Effective participatory decisio makig at a local level is required. Empowermet of commuities ad idividuals is at the heart of actio Creatig a eablig society that maximises idividual ad commuity potetial should be a policy goal (p.20). For some commuities to take cotrol of their ow lives will require the removal of structural barriers to participatio or developig capability through persoal/commuity developmet. There eeds to be a more systematic approach to egagig commuities by local strategic parterships; movig beyod brief cosultatios to effective participatio where commuities defie problems ad develop solutios. The review provides evidece ad directios of travel (p.34), ot detailed prescriptio of delivery. Disease prevetio Substace use Persoal wellbeig Safety/ accidet prevetio Social capital/ cohesio Childre & Youg People/ Paretig Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators Social capital Morga (2004)(M orga et al., 2004) Mixed methods evaluatio Questio aire/ survey Social capital for health a collectio of quatitative research projects that ivestigate the relevace of the cocept of social capital to health developmet i Eglad. Social capital/ cohesio Commuity assets Social capital I, C Murray, ()(Murray ) Mixed methods evaluatio CALL-ME (Commuity Actio i Later Life - Machester Egagemet) The CALL-ME project is a three year collaborative ad participat the processes ivolved i developig local commuitybased strategies for promotig ehaced social iteractio amog older residets of four disadvataged of these activities o improvig opportuities for older Persoal wellbeig Commuity wellbeig Social capital/ cohesio Socioecoomic idicators [Ifo] disadvataged eighbourhoods Other idicators of disadvatage [Ifo] older people WB, SDH, I, C 221

222 procedures for etrechig ad broadeig these activities. Muscat (2010)(M uscat, 2010) Other [Ifo] met hods ot described New Deal for Commuities Area based iitiatives; eighbourhood reewal/ regeeratio Prevetio violece/ abuse/ crime Persoal wellbeig [Ifo] educatio Commuity wellbeig Social capital/ cohesio Persoal assets Other regeeratio Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] deprived localities Social capital Other idicators of disadvatage H, SDH, C, H, P Naylor (2013)(N aylor et al., 2013) Mixed methods evaluatio Qualitati ve study voluteerig Commuity wellbeig Geeral health (commuity) P Nesta (2012)(N esta, 2012b) Practice descriptio Discussi o By us, for usthe power of co-desig ad codelivery 'People powered approach' to co-productio ad codelivery Commuity assets Other [Ifo] Access to services NESTA (2012)(N esta, 2012a) Practice descriptio people powered health co-productio Metal health Persoal wellbeig Social capital/ cohesio Other [Ifo] self help Geeral health (persoal)

223 NESTA (2013)(N esta, 2013) Other People Powered Health peer support Geeral health (persoal) [Ifo] log term coditios + 3 WB, I, P, E Neumark (2010)(N eumark, 2010) Practice descriptio The Take Part approach Commuity empowermet - helpig people to; gai the skills, kowledge ad cofidece to become empowered, eablig them to make a active cotributio to their commuities ad ifluece public policies ad services. Commuity wellbeig Geeral health (commuity) ++ 1 New Ecoomic s Foudati o (2002)(N ew Ecoomic s Foudati o, 2002) Mixed methods evaluatio commuity time bak commuity time bak Persoal wellbeig Social capital/ cohesio -Rushey Gree Race/ ethicity-, 44 per cet are from miority ethic group Geder- 29 per cet me, 71 per cet wome. Of these, 44 per cet are from miority ethic groups ad 52 per cet have some kid of disability. Other idicators of disadvatage -52 per cet have some kid of disability; WB, I, H, P Newbur (2013)(N ewbur et al., 2013) Practice descriptio Birth ad Beyod Commuity supporters traiig refugees ad asylum seekers as peer supporters for pregat ad ew mothers i their commuities. The role of the NCT commuity peer supporters is to egage with local parets as befrieders, offerig empathy ad ecouragemet, ad to sigpost them to relevat services. Persoal wellbeig; Childre & Youg People/ Paretig wome from the South Asia commuities i East Lacashire ad the West Midlads ad youg army families i Catterick Garriso, North Yorkshire as well as refugee ad asylum-seekig wome i West Yorkshire. + 3, 8 Newbur (2014)(N ewbur ad Bhavai, 2014) Practice descriptio Commuity paret befrieders peer support for pregat ad ew mothers Persoal wellbeig; Childre & Youg People/ Paretig South Asia wome; ew mothers; area of high deprivatio + 3 NHS (2012) Practice descriptio commuity health champios Persoal wellbeig Commuity assets Geeral health Race/ ethicity Religio/ culture

224 (persoal) Geeral health (commuity) Socioecoomic idicators Social capital 5 North West Public Health Observat ory (2011)(N orth West Public Health Observat ory, 2011) Mixed methods evaluatio Health Traiers health traiers offerig geeral support Physical activity Healthy eatig Metal health Socioecoomic idicators [Ifo] workless, homeless Other idicators of disadvatage [Ifo] ex-offeders, metal health issues + 3 H, WB, I O'Brie, (2011)(O' Brie et al., 2011) 2 separate studies Eviromet al voluteerig Study 1: geeral evirometal voluteerig i Norther Eglad ad Souther Scotlad. Study 2: metal health participats at Meawhile Wildlife Garde i Lodo. Metal health Geeral health (commuity) Other idicators of disadvatage [Ifo] metal health issues. Voluteers from a rage of ages ad differet socioecoomic backgrouds + 7 WB, SDH, I, P Office of The Deputy Prime Miister (2002)(Of fice of the Deputy Prime Miister, 2002) Qualitativ e study Questio aire/ survey summarises the evaluatio evidece draw from te case study Regeeratio Budget parterships eighbourhood regeeratio; area based iitiative Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] regeeratio Socioecoomic idicators [Ifo] targetig social eed ad deprivatio Social capital SDH, C, P Office of the Deputy Prime Miister (2004)(Of Mixed methods evaluatio Other [Ifo] cas residets' cosultacy pilots iitiative The Residets Cosultacy Pilot (RCP) iitiative recogised this fact. It ivestigated the extet to which residets with experiece of effective commuitybased regeeratio could play a valuable role i providig advice ad ispiratio to others, ad promotig good practice to brig about chage; The Persoal assets- Beefits for the cosultats have icluded icreased cofidece ad ehaced skills, icludig the [Ifo] Ket, Birmigham, Lodo, Sheffield, Plymouth, Liverpool, Oldham, Suderlad WB, SDH, U 224

225 fice of the Deputy Prime Miister, 2004) e studies aim was to test differet approaches to egagig ad trasferrig residets expertise i order to promote eighbourhood reewal ad commuity-led regeeratio realisatio of previously urecogised skills.. Office of the Deputy Prime Miister (2005)(Of fice of the Deputy Prime Miister ad Neighbou rhood Reewal, 2005) Qualitati ve study 2 focus groups i each of the 39 NDC areas. those seekig work or people over 55. New Deal for Commuities eighbourhood reewal/ regeeratio Commuity wellbeig Social capital/ cohesio Other [Ifo] eighbourhood regeeratio Socioecoomic idicators [Ifo] NDC areas are geerally "deprived" Social capital [Ifo] NDC areas are geerally areas of social exclusio WB, C, P Office of the Deputy Prime Miister (2006)(Of fice of the Deputy Prime Miister, 2006) Mixed methods evaluatio The Pathfider Programme Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Safety/ accidet prevetio Socioecoomic idicators ++ 1 WB, SDH, C, P Osbore (2002)(O sbore et al., 2002) case studies rural regeeratio parterships rural regeeratio parterships i the UK Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] regeeratio + 2 C, P Owes before Roy Castle adult smokig-cessatio service across Liverpool. Substace use ++ 1 H, P, 225

226 (2006)(O wes ad Sprigett, 2006) ad after study Fag Eds Commuity Stop Smokig Service Uique aspects are that the service is provided by traied lay advisors with a omedical backgroud ad there is o waitig list cliets ca self-refer by callig a helplie or walkig ito a meetig. [Ifo] SMOKING CESSATION [Ifo] Liverpool 5 U Passa, (2014)(P assa) Practice descriptio Leeds Ivolvig People Leeds Ivolvig People is a iovative orgaisatio that leads o ivolvig citizes i redesigig the health ad social services. The orgaisatio has strog liks with CQC ad Leadership Academy, ad are a cosortia parter withi Healthwatch, CCGs, REACT, Leeds Teachig Hospital, Leeds Commuity Healthcare, NHS IR, WYCLRN, West Yorkshire Police. Aims to esure the voice of the citize is at the heart of service provisio, commissioig ad evaluatio by workig with a rage of parters icludig regulatory bodies, providers, commuity sector ad commissioers. Supportig ad traiig citizes to be ivolved ad orgaisatios to ivolve citizes, i all their activities to meet emergig eeds of icreased populatio demads (i a co-productio approach) by havig policies ad practises that ecourage ivolvemet. Other redesigig health ad social services. health ad social care traiig orgaisatios i citize ivolvemet ad traiig citizes (patiets ad public) to be ready to be ivolved ad esure strog participatio i a solutio focused approach Metal Health Geeral health (commuity) Race/ ethicity Other idicators of disadvatage [Ifo] Patiets/ service users? Vulerable commuities Hard to reach ad seldom heard, older people, metal health, dual diagosis LIP works with Deaf commuities, partially sighted, Older ad other vulerable groups icl BME whose represetatio is poor Pemberto, (2008)(P emberto ad Maso, 2008) Qualitati ve study Sure Start Childre's Cetres Sure Start childre's Cetres (SSCCs) - created to address child poverty ad social exclusio with a emphasis o participatory approaches. Social capital/ cohesio Childre ad Youg People/ Paretig Race/ ethicity Social capital C, P Persoal (2009) Mixed methods evaluatio Parterships for Older People Programme aims to create a sustaiable shift i the care of older people, movig away from a focus o istitutioal ad hospital based crisis care toward earlier ad better targeted itervetios withi commuity settigs. Older people are ivolved i desig but mai parterships are betwee professioals. Disease prevetio Persoal wellbeig Social capital/ cohesio Geeral health (persoal) Other idicators of disadvatage [Ifo] older people H, WB, P Phillips (2012)(P hillips et RCT Questio aire/ Well Lodo The Well Lodo program used a commuity egagemet ad co-productio approach to desig ad deliver a suite of commuity-based projects with the aim Physical activity Healthy eatig Metal health Socioecoomic idicators [Ifo] defied as UK cesus +er super output areas H, U 226

227 al., 2012) survey of icreasig physical activity, healthy eatig, ad metal health ad wellbeig i 20 of the most deprived eighbourhoods i Lodo. Persoal wellbeig Commuity wellbeig Geeral health (commuity) (LSOAs); raked i the 11% most deprived LSOAs i Lodo by the Eglish Idices of Multiple Deprivatio) Phillips (2014)(P hillips et al., 2014) Study desig RCT Well Lodo commuity egagemet activity to promote health ad wellbeig Physical activity Healthy eatig Metal health Persoal wellbeig Commuity wellbeig Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] deprived ier city eighbourhoods H, WB, I Place Shapers Group (2011)(Pl ace Shapers Group, 2011) Practice descriptio Workig with commuities to improve homes, health, opportuities ad aspiratios Metal health Prevetio violece/ abuse/ crime Other [Ifo] support, advice, protectio ad alterative sources of fiace to help people avoid ad defeat illegal, doorstep leders Platt (2005)(Pl att et al., 2005) Mixed methods evaluatio Healthy Livig Cetre Programme i Scotlad Fidigs cover six key aspects of HLC strategic ad operatioal activity: iitiatio ad developmet of the HLC; partership workig; commuity ivolvemet; tacklig iequalities i health; sustaiig the HLC beyod the iitial BLF fudig period; ad moitorig ad evaluatio. Commuity wellbeig Social capital/ cohesio Commuity assets P Platt (2003)(Pl att et al., 2003) Mixed methods evaluatio Breathig Space commuity-based programme usig iovative approach to try to achieve a sigificat shift i commuity attitudes towards o-smokig Substace use [Ifo] smokig Socioecoomic idicators H, I, C, P Power (2001)(P ower ad Huter, Mixed methods evaluatio A survey of 100 Big Issue ewspaper Commuity-based health promotio targetig homeless populatios Geeral health (persoal) Occupatio [Ifo] Big Issue vedors + 1 H, WB, I 227

228 2001) vedors Pritchard, (2006)(Pr itchard et al., 2006) Other [Ifo] met hods used ot stated Greewich Commuity Food Co-op commuity food iitiatives Healthy eatig [Ifo] Greewich Other idicators of disadvatage [Ifo] Forty-five per cet of customers had a gross household icome of less tha 150 per week H, SDH, I, P Qui (2012)(Q ui ad Kifto, 2012) Qualitativ e study Positive Metal Attitudes metal health iequalities iitiative: promotig metal health Metal health Commuity wellbeig Social capital/ cohesio Commuity assets Occupatio [Ifo] over 50% of the adult populatio are ecoomically iactive Educatio [Ifo] 58% have o qualificatios Socioecoomic idicators [Ifo] UK's highest cocetrated area of socioecoomic deprivatio Other idicators of disadvatage [Ifo] 30% state that they have a log-term limitig illess +++; C, P Qui, (2005)(Q ui ad Kifto, 2005) Mixed methods evaluatio Positive Metal Attitudes Programme H, WB, C, P Raie (2003)(R aie, 2003) Qualitati ve study peer-support itervetio to promote breast-feedig i a deprived area Healthy eatig [Ifo] breastfeedig Childre ad Youg People/ Paretig Geder [Ifo] Wome - mothers Other idicators of disadvatage [Ifo] "deprived area" H, I, P Reece, (2012)(R eece ad Flit, 2012) Mixed methods evaluatio commuity health champios Physical activity Healthy eatig Metal health Geeral health (commuity) WB, I, P Reeve, Qualitati catcho2us! Requiremets icluded local ivolvemet i all aspects Persoal wellbeig WB, 228

229 (2007)(R eeve ad Peerbhoy, 2007) ve study case study Other discussio of evaluatio methodol ogy (Healthy Livig Cetre) of developmet ad delivery of services, joit workig betwee local agecies icludig the NHS, ad evaluatio of idividual HLC projects to provide a evidece base Commuity wellbeig Social capital/ cohesio Geeral health (persoal) Geeral health (commuity) 2 4 C, P Ritchie (2001)(Ri tchie, 2001) Qualitati ve study Other [Ifo] ad mappig exercise Breathig Space The aim of the itervetio is to produce a sigificat cultural shift i the local commuity towards otoleratio ad o-practice of smokig, through the developmet of a iterliked ad co-ordiated respose across a rage of health promotio settigs based o commuity actio Substace use [Ifo] smokig [Ifo] Ediburgh Geder [Ifo] me ad wome Socioecoomic idicators [Ifo] + icome Other idicators of disadvatage [Ifo] adults ad youg people years; areas of disadvatage P Ritchie (2004)(Ri tchie et al., 2004) Qualitati ve study Breathig Space The aim of the programme was to capitalize o local kowledge ad ecourage local ivolvemet i the developmet of a programme of activities that would create a supportive eviromet to eable local people to make healthy choices. Substace use [Ifo] smokig Socioecoomic idicators P Robiso (2010) Mixed methods evaluatio to review curret policy, guidelies ad practice o patiet public egagemet (PPE) i sexual ad reproductive health ad HIV/ AIDS (SRHH) services, ad produce recommedatios o how to effectively egage patiets ad the public i SRHH services i Lodo i order to iform SRHH strategies. Disease prevetio STIs Geeral health (persoal) [Ifo] sexual ad reproductive health + 2 C, P, U Robiso, (2010)(R obiso et al., 2010) Qualitativ e study Workig our Way to Health Ehacig the health of me i deprived areas. The programme was udertake with me to icrease their health kowledge, ad ecourage behaviour modificatio ad access to health improvemet services. Physical activity Healthy eatig Metal health Disease prevetio Substace use Social capital/ cohesio Occupatio [Ifo] + paid maual occupatios, uemployed, o icapacity beefit, or actig as carers, Geder [Ifo] Males Socioecoomic idicators H, WB, C, P 229

230 Geeral health (persoal) Geeral health (commuity) [Ifo] me aged 35 years ad above i + paid maual occupatios, uemployed, o icapacity beefit, or actig as carers, i the most deprived areas of Sefto. Roma Support Group (2009)(R oma Support Group, 2009) Qualitati ve study Actio Research Roma Support Group Actio Research i order to idetify the barriers ad eablers faced by the Roma refugee ad migrat commuity whe egagig i maistream empowermet mechaisms. Persoal wellbeig Commuity wellbeig Other [Ifo] egagemet with public services, icludig health Geeral health (commuity) Race/ ethicity [Ifo] Roma refugee ad migrat commuity Religio/ culture Socioecoomic idicators Social capital P Romeo- Velilla, ()(Romeo -Velilla) Practice descriptio My Commuity Matters MCM is a commuity-led itervetio based o the Coectig Commuities (C2) framework. This is a bottom-up approach of accelerated eighbourhood developmet that aims to improve health, wellbeig ad local coditios i disadvataged areas. Prevetio violece/ abuse/ crime Persoal wellbeig Commuity wellbeig Social capital/ cohesio Commuity assets Other Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators [Ifo] disadvataged areas Social capital Rosebur g (2011)(R oseburg, 2011) Walterto ad Elgi Commuity Homes (WECH) commuity-owed ad maaged social housig agecy Commuity wellbeig Social capital/ cohesio Commuity assets Socioecoomic idicators [Ifo] poor eighbourhoods Social capital WB, SDH, C, P Royal Society for Public Health (2011)(R oyal Society Evaluatio / research Discussi o The Youth Health Champio (YHC) Health Traier Service, which eables youg childre to act as health advisors to their peers. Physical activity Healthy eatig Metal health Substace use Childre & Youg People/ Paretig Geeral health Educatio [Ifo] Secodary school level Socioecoomic idicators [Ifo] deprived areas

231 for Public Health, 2011) (commuity) Sadare (2011)(S adare, 2011) Mixed methods evaluatio Qualitativ e study Well Lodo programme (World Cafe) a 5 year health promotio programme icorporatig metal wellbeig, physical activity ad diet Physical activity Healthy eatig Metal health Persoal wellbeig Commuity wellbeig Social capital/ cohesio Commuity assets Socioecoomic idicators [Ifo] multiple deprived eighbourhoods Social capital P Salisbury, ()(Salisbu ry) Practice descriptio Bristol Crisis Service for wome Metal health Persoal wellbeig Geeral health (persoal) 4 Scottish Goverm et (2009)(Sc ottish Goverm et, 2009) Policy Scottish Commuity Empowerme t Actio Pla commuity empowermet policy Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (commuity) Socioecoomic idicators [Ifo] tacklig health iequalities Scottish Commui ty Develop met Cetre (2011)(Sc ottish Commui ty Develop met Cetre, Practice descriptio Mugo Foudatio; Toy Box; The Muslim Elderly Day Care Cetre; Jewish Care; The Crahill commuity project; Glasgow Commuity Plaig The Roma Catholic Church established the Mugo Foudatio, which ow rus over 50 differet projects icludig care homes ad hostel accommodatio; The Quaker commuity set up the Toy Box project i Barliie priso, a iitiative desiged to support voluteers to look after childre of visitors to the priso visitig rooms, esurig that the childre s visit to a priso is a good experiece. The Muslim Elderly Day Care Cetre, commuity plaig processes; Equality ad Huma Rights Commissio; heritage work Substace use Social capital/ cohesio Other [Ifo] homelessess; offeders; socio-cultural activities, healthcare ad welfare surgeries, adult educatio ad advice ad iformatio; welfare, ESOL, COMMUNITY PLANNING; HERITAGE [Ifo] Scotlad Religio/ culture [Ifo] Roma Catholic, Quaker, Muslim, Jewish commuity, Church of Scotlad Other idicators of disadvatage [Ifo] homeless, offeders, older people, childre

232 2011) Partership (Equality ad Huma Rights Commissio, Calto Parkhead Parish Church; Orbisto Neighbourhood Cetre) Childre & Youg People/ Paretig Scottish Commui ty Develop met Cetre (2013)(Sc ottish Commui ty Develop met Cetre, 2013) Other [Ifo] ot sure this is research! asset based approaches Draws o curret debates o assets based approaches to health improvemet to support the developmet of a culture of thoughtfuless. Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (commuity) Seebohm (2008)(S eebohm ad Gilchrist, 2008) Mixed methods evaluatio It explores how commuity developmet ca cotribute to a idividual s recovery from metal illhealth ad also how it ca promote commuity well-beig withi a locality or commuity of iterest. Metal health Other [Ifo] commuity developmet DIFFERENT SETTINGS ACROSS uk Race/ ethicity CD PRACTITIONERS: About two thirds (12) described themselves as White British, ad the rest were Australia (oe), Europea (oe) Pakistai (three), Caribbea (oe) ad Africa (oe); The metal health survivors, activists, service users ad carers- Nearly two thirds described themselves as White British, ad the others were Caribbea, Africa, Turkish, Africa Asia, Pakistai, ad Black Other (Nubia). Occupatio practitioers Geder Other idicators of disadvatage 7 P Seebohm (2012)(S eebohm et al., Qualitativ e study Iitiatives- UTASS, Sharig Voices ad commuity developmet Physical activity Healthy eatig Metal health Commuity wellbeig + 3 P 232

233 2012) Beat the Blues Social capital/ cohesio Geeral health (commuity) Seder, (2011)(S eder et al., 2011) Natioal Empowerme t Partership Programme The NEP programme aimed to empower citizes ad commuities, ad to: demostrate the differece that commuity empowermet ca make to idividuals, commuity groups, commuities ad public agecies; develop effective methods of quality assurace for commuity empowermet; promote good practice etworks. Commuity wellbeig Social capital/ cohesio Social capital SDH, C, P Race for Health 2010(Rac e for Health, 2010) Practice descriptio Disease prevetio [Ifo] eye health; maagig diabetes Other [Ifo] prevetig avoidable sight loss Race/ ethicity [Ifo] South Asia, Black Africa ad Caribbea Socioecoomic idicators [Ifo] + icome commuities NHS Greater Glasgow ad Clyde 2010 Practice descriptio Physical activity STIs Substace use Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Commuity assets Childre & Youg People/ Paretig Socioecoomic idicators Social capital Lee (2014)(Le e, 2014) Practice descriptio Eye health commuity egagemet projects Workig i partership with commuities particularly at risk of avoidable sight loss ad service providers to trial a rage of sight loss prevetio itervetios. RNIB has pilot projects throughout the UK workig with South Asia, Black Africa ad Caribbea ad white + icome commuities desiged to promote eye health ad prevet avoidable sight loss. Rage of itervetios icludig eye health voluteers ad champios; service Commuity wellbeig Commuity assets Other [Ifo] improvig local coditios Geeral health (persoal) Geeral health Socioecoomic idicators [Ifo] "disadvataged areas"

234 redesig; supportig self maagemet of diabetes; glaucoma case fidig i primary care; commuity educatio ad outreach, (commuity) Stutely (2014)(St uteley) C2 (Coectig Commuities ) C2 is short for Coectig Commuities, deliverig a practical 7-step applicatio of a assets- based approach to commuity improvemet. Essetially collaborative, it empowers both local residets ad public service workers to improve health, wellbeig ad local coditios i disadvataged areas. It uses a tried ad tested 7-step evidece-based model that works. C2 7 step programme supports delivery of a 2 year itervetio desiged to reverse the H & WB of disadvataged commuities Chaa (2011)(C haa, 2011) Health Empowerme t Leverage Project. To promote better collaboratio betwee health agecies ad local commuities, with a particular iterest i the potetial for commuity developmet to play a wider role i relatio to iovatio, prevetio ad participatio. For its field projects HELP decided to cocetrate o a particular form of commuity developmet, the creatio of a eighbourhood partership. NHS Greater Glasgow ad Clyde (2010) Mosaics of meaig to research ad the address stigma relatig to metal health problems with the four largest settled BME groups i Glasgow: Pakistai, Chiese, Idia ad Africa ad Caribbea. Metal health [Ifo] address stigma related to metal health Persoal assets [Ifo] Scotlad Race/ ethicity [Ifo] BME commuities WB, SDH Set short title Other [Ifo] cas e studies ] The Black ad Miority Ethic (BME) Health Forum Forum ad commuity participatory research; health promotio pilot which egaged BME wome from a local GP practice to ascertai ad improve historically + levels of uptake i breast screeig appoitmets Disease prevetio Prevetio violece/ abuse/ crime Social capital/ cohesio Persoal assets Other [Ifo] The BME Health Forum is a example of a well established [Ifo] Lodo, Bristol Race/ ethicity [Ifo] BME Geder [Ifo] WOMEN H, SDH, I, C, P 234

235 model of commuity egagemet which iforms the commissioig process by represetig, commissioig research, ad lobbyig o behalf of the eeds of BME commuities, public health campaigs, obesity Geeral health (commuity) Seyfag (2002)(S eyfag ad Smith, 2002) Other [Ifo] eval uatio - methods ot discussed Time Baks time bak is a way for people to come together ad help each other. Participats deposit their time i the bak by givig practical help ad support to others ad are able to withdraw their time whe they eed somethig doe themselves. Social capital/ cohesio Persoal assets Ecouragig core public services to ivest i buildig people s capacity to help themselves. Other [Ifo] UK Other idicators of disadvatage [Ifo] This report looks at time bakig, a ew govermet supported iitiative which aims to tackle the problems of deprived eighbourhoods WB, SDH, P, U Seyfag (2003)(S eyfag, 2003) Mixed methods evaluatio Other [Ifo] cas e study Rushey Gree Time Bak Persoal wellbeig Social capital/ cohesio Geeral health (persoal) [Ifo] i East Lewisham, South Lodo Race/ ethicity [Ifo] The ethic mix of the time bak membership reflects that of the local populatio: 53% are from ethic miorities. Occupatio- The majority of Rushey Gree Time Bak members are ot i paid employmet: 80% are jobless, compared to 51% of the populatio (OPCS, 1993b). Geder- Coordiators estimates show the membership has a majority of wome (71%), Other idicators of disadvatage WB, SDH, P Sherida (2010)(S herida Cocept/ theory outlies a framework that will help public bodies to approach egagemet more strategically Commuity wellbeig Social capital/ cohesio Geeral health

236 ad Tobi, 2010) (commuity) Sherida (2010)(S herida et al., 2010) Evaluatio / research Practice descriptio Commuity egagemet usig World Café: The Well Lodo experiece To improve the health ad well-beig of residets livig i some of the most deprived commuities i Lodo. Build a collaborative relatioship with local commuities Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (commuity) Socioecoomic idicators [Ifo] deprived commuities Shircore, ()(Shircor e, 2013) Health Traiers health traiers: lay workers supportig idividual behaviour chage Physical activity Healthy eatig Metal health Substace use Persoal wellbeig [Ifo] e.g. resiliece; selfefficacy Geeral health (persoal) Race/ ethicity Socioecoomic idicators [Ifo] Results demostrate a excellet capacity to egage with cliets i the +est socio-ecoomic Quitile 1. May i this quitile beig the most difficult to egage with i respect of health issues Skidmore (2006)(Sk idmore et al., 2006) Qualitati ve study [Ifo] cas e studies This report uses three key cocepts: goverace, participatio ad social capital, defied as : - Goverace: ay decisio-makig body or structure that exists withi a local authority area ad has a remit to affect public service plaig ad delivery. Social capital/ cohesio Social capital ++ 2 WB, C, H, P Smith, ()(Smith) Practice descriptio Leeds HIV prevetio & testig service for Black Africa commuities Egagemet with Black Africa commuities i Leeds to promote behaviour chage to reduce risk of HIV trasmissio, ad to icrease access to HIV testig, to ultimately reduce the umber of Black Africas with udiagosed HIV i Leeds. 121 iformatio & advice i the commuity - Group iformatio & advice i the commuity - HIV testig i the commuity - Egagemet & developmet with commuity leaders & key people withi the commuities. Disease prevetio STIs Substace use Race/ ethicity [Ifo] Black Africa commuities + 2 Smith, (2010)(S mith et Other [Ifo] com parsio of 2 case West Johstoe Digital Iclusio two area-based commuity empowermet iitiatives i UK cities which had commo social iclusio goals but operated at differet scales (eighbourhood ad citywide) ad i differet domais (digital iclusio ad Persoal wellbeig [Ifo] self-efficacy Social capital/ cohesio [Ifo] commuity [Ifo] Refrewshire, Scotlad; Salford, Greater Machester Occupatio P 236

237 al., 2010) studies Project (DIP), based i Refrewshire,Scotlad, ad Hearts of Salford (HoS), based i Greater Machester health) empowermet ad social iclusio Childre ad Youg People/ Paretig Geeral health (persoal) [Ifo] heart health [Ifo] Priority to families with childre, sigle parets, older people, disabled, people with learig difficulties, uemployed ad voluteers Educatio [Ifo] There are, however, fewer people with o formal qualificatios tha would be expected, which cotrasts sharply with the DIP sample. - HOS Socioecoomic idicators [Ifo] Residets of oe 5 per cet deprivatio zoe (area 32 ha, populatio 2180), a outer-city public housig scheme 6 km from Paisley Other idicators of disadvatage South (2007)(S outh et al., 2007) Mixed methods evaluatio health traiers health traiers: lay workers supportig idividual behaviour chage Persoal wellbeig Geeral health (persoal) [Ifo] thematic aalysis idetified six core actios: listeig, supportig, empathisig, helpig empower cliets, givig cliets cofidece ad sigpostig. Race/ ethicity [Ifo] I terms of ethic profile, 11 HTs were White British, seve were Asia British/Asia Pakistai ad three were from Black or mixed backgroud. Socioecoomic idicators H, WB, I, C, P South (2011)(S outh et al., 2011) Other [Ifo] Exp ert Hearigs study o lay people i public health roles Physical activity Healthy eatig Metal health Substace use Persoal wellbeig Geeral health (persoal) Socioecoomic idicators [Ifo] Health traiers operate i areas of deprivatio P South (2014) Cocept/ theory Specer (2014)(S pecer, Qualitativ e study Drawig o fidigs from a ethographic study o empowermet ad youg people s health, this article develops six coceptually distict forms of empowermet (impositioal, dispositioal, cocessioal, Childre ad Youg People/ Paretig Geeral health (persoal) P 237

238 2014) oppositioal, ormative ad trasformative). Stafford, (2008)(St afford et al., 2008) Questio aire/ survey New Deal for Commuities eighbourhood reewal/ regeeratio Physical activity Healthy eatig Metal health Commuity wellbeig Other [Ifo] Social determiats: employmet, educatio, crime Geeral health (persoal) Race/ ethicity [Ifo] 20% o-white Socioecoomic idicators Social capital H, WB, SDH, I, C Starkey (2005) RCT [Ifo] Clu ster RCT ASSIST (A Stop Smokig i Schools Trial) To ecourage stoppig smokig Substace use [Ifo] Smokig Educatio [Ifo] Secodary school level, Year 8 aged P Starkey (2009) Questio aire/ survey A Stop Smokig I Schools Trial (ASSIST) Substace use Race/ ethicity [Ifo] Welsh Educatio [Ifo] Secodary school level- Year 8 (aged years). + 3 H, P Stephes o (2004) RCT RIPPLE study Peer-led sex educatio. I itervetio schools, peer educators aged years delivered three sessios of sex educatio to year-old pupils from the same schools. Persoal wellbeig Other [Ifo] sex educatio Childre ad Youg People/ Paretig + 3 WB, I Stephes o, (2008) RCT [Ifo] Clu ster RCT RIPPLE (Peer-Led Sex Educatio Programme) Peer-Led Sex Educatio Programme STIs [Ifo] sex educatio Childre ad Youg People/ Paretig [Ifo] sex educatio Educatio [Ifo] Secodary school, Year 9 pupils (8th grade, aged y) + 3 H, C, P Steve Mixed methods Walkig for Health Physical activity, walkig Physical activity Metal health Race/ ethicity + 7 H, WB, 238

239 (2000) evaluatio Social capital/ cohesio [Ifo] All walk leaders i the case studies were white Geder [Ifo] Almost equal split of males ad females Other idicators of disadvatage C, H, P Stutely, (2002) The Beaco Project, commuity regeeratio- aim to tackle the rapidly decliig health ad social eeds of a commuity i Corwall Physical activity Healthy eatig Metal health Substace use Prevetio violece/ abuse/ crime Commuity assets Geeral health (commuity) Social capital Other idicators of disadvatage ++ 2 H, WB, C Stutely, (2004) Qualitati ve study the Falmouth Beaco Project Multi-agecy itervetio i a commuity fraught with social ad ecoomic problems. The itervetio devised by the health visitors was a mix of the formal ad the iformal, for although it ivolved the statutory agecies, it also raised the capacity of ordiary residets o the Estate to have their voice heard, ad to create etirely ew pathways for cosultatio ad ivolvemet. Prevetio violece/ abuse/ crime Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (commuity) Socioecoomic idicators high deprivatio estate. Commuity fraught with social ad ecoomic problems. Accordig to the Breadlie Britai Idex (MORI, 1998), of CorwallÕs 133 wards Pewerris had the highest proportio (30.8%) of poor households, ad they were poorer tha the atioal average. Paye et al further idicated that Pewerris had the high percetage i Corwall of childre livig i households with o wage earer, ad the secod highest percetage of childre livig with loe parets. Social capital [high icidece of violet crime, itimidatio ad drug-dealig ad may childre o the Child Protectio Register H, WB, SDH, C, P Summerfi eld, () Practice descriptio Safer Places Scheme Commuity Developmet Team - promotig social iclusio for people with learig disabilities: Safer Places scheme (detailed be+); Researchig ad sourcig Opportuities, regular directories of all iclusive activities ad evets. Valued Voluteer scheme, recruitig voluteers to support adults with a learig disability to take part i the activities of their choice. Recruited over 140 public, private ad volutary orgaisatios to provide assistace to Social capital/ cohesio Other [Ifo] disability awareess ad safeguardig Other idicators of disadvatage [Ifo] People with a learig disability from 14 upwards. It is plaed to exted this to cover other vulerable groups ie. People with physical disabilities, sesory impairmet, demetia ad metal health issues

240 members if they feel ucomfortable or scared i the commuity. Members carry a card with the cotacts of 2 relatives/frieds. Summerfi eld, () Susa (2006) Mixed methods evaluatio Age Cocer Newcastle The Big Lottery fuded Age Cocer Newcastle - i partership with Newcastle Uiversity - to udertake research desiged to icrease uderstadig of voluteerig amogst older people. The research team used a rage of social sciece techiques (surveys, i-depth iterviews ad focus groups) to assess the coditios uder which older people become voluteers, their capacity to remai voluteers, ad costraits that impact o voluteerig for them. Commuity wellbeig [Ifo] The missio of Age Cocer Newcastle is to promote the status ad wellbeig of all older people i the City of Newcastle upo Tye ad to make later life a fulfillig ad ejoyable experiece. Social capital/ cohesio [Ifo] promote social iclusio Other [Ifo] older people [ Newcastle Occupatio More tha three fifths (62 per cet) of all the curret voluteers who respoded to the survey questio about employmet status described themselves as retired; Less tha a fifth (19 per cet) of the voluteers across all the age rages were i paid work Geder largely wome Educatio Nearly two fifths (39 per cet) of the voluteers completed their schoolig at age 15 ad be+, all of whom were over the age of 55 at the time of the survey Other idicators of disadvatage WB, SDH, I, P Sustaia ble (2010) Policy Discussi o itegrated, area-based approaches Commuity wellbeig Social capital/ cohesio Commuity assets Other [Ifo] eighbourhood reewal/ upgradig ifrastructure/ sustaiability Social capital Sustaia ble (2010) Taylor (2005) Mixed methods evaluatio (CPP): The Commuity Empowerme t Fud Neighbourhood reewal. They were desiged to: ecourage more people to become ivolved i the regeeratio of their eighbourhoods; help residets gai the skills ad kowledge they eed to Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (commuity) Socioecoomic idicators [Ifo] disadvataged eighbourhoods Social capital SDH, C, P 240

241 (CEF), Commuity Chests (CCs) ad Commuity Learig Chests (CLCs) play a active role i Neighbourhood Reewal; ad support the ivolvemet of the local commuity ad volutary sector as a equal parter i local strategic parterships (LSPs). Taylor, () Practice descriptio The JRF Neighbou rhood Program me: a light touch learig etwork Neighbourhood reewal; capacity buildig, commuity empowermet ad buildig social capital. Physical activity Commuity wellbeig Social capital/ cohesio Childre & Youg People/ Paretig Geeral health (commuity) Taylor, (2009) Practice descriptio Healthy Livig Cetres; The Dudee Healthy Livig Iitiative; Healthy Livig Cetres (HLCs); commuity-led health; Healthy Livig Iitiative Physical activity Healthy eatig Metal health Substace use Persoal wellbeig Social capital/ cohesio Persoal assets [Ifo] Health Issues i the Commuity traiig. Commuity assets Other [Ifo] Weight; healthy eviromets; improvig facilities; wider outreach programmes Childre & Youg People/ Paretig Geeral health (persoal) Geeral health (commuity) [Ifo] Argyll ad Bute; Dudee; Ediburgh; Falkirk; North Laarkshire Geder [Ifo] me ad wome's group Thraves (2013) Policy localism Examies the aims of itegratig public health across all services, helpig commuities provide services themselves ad ivestig i prevetio. There is a Disease prevetio Geeral health (persoal) Geeral health (commuity)

242 Truma, (2001) Cocept/ theory growig recogitio that commuity iput i decisiomakig ca help promote health outcomes. However, the key to realisig these health gais is givig commuities real decisio-makig power. Oe optio is to employ commuity commissioers. Local authorities should istead focus o stregtheig pre-existig etworks i commuities that could play a role i deliverig services. Ward coucillors are the direct lik betwee the local authority ad commuity. They are best placed to ecourage people to get ivolved improvig public health outcomes. ivolvig users i evaluatio Metal health ++ 2 Tuariu (2011) Mixed methods evaluatio Qualitativ e study Well Lodo DIY Happies s Project Of the three projects specifically desiged to address the theme of metal health ad well-beig, DIYH is the project that aims to improve idividual ad commuity health ad well-beig by explorig ew ways to promote positive metal health from a whole populatio perspective by ecouragig people to explore what subjective well-beig ad happiess meas to them. The project aims to steer people away from the idea that metal health is syoymous with metal illess ad begi to move people towards seeig metal health as a positive resource which ca be improved ad protected by makig small effective chages Physical activity Healthy eatig Metal health Persoal wellbeig Social capital/ cohesio Persoal assets Geeral health (persoal) Socioecoomic idicators [Ifo] workig with groups of wome i 20 +er Super Output Areas facig the greatest health iequalities i Lodo + 1 H, WB, I, P, U Tustill (2005) Mixed methods evaluatio Sure Start Cetres Sure Start Cetres Healthy eatig Substace use Childre ad Youg People/ Paretig Geeral health (persoal) [Ifo] Natioal Geder [Ifo] Largely mothers Other idicators of disadvatage [Ifo] deprived areas P, U UK Qualitativ Get Heard Get Heard is oe of the largest projects udertake i the UK to ivolve people with first-had experiece of Prevetio violece/ abuse/ crime [Ifo] Norther Irelad, Scotlad ad Wales P 242

243 (2007) e study project poverty to give their views o govermet policies desiged to combat poverty ad i doig so to attempt to shape those policies which affect their lives. It was set up by the Social Policy Task Force, comprisig the Europea Ati-Poverty Network, Eglad; Poverty Alliace, Scotlad; Norther Irelad Ati-Poverty Network; Ati-Poverty Network Cymru, Wales; Oxfam s UK Poverty Programme; the UK Coalitio Agaist Poverty; ad Age Cocer Persoal assets Other [Ifo] housig, beefits ad ito work, fiace, trasport, eighbourhood reewal Childre ad Youg People/ Paretig [Ifo] Beefits ad ito work Geeral health (persoal) Race/ ethicity [Ifo] BME Geder Other idicators of disadvatage [Ifo] loe parets; carers; disabled people, older people, migrats homeless; people livig i poverty Visram (2006) Mixed methods evaluatio Qualitativ e study health traiers health traiers: lay workers supportig idividual behaviour chage Physical activity Healthy eatig Metal health Substace use Persoal wellbeig Geeral health (persoal) Socioecoomic idicators P Wait (2006) Policy Cocept/ theory This paper explores some of the uderlyig cocepts, defiitios, ad issues uderpiig public ivolvemet policies ad proposes a set of criteria ad questios that eed to be addressed to al+ for the evaluatio of public ivolvemet strategies ad their impact o the health policy process Geeral health (persoal) Geeral health (commuity) [Ifo] public ivolvemet policies i healthcare 2 Wales (2008) Policy Desiged to add value - a third dimesio to iform future directios ad support the evidece base of the volutary sector's cotributio to health ad social care. It will serve to iform plaers ad commissioers i the developmet of the Health, Social Care ad Wellbeig Strategies ad the commissioig process across Wales. Persoal wellbeig Other [Ifo] health ad social care Geeral health (persoal) Geeral health (commuity) Other idicators of disadvatage [Ifo] vulerable groups Wallace, (2007) Policy Cocept/ theory Discussi o New Deal for Commuiti es Regeeratio. Coceptual paper. Commuity wellbeig Social capital/ cohesio Commuity assets Socioecoomic idicators [Ifo] excluded eighbourhoods 1 2 Waless (2002) Policy Waless report health policy; people beig fully egaged with their ow health care Disease prevetio Other [Ifo] log term coditios + 243

244 Geeral health (persoal) Waless (2004) Mixed methods evaluatio It was asked to cosider cosistecy of curret policy with the public health aspects of the fully egaged sceario outlied i the 2002 report Securig Our Future Health: Takig A Log- Term View Other [Ifo] health services - prevetio, wider determiats ad reducig health iequalities Geeral health (persoal) + 2 H, C Ward (2009) Mixed methods evaluatio West Sussex Health Traiers service Health Traiers service Physical activity Healthy eatig Metal health Social capital/ cohesio Geeral health (commuity) Socioecoomic idicators [Ifo] deprived commuities; Local Neighbourhood Improvemet areas (LNIAs) ad with older people i other areas. + 5 H, WB,C, HP Watso, (2004) Mixed methods evaluatio commuit y champio s fud The aim of CCF was to icrease the skills levels of idividuals to eable them to act as ispiratioal figures, commuity etrepreeurs, commuity metors ad commuity leaders; ad to also icrease the ivolvemet of commuities i regeeratio ad learig activity Commuity wellbeig Social capital/ cohesio Other [Ifo] regeeratio; learig activity Childre ad Youg People/ Paretig Race/ ethicity SDH, C, P Watt (2009) RCT social support itervetio Healthy eatig Childre ad Youg People/ Paretig Geder [Ifo] wome Socioecoomic idicators [Ifo] disadvataged areas + 7 H, C, P Webster (2000) Mixed methods evaluatio The Commui ty Mappig project commuity mappig Healthy eatig Substace use Prevetio violece/ abuse/ crime Social capital/ cohesio Build the capacity of local people by traiig or ivolvig them i PA methods to develop their kowledge ad skills so that they ca uderstad more about how their food ecoomy works ad how they ca [Ifo] Brighto, Covetry ad Leicester P 244

245 chage it; Other Well (2011) Qualitativ e study Well Lodo Tacklig health iequalities- peer support tacklig obesity, reducig smokig, cacer screeig, improvig metal health - health champios Physical activity Healthy eatig Metal health Substace use Commuity wellbeig [Ifo] tacklig health iequalities Geeral health (commuity) Race/ ethicity, the populatio of the White City Estate was measured at 6,300 residets with 2,450 households, twice the average borough desity. Occupatio 31% of residets (oe i three adults aged betwee 16 ad 74) have o formal educatioal qualificatios. Religio/ culture Socioecoomic idicators [The estate is situated i the North Hammersmith area coverig the easter part of the Wormholt & White City ward. It is the secod most deprived eighbourhood i the borough with +++ scores o most socioecoomic idicators. Other idicators of disadvatage"deprived" H, WB, SDH, I, C, P White (2012) Mixed methods evaluatio Kirklees Health Traier Service Health Traier Service Geeral health ad wellbeig, support for people with LTCs Metal health Substace use Persoal wellbeig Geeral health (persoal) [Ifo] People livig with Log Term Coditios [Ifo] Kirklees commuity Socioecoomic idicators [Ifo] Targeted areas of social deprivatio Other idicators of disadvatage [Ifo] People livig with a LTC ; alcohol use? H, WB, SDH, I, P White (2013) Qualitativ e study Commui ty Health Champio program mes Health Champios Physical activity Healthy eatig Substace use Persoal wellbeig Social capital/ cohesio [Ifo] befriedig Persoal assets [Ifo] traiig Other [Ifo] early detectio of cacer Geeral health (persoal) [Ifo] Licolshire Other idicators of disadvatage [Ifo] A large proportio of voluteers were older or retired WB, I, P 245

246 Whitehe ad (2007) Policy Discussio discussio paper o cocepts ad priciples for tacklig social iequities i health Other [Ifo] health care; access to health care Geeral health (commuity) Occupatio Educatio Socioecoomic idicators 2 Williams o, (2009) Mixed methods evaluatio Rochdal e Parters hips for Older People Program me Rochdale POPP, lauched i May 2007, set out to eable older people to have power ad cotrol over their lives to sustai idepedece ad well-beig i older age. Disease prevetio Persoal wellbeig Social capital/ cohesio Geeral health (persoal) Other idicators of disadvatage [Ifo] older people + H, WB, I, C, P Wood (2013) (Wood et al., 2013) Mixed methods evaluatio Natural Choices for Health ad Wellbei g Program me The Natural Choices for Health ad Wellbeig programme provides support for projects throughout Liverpool which ca demostrate that they are i) helpig to improve wellbeig through as may of the five ways to wellbeig as possible ad ii) makig use of the atural eviromet i the delivery of the project. A variety of differet commuity projects are ivolved icludig commuity food growig, helpig vulerable groups to access ature, forest schools, reducig the carbo footprit ad tree platig, developig commuity ad therapeutic gardes ad helpig the homeless. Physical activity Persoal wellbeig Commuity wellbeig Commuity assets 51% of projects were i areas withi the most deprived 1% i the UK ++ H, WB, I, C, P, E 246

247 Woodall (2012) Mixed methods evaluatio Qualitative study commui ty health champio s lay public health roles (icludig health champios) Physical activity Healthy eatig Metal health Persoal wellbeig Commuity wellbeig Social capital/ cohesio Geeral health (persoal) Geeral health (commuity) Safety/ accidet prevetio Other idicators of disadvatage [Ifo] older people + H, WB, I, C, P, E Woodall, J., (2012) Qualitative study commui ty health champio s Commuity health champios i Yorkshire ad Humber are ivolved i a huge rage of activities icludig, amog others, leadig orgaised health walks, workig i allotmet ad foodgrowig iitiatives, settig up social clubs, deliverig healthawareess presetatios o chroic coditios, ad sigpostig. Physical activity Healthy eatig Persoal wellbeig Commuity wellbeig Geeral health (persoal) Geeral health (commuity) Socioecoomic idicators Social capital ++ H, WB, I, C, P YHEP (2010) Practice descriptio commuit y health champios - Altogether Better commuity health champios Physical activity Healthy eatig Metal health Substace use Persoal wellbeig Commuity wellbeig Social capital/ cohesio Commuity assets Geeral health (persoal) Geeral health (commuity) Race/ ethicity Religio/ culture Socioecoomic idicators Social capital Ziersc h (2000) Cotrolled trial quasie xperimet al desig. pilot peer educatio STI prevetio programme STIs Persoal assets [Ifo] peer educatio traiig -Lodo Race/ ethicity Geder- males Educatio + 3 P 247

248 Qualitativ e study Other idicators of disadvatage 248

249 APPENDIX H The family of commuity-cetred approaches (South 2014) Commuity-cetred approaches for health & wellbeig Stregtheig commuities Voluteer ad peer roles Collaboratios & parterships Access to commuity resources Commuity developmet Bridgig roles Commuity-Based Participatory Research Pathways to participatio Asset based methods Peer itervetios Area based Iitiatives Commuity hubs Social etwork approaches Peer support APPENDIX I Studies by type of commuity egagemet approach (South 2014; South 2015). Peer educatio Year Stregtheig commuities Voluteer & peer roles Collaboratios & parterships Access to commuity resources Peer metorig Commuity egagemet i plaig Co-productio projects Commuity-based commissioig Voluteer health roles 249