Bandesha G, Litva A
University of Manchester, 2nd Floor, Stopford Building, Oxford Road, Manchester M13 9PL, UK.
J Public Health (Oxf). 2005 Sep;27(3):241-5. doi: 10.1093/pubmed/fdi044. Epub 2005 Jul 6.
The new public health rejects old individualist attempts at improving health and embraces community-based approaches in reducing health inequalities. Primary Care Trusts in England face the challenge of converting community participation in health into reality. This study explores differences in perception of participation between lay and professional stakeholders of a community health project for a South Asian population in Greater Manchester.
In-depth interviews and focus groups were used to explore the views of professional and lay stakeholders. All data were audio-taped, transcribed and analysed for emerging themes using a qualitative framework.
Professionals talked of working in partnership with the community but lay stakeholders did not feel that they had control over the project. There were problems in engaging the community and local health professionals in the project. Lack of cultural awareness hampered participation in the project. There was agreement that the project improved the self-confidence of participants and created a more informed population. However, there was little support for claims of improvements in social cohesion and changes in lifestyle directly as a result of the project.
Converting the rhetoric of community participation in health into reality is a greater challenge than was envisaged by policy makers. Marginalized communities may not be willing participants and issues of language and cultural sensitivity are important. Project outcomes need to be agreed to ensure projects are evaluated appropriately. Projects with South Asian communities should not be seen to be dealing with all 'ethnic health' issues without addressing changes in statutory organizations and other wider social determinants of health.
新公共卫生摒弃了以往改善健康的个人主义尝试，转而采用基于社区的方法来减少健康不平等现象。英国的初级保健信托机构面临着将社区参与健康转化为现实的挑战。本研究探讨了大曼彻斯特一个针对南亚人群的社区健康项目中，普通利益相关者和专业利益相关者在参与认知上的差异。
采用深度访谈和焦点小组讨论来探究专业和普通利益相关者的观点。所有数据都进行了录音、转录，并使用定性框架分析以找出新出现的主题。
专业人员谈到与社区合作开展工作，但普通利益相关者感觉他们对项目没有控制权。在让社区和当地卫生专业人员参与项目方面存在问题。缺乏文化意识阻碍了对项目的参与。大家一致认为该项目提高了参与者的自信心，并使民众更加了解相关信息。然而，对于该项目直接改善社会凝聚力和改变生活方式的说法，几乎没有得到支持。
将社区参与健康的言辞转化为现实比政策制定者预想的更具挑战性。边缘化社区可能不愿意参与，语言和文化敏感性问题很重要。需要就项目成果达成一致，以确保对项目进行适当评估。针对南亚社区的项目不应被视为在不解决法定组织的变革及其他更广泛的健康社会决定因素的情况下，就能处理所有“种族健康”问题。
