School of Public Health and Community Medicine, UNSW, Sydney, NSW 2052, Australia.
BMC Health Serv Res. 2013 Apr 29;13:154. doi: 10.1186/1472-6963-13-154.
Commitments to community participation are common in health policy, yet ways to maximise the input and impact of community representatives in health service delivery and care remain elusive, lack empirical evidence and are under-theorised.
The role of Community Participation (CP) Coordinators involved in an Australian health service were examined in a triangulated multi-method, multi-site ethnographically informed three year study. Formal fieldwork involved observation of just over 42 hours of meetings together with informal interactions in the field with staff and community members and in-depth interviews and discussions with 10 Community Representatives, 19 staff and the seven CP Coordinators employed during the study period.
Four key roles that Community Participation Coordinators undertake to support and facilitate the action of community representatives operating within a health service were identified in our analysis: 1) Building skills and confidence; 2) Engaging them in agendas for action: 3) Helping them navigate and understand the health system; and 4) Advocating to staff. A fifth role of advocating externally to outside groups and building coalitions is suggested as important, but was not strongly represented in our data.
This study offers a new model synthesising the key roles of coordinating and facilitating community participation in health services which may be transferable to other health service settings. Our findings call attention to the need for health services to employ a facilitator who can support, engage, navigate and advocate for community representative's participation and influence in health service policy and practice.
社区参与承诺在卫生政策中很常见，但如何最大限度地提高社区代表在卫生服务提供和护理中的投入和影响仍然难以实现，缺乏经验证据，理论研究也不足。
在一项为期三年的三角多方法、多地点人种学知情的研究中，对参与澳大利亚卫生服务的社区参与协调员的作用进行了检查。正式的实地工作包括观察 42 个多小时的会议，以及与工作人员和社区成员在实地的非正式互动，以及对 10 名社区代表、19 名工作人员和在研究期间雇用的 7 名社区参与协调员进行深入访谈和讨论。
在我们的分析中，确定了社区参与协调员为支持和促进在卫生服务中运作的社区代表的行动而承担的四个关键角色：1）建立技能和信心；2）让他们参与行动议程；3）帮助他们了解和理解卫生系统；4）向工作人员宣传。第五个角色是向外部团体宣传和建立联盟，这被认为很重要，但在我们的数据中并没有得到强烈体现。
本研究提出了一个新的综合模型，综合了协调和促进社区参与卫生服务的关键角色，这可能适用于其他卫生服务环境。我们的研究结果提请注意卫生服务部门需要雇用一名能够支持、参与、引导和倡导社区代表参与卫生服务政策和实践的促进者。
