Mantovani Nadia, Pizzolati Micol, Gillard Steve
Population Health Research Institute, St George's University of London, London, UK.
Department of Economics, Management, Society and Institutions, Universitá del Molise, Campobasso, Italy.
Health Soc Care Community. 2017 Jan;25(1):167-176. doi: 10.1111/hsc.12288. Epub 2015 Oct 5.
Over the last decade, Britain has undergone reforms to promote engagement in local structures of governance. These reforms have encouraged the promotion of active citizenship and have been central to the government's public service modernisation agenda. This article presents the findings from a study evaluating a pilot outreach intervention which adopted a community engagement model to address the mental health needs of African and African Caribbean groups, which entailed a partnership between faith-based organisations, local public services and community organisations to co-produce the pilot project. Lay people were trained to raise awareness about mental health among these communities in South London. Between 2012 and 2013, a qualitative participatory approach was used to evaluate the pilot project, which enabled a researcher to take part in the engagement phase of the pilot project, and the project co-ordinators to be involved in the research process. Semi-structured, one-to-one interviews were carried out with 13 community and well-being champions (CWBCs) recruited from African and African Caribbean communities (seven male and six female). This study examines the impact of the relationship between the intervention and community through the participants' engagement in the pilot outreach project and the action undertaken as champions. We found that although CWBCs used circles of influence to share ideas about mental health and well-being and to encourage change, they encountered resistance on the part of the people they engaged with, which resulted from a lack of knowledge about mental health, taboos and ascribed stigma. We argue that CWBCs acted as healthy examples to communicate mental health knowledge to those approached, but that they needed to be equipped with bespoke communication skills to be able to talk about such sensitive issues as mental health.
在过去十年中，英国进行了改革，以促进民众参与地方治理结构。这些改革鼓励推动积极公民意识，并且一直是政府公共服务现代化议程的核心。本文介绍了一项研究的结果，该研究评估了一个试点外展干预项目，该项目采用社区参与模式来满足非洲和非洲加勒比群体的心理健康需求，这需要基于信仰的组织、地方公共服务机构和社区组织之间建立伙伴关系，共同开展该试点项目。非专业人员接受培训，以提高伦敦南部这些社区对心理健康的认识。在2012年至2013年期间，采用定性参与式方法对该试点项目进行评估，这使一名研究人员能够参与试点项目的参与阶段，项目协调员也能参与研究过程。对从非洲和非洲加勒比社区招募的13名社区与福祉倡导者（CWBC）进行了半结构化的一对一访谈（7名男性和6名女性）。本研究通过参与者对试点外展项目的参与以及作为倡导者所采取的行动，考察了干预措施与社区之间关系的影响。我们发现，尽管社区与福祉倡导者利用影响力圈子来分享关于心理健康和福祉的想法并鼓励变革，但他们在与所接触的人互动时遇到了阻力，这是由于对心理健康缺乏了解、存在禁忌以及有既定的污名化观念所致。我们认为，社区与福祉倡导者起到了健康榜样的作用，向所接触的人传播心理健康知识，但他们需要具备定制的沟通技巧，以便能够谈论诸如心理健康这样的敏感问题。
