A Roadmap for Authentic Community Engagement
We can’t improve maternal and child health without engaging community voices—without practicing what NICHQ Senior Project Director Kenn Harris calls “true, authentic community engagement.” This holds whether seeking change at the policy level or within an organization, hospital or clinic.
“The belief behind community engagement is that the people impacted by the problem have some of the best solutions,” says Harris. “They help us understand how they experience the system, their lived experience, and that’s not something we can learn anywhere else. When those experiences and their voices become part of the solution—when they’re combined with organizational knowledge, resources and expertise—it becomes a pretty amazing partnership that inspires innovative thinking.”
Harris has spent more than two decades working with the Healthy Start federal program, one of the first public initiatives that genuinely engaged communities as equal partners for improving the health of children and families. At NICHQ, Harris leads the Supporting Healthy Start Performance Project, which partners with all Healthy Start communities through a comprehensive capacity-building training program. Having witnessed the importance of community engagement first-hand, Harris is passionate about helping improvement initiatives across the country develop and sustain the authentic community engagement needed for change.
“There’s this large breadth to community engagement because it happens in so many places—in hospitals and individual clinics, in organizations and foundations, among systems improvement initiatives,” says Harris. “But no matter where it takes place, it needs to have the depth; it needs to be authentic and committed, locked-in with trust, to make it real.”
Developing this authentic community engagement requires intentional interest and decisions from all participants. Below, Harris shares some of his lessons, learned from nearly 30 years of working with communities.
Bring your most authentic self to the table
Authentic community engagement requires authenticity from all participants, explains Harris.
“If I come to a meeting with community partners and I am not being my real self, I can’t develop an authentic relationship with them. Being open to the reality that you don’t have all the answers, being honest about who you are and where you come from, and openly evolving every day—this is what’s required. It means being vulnerable, but it is also what builds trust.”
Harris recommends taking lessons from home and personal relationships and applying them to community engagement. The same requirements for intimate relationships—significant time and attention, honesty and authenticity, and dependability—are all needed to engage meaningfully with community partners.
Prioritize the three Ps
Whether you’re bringing together a meeting of community partners or engaging families in pediatric practice improvement, Harris recommends prioritizing three Ps: Place, People, and Practices.
- Place represents creating space for community engagement to happen. It should be a space that is inviting and respectful, so people feel comfortable and valued. Welcoming decorations, snacks or a meal for attendees, a space that can accommodate children—these considerations help lay the groundwork for authentic engagement.
- Prioritizing people means ensuring the right people come together. This relies on thoughtfully discussing how to connect with community partners, considering their individual circumstances and what might make it difficult to attend a meeting or join a call, and thinking through how to create an engaging and enjoyable event.
- Practices are the rules of engagement: the agreed-upon policies and practices that create a safe space for engagement. For a clinic prioritizing family engagement, this might mean implementing a policy for greeting families when they come through the door. For a community meeting, this might be the policies that guide behavior, such as how to facilitate inclusive discussion.
All three Ps are needed to support authentic community engagement.
Full engagement means giving up power
There’s a spectrum of community engagement, says Harris. It begins at an advisory level, then moves to focus groups, then to helping influencing decision-making, and then, at full engagement, to leading decision making and truly helping determine what happens. Full engagement is the most authentic engagement and the most powerful. But promoting it requires shifting power from whoever is leading the initiative—the clinician, the lead researcher, the organizational lead—to the community.
“For true engagement, you have to be willing to give up the power,” says Harris. “We talk about sharing power but that isn’t enough; I can’t share power unless I am willing to give some of it up. And this is the risk because we lose some of the control and we have to be vulnerable… but it’s what incites true partnership and ultimately builds momentum, causing you to go further together than you ever could have gone alone.”
Bring together state and community partners
Community engagement at the grassroots level—where organizations and individuals work together in the space where they live—inspires incredible community-based change; but too often, this change doesn’t trickle up to state and national policies and doesn’t influence broader systems that perpetuate inequities. Moreover, without systems change, grassroots initiatives can’t experience maximum impact because even the strongest community-based program can’t fully thrive in a flawed system. Helping policy makers and state leaders connect with grassroots community efforts results in greater impact and really demonstrates the true potential of authentic community engagement, says Harris.
“We often think about change as coming from the top-down, or from the bottom-up, but community engagement is most effective when the two meet in the middle. The magic is in the middle—that’s the good stuff; and my work is all about moving communities and organizations to the good stuff.”
And remember, always trust the process
“Authentic community engagement—the kind that has the depth that really works—takes time, so if you aren’t interested in it, don’t start it,” says Harris. “You have to believe that community engagement matters, trust in the process and not rush it for results.”
Interested in learning how states can better support community-based early childhood efforts? Read this recent article on how New York State is elevating the work at the community level to inform policy and program improvements.
Strengthening the Developmental Screening Process
Two counties in southeast Kansas are streamlining early childhood systems to ensure effective developmental screenings and referrals to supportive services to improve children’s developmental health outcomes.
Breastfeeding Takes a Village and, Too Often, Black Women Don’t Have One
Breastfeeding peer support networks run for and by Black women fill a gap in breastfeeding support for Black women—a gap largely created by historic and systemic inequities. Here, Khadija Garrison Adams, co-founder of Black Lactation Circle (BLaC) of Central Ohio, shares how their community is empowering black pregnant and nursing mothers to meet their breastfeeding goals.
Family Advocates Demand More from Their Government
An advocacy group led by and for parents and community members spearheaded a campaign for funding to address lead in the homes throughout their city. Their successes illustrates the vital impact families play in advocating for policy change on behalf of children. Here, two parent leaders share their experiences and advice for supporting family-led civic engagement.
Ohio’s Multi-Pronged Approach to Addressing the Opioid Crisis
The Ohio Perinatal Quality Collaborative is testing innovative strategies for improving outcomes for the thousands of families affected by the opioid crisis. Here, they share their approach, including standardizing identification and treatment for opioid exposed infants in NICUs, encouraging compassionate responses from providers, and ensuring comprehensive, coordinated maternity care.
Eliminating Sleep-Related Infant Deaths Starts by Identifying What Causes Them
Understanding what causes infant deaths gives states and communities the information they need to identify focused, effective solutions. This makes infant mortality data—data that reveals the causes and contributors to death and system barriers—irreplaceable assets for any infant health improvement effort. And that makes the National Center for Fatality Review and Prevention (National CFRP) an essential partner.