Engaging and Empowering People and Communities Karen Barrie & Nick Goodwin Transformers II, Session 2, 13:00 to 16:30 The Ramada, Ballina, NSW

Key Concepts People’s “Empowerment” refers to the process by which people develop their intrinsic capabilities to increase control over the factors, decisions and actions that affect their health and care and the process of gaining power externally over them. People’s “Engagement” refers to the process by which people increase their degree of active involvement in caring for themselves and in shaping their health determinants.

Key Concepts People’s “Activation” describes the knowledge, skills and confidence a person has in managing their own health and health care. Co-production” is the co-development of public services between professionals, people using services, their families and their neighbours in the context of an equal and reciprocal relationship.

Shared Decision-Making Key Strategies Health Literacy Shared Decision-Making Common strategies include: mass media campaigns, the development of targeted educational packages and lifestyle programs – e.g. supported by schools and care professionals e-health Strategies that encourage lay, parental and family-led advice and support in local communities have also been adopted. The evidence for positive benefits is strong and includes enabling people to better manage their health conditions and control risk factors associated to changes in lifestyle Promotion of patient and family involvement in decision-making about care and treatment options remains under-developed but is becoming a common element of health care in many countries The evidence for positive benefits is strong with shared decision-making being associated with: the development of more appropriate interventions that better match patient preferences and needs; reduced misdiagnosis; greater patient satisfaction and independence

Key Strategies Supported Self-Management Care Assessments Support for self management is widely used in advanced economies for conditions such as asthma, diabetes mellitus and heart failure Self-care requires pro-active patients, but there is often a lack of willingness or capability to engage – hence, effective self management often includes a focus on the patient’s motivation and goals The evidence is highly positive in terms of: improving health status Improving quality of life reducing unnecessary hospital visits and/or hospital readmissions Comprehensive and holistic assessments of needs, including personalized care plans, have been associated with greater patient satisfaction, improved care co- ordination and reduced cost Personal care assessments and plans add additional time and costs that might outweigh the benefits of adoption to all but the most complex cases. Electronic care records, including a patient’s access to them, can better support the process of care planning leading to better care co-ordination and cost reduction

Community Participation Community Delivered Care Key Strategies Community Participation Community Delivered Care Community participation in planning and goal setting is a widely used strategy . The approach helps communities examine the underlying factors behind health problems, raise community awareness and support health improvements Interventions that support education and awareness with participatory groups can improve health outcomes where this is culturally sensitive and targeted to specific health problems. There is evidence for the need to supporting social networks and social integration since cultural and political characteristics in local communities may have unpredictable dynamics The development of community health workers and the role local people in being partners in care has good evidence in: supporting better access to care, promoting legitimacy and trust, and offering new opportunities for peer-to-peer learning and strengthened advocacy The assets-based approach can be difficult to sustain since it requires a new type of partnership between health professionals and the community

Tools and Approaches Source: de Silva, D. Helping people help themselves. The Health Foundation, 2011. www.health.org.uk/publications/evidence-helping-people-help-themselves/

Reflections Source: Image Purchased from 123RF

And People’s “Empowerment” refers to the process by which people develop their intrinsic capabilities to increase control over the factors, decisions and actions that affect their health and care and the process of gaining power externally over them. People’s “Engagement” refers to the process by which people increase their degree of active involvement in caring for themselves and in shaping their health determinants. People’s “Activation” describes the knowledge, skills and confidence a person has in managing their own health and health care. The development of community health workers and the role local people in being partners in care has good evidence in: supporting better access to care, promoting legitimacy and trust, and offering new opportunities for peer-to-peer learning and strengthened advocacy The assets-based approach can be difficult to sustain since it requires a new type of partnership between health professionals and the community Co-production” is the co-development of public services between professionals, people using services, their families and their neighbours in the context of an equal and reciprocal relationship. Comprehensive and holistic assessments of needs, including personalized care plans, have been associated with greater patient satisfaction, improved care co-ordination and reduced cost Personal care assessments and plans add additional time and costs that might outweigh the benefits of adoption to all but the most complex cases. Electronic care records, including a patient’s access to them, can better support the process of care planning leading to better care co-ordination and cost reduction Support for self management is widely used in advanced economies for conditions such as asthma, diabetes mellitus and heart failure Self-care requires pro-active patients, but there is often a lack of willingness or capability to engage – hence, effective self management often includes a focus on the patient’s motivation and goals The evidence is highly positive in terms of: improving health status Improving quality of life reducing unnecessary hospital visits and/or hospital readmissions Promotion of patient and family involvement in decision-making about care and treatment options remains under-developed but is becoming a common element of health care in many countries The evidence for positive benefits is strong with shared decision-making being associated with: the development of more appropriate interventions that better match patient preferences and needs; reduced misdiagnosis; greater patient satisfaction and independence Community participation in planning and goal setting is a widely used strategy . The approach helps communities examine the underlying factors behind health problems, raise community awareness and support health improvements Interventions that support education and awareness with participatory groups can improve health outcomes where this is culturally sensitive and targeted to specific health problems. There is evidence for the need to supporting social networks and social integration since cultural and political characteristics in local communities may have unpredictable dynamics Community participation in planning and goal setting is a widely used strategy . The approach helps communities examine the underlying factors behind health problems, raise community awareness and support health improvements Interventions that support education and awareness with participatory groups can improve health outcomes where this is culturally sensitive and targeted to specific health problems. There is evidence for the need to supporting social networks and social integration since cultural and political characteristics in local communities may have unpredictable dynamics Common health literacy strategies include: mass media campaigns, the development of targeted educational packages and lifestyle programs – e.g. supported by schools and care professionals e-health Strategies that encourage lay, parental and family-led advice and support in local communities have also been adopted. The evidence for positive benefits is strong and includes enabling people to better manage their health conditions and control risk factors associated to changes in lifestyle

Finding a common language