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

2. 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.

3. 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.

4. 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

5. 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

6. 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

7. Tools and Approaches
Source: de Silva, D. Helping people help themselves. The Health Foundation, 2011.

8. Reflections
Source: Image Purchased from 123RF

9. 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

10. Finding a common language