1. Chris Nield Consultant in Public Health
Developing social capital to improve mental health and wellbeing Building communities has always depended on mobilising the capacity and assets of people and place.”Kretzman & McKnight (1993) Building Communities from the Inside Out
Chris Nield
Consultant in Public Health

2. Community-centred approaches for health and wellbeing –PHE 2015
local government and the NHS, together with the third sector, have vital roles to play in building confident and connected communities as part of efforts to improve health and reduce health inequalities
community-centred approaches seek to mobilise the assets within communities, promote equity and increase people’s control over their health and lives
there is a diverse range of practical, evidence-based approaches that can be used by local leaders, commissioners and service providers to work with communities. These are grouped into:
-strengthening communities;
- volunteer and peer roles
- collaborations and partnerships
- access to community resources

3. Health matters: community-centred health and wellbeing approaches
As well as having health needs, all communities have health assets that can contribute to the positive health and wellbeing of its members
Recognising assets helps value community strengths and ensure everyone has access to them. It builds on the positives and ensures that health action is co-produced equally between communities and services.
Community-centred ways of working are important for all aspects of public health
Community approaches are more sustainable and effective approaches to reduce health inequalities.
Participatory approaches can directly address marginalisation and powerlessness that underpin inequities and can therefore be more effective than professional-led services in reducing inequalities.

4. The family of community-centred approaches (South 2014) PHE

5. Psychosocial pathways

6. NICE Guidance – Community Engagement : 2016
Ensure local communities, community and voluntary sector organisations and statutory services work together to plan, design, develop, deliver and evaluate health and wellbeing initiatives.
Community engagement: improving health and wellbeing
and reducing health inequalities
NICE guideline [NG44] Published date: March 2016

7. Key message from Research and Community Programmes in Sheffield
Improving health and well being is dependent upon increasing skills and confidence and empowering local people.
Examples : Peer support
Health Trainers & Health Champions

8. Janet Harris, University of Sheffield
Community-based Peer Support: A participatory review of what works, for whom, in what circumstances Using a community network to research peer support
Janet Harris, University of Sheffield

9. “It’s a process that takes time.”
“One of the hardest things is getting people to come in the first place.”
“It’s ‘hidden’ work, getting people to engage. It doesn’t get funded.”
“Supporting volunteers and helping them to move on is essential. There’s an obvious benefit, but it’s underfunded.”
“There are a lot of social outcomes before you get to the health outcomes. How do we measure that?”

10. Practice Champions

11. Change in self-efficacy, general health and wellbeing
Measures were developed for the National Health Trainers Data Collection and Reporting System (Department of Health, 2011) which is used by Sheffield HT
Measure
Before
After
% Change
Self-efficacy
68.4
74.1
8.32
General Health
38.3
51.7
35.1
WHO Five-Wellbeing
29.1
44.5
52.95
Increases were reported across all measures, with the greatest increase in perceived wellbeing, followed by general health and self-efficacy
Characteristic
national
local
Deprivation (highest quintile)
65.55%
68.43%
BME
29.9%
55.05%

12. Community Health Trainer Persistent Pain Service Evaluation: ScHARR
The 9 month pilot indicated that clients experienced
- Increased psychological capability: knowledge about the condition; understanding of how to negotiate to get needs met
Increased social opportunity: options for joining groups and participating in events
Increased reflective motivation: ability to consider how health information is relevant to their own situation;
Increased physical opportunity:
possible activities and exercise programmes
Increased physical capability:
skills and to self-manage their pain

13. It’s been 4 years since my accident, I’ve just been stuck in the flat
What did I get from using the Health Trainers Service…. DCRS Data & Sheffield University Evaluation May 2012
More energetic, I interact more with people, I get out more, I do stuff instead of being stuck inside
Before [the CCPP] I used to just stay indoors all the time, use a hot water bottle and stay in bed
She helped me with me confidence, with me motivation. Gave me advice on where to go, who to speak to. I’d hit a brick wall and didn’t know where to turn to.
She helped me to think about options instead of telling me what to do. I’d rather be able to think it out for myself, it’s a really good service that way
I were depressed, didn’t exercise much, didn’t feel like doing much at all before I started seeing a HT
I would have been back on anti-depressants if it wasn’t for this [Health Trainer support]. It’s refreshing not to have to take medication, this is a much quicker way to get right.”
It’s been 4 years since my accident, I’ve just been stuck in the flat