Insights

4 Key Considerations for Family and Community Engagement in Public Health

Kelly Devlin
Kelley Devlin, MPH, RD: Project manager, NICHQ

As public health professionals, we are tasked with designing, implementing and evaluating programs and policies that are intended to improve population health. A critical part of this work is engaging families in communities we want to reach. This is the best way to try to understand what matters most to them and how to plan culturally sensitive programs and policies that have potential for meaningful impact.

As part of the Childhood Obesity Prevention and Treatment (CHOPT) projects, NICHQ interviewed 28 families across the country this summer about their participation in Medicaid obesity programs. In the interviews, families were asked to explain what matters most to them about their health, describe their experiences in the programs and make recommendations for improving the programs to better fit their needs. Over the course of these conversations, families explained what they found beneficial, such as learning how to make healthier meals, and what could be improved, such as accessibility or program hours. Ultimately, this information will inform a toolkit for Medicaid health plans that is being created by the Institute for Medicaid Innovation. 

As I traveled around the country conducting these interviews, I was struck by families’ desire for more information and programming. When I asked them what they most wanted me to take away from the interview, the majority said that they just wanted the program to continue so that their communities could learn more and their children could be healthier. Most were motivated by family members who live with chronic diseases and the desire to prevent their children from experiencing the same. In many cases, the key to the programs was having a leader or clinician who could connect with the families. Hearing directly from families about what worked well in these programs reminded me how important it is to engage families in all aspects of program design and evaluation.

There are many factors to account for when engaging family and community partners in public health programs and research. From my experience, these four key considerations have emerged:

1) Embrace community members as equal experts

Community partners are experts in their lived experiences. It is essential that improvement teams, be they healthcare providers, policymakers or public health professionals, understand this and take steps to create an environment where everyone at the table feels equally valued, which includes fair compensation. Many times, it is the most passionate community members who get involved in these initiatives and would volunteer their time, but they deserve paid opportunities as equal experts.

2) Make sure it’s meaningful

Community and family engagement cannot be an afterthought. Ideally, these partners would be involved from the planning phase, which may start with input on grants or research proposals. That said, if there does not seem to be a meaningful way to engage these partners, it should not be forced in a way that treats it like a minimum requirement.

3) Be clear about the commitment

There are various ways to engage family or community partners in workshops or meetings. It’s important to be clear about the timeline, expected commitment, amount of flexibility, and if possible, options for participating in order to set people up for success and avoid confusion or miscommunications down the road.

4) Remember that one voice represents one person

Perhaps most importantly, we have to remember that one person does not represent anyone other than that person. One person can offer insight and opinions based on their experience and preferences but should not be made to feel as though they are expected to speak for an entire community.

Without seeking input from the most important stakeholders, families and community members, we are making potentially costly assumptions. Even the most well-intentioned efforts will not be effective unless the intended participants are on board in a meaningful way. 

Kelley Devlin, MPH, RD, is a project manager at NICHQ, focusing on children with special healthcare needs.