A Roadmap for Authentic Community Engagement
We can’t improve maternal and child health without engaging community voices—without practicing what NICHQ Executive 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.
NICHQ Employee Spotlight: Chiagbanwe Enwere, NICHQ Project Analyst
As a member of NICHQ's Data Applied Research and Evaluation (DARE) team, NICHQ Project Analyst Chiagbanwe Enwere brings a unique data and equity perspective to the New York State Maternal and Child Health Collaboratives project
MCH Lead Poisoning Toolkit: Lessons on Using Data for Improvement
The Maternal and Child Environmental Health Collaborative Improvement and Innovation Network (MCEH CoIIN), a national initiative led by the Association of Maternal and Child Health Programs developed the MCH Lead Poisoning Toolkit to share innovative practices and methods that nine different state teams tested out to improve access to systems and services that address the needs for pregnant women, infants, children, and families that are exposed to lead. NICHQ provided quality improvement expertise and technical assistance for the MCEH CoIIN—offering state teams guidance on using data and measurement to determine where improvements have been made and areas that still require change. Read tips and take-aways from the three-year CoIIN for data collection and using data for Improvement.
A Physician’s Reflections on Racism and Treating Sickle Cell Disease
For NICHQ’s current and future work, I am motivated by wanting to be a better version of myself in service of others. Wondering whether my own implicit biases impacted my care of patients and families, I realize that I cannot redo past ER experiences. If I could go back, I would slow down to acknowledge and try to set my biases aside and approach patients from a personally more informed perspective. But now, I can use my past, present, and future experiences to ensure NICHQ is amplifying important lessons from this multi-year effort reflecting the compassion, care, and commitment of hundreds of dedicated professionals in pursuit of equitable, accessible, and quality healthcare for people living with sickle cell disease.
NICHQ Employee Spotlight: Kim Sprunck
As NICHQ's Associate Director of Programs and Project Director for the Sickle Cell Disease Treatment Demonstration Regional Collaboratives Program and Content Development for Newborn Screening Clearinghouse initiatives, Kim Sprunk shares key takeaways and findings from the projects and their importance to NICHQ's overall programming goals.
Navigating Well-Child Visits and Vaccinations during COVID-19
Well-child visits and recommended vaccinations are essential, ensuring children stay healthy and are protected from preventable diseases and illnesses such as measles, whooping cough, and seasonal flu. But, as the COVID-19 pandemic persists, data shows that fewer childhood vaccinations have been given and many children have fallen behind on their scheduled appointments. Healthcare professionals should utilize the following strategies to work with parents and caregivers to get their children caught up on missed appointments and recommended vaccinations.
Exploring a Nonbinary Approach to Health
NICHQ is not abandoning the traditional use of the terms “mother” and “maternal.” We are embracing the inclusive language of “birthing person/people” across our work. A move toward inclusive language does not force us to stop using language that so many people identify with; at its core, inclusion is about creating more space for one another. We are taking care to expand the use of these terms in our communications, on our website, in our resources, and eventually, in all our projects.