How are community participation and empowerment processes shaped and fostered in practice in community health centres in Emilia-Romagna, Italy? A qualitative study.

AIM: This study examines how community participation and empowerment processes are shaped and fostered in practice in the context of community health centres (CHCs) in Emilia-Romagna, Italy.

BACKGROUND

European health care systems are encouraged to make their primary health care more people centred. With the introduction of CHCs, Italy is promoting this development. In this context, community participation and empowerment represent important features.

METHODS

This qualitative study draws on the experiences of practitioners and stakeholders working in the field of community participation and empowerment in CHCs. We conducted 19 in-depth interviews and our interviewees provided descriptions from 14 good-practice CHCs. The examples were organized according to different levels of participation, thus highlighting four themes: a) connecting with the community by informing, meeting, and proposing activities; b) consulting with the community to identify its needs; c) collaborating with the community (including prior consultation); and d) the community as the leader of the process.

FINDINGS: In terms of the four themes and the extent of involvement, we identified a variety of processes aimed at supporting community participation and empowerment and provided various examples. We described the different goals of community participation and empowerment (e.g., the appropriateness, accessibility and visibility of CHC services; improved health; the mobilization of community resources; the construction of supportive networks; and the creation of spaces for capacity-building), the interviewees' reported potential benefits; the community participation methods used (e.g., world cafés, workshops) and the different target groups addressed (e.g., specific disadvantaged groups or entire local community).