Health promotion by communities and in communities: current issues for research and practice

This paper explores contemporary issues around community-based health promotion in the light of international health policies reaffirming the central role of community action within broader efforts to achieve health equity. Adopting a system-level approach poses challenges for current health promotion practice and evaluation, particularly where there is a shift in emphasis from small-scale community health projects towards mainstream community programmes, capable of engaging widely across diverse populations.

Drawing on research with community members carried out by the Centre for Health Promotion Research, Leeds Metropolitan University, UK, the paper re-examines assumptions about the nature of interventions within community settings, and what participation means from a lay perspective. Key research issues for community-based health promotion are highlighted.

The paper concludes by proposing that community-based interventions need to be reframed, if the dual challenges of citizen involvement and evidence based practice are to be met.