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Updated: Jan 18, 2026

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Whose knowledge counts? Involving communities in intervention and trial design using community conversations.

Rochelle A Burgess1, Funmilayo Shittu2,3, Agnese Iuliano3

  • 1Institute for Global Health, University College London, London, UK. r.burgess@ucl.ac.uk.

Trials
|June 7, 2023
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Summary

Community conversations (CCs) engaged large numbers of Nigerian caregivers to inform a trial reducing child mortality. This method identified factors influencing health decisions and trial design, empowering community voices.

Keywords:
Community conversationsCommunity engagementFormative researchParticipationTrialsUnder-5 pneumonia

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Area of Science:

  • Global Health Research
  • Community-Based Participatory Research
  • Public Health Interventions

Background:

  • Global health initiatives increasingly require inclusive methodologies for knowledge production and intervention design.
  • Traditional trial research often limits citizen input in trial structure and nature.
  • This study adapted community conversations (CCs) for formative trial work, engaging large community groups in dialogue.

Purpose of the Study:

  • To explore community perspectives on childhood pneumonia and under-5 child health management in Northern Nigeria.
  • To inform the design of a pragmatic cluster randomised controlled trial evaluating a complex intervention to reduce under-5 mortality.
  • To adapt and apply the community conversations (CCs) methodology for large-scale community engagement in trial design.

Main Methods:

  • Conducted 12 rounds of community conversations (CCs) with 320 male and female caregivers of children under five in Jigawa state, Nigeria.
  • Utilized participatory learning and action activities, including drawings and discussions, to facilitate engagement across different age and gender subgroups.
  • Followed initial CC analysis with focus group discussions in new sites to ensure comprehensive input from all administrative wards for intervention design.

Main Results:

  • Identified key enabling and limiting factors for trial implementation, such as household power dynamics and gendered use of space affecting women's health decisions.
  • Observed positive participant engagement, with many valuing the opportunity for self-expression previously unavailable.
  • Gained insights into community perspectives on pneumonia and child health management crucial for tailoring the intervention.

Conclusions:

  • Community conversations (CCs) offer a structured method for meaningful engagement of citizens in intervention and trial design.
  • Successful implementation of CCs requires adequate resources and a commitment to integrating qualitative research within trial frameworks.
  • The adapted CC methodology proved effective in gathering diverse community perspectives to inform a large-scale public health trial.