ArticleHealth expectations : an international journal of public participation in health care and health policy2022
'They need to ask me first'. Community engagement with low-income citizens. A realist qualitative case-study.
Article in Health expectations : an international journal of public participation in health care and health policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 19 citations in OpenAlex.
- Collaboration between healthcare citizen initiatives and primary healthcare care providers: semi-structured interviews and focus groups with Dutch stakeholders.BMC public health · 2026Article
- Co-production of informal settlement health: a community based participatory research program for building healthy communities in urban informal settlements of Salvador, Brazil.Frontiers in public health · 2026Article
- Civic Engagement and Social Connectedness in Rural Communities: The Role of Sociodemographic Factors and Social Determinants of Health in Rural Areas of the United States.Social sciences · 2025Article
- How to improve support for people with (complex) multiple-problems through social prescribing in a vulnerable neighborhood; professionals', experts-by-experience' and clients' perspectives.BMC primary care · 2025Article
- Implement social prescribing successfully towards embedding: what works, for whom and in which context? A rapid realist review.BMC public health · 2024Review
- Tracking the Development of Community Engagement Over Time: Realist Qualitative Study.Journal of participatory medicine · 2024Article
- Health-related quality of life of children from low-income families: the new patterns study.BMC public health · 2023Article
- 'They need to ask me first'. Community engagement with low-income citizens. A realist qualitative case-study.Health expectations : an international journal of public participation in health care and health policy · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCommunity engagement is seen as key to citizen-centred and sustainable healthcare systems as involving citizens in the designing, implementation and improvement of services and policies is thought to tailor these more closely to communities' own needs and experiences. Organizations have struggled to reach out to and involve disadvantaged citizens. This paper examines how if, why, and when low-income citizens wish to be involved.
methodsFor this qualitative realist case-study, 19 interviews (one dyad) were held with (20) low-income citizens in two Dutch municipalities. Additionally, the results were discussed with a reference panel consisting of professionals and citizens to enrich the results and to ensure the results had face validity.
resultsThe results showed four different ways in which low-income citizens wished to be involved: (a) in a practical/volunteer way; (b) as a buddy; (c) as a lay expert; (d) not involved at all. The factors affecting citizens' interest and capacity to participate include citizens' own experiences of the services they access and their personal situations, e.g. their mental or physical health, extent of financial crisis, family situation, home environment. None of the interviewees was currently involved, but all had ideas for improving health(care) services and policies. Citizens' experiences of the services they accessed acted as a motivator for some to be involved as they wanted to ensure others would not have the same struggles, while for others their own needs and an apathetic system remained too high a barrier. To enable involvement, citizens need continued support for their own health(care) and financial situation, better communication and accessibility from services, practical support (e.g., training and bus passes) and recognition for their input (e.g., monetary compensation).
conclusionThe study shows that citizens' experiences of the services they accessed influenced if and how they wanted to be involved with health and care services. Despite the fact that all participants had shared solid ideas for improving services and policies, they were hindered by a bureaucratic, impersonal and inaccessible system. Organizations seem to underestimate the required investments to reach out to low-income citizens and the support required to ensure their involvement. PATIENT AND PUBLIC INVOLVEMENT (PPI) IN STUDY: Citizens as well as PPI organizations were members of the reference panel who helped formulate the research questions and recruitment strategy. The local reference panel also helped to interpret and refine the initial findings.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.