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      Herramienta multidimensional para la medición de la calidad de la participación en salud Translated title: A multidimensional tool to measure quality of social participation in health

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          Abstract

          Resumen Las estrategias, los programas y las acciones en salud han sido históricamente el resultado de prácticas institucionales con un componente participativo limitado. La acción institucional ha venido determinada sobre todo por el criterio de actores políticos y, en el mejor de los casos, por el criterio de profesionales de la salud. Nuevas formas de gobernanza para la equidad en salud abogan por la inclusión de la comunidad en el diseño de estrategias, programas y actividades en salud. Por ello, una preocupación creciente en el campo de la participación en salud es la medición de la calidad participativa de los nuevos diseños de prácticas institucionales. Este artículo tiene como objetivo desarrollar una propuesta operativa para diseñar, medir o describir el alcance en términos participativos de los procesos de planificación en salud. La propuesta elabora seis dimensiones para la medición y la evaluación del proceso participativo: inclusividad, flujo de información, calidad deliberativa, toma de decisiones, compromiso institucional y empoderamiento comunitario.

          Translated abstract

          Abstract Health strategies, programs and activities have historically been the result of institutional practices with a limited participatory component. Traditionally, institutional action is mainly determined by the criteria of the political actors and, in the best of cases, by the criteria of healthcare professionals. New forms of governance for health equity advocate for the inclusion of the community in the design of strategies, programmes and activities in health. For this reason, a growing concern in the field of participation in health is the measurement of the participatory quality of new designs of institutional practices. This article aims to develop an operational proposal to design, measure or describe the scope in participatory terms of the health planning processes. The proposal elaborates six dimensions for the measurement and assessment of participatory process: inclusivity, information flow, deliberative quality, decision making, institutional commitment and community empowerment.

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          Putting the Public Back into Governance: The Challenges of Citizen Participation and Its Future

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            Impact of Participatory Health Research: A Test of the Community-Based Participatory Research Conceptual Model

            Objectives A key challenge in evaluating the impact of community-based participatory research (CBPR) is identifying what mechanisms and pathways are critical for health equity outcomes. Our purpose is to provide an empirical test of the CBPR conceptual model to address this challenge. Methods A three-stage quantitative survey was completed: (1) 294 US CBPR projects with US federal funding were identified; (2) 200 principal investigators completed a questionnaire about project-level details; and (3) 450 community or academic partners and principal investigators completed a questionnaire about perceived contextual, process, and outcome variables. Seven in-depth qualitative case studies were conducted to explore elements of the model not captured in the survey; one is presented due to space limitations. Results We demonstrated support for multiple mechanisms illustrated by the conceptual model using a latent structural equation model. Significant pathways were identified, showing the positive association of context with partnership structures and dynamics. Partnership structures and dynamics showed similar associations with partnership synergy and community involvement in research; both of these had positive associations with intermediate community changes and distal health outcomes. The case study complemented and extended understandings of the mechanisms of how partnerships can improve community conditions. Conclusions The CBPR conceptual model is well suited to explain key relational and structural pathways for impact on health equity outcomes.
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              Power, control, communities and health inequalities I: theories, concepts and analytical frameworks

              This is Part I of a three-part series on community empowerment as a route to greater health equity. We argue that community ‘empowerment’ approaches in the health field are increasingly restricted to an inward gaze on community psycho-social capacities and proximal neighbourhood conditions, neglecting the outward gaze on political and social transformation for greater equity embedded in foundational statements on health promotion. We suggest there are three imperatives if these approaches are to contribute to increased equity. First, to understand pathways from empowerment to health equity and drivers of the depoliticisation of contemporary empowerment practices. Second, to return to the original concept of empowerment processes that support communities of place/interest to develop capabilities needed to exercise collective control over decisions and actions in the pursuit of social justice. Third, to understand, and engage with, power dynamics in community settings. Based on our longitudinal evaluation of a major English community empowerment initiative and research on neighbourhood resilience, we propose two complementary frameworks to support these shifts. The Emancipatory Power Framework presents collective control capabilities as forms of positive power. The Limiting Power Framework elaborates negative forms of power that restrict the development and exercise of a community’s capabilities for collective control. Parts II and III of this series present empirical findings on the operationalization of these frameworks. Part II focuses on qualitative markers of shifts in emancipatory power in BL communities and Part III explores how power dynamics unfolded in these neighbourhoods.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) (Barcelona, Barcelona, Spain )
                0213-9111
                February 2022
                : 36
                : 1
                : 60-63
                Affiliations
                [1] Alicante Valencia orgnameUniversidad de Alicante orgdiv1Departamento de Sociología II Spain
                Article
                S0213-91112022000100060 S0213-9111(22)03600100060
                10.1016/j.gaceta.2021.03.009
                65b01370-f2c7-4745-989a-3e8eae9d46c1

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 04 February 2021
                : 30 March 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 4
                Product

                SciELO Spain

                Categories
                Notas Metodológicas

                Community,Health planning,Methods,Community-based participatory research,Social participation,Comunidad,Planificación en salud,Métodos,Investigación participativa,Participación social

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