Community Engagement with Michigan Area Health Education Centers (AHEC): Selecting Strategies and Making Choices

Background and Purpose: Engaging community members in a process to identify and solve problems that impact their wellbeing is a fundamental value and method of social work. There are a range of strategies that can be applied to gain trust, understanding and for the mutually beneficial exchange of information in a context of partnerships and reciprocity. This study contributes to community practice knowledge about the strategies and choices of community engagement methods. The aim is to analyze four community engagement applications used with Area Health Education Centers (AHEC) that can identify patterns of practice decisions to produce greater generalizability (Yin, 1994). AHEC seek to expose disadvantaged students to health care opportunities, expand the number of underrepresented minorities in the health professions, and encourage students and health professionals to work in areas that need greater access to primary care providers.

The questions are: 1) What strategic considerations were utilized to decide which engagement method was most appropriate for the local community? 2) How did participants react to community engagement? What were the relative merits? 3) To what extent did AHEC use the process and information generated to form alliances and develop local programs?

Methods: This paper uses a case study of four community engagement applications that used techniques of Open Space Technology and World Café with different population groups in four regions of the state. Analytic techniques, including pattern matching, were applied to assess how each application compared in terms of strategy, choices and outcomes.

Results: Qualitative analysis of Open Space Technology and World Cafe yielded important results and lessons. First, strategic selection of techniques depended on the existing relationships and capacity of AHEC and ability of partners to mobilize pre and post action. Second, the methodologies used were found to be appropriate across population groups and topics. Disadvantaged community residents, youth, health professionals and educators were open to the process and engaged in dialogues that encouraged and documented their voices about health care access and careers. AHEC teams were challenged by community engagement strategies that required familiarity with proposed topics – however the techniques that were used provided the opportunity to broaden awareness, develop a larger community contact base, and generated foundational data that informed initial programmatic response and planning to stakeholder needs, questions, and ideas. In addition, new alliances were formed as a result of shared vision and dialogue. Like-minded community participants were able to explicate best practices and programs being implemented in their organizations, schools and agencies and sub-groups formed to address specific areas of interest and concern.

Conclusions: Effective community engagement is a bidirectional relationship whereby efforts result in a mutual exchange of information, ideas, and resources that improves the potential for sustainable change. This study found shortcomings and strengths of using community engagement particularly related to readiness. Helping communities develop the capacity for successful change takes time and strategy but practitioners can be assured that using different techniques can be a first step in successful community engagement.