What is it?

REAL is a realist review of community engagement in global health research. The review aims to bring greater conceptual clarity and consistency to the field through review of the evidence around community and public engagement. Better understanding of key mechanisms underpinning engagement will be a foundation for strategic development of community and public engagement in global health research and interventions. The review is supported by the Wellcome Trust, UK, KEMRI-Wellcome Trust Research Programme, Kenya and Emory University, USA (2019-20).

Why is it needed?

Community Engagement (CE) is increasingly recognised as a critical aspect of global health. Recent years have seen an expansion of CE activities linked to health research, but clarity about the aims of engagement, consistency around the distinctions between types of engagement - and the mechanisms underpinning them - has yet to be established. Deeper investment in CE by funders, implementers and health research programmes is hampered by the lack of a coherent evidence base for the impact and value of CE.

Part of the challenge is that community engagement is a complex, multi-stakeholder process that varies widely according to the goals of the research, and the contexts of application. Realist review is a recognised way of helping to understand how and why the same intervention may perform differently when the context and implementation vary. Realist review can organise evidence on complex interventions to draw out transferable learning and identify ‘what works for whom in what circumstances’.

What will it do?

REAL will address this critical knowledge gap by conducting a comprehensive realist review of CE in the context of global health research. This will help in understanding the characteristics and impacts of engagement between research institutions, researchers, communities and stakeholders affected by health research.

Review questions will include; what are the intended outcomes of CE strategies? what mechanisms underpin intended and unintended outcomes of CE? and what important aspects of context have an influence?

Given the scope and heterogeneity of the CE literature, Malaria will be a ‘pathfinder’ topic. Malaria is both a high priority for partners and an area where there is extensive engagement experience. The review will be extended to other areas as it evolves.

Who will do it?

The review team includes leading international CE scholars, Sassy Molyneux (KEMRI/Oxford) and Jim Lavery (Emory) and realist review expert Geoff Wong (Oxford). Project advisors includes those with extensive experience in Bioethics, Malaria, realist review, and designing and delivering CE strategies for global health.

The review will consult a wide range of stakeholders - including practitioners, academics, funders and implementers - who will also be drawn on to validate and make use of the findings in specifically designed validation workshops and outreach.

Findings of the review as it evolves will also be shared through the MESH community engagement network and the Human Engagement Learning Platform (HELP). In addition to academic outputs the review will produce guidance for planning and implementation of CE in a variety of accessible formats to be applied by users depending on their context and needs.

To what end?

 The review aims to assemble, critically analyse and synthesise the CE literature to draw out transferrable learning. This will help to:

  • provide a conceptual and empirical foundation upon which the contributions of new knowledge can be better understood and applied
  • enrich our understanding of the mechanisms through which CE produces specific changes and outcomes of interest, and improve our ability to design effective CE
  • help clarify the value of CE for global health research, and help facilitate improved evaluation and assessment of the return on investment for CE

Supported by Wellcome Trust grant: 210505/Z/18/Z

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Read the full Study Protocol paper on Wellcome Open Research.