'Getting involved means making a difference?' Insider views on the impact of a 'healthy living' community intervention

摘要

Addressing inequalities in health has featured strongly in UK health care policy over recent years, and efforts to consider inequalities at 'ground level' are increasingly evident. This includes enhancing primary care and other community-based services and emphasising consultation at community levels. The Healthy Living Approach to community development in Pembrokeshire, West Wales, was initiated and evaluated as part of the Welsh Assembly Government's Sustainable Health Action Research Programme (SHARP). As part of that programme an action research project was organised to respond to a context of funding and service delivery coloured by rural isolation, social exclusion and poor health. The project was adopted in three marginal communities and was evaluated using multiple methods to understand the effects of the initiative and how well it was seen to have worked. This paper reports on one aspect of that evaluation: focus groups with Project Steering Group members that examined the impact of the intervention from the perspective of those involved in the study's implementation. The paper highlights the perceived impact on community members and study organisers, the process of liaison between community and statutory body advisers and the appropriateness of the methodology. There was overwhelming support for the project and agreement that action research was the only feasible working methodology. The results offer insider views on the potential for 'healthy living' community interventions to enable communities to engage with locally defined health issues, but sets a note of caution about being able to achieve real and sustainable change.