Working with community researchers to achieve change for people

Guidance - 5 September 2022

Examples from Healthwatch Oxfordshire demonstrate how working with communities can strengthen your research project and improve outcomes for the community.
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What is community research? 

Community research involves working with communities - speaking to people, identifying key issues, and seeing where change or practical solutions can be achieved. 

The research is action-focused and participatory, meaning communities are at the heart of this approach from beginning to end. 

Working this way means local Healthwatch can bring resources, time, and effort to support, listen, and build skills.  It can help communities to bring their views and voice to the fore and explain what health and social care issues are important to them. 

Together, we can work creatively - building skills with individual community researchers or supporting community groups to do their own research. 

Community research is important because it is: 

  • Community-led throughout and focused on issues of concern 

  • Action focused – achieving results for the community themselves 

  • Reaches people whose voices are underrepresented 

  • Builds confidence and recognises skills, knowledge and expertise in communities

  • Reimburses community members for their time and input 

  • Can start to address inequalities in access and resource 

  • About the process as well as the result 

  • Moves away from extractive research approaches 

  • Supporting communities is a continuous ongoing dialogue: it can influence health and care providers to build responsive and culturally appropriate  services for underrepresented communities, based on equity, trust and access.

How do we do it? 

Healthwatch works with communities in many ways. Through open discussions we can support communities to identify how best to raise what is important to them in health and care and to get their voices heard. This two-way process takes time to build relationships, trust and dialogue. It is not a shortcut approach. 

In 2021 Healthwatch Oxfordshire supported two community researchers under a Community Participatory Action Research (CPAR) programme. This support was initiated and funded by Health Education England South-East and developed in collaboration with the Office for Health Improvement and Disparities, the Scottish Community Development Centre and NHS England and Improvement.

Healthwatch Oxfordshire developed two models of community research

Model one: Supporting community action researchers on their chosen topic 

People from a community who want to focus on an issue of importance to them can work with Healthwatch as community researchers. We support them in highlighting the important concerns in their community. We are alongside them to provide support, build skills, help research planning, and provide resources for this to happen. We help the researchers and communities to share what they have heard directly with the health and care system. 

In this model, the community chooses the issue, the research methods, and how the research will be used. This process takes time and strongly focuses on participation and change, identifying areas for practical action.  

Example. Model one – community action research (nine - 12 months)  

Healthwatch Oxfordshire recruited a community researcher. She came via existing links with a local grassroots organisation with strong relationships within Oxford’s diverse and multi-ethnic communities.  

Speaking with women in the community, she found that black women's experiences of maternity were a topic of concern. Healthwatch helped her develop a research plan and provided skills development, mentoring, and other resources. 

The researcher held a community event bringing women together to discuss their experiences. The women shared their stories and identified areas for improvement in maternity care. Their conversation was recorded on video. 

Outcomes: The community researcher and the women showed the film at a celebratory screening event with health professionals from local maternity services. This led to a commitment to work more closely with women from black and minority ethnic communities to develop dialogue, listen, and explore more culturally appropriate ways of delivering maternity services.  

The community researcher built links with the local maternity health inclusion group and Maternity Voices Partnership. The grassroots organisation has started a community women's session. Improvement and action on the provision of interpreters in hospital maternity services have also been highlighted, and a working group set up.  

The researcher commented, "… everyone just started sharing. It was really, really powerful. And I was thinking, this is amazing. I thought, yes, there is no way you can't learn something from it. It teaches you … where you can change and make things right. And that's exactly how I wanted it to be" 

Watch the film

Model two: Working with community researchers on specific issues 

In this model, Healthwatch can work with community researchers on a specific piece of research. The focus topic is defined up front, either from the community or in response to pressing issues or themes.  

This is a shorter-term commitment and focuses on enabling voices to be heard by the health and care system. We provide support and training to community members to build research skills and highlight areas for change to decision-makers.  

Whilst the community researcher builds skills, there is less focus on wider community participation within the research process. 

Example. Model two – short-term project (three-four months) 

Healthwatch Oxfordshire recruited two community researchers from Arabic-speaking and Albanian communities. We wanted to learn more about barriers to accessing NHS health and care services and speaking up about concerns. We asked researchers to hold focus groups or in-depth interviews with a mix of people from their community.  

Project scope: 

The project was clearly defined by Healthwatch from the start, including a clear project brief and specific theme and clearly defined time allocation (hours) 

Outcomes:  

We shared the final report with local health and care providers and at the Oxfordshire Health and Wellbeing Board. A summary in English, Albanian and Arabic was also shared with the communities, giving advice and information about “how to comment or complain’’ to local services.  

The report gave insight into why people find it hard to raise their voice, as well as cultural and language barriers to services. The local hospital trust noted the need for better interpreting support and is working to improve its offer. Members of the Albanian community have been linked in with Core Plus 20 Connectors Community Champions Programme. 

The Albanian community researcher commented, "I gained new insights into my own community. The interviewees shared things that I would not have heard if it wasn't for this research setting. I also gained valuable research experience which has enhanced my professional set of skills" 

Read the report

Step-by-step guide.  

NB flexibility and adaptation are required! 

Action research cycle through five steps – Plan, Observe, Act, Disseminate, Reflect. 

Step one: Plan  

Lay foundations (Healthwatch led): 

  • Set up internal Healthwatch procedures first 

  • Establish scope, timeline and budget for the project 

  • Agree on reimbursement process for community members' time in group sessions, including transparency around responsibility for tax/benefits declarations etc.  

  • Provide equipment and staff support as needed  

  • Provide dedicated staff time for support and mentoring 

  • Recruit community researchers via local links (E.g. from a community of interest, place, culture)  

  • Provide training, induction, mentoring and support for community researchers  

Community plan (community researcher-led) 

  • Support researchers to identify the community of focus  

  • Support researchers to identify project theme/problem/question/issue in collaboration with the community 

  • Build bridges and dialogue between researchers, community and local health and care services 

Step two: Observe (community researcher-led) 

  • Develop research methods, approach and plan with the community 

  • Promote any events through community networks and social media 

  • Gather information, listen and involve communities – make sure research is inclusive, culturally appropriate and accessible and remove barriers to participation 

  • Use creative methods to reach people and hear their voice  

  • Focus on process, challenges and solutions 

Step three: Act (community researcher-led) 

  • Based on what you hear, decide the way forward and identify action points 

  • With the community, determine what practical changes are needed; where, how and by whom? 

  • Decide on how you will tell the story. 

Step four: Disseminate (Healthwatch with researcher and community) 

  • Help community researchers and community members share insights and lessons, e.g. to health and care providers, Health and Wellbeing Board  

  • Facilitate round table discussions, community events etc. 

  • Make sure health and care providers report back to the community and highlight what has happened as a result. 

Step five: Reflect 

  • Change may not be immediate and make take years. Follow impact over time  

  • Keep the community updated about progress and changes  

  • Keep learning and developing with communities’ input: use lessons to inform the improvement of this approach for

Resource considerations for Healthwatch 

Admin, induction and support for community researcher 

  • Recruitment 

  • Healthwatch induction, policies and procedures 

  • DBS check, Safeguarding and GDPR 

  • Comms support with the project, e.g. social media, posters, report 

  • Ongoing troubleshooting, mentoring and admin support 

Training for community researcher 

Up to three days of training, including: 

  • Understanding models of health and health determinants  

  • Community participatory action research – what and why? 

  • Action Research, the ‘research cycle’ and identifying change 

  • ‘Good research’, ethics, data handling, GDPR, solving challenges 

  • Scoping and planning your research 

  • Research methods, tools and approaches 

  • Telling the story, data collection and analysis,  

  • Report development and dissemination, building confidence  

  • Feeding back to the community and ‘what next?’ 

  • Next steps and learning 

Equipment and IT for community researcher 

  • Voice recorder, phone, ID lanyard 

  • Secure community researcher email and Dropbox access 

  • Consider the need for dedicated IT research support, e.g. Smart Survey  

Reimbursement for community researcher 

  • Travel and subsistence costs 

  • Reimbursement for time (training, research and dissemination). Suggest a minimum of £11 per hour 

Project support 

  • Events fund, e.g. focus group, event costs, vouchers for attendees 

  • Disseminating findings, e.g. film production, leaflets, reports 

  • Translation and interpreting, childcare and other costs   

Healthwatch staff time and skills 

  • Dedicated staff time ongoing through the project: training, mentoring, support and supervision, dissemination (estimated at one day/week on average over nine months)  

  • Office management support: budget, procedures etc 

  • Social media and comms support 

  • Skills in community development approaches 

Community action research is part of a family of participatory approaches, e.g. Community Participatory Action Research (CPAR), Action Research, and Community-led research. To learn more:  

Resources and helpful guides: 

Healthwatch Oxfordshire's community researchers explainer film

Scottish Community Development Association

Centric community research hub

Literature review community research

Healthwatch Oxfordshire are happy to share insights into their experience working with community researchers. Please get in touch with them by email at hello@healthwatchoxfordshire.co.uk or calling 01865 520520. You can see examples of this work on their website.  

Costs (based on model one, up to nine months)

  • Training (three days @ £11/hour): £231
  • Research (100 hours @ £11/hour): £1,100
  • Support (10 hours @ £11/hour): £110
  • Presentations (10 hours @ £11/hour): £110
  • Phone: Nine months @ £15/month: £135
  • Travel: Reimbursement/mileage @45p/mile: £100
  • Events: 2 @ £200: £400

Total/community researcher: £2,065

Community research is: 

  • A process as much as an outcome 

  • Time-consuming 

  • It takes commitment, skill, risk and an iterative learning approach 

  • Rewarding for both community and Healthwatch 

  • Highlights issues, perspectives and concerns of seldom heard communities on their own terms and led by them 

  • Action-based and focused on change 

  • A way of working with communities based on respect, partnership and value 

What community research is not:

  • A quick fix 
  • Easy 
  • Tokenistic
  •  A clear-cut ‘toolkit’ approach 
  • A guaranteed product, outcome or ‘success’ 
  • Without risk 
  • Appropriate in all circumstances

What are the challenges?

  • Doesn’t stick to ‘office hours’ -challenges boundaries  

  • Researchers vary in skills and confidence and may need different levels of support 

  • Researchers and community members have busy lives, often juggling jobs and family, so they have little time 

  • Needs ongoing problem solving, e.g. challenges with boundaries, GDPR and confidentiality 

  • May not be free of community ‘politics’ 

  • Needs understanding how to support beyond the research to protect/ navigate researcher and community in dialogue with health and care system and subsequent demands 

  • Organisational and service change is slow and takes time, leaving communities frustrated. Make sure to focus on real changes that people can see 

Downloads

Community research theory of change
Download (PDF 146 KB)