Connecting communities and complexity: a case study in creating the conditions for transformational change

Abstract

The standard, deficit-based, approach to health promotion tends to focus on health problems, designing services which are meant to solve these problems, of which members of communities are made the passive recipients. An alternative approach recognises that health problems are complex, having many causal pathways and as a result will require locally tailored interventions, involving multiple service providers working with local communities. Using empirical research from the development of two transformational community-led partnerships, an experiential learning programme was developed, Connecting Communities (C2). Complexity science is the underpinning theoretical framework for C2, which seeks to create the conditions to transform the health and well-being of disadvantaged communities. C2 focuses specifically on the nature of the relations between the agents in the system and their interactions with the social environment which determine the system’s behaviour. This is because a key tenet of complexity science is that systemic change cannot be externally directed, but occurs as a result of the self-organising interactions and relationships within the system. C2 takes an explicit asset-based community development approach, seeking to facilitate and support the development of local neighbourhood partnerships which focus on the strengths and aspirations of the community, rather than perceived deficits. This paper reports on the development of C2, its delivery, presents a case study of one of the first groups to undertake the Programme, and assesses its subsequent impacts on the participants’ ways of working, and in the local community.

Keywords:

• population health
• research
• health promotion

Acknowledgements

The authors thank Anthea Duquemin for her evaluation of Camborne C2; and Hazel Stuteley, Jonathan Stead and Susanne Hughes for their ongoing collaboration and discussion about C2 and its outcomes. Katrina Wyatt is partially supported by the National Institute for Health Research (NIHR) PenCLAHRC. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.