title: The effectiveness of community engagement in public health interventions for disadvantaged groups: a meta-analysis.
abstract: BACKGROUND
  Inequalities in health are acknowledged in many developed countries, whereby disadvantaged groups systematically suffer from worse health outcomes such as lower life expectancy than non-disadvantaged groups. Engaging members of disadvantaged communities in public health initiatives has been suggested as a way to reduce health inequities. This systematic review was conducted to evaluate the effectiveness of public health interventions that engage the community on a range of health outcomes across diverse health issues.
  
  
  METHODS
  We searched the following sources for systematic reviews of public health interventions: Cochrane CDSR and CENTRAL, Campbell Library, DARE, NIHR HTA programme website, HTA database, and DoPHER. Through the identified reviews, we collated a database of primary studies that appeared to be relevant, and screened the full-text documents of those primary studies against our inclusion criteria. In parallel, we searched the NHS EED and TRoPHI databases for additional primary studies. For the purposes of these analyses, study design was limited to randomised and non-randomised controlled trials. Only interventions conducted in OECD countries and published since 1990 were included. We conducted a random effects meta-analysis of health behaviour, health consequences, self-efficacy, and social support outcomes, and a narrative summary of community outcomes. We tested a range of moderator variables, with a particular emphasis on the model of community engagement used as a potential moderator of intervention effectiveness.
  
  
  RESULTS
  Of the 9,467 primary studies scanned, we identified 131 for inclusion in the meta-analysis. The overall effect size for health behaviour outcomes is d = .33 (95% CI .26, .40). The interventions were also effective in increasing health consequences (d = .16, 95% CI .06, .27); health behaviour self-efficacy (d = .41, 95% CI .16, .65) and perceived social support (d = .41, 95% CI .23, .65). Although the type of community engagement was not a significant moderator of effect, we identified some trends across studies.
  
  
  CONCLUSIONS
  There is solid evidence that community engagement interventions have a positive impact on a range of health outcomes across various conditions. There is insufficient evidence to determine whether one particular model of community engagement is more effective than any other.
authors.affiliation: Social Science Research Unit, UCL Institute of Education, London, UK. a.omara-eves@ioe.ac.uk.
authors.forename: Alison
authors.initials: A
authors.lastname: O'Mara-Eves
authors.affiliation: Social Science Research Unit, UCL Institute of Education, London, UK. g.brunton@ioe.ac.uk.
authors.forename: Ginny
authors.initials: G
authors.lastname: Brunton
authors.affiliation: Social Science Research Unit, UCL Institute of Education, London, UK. s.oliver@ioe.ac.uk.
authors.forename: Sandy
authors.initials: S
authors.lastname: Oliver
authors.affiliation: Social Science Research Unit, UCL Institute of Education, London, UK. j.kavanagh@ioe.ac.uk.
authors.forename: Josephine
authors.initials: J
authors.lastname: Kavanagh
authors.affiliation: Institute for Health and Human Development, University of East, London, UK. f.jamal@uel.ac.uk.
authors.forename: Farah
authors.initials: F
authors.lastname: Jamal
authors.affiliation: Social Science Research Unit, UCL Institute of Education, London, UK. j.thomas@ioe.ac.uk.
authors.forename: James
authors.initials: J
authors.lastname: Thomas
mesh_terms: D002986:Clinical Trials as Topic; D003256:Community Participation; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D054624:Health Status Disparities; D006801:Humans; D011634:Public Health; D020377:Self Efficacy; D012944:Social Support; D013222:State Medicine; D006113:United Kingdom; D035862:Vulnerable Populations