Community participation in health initiatives for marginalized populations.

Community-based participatory methods have emerged as a response to conventional approaches that have historically failed to make notable improvement in health status or reduce chronic disease among marginalized populations. The social-ecological model provides a framework to develop and implement strategies directed to affecting multiple levels (societal, community, organizational, and individual) of influence on health status. A systems approach can facilitate the identification of the complex interrelationships of factors at all levels that contribute to health disparities by making use of the unique knowledge, expertise, and resources of community partners. Community engagement in the planning, implementation, and evaluation of health initiatives builds community capacity to create sustainable changes at all levels to achieve and maintain optimal health for those who bear the greatest burden of disease.