The scope and impact of community participation: The views of community representatives in an Australian health service.

PURPOSE: The purpose of this paper is to examine the views of community representatives participating in a large health service in Australia. DESIGN/METHODOLOGY/APPROACH: Cross-sectional survey of 49 community representatives and interviews with a purposeful sample of representatives (n = 10) and staff (n = 19).
FINDINGS: Most community representatives had positive attitudes about their value and potential for influence, citing concrete examples of impact. Having an external network or group was related to their beliefs in their ability to add value to their health service. Community representatives largely agreed they provided a link to, and represented, the wider community although most thought staff did not understand their role or how to work with them. Some staff questioned representativeness of their community representatives. PRACTICAL IMPLICATIONS: Improving community participation is argued to be important in delivering better healthcare services, but effective engagement and representation at the local level is often challenging. Focusing on community representative views takes us beyond debates around representativeness to identify practical strategies to improve practice. The authors recommend health services recruit consumers with strong links to networks in the community, provide a structured and supported program, and improve staff understanding of the range of possible roles for community representatives. Local examples of community representatives' impact on policy and practice should be widely communicated. ORIGINALITY/VALUE: In giving prominence to the views of consumers using triangulated methods, the authors found most could report with clarity what their role was and how they impacted at their local health service.