Facilitators and barriers to implement community engagement approaches in health promotion projects: A qualitative study in 13 projects in Spain

Abstract

Objectives

Evidence shows that community health promotion projects should be participatory. However, contextual factors affect the ways these projects can be designed and implemented. This article is part of a study to implement evidence-based guidelines to promote community engagement and it describes barriers and facilitators that can influence its implementation.

Study design

Qualitative explorative study using semi-structured interviews and interactive workshops in 13 community health promotion projects across Spain.

Methods

Data were collected through semi-structured interviews and workshops with 68 participants from core working groups and key stakeholders from 13 community health projects. Descriptive thematic analysis helped identify codes related to barriers and facilitators. Data were then organized in a matrix to identify how each factor influenced each project (content analysis) and to what degree (totally, partially or absent).

Results

Fourteen facilitators were identified, related to internal organization and strategies to work effectively; and seven barriers, related to lack of resources, dependence on external factors and not knowing how to evaluate.

Conclusions

Most of the factors identified are related to the organisation of the project, with no apparent relation with community engagement. This suggests that organisational structures should be prioritise to ensure the quality of community health promotion projects and their continuity, and to enable engagement of community members throughout a project.