Searching for new community engagement approaches in the Netherlands: A realist qualitative study

E. J. de Weger*, N. J. E. van Vooren, H. W. Drewes, K. G. Luijkx, C. A. Baan

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

12 Citations (Scopus)
148 Downloads (Pure)


Community engagement is increasingly seen as key to improving healthcare systems and to increasing communities' involvement in the shaping of their own communities. This paper describes how 'community engagement' (CE) is understood and being operationalised in the Dutch healthcare system by investigating the CE approaches being implemented in six different regions and by examining engaged citizens' and professionals' experiences of those CE approaches.

For this realist study, interviews and focus groups were held with citizens (16) and professionals (42) involved in CE approaches in the six regions. Additionally, CE-related activities were observed to supplement interview data.

This study shows that citizens and professionals defined and experienced CE differently and that they differed in who they felt had ownership of CE. The CE approaches implemented in community-led initiatives and organisationally-led initiatives varied accordingly. Furthermore, both citizens and professionals were searching for meaningful ways for citizens to have more control over healthcare in their own communities.

CE can be improved by, first of all, developing a shared and overarching vision of what CE should look like, establishing clear roles and remits for organisations and communities, and taking active measures to ensure CE is more inclusive and representative of harder-to-reach groups. At the same time, to help ensure such shared visions do not further entrench power imbalances between citizens and professionals, professionals require training in successful CE approaches.

This study received ethics approval from Tilburg University (reference: EC-2017.96)
Original languageEnglish
Article number508
Number of pages13
JournalBMC Public Health
Publication statusPublished - 2020


  • Community Participation/statistics & numerical data
  • Community-Based Participatory Research/organization & administration
  • Cooperative Behavior
  • Delivery of Health Care
  • Ethnic Groups/statistics & numerical data
  • Focus Groups
  • Health Services Needs and Demand/statistics & numerical data
  • Humans
  • Netherlands
  • Qualitative Research
  • Socioeconomic Factors


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