Table 4.

Summary of guiding principles and corresponding supportive interventions, contextual factors and mechanisms leading to successful CE interventions

Interventions	Enabling contextual factors	Enabling mechanisms	Relevant citations
Guiding principle 1: Ensure staff provide supportive and facilitative leadership based on transparency
Provide citizens access to all relevant resources Implement two-way communication with citizens Facilitate citizens’ understanding of key topics	Accessible points of connection between communities & local services Supportive organisational structures Unique points of connection between communities and local services	Staff’s support and facilitation makes citizens feel valued Professionals openly listening to citizens’ problems and ideas, improves professionals’ understanding of communities’ needs Transparency about limited resources can prevent communities from feeling frustrated	Chan & Benecki [30] Durey et al. [32] Tenbensel et al. [37] Yoo et al. [40]
Guiding principle 2: Foster a safe & trusting environment to enable citizens to provide input
Invest resources in the building of trusting relationships with communities Tailor strategies to citizens’ needs and preferences Hold meetings outside organisational sphere Adjust meetings and activities to citizens’ needs (e.g. language, timetable) Citizens to (co)chair boards, steering groups Hire demographically and culturally diverse staff in order to better reflect and connect with the communities	Accessible organisational structures Community members included in governance and leadership of intervention and engaged in decision-making processes Pre-established trusting relationships with communities	Culturally safe spaces build communities’ confidence to discuss their needs Staff who create safe environments and address citizens’ supportive needs help build trust and cohesion	De Freitas & Martin [16] Durey et al. [32] Kegler et al. [41] Kelaher et al. [33] Luluquisen & Pettis [34] Montesanti et al. [35] Schoch-Spana et al. [42] Veronesi & Keasey [39]
Guiding principle 3: Ensure citizens’ early involvement
Discuss with citizens the stage at which they want to be involved Align organisational and citizens’ health definitions and priorities Include citizens in needs assessments and identification of priorities	Financial or quality related organisational crises highlighting need for far-reaching change Pre-established collaborative relationships	Early involvement motivates and enables all stakeholders to bring about change Early involvement of some citizens can trigger others to become involved as well	Carlisle (2010) Clark et al. [31] Lang et al. [12] Tenbensel et al. [37] Veronesi & Keasey [39]
Guiding principle 4: Share decision-making and governance control with citizens
Adjust decision-making methods by having multiple professionals from the same organisation share one vote on decision-making committees, thus levelling out the vote share Place citizens in leadership and decision-making positions Share relevant resources and tools with engaged citizens	More in-depth collaboration between partners Interventions initiated by citizens themselves Organisations willing to address power imbalances	Citizens’ willingness to join intervention depends on extent to which organisations are ready to share control Satisfaction rates of CE forums increases with number of involved citizens Increasing citizens’ input during strategic and decision-making stages is valued by citizens and helps prevent feelings of disempowerment	Carlisle (2010) [9] Clark et al. [31] Durey et al. [32] Kelaher et al. [33] Lang et al. [12] Luluquisen & Pettis [34]
Guiding principle 5: Acknowledge and address citizens’ experiences of power imbalances
Invest in communities with low levels of readiness to build their capacity Adjust organisational approaches, structures, processes by privileging citizens Allow citizens to shape their own role	Inclusive organisational structures Equal number of citizens and professionals in leadership and decision-making positions Clear remits for professionals and citizens	Clear recognition of citizens’ valuable contributions, legitimises initiatives Equal presence of citizens on forums prevents citizens from experiencing being at the lower end of the power spectrum	Carlisle (2010) [9] Kelaher et al. [33] Lewis [17] Luluquisen & Pettis [34] Renedo & Marston [18]
Guiding principle 6: Invest in citizens who feel they lack the skills and confidence to engage
Provide professional or leadership training, e.g. in chairing meetings, conducting support-group sessions Provide learning opportunities highlighting causes of citizens’ disadvantage and tools to alleviate these	Citizens motivated to improve their neighbourhoods and services they access	Improved awareness helps citizens to develop greater sense of control, self-confidence, skills Being involved in direct peer recruitment can lead to service-users recognising their own entitlement to participation	Crondahl & Eklund Karlsson [10] De Freitas & Martin [16] Durey et al. [32] Lang et al. [12] Renedo & Marston [18]
Guiding principle 7: Create quick and tangible wins
Offer short-term mobilisation activities, e.g. neighbourhood clean-ups Ensure citizens’ input is actually used Use local media to share quick win stories	Pressing and visible health and socio-economic needs combined with significant community support for change	Early successes provide momentum, creates trust in CE processes and inspires other citizens to become involved Short-term concrete improvements can maintain citizens’ dedication to CE processes when problems arise	Durey et al. [32] Hamamoto et al. [11] Kegler et al. [41] Luluquisen & Pettis [34] [40])
Guiding principle 8: Take into account both citizens’ and organisations’ motivations
Be flexible and allow citizens to focus only on those issues that interest them Use crises situations to catalyse citizen engagement Be transparent about organisational motivations and requirements Be open and receptive to citizens’ negative service-usage experiences	Pressing and visible health and socio-economic needs and significant community support for change Service-users and carers wanting to increase level of social interactions, and to upskill	Catering to citizens’ motivations helps maintain momentum Building on citizens’ emotional links to neighbourhood or services can connect citizens Crises situations can mean organisations are forced to change their traditional patterns	De Freitas & Martin [16] Hamamoto et al. [11] Lang et al. [12] Lewis [17] Pennel et al. [36] Schoch-Spana et al. [42] Van Eijk & Steen [38] Veronesi & Keasey [39]