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BACKGROUND: Despite insistent calls for more and better evidence to inform action to reduce health inequities, applied health research sensitive to these inequalities is rare. Recognising this problem, the Collaboration for Leadership in Applied Research and Care in the North West Coast (England) developed the Health Inequalities Assessment Toolkit (HIAT) to support those involved in health research to integrate equity into their work. OBJECTIVE: This paper reports on an evaluation of the extent to which HIAT enhances the equity focus of the work of users. METHODS: The evaluation used semi-structured interviews, focus groups and workshops (n = 131 respondents including Public Advisers, university, NHS and local government partners). Routine data included HIAT feedback forms. FINDINGS: HIAT can help to strengthen the equity focus of applied health research by: increasing understanding of how socioeconomic inequities impact on health; building capacity for integrating equity into all aspects of research, implementation and capacity building; stimulating thinking on action to address local structural drivers of health inequalities; and increasing understanding of the positive contribution public involvement can make to research. CONCLUSION: If we are to advance health equity goals delivering research and training needs to be combined with political commitment to create more equal societies.

English
The qualitative research described in this article aims to explore the dynamics of routine public health practice and policy within two local health systems. Using a theoretical framework drawn from social science and management literatures on 'communities of practice' (Wenger, 1998), we seek to illuminate the values and ideas that shape the way in which public health practice and policy making is 'done' on a routine basis. In particular, we suggest that people's narratives about their daily work resonate with the concepts of engagement, peripheral participation and marginalisation used in the communities of practice literature.

Purpose: Strengthening research capacity (RC) amongst health professionals has both organisational and individual benefits. It can increase the quality of research and support the transfer of evidence into practice and policy. However there is little evidence on what works to develop and strengthen RC. This paper contributes to the evidence base by reporting findings from an evaluation of a programme that aimed to build capacity to use and do research amongst NHS and local authority organisations and their staff in a large English research partnership organisation. Methods: The evaluation used multiple qualitative methods including semi-structured interviews, focus groups and workshops (n=131 respondents including public advisers, university, NHS, and local government partners). Results: The RC building programme provided a range of development opportunities for NHS and local authority staff resulting in increased confidence and skills to undertake, participate in, and use research. Additionally, positive influences on organisational practice and collaborative working were reported. Conversely, challenges to developing research capacity were also identified as were the importance of resources, senior level buy-in, and the relevance of research topic to practice in facilitating participation in the programme. Conclusion: Collaboration for Leadership in Applied Health Research and Care North West Coast's (CLAHRC-NWC) RC building programme differed from conventional approaches giving less emphasis to formal teaching and more to experiential learning and focusing on both individual capacities and supporting organisations to integrate RC building into staff development programmes. The findings demonstrate that providing opportunities for staff in NHS and local authority organisations to develop research knowledge and skills alongside an infrastructure that supports and encourages their participation in research can have positive impacts on research capacity and organisational research culture. The potential for ...

This is Part I of a three-part series on community empowerment as a route to greater health equity. We argue that community 'empowerment' approaches in the health field are increasingly restricted to an inward gaze on community psycho-social capacities and proximal neighbourhood conditions, neglecting the outward gaze on political and social transformation for greater equity embedded in foundational statements on health promotion. We suggest there are three imperatives if these approaches are to contribute to increased equity. First, to understand pathways from empowerment to health equity and drivers of the depoliticisation of contemporary empowerment practices. Second, to return to the original concept of empowerment processes that support communities of place/interest to develop capabilities needed to exercise collective control over decisions and actions in the pursuit of social justice. Third, to understand, and engage with, power dynamics in community settings. Based on our longitudinal evaluation of a major English community empowerment initiative and research on neighbourhood resilience, we propose two complementary frameworks to support these shifts. The Emancipatory Power Framework presents collective control capabilities as forms of positive power. The Limiting Power Framework elaborates negative forms of power that restrict the development and exercise of a community's capabilities for collective control. Parts II and III of this series present empirical findings on the operationalization of these frameworks. Part II focuses on qualitative markers of shifts in emancipatory power in BL communities and Part III explores how power dynamics unfolded in these neighbourhoods.

The objective was to assess the impact of new guidance on the conduct of narrative synthesis in systematic reviews of effectiveness, by means of a blinded comparison of guidance-led narrative synthesis against a meta-analysis of the same study data.The conclusions of the two syntheses were broadly similar. However, differences between the approaches meant that conclusions about the impact of moderators of effect appeared stronger when derived from the meta-analysis, whereas implications for future research appeared more extensive when derived from the narrative synthesis. These findings emphasize that a rigorously conducted narrative synthesis can add meaning and value to the findings of meta-analysis.The guidance framework provided a useful vehicle for structuring a narrative synthesis and increasing transparency and rigour of the process.While there may be risks with overinterpretation of study data, the framework, tools and techniques described in the guidance appear to increase the transparency and reproducibility of narrative synthesis.