Summary of Session:

This research progressed cooperative learning on smoking within the cost-of-living crisis, cognisant the social, political, and commercial determinants of health inequalities as an essential perspective and one that informs and benefits people in communities and people working with them. Participation of communities in public services is long recognised as enhancing legitimacy and acceptability of decisions, and furthering trust in public institutions. In practice, participation takes many forms, however, and in some cases reproduces the very power asymmetries it seeks to confront. Operational guidance on participation is limited, and the central category of power is drastically under-theorised. This demonstration project embedded community empowerment within a learning health systems process. Learning is crucial for systems performance; however, operational understanding is lacking. Emerging evidence supports: the development of capabilities to engage iteratively with problems; draw on different forms of knowledge; create common understandings and define appropriate solutions; and creating spaces and providing resources for communities, staff, and managers to find solutions for challenges.