Master of Health Care Innovation faculty member and implementation scientist Kimberly T. Arnold, PhD, MPH provides a framework for thinking about stakeholder engagement in the design and implementation of innovative health and health care initiatives.

Building strong relationships with stakeholders, she tells us, can improve the planning, implementation, evaluation, sustainability, and spread of a new initiative. And involving stakeholders throughout the design and implementation process can promote equity and inclusion for underserved communities.

Stakeholders are individuals or groups who can affect, or are affected by, an issue—or who might be affected by attempts to address a given challenge.

In health care, stakeholders include patients, providers, insurers, researchers, and policymakers. They also exist in the broader community:

• Family members and caregivers for patients.

• Community organizations like churches and social clubs.

• Advocacy organizations, who may act on behalf of a neighborhood or a group of patients with a particular condition.

• Local businesses, whose operations might be affected by a new health initiative.

Stakeholder engagement often falls on a broad continuum with varying levels of participation within and among stakeholder groups:

• Nonparticipation
  In which designers inform stakeholders rather than engaging them in planning or decision-making efforts.

• Symbolic participation
  In which stakeholders are invited to discuss plans and offer advice, but with no guarantee that their suggestions will be adopted.

• Engaged participation
  In which designers share authority and collaboratively manage the creation and implementation efforts.

Engaged participation is the gold standard, helping to build mutual trust and respect, emphasizing expertise drawn from lived experience and mutual benefit for all stakeholders, and fostering shared decision making. However, not every stakeholder group needs to participate with the same level of engagement. Identifying the appropriate level of stakeholder engagement needed to meet the project’s goals is an important step that should be taken early in the planning phase.

In health and health care, stakeholder engagement can promote the development of lasting partnerships and collaborations, which can lead to more effective and sustainable interventions that are responsive to a wide range of needs. And it can build trust among stakeholder groups including communities, universities, and health systems, which may lead to increased uptake and utilization of evidence-based health interventions.

Moreover, effective stakeholder engagement promotes equity. By definition, it requires involvement from diverse voices and perspectives throughout planning and implementation. This can lead to more culturally appropriate, accessible, and responsive interventions that can help to address health disparities. And it can enhance health outcomes for all individuals.

Learn more about how you can leverage stakeholder engagement to promote equity in MEHP Online’s course, Advancing Health Equity, taught by Kimberly T. Arnold, PhD, MHP and Kevin Ahmaad Jenkins, PhD. In addition, view how some Penn MHCI students applied health equity lessons in their work.

Goodman, Melody S., and Vetta L. Sanders Thompson. “The Science of Stakeholder Engagement in Research: Classification, Implementation, and Evaluation.” Translational Behavioral Medicine 7, no. 3 (September 2017): 486–91.

Schiller, Claire, Meghan Winters, et al. “A Framework for Stakeholder Identification in Concept Mapping and Health Research: A Novel Process and Its Application to Older Adult Mobility and the Built Environment.” BMC Public Health 13, no. 1 (May 2, 2013): 428.