Barriers to and facilitators of community participation and empowerment in primary health care centres in Italy: The perspectives of stakeholders and practitioners

Background/Objectives: Community participation and community empowerment are key features of people-centred primary health care systems and are crucial ways to make health services more equitable and appropriate for people’s needs while improving these services. This qualitative study investigates the facilitators and barriers that practitioners and stakeholders encounter in their efforts to support community participation and community empowerment in primary health care centres. In this context, we focus on the Case della Salute/Case della Comunità in Emilia-Romagna, Italy. Methods: We conducted semistructured interviews with 19 practitioners and stakeholders who had practical or research experience with this topic from October 2020 to May 2021. These interviews were analysed inductively via qualitative content analysis. Results: The barriers and facilitators identified in this context were related to four themes: (a) the culture and mindset of practitioners and organisations as well as the competences that enable them to support community participation and empowerment; (b) reframing local health care politics, the organisation and the role played by health care organisations in this context; (c) investing human and financial resources and creating appropriate spaces for community participation and empowerment; and (d) operational aspects that facilitate community participation and empowerment. Conclusions: The study presents various barriers and facilitators that operate at different levels, such as the level of the health care system, the organisational level and the operational level. We discuss the barriers and facilitators that are encountered in this context and offer suggestions regarding what stakeholders, managers and practitioners can learn from these insights.