Ownership of change: Addressing health disparities through authentic resident engagement

Background: The Monument Community is a low-income, high-density, and under-resourced neighborhood in California. Residents are faced with multiple health risk factors, including barriers to affordable, nutritious food, physical activity opportunities and quality health care. Monument Community Partnership (MCP) has been at the forefront of utilizing authentic resident engagement efforts to increase the opportunities and well-being of children and families. Methods: Through a sequence of initiatives, MCP employed community engagement processes to address the myriad of issues residents face. Currently, residents are engaged in community improvement projects that contribute to a health-promoting environment. MCP engaged See Change to evaluate this series of initiatives, from which a theory of resident-driven change was created. Findings: Residents progress through eight stages of advancing individual and community capacity for civic engagement, gaining a sense of ownership and pride in the community, which allows them to successfully advocate for resident-identified and culturally appropriate solutions to resident-identified health disparities in their neighborhood. Monument residents successfully mobilized and advocated for community-identified change to the city's plan for redevelopment of the Monument. They also provide education and support to neighbors working to change eating habits and physical activity. Conclusion: A resident-driven theory of change, embedded in the community ethos, allows for a continual and sustainable infrastructure for engagement of traditionally underrepresented populations as full participants in civic processes. Residents of the Monument truly see themselves as active stakeholders in building a healthy community. Addressing structural health disparities is a long-term endeavor, and is best done from the inside out.