Citizen engagement for health equity: evidence from the PIECES project
C Martínez Martínez, S Semple, R O’Donnell, L Macaulay, A Khatchadourian, M Kubo, LA Rodríguez-Guerrero, C Fàbregas, A GilAbstract
Background
Effective cancer prevention necessitates programmes that address modifiable risk factors. As part of PIECES a methodological implementation framework (PCP-IT) tailored to cancer is created, evaluated, and distributed.
Objectives
To co-develop and implement an integrated PCP Implementation Toolkit that supports the identification, selection, contextualisation, and implementation of evidence-based primary cancer prevention programmes across diverse European settings.
Methods
We employed a stakeholder-centred engagement approach grounded in the principles of co-creation and implementation science. Stakeholder mapping was conducted across sites, followed by iterative engagement through multiple channels (emails, newsletters, webinars, calls, and meetings). Participants included 32-40 stakeholders from governmental and non-governmental organisations across 10 implementation sites. Iterative cycles of testing, feedback, and refinement were implemented through regular site-level meetings, consistent with a Living Lab approach. Stakeholder perspectives were analysed using thematic analysis.
Results
According to the participants, personalised, direct communication was reported and proved more effective than emails in sustaining engagement. Staff availability and turnover among stakeholder groups posed persistent challenges, underscoring the need for flexible, relationship-centred strategies. Gender balance and wide European representation in the stakeholder group are important for ensuring the toolkit’s cross-contextual relevance.
Conclusions
Translating evidence-based cancer prevention into real-world implementation requires adaptive engagement-driven frameworks. Findings highlight the importance of personalised communication, sustained interaction, and context-sensitive adaptation. The PCP-IT offers a transferable and scalable model for supporting context-sensitive implementation across diverse European health systems.