Diverse approaches to health extension are tied by a common aim – to serve the public good by improving community health and well-being. Engagement raises the bar of that aim above common measures of public service to include indicators that are meaningful to stakeholders – and are also determinates of health – ‘green flags’ pointing to institutions that are accessible, responsive, relevant, and accountable to communities. The stretch to engagement also shifts how we view, value, and work with communities. It implies a mutuality and reciprocity between institutions and their stakeholder-partners that calls for deeper commitments than traditional one-way transfers of knowledge or services.

At the institutional level, engagement cuts across (and integrates) traditionally-siloed mission areas, and is transdisciplinary. It is also transformative: through engagement, ‘beneficiaries’ of public institutions become partners in learning, discovery, and putting ‘knowledge to work’ to solve problems that matter to communities. Engagement presents an invitation and occasion for institutions to re-tool to acquire ‘community competencies’.

Fueled by an engagement imperative, health extension advances the social mission of pubic and publically-serving institutions by improving well-being and creating value that is timely and meaningful to constituents. It harnesses and aligns our resources and investments with what we say we value and what communities want. More than an approach or method, health extension hardwires engagement into the way we do the business – because it’s the right thing, because the public demands it, and because it works.

Defining Engagement

Engagement has been defined in many ways:

“Community engagement is the collaboration between institutions of higher education and their larger communities (local, regional/state, national, global) for the mutually beneficial exchange of knowledge and resources in a context of partnership and reciprocity.
Carnegie Foundation

“An Engaged Institution… is fully committed to direct, two-way interaction with communities and other external constituencies through the development, exchange, and application of knowledge, information and expertise for mutual benefit.”
American Association of State Colleges and Universities, Task Force on Public Engagement

“(Engaged Scholarship is) a specific conception of faculty work that connects the intellectual assets of the institution (i.e. faculty expertise) to public issues such as community, social, cultural, human, and economic development. Through engaged forms of teaching and research, faculty apply their academic expertise to public purposes, as a way of contribution to the fulfillment pf the core mission of the institution.”
Barbara Holland, University of Sydney

“Engagement is the partnership of university knowledge and resources with those of the public and private sectors to, enrich scholarship and research, enhance curricular content and process, prepare citizen scholars, endorse democratic values and civic responsibility, address critical societal issues, and contribute to the public good.”
Committee on Institutional Cooperation

The Imperative for Engagement: Leadership & Policy

This year, the nation’s public and land grant universities celebrate the 150th anniversary of the Morrill Land-grant Act, enabling states to open public colleges and laying the foundation for democratizing access to higher education for all Americans. With a bold stroke of public policy, access to public higher education was opened to working Americans and tied to improving public well-being. One-hundred and fifty years later – propelled by the urgent call to improve heath and health equity – HERO serves as an engagement strategy to harness and integrate the knowledge and resources of New Mexico’s flagship university to improve the health and health equity of New Mexicans. The below video describes the importance of this sesquicentennial anniversary:

Universities and institution of higher education can participate in the Engagement Academy, a “unique executive development program is designed for leaders responsible for developing institutional capacity for community engagement. Participants will develop institutional plans for engagement and will return to their campuses with the ability to advance their plan as well as effectively link community engagement to the teaching, research, and service missions of the institution.” Click below to learn more about this program:

Are you Engaged? Take the Test!

The Kellogg Commission has developed the following questions to gage the engagement level of an institution:

Responsiveness: Are we listening to communities? Asking the right questions? Are our communications clear? Do we understand that in reaching out, we are also obtaining valuable information for our own purposes?
Respect for partners: Do we encourage joint definitions of problems, solutions, and definitions of success? Do we genuinely respect the skills and capacities of our partners? Do we recognize we have as much to learn as we have to offer?
Academic neutrality: Does our outreach maintain our role as neutral facilitator and source of information in the policy arena?
Accessibility: How do we help potential partners navigate our complex organizational structures? Is our expertise equally accessible to all constituencies of concern within our state and community?
Integration: How does our institution encourage and incentivize outreach, service and engagement? How does interdisciplinary work drive integration?
Coordination: Are our academic units dealing with each other productively? Do the communications and government relations offices understand our engagement agenda? Do our faculty, staff, and students need help in developing the skills of translating expert knowledge into something the public appreciates?
Resource partnerships: Are the resources we’ve committed to engagement sufficient? How do we resource the time and efforts of staff, faculty, students, as well as curriculum and program costs?

Extension for Engagement: How Extension Reflects the Values of an Engaged Institution

COMING SOON, STAY TUNED! (video vignette from Oregon partners on the shift from “transfer of expertise” to “sharing and reciprocity”)

Engaged Scholarship: Integrated Knowledge that WORKS

Community-engaged scholarship “involves the faculty member in a mutually beneficial partnership with the community. Community-engaged scholarship can be trans-disciplinary and often integrates some combination of multiple forms of scholarship. For example, service-learning can integrate the scholarship of teaching, application, and engagement, and community-based participatory research can integrate the scholarship of discovery, integration, application and engagement.”

Some of the types of community-engaged scholarship include:

  • Service-learning
  • Community-Bases Participatory Research (CBPR)
  • Academic public health practice

Engaging faculty in the community through scholarship leads to many important goals that are important to academic health centers:

  • Improve health professional education
  • Achieve a diverse health workforce
  • Increase access to care
  • Eliminate health disparites

Working with communities is important work for faculty. However, in order to be considered scholarship, the following must exist:

  • Clear goals
  • Adequate preparation
  • Appropriate methods
  • Significant results
  • Effective presentation
  • Reflective critique
  • Rigor
  • Peer review

To learn more on how Academic Health Centers can support community-engaged scholarship, click on the table below:

The Clinical and Translational Science Awards Consortium has compiled the following principles of community engagement:

  • Be clear about the purposes or goals of the engagement.
  • Become knowledgeable about the community’s culture, economic conditions, social networks, political and power structures, norms and values, history, and experience with efforts by outside groups to engage it in various programs.
  • Go to the community, establish relationships, build trust, work with the formal and informal leadership.
  • No external entity should assume it can bestow on a community the power to act in its own self-interest.
  • Partnering with the community is necessary to create change and improve health.
  • All aspects of community engagement must recognize and respect the diversity of the community. Awareness of the various cultures of a community and other factors affecting diversity must be paramount in planning, designing, and implementing approaches to engaging a community.
  • Community engagement can only be sustained by identifying and mobilizing community assets and strengths and by developing the community’s capacity and resources to make decisions and take action.
  • Organizations that wish to engage a community as well as individuals seeking to effect change must be prepared to release control of actions or interventions to the community and be flexible enough to meet its changing needs.
  • Community collaboration requires long-term commitment by the engaging organization and its partners.

The full document can be found in “Related Literature and Tools”, below.

Community Engaged Policy

Policy that supports engagement requires support from the leadership of the institution and willingness to change the culture to support community-engaged work. Promotion and tenure practices that recognize the value of working with communities and the unique challenges it brings need to be strived for; see the community-engaged scholarship section for more information on these policies.

There must also be structures in place within colleges and departments that allow for long-term relationships with community partners built on trust and mutual benefit. This requires students, faculty, and staff work on priorities and projects that are important to and beneficial to the community. To do this leadership must recognize that timelines may be delayed, recognition of the community partners needs to be prioritized, and the power differential between academic institutions and community members and organizations be recognized and discussed.

The HSC engaged communities in a process to receive feedback on their partnerships; the summary of recommendations that lead to effective and meaningful engagement include the following

  • Planning the meetings and connecting to the community partners is as important as visits
  • It is essential to follow-up on recommendations from communities
  • Do our homework and enter the community to listen, learn, and identify how we can partner
  • Be humble, don’t suggest or promise what you can’t deliver, become part of the community, don’t repeat the mistakes of the past in how the University engages in community
  • Create a permanent presence in communities (i.e. the Health Extension model)
  • Communities need to identify which professionals they’d like to work with in the establishment of a local “hub”
  • Evaluators, epidemiologists, and others who can assist with community needs assessment could be just as helpful in some communities as medical providers

Related Literature & Tools

Click on the thumbnail images below to access key literature related to the principle of engagement:

“Returning to our Roots:
The Engaged Institution”

“Global Consensus for the Social Accountability of Medical Schools”

“Linking Scholarship & Community:
Report of the Commission on Community- Engaged Scholarship in the Health Professions”

“Principles of Community Engagement”

“A Promising Connection: Increasing College Access & Success through Civic Engagement”

“The Active Community Engagement Continuum”

“Campus Compact: President’s Declaration on the Civic Responsibility of Higher Education”

“Engaged Scholarship: A Resource Guide”

“Five Dimension of Enhancing Community-Campus Connections for Access and Success”

The following presentation may also be useful tools in learning about engagement:

“Scholarship-Focused Outreach and Engagement: Aligning Institutional Capacity with Engaged Scholarship”

“Community Engagement as Health Promotion”

“Integrating Civic Engagement into State Initiatives”

There are several other key articles and tools you may find useful. Click on the links below to access them:



Metrics and Evaluation Financing Message Mapping Building a Movement Chp6 Sustainability Diverse Populations Critical Health Literacy CHWs Chp5 Population Health Beyond PCMH Shared Resources Community Health Systems Small Practices PCEP Chp4 Primary Care Health Outcomes Core HERO Functions Engagement Perspective HERO Model Chp3 Health Extension Model Public Health Cooperative Extension Academic Health Centers Primer for Engagement Chp2 Engagement What is a Hero General Overview Using the Toolkit Chp1 Getting Started