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Involving Citizens in Integrated Care. Lessons Learned Through Participatory Action Research in Three Communities in the Netherlands Cover

Involving Citizens in Integrated Care. Lessons Learned Through Participatory Action Research in Three Communities in the Netherlands

Open Access
|Apr 2026

Figures & Tables

Figure 1

ESSA-model of network formation.

Table 1

Characteristics of the included networks.

RURAL VILLAGE (A)URBAN DISTRICT (B)SMALL MUNICIPALITY (C)
Contextagricultural; socially active community, strong social cohesioncity; various health related and social challenges; high demand for healthcareagricultural; GP seeks to prevent (future) challenges in the provision of care
Populationhomogeneousmulticultural > 60 nationalitieslow diversity
Number of residents2.10016.00021.000
Income level#low to averagevery low to lowaverage
Networkcare cooperative: Vitality cooperativeinterprofessional healthcare networkhealth cooperative
Network initiatorhigh to medium educated group of citizensprimary care health centreprimary care physician with small group of high educated citizens
Network stage##strengtheningshapingexploring

[i] # Income level compared to nationwide income level (average income in the Netherlands in 2025 is just over €46,000 gross per year. Source: Netherlands Bureau for Economic Policy Analysis (CPB)).

## Related to ESSA-Model.

Table 2

Participants in the interviews.

NETWORKTYPE OF INTERVIEWNUMBER OF INTERVIEWSPARTICIPANTS
Rural community (A)Duo interview1
  • General Practitioner

  • Nurse practitioner

Group interview1
  • Community support workers (citizen; n = 2)

  • Community nurse

  • Former community support worker (citizen)

Individual interviews2
  • External advisor citizen initiative (change agent)

  • Community nurse

Urban district (B)Group interview1
  • GP assistant

  • Community support worker (citizen)

  • Manager homecare

  • Manager general practitioner

Individual interviews9
  • GP assistants (n = 4)

  • General practitioner (n = 2)

  • Citizens (n = 3)

Duo interview1
  • Project leaders (n = 2)

Small Municipality (C)Individual interviews4
  • General Practitioner

  • Citizen (n = 2 of whom one is also care and welfare advisor)

  • Project leader

Duo interview1
  • Citizens (n = 2)

Table 3

Strategies applied to support development of the three networks.

STRATEGIESRURAL VILLAGE (A)URBAN DISTRICT (B)SMALL MUNICIPALITY (C)
Analysis of potential partners for collaboration
Organizing the dialogue with partners to reach mutual understanding
Co-creating a tool to measure the value of the interventions
Supporting the organization of meetings with healthcare professionals and/or social workers and/or citizens
The establishment and organisation of dialogue meetings with the sounding board group of citizens
A stakeholder- and force-field analysis, stakeholder interviews
Strength and Weakness (SWOT)-analysis
Feedback on documents (e.g. job descriptions; a community care plan)
Supporting the development of new strategic network objectives
Dialogue sessions with the initiators of the network to share research findings
Figure 2

Factors influencing collaboration.

DOI: https://doi.org/10.5334/ijic.9026 | Journal eISSN: 1568-4156
Language: English
Submitted on: Nov 5, 2024
Accepted on: Apr 3, 2026
Published on: Apr 16, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2026 Geert M. Rutten, Ellen van Wijk, Saskia Sleijster, Dorien L. Oostra, Janine Roenhorst, Marloes Kleinjan, Miranda Laurant, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.