Bridging Health & Community
Improving Health Through Community Agency

12 Principles

That Describe The Field Of Practice

The field is defined by an inclusive, participatory and responsive process. It's not new, but it's new to many working in health. We have identified 12 principles to help make the shift. 

The principles, and the work they're based on, are described in our March 2017 report, Fostering Agency to Improve Health (see below).

  1. Include in a community’s collective effort those who live there, those who work there, and those who deliver or support services provided there
  2. Spend time understanding differences in context, goals and power
  3. Appreciate the arc of local history as part of the story of a place
  4. Elicit, value and respond to what matters to community residents
  5. Facilitate and support the sharing of power, including building the capacity to use it and acknowledging existing imbalances
  6. Operate at four levels at the same time: individual, community, institutional and policy
  7. Accept that this is long-term, iterative work
  8. Embrace uncertainty, tension and missteps as sources of success
  9. Measure what matters, including the process and experience of the work
  10. Build a vehicle buffered from the constraints of existing systems and able to respond to what happens, as it happens
  11. Build a team capable of working in a collaborative, iterative way, including being able to navigate the tensions inherent in this work
  12. Pursue sustainability creatively; it’s as much about narrative, process and relationships as it is about resources

Fostering Agency to Improve Health

Published March 2017, this report brings together what we've learned since we started in early 2013. 

Full Version

The full version includes the report (26 pages), two forewords, and seven appendices, including a summary of the evidence linking agency and well-being, abstracts of the presentations from the Creating Health Collaborative's 2016 meeting, and a series of commentaries on our 2016 report.


The two-page summary is available as a stand-alone PDF

A Tool to Apply the 12 Principles

This tool has been created to help you embrace and apply the way of working that is described by the 12 principles. 

It enables you to take stock of your community health effort and to explore how you might deepen your practice so as intentionally foster the agency of your community. 

The tool can be used in a self-guided group process or as part of a facilitated process coached by us.

Share The Principles

Use the images below to share the principles. 

If sharing on social media, note that our preferred hashtag is #agencyandhealth.