Rural Co-Design and Collaboration: Maximising Rural Community Assets to Reduce Place-Based Health Inequalities

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The project will build on the findings of the Prescribe Heritage Highland (PHH) work, funded under Phase 1, which examined delivery challenges and conditions for scalability of a cultural and natural heritage intervention to promote rural mental health and well-being. The value of non-clinical interventions is increasingly recognised by health and social care service planners and professionals. Community-based services like exercise groups, outdoor activities, art therapies and peer support are being 'prescribed' to 'treat' mental health conditions, address sedentary lifestyles and reduce health inequalities. Although awareness is increasing about potential benefits, such interventions are not universally available or accessible, particularly to those from disadvantaged rural areas (Morton and Bradley, 2020). Although rural communities can be perceived as tight-knit and resilient, the extent of social isolation and deprivation can remain hidden. Rural deprivation is hard to measure using conventional tools such as the Scottish Index of Multiple Deprivation (SIMD) due to low population densities and rural data is scarce (RSE, 2023). However, a "rural premium" is evident, with living costs generally higher than in urban areas (RSE 2023). Rural areas provide unique challenges for service delivery, particularly at scale, due to the economic and logistical challenges in large geographical areas with dispersed populations.Drawing on PHH findings, the project will develop a replicable rural model for collaborative community working using a co-design approach. The collaboration's aim is to maximise the use of existing community assets (e.g. museums, archive centres, libraries and green spaces) and develop new ways of integrating them with mainstream healthcare in order to inform service commissioning, improve services, increase community resilience and reduce rural health inequalities. The collaborative model will be developed through local stakeholder groups comprising community members with lived experience, healthcare professionals and third sector organisations in six rural mainland and island communities. The groups will be supported by the research team, who have expertise in community engagement and co-production. The groups will share their learning to develop a toolkit for other rural regions experiencing similar logistical and health equity challenges. The toolkit will be of value to rural communities, service planners and policy makers. The project will add to evidence on co-production, community engagement, service design and the value of community assets as well as offer new insights for rural policy.The project will:establish a regional advisory group comprising people with lived experience and third sector representatives (encompassing heritage, health and rural poverty), NHS and Local Authorities.engage community researchers in asset mapping to identify key local resources, health needs and gaps in rural dataestablish and support community co-design groups to develop new ways to maximise the value of existing assets and facilities to address local needs based on data gathered4. conduct a policy/literature reviews and data mapping5. develop a replicable collaborative model by researching barriers and enablers from each member perspective and develop a toolkit for rural communities, service planners and policy makers6. implement a clear communication, dissemination and impact strategy involving a range of creative and accessible outputs.