Community development in primary care: opportunities and challenges.

This qualitative study aimed to explore primary health care professionals' views on community development, and to identify the opportunities and barriers associated with using this approach in practice. Participants in community development training--mainly health visitors--took part in small group discussions before, after, and six months following the training course. Opportunities for using a community development approach were identified, but were restricted by lack of interest from some communities, lack of leadership and support within health visiting, and by the increasing medicalisation of health promotion. There is a potential conflict between the ethos of community development and the aim of the national, policy-driven public agenda. Recommendations are suggested to change the organisation of health visiting in order to facilitate the adoption of public health approaches, including community development. These changes would enable health visitors to make use of the help which is readily available from recently appointed public health practitioners, whose role is to promote public health practice in primary health care.