Assessment of the Need

Despite efforts to engage communities where public health interventions occur, there remain deep-rooted barriers to fostering authentic, bidirectional partnerships between residents, institutions, and researchers (Barkin et al., 2013). Many communities experience structural exclusion where research is conducted about them but not with them, leading to harmful cycles of extraction rather than co-creation. LEGO® facilitation is a participatory methodology which relies on the unique insight that comes from the process of building a physical representation of an idea, process, or challenge and discussing the associated meanings of parts of the model. These meanings may include specific frustrations, opportunities for change, and strong emotional connections.

Workshops are designed to help participants move through a “learning spiral” in which they iteratively learn and refine their ideas about a given topic (LEGO® Serious Play, 2010). In order to ensure that people are able to engage with the material presented in the workshop, facilitators first provide context to the specific questions that will be asked. This baseline ensures that all participants understand the focus and directed goals of the workshop. Second, participants use a broad range of bricks—varying in color, shape, and size—to represent their perspectives, insights, and beliefs about the proposed question or challenge. While building a LEGO® model, participants are encouraged to assign meaning to specific bricks and reflect on how they can incorporate narrative and personal experience into their models. This practice allows individuals to include representations of specific memories, goals, and views when discussing a given topic. Together, these meanings make up the “story” of the model—how aspects fit together, what key challenges are present, and how to remove barriers. Lastly, participants detail the significance of their model and the specific pieces they chose to use in their creation. A facilitator and other participants are encouraged to ask questions to probe further reflections about the model and how it relates to the ideals of the builder. Using this three-step process multiple times, whether in the same workshop or multiple workshops, allows participants to actively engage in defining a problem and possible solutions.

We used LEGO® facilitation techniques in a community listening session designed to promote robust partnerships between residents of the Grays Ferry neighborhood in South Philadelphia, the Young Chances Foundation, and researchers from the University of Pennsylvania REACH initiative (Research and Engagement in Academic-Community Partnerships for Health) and the Johns Hopkins Center for Gun Violence Solutions. This approach offered critical insight into both the effectiveness of public health intervention and opportunities for community-engagement.

Description of Strategy and Innovation

The Grays Ferry neighborhood is located in South Philadelphia; it consistently experiences one of the highest rates of firearm violence in the city. Approximately twenty residents were recruited by Tyrique Glasgow, long time community organizer and executive director of Young Chances Foundation. The workshop was promoted on the Young Chances Foundation Instagram page and through word of mouth. Residents had a wide age range and all residents self-identified as Black. Since the event space was held on the campus of the University of Pennsylvania, transportation was provided for all community members. All residents were provided with a $50 gift card and were served lunch by a local chef to compensate them for their time. The researchers, William Wical and Sara Solomon, both have expertise in conducting qualitative and community-engaged research focusing on public health approaches to violence prevention. Further, as the director of a state-funded community-engaged street outreach model designed to mitigate the harms of community gun violence in Philadelphia, Sara Solomon has engaged in creating and implementing programs which enhance community and academic partnerships. Lastly, practitioners (physicians, community service organizers, and public health professionals) were recruited via word of mouth and dissemination of the flyer through the REACH Initiative.

We established a shared language and process of problem definition between different stakeholders. This was completed at the beginning of the facilitation workshop by asking participants to state how they understood the problem of exclusion in research about violence and safety. Each person was invited to write their frustrations, criticisms, or characterizations of why it was difficult for academics, practitioners, and community members to collaborate on violence prevention. These responses were written on a sticky note that was placed on a larger board to serve as a guide for the workshop’s goal of promoting partnership. Reflections highlighted the differences between community goals and current approaches to violence prevention (i.e. safety vs. policing), challenges with communication about research (length of time to report findings/lack of transparency from researchers), and deep-seated mistrust of institutions (including the University of Pennsylvania). Once everyone had placed their notes on the board, the facilitator led a group discussion of how the barriers connected to one another.

We used LEGO® facilitation as a method to creatively express ideas, brainstorm solutions, and share perspectives (Rose & Furness, 2024). As a method of communication and problem-solving, LEGO® facilitation is informed by research from education, organizational development, and psychology. This approach is designed to develop person-focused and situation-specific solutions. Concretely, LEGO® facilitation is used to elicit and visualize individual perspectives about a given issue without imposing pre-determined solutions. In recognizing the unique perspectives that people with different life experiences have, this approach can attend to local histories of exclusion and marginalization (i.e, relationships between communities and specific institutions). We utilized a four-stage approach inspired by design thinking—a problem-solving strategy that underscores the need for experimentation and collaboration—to structure the workshop. These stages include clarifying problems and barriers, ideating innovative and creative approaches, developing a range of potential solutions, and implementing strategies for success (Tschimmel, 2012).

Participants were broken into smaller working groups (between three and six people) at tables with a large selection of unique LEGO® pieces. Each table collaboratively built a visual representation of what they imagined what cooperation between community members, institutions, and researchers on gun violence prevention could look like. Specifically, this included reflections on access to resources, communication and transparency, and how to address past experiences of harm with violence prevention efforts (e.g., lack of say in what research was done, using narratives in inappropriate ways, distrust of researchers who did not have relationships with the community). Subsequently, each group explained their model to the entirety of the workshop and answered questions about what they had envisioned. Thus, the LEGO® models served as a method of fostering group discussion, supporting knowledge sharing, and collaborative problem solving.

Table 1.LEGO® Facilitation Process Summary
Phase Description
1. Stage Setting The facilitator introduces the focal topic and provides essential context to ensure a shared foundation among participants.
2. Model Construction Participants use a wide range of LEGO® bricks to create metaphorical representations of their experiences, perspectives, or conceptual ideas.
3. Narrative and Exploration Participants describe the meaning of their models, while facilitators and peers engage through reflective questioning and collaborative discussion.
Iterative Engagement Repeated use of this process supports the refinement of individual and group understanding through progressive cycles of making and reflecting.

Challenges and Successes

Gap between academics and community members

Community members expressed that they felt as though they were often excluded from defining the problems in their community and the appropriate strategies to ameliorate them. This included differences in how to define the violence that impacted their lives—shifting attention beyond simply focusing on gun violence to include the ways that social institutions harm their neighborhood and promote the social conditions which result in high rates of violence. During the workshop, a participant described that residents in Grays Ferry were the “forgotten people”—a status reflecting racial and spatial exclusion. Participants highlighted economic and racial marginalization, with sentiments such as “If you’re not rich, they push you aside” noting that “they” referred to insurers, medical providers, police, and institutions outside of the neighborhoods. During the group discussion of models, different tables highlighted how community-driven solutions to safety are more effective than solely relying on policing. Narratives included how empowering communities—through resources, training, and personnel—would address the simultaneous harm of over- and under-policing. Other participants endorsed exclusion as a core challenge, citing that community residents were not treated as a priority and were often left to address challenges with little support from researchers and institutions. For residents, this was particularly challenging as researchers and institutions often had access to resources which could address some of the structural barriers to safe communities (e.g., funding, social capital, and opportunities). Participants also noted a lack of transparency from researchers and government agencies, emphasizing that there is rarely any communication back to the community about developments in public health interventions, such as, when they would be implemented, how feedback can be reported, or how the community would benefit.

“If we work together, we can be whole”—Community listening sessions as an intervention

Community members provided critical insight on what they would like to see in terms of collaboration between themselves, institutions, and researchers on how to prevent violence. This was symbolized in their LEGO® models:

  • Bridges, open doors, pathways, and protective measures – representing the need for clear communication, accessibility, and transparency to avoid extraction of knowledge and resources.

  • A central pot for resources – a metaphor for community-controlled funding, where resources are available for those who contribute.

  • A spaceship – symbolizing a collective journey toward opportunity, with the need for community-led navigation and protection.

  • Community-owned institutions – participants imagined self-governed safety structures (e.g. community-led policing and emergency services) to reduce reliance on external systems that have historically failed them.

  • Demolition of harmful structures – Highlighting the importance of removing institutional barriers that perpetuate inequities while rebuilding support systems that directly serve community needs.

These features of the models reflected a desire for community members to participate in public health efforts, redefinitions of safety and well-being, and social movements. Models also included representations of access, often underscoring the importance of working around the schedules and needs of community members rather than solely those of academic partners.

Elements such as community-owned institutions, a central pot for shared resources, and demolition of harmful structures emphasized a vision centered on community control, rather than institutional dominance. Participants envisioned systems developed and governed by the community itself—systems intentionally designed to operate outside the confines of traditional institutions that have historically marginalized their voices. This reflected a form of aspirational thinking in which residents imagined starting anew and building structures rooted in equity, accountability, and inclusion. Notably, this vision parallels emergent political discourse in which historically excluded groups advocate for transformative change led by those most directly impacted by systemic inequities.

Models also included communication channels to emphasize the need for better dissemination of research findings and public health interventions in culturally and structurally competent ways. For example, the bridges and open doors represented transparency and bidirectional communication. This was particularly significant for violence prevention work, as residents felt as though they did not have access to information on what research and interventions were taking place. Taken together, these depictions highlighted a desire from community members and researchers alike agreed for more collaboration and shared responsibility in creating change.

Next Steps

This community listening session was the first in a series of ongoing workshops designed to sustain collaboration between community members, institutions, and researchers. Future sessions will explore the concept of community control more deeply, particularly as it relates to the dissemination of research and other areas identified as priorities by community stakeholders. We will begin by continuing this work with the same community and then expand to additional communities to assess both similarities and context-specific differences. We are also interested in examining the role of technology—especially emerging technological advances—in supporting community-centered approaches and ensuring that these tools align with the needs and values of the communities they aim to serve.

In addition, in response to the repeated assertion that researchers and institutions often struggle to effectively communicate the goals, strategies, and challenges of public health promotion, we are developing a glossary which includes common language used by both community members and academics which are commonly misunderstood by other stakeholders. This project builds upon our commitment to enhancing the quality and frequency of communication between different groups of stakeholders. The next community listening session will focus on developing strategies to empower community members to shape the narrative about themselves, their neighborhoods, and the public health work they are already doing.

Implications for Practice

There are three notable implications from using this methodology to foster collaboration between community residents, researchers, and institutions.

  1. Creating a shared language of problems, interventions, and strategies for implementation is vitally important in ensuring transparent and responsible public health practice. LEGO® facilitation offered a methodology for creatively co-constructing communication channels.

  2. Community members unanimously agreed that using LEGO® facilitation was an engaging and useful strategy to acknowledge the scope of differing perspectives about violence, safety, and health. The use of three-dimensional modeling allowed for a more accurate representation of the ideal relationships between stakeholders needed to address public health concerns.

  3. This session was just the beginning—there is a critical opportunity to continue engaging the community in shaping and implementing the solutions they envisioned.

Implications for Research

Public health research can move beyond traditional approaches in engaging community members in defining the terms, goals, and implementation strategies. These efforts ensure bidirectional knowledge exchange where findings, resources, and interventions are equitably shared and emphasize the importance of participatory, creative methodologies as legitimate research tools that challenge power imbalances and elevate community expertise. Participatory methods, like LEGO® facilitation, offer an important avenue for community members to engage in problem definition, ideate creative solutions to complex problems, and share in the development of an implementation plan. It offers a way to think three-dimensionally—unlike other methods—while allowing participants to continuously engage with and build upon each other’s ideas, similar to a traditional focus group. In doing so, it fosters accountability between academics and practitioners to the people they work with and promotes the development of bidirectional relationships. In our workshop, we found LEGO® facilitation to be a particularly promising approach because of its use of physical representations of how people understand, feel about, and orient themselves toward a given issue.