**5. Discussion**

Participation can be realized to different degrees depending on the practical conditions within a health promotion program and the living conditions of the target group. The object is to find the appropriate level of participation based on the conditions [5].

This text presents examples of participation and involvement of key implementation actors as well as parts of the population of a disadvantaged neighborhood. Both the surveying of the main actors and the surveying of the population represented a complex approach of activating and involving different groups, following a systematic and complex procedure. For this, the corresponding resources must be to hand and available, as can certainly be the case in a project between science and practice. This was different with the "Lenzgesund" round table participatory mode also presented – which can also be designed and implemented within the framework of the standard tasks.

If one wants to classify the examples in the step models, one may say that the presented forms of surveys – in simplified terms – are about "being allowed to have a say." In the model (**Figure 4**) they are to be classified as medium-to-high participatory approaches, all the way up to "partnership-based collaboration." They do not

#### **Figure 4.**

*Classification scheme for various forms of sham-participation to real participation ("12-step ladder") according to Trojan 2001 [19] (source: [20]).* 

#### *Participation as a Core Principle of Community Health Promotion: General Account… DOI: http://dx.doi.org/10.5772/intechopen.111930*

reach the range of categories for which decision-making power must be handed over to the residents. The round table is also not a body endowed with authority and decision-making powers that decides on the services to be provided by other actors, institutions, or bodies. In the language of the ladder models, the round table is a partnership-based collaboration in the interests of consultation, involvement, networking, and voluntary prioritization by participating institutions for their health-related activities in this disadvantaged settlement.

Looking at the capacity-building process in its entirety and over time, the Lenzsiedlung saw a relatively large amount of civic involvement and social participation on a small scale at different levels, for example, the health talks for women, the many neighborhood festivals and meet-up initiatives, which were repeatedly awarded prizes for best neighborhood. If we take a look at the different traditional and creative participatory instruments, methods, and procedures mentioned at the start, it becomes clear that these usually fit with programs and (standard) activities that are equipped with special and sometimes considerable resources for participation and civic involvement. The possible participatory methods are, in each case, always strongly contextual, i.e., dependent on financial resources, the subject matter, the nature of the program, and, not least, the competence encountered among the citizens to be involved.
