Power, authority and hierarchy are part of health and research institutions. The power and authority in decision making and systems often rest with the health professional and researcher. By involving consumers and the community in this relationship we challenge traditional ways of working. As we move away from the language and approaches of 'us and them' where projects are 'about' or 'for' consumers and community – to the language of 'with or by', we more genuinely partner with consumers. Read more about power and consumer and community involvement below.

Power dynamics can affect the researcher/health professional and consumer relationship as well as the consumer to consumer relationship. The tips below provide ideas of how to address power imbalances when working with consumers:

• Set clear expectations of the consumer role. Establish terms for engagement early in the partnership process. Ensure all engagement is conducted with mutual respect and valuing of each other’s experiences and contributions.
• Ensure communication is clear and at a level everyone can understand. Effective and on-going communication between consumers, researchers and health professionals makes consumer and the community feel more valued, included, and heard. It also enables expectations to be clarified.
• Relax the use of titles such as ‘professor’ that can be unnecessarily intimidating. Introduce roles, but encourage informality by calling each other by first names
• A collaborative approach to developing the consumer and community involvement role which meets the expectations of consumers, the community, and health professionals will assist in reducing the power gap between them
• Compensate consumers for their time and expertise
• Ensure consumers, health professionals and researchers on the project have received training, mentorship and/or advice on undertaking consumer and community involvement
• Provide feedback to consumers to reassure that they have impact, influence and that their contribution has been 'useful and valued'.