Methodological Challenges in Communication and Engagement with vulnerable groups

Engaging marginalized groups in public health requires more than inclusive intentions — it demands systematic approaches that confront structural silence, historical exclusion, and community-specific distrust. This presentation reflects on four years of research with a critical yet often invisible population in public health work: older LGBTQ+ individuals. Despite Norway’s reputation for equality and strong legal protections, many LGBTQ+ elders remain silenced, invisible, and silent (Glenn, 2004) in municipal services, research, and crisis preparedness structures. Through 23 co-constructed interviews (Rojaz-Lizana, 2016) with participants aged 60 to 90+ in nine Norwegian municpalities, this study explored identity fluidity, trust-building, and the personal crises that shape participation and response. Findings reveal that conventional outreach strategies, through municipalities, institutions, and organizations, often fail to reach LGBTQ+ elders. Instead, meaningful engagement emerges from long-term, trust-based, and network-driven approaches, often catalyzed by personal crisis rather than formal structures. The study highlights critical methodological and ethical challenges in reaching vulnerable groups in both practice and research and calls for a rethinking of municipal strategies. Public health systems must recognize rhetorical and structural silence not just as gaps, but as active barriers to equity. This contribution offers practical and ethical insights for professionals and researchers developing inclusive, dialogic, and resilient risk and health communication strategies.