In the sectors of public health, animal health and environment, several international organizations develop policies and initiatives, which are awkward to be implemented at the national and local levels. Local communities are the targets of numerous initiatives and policies particularly in developing countries, mainly through nongovernmental organizations, in the domains of health, rural development and conservation biology. Assessing the interactions between health and biodiversity raises many research questions linked to its implementation regarding the ecological and epidemiological patterns, the associated indicators and stakeholders involved in monitoring at local level. Getting communities involved, beyond passive participation, remains a tricky challenge in the framework of One Health/EcoHealth approaches. It deals with the issue of power sharing and communication gaps between communities and “risk specialists” as well as within communities. This chapter reviews how lessons are learnt from several community-based, participatory and adaptive management initiatives since the nineties could be promoted in the frame of a One Health approach's implementation, in order to improve risk communication and to help turning rhetoric into reality.