In Spring 2013, we are on the precipice of dramatic, disruptive change in the health field that offers an unprecedented opportunity and challenge to transform health care and population health.
We know that traditional public health approaches along with more and better health care are not enough to improve health outcomes, equity, and cost. We must also:
- implement sustainable, fundamental "upstream" changes that address the root causes of disease and disability; and
- transform the way we deliver health care to ensure access to quality, affordable health care for all.
Enjoy this Bright Spot presentation from Sana Chehimi of the Prevention Institute, which was presented at the 2013 Annual Leadership Conference, co-sponsored by the Center for Health Leadership (CHL) and the California Pacific Public Health Training Center (CALPACT) at UC Berkeley's School of Public Health.
To learn more about this event, please visit:
http://calpact.org/index.php/en/events/leadership-conference
Learn more about CALPACT:
http://calpact.org/
Learn more about the CHL:
http://chl.berkeley.edu/
Health 3.0 Leadership Conference: Building and Maintaining Multi-Sector Partnerships with Sana Chehimi
1. Sana Chehimi
Program Director
Health 3.0: Transforming Community Health
and Care Delivery
Berkeley, CA
05/31/2013
Building and Maintaining
Effective Multi-Sector
Partnerships
@preventioninst
http://www.facebook.com/PreventionInstitute.org
2. Developing Effective Coalitions:
The 8-Step Process
1.Analyze program objectives, determine whether
to form a coalition
2. Recruit the right people
3. Devise preliminary objectives and activities
4. Convene the coalition
5. Anticipate necessary resources
6. Develop a successful structure
7. Maintain coalition vitality
8. Improve through evaluation
8. Coalitions may be...
u Time intensive
u Frustrating
u Inefficient
u Poorly utilized
“Another meeting?
I'd like to attend but
I have real work to
do.”
“This coalition
used to be
worthwhile, but
now it is a waste of
time.”
10. Coalitions are a tool for
effectively and
sustainably achieving a
broad range of goals.
11. Developing Effective Coalitions:
The 8-Step Process
1.Analyze program objectives, determine whether
to form a coalition
2. Recruit the right people
3. Devise preliminary objectives and activities
4. Convene the coalition
5. Anticipate necessary resources
6. Develop a successful structure
7. Maintain coalition vitality
8. Improve through evaluation
12. Analyze your objectives and goals and
determine whether to form a coalition.
u Clarify current
objectives
u Examine
approaches
which might
be effective
u Assess current community
strengths and needs
Developing Effective Coalitions
1
Photo credit: Healthy City
STEP
14. Recruit the right people.
u Identify people working on the issue
u Consider who has influence
u Determine who will
be supportive
u Identify who may put
obstacles in your path
u Consider how many
people should be
involved
STEP
Developing Effective Coalitions
2
15. Equity Matters
u More than just placeholders
n Simply inserting a person of color or a person
from a low-income community into the process is
not enough
u Diverse and divergent perspectives
n Engage in how perspectives differ and how those
differences may influence decisions and solutions
u Buy-in for change
n Including community members can strengthen the
process and support
18. Set preliminary objectives and activities.
u Propose a variety of
activities to meet
members’ needs and
skills
u Identify short-term
successes
STEP
Developing Effective Coalitions
3
19. Influencing Policy Legislation
Changing Organizational Practices
Fostering Coalitions Networks
Educating Providers
Promoting Community Education
The Spectrum of Prevention
Strengthening Individual Knowledge Skills
23. Anticipate the necessary resources.
u Clerical
u Meeting planning, preparation
and facilitation
u Membership recruitment,
orientation and encouragement
u Research and data collection
u Participation in activities
and projects
STEP
Developing Effective Coalitions
5
24. Devise a successful coalition structure.
u Should coalition be ad hoc or ongoing?
u How long and frequent should meetings be?
u Should agencies officially join the coalition?
u How will decisions be made?
u How will agendas be
structured?
u How much will members
realistically participate
between meetings?
STEP
Developing Effective Coalitions
6
30. Maintain the coalition’s vitality.
u Difficulties generally arise due to:
n poor group dynamics
n inadequate membership
participation
n ineffective coalition activities
n external changes which
affect the coalition’s mission
Developing Effective CoalitionsSTEP
7
31. Make improvements through evaluation.
u Ask for feedback
u Evaluate the effectiveness
of specific activities
STEP
Developing Effective Coalitions
8
u Know when it is time to
dissolve, disband, or
change the structure of
the coalition
Photocredit:EmilyBarney
32. Recognize Unintended Successes
-- Cherie R. Brown
“C
oalition organizers should avoid
getting so caught up in any one effort as
to view it as ‘make or break.’
Every effort prepares for greater and
more sustained efforts in the future.
”
36. ¿ Coalitions tend to be made up of passionate
members
¿ Non-coalition related issues
¿ Conflicting agendas
¿ Previous bad relations
¿ Control over the coalition
(identity, ideology, strategy)
¿ Who gets recognition and resources
Why Do Turf Issues Arise?
38. u Acknowledge potential turf issues
u Shape collective identity
u Secure funding
u Remind participants
of the big picture
How to Manage Turf:
Tips for Coalition Leaders
Photo credit: Tord Sollie
39. Types of Turf Battles
¿ Member vs. member: often unrelated to joint
work
¿ Members vs. intersectoral effort: members
compete for the same pool of resources as the
coalition
¿ Members vs. leadership: leadership may
acquire resources at the expense of individual
members
40. Tools and Tips
u Acknowledge potential
turf issues – have honest
conversations about the
history of relationships
between organizations.
u Talk details – openly
discuss why each
participant/organization
is at the table.
41. u Shape collective identify – build a common focus and
commitment among members.
u Make fair decisions – decisions should be discussed and
represent majority support.
Tools and Tips
42. u Seek funding, if appropriate, for coordination –
external funding can help alleviate internal
pressure for resources.
u Reward partners and celebrate successes –
Acknowledge success along the way so that
partners see that they are achieving the desired
goals.
Tools and Tips
43. u Build bridges – trust,
respect, and amicability
are key to the success.
u Remind participants of
the big picture – key
members, such as
youth or faith leaders,
can help reunify the
group and remind it of
common goals.
Tools and Tips
44. u Make struggles overt –
if turf issues arise,
members need to admit
they exist to quickly
resolve issues.
u Encourage flexibility –
this helps cooperation
and success.
Tools and Tips
45. Building Trust
u Trust is about predicting behaviors.
u Building trust is a cyclical process.
u Start with “low-hanging fruit” but do not lose
sight of long-term goals.
u Interagency trust can often serve in the absence
of a formal agreement.
47. he determinants of health are
beyond the capacity of any one
practitioner or discipline to
manage… We must collaborate to
survive, as disciplines and as
professionals attempting to help
our communities and each other.
–Mitchel and Crittenden,
Washington Public Health Fall 2000
“T
”
53. Public Health
Urban Agriculture
Violence Prevention
City Council
Parks Recreation
Youth
mmunity
elopment
Faith-based
Planning Depa
School
Promotores
unity Health
ducation
Goal: Preventing violence through urban farming
54. Expertise Assets Desired Outcomes Strategies
Urban
Ag.
City
Council
n Policies that promote
health and safety in the
district
n Help leverage
funds for long-term
sustainability
n Knowledge on
urban food system
infrastructure and
implementation
n Long-term
partnerships to achieve
sustainable food
systems
n Create
mechanisms for
residents to access
fresh, affordable
healthy foods
Violence
Prev.
n Expertise in youth
violence prevention
and intervention
n Decreased gang
violence and increased
positive opportunities
for at-risk youth
n Build youth
leadership and
connect youth to
training and
employment
opportunities
Public
Health
n Experience in
population-based
interventions and
collection of data
on chronic disease
and injury rates
n Unification of
collaborative efforts to
address violence and
chronic disease
n Facilitate system
and policy changes
that link healthy
eating active living
with violence
prevention efforts
Phase I: Information Gathering
n Knowledge and
ability to influence
local policy
decisions
n Strong community
infrastructure for
communication,
involvement, outreach
and education.
n Experienced in
street (community)
organizing
n Established and
trusted partner
within the
community that can
provide data and
staff resources.
n Ability to
influence the
allocation of City
resources for
programs and
services.
56. Urban Agriculture
Expertise:
• Knowledge on urban food system infrastructure
and implementation
Desired Outcomes:
• Long-term partnerships to achieve sustainable
food systems
Key Strategies:
• Create mechanisms for residents to access
fresh, affordable healthy foods
UA
58. Violence Prevention
Expertise:
• Expertise in youth violence prevention and
intervention
Desired Outcomes:
• Decreased gang violence and increased
positive opportunities for at-risk youth
Key Strategies:
• Build youth leadership and connect youth to
training and employment opportunities
VP
59. Collaboration Multiplier:
Improving Safety and Increasing Access to Healthy Food
+ City Council
Expertise:
• Knowledge and ability to influence local
policy decisions
Desired Outcomes:
• Policies that promote health and safety in
the district
Key Strategies:
• Help leverage funds for long-term
sustainability
Violence Prevention
Expertise:
• Expertise in youth violence prevention and
intervention
Desired Outcomes:
• Decreased gang violence and increased
positive opportunities for at-risk youth
Key Strategies:
• Build youth leadership and connect youth
to training and employment opportunities
Public Health
Expertise:
• Experience in population-based interventions
and collection of data on chronic disease and
injury rates
Desired Outcomes:
• Unification of collaborative efforts to address
violence and chronic disease
Key Strategies:
• Facilitate system and policy changes that link
healthy eating active living with violence
prevention efforts
Urban Agriculture
Expertise:
• Knowledge on urban food system infrastructure and
implementation
Desired Outcomes:
• Long-term partnerships to achieve sustainable
food systems
Key Strategies:
• Create mechanisms for residents to access
fresh, affordable healthy foods
CC
VPPH
UA
60. City Council CC
Expertise:
• Knowledge and ability to influence
local policy decisions
Desired Outcomes:
• Policies that promote health and
safety in the district
Key Strategies:
• Help leverage funds for long-term
sustainability
Violence
Prevention
VP
Expertise:
• Expertise in youth violence prevention
and intervention
Desired Outcomes:
• Decreased gang violence and
increased positive opportunities for
at-risk youth
Key Strategies:
• Build youth leadership and connect
youth to training and employment
opportunities
Shared Outcomes
Partner Strengths
Joint Strategies/
Activities
Public Health PH
Expertise:
• Experience in population-based
interventions and collection of data
on chronic disease and injury rates
Desired Outcomes:
• Unification of collaborative efforts to
address violence and chronic disease
Key Strategies:
• Facilitate system and policy changes
that link healthy eating active living
with violence prevention efforts
Urban Agriculture
Expertise:
• Knowledge on urban food system
infrastructure and implementation
Desired Outcomes:
• Long-term partnerships to achieve
sustainable food systems
Key Strategies:
• Create mechanisms for residents to
access fresh, affordable healthy
foods
UA
61. Shared Outcomes
• Strong partnerships among partner
organizations and community
members
• Safe community gathering space:
Urban farm
• Employment for youth and adults
• Increased access to healthy foods
• Institutional systems and local
policies to promote health and
safety
PH VP UA ++ + CC
62. Partner Strengths
• Established trust and respect in
community
• Experience in community
engagement and training
• In-kind support
• Linked to broader city-wide
initiatives
PH
VP
UA
CC
63. Joint Strategies/Activities
• Establish Urban Farm and Farmer’s
Market
• Connect Youth and Community
Residents to Training and Employment
Opportunities
PH VP UA ++ + CC
PHVP UA+
64. City Council
Expertise:
• Knowledge and ability to
influence local policy
decisions
Desired Outcomes:
• Policies that promote health
and safety in the district
Key Strategies:
• Help leverage funds for long-
term sustainability
Violence Prevention
VP
Expertise:
• Expertise in youth violence
prevention and intervention
Desired Outcomes:
• Decreased gang violence and
increased positive
opportunities for at-risk youth
Key Strategies:
• Build youth leadership and
connect youth to training and
employment opportunities
Public Health
PH
Expertise:
• Experience in population-based
interventions and collection of data
on chronic disease and injury rates
Desired Outcomes:
• Unification of collaborative
efforts to address violence and
chronic disease
Key Strategies:
• Facilitate system and policy
changes that link healthy eating
active living with violence
prevention efforts
Urban Agriculture
Expertise/:
• Knowledge on urban food
system infrastructure and
implementation
Desired Outcomes:
• Long-term partnerships to
achieve sustainable food
systems
Key Strategies:
• Create mechanisms for
residents to access fresh,
affordable healthy foods
Shared Outcomes
• Strong partnerships among partner
organizations and community members
• Safe community gathering space: Urban
farm
• Employment for youth and adults
• Increased access to healthy foods
• Institutional systems and local policies to
promote health and safety
Partner Strengths
• Established trust and respect in community
• Local policy maker involvement and
support
• Experience in community engagement and
training
• Content expertise
• In-kind support
• Linked to broader city-wide initiatives
Joint Strategies/Activities
• Establish urban farm and farmer’s market
• Build youth capacity to understand goal and
advocate for environmental and policy
changes
• Build capacity of leaders
• Cultivate relationships and partnerships
• Connect youth and community residents to
training and employment opportunities
UA
CC
65. POLICY CONCERNS
PROBLEM DEFINITION
DESIRED OUTCOMES
DATA
FUNDING SOURCES
TRAINING AUDIENCES
MAJOR PRIORITY ISSUES
PLAYERSAPPROACHES
TRAINING EMPHASIS
NETWORKS PARTNERS
FUNDED MANDATES
Elements of Collaboration Multiplier can be
modified depending on coalition needs…
66. IMPORTANCE: Why is this issue important to your field?
ORGANIZATIONAL GOALS: What are your organization’s
goals related to this issue?
EXPERTISE: What unique expertise does your field bring to
the collaborative?
ASSETS/STRENGTHS: What resources (skills, training,
funding) can you bring to the table?
KEY STRATEGIES: What key strategies/activities are you
implementing that are relevant to this issue?
Categories
67. DESIRED OUTCOMES: What specific results/outcomes are
you seeking as a result of this collaboration? What does
success look like to you?
DATA: What data do you collect, and how?
PARTNERSHIP: Which partners/participants can you bring to
the table to enhance outcomes?
ORGANIZATIONAL BENEFIT: How does your organization
benefit from participating in this collaborative?
Categories
73. Education
Expertise:
• Experience working with afterschool providers
• Understanding of capacity of school facilities
Desired Outcomes:
• Equitable access to PA opportunities
• Improved behavior and academic
achievement
• Community ownership of public facilities
Key Strategies:
• Open facilities during non-school hours
• Address liability issues for community usage
• Engage partners to increase programming
and recreation opportunities
E
75. Public Health
Expertise:
• Impact of inactivity environments on health
Desired Outcomes:
• Equitable access to PA opportunities to prevent
chronic diseases
• Improved health behavior surveys, score cards
Key Strategies:
• Broker deals with a health perspective
• Foster partnerships across sectors
• Document the process
PH
77. Faith
Expertise:
• Strong ability to train and cultivate leaders and
congregation
Desired Outcomes:
• Community connection cohesion
• Services with community relevance
• Improved community health outcomes
Key Strategies:
• Open facilities
• Outreach to congregation to build momentum and
support
F
79. Local Business
Expertise:
Desired Outcomes:
Key Strategies:
LB
Expertise:
• Understanding community needs from a
business perspective
• Impact of safety on patronage of businesses
Desired Outcomes:
• Increased safety in surrounding areas
• Increased patron traffic due to usage
Key Strategies:
• Provide funding or sponsorship
• Promote joint use to community members
• Advocate to elected officials on joint use
issues
80. Expertise Assets Desired Outcomes Strategies
Education
Local
Business
n Financial opportunity to
support programming or
recreation n Presence in
community n
Connection with other
partners and sectors
n Increased safety in
surrounding areas
n Increased patron traffic
due to usage
n Provide funding or
sponsorship n
Promote to community
members n Advocate
to elected officials on
joint use issue
Experience working
with afterschool
providers and have
understanding of the
capacity of school
facilities
n Public facilities n
Access to students and
parents n Partnership
with institution
n Equitable access to PA
opportunities n Improved
behavior and academic
achievement n
Community ownership
n Open facilities
during non-school
hours n Address
liability issues n
Engage partners
Faith
Strong ability to
cultivate leaders and
congregation
n Facilities access to
congregation (families)
n Trust of residents
n Community cohesion n
Services with community
relevance n Improved
health outcomes
n Open facilities
n Outreach to build
momentum and
support
Public
Health
Impact of inactivity
environments on
health and are experts
on promising
strategies to increase
PA
n Prevention and
Wellness dollars n local
health data n convening
and faciliatating
n Equitable access to PA
opportunities to prevent
chronic diseases n
Improved health behavior
surveys, score cards
n Broker deals with a
health lens n
Foster partnerships n
Document the
process
Phase I: Information Gathering
Understanding
community needs from
a business perspective
and impact of safety
on patronage of
businesses
81. + Local Business
EducationPublic Health
Desired Outcomes:
• Equitable access to PA opportunities to prevent
chronic diseases
• Improved health behavior surveys, score cards
Key Strategies:
• Broker deals with a health perspective
• Foster partnerships across sectors
• Document the process
Faith
Expertise:
• Strong ability to train and cultivate leaders and
congregation
Desired Outcomes:
• Community connection cohesion
• Services with community relevance
• Improved community health outcomes
Key Strategies:
• Open facilities
• Outreach to congregation to build momentum
and support
LB
EPH
F
Expertise:
• Impact of inactivity environments on health
Expertise:
• Experience working with afterschool providers
• Understanding of capacity of school facilities
Desired Outcomes:
• Equitable access to PA opportunities
• Improved behavior and academic achievement
• Community ownership of public facilities
Key Strategies:
• Open facilities during non-school hours
• Address liability issues for community usage
• Engage partners to increase programming and
recreation opportunities
Expertise:
• Understanding community needs from a
business perspective
• Impact of safety on patronage of businesses
Desired Outcomes:
• Increased safety in surrounding areas
• Increased patron traffic due to usage
Key Strategies:
• Provide funding or sponsorship
• Promote to joint use to community members
• Advocate to elected officials on joint use issues
82. Local Business LB
Education E
Shared Outcomes
Partner Strengths
Joint Strategies
Public Health PH
Faith
F
Desired Outcomes:
• Equitable access to PA opportunities
to prevent chronic diseases
• Improved health behavior surveys,
score cards
Key Strategies:
• Broker deals with a health perspective
• Foster partnerships across sectors
• Document the process
Expertise:
• Impact of inactivity environments on
health
Expertise:
• Strong ability to train and cultivate
leaders and congregation
Desired Outcomes:
• Community connection cohesion
• Services with community relevance
• Improved community health outcomes
Key Strategies:
• Open facilities
• Outreach to congregation, building
momentum and support
Expertise:
• Experience working with children
youth and conducting fitness
assessments
Desired Outcomes:
• Equitable access to PA opportunities
• Improved behavior and academic
achievement
• Community ownership of public
facilities
Key Strategies:
• Open facilities during non-school hrs
• Address liability issues
• Engage partners
Expertise:
• Understanding community needs
from a business perspective
• Impact of safety on patronage of
businesses
Desired Outcomes:
• Increased safety in surrounding
areas
• Increased patron traffic due to usage
Key Strategies:
• Promote joint use to community
members
• Advocate to elected officials on joint
use issues
83. Joint Strategies
• Open facilities during non-school hours
• Support outreach efforts to community
members and residents
• Engage new partners to support broader
stewardship
E F+
PH E F ++ + LB
F + LB
84. Local Business LB
Education E
Shared Outcomes
Partner Strengths
Joint Strategies
Public Health PH
Faith
F
Desired Outcomes:
• Equitable access to PA opportunities
to prevent chronic diseases
• Improved health behavior surveys,
score cards
Key Strategies:
• Broker deals with a health perspective
• Foster partnerships across sectors
• Document the process
Expertise:
• Impact of inactivity environments on
health
Expertise:
• Strong ability to train and cultivate
leaders and congregation
Desired Outcomes:
• Community connection cohesion
• Services with community relevance
• Improved community health outcomes
Key Strategies:
• Open facilities
• Outreach to congregation, building
momentum and support
Expertise:
• Experience working with children
youth and conducting fitness
assessments
Desired Outcomes:
• Equitable access to PA opportunities
• Improved behavior and academic
achievement
• Community ownership of public
facilities
Key Strategies:
• Open facilities during non-school hrs
• Address liability issues
• Engage partners
Expertise:
• Understanding community needs
from a business perspective
• Impact of safety on patronage of
businesses
Desired Outcomes:
• Increased safety in surrounding
areas
• Increased patron traffic due to usage
Key Strategies:
• Provide funding or sponsorship
• Promote to community members
• Provide public support around issue
to elected officials
• Safe places for play and recreation
• Safe community gathering spaces
• Improved health outcomes for
children and families
• Community ownership of public
resources
• Subject matter expertise and
credibility
• Community trust and established
history in community
• Connections to a variety of
institutions, organizations and
sectors
• Open facilities during non-school
hours
• Support outreach efforts to
community members and residents
• Engage new partners to support
broader stewardship
85. Next Steps After Completion
of Collaboration Multiplier
u Tailor your messages to engage different fields in
achieving your goals
u Identify additional partners, outreach, and learn
how they fit into the matrix
u Build and strengthen the coalition
u Develop a comprehensive strategic approach
91. Promising Practices in
Nutrition and Physical Activity
Catalogues promising
policies in nutrition
and activity at the local
level
Local Policy Database
http://preventioninstitute.org/sa/policies/
92.
93. 221 Oak Street
Oakland, CA 94607
Tel: (510) 444-7738
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