Coalitions and Partnerships in Community Health

Preface xvii

Acknowledgments xxiii

About the Author xxv

Part I: Making the Case for Coalitions and Partnerships 1

1 Historical Perspective of Coalitions 3

Cooperation and Settlement in Early America 3

The Development of Associations 4

Community Organizing for Social Change: Trade Unions, Settlement Houses, and Neighborhood and Community Development 5

Social Work Approach 6

Political Activist Approach 7

Neighborhood-Maintenance, or Community-Development, Approach 8

Contemporary Efforts and Models of Social Action Community Organizing 10

Contemporary Roots of Coalitions and Partnerships for Health Promotion 12

Community Development 12

Citizen Participation 12

Empowerment 13

Community Capacity 14

Community Competence 15

Social Capital 15

Coalitions: A Public Health Strategy to Build Capable, Competent Communities 16

The Rise of Coalitions (1990–2006) 17

Alcohol, Tobacco, and Other Drug Abuse Prevention 17

Immunization Promotion 19

Oral Health Promotion 19

Teen Pregnancy Prevention 20

Injury Prevention 20

HIV/AIDS Prevention 20

Promoting Health Insurance 21

Prevention of Chronic Disease: Cardiovascular Disease, Cancer, and Diabetes 21

Asthma 22

Multiple Health Issue Coalitions: Turning Point Initiative 23

Racial and Ethnic Approaches to Community Health (REACH) 2010 23

Steps to a HealthierUS 24

Summary 24

Questions for Review 25

2 Principles of Collaboration and Partnering: Coalitions Defined 26

Defining Collaboration 26

Intensity and Levels of Collaborative Work 27

What’s in a Name? 29

Models of Collaboration 30

What Makes a Coalition a Coalition? 31

Types of Coalitions 32

How Community Coalitions Differ from Other Types of Coalitions 34

Community Coalitions 34

State Coalitions 34

Regional or National Coalitions 36

Competing Coalitions 36

Coalition Spotlight: Changing with the Times—The Consortium for Infant and Child Health (CINCH) 37

Summary 38

Questions for Review 38

3 Why Coalitions? 49

Why Coalitions Form 49

The Importance of Community Context 51

Benefits of a Coalition Approach 53

Challenges of a Coalition Approach 55

Applying Democratic Principles to Coalition Building 57

When Coalitions Are Not the Solution 58

To Be or Not to Be? Should Coalitions Ever Disband? 59

Summary 60

Questions for Review 60

4 The Community Coalition Action Theory (CCAT) 61

The Community Coalition Action Theory (CCAT): Origin and Roots 62

Coalition Frameworks and Models 62

Community Organization and Development Model 62

Framework for Partnerships for Community Development 63

Framework of Organizational Viability 64

Community Coalition Model 65

Work Group on Health Promotion and Community Development Model 67

The Collaboration Framework 68

Typology of Community Organization and Community Building 69

The Conceptual Framework for Coalition Assessment 69

Model of Community Health Governance 69

Community Coalition Action Theory: Assumptions and Constructs 71

Outline of the CCAT Theory 71

Empirical Support for the CCAT Theory 76

Stages of Development 76

Community Context 77

Lead Agency or Convener Group 77

Coalition Membership 78

Coalition Operations and Processes 78

Leadership and Staffing 80

Coalition Structures 81

Pooled Member and External Resources 81

Member Engagement 82

Assessment and Planning 82

Implementation of Strategies 83

Community Change Outcomes 83

Health and Social Outcomes 83

Community Capacity 84

Application of CCAT: Consortium for the Immunization of Norfolk’s Children (CINCH) 84

Stages of Development 85

Community Context 85

Lead Agency or Convener Group 85

Coalition Membership 86

Coalition Operations and Processes 86

Leadership and Staffing 86

Coalition Structures 87

Pooled Member and External Resources 87

Member Engagement 87

Assessment and Planning 87

Implementation of Strategies 88

Community Change and Health Outcomes 88

Community Capacity 88

Strengths and Limitations of the Theory, or Model 89

Future Directions 90

Summary 91

Questions for Review 91

Part II: Building Effective Coalitions and Partnerships 93

5 Lead Agency, Coalition Staff, and Leadership 95

Who is the Lead Agency? 96

Types of Lead Agencies 96

The Role of Lead Agencies 97

What Makes a Good Lead Agency? 97

Coalition Staff 98

Staff Roles 99

Coalition Leadership 108

Collaborative, or Transformational, Leaders 109

Leadership Recruitment 117

Leadership Styles 118

Leadership Traits, Skills, and Roles 121

Team Leadership 126

Training, Technical Assistance, and Orientation 126

Training 127

Technical Assistance 128

Trainers’ and Technical-Assistance Consultants’ Roles, Responsibilities, and Characteristics 129

Coalition Roles, Responsibilities, and Characteristics 129

Building and Sustaining Technical-Assistance Consultant–Coalition Relationships 129

Training and Technical Assistance Venues 130

Summary 134

Questions for Review 135

Resources 135

6 Coalition Membership and Teamwork 138

Member Organizations versus Individual Members 138

Categories of Membership 139

Member Characteristics, Capacities, and Skills 140

Member Responsibilities 142

Member Roles 144

Member Recruitment 144

Investing in Recruitment 148

Building Member Diversity 149

Member Retention 158

Does Size Matter? 162

Building Effective Teams and Work Groups 163

Stages of Team Development 164

Traits of Teams and Work Groups 165

Team and Work Group Roles 174

Building Community Ownership of the Coalition 175

Summary 176

Questions for Review 177

Resources 177

Organizations 177

Publications 179

7 Essential Coalition Processes 181

Communication 182

The Communication Process 183

Miscommunication 185

Communication Channels 185

Features of Effective Group Communication 186

Problem Solving 190

Effective Decision Making 195

Decision-Making Styles 196

Techniques for Building Majority-Rule Decisions 199

Techniques for Building Consensus 199

Prioritizing 200

Multi-Voting 201

Zero to Ten Rating 201

Ethical Decision Making 202

Resolving Conflict 203

Types of Conflict 204

General Conflict Resolution Strategies 207

Conflict Management Skills 208

Turfism 212

Types of Turf Issues That Coalitions Face 213

Avoiding and Resolving Turf Battles 213

Effective Turf Management Tips 215

Coalition Spotlight: Virginians for a Healthy Future 216

Summary 217

Questions for Review 218

Resources 219

General 219

Decision Making 219

Conflict Resolution 219

8 Coalition Infrastructure 222

Formalized Rules and Procedures 223

Coalition Vision and Mission Statements 223

SWOT Analysis 224

Vision Statements 224

Mission Statements 225

Slogans or Bylines 225

Roles and Job Descriptions 225

Organizational Charts 227

Steering Committees and Governance 229

Work Groups and Subgroups 230

Bylaws and Guidelines for Operations 231

Coalition Meetings 240

Meeting Basics 241

Timing of Meetings 242

Ground Rules 243

Meeting Process 244

Meeting Roles 244

Common Meeting Challenges 245

Agenda 249

Minutes 250

Parliamentary Procedure 250

Coalition Spotlight: Conducting Empowering Meetings 255

Summary 256

Questions for Review 256

Resources 256

Part III: Sustaining Effective Coalitions and Partnerships 259

9 Marketing the Coalition and Its Agenda 261

Marketing or Promoting the Coalition 262

Developing an Effective Organizational Message 262

Developing a Business Plan 265

Coalition Branding: Logo and Name 267

Promotional Materials 267

Brochures 268

Newsletters 270

Websites 273

Coalition Spokespersons 275

Summary 276

Questions for Review 276

Resources 277

10 Funding, Resource Development, and Sustainability 278

Sources of Coalition Funds 279

Sustainability 279

Social Enterprise 280

Social Entrepreneurs 281

Funding Characteristics 281

To Incorporate or Not? 282

Developing the Coalition Budget 285

Steps in the Budgeting Process 287

Fund-Raising 290

The Resource Development Team 292

The Resource Development Plan 293

Resource Planning Steps 293

Obtaining Corporate, Foundation, and Government Grants 298

Identifying and Researching Grant Funding Sources 299

Contacting the Funder 301

Building Support for the Grant Proposal 301

Requests for Proposals 302

Proposal Timelines 303

Writing a Grant Proposal 303

Reviewing Process for Competitive Grant Applications 304

Letters of Intent 305

The Grant Application 305

Dealing with Rejection 309

Improving Competitive Applications 310

Coalition Spotlight: Arkansas Oral Health Coalition 314

Summary 316

Questions for Review 316

Resources 316

Part IV: Coalitions and Partnerships in Action 319

11 Community Assessment 321

Choosing Coalition Issue(s) That Resonate with the Community 322

Framing the Issue to Build Support 323

Impact of the Issue on the Coalition 326

Priority Populations 326

Involving the Priority Population in the Work 327

An Asset-Based Approach to Community Assessments 328

Benefits and Challenges of Conducting Assessments 330

Conducting the Assessment 331

Determining the Assessment’s Purpose and Scope 332

Defining the Assessment’s Goals and Objectives 332

Selecting the Approach and Methods for Collecting Data 332

Designing and Pilot-Testing the Instruments and Procedures 347

Preparing a Timeline and Budget 348

Collecting the Data 348

Analyzing the Data 348

Preparing and Disseminating the Findings 349

Evaluating the Assessment’s Merit and Worth 351

Coalitions and Assessments: Issues and Lessons Learned 351

Coalition Spotlight: Community Assessment with the Metropolitan Boston Haitian HIV Prevention Coalition 352

Summary 352

Questions for Review 353

Resources 353

12 Coalitions and Planning 356

Public Health Planning Models 357

Getting To Outcomes: Methods and Tools for Planning, Evaluation and Accountability (GTO) 359

The Strategic Planning Process 361

Evaluating Strategic and Action Plans and the Planning Process 371

Coalition Spotlight: Strategic Planning with the Decade of Hope Coalition in Dulce, New Mexico 379

Summary 389

Questions for Review 390

Resources 390

13 Coalition Activities and Interventions 391

Phases of Program Implementation 392

Selecting and Implementing Projects 392

The Project Team 394

Assessing Promising Practices and Interventions 395

Characteristics of Successful Interventions 399

Implementing Community-Based Strategies 401

Levels of Intervention 401

Replicating Community-Based Strategies 402

Types of Intervention Strategies 403

Social Marketing 407

Essential Elements of Social Marketing 407

Features of Social Marketing 408

Creating a Social Marketing Plan 409

Media Advocacy 411

How Does Media Advocacy Work? 412

Media Advocacy Strategies 413

Interview Basics 416

Developing an Advocacy Strategy 417

The Advocacy Team 418

Coalition Spotlight: Media Advocacy with Los Angeles County Alcohol, Tobacco, and Drug Policy Coalition 419

Legal and Ethical Issues in Community Interventions 421

Liability 422

Confidentiality 422

Informed Consent 423

Disclosure 424

Competence 424

Conflict of Interest 424

Coalition Spotlight: Comprehensive Community Interventions—Injury Free Coalition for Kids of Philadelphia 425

Summary 426

Questions for Review 427

Resources 428

Examples of Social Marketing Campaigns 428

Other Social Marketing and Media Advocacy Resources 428

Ethics Websites 431

14 Evaluating Coalitions and Partnerships 433

Evaluation Paradigms 435

Coalition Evaluation: Promoting Self-Reflection and Improvement 436

Key Concepts and Levels of Coalition Evaluation 437

Key Terms of Coalition Evaluation 438

Ecological Levels of Outcomes 439

Levels of Coalition Evaluation 440

Evaluation Frameworks and Models 442

Kansas University Work Group’s Framework for Participatory Evaluation of Community Initiatives 443

CDC’s Framework for Program Evaluation in Public Health 444

The Kellogg Foundation’s Steps to Program Evaluation 446

Evaluation Steps 447

Coalition Measures 470

Level 1. Measures of Coalition Infrastructure, Function, and Processes 470

Level 2. Measures of Coalition Programs and Interventions 474

Level 3. Measures of Health Status and Community Change Outcomes 475

Coalition Evaluation Instruments 476

Challenges of Evaluating Community-Based Initiatives 486

The Challenges of Coalition Evaluation 487

Solving the Coalition Evaluation Dilemma 490

Coalition Spotlight: The California Coalition for Childhood Immunization 492

Summary 493

Questions for Review 493

Resources 494

General Evaluation Instruments 494

Other Resources 497

15 Coalitions and Partnerships: Their Promise and Future 501

Reflections on the Power of Working in Partnership 501

Lessons Learned from Coalition Evaluations 502

Summing Up: Factors That Promote Coalition Success 505

Implications and Future Research 507

References 511

Name Index 553

Subject Index 561