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Developing an Effective Oral Health Coalition

by

Sean Isaac, MPH, BSWFlorida Department of HealthPublic Health Dental Program

Community Water Fluoridation

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What We Will Cover

• What are coalitions?

• Structure

• Membership

• Effective Coalitions

• An Example of Coalition Building

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Why Oral Health Coalitions?

• Oral Health is not seen as important to total health

• When focusing on general health, oral health often gets lost– Needs oral health advocates that understand

systemic connections

• Messages that frame oral health must be salient and consistent - based upon evidence

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The Spirit of the Coalition

Bill Berkowitz, PhD and Tom Wolf, PhD

Publisher American Public Health Association

Website address: http://www.apha.org

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National Focus on Coalitions to Improve Oral Health

• Federal Health Resources and Services Administration (HRSA)

• Centers for Disease Control and Prevention• Association of State and Territorial Dental

Directors (ASTDD)• American Association of Community Dental

Programs• Oral Health America• Oral Health Florida

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Bill Berkowitz, PhD Department of Psychology University of Massachusetts Lowell

• 15 years creating, leading and consulting community coalitions statewide and

nationally

Tom Wolf, PhDDirector of Community Development

University of Massachusetts Medical School

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• definition: a group involving multiple sectors of the community, coming together to address community needs and solve community problems

• benefits: cost little, time commitments can be modest, little expertise is required yet can accomplish a lot

What are Coalitions?

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Concerns About American Community Life

• Participation in local organizations and activities is low – declining for generations.

• Social connections are weak in communities and are not valued

• Social alienation levels are at all time high while trust is at all time low

• Familiar social problems – poverty, violence, and others are higher

• Public and Private dollars are scarce

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Coalitions Can ProvideCommunity Structure

• Poll: 63% believe that people would be willing to pitch in to fix community problems, if they knew how

• The structures for organizing and mobilizing community resources are generally not in place

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“Every living person has some gift or capacity of value to others. A strong community is a place that recognizes those gifts and ensures that they are

given “– Kretzmann - McKnight

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Coalitions as a Unifying Structure

• Reduce the fragmentation among services• Reduce unnecessary service duplication • Improve coordination of existing services• Monitor and evaluate service quality• Assess the need for new services• Raise public awareness of service needs• Advocate for services• Generate fiscal and personnel resources to bring

services to life

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Coalition Building

• There is an evolving technology of coalition building that can be learned and applied. (in book)

• Spirit - conviction, engagement wholeheartedness, passion

• A coalition, its leaders and community must be sparked by the same spirit that sparks you when you are at your best

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Coalitions Influenced by Social Policy

• Reduced reliance on federal spending is putting pressure on states and communities to increase local self –sufficiency.

“ In a purely economic since, coalitions are a good hedge against bad economic times.”

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Lessons From the Field

–“ Everyone at the table has a responsibility to make sure the expertise of every individual there is brought to the table and laid out.”

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Key Issues Coalitions Face

• Recruiting• Structuring• Meeting• Leading• Publicizing• Funding • Advocating• Sustaining

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Coalitions Have Many Structures – National, Statewide, Local

• Oral Health Florida structure– informal– broad-based– inclusive– multiple workgroups– several local community coalitions

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Engaging Citizens

• Learn about citizens’ groups and associations• Develop contacts and relationships with these

groups• Keep on the lookout for potential new recruits• Make personal contacts with prospective citizen

members• Suggest giving the coalition a try (small steps)• Provide an incentive• Offer a range of ways people can help• Start with where you are and make something

happen with what you’ve got.

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Coalition Structure

Why is structure important?• Conflict

• Peaks and troughs

• Distractions

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Coalition Structure

Four reasons for structure:– Guidelines for uncertainty/disagreement

– Meaning/Identity for regularity/order

– Continuity and Forward Motion

– Supports goals of coalition

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Coalition Membership

• “…Membership is the core of it all. We really do need to keep bringing in new people, or else we’re dead. Membership is the glue that keeps it all together.”

– Members give strength in numbers– Members increase productivity– Members increase visibility– Members become empowered

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Coalition Membership

• Diversity and Inclusiveness

– Often requires ingenuity and extra effort

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Building Citizen Participation

• Meet at convenient times/locations

• Allow for informal interaction

• Let group share goals/expectations/feelings

• Make sure citizens have an equal voice

• Hire agency staff from within the community

• Allow time for trust to develop

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Giving Up

• Encourage free expression of diverse opinions• Move from “mine” and “theirs” to “ours”• Provide specific procedures and clear ground

rules• Believe in your own members’ abilities• Accept that mistakes may occur• Consider that disagreements may be healthy

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“ I am most successful when I leave my ego at the door. When I bring my own agendas to the meeting, then I become the center instead of the issue becoming the center.”

Trust the Coalition to Chart Its Own Best Coarse

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Giving Up Territory

• Take account of history and past territorial factors

• Acknowledge territorial concerns may exist• Understand current territorial definitions• Respect members’ self-interest and their need

to hold on to some ‘territory” of their own• Find ways to cooperate that don’t involve

territory• Be gentle, persistent, and patient around these

issues• Keep coalition members focused on greater

good rather than established positions

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Taking Meaningful Action

• Clarify the overall goals of the coalition• Create a plan with clear objectives, action and

timelines• Move on from planning to action and change• Give advance notice of decisions to be made

(e.g. on coalition agendas)• Follow-up on decisions with actions • Discuss difficulties in decision making and

taking action• Avoid getting caught in information sharing as

purpose

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• “Community Action is the coalition’s currency. If the coalition fails to act it will soon be out of funds.”

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Exert Your Leadership

• Leadership must represent the full coalition• Clarify work expectations with coalition

members• Make sure some responsibility is part of

membership expectation• Delegate responsibility within agreed-upon

limits• Follow-up on responsibilities delegated• Leadership training for prospective new

leaders

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Balance Your Life

• Find time for community amid life

• What works for you personally

• Lead a healthy lifestyle with time for rest and vacations

• Keep interests beyond the coalition

• Find supportive people you can talk to when needed

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Keep the Flame Alive

• We now think of coalitions as lasting longer• Plan future directions together• Take time to build good relationships• Find the right pace for change• Groom new leadership• Take on winnable activities• Reward members for accomplishments• Build in celebration and fun times

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Keeping the Faith

• Keeping the Faith– “a strong conviction –and we would call it

a spiritual conviction- that proper frame of mind, combined with proper action, will bring you to your destination.”

“Faith in the coalition and its success is essential”