health 3.0 leadership conference: building and maintaining multi-sector partnerships with sana...
DESCRIPTION
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/TRANSCRIPT
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
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
The Tension
of Turf
Collaborator 4
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 3
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 1
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 2
Expertise:
Desired Outcomes:
Key Strategies:
Shared Outcomes
Partner Strengths
Joint Strategies
Collaboration Multiplier
Picture a Coalition
6
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.”
Coalitions are a tool for achieving a broad range
of goals.
Coalitions are a tool for effectively and
sustainably achieving a broad range of goals.
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
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
Recruit the right people.
STEP Developing Effective Coalitions
2
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
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
Coalition Members Wear
2 Hats
Photo credit: Martin Ujlaki
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
Influencing Policy & Legislation
Changing Organizational Practices
Fostering Coalitions & Networks
Educating Providers Promoting Community Education
The Spectrum of Prevention
Strengthening Individual Knowledge & Skills
Collaborator 4
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 3
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 1
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 2
Expertise:
Desired Outcomes:
Key Strategies:
Shared Outcomes
Partner Strengths
Joint Strategies
Collaboration Multiplier
through an invited meeting
through a training
through a conference
STEP Developing Effective Coalitions
4 Convene the coalition...
STEP Developing Effective Coalitions
4 Convene the coalition...
through an invited meeting
through a training
through a conference
ü
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
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
Avoid Burnout…
How long and how frequent should coalitions meet?
Photo credit: dnnya
How should decisions be made?
Photo credit: dnnya
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 Coalitions STEP
7
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
Phot
o cr
edit:
Em
ily B
arne
y
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. ”
The Tension
of Turf
“The conflict between organizations with seemingly
common goals.”
--Peck and Hague
TURF
Why Do Turf Issues Arise?
¿ 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?
What turf challenges have you faced before, or might
arise in your coalition?
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
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
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.
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
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
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
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
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.
Collaborator 4
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 3
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 1
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 2
Expertise:
Desired Outcomes:
Key Strategies:
Shared Outcomes
Partner Strengths
Joint Strategies
Collaboration Multiplier
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
”
A good solution solves multiple problems.
Prevention Institute
Benefits to Multi-Field Collaboration
u Diverse expertise and resources
u Access to broader networks
u Access to funding opportunities and other resources
u Fosters sustainability
Addressing the Intersection: Preventing Violence and Promoting
Healthy Eating and Active Living
Healthy Eating & Physical Activity
Safety &
Preventing Violence
Preventing violence through urban farming
Denver, CO
Collaboration Multiplier Approach
Information Gathering Collaboration Multiplier Analysis
1 2
Public Health
Urban Agriculture
Violence Prevention
City Council
Parks & Recreation
Youth
Community Development
Faith-based Orgs
Planning Department
School
Promotores Community Health
Education
Goal: Preventing violence through urban farming
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.
Urban Agriculture
Expertise:
Desired Outcomes:
Key Strategies:
UA
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
Violence Prevention
Expertise:
Desired Outcomes:
Key Strategies:
VP
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
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
VP PH
UA
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
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
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
Joint Strategies/Activities
• Establish Urban Farm and Farmer’s Market
• Connect Youth and Community Residents to Training and Employment
Opportunities
PH VP UA + + + CC
PH VP UA +
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
POLICY CONCERNS
PROBLEM DEFINITION
DESIRED OUTCOMES
DATA
FUNDING SOURCES
TRAINING AUDIENCES
MAJOR PRIORITY ISSUES PLAYERS APPROACHES
TRAINING EMPHASIS
NETWORKS & PARTNERS
FUNDED MANDATES
Elements of Collaboration Multiplier can be modified depending on coalition needs…
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
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
Collaborator 4
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 3
Expertise:
Key Strategies:
Collaborator 1
Expertise:
Desired Outcomes:
Key Strategies:
Collaborator 2
Expertise:
Desired Outcomes:
Key Strategies:
Shared Outcomes
Partner Strengths
Joint Strategies
Phase II:
Collaboration Multiplier Analysis
Desired Outcomes:
Promote Joint Use of Recreational Facilities
Who are some key partners?
Public Health
Faith
Education
Business
Joint Use: Increase use of schools / facilities for recreation during non-school hours
Education
Expertise:
Desired Outcomes:
Key Strategies:
E
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
Public Health
Expertise:
Desired Outcomes:
Key Strategies:
PH
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
Faith
Expertise:
Desired Outcomes:
Key Strategies:
F
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
Local Business
Expertise:
Desired Outcomes:
Key Strategies:
LB
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
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
+ Local Business
Education Public 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
E PH
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
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
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
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
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
www.preventioninstitute.org Photo credit: Emily Barney
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