Coalitions and Partnerships in Community Health

Frances Dunn Butterfoss Ph.D., is a well known researcher, theorist, educator, speaker, and practitioner. She is a professor and Division Director of Behavioral Research and Community Health in the Department of Pediatrics at Eastern Virginia Medical School (EVMS). Dr. Butterfoss was recently awarded the EVMS Foundation Chair in Pediatrics.

• Preface xviiAcknowledgments xxiiiAbout the Author xxvPart I: Making the Case for Coalitions and Partnerships 11 Historical Perspective of Coalitions 3Cooperation and Settlement in Early America 3The Development of Associations 4Community Organizing for Social Change: Trade Unions, Settlement Houses, and Neighborhood and Community Development 5Social Work Approach 6Political Activist Approach 7Neighborhood-Maintenance, or Community-Development, Approach 8Contemporary Efforts and Models of Social Action Community Organizing 10Contemporary Roots of Coalitions and Partnerships for Health Promotion 12Community Development 12Citizen Participation 12Empowerment 13Community Capacity 14Community Competence 15Social Capital 15Coalitions: A Public Health Strategy to Build Capable, Competent Communities 16The Rise of Coalitions (1990–2006) 17Alcohol, Tobacco, and Other Drug Abuse Prevention 17Immunization Promotion 19Oral Health Promotion 19Teen Pregnancy Prevention 20Injury Prevention 20HIV/AIDS Prevention 20Promoting Health Insurance 21Prevention of Chronic Disease: Cardiovascular Disease, Cancer, and Diabetes 21Asthma 22Multiple Health Issue Coalitions: Turning Point Initiative 23Racial and Ethnic Approaches to Community Health (REACH) 2010 23Steps to a HealthierUS 24Summary 24Questions for Review 252 Principles of Collaboration and Partnering: Coalitions Defined 26Defining Collaboration 26Intensity and Levels of Collaborative Work 27What’s in a Name? 29Models of Collaboration 30What Makes a Coalition a Coalition? 31Types of Coalitions 32How Community Coalitions Differ from Other Types of Coalitions 34Community Coalitions 34State Coalitions 34Regional or National Coalitions 36Competing Coalitions 36Coalition Spotlight: Changing with the Times—The Consortium for Infant and Child Health (CINCH) 37Summary 38Questions for Review 383 Why Coalitions? 49Why Coalitions Form 49The Importance of Community Context 51Benefits of a Coalition Approach 53Challenges of a Coalition Approach 55Applying Democratic Principles to Coalition Building 57When Coalitions Are Not the Solution 58To Be or Not to Be? Should Coalitions Ever Disband? 59Summary 60Questions for Review 604 The Community Coalition Action Theory (CCAT) 61The Community Coalition Action Theory (CCAT): Origin and Roots 62Coalition Frameworks and Models 62Community Organization and Development Model 62Framework for Partnerships for Community Development 63Framework of Organizational Viability 64Community Coalition Model 65Work Group on Health Promotion and Community Development Model 67The Collaboration Framework 68Typology of Community Organization and Community Building 69The Conceptual Framework for Coalition Assessment 69Model of Community Health Governance 69Community Coalition Action Theory: Assumptions and Constructs 71Outline of the CCAT Theory 71Empirical Support for the CCAT Theory 76Stages of Development 76Community Context 77Lead Agency or Convener Group 77Coalition Membership 78Coalition Operations and Processes 78Leadership and Staffing 80Coalition Structures 81Pooled Member and External Resources 81Member Engagement 82Assessment and Planning 82Implementation of Strategies 83Community Change Outcomes 83Health and Social Outcomes 83Community Capacity 84Application of CCAT: Consortium for the Immunization of Norfolk’s Children (CINCH) 84Stages of Development 85Community Context 85Lead Agency or Convener Group 85Coalition Membership 86Coalition Operations and Processes 86Leadership and Staffing 86Coalition Structures 87Pooled Member and External Resources 87Member Engagement 87Assessment and Planning 87Implementation of Strategies 88Community Change and Health Outcomes 88Community Capacity 88Strengths and Limitations of the Theory, or Model 89Future Directions 90Summary 91Questions for Review 91Part II: Building Effective Coalitions and Partnerships 935 Lead Agency, Coalition Staff, and Leadership 95Who is the Lead Agency? 96Types of Lead Agencies 96The Role of Lead Agencies 97What Makes a Good Lead Agency? 97Coalition Staff 98Staff Roles 99Coalition Leadership 108Collaborative, or Transformational, Leaders 109Leadership Recruitment 117Leadership Styles 118Leadership Traits, Skills, and Roles 121Team Leadership 126Training, Technical Assistance, and Orientation 126Training 127Technical Assistance 128Trainers’ and Technical-Assistance Consultants’ Roles, Responsibilities, and Characteristics 129Coalition Roles, Responsibilities, and Characteristics 129Building and Sustaining Technical-Assistance Consultant–Coalition Relationships 129Training and Technical Assistance Venues 130Summary 134Questions for Review 135Resources 1356 Coalition Membership and Teamwork 138Member Organizations versus Individual Members 138Categories of Membership 139Member Characteristics, Capacities, and Skills 140Member Responsibilities 142Member Roles 144Member Recruitment 144Investing in Recruitment 148Building Member Diversity 149Member Retention 158Does Size Matter? 162Building Effective Teams and Work Groups 163Stages of Team Development 164Traits of Teams and Work Groups 165Team and Work Group Roles 174Building Community Ownership of the Coalition 175Summary 176Questions for Review 177Resources 177Organizations 177Publications 1797 Essential Coalition Processes 181Communication 182The Communication Process 183Miscommunication 185Communication Channels 185Features of Effective Group Communication 186Problem Solving 190Effective Decision Making 195Decision-Making Styles 196Techniques for Building Majority-Rule Decisions 199Techniques for Building Consensus 199Prioritizing 200Multi-Voting 201Zero to Ten Rating 201Ethical Decision Making 202Resolving Conflict 203Types of Conflict 204General Conflict Resolution Strategies 207Conflict Management Skills 208Turfism 212Types of Turf Issues That Coalitions Face 213Avoiding and Resolving Turf Battles 213Effective Turf Management Tips 215Coalition Spotlight: Virginians for a Healthy Future 216Summary 217Questions for Review 218Resources 219General 219Decision Making 219Conflict Resolution 2198 Coalition Infrastructure 222Formalized Rules and Procedures 223Coalition Vision and Mission Statements 223SWOT Analysis 224Vision Statements 224Mission Statements 225Slogans or Bylines 225Roles and Job Descriptions 225Organizational Charts 227Steering Committees and Governance 229Work Groups and Subgroups 230Bylaws and Guidelines for Operations 231Coalition Meetings 240Meeting Basics 241Timing of Meetings 242Ground Rules 243Meeting Process 244Meeting Roles 244Common Meeting Challenges 245Agenda 249Minutes 250Parliamentary Procedure 250Coalition Spotlight: Conducting Empowering Meetings 255Summary 256Questions for Review 256Resources 256Part III: Sustaining Effective Coalitions and Partnerships 2599 Marketing the Coalition and Its Agenda 261Marketing or Promoting the Coalition 262Developing an Effective Organizational Message 262Developing a Business Plan 265Coalition Branding: Logo and Name 267Promotional Materials 267Brochures 268Newsletters 270Websites 273Coalition Spokespersons 275Summary 276Questions for Review 276Resources 27710 Funding, Resource Development, and Sustainability 278Sources of Coalition Funds 279Sustainability 279Social Enterprise 280Social Entrepreneurs 281Funding Characteristics 281To Incorporate or Not? 282Developing the Coalition Budget 285Steps in the Budgeting Process 287Fund-Raising 290The Resource Development Team 292The Resource Development Plan 293Resource Planning Steps 293Obtaining Corporate, Foundation, and Government Grants 298Identifying and Researching Grant Funding Sources 299Contacting the Funder 301Building Support for the Grant Proposal 301Requests for Proposals 302Proposal Timelines 303Writing a Grant Proposal 303Reviewing Process for Competitive Grant Applications 304Letters of Intent 305The Grant Application 305Dealing with Rejection 309Improving Competitive Applications 310Coalition Spotlight: Arkansas Oral Health Coalition 314Summary 316Questions for Review 316Resources 316Part IV: Coalitions and Partnerships in Action 31911 Community Assessment 321Choosing Coalition Issue(s) That Resonate with the Community 322Framing the Issue to Build Support 323Impact of the Issue on the Coalition 326Priority Populations 326Involving the Priority Population in the Work 327An Asset-Based Approach to Community Assessments 328Benefits and Challenges of Conducting Assessments 330Conducting the Assessment 331Determining the Assessment’s Purpose and Scope 332Defining the Assessment’s Goals and Objectives 332Selecting the Approach and Methods for Collecting Data 332Designing and Pilot-Testing the Instruments and Procedures 347Preparing a Timeline and Budget 348Collecting the Data 348Analyzing the Data 348Preparing and Disseminating the Findings 349Evaluating the Assessment’s Merit and Worth 351Coalitions and Assessments: Issues and Lessons Learned 351Coalition Spotlight: Community Assessment with the Metropolitan Boston Haitian HIV Prevention Coalition 352Summary 352Questions for Review 353Resources 35312 Coalitions and Planning 356Public Health Planning Models 357Getting To Outcomes: Methods and Tools for Planning, Evaluation and Accountability (GTO) 359The Strategic Planning Process 361Evaluating Strategic and Action Plans and the Planning Process 371Coalition Spotlight: Strategic Planning with the Decade of Hope Coalition in Dulce, New Mexico 379Summary 389Questions for Review 390Resources 39013 Coalition Activities and Interventions 391Phases of Program Implementation 392Selecting and Implementing Projects 392The Project Team 394Assessing Promising Practices and Interventions 395Characteristics of Successful Interventions 399Implementing Community-Based Strategies 401Levels of Intervention 401Replicating Community-Based Strategies 402Types of Intervention Strategies 403Social Marketing 407Essential Elements of Social Marketing 407Features of Social Marketing 408Creating a Social Marketing Plan 409Media Advocacy 411How Does Media Advocacy Work? 412Media Advocacy Strategies 413Interview Basics 416Developing an Advocacy Strategy 417The Advocacy Team 418Coalition Spotlight: Media Advocacy with Los Angeles County Alcohol, Tobacco, and Drug Policy Coalition 419Legal and Ethical Issues in Community Interventions 421Liability 422Confidentiality 422Informed Consent 423Disclosure 424Competence 424Conflict of Interest 424Coalition Spotlight: Comprehensive Community Interventions—Injury Free Coalition for Kids of Philadelphia 425Summary 426Questions for Review 427Resources 428Examples of Social Marketing Campaigns 428Other Social Marketing and Media Advocacy Resources 428Ethics Websites 43114 Evaluating Coalitions and Partnerships 433Evaluation Paradigms 435Coalition Evaluation: Promoting Self-Reflection and Improvement 436Key Concepts and Levels of Coalition Evaluation 437Key Terms of Coalition Evaluation 438Ecological Levels of Outcomes 439Levels of Coalition Evaluation 440Evaluation Frameworks and Models 442Kansas University Work Group’s Framework for Participatory Evaluation of Community Initiatives 443CDC’s Framework for Program Evaluation in Public Health 444The Kellogg Foundation’s Steps to Program Evaluation 446Evaluation Steps 447Coalition Measures 470Level 1. Measures of Coalition Infrastructure, Function, and Processes 470Level 2. Measures of Coalition Programs and Interventions 474Level 3. Measures of Health Status and Community Change Outcomes 475Coalition Evaluation Instruments 476Challenges of Evaluating Community-Based Initiatives 486The Challenges of Coalition Evaluation 487Solving the Coalition Evaluation Dilemma 490Coalition Spotlight: The California Coalition for Childhood Immunization 492Summary 493Questions for Review 493Resources 494General Evaluation Instruments 494Other Resources 49715 Coalitions and Partnerships: Their Promise and Future 501Reflections on the Power of Working in Partnership 501Lessons Learned from Coalition Evaluations 502Summing Up: Factors That Promote Coalition Success 505Implications and Future Research 507References 511Name Index 553Subject Index 561

"This comprehensive text will be an invaluable resource not only for the practitioner and researcher practicing in all segments of public health but also for the academician preparing our future health educators. The rich experience of the author of more than 15 years of building, leading, evaluating, and consulting on coalitions and partnerships is evident as she combines her practical experience and insights with the published sources to make her points. . . . This book achieves the stated goal of being a one-stop shop that provides not only a philosophical and theoretical basis but also practical guidance and tools on how to develop and sustain successful partnerships and coalitions."-- Health Promotion Practice, April 2008