Evaluating Community-Based Collaborative Mechanisms: Implications for Practitioners

This article examines the possible reasons why the published literature on community-based coalition strategies offers only marginal evidence that such approaches lead to health status/health systems change. Three possible explanations are proposed: (a) collaborative mechanisms are inefficient and/or insufficient mechanisms for carrying out critical planning and implementation tasks, (b) expectations of health status/health systems change outcomes are unrealistic, and/or (c) Health status/health systems changes may occur but may go undetected because it is difficult to evaluate and demonstrate a cause-and-effect relationship. The implications of each possible explanation are addressed through a review of the literature on stages of coalition building, focusing on key factors for success at each stage. The authors conclude that funders and practitioners may be expecting too much from these increasingly popular mechanisms and may not be asking the right questions when evaluating collaborative activity.

[1]  J. Fleishman,et al.  Developing AIDS community service consortia. , 1993, Health affairs.

[2]  M. Kreuter,et al.  Applications workbook to accompany health promotion planning : an educational and ecological approach , 1999 .

[3]  R. Brownson,et al.  The role of data-driven planning and coalition development in preventing cardiovascular disease. , 1992, Public health reports.

[4]  P. Gillies.  Effectiveness of Alliances and Partnerships for Health Promotion , 1998 .

[5]  E. Fisher,et al.  Community organization and health promotion in minority neighborhoods. , 1992, Ethnicity & disease.

[6]  R. Chamberlin.  "It takes a whole village": working with community coalitions to promote positive parenting and strengthen families. , 1996, Pediatrics.

[7]  R. Mitchell,et al.  Identifying training and technical assistance needs in community coalitions: a developmental approach. , 1993, Health education research.

[8]  C. Turner,et al.  Leadership and team effectiveness in community coalitions for the prevention of alcohol and other drug abuse , 1993 .

[9]  Robert M. Goodman,et al.  A model for the institutionalization of health promotion programs , 1989 .

[10]  R M Goodman,et al.  An ecological assessment of community-based interventions for prevention and health promotion: Approaches to measuring community coalitions , 1996, American journal of community psychology.

[11]  D. Bibeau,et al.  The Role of a Community Coalition in the Development of Health Services for the Poor and Uninsured , 1996, International journal of health services : planning, administration, evaluation.

[12]  William R. Potapchuk,et al.  Systems Reform and Local Government: Improving Outcomes for Children, Families, and Neighborhoods. , 1998 .

[13]  R. Gibberd,et al.  Community action for health promotion: a review of methods and outcomes 1990-1995. , 1997, American journal of preventive medicine.

[14]  A. M. Myers,et al.  Building a community-based consortium for AIDS patient services. , 1994, Public health reports.

[15]  C Lexau,et al.  Building coalitions: a community wide approach for promoting farming health and safety. , 1993, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[16]  J. Salonen,et al.  The community-based strategy to prevent coronary heart disease: conclusions from the ten years of the North Karelia project. , 1985, Annual review of public health.

[17]  A Cheadle,et al.  Conference report: community-based health promotion--state of the art and recommendations for the future. , 1997, American journal of preventive medicine.

[18]  A. Plough,et al.  Implementing the Boston Healthy Start Initiative: A Case Study of Community Empowerment and Public Health , 1994, Health education quarterly.

[19]  M. Durkin,et al.  Injury prevention in an urban setting: challenges and successes. , 1995, Bulletin of the New York Academy of Medicine.

[20]  N. Bracht.  Health promotion at the community level , 1990 .

[21]  D. Altman,et al.  Sustaining interventions in community systems: on the relationship between researchers and communities. , 1995, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[22]  J. Morone.  The Democratic Wish: Popular Participation and the Limits of American Government , 1991 .

[23]  B. Loken,et al.  Community impact of a localized smoking cessation contest. , 1990, American journal of public health.

[24]  D. Celentano,et al.  An analysis of the greater Baltimore HIV services planning council , 1992 .

[25]  A. L. Schlaff,et al.  Boston's Codman Square Community Partnership for Health Promotion. , 1991, Public health reports.

[26]  Christopher M. Anderson,et al.  The perceptions of costs and benefits of high active versus low active groups in community coalitions at different stages in coalition development , 1998 .

[27]  R M Goodman,et al.  Community coalitions for prevention and health promotion. , 1993, Health education research.