Bridging for Health Advisory Panel Insights Part 1: Strengthening Coalitions to Improve Health Equity
“Coming together is a beginning, staying together is progress, and working together is success.”
— Henry Ford
Building and sustaining a strong coalition of diverse, yet invested participants is no small challenge. We recently asked the Bridging for Health advisory panel for their tips for building an inclusive collaborative, pitfalls to avoid in building a multisector coalition, and how decisions about coalition makeup can benefit health equity.
Lay a Strong Foundation
Make sure everybody is on the same page. It sounds simple, but in practice, language and framing issues can make cross-sector collaboration challenging.
“We really need to work to understand each other’s language. How do they frame things? What’s important to them?” explains Craig Weber, founder of the Weber Consulting Group. “Framing is really important, so everyone is on the same page about what we’re trying to accomplish together, why it matters to all parties involved, and then how we work effectively to coordinate actions and address the goals we are trying to accomplish together.”
Weber stresses this is critical, up-front work, especially for groups of people who have not previously worked together. “If you underinvest in that process, you always pay for it downstream,” he warns.
Synchronizing language, framing, and goals plays a key role, Weber says, in deliberately designing engagement to achieve big change.
“If people don’t see the price they’re paying for the status quo and the advantages they can gain from the changes you’re advocating,” Weber says, “They’re very unlikely to come to the table in an eager way, meaning they’re very unlikely to roll up their sleeves and do the hard work required to create change.”
Recognize Partners’ Strengths
One key to getting collaborative partners to meaningfully engage is playing to their strengths.
“What we find is that you can have much more specific conversations with partners if they are not just sitting at the coalition table waiting for our long process to play out,” says Soma Stout, executive lead of the 100 Million Healthier Lives initiative at the Institute for Healthcare Improvement. “Instead, be able to make that more specific ask that matches the strengths and readiness of the partner to contribute to solutions that are needed to improve the well-being of a community. We find this usually leads to a better and more efficient outcome.”
In some cases a partner’s strength can be in its influence to convene.
“It is very easy to say, ‘We need to all be connected so we are going to host the party,’ rather than saying, ‘Who is best positioned to invite the residents most affected by the work that we are doing who are to become part of convening and help envision what’s possible for the future?’” says Ruth Wageman, director of stewardship at ReThink Health.
“Our tendency is to go to people who think a lot like us, because we are more comfortable with them, but we have got to break out of that,” says Vondie Woodbury, consultant and former vice president of community benefit at Trinity Health. “More often than not you will work with a coalition and it is all nonprofit folks who are in the business of doing community types of work. Yet, there are other huge pieces of the community who are absent.”
Community coalitions need to take significant steps to ensure they truly represent the community.
“Rather than trying to guess what would improve health equity, integrate people who are going to be most affected by the thing that we’re trying to improve in the design process,” explains Stout. “We really strongly encourage leaders to use codesign processes to get out of boardroom and coalition tables and to be in kitchen tables, to shift the balance of power in those conversations but more importantly to recognize that people with lived experience of a particular inequity have a wealth of experience. We’re inviting them to be the creators of the solution.”
Engaging those community members from the beginning is essential.
“The underlying stance of great partners and would-be stewards is understanding that this is about the residents of a community and that the work is not about doing something to them,” says Wageman. “It is about doing something with them and thinking right from the beginning about how residents can be driving what this is all about — what its ultimate aims are. How are our efforts going to be accountable to particularly those who are most suffering and the most vulnerable populations.”
Woodbury says that additional steps coalitions can do to go the “extra mile” to engage community members include:
- Holding open mic nights where people are during nonbusiness hours.
- If polling, oversampling communities.
- Being knowledgeable about the data and not understating the data you have.
“Growth of ownership in the process of improving health equity by people who are most affected by inequity has real health and well-being impacts for that person and the community,” says Stout.
About Bridging for Health
Bridging for Health: Improving Community Health Through Innovations in Financing, supported by the Robert Wood Johnson Foundation, takes a systemic approach to improving population health. It fosters connections among diverse stakeholders to align investments to target the upstream drivers of health that will ultimately improve population health outcomes. To accomplish this, Bridging for Health focuses on the linkages between three key areas—innovations in financing, collaboration, and health equity. The Georgia Health Policy Center is the national coordinating center for Bridging for Health.