Cross Jurisdictional Boundaries to Build a Health Coalition: A Kentucky Case Study.

Angela L. Carman,Margaret L. McGladrey

doi:10.3389/fpubh.2018.00189

Angela L. Carman, Margaret L. McGladrey

Open Access

https://doi.org/10.3389/fpubh.2018.00189

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Abstract

Cross-jurisdictional sharing is accomplished through collaboration across jurisdictional boundaries to deliver essential public health services and solve problems that cannot be easily addressed by single organizations or jurisdictions. Partners across 10 counties and three public health jurisdictions of the Barren River Area Development District (BRADD) convened as Barren River Initiative to Get Healthy Together (BRIGHT), a community health improvement coalition. Focus groups and interviews with BRIGHT members indicate that the use of effective strategies to focus collaborative health improvement efforts fosters a cohesive coalition even when the group is populated by individuals from across public health jurisdictional boundaries. Focusing strategies identified included: the importance of organizing workgroups so members can draw upon expertise, adoption of a community engagement model for health assessment and improvement; and use of a facilitator, who offers guidance and administrative support to groups and focuses members on accomplishing goals.

Highlights

America’s Health Rankings provides an overall ranking for each state based on a number of health factors, such as behaviors, clinical care, and environment, and health outcomes, such as cancer and cardiovascular deaths
A potential catalyst for large-scale health improvements in Kentucky may be its local public health departments (LHD), as Kentucky ranks among the top states with LHDs accredited by the Public Health Accreditation Board (PHAB) [4]
These accredited health departments and those pursuing national, voluntary public health accreditation follow a system of standards and measures are created in domains that mirror the 10 essential public health services (EPHS), a framework developed by the Core Public Health Functions Steering Committee [5, 6] EPHS #4 directs LHDs to “mobilize community partnerships and action to identify and solve health problems;” [5] LHDs often serve as conveners of community partners, such as hospitals, schools, non-profit organizations, businesses, faith-based organizations, and others whose objectives include health improvement [7]

Summary

INTRODUCTION

America’s Health Rankings provides an overall ranking for each state based on a number of health factors, such as behaviors, clinical care, and environment, and health outcomes, such as cancer and cardiovascular deaths. This study is novel in that it leverages the local expertise of BRADD community partners in the Barren River Initiative to Get Healthy Together (BRIGHT) whose resource constraints and geographic isolation make coalition work complex to identify how and why rural partners across the 10 counties and three local public health jurisdictions convened as a health improvement coalition. It explores how community partners sustained their efforts by assessing health needs and developing and implementing cross-jurisdictional community health initiatives to address those needs

METHODS

RESULTS AND DISCUSSION

LIMITATIONS

CONCLUSION