\u201cHey, We Can Do This Together\u201d: Findings from an Evaluation of a Multi-sectoral Community Coalition

Lindsey Realmuto,Susan Beane,José A Pagán,Linda Weiss,Rashi Kumar,Kumbie Madondo,Patrick Masseo

doi:10.1007/s11524-020-00473-3

Abstract

Multi-sectoral coalitions focused on systemic health inequities are commonly promoted as important mechanisms to facilitate changes with lasting impacts on population health. However, the development and implementation of such initiatives present significant challenges, and evaluation results are commonly inconclusive. In an effort to add to the evidence base, we conducted a mixed-methods evaluation of the Claremont Healthy Village Initiative, a multi-sectoral partnership based in the Bronx, New York City. At an organizational level, there were positive outcomes with respect to expanded services, increased access to resources for programs, improved linkages, better coordination, and empowerment of local leaders—all consistent with a systemic, community building approach to change. Direct impacts on community members were more difficult to assess: perceived access to health and other services improved, while community violence and poor sanitation, which were also priorities for community members, remained important challenges. Findings suggest significant progress, as well as continued need.

Highlights

In low-income communities that have experienced decades of disinvestment from the public and business sectors, interventions with a limited focus on individual behaviors and health conditions—and with a short time horizon—are unlikely to have substantial impacts on population health or its determinants [1, 2]
Broader initiatives [3], often including multi-sectoral coalitions focused on systemic challenges, are commonly considered to be important mechanisms to facilitate changes that are sensitive to local priorities [4] and are more likely to have widespread and lasting impact [5,6,7]
In an effort to add to the evidence base regarding multi-sectoral collaborations, we conducted mixedmethods evaluation of the Claremont Healthy Village Initiative (CHVI), which is a coalition based in Claremont, a section in the Morrissania neighborhood of the Bronx, New York City (NYC)

Summary

Introduction

In low-income communities that have experienced decades of disinvestment from the public and business sectors, interventions with a limited focus on individual behaviors and health conditions—and with a short time horizon—are unlikely to have substantial impacts on population health or its determinants [1, 2]. Broader initiatives [3], often including multi-sectoral coalitions focused on systemic challenges, are commonly considered to be important mechanisms to facilitate changes that are sensitive to local priorities [4] and are more likely to have widespread and lasting impact [5,6,7]. Evaluation is challenging given the scope and fluidity of multi-sectoral initiatives, difficulties delineating the affected population and defining an appropriate comparison group, the length of time needed to observe a relevant and measurable impact, and concurrent programs and initiatives that may be effectively working toward similar goals [6, 8]. In an effort to add to the evidence base regarding multi-sectoral collaborations, we conducted mixedmethods evaluation of the Claremont Healthy Village Initiative (CHVI), which is a coalition based in Claremont, a section in the Morrissania neighborhood of the Bronx, New York City (NYC). At 76.2 years, life expectancy is 5 years shorter than the NYC average [9]

Results

Discussion

Conclusion