Community-based Nonprofit Organizations Research Articles

Love Your Neighbor Collaborative: A Multi-Sector Collaborative to Target Health Disparities for Vulnerable Populations

The Love Your Neighbor Collaborative (LYNC) is a multi-sector collaborative of nonprofit community-based organizations, faith communities, educational institutions, local government, and local supportive businesses to target health disparities for the vulnerable population of individuals in homelessness, and near homelessness, throughout the city of Riverside, California.. The goal of LYNC is to reduce and prevent homelessness by building a coalition of RAOs, academic institutions, and nonprofit organizations to work collaboratively with the city of Riverside to create a stronger, more integrated collective effort resourcing those who are in homeless situations or, at risk of losing their home.

Integrating community-based nonprofit organizations into the cancer care journey: how do connections and coordination take shape?

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

The Geography of Grantmaking—Does Location Matter? Neighborhood Effects and Foundation Philanthropy

The neighborhood effects scholarship in urban sociology demonstrates the importance of geographic location to many social outcomes previously thought to be solely determined by individual characteristics (e.g. educational attainment). This article applies the theory and methods of neighborhood effects research to the study of community-based nonprofit organizations. If neighborhood composition and processes matter for individuals, do they also influence organizational outcomes such as resource procurement? An analysis of foundation grantmaking in the city of Chicago reveals that nonprofits’ ability to secure grants is influenced by both organizational and neighborhood characteristics. Larger, younger nonprofits with lower debt ratios, engagement in local networks and a previous record of foundation funding, are more likely to secure foundation support. While organizational factors matter, securing grants is also independently influenced by a nonprofit’s neighborhood location. Nonprofits in neighborhoods with a lower percentage of households in poverty, higher nonprofit density, and evidence of government grant support are more likely to receive foundation grants. We find neighborhood effects for nonprofit organizations for the outcome of resource procurement, specifically securing foundation grants. The article considers implications of these findings for nonprofits and the populations they serve.

Building social capital through nonprofit capacity building programs: The case of Omaha Community Foundation

ABSTRACT Community foundations can play an essential role in organizing, facilitating, supporting, and promoting the development of social capital among community-based nonprofit organizations. Accordingly, the Omaha Community Foundation has delivered a year-long capacity-building program for local nonprofit leaders for over eight years. A distinctive feature of this program is the cohort design that prioritizes relationship building among cohort members, while also providing technical assistance and training to program participants. A key outcome for this program has been the increase in social capital among program participants. This case study will review the evolution of this capacity-building program and how social capital building within a cohort model has been the consistent outcome since the program’s beginning. Discussion will include recommendations for how community foundations engage in building social capital in community-based nonprofit organizations.

Scaling Social Impact: Marketing to Grow Nonprofit Solutions

Nonprofit organizations addressing societal challenges such as hunger, poverty, and racial inequities want to grow the impact of their promising solutions to these problems—scaling social impact. Yet, local, community-based nonprofits often struggle to identify a path to scale their impact. To address this problem, the authors partnered with 11 nonprofits engaged in social impact scaling. By integrating insights on scaling from these nonprofit research partners together with academic research on scaling across a range of disciplines, they outline a framework for scaling community-based nonprofits and the marketing practices that support it. This research advances a two-stage social impact scaling framework termed “T-shaped Scaling.” Within this framework, the vertical bar of the T refers to “scaling deep,” grounding solutions within a community, and the horizontal bar of the T represents “scaling wide,” adapting and transferring the scaled deep solutions to new communities. This framework advances both conceptual and practical understandings of social impact scaling. Finally, the authors explore the policy implications of social impact scaling and call on researchers in marketing to further investigate the scaling strategies and marketing practices that grow social impact.

Understanding the challenges faced by Michigan’s family farmers: race/ethnicity and the impacts of a pandemic

Michigan is a critical agricultural state, and small family farms are a crucial component of the state’s food sector. This paper examines how the race/ethnicity of the family farm owners/operators is related to farm characteristics, financing, and impacts of the pandemic. It compares 75 farms owned/operated solely by Whites and 15 with People of Color owners/operators. The essay examines how farmers finance their farm operations and the challenges they face doing so. The article also explores how the Coronavirus-19 (COVID-19) pandemic affected farming operations, the financial viability of farms, and how farmers responded to the challenges posed by the pandemic. The study found that People of Color farm owners/operators were younger than White farm owners/operators. The People of Color farm owners/operators tended to manage smaller farms for shorter periods than White farm owners/operators. Though two-thirds of the Farmers of Color owned their farms, they were more financially vulnerable than White farm owners/operators. The farmers studied had difficulty obtaining loans to finance their farms. Farmers reported increasing requests from people for food assistance during the pandemic. Farmers responded to the pandemic by participating in government programs such as the Farm to Families Food Box Program that purchased their produce. It allowed farmers to supply emergency food assistance programs with products from their farms. The products went to families receiving food assistance from soup kitchens, food banks, and other community-based nonprofits.

The impact of Strong Families, Strong Communities on relationship functioning in low-income African American and Hispanic individuals: Findings from a federally funded randomized control trial.

Low-income minorities face many complex barriers to building stable and healthy relationships. AVANCE Houston, a non-profit community-based organization in Houston, Texas, developed the Strong Families, Strong Communities (SFSC) program to address such barriers by providing interactive healthy marriage and relationship skills workshops to low-income English- and Spanish-speaking Hispanic and English-speaking African American individuals. Using a randomized control trial (RCT) design with random assignment to the 7-week treatment group (n=649) or a 12-month wait-list control group (n=600), we examined the impact of the program on four dimensions of relationship functioning: relationship satisfaction, connectedness, and quality; and conflict resolution, at post-test and then 6 and 12months later. Using a repeated measure multilevel model with a difference-in-difference impact estimate, we found that all four dimensions of relationship functioning improved with small effect sizes that were larger than those found in previous relationship education programs for low-income individuals (Cohen's d's of 0.18 for relationship satisfaction, 0.24 for connectedness, 0.19 for quality, and 0.20 for conflict resolution). Findings from this study provide evidence of program effectiveness on dimensions of relationship functioning for low-income minorities, comparable to or better than those seen in other healthy marriage program RCTs. The findings of this impact evaluation are promising regarding the impact of programs like SFSC on dimensions of relationship functioning in low-income Hispanic and African American participants.

Dynamics between fragmentation and unity: Identity and nonprofit relationship management in the Asian American Community

Focusing on community-based nonprofits with specific missions of serving the Asian American community, this study examined the dynamics between various layers of identity, including ethnicity and panethnicity, and identified how intercultural relationship management contributed to a sense of community and empowerment among minority communities. Interviews from both nonprofit community organizations and community members revealed the following major findings. First, Asian American community nonprofits needed to manage a myriad of identities within their community, particularly the interplay between diverse ethnic identities and the pan-Asian ethnic identity. To help manage these identities, these nonprofits adopted a dual approach using both segmented outreach and coherent advocacy. Second, these community nonprofits used intercultural relationship management to build a sense of community and efficacy, promoting outcomes such as health awareness, communicative activeness, cultural shift, political engagement, and community alliances. This study contributes to relationship management literature through introducing identity-based relationship building strategies.

Employment and child support outcomes among noncustodial fathers: An evaluation of the Fathers Advancing Community Together program.

Prior research underscores the importance of fathers' involvement in their children's lives. However, there is mixed evidence about the degree to which fatherhood programs improve economic stability and child support outcomes among noncustodial fathers. We attempted to address some of these gaps in the literature by evaluating the Fathers Advancing Community Together (FACT) program. FACT was implemented by Rubicon Programs, a community-based nonprofit organization in the Bay Area, California known for providing services to help move people out of poverty. The program provided parents economic stability, responsible parenting, and healthy relationship workshops, as well as support services and intensive case management. We relied on data from the Department of Child Support Services to assess whether FACT increased the likelihood of employment, child support modifications, and child support payments among noncustodial fathers during a 6-month post-enrollment period. Using 3:1 coarsened exact matching procedures, the total sample resulted in 744 fathers (186 in the intervention group and 558 in the comparison group). Results from logistic regression models indicate that FACT participants were more likely to be employed and more likely to receive a child support modification during the post-enrollment period than their comparison counterparts, though we found no significant relationship between FACT participation and whether fathers made a child support payment.

Funding Community Health Activities: An Experiment Comparing Health Foundation's Priorities to Those of Public Health Agencies, Hospitals, and Nonprofit Organizations.

Health foundations provide significant financial resources for community health. Foundation priorities, therefore, can play a key role in setting community agenda, but little is known about the criteria foundations use to prioritize projects. To understand the priorities that guide decision makers in health foundations and compare those priorities with what is known about nonprofit hospitals, public health, and community-based nonprofits. An online survey with a discrete choice experiment and open-ended questions, asking respondents to choose between different types of community health projects based on project characteristics. Survey respondents were employed by health foundations located in the United States. Respondents were leaders at health foundations (n = 173), the majority of which (56.2%) worked at foundations with assets greater than $50 million. These respondents were compared with an earlier survey (n = 561) from nonprofit hospitals, public health, and community-based nonprofits. A conditional logit model was used to estimate how various project characteristics led to greater or lesser support of a given health project. Open-ended questions aided interpretation. A two sample t test was used to compare groups. Foundation decision makers placed the greatest value on programs with coalitions of community partners, programs with a growing or existing base of evidence for effectiveness, and programs that focus on social determinants of health. These priorities are similar to those of community nonprofits, public health departments, and health systems. However, foundation leaders are more willing to fund interventions with longer time horizons and interventions that are not yet fully evidence-based. Foundations are also less interested in clinical care and more interested in advocacy programs. Cooperation in funding and implementation is essential to community health improvement, and major organizations could benefit from everyone clearly articulating their priorities. There are good reasons to intentionally foster both similarities and differences in priorities across organizations.

Implementing a low-threshold audio-only telehealth model for medication-assisted treatment of opioid use disorder at a community-based non-profit organization in Washington, D.C.

BackgroundThe COVID-19 pandemic has had especially devastating effects on people who use drugs. Due to pandemic protocols in the USA, medication-assisted treatment (MAT) regulations became more flexible, permitting our community-based nonprofit organization to transition its low-threshold MAT clinic to an audio-only telehealth model of care in 2020. Lessons learned have the potential to improve MAT delivery to people with OUD.Case presentationThis case study describes our transition from a low-threshold community-based in-person MAT clinic to an audio-only telehealth model. We extracted data from electronic health records to describe patient characteristics and to calculate treatment retention rates. Patients were predominantly male (74.4%) and black (90.6%). The mean age was 53 years old with more than half of the clients aged 55 or older. Less than half (42.3%) of the patients lived in stable housing. Patients commonly had self-reported comorbid conditions such as hypertension (35.4%), hepatitis C (23.5%), diabetes (11.9%), human immunodeficiency virus (HIV) (7.2%). A majority of patients (68.6%) reported engagement with behavioral health care. We measure the success of our intervention relative to published retention rates, both overall as well as for in-person and telehealth care. In-person retention rates at 90- and 180-days were substantially higher than telehealth retention rates (93.9% vs 68.4% and 91.5% vs 51.9%, respectively).ConclusionsLow-threshold medication-assisted treatment in the care of people with opioid use disorder is essential to increasing treatment access and continuity. We found that an audio-only telehealth model was viable. Although we had decreased retention rates following the transition to an audio-only telehealth model, our rates remained excellent compared to published values for in-person MAT care. We call for advocacy and regulations to support continued use of telehealth services throughout and beyond the COVID-19 pandemic.

The implementation and role of a staff naloxone program for non-profit community-based sites in British Columbia: A descriptive study.

IntroductionThe BC Centre for Disease Control implemented the Facility Overdose Response Box (FORB) program December 1st, 2016 to train and support non-healthcare service providers who may respond to an overdose in the workplace. The program aims to support staff at non-profit community-based organizations by ensuring policy development, training, practice overdose response exercises, and post-overdose debriefing opportunities are established and implemented.Materials and methodsThree data sources were used in this descriptive cross-sectional study: FORB site registration data; naloxone administration forms; and a survey that was distributed to FORB sites in February 2019. FORB program site and naloxone administration data from December 1st, 2016 to December 31st, 2019 were analyzed using descriptive statistics. A Cochran-Armitage test was used to assess trends over time in naloxone administration event characteristics. Site coordinator survey results are reported to supplement findings from administrative data.ResultsAs of December 31st, 2019, FORB was implemented at 613 sites across BC and 1,758 naloxone administration events were reported. The majority (86.3%, n = 1,517) were indicated as overdose reversals. At registration, 43.6% of sites provided housing services, 26.3% offered harm reduction supplies, and 18.6% provided Take Home Naloxone. Refusal to be transported to hospital following overdose events when emergency services were called showed an increasing trend over time. Most respondents (81.3%) reported feeling confident in their ability to respond to the overdose and 59.6% were offered staff debrief. Based on the 89 site survey responses, supports most commonly made available following an overdose were debrief with a fellow staff member (91.0%), debrief with a supervisor (89.9%), and/or counselling services (84.3%).ConclusionsThe uptake of the FORB program has contributed to hundreds of overdose reversals in community settings in BC. Findings suggest that the FORB program supports developing staff preparedness and confidence in overdose response in community-based settings.

'A Library of People'

Social media platforms provide access to informational and emotional resources that can enable low-income populations to further their socioeconomic mobility and cope with unexpected life demands. However, lack of both interpersonal trust and a sense of shared identity often prevent low-income individuals from eliciting resources from the diverse networks embedded in these platforms. Building on past research, we investigated factors that facilitated and deterred low-income members of the community-based non-profit organization Family Independence Initiative (FII) from seeking informational and emotional support from other members on the organization's social media platform, UpTogether. We found that despite participants' perceived shared identity, members primarily requested resources from other UpTogether members through offline interactions due to lack of interpersonal trust. We extend existing research on the limitations of shared identity and the role of interpersonal trust and social norms in facilitating resource-seeking interactions among strangers in low-income contexts. We suggest that social media platforms incorporate pseudonymous posting to facilitate relationship development and allow users to disclose their needs without revealing identifying information.

Building Sustainable Organizational and Community Capacity for Research Partnerships: A Decade of Experience.

The purpose of this article is to share community partner perspectives of impact and lessons learned from a decade long community-academic partnership between the Collaborative Center for Health Equity at the University of Wisconsin-Madison, and the United Community Center/Centro de la Comunidad Unida, a nonprofit community-based organization providing services across the lifespan for Latino communities of Milwaukee. The partnership was established in 2010 to support bidirectional communication, trust building and mutual benefit though community engaged research and collaborative student teaching. Over the years, we have achieved a variety of outcomes on both sides of the partnership. For our community organization, the partnership has evolved to create substantial benefits through opportunities for new collaborations, service program development and grantsmanship. Several factors contributed to our success including sustained stable funding not tied to an individual research project and academic investment in community capacity.

Evaluating the Role of Government Collaboration in the Perceived Performance of Community-Based Nonprofits: Three Propositions

Abstract The topic of government–nonprofit collaboration continues to be much-discussed in the literature. However, there has been little consensus on whether and how collaborating with government is beneficial for the performance of community-based nonprofits. This article examines three dominant theoretical interpretations of the relationship between collaboration and performance: collaboration is necessary for the performance of nonprofits; the absence of collaboration is necessary for the performance of nonprofits; and the effect of collaboration is contingent on the nonprofits’ bridging and bonding network ties. Building on the ideas of governance, nonprofit, and social capital in their respective literature, this article uses set-theoretic methods (fsQCA) to conceptualize and test their relationship. Results show the pivotal role of the nonprofit’s network ties in mitigating the effects of either collaborating or abstaining from collaborating with government. Particularly, the political network ties of nonprofits are crucial to explaining the relationship between collaboration and performance. The evidence demonstrates the value of studying collaboration processes in context.

Nothing about us without us: community development as human resource development

ABSTRACT This article reports the findings from an exploratory and qualitative case study to understand how 34 leaders from 17 community-based non-profit organizations located in a municipality within the United States described their community development roles. Interviews with study participants evidenced that they conceptualized community development as processes to facilitate learning, organize community, and develop leaders. The findings revealed intersecting principles and practices among the adult education, community development, and human resource development (HRD) disciplines. This research advances scholarship that seeks to expand the boundaries of HRD and better understand the roles and contributions of non-profit organizations in community and societal development.

Using a Quality Improvement Model to Implement Distress Screening in a Community Cancer Setting

BackgroundQuality cancer care includes routine screening for psychosocial distress. This quality improvement project focused on the implementation of distress screening at a licensed affiliate of Cancer Support Community, a community-based non-profit organization that provides professionally led cancer support.MethodsAn advanced practice oncology nurse assisted the staff in implementing and evaluating the process of distress screening. CancerSupportSource (CSS), a validated web-based distress screening program developed by Cancer Support Community for use in community cancer settings, was employed to screen for distress, identify potential resources, and improve in-house and community referrals. For purposes of this quality improvement project, CSS was administered in interview format by staff. The Plan-Do-Study-Act (PDSA) quality improvement approach was used to implement CSS.ResultsTo implement the practice of distress screening, 21 patient participants were initially screened and evaluated for distress, including risk for clinically significant levels of depression, using CSS. The tool identified participant concerns and flagged thirteen persons as at risk for depression. After implementation and evaluation of distress screening using PDSA, in a year, 51 participants were screened. Participants stated that distress screening allowed for discussion of intimate questions that may not have otherwise occurred in an intake interview.ConclusionIt was demonstrated that CSS identified psychosocial and practical needs, facilitating the referral process and identification of community resources. Application of the PDSA model was an effective quality improvement model that can be used for the implementation and sustainability of distress screening across settings.

Home Is Where the Heart Is: The Impact of Home-Based Palliative Care on Patients with Advanced Heart Failure

Introduction There is growing interest in the effect that specialty palliative care (PC) has on outcomes for patients with advanced heart failure (HF). Some evidence suggests that PC may improve quality of life, understanding of prognosis, and documentation of treatment preferences but that it does not affect hospitalization or mortality. Objectives To determine the effect of home-based PC on documentation of treatment preferences and healthcare utilization for patients with advanced HF. Methods A community-based non-profit hospice and PC organization partnered with the heart failure clinic at a general hospital that is a member of a large, state-owned, academic health system. The clinic referred patients with advanced HF to a 30-day program with weekly visits from a PC RN for ongoing physical and symptom assessment, medication reconciliation, advance care planning, home safety evaluation, and psychosocial support. Additional involvement from PC SW, NP, and MD was available as needed. Outcomes included discussion and clarification of code status, discussion and completion of health care power of attorney (HCPOA), and 30-day health care utilization for patients admitted to the program compared to 90 days prior to admission. Results Over 13 months, 40 patients were referred to the program. Of those, 29 agreed to admission, 7 declined admission but enrolled in other services such as hospice, and 4 declined admission and any services. During the 30-day program, code status was discussed with all 29 patients (100%). On admission, code status was “Full” for 23 patients (79%). After 30 days, 11 patients changed their code status to “DNR.” HCPOA completion was discussed with 25 patients (86%). On admission, 15 patients (52%) of patients already had completed a HCPOA. After 30 days, an additional 7 patients completed a HCPOA. On discharge from the program, 17 patients (59%) continued with PC services, 6 (21%) declined follow up, 5 (17%) enrolled in hospice, and 1 (3%) died prior to discharge. Compared to 90 days prior to admission, hospitalizations for the 29 admitted patients decreased 70% from 0.47 hospitalizations per patient per 30 days to 0.14 during the program. Hospitalization length of stay (LOS) decreased 92% from 2.64 days per patient per 30 days to 0.21. Conclusions A 30-day home-based PC program for patients with advanced HF did increase documentation of treatment preferences such as code status and completion of HCPOA. Hospitalizations and hospitalization LOS were reduced during the program when compared to 90 days prior to program admission.

“But are we going to deal with the hard questions?”: Waves of Compassion in Halifax Regional Municipality

Within broader social concern about compassion and learning to live well together in the world, a non-profit community-based organization called Waves of Compassion has emerged in Halifax Regional Municipality (HRM) in Nova Scotia, Canada. In this article, we explore how compassion relates to some “hard questions” that have arise for the organization—questions related to issues of marginalization and inclusivity: for example, what it might mean to “walk in another’s shoes,” particularly when that person or group of people is different from you in terms of age, race, ethnicity, sexual orientation, socioeconomic status, or citizenship. We also wonder what role the Waves organization might take up in terms of action and/or practice with regard to transforming inequity and promoting inclusivity in the community. We consider such questions in the context of data derived from a recent survey that Waves of Compassion undertook. We integrate found poems (many of which are derived from the survey data) and expository writing as means of underlining what some writers have said about compassion—that it involves both emotions and rational thought, the undoing of sharp distinctions between the two. We see compassion as a form of practice where boundaries and separations might be dissolved (at least at times) through being and knowing in different ways.

Listening to Women: Recommendations from Women of Color to Improve Experiences in Pregnancy and Birth Care.

Women of color are at increased risk for poor birth outcomes, often driven by upstream social determinants and socially structured systems. Given the increasing rate of maternal mortality in the United States, particularly for women of color, there is a pressing need to find solutions to improving care quality and access for racially marginalized communities. This study aims to describe and thematically analyze the recommendations to improve pregnancy and birth care made by women of color with lived experience of perinatal health care. Twenty-two women of color living in the San Francisco Bay Area and receiving support services from a community-based nonprofit organization participated in semistructured interviews about their experiences receiving health care during pregnancy and birth. Interviews were audio-recorded and transcribed, and transcripts were analyzed using thematic analysis to highlight recommendations for improving perinatal care experiences. Participants shared experiences and provided recommendations for improving care at the individual health care provider level, including spending quality time, relationship building and making meaningful connections, individualized person-centered care, and partnership in decision making. At the health systems level, recommendations included continuity of care, racial concordance with providers, supportive health care system structures to meet the needs of women of color, and implicit bias trainings and education to reduce judgment, stereotyping, and discrimination. Participants in this study shared practical ways that health care providers and systems can improve pregnancy and birth care experiences for women of color. In addition to the actions needed to address the recommendations, health care providers and systems need to listen more closely to women of color as experts on their experiences in order to create effective change. Community-centered research, driven by and for women of color, is essential to improve health disparities during pregnancy and birth.