Healthy Communities Initiative Research Articles

Longitudinal Policy and Systems Change as a Component of Community Power.

Community power represents the ability of communities to develop, sustain, and grow the capacity to participate in and advance systems change that addresses health inequities but is difficult to assess because of its multifaceted, longitudinal nature. Using California's school-based Local Control Funding Formula (LCFF) as an example, this article examines the interconnectedness of longitudinal policy and systems changes as one approach to understanding and visualizing evolving community power. Data on policy and systems changes were collected during the 10-year, place-based Building Healthy Communities initiative and coded using thematic analysis. Related changes within sites and between community and state levels were linked to show how changes built and overlapped over time. Around 45% of changes were interconnected and cascaded to build momentum within sites; in addition, a substantial proportion of statewide changes (68%) overlapped with community ones. The state-level LCFF policy led to multiple community-based changes over time, involving ongoing engagement from various community groups across communities. Local implementation of the LCFF policy change was used to illustrate the usefulness of connecting community-driven policy and systems changes over time to explore the dynamics of community power and address some of the limitations of that approach.

The LSU AgCenter Healthy Communities Initiative: Community-Participatory Policy, Systems, and Environmental Change

The LSU AgCenter Healthy Communities Initiative: Community-Participatory Policy, Systems, and Environmental Change

Investing in community power building to increase civic engagement through voting: lessons from the Building Healthy Communities initiative

ABSTRACT The objective of this study was to examine the impact of investments in community organizing made as part of a 10-year comprehensive community initiative focused on community power building in California. Data from multiple sources were used to examine the relationship between investments and one measure of civic engagement, voter turnout. Comparisons were made over time (2010–2019) and between intervention and propensity-weighted comparison sites. Analyses determined that investments by the funder were positively associated with turnout; this effect differed across elections and was largest in 2012. Broad investments to support community engagement, organizing, and base building had a positive impact on voting, an important indicator of civic engagement. In historically marginalized or underserved communities, investing in power building can yield benefits despite structural barriers that result in inequities. As restrictive electoral reforms grow across the country in the wake of the 2020 election, initiatives designed to build power may support proactively organizing against these changes or provide the infrastructure to understand and navigate them. Investing in community power building is a promising strategy for philanthropic organizations, organizers, and policy makers.

Building soil by building community: How can an interdisciplinary approach better support community needs and urban resilience?

Given the interrelated problems of climate change, energy and resource scarcity, and the challenge of supporting critical natural systems in cities, urban dwellers may be exceptionally vulnerable to the impacts of climate change. While a number of programs and policies have been developed and implemented to help reduce the environmental and social impacts of climate change on communities, we argue that effective and sustainable programs must not only consider how the changing environment impacts communities, but also how communities interact with and impact the environment. Specifically, drawing on a case study of the needs assessment of the Healthy Soils for Healthy Communities Initiative conducted in Los Angeles (LA) County, CA as a model for a Virtuous Cycle Framework, we attempted to better understand how urban residents interact with land, green spaces, and soil as a means of finding ways to address some of the environmental and health disparities that many urban residents experience, while also exploring ways to improve soil health to support its capacity to provide essential ecosystem services (e.g., carbon sequestration, water filtration, food and biomass production). A unique feature of our approach is that it involved an interdisciplinary and multi-level partnership composed of a well-established environmental organization dedicated to urban forestry, environmental justice, and climate resilience, university faculty researchers who study human behavior and human-nature relationships, government partners, and, most importantly, community members, among others. The first step in understanding how community members interact with their environment involved collecting survey and focus group data from residents of LA County to assess attitudes, beliefs, and behaviors around land and soil. Results were used to explore strategies for deepening community engagement, addressing knowledge gaps, and shaping policies that would benefit not just people who live/work in LA, but also the soil and other natural systems that rely on soil. This article integrates our previously published survey and focus group findings with new results that pertain specifically to the Virtuous Cycle Framework, and demonstrates how the data are being used to inform our community-based interventions (e.g., policy change, public education and community engagement, and demonstration projects).

Abstract P146: A Report On The Outcomes Of The Cleveland Clinic Community Care Health Challenges Project 2018 To 2019.

Healthy Community Initiatives is a means of directly impacting the health and well-being of the cities and communities served by the Cleveland Clinic. The Health Challenge is the signature program of the Cleveland Clinic Healthy Community Initiatives. It is a collaborative effort between Cleveland Clinic and community partners to engage individuals in the community to help manage chronic conditions and promote a healthier lifestyle. The population is the Cleveland Clinic Central region and other nearby neighborhoods impacting 59 zip codes. Each Health Challenge lasted 8 weeks. Neighborhood participants representing each area acquired points by attending health and wellness classes and events held at the Cleveland Clinic community center and partner locations. Individuals are awarded points for participation and improvement in biometric results and/or completion of a clinical appointment. Data was collected by summing up scores received from the different events in the health challenges as noted : Pre-Program Health Screening (1 point), Post-Program Health Screening (1 point), Decrease in BMI at End of Program (1 Point), Decrease in Blood Pressure at End of Program (1 point), Attend classes, programs, or exercise sessions at partner organizations (1 point), Attend classes, programs, or exercise sessions (2 points), mammography (5 points) and Women's Clinic Appointment (5 points) at the Cleveland Clinic Community Center. The winner of individual health challenge was determined by a point system based on participation and completion percentage. There were 17 eight week Health Challenges held in 2018 and 2019 in which a total of 1889 participants enrolled. Average age was 60 years. Average participant attended 9.4 classes/programs or exercise sessions during the 8 week program - total number attended by all the participants was 7,433. The completion percentage was 47.6%. From 2018 to 2019, enrollment increased by 24.9%, weight (by pounds) decreased by 27.7% (a net total of 2,133.7 pounds lost). However, completion rate decreased by 6.6%. Blood pressure abnormality (number of participants with stage 2 blood pressure abnormality decreased from 33% to 23% (national average 28.3%) ; initial lack of physical activity decreased from 51.2% to 32.2% (national average 25.4%) , initial lack of sleep decreased from 50.2% to 41% (national average 29.2%). The main objective of this report is to show how community health interventions such as these have positive impact on the health and well-being of both individuals and community at large. It is anticipated that dissemination of the positive outcomes of these community health interventions will encourage and consolidate healthy behaviors. It may also create incentives for both community and institutional investment and support in such beneficial health focused activities at the grassroots level.

Adapting Ripple Effect Mapping to a Virtual Survey Format

Community development projects continue despite the COVID-19 pandemic. Participatory evaluation of these projects is crucial. Ripple effect mapping (REM) is a participatory approach to evaluation that captures coalition and community member perspectives on program outcomes and impacts. In response to COVID-19, the Louisiana State University AgCenter Healthy Communities Initiative adapted REM for online delivery. The REM evaluation was found to be an effective way for community coalitions to reflect on outcomes and impacts and to motivate continued engagement.

P110 The Healthy Communities Initiative: Gathering Community Input During COVID-19

<h3>Background</h3> The Louisiana Healthy Communities Initiative, led by the LSU AgCenter, guides SNAP-Ed policy, systems, and environmental change efforts. Prior to COVID19, agents held in-person community forums to gather input and community priorities for interventions. COVID19 spurred innovation in this process. Although many states have used videoconferencing services to host meetings, lack of functional internet access posed a barrier for many communities in Louisiana. <h3>Objective</h3> To gather broad community input through Qualtrics surveys in order to assess needs and assets, guide project prioritization, and gather feedback on previous projects. <h3>Study Design, Settings, Participants</h3> Qualtrics surveys were distributed via email to community members, stakeholders, and partners serving low-income audiences. Three surveys solicited feedback for existing Healthy Communities coalitions (n = 45); 1 survey gathered initial input for a newly formed Healthy Communities coalition (n = 63). The overall response rate across all surveys was 23.6%. <h3>Measurable Outcome/Analysis</h3> Survey responses to community health and engagement questions were separated by counties and analyzed through qualitative content analysis. The research team worked with Extension agents to conduct member checking through discussing survey results with participants. <h3>Results</h3> One hundred and eight responses were received from 4 communities. Extension agents reported high satisfaction with the process. Surveys provided action items and potential new coalition members. Across all 4 communities, common themes included acknowledging racial health disparities, a need for greater community involvement in coalition efforts, and a lack of healthy food options. <h3>Conclusion</h3> Qualtrics surveys were an effective way to gather community input and allowed wider participation than would have been possible with a virtual meeting. Post-COVID, agents plan to continue to solicit community input through Qualtrics surveys, in addition to face-to-face forums. This method is a valuable tool for lower-income and rural communities. Results reflected an awareness of low community engagement, racial health disparities and limited healthy food access.

Be Well Communities\u2122: mobilizing communities to promote wellness and stop cancer before it starts

PurposeIncreasingly, cancer centers are delivering population-based approaches to narrow the gap between known cancer prevention strategies and their effective implementation. Leveraging successful healthy community initiatives, MD Anderson developed Be Well Communities™, a model that implements evidence-based actions to directly impact people’s lives.MethodsIn partnership with local organizations, MD Anderson’s Be Well Communities team executed and evaluated 16 evidence-based interventions to address community priorities in healthy diets, physical activity, and sun safety. Evaluation included assessing the effectiveness of evidence-based interventions, stakeholders’ perceptions of collaboration, and the population-level impact on dietary and physical activity behaviors among students using the School Physical Activity and Nutrition Survey and the System for Observing Fitness Instruction Time. Two-tailed t-tests were used to compare tested parameters at baseline and follow-up. p values less than .05 were considered significant.ResultsThis model achieved its early outcomes, including effectively implementing evidence-based interventions, building strong partnerships, increasing access to healthy foods, improving the built environment, and increasing healthy food and water consumption and moderate to vigorous physical activity among students (p < .001).ConclusionsBe Well Communities is an effective model for positively impacting community health which could be leveraged by others to deliver evidence-based actions to improve population health.

Building Support for Place-Based Solutions to Childhood Obesity: Findings From Missouri.

Place-based efforts offer promise in reducing childhood obesity. Yet, lack of public demand and support may hinder implementation. This study aimed to assess whether the emphasis on place-based solutions, community-wide strategies, and multisector engagement in the Healthy Schools Healthy Communities (HSHC) initiative would shift public views on obesity including the need for greater public involvement and an increase in awareness and support for strategies. As part of the evaluation, two surveys were conducted-in 2014 and 2016-to examine the relationship between HSHC strategies and changes in public perception, support, and awareness of obesity. Both surveys were cross-sectional and conducted with a randomized sample of households. Most respondents indicated that parents/family (84.3% in 2014; 87.8% in 2016) and children (70.9% in 2014; 74.8% in 2016) had a large/very large responsibility for addressing childhood obesity. A higher percentage of 2016 respondents indicated willingness to work with others to increase availability of healthy foods (71.3% vs. 64.2%, respectively; p = .0280) and increase the number of places to be physically active in their community (71.1% vs. 60.7%, respectively; p = .0015). Findings suggest awareness and support of place-based efforts and willingness to engage may help garner ongoing support. However, individuals and families are still perceived as primarily responsible for addressing childhood obesity. Countering this mindset remains an ongoing challenge. Streamlined messaging regarding the issue and associated solutions, enhanced skills and capacity to implement these efforts, and citizen engagement to garner support for place-based initiatives are important.

Association between multi-component initiatives and physical activity-related behaviors: interim findings from the Healthy Schools Healthy Communities initiative

BackgroundAlthough successful, assessment of multi-component initiatives (MCIs) prove to be very challenging. Further, rigorous evaluations may not be viable, especially when assessing the impact of MCIs on long-term population-level behavior change (e.g., physical activity (PA) and health outcomes (e.g., childhood obesity). The purpose of this study was to use intensity scoring, to assess whether higher intensity MCIs implemented as part of Healthy Schools Healthy Communities (HSHC) were associated with improved physical activity and reduced sedentary behaviors among youth (dependent variables).MethodsPA-related interventions were assigned point values based on three characteristics: 1) purpose of initiative; 2) duration; and 3) reach. A MCI intensity score of all strategies was calculated for each school district and its respective community. Multivariate longitudinal regressions were applied, controlling for measurement period, Cohort, and student enrollment size.ResultsStrategy intensity scores ranged from 0.3 to 3.0 with 20% considered “higher-scoring” (score > 2.1) and 47% considered “lower-scoring” (< 1.2). Average MCI intensity scores more than tripled over the evaluation period, rising from 14.8 in the first grant year to 32.1 in year 2, 41.1 in year 3, and 48.1 in year 4. For each additional point increase in average MCI intensity score, the number of days per week that students reported PA for at least 60 min increased by 0.010 days (p < 0.01), and the number of hours per weekday that students reported engaging in screen time strategies decreased by 0.006 h (p < 0.05). An increase of 50 points in MCI intensity score was associated with an average 0.5 day increase in number of weekdays physically active and an increase of 55 points was associated with an average decrease of 20 min of sedentary time per weekday.ConclusionsWe found a correlation between intensity and PA and sedentary time; increased PA and reduced sedentary time was found with higher-intensity MCIs. While additional research is warranted, practitioners implementing MCIs, especially with limited resources (and access to population-level behavior data), may consider intensity scoring as a realistic and cost effective way to assess their initiatives. At a minimum, the use of intensity scoring as an evaluation method can provide justification for, or against, the inclusion of an individual strategy into an MCI, as well as ways to increase the likelihood of the MCI impacting population-health outcomes.

Evaluation of the Reaching People with Disabilities through Healthy Communities Project

BackgroundPeople with disabilities experience disparities in chronic diseases, such as obesity, heart disease, and diabetes, in disproportionate numbers. Research suggests that healthy communities initiatives that work to implement policy, systems and environmental (PSE) changes can help reduce these disparities by improving access to healthy choices for community residents with disabilities. However, healthy communities efforts to implement PSE changes are often not inclusive of people with disabilities. ObjectiveThe purpose of this paper is to evaluate the implementation of an Inclusive Healthy Communities Model that was designed to reach people with disabilities through inclusive PSE changes. MethodsProfessionals from local public health agencies and disability organizations in 10 diverse communities worked to infuse disability inclusion into PSE changes promoting healthy living. Data on PSE implementation was collected and coded into categories to describe the nature of the inclusive PSEs. ResultsCommunities implemented 507 inclusive PSEs, 466 of which were environmental changes, 25 systems changes, and 16 policy changes. A large majority of PSEs were related to improving the built environment to facilitate access to public spaces, such as parks, playgrounds, and community gardens. Many communities also implemented policy and systems changes related to the addition of inclusion into existing policies, community plans, and ongoing training of staff. ConclusionIntegrating disability inclusion into traditional healthy communities efforts can facilitate improved access and opportunity for healthy living among people with disabilities. This pilot project has implications for public health workforce training, current practices, and PSE development with interdisciplinary teams and multisectoral coalitions.

Community Outreach Among Employees of an Academic Children's Hospital.

Ann & Robert H. Lurie Children's Hospital of Chicago, the largest freestanding academic pediatric hospital in Illinois, created the Healthy Communities initiative in 2016 to expand the hospital's mission to improve child health by partnering with local community organizations. Through the Thrive leadership development program, a group of hospital employees developed an action-learning project to understand how employees and physicians might engage with a specific Healthy Communities initiative to increase participation in organization-affiliated community outreach activities. After conducting a literature review and interviews with key stakeholders, the group characterized current employee and physician community outreach activities and interests through an online survey. The 19-item Likert style survey assessed perspectives on key motivations, barriers, and opportunities. A multidisciplinary sample of 564 respondents completed the survey. Although 87% of respondents currently participate in community outreach activities, only 44% participate through the institution. Motivations for participation included helping others less fortunate (70%), giving back to the community (68%), and creating awareness of an initiative (45%). The ideal setting for future participation would not require ongoing commitment (82%), could be done on weekends (69%), and completed with co-workers, friends or family (71%). The ideal types of opportunities for future participation could involve donations (86%), volunteering their skills (79%), and attending fundraisers (73%). Community outreach participation is high among employees and physicians at our institution. Targeting individual motivating factors could increase participation in activities through the institution. These findings guided the Healthy Communities team in organizing and developing opportunities for employees.

Overcoming Challenges Resulting From COVID-19: New York State's Creating Healthy Schools and Communities Initiative.

“Upstream” interventions that increase access or reduce barriers to healthy foods and opportunities for physical activity — referred to as policy, systems, or environmental strategies — are central to encouraging and supporting healthy behaviors that prevent chronic disease at a population level. However, they are complex and challenging to execute, especially during coronavirus disease 2019 (COVID-19), and efforts to build practitioner capacity are warranted. In this commentary, we describe a user or human-centered design (HCD) capacity-building approach to support practitioners in accomplishing the goals of the New York State Creating Healthy Schools and Communities (CHSC) initiative. This approach has been especially helpful during COVID-19, as it enables support to be responsive to practitioners’ constantly changing needs. Given that CHSC is a project specific to New York State and that the efforts of the Obesity Prevention Center for Excellence were tailored to obesity prevention, more research and evaluations should be conducted to better understand how the use of HCD could support practitioners addressing other complex public health issues in the United States.

The Louisiana Healthy Communities Initiative: A Community-Participatory Model for Obesity Prevention

Abstract Objectives Louisiana ranks 4th among US states for adult obesity, and 5th highest for physical inactivity. The Healthy Communities Initiative is a novel effort led by Cooperative Extension (CE) and SNAP-Ed staff in Louisiana to change the policy, systems, and environment (PSE) in target communities to encourage increased physical activity and healthier eating behaviors. The objective of this qualitative study was to identify community members’ perceived impacts of the Healthy Communities Initiative on their community according to the Community Capitals Framework using ripple effect mapping. Methods Local CE staff hold community forums where residents identify and prioritize strategies for PSE changes, then recruit community coalition members to collectively address needs identified at the forum. PSE strategies are different for each community targeted, with short-term impacts most effectively evaluated using qualitative methods. Ripple effect mapping is a community participatory qualitative evaluation method which allows evaluators to capture the effects of innovative interventions. Evaluators facilitate a focus group session in which community members create a map of the multiple impacts of an intervention according to the constructs of the Community Capitals Framework. We held a ripple effect mapping session with 15 participants in one Healthy Communities coalition to evaluate their progress after one year of PSE change work. Results Community members identified program impacts in each of the constructs of the community capitals framework. Participants most often identified program impacts that were improvements to the community's political capital, such as an improved ability to advocate for change. Participants identified the most impactful outcomes of the program, which included an increased awareness of inequity in the community, increased access to fresh produce for community members, and making connections with agencies and organizations which stretched across organizations’ “silos.” Conclusions The Louisiana Healthy Communities Initiative is an innovative strategy to encourage the adoption of PSE changes for obesity prevention. Ripple effect mapping proved to be an effective method for assessing community members’ perceptions of program impacts. Funding Sources SNAP-Ed.

The Stock Performance of American Companies Investing in a Culture of Health

We investigated the relationship between companies' efforts to build internal (COH-INT) and external cultures of health (COH-EXT) and their stock performance. We administered 2 surveys, which measure companies' programs, policies, and supports for improving the health of their employees and communities. We then compared the companies' stock performance to the Standard and Poor's (S&P) 500 Index from January 2013 through August 2017. United States. Representatives from 17 publicly traded companies who completed the COH-INT survey, of whom 14 also completed the COH-EXT. Culture of health scores were dichotomized into high versus low for both surveys. Stock price data for all companies were gathered from public sources. We constructed 5 stock portfolios: all 17 companies, high COH-INT, low COH-INT, high COH-EXT, and low COH-EXT companies. We examined total returns for each portfolio compared to the S&P 500. High COH-INT companies' stock price appreciated by 115% compared to the S&P benchmark (+69%), while low COH-INT companies appreciated only 43%. In contrast, high COH-EXT companies underperformed (+44%) when compared to the S&P 500 (+69%) and low COH-EXT companies (+89%). This study supports the view that employers' efforts to build an internal culture of health is a sound business strategy. More research is needed, however, to establish whether a link exists between supporting healthy community initiatives and company stock performance.

The Important Role of Government in Comprehensive Community Initiatives: A Case Study Analysis of the Building Healthy Communities Initiative

Comprehensive community initiatives (CCI) are multi-issue, large-scale, often philanthropic investments in disadvantaged communities to comprehensively address community problems. We studied two sites of The California Endowment’s Building Healthy Communities Initiative, Richmond and East Oakland, to examine CCI implementation. Prior research offers best practices focused on cultivating existing community organizational and organizing infrastructure. We find that CCI success also requires an enabling local government context. Where political will aligns with the initiative’s goals, CCIs should support work to inform and improve local public policy and systems. Inadequate government resources necessitate CCI investment, but government has an important role in CCI success.

Growing Healthy Communities Initiative

A contributing factor to the U.S. national obesity epidemic is the built environment-the physical aspects of a community in which we live, work and engage in our everyday activities. Therefore, modifying the built environment can be a solution to address the epidemic. Such an example is the Arkansas Coalition for Obesity Prevention (ArCOP) Growing Healthy Communities (GHC) initiative. The GHC initiative encourages community health workers, health education specialists, government officials and other stakeholders to embrace community collaboration in efforts to improve built environments by equipping them with resources that increase community access to healthy foods and physical activities to help combat obesity. ArCOP to date has funded 100+ GHC communities in Arkansas. One of the five communities being highlighted by the authors for their GHC efforts includes: the University of Arkansas at Little Rock University District community, in which the authors have contributed to implementing various GHC projects for the residents of this community. The GHC, a state initiative, has implications for national and global use, and it is emerging as an exemplary best practice model. It provides communities with effective strategies to help address the health inequities of obesity, through prevention and intervention measures to improve health behaviors.

Empowering the local community through a flexiible education program

Merri Health is a not-for-profit community health organisation with a focus on creating healthy, connected communities for people at every age and stage of life across northern metropolitan Melbourne and into the Hume region. Data shows Moreland has higher than average prevalence of many chronic diseases: in 2011, it was named a ‘diabetes hotspot’ by Diabetes Australia after diagnoses increased by 161% between 2006 and 2011. The municipality has significantly higher rates of cardiovascular disease than the Victorian average and also has high proportions of overweight and obese residents, with a significant proportion of the community not undertaking adequate physical exercise.1 As a disadvantaged municipality,2 the associated negative health effects of chronic health issues, obesity, poor food choices, and engagement with unhealthy behaviours represent an important need for intervention. A key goal of Merri Health is to develop initiatives that provide educational tools to develop healthy habits and long-term health maintenance strategies to create healthy communities. In 2012, we partnered with Moreland Council to deliver HEAL – a physical activity and lifestyle education program targeting people with or at risk of cardiovascular disease and diabetes. Through an 8-week lifestyle modification program, the project addresses the high prevalence of chronic disease in the area by supporting people to develop lifelong healthy eating and exercise practices. Our key objectives include empowering participants with health knowledge and improving their overall health and wellbeing. The initiative helps disadvantaged communities access tools and supports to empower them to improve and manage their own health. To promote greater access, our session fee of $7.50 can be reduced or waived. We also run a group specifically for women only to encourage greater participation of Muslim women. We’ve involved community and other stakeholders by meeting regularly with the Healthy Communities Initiative Project Manager at Moreland Council during implementation, connecting with GPs and community groups to increase awareness and boost referral whilst seeking ongoing feedback from participants to inform continuous improvement. In the first 3 years, HEAL participants:decreased waist circumference by 1.32% ,increased physical activity by 24.95% per week, decreased average daily sitting by 19.7%, increased daily vegetable servings by 24% and increased qualitative measures on healthy lifestyle knowledge and confidence Although healthy lifestyle programs may be common to many healthcare providers, our initiative takes an innovative approach by adapting an established model to the unique needs of our community. By considering cultural sensitivities, individualised engagement strategies, and opportunities to connect with people from disadvantaged groups, we’ve been able to flexibly support our community and demonstrate change in an at-risk population. Our data demonstrates excellence in primary prevention through improved outcomes across several key domains, which have been achieved by matching our program to the needs of our community. Through flexible delivery, we’ve engaged clients from diverse backgrounds and with other challenges such as socio-economic disadvantage, depression, and unemployment.

Better Care Teams: A Stepwise Skill Reinforcement Model.

The Building Healthy Urban Communities initiative presents a path for organizations partnering to improve patient outcomes with continuing education (CE) as a key component. Components of the CE initiative included traditional CE delivery formats with an essential element of adaptability and new methods, with rigorous evaluation over time that included evaluation prior to the course, immediately following the CE session, 6 to 8 weeks after the CE session, and then subsequent monthly "testlets." Outcome measures were designed to allow for ongoing adaptation of content, reinforcement of key learning objectives, and use of innovative concordant testing and retrieval practice techniques. The results after 1 year of programming suggest the stepwise skill reinforcement model is effective for learning and is an efficient use of financial and human resources. More important, its design is one that could be adopted at low cost by organizations willing to work in close partnership. J Contin Educ Nurs. 2016;47(6):283-288.

Healthy Communities Initiative: a preliminary assessment of the University of Missouri-Sedalia health promotion partnership

The persistence and growth of health disparities among different population groups have heightened interest in understanding the unique role University–community partnerships can play in promoting health and well-being. Through a qualitative approach, this study used in-depth interviews to understand the conditions and factors that determine the effectiveness of collaborative University–community partnerships, and how collective action can impact members and their communities. Findings show that the success of a partnership stems from the community’s social protective factors such as community capacity to participate in collaborative projects, sense of community, community participation, and community extent of empowerment fostered by the collective process. The study concludes with a call for committed collaboration between partnership members and among community coalitions.