Place-based Initiative Research Articles

How can community music shape individual and collective well-being? A case study of a place-based initiative.

There is an urgent need to investigate innovative and creative approaches in health promotion that support work towards health equity. In response, this study explores the potential for arts, and community music specifically, to strengthen individual and collective well-being. This study used a qualitative case study methodology that involved interviews, focus groups and ethnographic observation with participants (N = 13), facilitator (N = 1) and support staff (N = 2) of an established community music initiative conducted in an urban community. Data collection was conducted across 2023 and data analysis drew on a socioecological framework to explore potential individual and collective outcomes from the perspective of those involved in the initiative. Findings point to outcomes across socioecological levels with researchers identifying positive health and well-being implications for participants including joy, healing and a sense of purpose, creative self-expression, confidence, social connection and contribution. Positive outcomes for the wider community were also identified including developing community ties, promoting safety and shaping and sharing of collective identity. Findings suggest community-led opportunities for engagement can support healing and empowerment for people who are marginalised, and this can enable active community participation related to challenging the status quo and developing a shared set of values. Potential implications of these outcomes in relation to broader societal transformations are discussed. This study highlights how community music, and the arts more broadly are working in communities in ways that support potential personal, community and societal transformations towards health equity. SO WHAT?: By developing coalitions and collaborating with diverse sectors, including the arts and social sectors, health promotion practitioners and researchers can harness the creative strengths and resources that exist within a community to support positive individual and collective well-being.

Harlem Health Advocacy Partners: A Local Health Department's Place-Based Community Health Worker Program.

In January 2015, the New York City Department of Health and Mental Hygiene launched Harlem Health Advocacy Partners (HHAP), a place-based initiative to demonstrate the capacity of a CHW workforce to improve the health of residents of public housing. The long-term goal of HHAP is to improve the population health of residents of public housing in East and Central Harlem and to close racial gaps in health and social outcomes. A variety of evaluation approaches have been used to assess the initiative. This paper describes the HHAP model and methods for evaluating the program.

239 Promoting Health Equity in South Los Angeles: A Place-Based Initiative in the Nickerson Gardens Housing Development

OBJECTIVES/GOALS: Partnering with the Housing Authority of Los Angeles, we launched a place-based initiative in the Nickerson Gardens housing development in South Los Angeles, where we apply our community engagement approach of listening and learning, and trust and relationship building, to deliver public health interventions in a discrete community. METHODS/STUDY POPULATION: Nickerson Gardens is the largest housing development in Los Angeles, with 1,066 units and over 3,000 residents. 58% and 40% of the residents are Hispanic and Black/African American respectively with an average yearly income of less than $30,000. To build trust and establish relationships, our team began attending community events, holding weekly educational workshops, and participating in the summer program for youth. We also held listening sessions in English and Spanish that asked aboutthe overall health of the Nickerson Gardens community, environment and public space, access and barriers to care, needed healthcare services, and the lived experience within Nickerson Gardens. RESULTS/ANTICIPATED RESULTS: To date, we have held eight 90-minute listening sessions in English and Spanish with 59 participants. The sessions provided insight into theneeded health and educational resources and services, the organizational structure of the housing development and how that impacts access to information and services, as well as the nuanced and area-specific transportation issues and the connection to safety concerns. These findings will inform the next phase of this initiative which includes convening a Coordinating Council composed of service providers and Nickerson Gardens residents. This council will oversee the coordination and implementation of needed services, help maintain accountability of the providers, and offer residents the opportunity to take ownership of the process. DISCUSSION/SIGNIFICANCE: Academic-community partnerships are an effective strategy to deliver public health interventions and promote health equity in under-resourced communities. We tested and measured impact in a distinct community to reinforce a widely-applicable place-based model.

Health equity implementation expectations and challenges in a multi-level system reform initiative

Abstract Background Within Australia, a system reforming place-based initiative across an area the size of Spain is being implemented. The aim is to expand community-based care models and reduce hospital demand. As COVID-19 demonstrated, sustainability of healthy societies requires a health equity focus across all stages of health reform. Despite central equity principles, pressures risk diminishing this goal as policy is translated into practice across system levels. This initiative is a perfect case study opportunity to inform policy implementation through understanding operationalisation challenges and protections across a multi-level system. Methods 18 semi-structured interviews were conducted in 2022 and 2023 with a purposive sample of senior policy executives, program managers and clinicians across partner organisations and the NSW Ministry of Health. An iterative interview process captured perspectives across system levels as the program was progressively implemented. Interviews were analysed using an inductive constant comparative approach. Results Preliminary findings indicate tensions that impact on realising equity goals. Key tension points exist between levels of operationalisation. These can manifest as perceived trade-offs between health equity and efficiency; place-based reforms that put downward pressure on resource challenged local services to manage equity; and funding models that discourage access. Tension mitigation is partially achieved through leadership commitment, community building, and ring-fenced equity funds. The shared equity understanding in rural areas is also a protective factor. Conclusions While local mitigation factors can protect equity goal preservation, we recommend consideration towards building alignments across system levels. This can include aligning leadership goals and designated funding streams across levels. Further opportunities not often captured in the interviews exist, including aligning accountability and monitoring processes. Key messages • Mitigation strategies exist to overcome inherent system tensions that impact on reforms achieving equity goals. While these can be partially achieved at one level, multi-level alignment is critical. • Shared leadership goals and designated funding streams can support overcome health equity tensions during implementation of reform initiatives, and would be supported by multi-level system alignment.

The Children, Caregivers, and Community (C3) study of together growing strong: A protocol for an observational, place-based initiative in Sunset Park, Brooklyn.

Reaching population-level impact for families in poverty requires moving beyond a sole focus on individuals, to a wider focus on interactions between individuals and their broader environmental contexts. Place-based initiatives have emerged as a policy response to promote community-level change around these broader interactions between individuals and their local communities through addressing long-standing disparities in housing, employment, education, and health. Together Growing Strong (TGS) is one such place-based initiative focused on transforming the health, wellbeing, and development of young children and their families in Sunset Park, Brooklyn. The Children, Caregivers, and Community (C3) Study is an outcomes-based study designed to assess the trajectories of children and families in Sunset Park along indicators such as family health and wellbeing and child development in relation to TGS program participation. The aims, scope, and protocol of the C3 Study are the subjects of this paper.

Evaluation Strategies for Florida's Early Childhood Comprehensive Systems Impact Project

Early Childhood Comprehensive Systems (ECCS) grants help states and communities improve early childhood systems to support child development, equitable access to quality services and supports, and family well-being. Truly interdisciplinary, ECCS promotes cross-sector systems change initiatives that focus on integrating health care, mental health, social services, and family support broadly and within communities with concentrated risk factors that negatively impact child health and development. Florida was 1 of 12 states funded from 2016 to 2021 to use a Collaborative Improvement and Innovation Network (CoIIN) approach to do this work. Through community-driven initiatives that focus on policy, partnerships, and practices, Florida ECCS committed to ensuring equitable opportunities for families and young children who may face barriers due to residing in disenfranchised communities. This article describes the process of evaluating this multiyear community-led, place-based initiative that leveraged cross-sector state-level support and used a variety of methods to track evolving ECCS processes and outcomes.

Research and Evaluation in a Child-Focused Place-Based Initiative: West Philly Promise Neighborhood.

Place-based initiatives attempt to reduce persistent health inequities through multisectoral, cross-system collaborations incorporating multiple interventions targeted at varying levels from individuals to systems. Evaluations of these initiatives may be thought of as part of the community change process itself with a focus on real-time learning and accountability. We described the design, implementation, challenges, and initial results of an evaluation of the West Philly Promise Neighborhood, which is a comprehensive, child-focused place-based initiative in Philadelphia, Pennsylvania. Priorities for the evaluation were to build processes for and a culture of ongoing data collection, monitoring, and communication, with a focus on transparency, accountability, and data democratization; establish systems to collect data at multiple levels, with a focus on multiple uses of the data and future sustainability; and adhere to grant requirements on data collection and reporting. Data collection activities included the compilation of neighborhood-level indicators; the implementation of a program-tracking system; administrative data linkage; and neighborhood, school, and organizational surveys. Baseline results pointed to existing strengths in the neighborhood, such as the overwhelming majority of caregivers reporting that they read to their young children (86.9%), while other indicators showed areas of need for additional supports and were programmatic focuses for the initiative (e.g., about one-quarter of young children were not engaged in an early childhood education setting). Results were communicated in multiple formats. Challenges included aligning timelines, the measurement of relationship-building and other process-focused outcomes, data and technology limitations, and administrative and legal barriers. Evaluation approaches and funding models that acknowledge the importance of capacity-building processes and allow the development and measurement of population-level outcomes in a realistic timeframe are critical for measuring the success of place-based approaches.

Does place matter in the implementation of an evidence-based program policy in an Australian place-based initiative for children?

Policy-mandated requirements for use of evidence-based programs (EBP) in place-based initiatives are becoming more common. Little attention has been paid to the geographic aspects of uneven market development and urbanicity in implementing EBPs in large place-based initiatives. The aim of this study was to explore geographic variation in knowledge, attitudes, and experiences of service providers who implemented an EBP policy in Australia's largest place-based initiative for children, Communities for Children. A cross-sectional online survey of Communities for Children service providers was conducted in 2018-2019, yielding 197 participants from all of Australia's eight states and territories. Relationships between two measures of 'place' (thick and thin market states; urbanicity: urban, regional and remote) and study-designed measures of knowledge, attitudes, and implementation experiences were analyzed using adjusted logistic and multinomial regressions. Participants from thin market states (outside the Eastern Seaboard) were more resistant to the policy and experienced greater implementation challenges than those from thick market states (Eastern Seaboard). Regional participants reported greater knowledge about EBPs but experienced greater dissatisfaction and implementation challenges with the policy than both urban and remote participants. Our study found that place does matter when implementing EBPs in a place-based initiative.

Healthy Communities Delaware:: Accelerating Place-Based Efforts to Improve the Vital Conditions for Health, Well-Being and Equity.

Healthy Communities Delaware (HCD) is a place-based initiative to improve health, well-being and equity across Delaware. HCD is a network of community-based and investment partners working to create thriving communities through improvement in the vital conditions. Vital conditions are the components of communities that we all need, all the time, to thrive and reach our full potential-- humane housing, a thriving natural world, lifelong learning, meaningful work and wealth, reliable transportation, basic needs for health and safety, and a sense of belonging and civic muscle. HCD invests in communities through community-based organization partners, who work to improve the vital conditions in their communities, informed by data and resident priorities. The key tenets of the Healthy Communities Delaware approach--place-based, community-driven, equity-focused and improving the vital conditions—work together to create more communities of opportunity across Delaware.

Community empowerment and mental wellbeing: longitudinal findings from a survey of people actively involved in the big local place-based initiative in England.

Community empowerment initiatives are receiving increased interest as ways of improving health and reducing health inequalities. Longitudinally examine associations between collective control, social-cohesion and mental wellbeing amongst participants in the Big Local community empowerment initiative across 150 disadvantaged areas of England. As part of the independent Communities in Control study, we analysed nested cohort survey data on mental wellbeing (Short Warwick Edinburgh Mental Wellbeing Scale-SWEMWBS) and perceptions of collective control and social-cohesion. Data were obtained in 2016, 2018 and 2020 for 217 residents involved in the 150 Big Local areas in England. Adjusted linear mixed effect models were utilized to examine changes in SWEMWBS over the three waves. Subgroup analysis by gender and educational level was conducted. There was a significant 1.46 (0.14, 2.77) unit increase in mental wellbeing score at wave 2 (2018) but not in wave 3 (2020) (0.06 [-1.41, 1.53]). Across all waves, collective control was associated with a significantly higher mental wellbeing score (3.36 [1.51, 5.21]) as was social cohesion (1.09 [0.19, 2.00]). Higher educated participants (1.99 [0.14, 3.84]) and men (2.41 [0.55, 4.28]) experienced significant increases in mental wellbeing in 2018, but lower educated participants and women did not. Collective control and social cohesion are associated with better mental wellbeing amongst residents engaged with the Big Local initiative. These health benefits were greater amongst men and participants from higher educational backgrounds. This suggests that additional care must be taken in future interventions to ensure that benefits are distributed equally.

Service Provider Attitudes toward Evidence-Based Programs in an Australian Place-Based Initiative: Examining Organisational Roles and Evidence-Supportive Environments

Positive service provider attitudes toward evidence-based programs, and evidence-supportive organizational environments are essential for effective implementation in community settings. Few studies have examined whether there are differences in attitudes between managers and providers. This study investigates attitudes toward evidence-based programs across three levels of manager and provider roles in an Australian place-based initiative for children delivered by a heterogenous, multiskilled social services workforce, and investigates whether attitudes are influenced by an evidence-supportive organizational environment. An online survey was conducted between 2018 and 2019, yielding 205 participants: 70 Facilitating Partner managers, 93 Community Partner managers, and 42 direct service providers. Nine attitudes toward evidence-based programs were assessed using multiple linear regression, with an evidence-supportive organizational environment included as a moderating variable. Differences in attitudes were found between the three roles, with direct service providers more likely to be supportive of evidence-based programs compared to Facilitating Partner managers. An evidence-supportive environment was a strong predictor of more positive attitudes, and moderated the effects for Facilitating Partner managers for three measures. This study highlights the importance of positive leadership and supportive organizational environments in social services community settings. Future studies could examine associations between attitudes, organizational environment and effective implementation for this workforce.

Implementation Facilitators and Challenges of a Place-Based Intervention to Reduce Health Disparities in Harlem Through Community Activation and Mobilization.

BackgroundTo address significant health inequities experienced by residents of public housing in East and Central Harlem compared to other New Yorkers, NYC Department of Health and Mental Health (DOHMH) collaborated with community and academic organizations and the New York City Housing Authority to develop a place-based initiative to address chronic diseases in five housing developments, including a community activation and mobilization component led by community health organizers (CHOs).PurposeGuided by the Consolidated Framework for Implementation Research (CFIR), we evaluated the initial implementation of the community activation and mobilization component to systematically investigate factors that could influence the successful implementation of the intervention.MethodsNineteen in-depth qualitative interviews were conducted with a purposive sample of CHOs, community members and leaders, collaborating agencies and DOHMH staff. Interviews were transcribed verbatim, and themes and codes were developed to identify theoretically important concepts of the CFIR and emergent analytic patterns.ResultsFindings identified important facilitators to implementation: positive community perception of the program, CHO engagement and responsiveness to community needs, CHO norms and values and adaptability of DOHMH and CHOs to community needs. Challenges included the instability of the program in the first year, limited ability to address housing related issues, concerns about long term funding, competing community priorities, low expectations by the community for the program, time and labor intensity to build trust within the community, and the dual roles of CHOs as community advocates and DOHMH employees.ConclusionsFindings will guide future community activation and mobilization activities. The study demonstrates the value of integrating implementation science and health equity frameworks.

Lead, Advise, Witness: Shifting Mindsets to Achieving Impact at Scale

The David and Lucile Packard Foundation created Starting Smart and Strong, a 10-year, place-based initiative in three California communities, to develop and test solutions that support parents, caregivers, and educators as they prepare young children to be healthy and ready for school. The initiative brings together public and private partners to create comprehensive early learning systems, with a focus on impact at scale. Seven years into Starting Smart and Strong, we offer key insights into our experiences as program staff managing this complex initiative and how our approach to scaling impact has shifted over the course of the strategy. Listening deeply to communities and honoring how they define scale and drive their scaling efforts through the systems they built resulted in creative, locally owned solutions to achieve impact. This allowed us to think more expansively about impact, which led to the development of a bifurcated scaling strategy. Looking ahead as we plan for exit from the initiative in three years, we offer reflections on how our approach to scaling impact has changed over time, where we stumbled, and how we pivoted. We offer insights into how we are thinking about supporting communities’ ownership of their own scaling journeys to sustain lasting change, and how our roles changed as the strategy matured.

Implementation of Evidence-Based Programs within an Australian Place-Based Initiative for Children: a Qualitative Study

Implementation of Evidence-Based Programs within an Australian Place-Based Initiative for Children: a Qualitative Study

Social Enterprise Places: A Place-Based Initiative Facilitating Syntactic, Semantic and Pragmatic Constructions of Legitimacy

Social Enterprises are becoming a significant force of social as well as economic good despite facing many difficulties that are brought about by their unique characteristics. Chief among these is the question of their perceived legitimacy that impinges upon their ability to gain funding, acquire contracts and appear as capable organisations to potential partnering institutions. This study explores the means by which Social Enterprises are legitimized through participation in the Social Enterprise Place (SEP) programme in the UK. By examining the Boundary Objects (BO) that span the intersections of the incumbent social groups it identifies three pillars upon which SEPs have facilitated SE legitimacy. These pillars comprise (i) the place-based language (syntactic BO), that enables the identification of (ii) common social goals (semantic BOs), and thereby enables the (iii) mobilization of resources toward their resolution (pragmatic BOs). This research provides insight into the facilitation of legitimacy for Social Enterprises that are engaged in a place-based initiative. By responding to Peterson’s (2016) call for macromarketers to take more note of meso level marketing dynamics in different industries the paper highlights the potential for place to facilitate the legitimacy of SEs. In addition, it reveals a further macromarketing dimension to Boundary Object plasticity whereby they may evolve through syntactic, semantic and pragmatic forms over time.

Examining Resident Power Building in a Place-Based Initiative.

Rates of diseases and disabilities that are otherwise preventable are higher in low-income communities and communities of color. These disparities are attributed, in large part, to a power imbalance between residents and decision makers, and restoring resident power is necessary to improve health outcomes. A key strategy in many health promotion programs, resident power building is a process by which residents gain necessary skills to improve social conditions through their involvement in community change work. This study is part of a larger evaluation of Building Healthy Communities, a ground-breaking 10-year, $1 billion place-based initiative funded by The California Endowment designed to reverse the historical impact of racial and economic discrimination by advancing statewide policy, changing the narrative around health, and transforming underserved communities to achieve health equity. This article presents the resident power framework and identifies five domains that contributed to resident power building: continuity, culture, context, concrete action, and capacity. Continuity and culture mattered most to residents' ability to organize and to their ability to exercise their voice, respectively. While this study examined resident power building within the context of a large-scale place-based initiative, the domains that the authors identified are salient across health promotion programs that use power building as a key strategy to achieve program outcomes. The domains serve as opportunities to modify power-building strategies and allow program staff to allocate resources to specific activities to achieve program outcomes.

Vignette--Pivoting from Laboratory to Remote Research Using the Online Game Foldit

Honors College students at Purdue University are required to complete a capstone project as part of the curriculum. Many students experienced a disruption to their research plans in 2020 due to the COVID-19 pandemic. In response, faculty launched a place-based research initiative to recruit students to be onsite researchers from wherever they were. A Foldit research group was created for students from biology-related majors.

Place-Sensing through Haptic Interfaces: Proposing an Alternative to Modern Sustainability Education

In this article we address the issue of how an instrumental approach to sustainability education has dominated the scientific debate of the last 20 years. By conducting interviews and focus group interviews, we have investigated a community arts initiative in the Flemish city of Antwerp in which artists together with local inhabitants engaged in activities around two art installations and address the sustainability of a particular living environment. Our empirical study of this place-based initiative that we call a ‘critical zone observatory’ has been enriched by the work of Bruno Latour, Richard Sennett and Hans Schildermans. We conclude that a temporal and spatial shift in sustainability education (research) is needed from (1) development (a steady movement towards a planned future) and (2) human stewardship (the capability of people to shape their passive living environments) to (1) what we call co-sperity (a collective hope in the present) and (2) inhabitation (an attached and undetermined engagement with the dynamic of one’s habitat). By proposing a collective study pedagogy as an alternative to individual training, we suggest a need for future research on critical zone observatories.

Disrupting Intergenerational Poverty Through a Place-Based Education Initiative : A Review of Promise Neighborhoods in their First Decade

This study explains the complexities of attainment, implementation, and evaluation of the U.S. Department of Education's Promise Neighborhood (PN) initiative. PNs seek to disrupt intergenerational poverty through a place-based education initiative that creates a pipeline of health, social, and education resources within an economically distressed neighborhood in an urban, rural, or tribal setting. The PN implementation grantees manage a network of school-community partnerships aiming to support students from cradle to career. This study includes an analysis of the complexities of PN attainment with a focus on the PN grant awardees; the complexities of PN implementation with a focus on PN management and services; and lastly, the complexities of evaluation with a focus on the PN evaluation factors. Recommendations for the future of the PN initiative are discussed.

"I realised it weren't about spending the money. It's about doing something together:" the role of money in a community empowerment initiative and the implications for health and wellbeing.

Community initiatives aiming to reduce health inequalities are increasingly common in health policy. Though diverse many such initiatives aim to support residents of disadvantaged places to exercise greater collective control over decisions/actions that affect their lives - which research suggests is an important determinant of health - and some seek to achieve this by giving residents control over a budget. Informed by theoretical work in which community capabilities for collective control are conceptualised as different forms of power, and applying a relational lens, this paper presents findings on the potential role of money as a mechanism to enhance these capabilities from an on-going evaluation of a major place-based initiative being implemented in 150 neighbourhoods across England:The Big Local (BL). The research involved semi-structured interviews with 116 diverse stakeholders, including residents and participant observation in a diverse sample of 10 BL areas. We took a thematic constant comparative approach to the analysis of data from across the sites. The findings suggest that the money enabled the development of capabilities for collective control in these communities primarily by enhancing connectivity amongst residents and with external stakeholders. However, residents had to engage in significant 'relational work' to achieve these benefits and tensions around the money could hinder communities' 'power to act'. Greater social connectivity has been shown to directly affect individual and population health by increasing social cohesion and reducing loneliness. Additionally, supporting enhanced collective control of residents in these disadvantaged communities has the potential to improve population health and reduce health inequalities.