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4,306 result(s) for "Health care coalitions"
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Depression Remission From Community Coalitions Versus Individual Program Support for Services: Findings From Community Partners in Care, Los Angeles, California, 2010–2016
Objectives. To explore effects of coalitions (Community Engagement and Planning [CEP]) versus technical assistance (Resources for Services [RS]) for depression collaborative care and the effects of social determinants on long-term remission outcomes. Methods. We randomized 95 health care and community programs in Los Angeles County, California, to CEP or RS. In 2010, 1246 depressed (Patient Health Questionnaire [PHQ-8] ≥ 10) adults enrolled and were invited for baseline and 6-, 12-, and 36-month surveys. Of 598 3-year completers, 283 participated at 4 years (2016). We examined effects of CEP versus RS, social factors (e.g., family income, food insecurity) on time to and periods in clinical (PHQ-8 < 10) and community-defined (PHQ-8 < 10 or PHQ-2 < 3; mental health composite score [MCS-12] > 40, or mental wellness) remission during the course of 3 years, and at 4 years. Results. We found that CEP versus RS increased 4-year depression remission and, for women, community-defined remission outcomes during the course of 3 years. Social factors and clinical factors predicted remission. Conclusions. At 4 years, CEP was more effective than RS at increasing depression remission. Public Health Implications. Coalitions may improve 4-year depression remission, while addressing social and clinical factors associated with depression may hold potential to enhance remission.
Grassroots Coalitions and State Policy Change
Post examines how coalitions build power in the policymaking arena. She focuses on interorganizational partnerships, internal capacity building, and claims-making, and shows that multi-organizational alliances can be intermediary mechanisms for promoting interests and realizing political gains. With case studies from Massachusetts and California between 2004 and 2007, Post investigates how statewide, health policy coalitions incorporate immigrant interests in organizing strategies for policy change. The analysis supports a theoretical framework of how mediating institutions can facilitate the incorporation of interests in a broader policy context. This framework may serve as a practical guide for immigrant-based and community organizations interested in strengthening their capacity for policy change and political action.
Community Coalitions as a System: Effects of Network Change on Adoption of Evidence-Based Substance Abuse Prevention
Objectives. We examined the effect of community coalition network structure on the effectiveness of an intervention designed to accelerate the adoption of evidence-based substance abuse prevention programs. Methods. At baseline, 24 cities were matched and randomly assigned to 3 conditions (control, satellite TV training, and training plus technical assistance). We surveyed 415 community leaders at baseline and 406 at 18-month follow-up about their attitudes and practices toward substance abuse prevention programs. Network structure was measured by asking leaders whom in their coalition they turned to for advice about prevention programs. The outcome was a scale with 4 subscales: coalition function, planning, achievement of benchmarks, and progress in prevention activities. We used multiple linear regression and path analysis to test hypotheses. Results. Intervention had a significant effect on decreasing the density of coalition networks. The change in density subsequently increased adoption of evidence-based practices. Conclusions. Optimal community network structures for the adoption of public health programs are unknown, but it should not be assumed that increasing network density or centralization are appropriate goals. Lower-density networks may be more efficient for organizing evidence-based prevention programs in communities.
Building Collective Power to Advance Maternal and Child Health Equity: Lessons from the New Orleans Maternal and Child Health Coalition
ObjectivesThe New Orleans Maternal Child Health Coalition convenes to support and amplify the work of New Orleans-based individuals and organizations working to reduce disparities and protect the health of birthing families in the New Orleans area. The objectives of this qualitative study were to identify successes, challenges, and areas of growth for the Coalition and develop broadly generalizable recommendations for similar groups seeking to mobilize and advance health equity in their own communities.MethodsUsing purposive sampling, we conducted semi-structured interviews with 12 key informants from within and outside of the Coalition. Interviews were transcribed verbatim, and data was analyzed using inductive and deductive coding approaches.ResultsWe identified themes relating to the barriers and facilitators to the maintenance of the Coalition, as well as opportunities to advance the mission of the Coalition. Some themes included structural- and systemic-level barriers to achieving the mission, varying perspectives on the effectiveness of the Coalition, opportunities to enhance the operations of the Coalition’s work, and opportunities to involve other individuals, particularly those with lived experience, and non-MCH related sectors in Coalition’s work.Conclusions for PracticeAs the maternal health crisis continues, coalitions like the New Orleans MCH Coalition provide a vehicle to amplify the mission-driven work of people and organizations. Recommendations put forth by the Coalition can also be utilized by coalitions in other jurisdictions.SignificanceWhat is Already Known on this Subject?Black–White disparities in maternal and child health (MCH) have a longstanding history within the United States (US) and these disparities are mirrored in New Orleans, LA. The New Orleans Maternal and Child Health Coalition was founded to support the collective efficacy of numerous individuals and organizations to protect the health of birthing families in the community.What Does this Study Add?We identified the key barriers and facilitators to achieving the Coalition’s mission and building collective power to achieve MCH equity in the greater New Orleans area. Such evidence is a crucial contribution during this time when rates of maternal mortality and morbidity continue to rise throughout the country. This study amplifies the importance of community-driven work to address disparities in MCH and enhance health equity.
Building healthcare-community partnerships: process evaluation of a coalition approach to addressing cancer survivors’ health-related social needs
Background Coalitions involving both healthcare organizations and community organizations, are a way of providing community support to patients. However, the impact of these collaborations and partner satisfaction can be hard to measure without the use of a theoretical framework to guide progress. Methods In January 2023 we established the BEAT-C coalition, guided by the Community Coalition Action Theory (CCAT), to improve clinical-community linkages for addressing non-medical needs among individuals affected by cancer in the Washington, D.C. region. To create broad representation, we invited organizations focused on faith, older adults, cancer support, health promotion, healthy food access, and community health to join. The coalition dedicated significant effort at the outset to establish trust, cultivate relationships, and define shared values, mission, goals, and objectives. To assess coalition functioning, we administered a modified version of the Coalition Self-Assessment Survey (CSAS) in December 2023. Results Sixteen individuals representing 10 organizations completed the adapted CSAS. Respondents generally responded positively regarding the coalition and made decisions primarily through discussion and agreement (75.0%). Respondents noted respect for leadership (81.3%) and respect for and from fellow coalition members (100.0%). While 56.3% reported meaningful action through the coalition, 31.3% thought there could be more meaningful action. Qualitative feedback mirrored these findings: participants positively regarded the coalition’s responsiveness and noted activities occurring through partnerships developed from the coalition, but some respondents emphasized a desire to act more swiftly. Conclusion Our research described facilitators and barriers to early implementation of a theory-driven collaborative coalition to enhance cancer survivor support. Through the continued efforts of the coalition and increased community capacity building, the multi-disciplinary efforts of the coalition have potential to address the needs of cancer survivors.
The Coalition Against Typhoid
Typhoid became a low priority on the global public health agenda when it was largely eliminated from developed countries in the 1940s. However, communities in South Asia and sub-Saharan Africa continue to bear the brunt of the disease burden. One strategy to increase attention and coordinate action is the creation of a coalition to act as a steward for typhoid. The Coalition against Typhoid (CaT) was created in 2010 with the mission of preventing typhoid among vulnerable populations through research, education, and advocacy. CaT successfully raised the profile of typhoid through convening the community with a biennial international conference that has experienced growing participation, disseminating data and news through a website and newsletter with increasing readership, and advocating through social media and a blog reaching a diverse audience. In 2017, CaT joined forces with the Typhoid Vaccine Acceleration Consortium to “Take on Typhoid,” combining advocacy and communications efforts to mobilize researchers, clinicians, and decision makers at the global, regional, and local levels to introduce the new typhoid conjugate vaccine. As a result, the knowledge base, political will, and momentum are increasingly in place to implement prevention and control interventions including the typhoid conjugate vaccine in the poor communities that have historically been left behind.
Synergies, partnership outcomes, and lessons learned: a qualitative evaluation of cancer center–coalition engagement
Nine National Cancer Institute-Designated Cancer Centers received supplemental funding to expand community outreach and engagement activities through a partnership with Centers for Disease Control and Prevention-funded comprehensive cancer control coalitions. This article reports on an evaluation of these awards focused on organizational relationships and partnership outcomes. The National Cancer Institute, community outreach and engagement, and coalition representatives co-designed the evaluation, which involved document review and 18 semistructured interviews with 16 community outreach and engagement and 19 coalition representatives. Artificial intelligence-generated interview transcripts were dual-coded in NVivo, version 20/R1, software. The funding generated a diverse collection of projects and partnerships. Community outreach and engagement-coalition synergies and lessons learned were evident in the following domains: infrastructure; community and partner engagement; data monitoring; and intervention implementation, evaluation, and dissemination. Outcomes of this funding initiative were evident in the following domains: strengthened partnerships, expanded knowledge, improved health or health-care programs and policies, and thriving communities. Fostering community outreach and engagement-coalition partnerships created opportunities to use synergies and build capacity for engagement across multiple domains, contributing to enhanced trust and implementation of interventions across the cancer continuum. The findings provide examples and lessons on which cancer centers and coalitions can capitalize. Successful collaborative relationships were based on identifying shared goals and complementary expertise and roles, sharing financial and other resources, and a commitment to authentic and open dialogue. Although modest and short term, supplemental funding can strengthen organizational relationships and promote effective collaboration on community-facing activities; it can also lead to improved research engagement and translation of evidence to practice.
Tobacco Control and Health Advocacy in the European Union
Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood. Qualitative semi-structured, narrative interviews with 35 stakeholders involved in developing the European Council Recommendation on smoke-free environments. These were thematically analyzed to examine the dynamics of coalition-building, collaboration and leadership in the alliance of organizations which successfully called for the development of comprehensive European Union (EU) smoke-free policy. An alliance of tobacco control and public health advocacy organizations, scientific institutions, professional bodies, pharmaceutical companies, and other actors shared the goal of fighting the harms caused by second-hand smoke. Alliance members jointly called for comprehensive EU smoke-free policy and the protection of the political debates from tobacco industry interference. The alliance's success was enabled by a core group of national and European actors with long-standing experience in tobacco control, who facilitated consensus-building, mobilized allies and synchronized the actions of policy supporters. Representatives of Brussels-based organizations emerged as crucial strategic leaders. The insights gained and identification of key enablers of successful tobacco control advocacy highlight the strategic importance of investing into tobacco control at European level. Those interested in effective health policy can apply lessons learned from EU smoke-free policy to build effective alliances in tobacco control and other areas of public health.
The Paradoxes and Promise of Community Coalitions
Community coalitions, as they are currently applied, are unique organizations whose ability to promote community change is different from other types of community organizations. This article explores those differences and elaborates how community coalitions can use those differences to transform conflict into greater capacity, equity, and justice. Concerns are also raised in this article about how community coalitions can intentionally and unintentionally protect the status quo and contain the empowerment of grassroots leadership and those of marginalized groups. There is a need for more theory, research, and discourse on how community coalitions can transform conflict into social change and how they can increase the power of grassroots and other citizen‐lead organizations.
An Initial Attempt at Operationalizing and Testing the Community Coalition Action Theory
The Community Coalition Action Theory (CCAT) blends practice wisdom with empirical data to explain how community coalitions achieve community change and community capacity outcomes. The current study uses data from an evaluation of 20 California Healthy Cities and Communities coalitions to test relationships between coalition factors and outcomes as predicted by CCAT in two stages of coalition development. Data are from two rounds of coalition member surveys, interviews with local coalition coordinators, and semiannual progress reports. Consistent with CCAT predictions and prior research, shared decision making and leadership were correlated with participation; staff competence, task focus, and cohesion were correlated with member satisfaction. Coalition size was associated with participation and dollars leveraged. Also, consistent with CCAT, diversity of funding sources was associated with new leadership opportunities and program expansion; dollars leveraged was correlated with new leadership opportunities and new partners. Findings provide preliminary support for many, but not all, of the relationships predicted by CCAT.