An Assessment of the Sustainability and Impact of Community Coalitions once Federal Funding has Expired. Summary of Approaches to Studying Coalitions, Impacts, and Sustainability

06/01/2012

The federal government and foundations are increasingly investing in community coalition-driven programs to create capacities within and across organizations, convene different community segments, conduct innovative activities, and extend health and social benefits to underserved populations. Prior research supports this approach with evidence showing that community coalitions can fulfill three main functions: create collaborative capacity; build community capacity; and foster change at the local level. Coalitions mobilize community resources, creating collaborative capacity among coalition members, within member relationships, and through organizational structure and programs (Foster-Fishman, Berkowitz, Lounsbury, Jacobson, & Allen, 2001). In addition to increasing collaborative capacity, community coalitions strengthen community capacity by building social capital that can be applied to other health and social issues (Fawcett et al, 1995). Finally, because community coalitions are more focused on the implementation of services at the local level, they are positioned to bring about social change and improve the health of communities by creating new programs or services, developing new or more coordinated systems or infrastructure, advocating for stronger policies, influencing individual health or behavior, and disseminating products or materials, among other activities (Butterfoss, 2007; and Wolff, 2001).

Since community coalitions have emerged as a popular vehicle for addressing community health issues, significant resources have been invested in assessing best practices for the development and implementation of community coalitions. However, few systematic studies have been conducted to examine trends in community coalition outcomes and impacts (Berkowitz, 2001; Cramer, Mueller, & Harrop, 2003; Payne, 1999). Researchers developed and continue to refine evaluation models of community coalitions that capture both their impacts at the individual level (e.g., health outcomes) and at the community level (e.g., capacity and environment) (Backer, 2003; Taylor-Powell, Rossing & Geran, 1998). These models share a goal of providing an evaluation strategy that is specific enough to measure and assess a particular coalition, yet general enough to allow for valid comparisons between coalitions. However, even with these frameworks, a full accounting of the issues, populations, or intervention methods addressed by community coalitions is lacking.

Factors Identified in the Literature that Affect Coalition Functioning and Sustainability
Key factors that affect coalition functioning and sustainability are leadership, membership, structure, vision guiding action, funding diversity, sustainability planning, and contextual factors.

Given the research and programmatic investments in community coalitions to date, funders often expect that community coalitions and their activities will be sustained post-funding. While the concept of sustainability is germane to research on both community-based programs and community coalitions, a consensus definition of sustainability has not emerged in either body of research. The primary divergence among definitions in both bodies of literature relates to the unit of analysis—what is being sustained. Some definitions focus on sustaining the coalition (Rog et al., 2004; Butterfoss, 2007; Edwards et al., 2007), while others focus on sustaining the activities and impacts of the program or coalition (Scheirer, 2005; Alexander et al., 2003).

Researchers have developed conceptual frameworks and frameworks to define sustainability in the context of community coalitions (Alexander et al., 2003; Edwards et al., 2007; Mancini & Marek, 2004; Beery et al., 2005; Shediac-Rizkallah & Bone, 1998; Rog et al., 2004). Collectively, the models demonstrate the importance of measuring both the sustainability of the coalition and the coalition’s activities separately. The models also highlight different coalition-specific and contextual factors that affect sustainability. In reviewing these models and other literature, NORC identified several factors as key for coalition functioning and sustainability: leadership, membership, structure, vision guiding action, funding diversity, sustainability planning, and contextual factors.

  • Leadership. The CCAT, Empowerment Theory, and other studies have identified effective leadership as a facilitator of coalition action and sustainability (Butterfoss, Goodman, Wandersman, Valois, & Chinman, 1996a; Butterfoss, Goodman, & Wandersman, 1996b; Goodman et al., 1998). Leadership can consist of one or both of the following: the member organizations of a coalition, and the individual leaders within a coalition (Bailey & McNally Koney, 1995). Research suggests that the convening or "lead" agency must have organizational capacity, commitment, and vision, among other characteristics to build an effective coalition (Butterfoss, 2007). In addition, leadership from individual staff members in the member organizations is also critical. Coalitions and partnerships with action-oriented leadership (Bazzoli et al., 2003; Hasnain-Wynia, 2003) and competent, committed leaders are most effective (Conrad et al., 2003). Hasnain-Wynia et al. (2003) found that partnerships with effective or ethical leadership were more likely to be perceived by their memberships as effective in achieving their goals. Wagenaar and Wolfson (1993) found that coalition leaders from diverse cultural groups, especially those that reflect the community, are more successful in obtaining community buy-in for coalition activities.

  • Membership. Coalition membership includes a variety of organizations in the community that provide time or other resources to the coalition. Butterfoss (2007) noted that coalitions with a diverse membership of community gatekeepers, and professional and other grassroots organizations are most successful. A diverse membership brings a variety of perspectives from different sectors, backgrounds, and constituencies. Hays, Hays, Deville and Mulhall (2000) found that representation of a large number of community sectors was associated with achieving coalition outcomes. Diverse membership may create challenges for the coalition in the short-run (e.g., difficulty in obtaining consensus, divergent perspectives), but facilitates the achievement of community improvements in the long run (Easterling, 2003).

    Other membership factors that are associated with coalition effectiveness are the number of partners in the membership and the amount of time that member organizations can contribute to the coalition’s activities. There is an inverse relationship between the number of partners and the successful completion of activities: the more partners in the membership, the fewer activities successfully completed by the coalition (Hasnain-Wynia et al., 2003). Additionally, coalitions with a dedicated staff (those who are wholly committed to working on the activities of the coalition) demonstrate more results than coalitions without their own staff (Wolff, 2001b).

    The expertise of the membership can also affect the success of the coalition. Coalitions benefit from having staff members with experience in community planning and organization, as they understand what is required to engage the community and conduct activities that meet the community’s needs (Butterfoss, 2007; Wolff, 2001b). Finally, the commitment of the membership to the coalition and its activities facilitates coalition effectiveness (Butterfoss, 2007). Research shows member satisfaction is associated with coalition effectiveness, as satisfied members are more invested in the coalition and its activities (Kumpher, Turner, Hopkins, & Librett, 1993).

  • Structure. Structural characteristics refer to the administrative rules in place that facilitate the management of the community coalition. The CCAT illustrates that coalitions with structures are more likely to achieve collaborative synergy in the coalition. Researchers have also identified the importance of coalition structures in predicting coalition progress. Butterfoss (2007) notes that the development of structure, rules, and responsibilities early in a coalition’s development enables community coalitions to operate effectively. Butterfoss (2007) indicates that structures can take the form of written policies and laws (e.g., memoranda of understanding, bylaws, and policy and procedure manuals). Bryson (1988) adds that coalitions benefit from developing clear mission statements. Another important structure is a steering committee or executive board that provides guidance and governance to coalition activities (Butterfoss, 2007). The steering committee or executive board, comprised of representatives of the member organizations, convenes regularly to assess the goals and activities of the coalition. Such structures facilitate collaboration, as they help members to more fully understand the purpose of the coalition and their individual roles and responsibilities.

  • Vision Guiding Action. Vision guiding action refers to the extent to which the membership agrees on the long-term goals of the coalition (vision) and is committed to pursuing activities (action) that will move the coalition toward this shared vision. Action based on a shared vision affects sustainability in the long-term because it reflects the commitment of the membership to achieve the goals of the coalition. Each coalition has a number of goals—from allocating resources and providing services to suggesting new policies. Vision helps coalition members to understand the future direction of the coalition, and to recognize the benefits of their participation (Foster-Fishman et al., 2001). A clear vision helps the coalition to raise awareness of its activities within the community, identify partners and resources, and reduce conflict within its membership.

  • Funding Diversity. Funding diversity is a key predictor of sustainability in community coalitions (Butterfoss, 2007), and in organizations more generally (Leviton et al., 2006; Rog et al., 2004). Programs are more likely to survive when they have political, financial, and institutional resources (Feinberg et al., 2008). Resources include money, people, goods, and services. Funds can be obtained from membership dues, the lead agency, community donations, financial partners, and in-kind contributions, grants, and contracts (Butterfoss, 2007). Diverse funding reduces the imbalance in power that occurs when a single funder is controlling the coalition’s budget. With multiple funding sources, the coalition can ensure that it is fulfilling its own goals, as well as funders’ requirements. Two studies in particular demonstrate that resource diversity contributes to sustainability in community coalitions. Leviton et al. (2006) found that the size of the budget (at least $25,000 per year) and funding diversity (resources from at least three different community organizations) were associated with program survival. In another study, Rog et al. (2004) found that the community coalitions with diverse funding portfolios were expanding into new areas or becoming institutionalized in the community. Rog et al. found that funding should be flexible enough to support the core activities of the collaborative—rather than earmarked for specific programmatic activities that are carried out by the collaborative (e.g., service delivery).

  • Sustainability Planning. Moving sustainability from a goal to a reality requires creating goals and objectives, developing and implementing sustainability strategies, and continuously evaluating those strategies (Shediac-Rizkallah & Bone, 1998). Developing a comprehensive sustainability plan at the outset is critical to a coalition’s success (Friedman & Wicklund, 2006). Program results, strategic funding, and staff involvement and integration are also related to planning early for sustainability (Mancini & Marek, 2004). Models of the sustainability of community-based programs and community health initiatives also identify sustainability planning as an important step to achieving program sustainability (Mancini and Marek, 2004; Beery et al., 2005).

  • Contextual Factors. Contextual factors may also affect the formation and effectiveness of community coalitions. Contextual factors are external conditions that either exist or are lacking in the environment, and thus can enhance or inhibit the coalition’s activities. Both the CCAT and Empowerment Theory highlight the impact of contextual factors, suggesting their importance in predicting coalition effectiveness. Specifically, Butterfoss, Lachance, and Orians (2006) found that contextual factors such as politics, the history of collaboration among member organizations in the coalition, geography, and community readiness can impact coalition formation. Population demographics, the cultural climate in the community, overall community attitude toward a particular issue, and precipitating events in the community are other contextual factors that may impact coalition effectiveness (Butterfoss, 2007).

These findings, along with the background information gathered around the functions, characteristics, and impacts of community coalitions, led to the development of a conceptual framework of sustainability in community coalitions. The purpose of this framework was to guide the specific design of this study using the HCAP coalitions, as well as provide a conceptual approach to the study of sustainability issues for community coalitions more broadly.

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