Building and Sustaining Community Partnerships for Teen Pregnancy Prevention: A Working Paper. IV. Conclusions & Observations

06/01/1998

As we have seen, establishing "partnerships" is a widespread practice in addressing social problems and is commonly seen as a useful strategic tool to bring together the resources, expertise, and will of a community. Partnerships are most useful when the problem to be solved is complex and multi-faceted and rooted in both the individual and the environment and when the efforts of a single agency or institution, no matter how dedicated to the cause, are believed to be insufficient to produce significant, positive outcomes.

Partnerships come in a huge variety of forms and sizes. (Appendix D contains descriptions of several partnerships at both the state and local levels.) They range from informal, non-binding agreements that are not written or not written in detail. The continuation of such partnerships depends on the participants' continuing to see that the arrangement is producing results or shows promise. Other partnerships are highly structured, formal arrangements with written, legally-binding agreements among members. Often these partnerships continue as long as their funding lasts, with continued support determined by formal evaluation results or political considerations. In some instances, the creation of the partnership itself is seen as a valued product, by participants and funders alike. Smoother working relationships, increased trust, and reductions in tension can be potential by-products of working together in partnership, even if the effort fails to achieve its original ends.

Partnerships have a wide range of aspirations for their work. Some loosely structured coalitions, including coalitions to address teen pregnancy, are satisfied that their periodic meetings produce increased communication and coordination. Members learn what others are doing and on occasion can be helpful to one another. At the other end of the spectrum, some partnerships set their goals at the level of producing substantial social change-reducing teen pregnancy rates, the incidence of drug abuse or the school drop-out rate-and are supported by large public or private financial resources, formal third-party evaluations, and considerable public attention.

The challenge of preventing teen pregnancy is good candidate for a partnership intervention strategy. The literature suggests that teen pregnancy has a wide variety of antecedents that include factors related to teens' biology and personality, their families, partners, friends and communities. Most experts in the field suggest that there is a need for multi-pronged services, far beyond the authority and resources of any one institution to provide. Meaningful strategies need to be community-wide, coherent, and comprehensive. The services often suggested to create a "comprehensive" approach to reducing teen pregnancy include health education, contraception, educational supports, job training and employment counseling, self-esteem building activities, recreational activities, and a wide range of social supports. Partnerships are created out of a desire and need to pool resources, share risks, increase creativity, increase efficiency, integrate and coordinate services, maximize power, and build community. Supporting all of these motives is a strong commitment to the value of working together to achieve a common goal.

A large literature describes the work of partnerships in teen pregnancy prevention, substance abuse prevention, violence prevention, community and youth development, as well as other fields, such as business and environmental protection. Much of this is "wisdom literature," descriptions based on experience and impressions. A number of models have been used to describe partnerships, and a variety of studies have attempted to examine scientifically the relationship between aspects of partnership structure or composition or development and outcomes and impacts. These links are just beginning to emerge.

However, the literature contains a wealth of practical advice on creating and sustaining partnerships. From the environment that gives rise to partnership efforts to the development of group structures and processes, these documents provide useful guidance as they describe a number of challenges. Among them are:

  • attracting members from among community adults and youth and a broad range of institutions and service sectors, including religious and political leaders, representatives of business, youth serving agencies and organizations, schools, and many others;
  • fashioning this diverse mix of professions, races, classes, languages, and levels of education and experience into a working partnership that can set goals, make decisions, attract resources, develop and implement a plan of action;
  • developing the skill to establish an environment of trust, build consensus, expand leadership capacity, resolve conflict, and communicate effectively; and
  • documenting accomplishments to sustain support.

Consequently, while the establishment of partnerships to combat teen pregnancy is a wise strategic choice, it is not a choice that should be taken lightly. The most effective partnerships typically do not happen easily or overnight. Instead, they are most frequently long-term efforts that require unusually skilled and dedicated staff, sustained financial support, and clear and consistent goals. In the case examples, the partnership often took years to develop and even longer to become recognized as successful. As a result, those with limited resources or a short time frame for intervention should probably consider less complex, more direct strategies.

A promising option, however, rather than the creation of new partnerships, would be a strategy designed to enlist already existing partnerships-those established to work to improve housing or combat crime, for example-in efforts to combat teen pregnancy. While such groups would have to re-commit to working together on a new project and would have to learn together about new issues, their prior experience would in many cases shorten the time needed to get beyond partnership-building and on to addressing teen pregnancy.

Finally, while partnerships are, in general, a promising way to address community problems, it needs to be said that in some ways teen pregnancy prevention is a uniquely complex issue. Nearly everyone has an opinion about what should be done about teen pregnancy, and the range of opinions is unusually wide. Furthermore, feelings and beliefs about sexuality are strongly held and often deeply rooted in culture and religion. Strategies that value inclusiveness and that seek to bring everyone to the table will often face a difficult challenge in forging community consensus around these highly charged issues.

Nonetheless, utilizing a "partnership" strategy to undergird any long-term and ambitious effort to address teen pregnancy is extremely valuable. There is no practical way, without a partnership strategy, to pull together the forces needed to address this critical problem with the strength and power it takes to produce significant results.

BIBLIOGRAPHY

Aber, J.L., Brown, J.L., et al. 1996. The evaluation of the Resolving Conflict Creatively Program: An overview. American Journal of Preventive Medicine, 12 (5, supplement): 82-90.

Abramson, J.S. and Rosenthal, B.B. 1995. Interdisciplinary and interorganizational collaboration, pages 1479-1490 in Encyclopedia of Social Work, 19th edition. Washington, DC: National Association of Social Workers.

Alter, C. and Hage, J. 1993. Organizations Working Together. Newbury Park, CA: Sage Publishers, Inc.

American Leadership Forum. 1993. Involve Winning Strategies: Concluding Observations of Successful Partnering. Silicon Valley: American Leadership Forum.

Anderson, R. 1996. The action-learning model: Innovation in partnership. Optimum, 26(4): 14-24.

Annie E. Casey Foundation. 1993a. Getting to Know Your Community: Tools and Techniques for Plain Talk Sites. Greenwich, CT: Annie E. Casey Foundation.

Annie E. Casey Foundation. 1993b. Plain Talk: A Community Strategy for Reaching Sexually Active Youth, A Strategic Planning Guide. Greenwich, CT: Annie E. Casey Foundation.

Annie E. Casey Foundation. N.d. The Path of Most Resistance: Reflections on Lessons Learned from New Futures. Baltimore, MD: Annie E. Casey Foundation.

Bailey, D. and McNally Koney, K.M. 1996. Interorganizational community-based collaboratives. Social Work, 41(6): 602-611.

Bailey, D. and McNally Koney, K.M. 1995a. Community-based consortia: One Model for Creation and Development. Journal of Community Practice, 2(1); 21-41.

Bailey, D. and McNally Koney, K.M. 1995b. An integrative framework for the evaluation of community-based consortia. Evaluation and Program Planning, 18(3): 245-252.

Bardach, E. 1993. Turf barriers to interagency collaboration in human services delivery. Paper presented at the National Public Management Research Conference, Madison, WI.

Bracht, N. 1995. Prevention and Wellness, pages 1879-1886, in Encyclopedia of Social Work, 19th edition. Washington, DC: National Association of Social Workers.

Brindis, C. 1991. Adolescent Pregnancy Prevention: A Guidebook for Communities. Palo Alto, CA: Stanford Center for Research in Disease Prevention.

Burch, J.H. & Chemers, B.M. 1997. A comprehensive response to America's youth gang problem. Washington, DC: Office of Juvenile Justice and Delinquency Prevention.

Butterfoss, F.D., Goodman, R.M. and Wandersman, A. 1993. Community Coalitions for prevention and health promotion. Health Education Research: Theory and Practice, 8(3): 315-330.

Cagampang, H.H., Barth, R.P., et al. 1997. Education Now And Babies Later (ENABL): Life history of a campaign to postpone sexual involvement. Family Planning Perspectives, 29(3): 109-114.

Carbine, M.E. and Lee, P. 1988. Strategies for an integrated response to the AIDS epidemic: A Publication of the National AIDS Network. From the proceedings of the National Planning Conference for an Integrated Response to AIDS, Atlanta, GA: U.S. Dept. of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention.

Carnegie Corp. 1989. Turning Points: Preparing America's Youth for the 21st Century. Washington, DC: Carnegie Council on Adolescent Development.

Center for Substance Abuse Prevention. 1995. Community Partnerships: Promising Ways to Prevent Alcohol, Tobacco, and Other Drug Problems. Washington, DC: U.S. Dept. of Health and Human Services, CSAP.

Center for the Study of Social Policy. 1995. Building New Futures for At-Risk Youth: Findings from a Five-year Multi-Site Evaluation. Washington, DC: Center for the Study of Social Policy.

Centers for Disease Control and Prevention. 1995. Ways to Measure Program Effectiveness-Prevention and Beyond: A Framework for Collective Action. Proceedings of the National Conference on HIV Infection and AIDS among Racial and Ethnic Populations. Washington, DC: U.S. Dept. of Health and Human Services, Public Health Service, CDC.

Chavis, D.M. 1995. Building community capacity to prevent violence through coalitions and partnerships. Journal of Health Care for the Poor and Underserved, 6(2): 234-245.

Chavis, D.M., Florin, P. and Felix, M. 1993. Nurturing grassroots initiatives for community development: the role of enabling systems, pages 41-67 in Community Organization and Social Administration: Advances, Trends and Emerging Principles, edited by T. Mizrahi and J. Morrison. New York: The Haworth Press.

Cohen, S. & Lang, C. 1990. Applications of the principles of community-based programs. Background paper prepared for Youth Violence in Minority Communities: A Forum on Setting the Agenda for Prevention, Atlanta, GA. Newton, MA: Education Development Center.

Colorado Dept. of Health. n.d. Partners in Action for Teen Health (PATH): Replication Manual. Denver, CO: Colorado Dept. of Health, Adolescent Health Program.

The Community Toolbox. 1997. Community Partnership Implementation Manual. http://ctb.lsi.ukans.edu/

Cook, R., Roehl, J., Oros, C., & Trudeau, J. 1994. Conceptual and methodological issues in the evaluation of community-based substance abuse prevention coalitions: Lessons learned from the national evaluation of the Community Partnership Program. Journal of Community Psychology, 24 (2): 155-169.

Copple, J., Copple, B., et al., n.d. Experiential lessons on community coalitions for prevention substance abuse. Lawrence, KA: Work Group on Health Promotion and Community Development, University of Kansas.

Cornerstone Consulting Group, Inc. N.d.Collaboration on the Ground: Some Lessons. Houston,TX: Cornerstone Consulting Group, Inc.

Cornerstone Consulting Group, Inc., and Philliber Research Associates. 1997. The Community Engagement Process. Houston, TX: Cornerstone Consulting Group, Inc.

Dryfoos, J. 1990. Adolescents at Risk: Prevalence and Prevention. New York, NY: Oxford University Press.

Executive Office for Weed and Seed. n.d. Operation Weed and Seed Implementation Manual. Washington, DC: U.S. Dept. of Justice, Executive Office for Weed and Seed.

Fahlberg, L.L., et al., 1991. Empowerment as an emerging approach in health education. Journal of Health Education, 22: 185-193.

Falco, M. 1992. The making of a drug free America. New York, NY: Time Books.

Farrell, A.D., Meyer, A.L., & Dahlberg, L.L. 1996. Richmond youth against violence: A school-based program for urban adolescents. American Journal of Preventive Medicine, 12(5, supplement): 13-21.

Fawcett, S.B., Lewis, R.K., et al. 1995. Evaluating community coalitions for prevention of substance abuse: The case of Project Freedom. Health Education Quarterly

Fawcett, S.B., et al. 1994. Preventing Adolescent Pregnancy: An Action Planning Guide for Community-Based Initiatives. Lawrence, KS: Work Group on Health Promotion and Community Development, University of Kansas.

Fawcett, S.B., Paine, A.L., et al. 1993. Promoting health through community development, pages 233-255 in Promoting Health and Mental Health in Children, Youth, and Families, edited by D.S. Glenwick and L.A. Jason. New York: Springer Publishing Co.

Fawcett, S.B., Paine-Andrews, A., et al. 1995. Using empowerment theory in collaborative partnerships for community health and development. American Journal of Community Psychology, 23(5): 677-698.

Federal Advisory Committee of the Western Governors' Association. 1996. Develop On-Site Innovative Technologies (DOIT) promotes collaborative partnerships as key to innovative technology development. Colorado: Western Governors' Association.

Ferraro, P. 1994. Colorado's pollution-prevention partnership: Public and private organizaitons work together to uct use of toxic chemicals. EPA Journal, 20: 30-31.

Florin, P., et al. 1992. A systems approach to understanding and enhancing grassroots organizations, pages 215-243 in Analysis of Dynamic Psychological Systems, Vol. 2, edited by R.F.Lavine & H.E.Fitzgerald. New York, NY: Plenum Press.

Francisco, V.T., Fawcett, S.B., et al. 1996. Toward a research-based typology of health and human services coalitions. Amherst, MA: AHEC/Community Partners.

Francisco, V.T., Paine, A.L. and Fawcett, S.B., 1993. A methodology for monitoring and evaluating community health coalitions. Health Education Research: Theory and Practice, 8(3): 403-416.

Gambone, M.A. 1997. Launching a Resident-Driven Initiative: Community Change for Youth Development (CCYD) from Site-Selection to Early Implementation. Philadelphia: Public/Private Ventures.

Goodman, R.M. & Wandersman, A. 1994. FORECAST: A formative approach to evaluating community coalitions and community-based initiatives. Journal of Community Psychology, 24 (2): 6-25.

Gray, B. & Wood, D.J. 1991. Collaborative alliances: Moving from practice to theory. Journal of Applied Behavioral Science, 17(1): 3-22.

Green, L.W. and Kreuter, M.W. 1992. CDC's planned appraoch to community health as an application of PRECEED and an inspiration for PROCEED. Health Education, 23: 140-144.

Halpern, R. 1996. Neighborhood-based strategies to address poverty-related social problems: An historical perspective, pages 30-86, in Children and Their Families in Big Cities: Strategies for Service Reform, edited by A. Kahn and S. Kainerman. New York: Columbia University, Cross-National Studies Research Program.

Harrison, D. 1996. 10 public/private partnership commandments. American City and County, 111(13): 48-50.

Hawkins, J.D. and Catalano, R.F. Assoc. 1992. Communities that Care. San Francisco: Jossey-Bass Publishers.

Himmelman, A. 1992. Communities working collaboratively for change. Monograph available from the author, 1406 West Lake, Suite 209, Minneapolis, MN 55408.

ISA Associates. 1994. National Evaluation of the Community Partnership Demonstration Program, Third Annual Report. Washington, DC: U.S. Dept. of Health and Human Services, CSAP.

ISA Associates. 1992. National Evaluation of the Community Partnership Demonstration Program, Second Annual Report. Washington, DC: U.S. Dept. of Health and Human Services, CSAP.

Israel, B., et al. 1995. Organizational contributions and barriers to effective AIDS prevention programs, in AIDS Prevention in the Community, edited by N. Freudenberg and M.D. Zimmerman, Washington, DC: American Public Health Association.

Kirby, D. 1997. No Easy Answers: Research Findings on Programs to Reduce Teen Pregnancy. Washington, DC: The National Campaign to Reduce Teen Pregnancy.

Kleiner, G. 1994. Engaging the grassroots through neighborhood mobilizing. New Designs for Youth Development, 11(3): 27-29.

Kotloff, L.J., Roaf, P.A., and Gambone, M.A. 1995. The Plain Talk Planning Year: Mobilizing Communities to Change. Philadelphia: Public/Private Ventures.

Kracke, K. and staff. 1996. SafeFutures: Partnerships to reduce youth violence and delinquency/Fact Sheet. Washington, DC: U. S. Dept. of Justice, Office of Juvenile Justice and Delinquency Prevention.

Kreuter, M.W. 1992. PATCH: Its origin, basic concepts and links to contemporary public health policy. Journal of Health Education, 23: 134-139.

Mansergh, G., Rohrbach, L.A., et al. 1996. Process evaluation of community coalitions for alcohol and other drug abuse prevention: A case study comparison of researcher and community initiated models. Journal of Community Psychology, 24(2): 118- 135.

Mattessich, P.W. and Monsey, B.R. 1992. Collaboration: What Makes It Work. St. Paul, MN: Amherst H. Wilder Foundation.

Miller, B.C. 1995. Risk Factors for adolescent nonmarital childbearing, pages 217-227, in Report to Congress on Out of Wedlock Childbearing, DHHS Publication No. 95-1257, Washington, DC: U.S. Dept. of Health and Human Services.

Mizrahi, T. and Rosenthal, B. 1992. Managing dynamic tensions in social change coalitions, pages 11-40, in Community Organizing and Social Administration: Advances, trends, and Emerging Principles, edited by T. Mizrahi and J.D. Morrison. New York: Haworth Press.

Moore, K.A., Miller, B.C., et al. 1995. Adolescent Sex, Contraception, and Childbearing: A Review of Recent Research. Washington, DC: Child Trends, Inc.

Moore, K.A. and Sugland, B.W. 1996. Next steps and best bets: Approaches to preventing adolescent childbearing, Section 8 in Welfare Reform Resource Packet. Washington, DC: The National Campaign to Reduce Teen Pregnancy.

Moore, K.A., Sugland, B.W., et al. 1995. Adolescent Pregnancy Prevention Programs: Interventions and Evaluations. Washington, DC: Child Trends, Inc.

Motter, J., Rutsch, C. and Hamilton, S. 1993. Training as a strategy for enhancing community action projects for the prevention of alcohol and other drug abuse. The experience of OSAP's Community Partnership Training Program, in Experiences with Community Action Projects: New Research in the Prevention of Alcohol and Other Drug Problems. Center for Substance Abuse Prevention Monograph 14, Brandon, VT: Clinical Psychology Publishing Co.

Mulroy, E.A. 1997. Building a neighborhood network: Interorganizational collaboration to prevent child abuse and neglect. Social Work 42(3): 255-264.

Nadel, H., Spellmann, M., et al. 1996. The cycle of violence and victimization: A study of the school-based intervention of a multi-disciplinary youth violence prevention program. American Journal of Preventive Medicine, 12(5, supplement): 109-119.

National Assembly of National Voluntary Health and Social Welfare Organizations. 1991. The Community Collaboration Manual. Washington, DC: National Assembly.

National Center for Injury Prevention and Control. 1993. The Prevention of Youth Violence: A Framework for Community Action. Atlanta, GA: Centers for Disease Control and Prevention.

National Clearinghouse on Families and Youth. 1996. Reconnecting Youth & Community: A Youth Development Approach. Washington, DC: U.S. Dept. of Health and Human Services, Administration on Children, Youth and Families, Family and Youth Services Bureau.

National evaluation of the Community Partnership Program. New Designs for Youth Development, 11(3): 34-36, 1994.

National Institute of Justice. 1995. Evaluation of Boys and Girls Clubs in public housing. Washington, DC: U.S. Dept. of Justice, National Institute of Justice.

Nezlek, J.B. and Galano, J. 1993. Developing and maintaining state-wide adolescent pregnancy prevention coalitions: a preliminary investigation. Health Education Research: Theory and Practice, 8(3): 433-447.

Office of Substance Abuse Prevention. 1991a. Future by Design: Community Framework for Preventing Alcohol and Other Drug Problems through a Systems Approach. Washington, DC: U.S. Dept. of Health and Human Services, Office of Substance Abuse Prevention.

Office of Substance Abuse Prevention. 1991b. National Evaluation of the Community Partnership Program: Evaluation Plan, Final Report. Washington, DC: U.S. Dept. of Health and Human Services, Office of Substance Abuse Prevention.

Paine-Andrews, A., Vincent, M.L., et al., 1996. Replicating a community initiative for prevention adolescent pregnancy: from South Carolina to Kansas. Family and Community Health, 19(1): 14-30.

Rabin, S. 1992. Pooling resources builds private/public partnerships. Public Relations Journal, 48(10): 32-34.

Ringwalt, C.L., Graham, L.A., et al. 1996. Supporting adolescents with guidance and employment (SAGE). American Journal of Preventive Medicine, 12(5, supplement): 31-38.

Robert Wood Johnson Foundation. 1989. Fighting Back: Community Initiatives to Reduce Demand for Illegal Drugs and Alcohol. Princeton, NJ: Robert Wood Johnson Foundation.

Roberts-DeGennaro, M. 1986. Factors contributing to coalition maintenance. Journal of Sociology and Social Welfare, 13(2): 248-264.

Santelli, J. and Beilenson, P. 1992. Risk factors for adolescent sexual behavior, fertility, and sexually transmitted diseases. Journal of School Health, 62 (7): 271-279.

Scarlett, M.I., Williams, K.R. and Cotton, M.F. 1991. A private organization and public agency partnership in community health education. Public Health Reports, 106(6): 667-672.

Schatz, I., et al. 1993. A community-based alcohol and injury prevention project: Reflections from three U.S. communities, in Experiences with Community Action Projects: New Research in the Prevention of Alcohol and Other Drug Problems. Center for Substance Abuse Prevention Monograph 14, Brandon, VT: Clinical Psychology Publishing Co.

Schneider, A. 1994. Building strategic alliances. New Designs for Youth Development, 11(3): 23-26.

Tarlov, A.R., Kehrer, B.H., et al. 1987. Foundation work: The health promotion program of the Henry J. Kaiser Family Foundation. American Journal of Health Promotion, :74-80.

Thompson, B., Wallack, L., et al. 1991. Principles of community organization and partnership for smoking cessation in the Community Intervention Trial for Smoking Cessation (COMMIT). International Quarterly of Community Health Education, 11: 187-203.

U.S. Dept. of Health and Human Services. 1997. The National Strategy to Prevent Teen Pregnancy, Section 7 in Welfare Reform Resource Packet. Washington, DC: The National Campaign to Reduce Teen Pregnancy.

U.S. Dept. of Health and Human Services. 1997b. The National Strategy to Prevent Teen Pregnancy, Groups 1, 3, 5 and 7 of the national meeting on partnerships. Bethesda, MD: National Institutes of Health, July 29.

U.S. Dept. of Education. 1996. Putting the Pieces Together: Comprehensive School-linked Strategies for Children and Families. Washington, DC: U.S. Dept. of Education.

Weiss, J.A. 1987. Pathways to cooperation among public agencies. Journal of Policy Analysis and Management, 7(1): 94-117.

Wiist, W.H., Jackson, R.H. and Jackson, K.W. 1996. Peer and community leader education to prevent youth violence. American Journal of Preventive Medicine, 12(5, supplement): 56-64.

Williams, K.R., et al., 1991. Improving community support for HIV and AIDS prevention through national partnerships. Public Health Reports, 106(6): 672-677.

Wolff, T.J. and Foster, D.L. 1993. Monitoring and evaluation of coalitions: Lessons from 8 communities. Paper presented at the American Public Health Association Annual Meeting, October 25, San Francisco.

World Health Organization. 1986. The Ottawa Charter for health promotion. Health Promotion, 1: iii-v.

World Health Organization. 1978. Alma Alta 1978: Primary Health Care. Geneva: World Health Organization.

ENDNOTES

1. Dryfoos, 1990; Kirby, 1997; Miller, 1995; Moore, Miller, et al., 1995.

2. Moore, Miller, et al., 1995.

3. 1997, p.12.

4. Kirby, 1997; Moore, Sugland, et al., 1995; Santelli and Beilenson, 1992; Brindis, 1991.

5. Brindis, 1991; Carnegie Corp., 1989; Dryfoos, 1990; Moore, Sugland, et al., 1995; Santelli and Beilenson, 1992.

6. Kirby, 1997.

7. Executive Office for Weed and Seed, n.d.; OSAP, 1991; National Clearinghouse on Families and Youth, 1996.

8. Alter and Hage, 1993, p. 259.

9. Abramson & Rosenthal, 1995; Butterfoss, et al., 1993; Alter and Hage, 1993; Chavis, 1995; Cornerstone Consulting Group, 1997; CSAP, 1995; Mattessich & Monsey, 1992; Nezlek & Galano, 1993; Rabin, 1992; U.S. Environmental Protection Agency, 1990; Weiss, 1987.

10. Bracht, 1995.

11. Butterfoss, et al., 1993, p. 315.

12. Paine-Andrews, et al., 1996, p. 16.

13. WHO, 1978.

14. Kirby, 1997, p. 46; see also Santelli & Beilenson, 1992; Brindis, 1991; Carnegie Corp., 1989; Dryfoos, 1990.

15. Cohen & Lang, 1990.

16. NCIPC, 1993, p. 4.

17. OSAP, 1991, p. 3.

18. National Clearinghouse on Families and Youth, 1996, p. 19.

19. Annie E. Casey Foundation, n.d.; Cornerstone Consulting Group, n.d.

20. Nezlek & Galano, 1993, p. 434; see also Francisco, et al., 1993; Chavis, 1995.

21. Butterfoss, et al., 1993, p. 318.

22. Butterfoss, et al., 1993.

23. Francisco, et al., 1996.

24. Butterfoss, et al., 1993.

25. Mansergh, et al., 1996.

26. Nezlek & Galano, 1993.

27. Alter & Hage, 1993.

28. Allensworth, 1994; Brindis, 1991; Annie E. Casey Foundation, 1993b; Colorado Dept. of Health, n.d.; Cornerstone & Philliber, 1997; The Community Toolbox, 1997; Executive Office for Weed and Seed, n.d.; Fawcett, et al., 1993; National Assembly of National Voluntary Health and Social Welfare Organizations, 1991; OSAP, 1991.

29. Bailey & McNally Koney, 1995a, 1995b.

30. Weiss, 1987; Alter & Hage, 1993.

31. Abramson & Rosenthal, 1995; Butterfoss, et al., 1993; Francisco, et al., 1996; Mattessich & Monsey, 1992; Fawcett, et al., 1993.

32. Carbine & Lee, 1988; CDC, 1995; CSAP, 1995; Fawcett, et al., 1995; Ferraro, 1994; Kracke, 1996; NCIPC, 1993; Scarlett et al., 1991; Williams, et al., 1991; Weiss, 1987.

33. Abramson & Rosenthal, 1995; Alter & Hage, 1993; Butterfoss, et al., 1993; Weiss, 1987.

34. Abramson & Rosenthal, 1995; Butterfoss, et al., 1993; Weiss, 1987; see also the section on the history of partnerships, above, which notes various government and foundation initiatives that contributed to the creation of partnerships.

35. Weiss, 1987.

36. American Leadership Forum, 1993; Anderson, 1996; Rabin, 1992.

37. American Leadership Forum, 1993; Alter & Hage, 1993; Anderson, 1996; Butterfoss, et al., 1993; Rabin, 1992; Weiss, 1987.

38. Abramson & Rosenthal, 1995; Butterfoss, et al., 1993; Francisco, et al., 1996.

39. Abramson & Rosenthal, 1995; Alter & Hage, 1993; Butterfoss, et al., 1993; Mattessich and Monsey, 1992; Weiss, 1987.

40. Abramson & Rosenthal, 1995.

41. Mattessich & Monsey, 1995; Weiss, 1987.

42. Annie E. Casey, 1993a.

43. Brindis, 1991; Executive Office for Weed and Seed, n.d.; Colorado Dept. of Health, n.d.

44. Fawcett, et al., 1993; Fawcett, Paine Andrews, et al., 1995; Fawcett, et al., 1994.

45. Center for the Study of Social Policy, 1995; Cohen & Lang, 1990; Copple, et al., n.d.; Mulroy, 1997; Nadel, et al., 1996; Nezlek & Galano, 1993; NIJ, 1995.

46. Annie E. Casey, 1993a, b.

47. Annie E. Casey, 1993b; ISA Associates, 1994; Mulroy, 1997.

48. Nezlek & Galano, 1993.

49. Nadel, et al., 1996.

50. Kotloff, et al., 1995.

51. Kotloff, et al., 1995; Nezlek & Galano, 1993; see Cornerstone & Philliber, 1997 and Annie E. Casey, 1993a for examples of manuals designed to guide communities through this process.

52. Nezlek & Galano, 1993; OSAP, 1991.

53. Abramson & Rosenthal, 1995; Mattessich & Monsey, 1992.

54. Cohen & Lange, 1990: Fawcett, Paine Andrews, et al., 1995; Harrison, 1996; Kotloff, et al., 1995; Mattessich & Monsey, 1992; Mulroy, 1997; NCIPC, 1993; Rabin, 1992; Wolff & Foster, 1993.

55. Copple, et al., n.d.; Gambone, 1997; Kotloff, et al., 1995; NIJ, 1995.

56. Kotloff, et al., 1995.

57. Gambone, 1997; Kotloff, et al., 1995; Mulroy, 1997; Mattessich & Monsey, 1992; U.S. Dept. of Health and Human Services, 1997b, Group 3..

58. Copple, et al., n.d..

59. Fawcett, Paine Andrews, et al., 1995; Kotloff, et al, 1995; NIJ, 1995; Paine-Andrews, et al., 1996.

60. Gambone, 1997.

61. Butterfoss, et al., 1993; CSAP, 1995; Center for the Study of Social Policy, 1995; Copple, et al., n.d.; Kotloff, et al., 1995; Mattessich & Monsey, 1992; Nezlek & Galano, 1993; OSAP, 1991; Willaims, et al., 1991.

62. Motter, et al., 1993, page 263.

63. Butterfoss, et al., 1993; Copple, et al., n.d.; Fawcett, Paine Andrews, et al., 1995; Mattessich & Monsey, 1992; Mulroy, 1997; Nezlek & Galano, 1993; U.S. Dept. of Health and Human Services, 1997b, Group 1 and 3; Wolff & Foster, 1993.

64. U.S. Dept. of Health and Human Services, 1997b, Group 3.

65. Nezlek & Galano, 1993.

66. Kotloff, et al., 1995.

67. Nezlek & Galano, 1993.

68. Mulroy, 1997.

69. Alter & Hage, 1993; ISA Associates, 1994.

70. Mattessich & Monsey, 1992.

71. Abramson & Rosenthal, 1995; Nadel, et al., 1996.

72. Mulroy, 1997; NIJ, 1995; Wiist, et al., 1996.

73. Bailey & McNally Koney, 1995a.

74. Copple, et al., n.d..

75. Nezlek & Galano, 1993.

76. Fawcett, Paine Andrews, 1995.

77. Chavis, 1993; Mattessich & Monsey, 1992; Nezlek & Galano, 1993.

78. Bailey & Koney, 1995a, 1995b; Kotloff, et al., 1995; Mulroy, 1997; Wolff & Foster, 1993.

79. Fawcett, Paine Andrews, et al., 1995; Francisco, et al., 1996.

80. Center for the Study of Social Policy, 1995; National Evaluation of the Community Partnership Program, 1994.

81. Butterfoss, et al., 1993.

82. CSAP, 1995; ISA Associates, 1994; Nezlek & Galano, 1993; OSAP, 1991b.

83. Harrison, 1996.

84. Mattessich & Monsey, 1992; National Evaluation of the Community Partnership Program, 1994; Rabin, 1992; Ringwalt, et al., 1996.

85. Abramson & Rosenthal, 1995.

86. Butterfoss, et al., 1993.

87. Mattessich & Monsey, 1992; Ringwalt, et al.,1996.

88. Abramson & Rosenthal, 1995; Ringwalt, et al., 1996.

89. Butterfoss, et al., 1993.

90. Mattessich & Monsey, 1992.

91. Copple, et al., n.d.; Kotloff, et al., 1995.

92. Copple, et al., n.d..

93. Wiist, et al., 1996.

94. Butterfoss, et al., 1993; Ringwalt, et al., 1996.

95. Bailey & McNally Koney, 1995a; Butterfoss, et al., 1993; Kotloff, et al., 1995.

96. Kotloff, et al., 1995.

97. Abramson & Rosenthal, 1995; Alter & Hage, 1993; Butterfoss, et al., 1993; Copple, et al., n.d.; Francisco, et al., 1996; ISA Associates, 1994; Mattessich & Monsey, 1992; Mulroy, 1997; Schatz, et al., 1993; Williams, et al. 1991; Wolff & Foster, 1993.

98. Alter & Hage, 1993.

99. Butterfoss, et al., 1993.

100. Mattessich & Monsey, 1992.

101. ISA Associates, 1992, 1994.

102. Alter & Hage, 1993, p. 242.

103. Abramson & Rosenthal, 1995; Alter & Hage, 1993; Mattessich & Monsey, 1992; Mulroy, 1997; Ringwalt, et al., 1996.

104. Butterfoss, et al., 1993; Gambone, 1997; Harrison, 1996; Mattessich & Monsey, 1992; Nadel, et al., 1996; Ringwalt, et al., 1996.

105. Bailey & Koney, 1995a, 1995b; Mattessich & Monsey, 1992; Ringwalt, et al., 1996.

106. Aber, et al., 1996; Farrell, et al., 1996; Nadel, et al., 1996.

107. U.S. Dept. of Health and Human Services, 1997b, Group 7.

108. Kotloff, et al., 1995.

109. Bailey & McNally Koney, 1995a.

110. Butterfoss, et al., 1993; Gambone, 1997; Kotloff, et al., 1995; see also CSAP, 1995; Motter, et al., 1993; National Evaluation of the Community Partnership program, 1994; and OSAP, 1991; for discussion of the community capacity-building efforts of the CSAP Community Partnership Program.

111. Aber, et al., 1996; Schatz, et al., 1996.

112. Nadel, et al., 1996.

113. Kotloff, et al., 1995; Mansergh, et al., 1996.

114. Kotloff, et al., 1995.

115. Fawcett, Paine Andrews, et al., 1995; Mulroy, 1997; OSAP, 1991; and see section IIB above.

116. Butterfoss, et al., 1993; Harrison, 1996; Mattessich & Monsey, 1992; Rabin, 1992.

117. Alter & Hage, 1993.

118. ISA Associates, 1994.

119. Center for the Study of Social Policy, 1995; Kleiner, 1994; Schneider, 1994; Schatz, et al., 1993.

120. Butterfoss, et al., 1993; Gambone, 1997; Mattessich & Monsey, 1992; U.S. Dept. of Health and Human Services, 1997b, Group 3.

121. Gambone, 1997; Mulroy, 1997.

122. Butterfoss, et al., 1993.

123. Butterfoss, et al., 1993; Cohen & Lang, 1990; Gambone, 1997; Harrison, 1996; Kotloff, et al. 1995; Mattessich & Monsey, 1992.

124. Butterfoss, et al., 1993.

125. National Evaluation of the Community Partnership Program, 1994.

126. Abramson & Rosenthal, 1995; Francisco, et al., 1996.

127. Bailey & McNally Koney, 1995a; Cohen & Lang, 1990; Copple, et al., n.d.; Fawcett, et al., 1993; Fawcett, Paine Andrews, et al., 1995; ISA Associates, 1994; Kotloff, et al., 1995; Schatz, et al., 1993; Williams, et al., 1991.

128. Mattessich & Monsey, 1992.

129. Francisco, et al., 1996.

130. Mattessich & Monsey, 1992.

131. Copple, et al., n.d.; Mattessich & Monsey, 1992.

132. Butterfoss, et al., 1993; Center for the Study of Social Policy, 1995; Fawcett, Paine Andrews, et al., 1995; Mattessich & Monsey, 1992.

133. Schneider, 1994; U.S. Dept. of Health and Human Services, 1997b, Group 3.

134. Bailey & McNally Koney, 1995a.

135. Gambone, 1997.

136. Paine-Andrews, et al., 1996.

137. Kotloff, et al., 1995; ISA Associates, 1994; Schatz, et al., 1993; Willaims, et al., 1991.

138. Alter & Hage, 1993; ISA Associates, 1994; Kotloff, et al., 1995; Nezlek & Galano, 1993.

139. Nezlek & Galano, 1993.

140. Andersen, 1996; Ferraro, 1994; Israel, 1995; Rabin, 1992.

141. Kotloff, et al., 1995.

142. Bailey & McNally Koney, 1995a; Kotloff, et al., 1995.

143. Kotloff, et al., 1995; Nezlek & Galano, 1993.

144. Bailey & McNally Koney, 1995a.

145. Mizrahi & Rosenthal, 1992.

146. Alter & Hage, 1993.

147. Abramson & Rosenthal, 1995, p. 1483; see also ISA Associates, 1994.

148. ISA Associates, 1992.

149. Alter & Hage, 1993; Butterfoss, et al., 1993; Kotloff, et al., 1995; Mattessich & Monsey, 1992; Nezlek & Galano, 1993.

150. Fawcett, Paine Andrews, et al., 1995.

151. Abramson & Rosenthal, 1995; Butterfoss, et al., 1993.

152. Abramson & Rosenthal, 1995.

153. Alter & Hage, 1993.

154. Bailey & Koney, 1995a.

155. Mattessich & Monsey, 1992.

156. Ibid.

157. Bailey & Koney, 1995a.

158. Copple, et al., n.d.; ISA Associates, 1992; Kotloff, et al., 1995.

159. Francisco, et al., 1996.

160. Copple, et al., n.d.; Kotloff, et al., 1995; Paine-Andrews, et al., 1996.

161. Copple, et al., n.d..

162. Cohen & Lang, 1990.

163. Copple, et al., n.d., p..

164. Kotloff, et al., 1995.

165. Nezlek & Galano, 1993.

166. Fawcett, et al., 1993; Fawcett, Paine Andrews, et al., 1995; Francisco, et al., 1993, 1996.

167. Paine-Andrews, et al., 1996.

168. ISA Associates, 1992.

169. Copple, et al., n.d.

170. Wolff & Foster, 1993.

171. Fawcett, Lewis, et al., 1995, Fawcett, Paine Andrews, et al., 1995.

172. Bardach, 1993; Center for the Study of Social Policy, 1995; Fawcett, Lewis, et al., 1995; Francisco, et al., 1996; NIJ, 1995.

173. Mulroy, 1997.

174. Butterfoss, et al., 1993; Kotloff, et. al., 1995.

175. Fawcett, Lewis, et al, 1995; Gambone, 1997.

176. Schatz, et al., 1993.

177. Cohen & Lang, 1990; NIJ, 1995.

178. Center for the Study of Social Policy, 1995; Cohen & Lang, 1990; Gambone, 1997; ISA Associates, 1992; Mattessich & Monsey, 1992; Nezlek & Galano, 1993; Weiss, 1987.

179. Fawcett,

180. Copple, et al., n.d.

181. Copple, et al., n.d.

182. Nezlek & Galano, 1993.

183. Wolff & Foster, 1993.

184. Bailey & Koney, 1996; Butterfoss, et al., 1993; NCIPC, 1993; Schatz, et al., 1993.

185. Butterfoss, et al., 1993.

186. Ibid.

187. Mattessich & Monsey, 1992.

188. Fawcett, Paine Andrews, et al., 1995; Nezlek & Galano, 1993.

189. Bailey & Koney, 1995b; Copple, et al., n.d.; Fawcett, Lewis, et al., 1995; Francisco, et al., 1996; Gambone, 1997; Wolff & Foster, 1993.

190. Nezlek & Galano, 1993; Schneider, 1994; Wolff & Foster, 1993.

191. Gambone, 1997; Mattessich & Monsey, 1992.

192. Copple, et al., n.d.; U.S. Dept. of Health and Human Services, 1997b, Group 1.

193. Mulroy, 1997.

194. Bailey & McNally Koney, 1996.

195. Bailey & McNally Koney, 1995a, Mattessich & Monsey, 1992.

196. Butterfoss, et al., 1993.

197. Kotloff, et al., 1995.

198. Fawcett, Paine Andrews, et al., 1995; Gambone, 1997; NIJ, 1995.

199. Paine-Andrews, et al., 1996.

200. Fawcett, Paine Andrews, et al., 1995; Mattessich & Monsey, 1992.

201. Fawcett, Paine Andrews, et al., 1995; Paine-Andrews, et al., 1996.

202. Francisco, et al., 1996; Paine-Andrews, et al., 1996; Wolff & Foster, 1993.

203. Fawcett, Paine Andrews, et al., 1995.

204. Nezlek & Galano, 1993; Paine Andrews, et al., 1996.

205. Wolff & Foster, 1993.

206. Fawcett, Paine Andrews, et al., 1995.

207. Francisco, et al., 1996.

208. Florin, et al., 1992.

209. Copple, et al., n.d.

210. Ibid.

211. Bailey & McNally Koney, 1995b; Chavis, et al., 1993.

212. Copple, et al., n.d.; Fawcett, Lewis, et al., 1995; Wolff & Foster, 1993.

213. Bailey & McNally Koney, 1995b; Fawcett, Lewis, et al., 1995; Francisco, et al., 1993, 1996.

214. Bailey & McNally Koney, 1995b; Copple, et al., n.d.; Fawcett, Lewis, et al., 1995.

215. Bailey & McNally Koney, 1995b; Cook, et al., 1994; Fawcett, et al., 1993.

216. U.S. Dept. of Health and Human Services, 1997b, Group 1.

217. Fawcett, et al., 1993; Fawcett, Paine Andrews, et al., 1995; Francisco, et al., 1996; Wolff & Foster, 1993.

218. Kotloff, et al., 1995.

219. Goodman & Wandersman, 1994.

220. Cohen & Lange, 1990; Fawcett, Lewis, et al., 1995; Florin, et al., 1992; NIJ, 1995; Ringwalt, et al., 1996; Schatz, et al., 1993.

221. Florin, et al., 1992.

222. Francisco, et al., 1993, 1996; Fawcett, Paine, et al., 1993.

223. Copple, et al., n.d.; Wolff & Foster, 1993.

224. Fawcett, Lewis, et al. 1995.

225. Wolff & Foster, 1993.

226. Fawcett, Lewis, et al., 1995.

227. Butterfoss, et al., 1993, p. 327.

228. Chavis, 1995; Cohen & Lange, 1990; Francisco, et al., 1993; Wolff & Foster, 1993.

229. Copple, et al., n.d.; Fawcett, Lewis, et al., 1995.

230. Fawcett, et al., 1993; Cook, et al., 1994.

231. Fawcett, Lewis, et al., 1995.

232. Cagampang, et al., 1997.

233. Cagampang, et al., 1997; Cook, et al., 1994; Fawcett, Lewis, et al., 1995; Fawcett, Paine, et al., 1993.

234. Center for the Study of Social Policy, 1005; Francisco, et al., 1996.

235. Butterfoss, et al., 1993; see also Schneider, 1994.

236. Abramson & Rosenthal, 1995; Cohen & Lang, 1990; Copple, et al, n.d.; National Evaluation of the Community Partnership Program.

237. Copple, et al., n.d..

238. Bailey & McNally Koney, 1995a; Francisco, et al., 1996.

239. Wolff & Foster, 1993.

240. Bailey & McNally Koney, 1995a.

241. Paine-Andrews, et al., 1996.

242. Butterfoss, 1993, p. 316.

243. Ibid., p. 317.

244. Abramson & Rosenthal, 1995, p. 1479.

245. Chavis, 1995, p. 235.

246. Bailey & McNally Koney, 1995a, p.22.

247. Alter & Hage, 1993, p. 46.

248. Mattessich & Monsey, 1992, p. 4.

249. Gray & Wood, 1991.

250. Chavis, 1993; Chavis, et al., 1993; Florin, et al., 1992.

251. Fawcett, et al., 1993; Fawcett, Paine Andrews, et al., 1995; Francisco, et al., 1993, 1996; Wolff & Foster, 1993.

252. Bailey & McNally Koney, 1995a, 1995b, 1996.

253. Mizrahi & Rosenthal, 1992; Roberts-DeGennaro, 1986.

254. Alter & Hage, 1993.

255. Ibid., p. 265.

256. Ibid., p. 103.