The concept of sustainability is germane to research on both community-based programs and community coalitions. However, a consensus definition of sustainability has not emerged in either body of research (Shediac-Rizkallah and Bone, 1998; Altarum Institute, 2009). The primary divergence among definitions in the literature relates to the unit of analysis—what is being sustained. As the literature discussed in this section reveals, some definitions focus on sustaining the program or coalition, while others focus on sustaining the activities and impacts of the program or coalition. Exhibit 4.1 provides an overview of selected definitions of sustainability in the community-based health programs and community coalition literatures. Each definition is categorized as having a primary emphasis on either the continuation of the program or coalition itself, or, the continuation of the program or coalition’s activities and effects.
The definitions included in Exhibit 4.1 illustrate several key points. First, many definitions of sustainability focus on specific aspects of program and coalition operations. For example, Mancini and Marek’s (2004) definition emphasizes the capacity of the program to continuously respond to community issues, and highlights flexibility and adaptability as important characteristics of the program. Edwards et al. (2007) and Rog et al. (2004) note that sustainability is related to the coalition’s capacity to secure stable funding and resources. Rog et al. also highlights other factors that are important to a coalition’s sustainability, noting that a coalition must be operational, cohesive, and growing. Therefore, a coalition’s structures (i.e., processes, regulations, and laws) and collaborative capacities will impact its sustainability.
|Definition of Sustainability in the Community-Based Health Programs Literature||Definitions of Sustainability in the Community Coalitions Literature|
|Focus on Continuing the Program or Coalition||
|Focus on Continuing the Activities and Effects of the Program or Coalition||
|* Excluding the Scheirer (2005) definition, all others provided in this table are direct quotations.|
Second, the definitions in Exhibit 4.1 suggest that sustainability is a process that occurs over time. For example, Swerissen and Crisp’s (2004) definition focuses on the continuation of the program’s benefits in the community. Stevens and Peikes (2006) define sustainability as the survival of the social service program and its ability to continue to provide social services. Butterfoss (2007) focuses on the capacity of a coalition to support its activities over time.
Third, these definitions point to the fact that sustainability is not an all or nothing phenomenon. For example, Shediac-Rizkallah and Bone (1998), who pioneered efforts to define and conceptualize sustainability in community-based programs, define sustainability as a multidisciplinary concept of the continuation process that can take on many different forms. Their research concludes that sustainability is a matter of degrees. Sustainability may mean that a program is continued under a different structure, or that parts of the program are transferred to the community. Furthermore, the uniqueness of each definition illustrates that each program or coalition must determine its own goals for what should be sustained over the long-term (Alexander et al., 2003; Butterfoss, 2007).
Based on the current definition, future efforts at defining the concept of sustainability for programs and coalitions should ensure a balance between the continuation of the program or coalition and the continuation of its activities and benefits. Furthermore, definitions should accommodate degrees of sustainability and an understanding that sustainability is a process that occurs over time.