PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jurbhealthspringer.comThis journalToc AlertsSubmit OnlineOpen ChoiceThis journal
 
J Urban Health. Mar 2003; 80(1): 14–47.
PMCID: PMC3456118
Broadening participation in community problem solving: A multidisciplinary model to support collaborative practice and research
Roz D. Lasker, MDcorresponding author and Elisa S. Weiss
Center for the Advancement of Collaborative Strategies in Health, Division of Public Health, The New York Academy of Medicine, 1216 Fifth Avenue, Room 452, 10029-5293 New York, NY
Roz D. Lasker, rlasker/at/nyam.org.
corresponding authorCorresponding author.
Abstract
Over the last 40 years, thousands of communities—in the United States and internationally—have been working to broaden the involvement of people and organizations in addressing community-level problems related to health and other areas. Yet, in spite of, this experience, many communities are having substantial difficulty achieving their collaborative objective, and many funders of community partnerships and participation initiatives are looking for ways to get more out of their investment. One of the reasons we are in this predicament is that the practitioners and researchers who are interested in community collaboration come from a variety of contexts, initiatives, and academic disciplines, and few of them have integrated their work with experiences or literatures beyond their own domain. In this article, we seek to overcome some of this fragmentation of effort by presenting a multidisciplinary model that lays out the pathways by which broadly participatory processes lead to more effective community problem solving and to improvements in community health. The model, which builds on a broad array of practical experience as well as conceptual and empirical work in multiple fields, is an outgrowth of a joint-learning work group that was organized to support nine communities in the Turning Point initiative. Following a detailed explication of the model, the article focuses on the implications of the model for research, practice, and policy. It describes how the model can help researchers answer the fundamental effectiveness and “how-to” questions related to community collaboration. In addition, the article explores differences between the model and current practice, suggesting strategies that can help the participants in, and funders of, community collaborations strengthen their efforts.
Full Text
The Full Text of this article is available as a PDF (185K).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
1. Box RC. Citizen Governance: Leading American Communities into the 21st Century. Thousand Oaks, CA: Sage Publications; 1998.
2. King CS, Stivers C. Government Is Us: Public Administration in an Anti-government Era. Thousand Oaks, CA: Sage Publications; 1998.
3. Denhardt RB, Denhardt JV. The new public service: serving rather than steering. Public Adm Rev. 2000;60:549–559. doi: 10.1111/0033-3352.00117. [Cross Ref]
4. McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. 1993;270:2207–2212. doi: 10.1001/jama.270.18.2207. [PubMed] [Cross Ref]
5. Goodman RM, Wandersman A. FORECAST: a formative approach to evaluating community coalitions and community-based initiatives.J Community Psychol. 1994;CSAP Special Issue:6–25.
6. Butterfoss FD, Goodman RM, Wandersman A. Community coalitions for prevention and health promotion: factors predicting satisfaction, participation, and planning. Health Educ Q. 1996;23:65–79. [PubMed]
7. Lasker RD., Committee on Medicine and Public Health Medicine and Public Health: the Power of Collaboration. Chicago, IL: Health Administration Press; 1997.
8. Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202. doi: 10.1146/annurev.publhealth.19.1.173. [PubMed] [Cross Ref]
9. Mitchell SM, Shortell SM. The governance and management of effective community health partnerships: a typology for research, policy and practice. Milbank Q. 2000;78:241–289. doi: 10.1111/1468-0009.00170. [PubMed] [Cross Ref]
10. Gray B. Collaborating: Finding Common Ground for Multiparty Problems. 1st ed. San Francisco, CA: Jossey-Bass; 1989.
11. Mattesich PW, Monsey BR. Collaboration: What Makes It Work. St. Paul, MN: Amherst H. Wilder Foundation; 1992.
12. Zuckerman HS, Kaluzny AD, Ricketts TC. Alliances in health care: what we know, what we think we know, and what we should know. Health Care Manage Rev. 1994;20:54–64. [PubMed]
13. Richardson WC, Allegrante JP. Shaping the future of health through global partnerships. In: Koop CF, Pearson CE, Schwarz MR, editors. Critical Issues in Global Health. San Francisco, CA: Jossey-Bass; 2000. pp. 375–383.
14. Bazzoli GJ, Stein R, Alexander JA, Conrad DA, Sofaer A, Shortell S. Public-private collaboration in health and human service delivery: evidence from community partnerships. Milbank Q. 1997;75:533–561. doi: 10.1111/1468-0009.00068. [PubMed] [Cross Ref]
15. Fawcett SB, Lewis RK, Paine-Andrews A, et al. Evaluating community coalitions for prevention of substance abuse: the case of Project Freedom. Health Educ Behav. 1997;24:812–828. [PubMed]
16. Bruce TA, McKane SU, editors. Community-Based Public Health: a Partnership Model. Washington, DC: American Public Health Association; 2000.
17. Kreuter MW, Lezin NA, Young LA. Evaluating community-based collaborative mechanisms: implications for practitioners. Health Promotion Pract. 2000;1:49–63. doi: 10.1177/152483990000100109. [Cross Ref]
18. Galea S, Factor SH, Bonner S, et al. Collaboration among community members, local health service providers, and researchers in an urban research center in Harlem, New York. Public Health Rep. 2001;116:530–539. [PMC free article] [PubMed]
19. Chaskin RJ. Lessons Learned From the Implementation of the Neighborbood and Family Initiative: a Summary of Findings. Chicago, IL: Chapin Hall Center for Children; 2001.
20. Wandersman A, Goodman RM, Butterfoss RD. Understanding coalitions and how they operate. In: Minkler M, editor. Community Organizing and Community Building for Health. New Brunswick, NJ: Rutgers University Press; 1997. pp. 261–277.
21. Okubo D, Weidman K. Engaging the community in core public health functions. Natl Civ Rev. 2000;89:309–325. doi: 10.1002/ncr.89403. [Cross Ref]
22. Swain D. Linking civic engagement and community improvement: a practitioner perspective on the communities movement. Natl Civ Rev. 2001;90:319–334. doi: 10.1002/ncr.90404. [Cross Ref]
23. Robertson A, Minkler M. New health promotion movement: a critical examination. Health Educ Q. 1994;21:295–312. [PubMed]
24. Kegler MC, Twiss JM, Look V. Assessing community change at multiple levels: the genesis of an evaluation framework for the California Healthy Cities Project. Health Educ Behav. 2000;27:760–779. [PubMed]
25. Roussos ST, Fawcett SB. A review of collaborative partnerships as a strategy for improving community health. Annu Rev Public Health. 2000;21:369–402. doi: 10.1146/annurev.publhealth.21.1.369. [PubMed] [Cross Ref]
26. Shortell SM, Zukoski AP, Alexander JA, et al. Evaluating Partnerships for community health improvement: tracking the footprints. J Health Polit Policy Law. 2002;27:49–91. doi: 10.1215/03616878-27-1-49. [PubMed] [Cross Ref]
27. Kenney DS. Arguing About Consensus: Examining the Case Against Western Watershed Initiatives and Other Collaborative Groups Active in Natural Resources Management. Boulder CO: Natural Resources Law Center; 2000.
28. Norris T. Civic gemstones: the emergent communities movement. Natl Civ Rev. 2001;90:307–318. doi: 10.1002/ncr.90403. [Cross Ref]
29. Voices From the Field: Learning From the Early Work of Comprebensive Community Initiatives. Washington, DC: The Aspen Institute; 1997.
30. Bruner C, Greenberg M, Guy C, Little M, Schorr L, Weiss H. Funding What Works: Exploring the Role of Research on Effective Programs and Practices in Government Decision-Making. Des Moines, IA: National Center for Service Integration; 2001.
31. MacFarlane S, Racelis M, Muli-Musiime F. Public health in developing countries. Lancet. 2000;356:841–46. doi: 10.1016/S0140-6736(00)02664-7. [PubMed] [Cross Ref]
32. Kesler JT, O'Connor D. The American communities movement. Natl Civ Rev. 2001;90:295–306. doi: 10.1002/ncr.90402. [Cross Ref]
33. Chang H. Drawing Strength From Diversity: Effective Services for Children, Youth, and Families. Oakland, CA: California Tomorrow; 1994.
34. Chrislip DD. American renewal: reconnecting citizens with public life. Natl Civ Rev. 1994;83:26–31.
35. Thomson K, Berry JM, Portney KE. Kernels of Democracy. Boston, MA: Lincoln Filene Center at Tufts University; 1994.
36. Chaskin RJ, Garg S. The Issue of Governance in Neighborhood-Based Initiatives. Chicago, IL: Chapin Hall Center for Children at the University of Chicago; 1997.
37. Creating a Community Agenda: How Governance Partnerships Can Improve Results for Children, Youth, and Families. Washington, DC: Center for the Study of Social Policy; 1998.
38. The Civic Index: Measuring Your Community's Civic Health. 2nd ed. Denver, CO: National Civic League; 1999.
39. Bruner C. Social Services Systems Reform in Poor Neighborhoods: What We Know and What We Need to Find Out. Des Moines, IA: National Center for Service Integration; 2000.
40. Fung A. Accountable autonomy: toward empowered deliberation in Chicago schools and policing. Polit Soc. 2001;29(1):73–103.
41. Kato L, Riccio J. Bullding New Partnerships for Employment: Collaboration Among Agencies and Public Housing Residents in the JOBS-PLUS Demonstration. New York: Manpower Demonstration Research Corporation; 2001.
42. Baxter RJ. What Turning Point Tells Us: Implications for National Policy. Battle Creek, MI: The W. K. Kellogg Foundation; 2001.
43. Turning Point Community Health Governance Workgroup: Creating Community-Driven Structures to Advance Community Health. New York, NY: The New York Academy of Medicine; 2001.
44. Nicola RM, Berkowitz B, Lafronza V. A turning point for public health. J Public Health Manag Pract. 2002;8:4–7.
45. Sabol B. Innovations in collaboration for the public's health through the Turning Point Initiative: the W. K. Kellogg Foundation Perspective. J Public Health Manag Pract. 2002;8:6–12. [PubMed]
46. World Health Organization A discussion document on the concept and principles of health promotion. Health Promotion. 1986;1:73–78.
47. Potapchuk WR, Crocker JP, Schechter WH. The transformative power of governance. Natl Civ Rev. 1999;88:217–247. doi: 10.1002/ncr.88307. [Cross Ref]
48. Eisen A. Survey of neighborhood-based, comprehensive community empowerment initiatives. Health Educ Q. 1994;21:235–252. [PubMed]
49. Israel BA, Checkoway B, Schulz A, Zimmerman M. Health education and community empowerment: conceptualizing and measuring perceptions of individual, organizational, and community control. Health Educ Q. 1994;21:149–170. [PubMed]
50. Wilcox R, Knapp A. Building communities that create health. Public Health Rep. 2000;115:139–143. doi: 10.1093/phr/115.2.139. [PMC free article] [PubMed] [Cross Ref]
51. Clark NM, Baker EA, Chawla A, Maru M. Sustaining collaborative problem solving: strategies from a study in six Asian countries. Health Educ Res. 1993;8:385–402. [PubMed]
52. Dearing JW, Larson SR, Randall LM, Pope RS. Local reinvention of the CDC HIV prevention community planning initiative. J Community Health. 1998;23:113–126. doi: 10.1023/A:1018709423879. [PubMed] [Cross Ref]
53. Wallis A, Crocker JP, Schechter B. Social capital and community building: part one. Natl Civ Rev. 1998;87:253–71. doi: 10.1002/ncr.87306. [Cross Ref]
54. Cottrell CS. The competent community. In: Kaplan BH, Wilson RN, Leighton AH, editors. Futher Explorations in Social Psychiatry. New York, NY: Basic Books; 1976. pp. 195–209.
55. O'Connor D, Gates CT. Toward a healthy democracy. Public Health Rep. 2000;115:157–160. doi: 10.1093/phr/115.2.157. [PMC free article] [PubMed] [Cross Ref]
56. Heaney CA, Israel BA. Social networks and social support. In: Glanz K, Lewis FM, Rimer BK, editors. Health Behavior and Health Education. 3rd ed. San Francisco, CA: Jossey-Bass; 2002. pp. 185–209.
57. Berry JM, Portney KE, Thomson K. The Rebirth of Urban Democracy. Washington, DC: The Brookings Institution; 1993.
58. Chrislip DD. The Collaborative Leadership Fieldbook. San Francisco, CA: Jossey-Bass; 2002.
59. Chrislip DD. Collaboration: the new leadership. Healthc Forum J. 1995;38(6):20–26. [PubMed]
60. Miller H. Reasoning together: any chance? Paper presented at: Annual Meeting of the Public Administration Theory Network; June 21–23, 2000; University of Leiden, The Netherlands.
61. McKnight JL. Health and empowerment. Can J Public Health. 1985;76:37–38. [PubMed]
62. Putnam RD. Bowling Alone. New York, NY: Simon and Schuster; 2000.
63. Macinko J, Starfield B. The utility of social capital in research on health determinants. Milbank Q. 2001;79:387–427. doi: 10.1111/1468-0009.00213. [PubMed] [Cross Ref]
64. Blackwell AG, Colmenar R. Community-building: from local wisdom to public policy. Public Health Rep. 2000;115:161–166. doi: 10.1093/phr/115.2.161. [PMC free article] [PubMed] [Cross Ref]
65. McKnight JL, Kretzmann JP. Mapping Community Capacity. Evanston, IL: Center for Urban Affairs and Policy Research, Northwestern University; 1992.
66. Thomas J. Public Participation in Public Decisions. San Francisco, CA: Jossey-Bass; 1995.
67. Chaskin RJ, Peters C. Decision Making and Action at the Neighborhood Level: an Exploration of Mechanisms and Processes. Chicago, IL: Chapin Hall Center for Children; 2000.
68. Rissel C. Empowerment: the holy grail of health promotion. Health Promot Int. 1994;9:39–47.
69. Freire P. Education for Critical Consciousness. New York, NY: Seabury Press; 1973.
70. Wallerstein N. Powerlessness, empowerment, and health: implications for health promotion programs. Am J Health Promot. 1992;6:197–205. [PubMed]
71. Zimmerman MA. Psychological empowerment: issues and illustrations. Am J Community Psychol. 1995;23:581–599. [PubMed]
72. Cornell Empowerment Group Empowerment and family support. Networking Bull. 1989;1:1–23.
73. Minkler M, Wallerstein N. Improving health through community organization and community building. In: Glanz K, Lewis FM, Rimer BK, editors. Health Behavior and Health Education: Theory, Research, and Practice. 2nd ed. San Francisco, CA: Jossey-Bass; 1997. pp. 241–269.
74. Rousseau JJ. The Social Contract (1762) Harmondsworth, UK: Penguin; 1968.
75. Barber B. Strong Democracy: Participatory Politics for a New Age. Berkeley and Los Angeles, CA: University of California Press; 1984.
76. Morone J. The Democratic Wish: Popular Participation and the Limits of American Government. New York, NY: Basic Books; 1990.
77. Schulz R. Aging and control. In: Garber J, Seligman M, editors. Human Helplessness: Theory and Applications. New York, NY: Academic Press; 1980. pp. 261–277.
78. Rodin J. Aging and health: effects of the sense of control. Science. 1986;233:1271–1276. [PubMed]
79. Karasek R, Baker D, Marxer F, Ahlbom A, Theorell T. Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. Am J Public Health. 1981;71:694–705. doi: 10.2105/AJPH.71.7.694. [PubMed] [Cross Ref]
80. Alfredsson L, Karasek R, Theorell T. Myocardial infarction risk and psychological work environment: an analysis of the male Swedish working force. Soc Sci Med. 1982;16:463–476. doi: 10.1016/0277-9536(82)90054-5. [PubMed] [Cross Ref]
81. Heller K. The return to community. Am J Community Psychol. 1989;17:1–15. doi: 10.1007/BF00931199. [PubMed] [Cross Ref]
82. Zimmerman MA. Empowerment theory. In: Rappaport J, Seidman E, editors. Handbook of Community Psychology. New York, NY: Kluwer Academic/Plenum Publishers; 2000. pp. 43–63.
83. Putnam RD, Leonardi R, Nanetti R. Making Democracy Work: Civic Traditions in Modern Italy. Princeton, NJ: Princeton University Press; 1993.
84. Minkler M. Building supportive ties and sense of community among the inner-city elderly: the Tenderloin senior outreach project. Health Educ Q. 1985;12:303–314. [PubMed]
85. Eng E, Parker E. Measuring community competence in the Mississippi delta: the interface between program evaluation and empowerment. Health Educ Q. 1994;21:199–220. [PubMed]
86. Durkheim E. Stuicide[1897] New York, NY: The Free Press; 1951.
87. House JS, Landis KR, Umberson D. Social relationships and health. In: Conrad P, Kerns R, editors. The Sociology of Health and Illness: Critical Perspectives. 3rd ed. New York, NY: St. Martins Press; 1990. pp. 85–94.
88. House JS, Kahn RL. Measures and concepts of social support. In: Cohen S, Syme SL, editors. Social Support and Health. Orlando, FL: Academic Press; 1985. pp. 83–108.
89. Israel BA, Rounds KA. Social networks and social support: a synthesis for health educators. Adv Health Educ Promot. 1987;2:311–351.
90. Turner RJ, Turner JB. Social integration and support. In: Aneshensel CS, Phelan JC, editors. Handbook of the Sociology of Mental Health. New York, NY: Plenum Publishers; 1999. pp. 301–319.
91. Berkman LF. The role of social relations in health promotion. Psychosom Med. 1995;57:245–254. [PubMed]
92. Thoits PA. Stress, coping, and social support processes: where are we? What next?J Health Soc Behav. 1995;Spec No: 53-79.
93. Berkman LF. Assessing the physical health effects of social networks and social support. Annu Rev Public Health. 1984;5:413–432. doi: 10.1146/annurev.pu.05.050184.002213. [PubMed] [Cross Ref]
94. Lin N, Ye X, Ensel WM. Social support and depressed mood: a structural analysis. J Health Soc Behav. 1999;40:344–359. doi: 10.2307/2676330. [PubMed] [Cross Ref]
95. Lasker RD, Weiss ES, Miller R. Partnership synergy: a practical framework for studying and strengthening the collaborative advantage. Milbank Q. 2001;79:179–206. doi: 10.1111/1468-0009.00203. [PubMed] [Cross Ref]
96. Fried BJ, Rundall TG. Mahaging groups and teams. In: Shortell SM, Kaluzny AD, eds.Health Care Management: Organization, Design, and Behavior. 1994;137–163.
97. Shannon VJ. Partnerships: the foundation for future success. Can J Nurs Adm. 1998;11:61–76. [PubMed]
98. Taylor-Powell E, Rossing B, Geran J. Evaluating Collaboratives: Reaching the Potential. Madison, WI: University of Wisconsin-Extension, Cooperative Extension; 1998.
99. Lasker RD, Weiss ES. Creating partnership synergy: the critical role of community stakeholders.J Health Hum Serv Adm. In press.
100. Farmer JD. The Language of Public Administration. Tuscaloosa, AL: University of Alabama Press; 1995.
101. McSwite OC. Legitimacy in Public Administration. Thousand Oaks, CA: Sage Publications; 1997.
102. Jewiss J, Hasazi S. Advancing Community Well-Being: a Developmental Perspective of Two Community Partnerships in Vermont. Burlington, VT: University of Vermont; 1999.
103. Silka L. Paradoxes of partnerships: reflections on university-community collaborations. In: Kleniewski N, editor. Research in Politics and Society. Greenwich, CT: JAI Press; 1999. pp. 335–359.
104. Principles of Community Engagement. Atlanta, GA: Centers for Disease Control and Prevention, Public Health Practice Program Office; 1997.
105. Weiss ES, Anderson R, Lasker RD. Making the most of collaboration: exploring the relationship between partnership synergy and partnership functioning. Health Educ Behav. 2002;29:683–698. doi: 10.1177/109019802237938. [PubMed] [Cross Ref]
106. Hollar D. Challenges of community engagement: conversations with people in low income communities in Mississippi. Paper presented at: National Conference of the American Society for Public Administration; Newark, NJ; March 10–13, 2001.
107. Kingsley GT, McNeely JB, Gibson JO. Community Building Coming of Age. Washington, DC: The Urban Institute; 1999.
108. Reich R. The Power of Public Ideas. Cambridge, MA: Harvard University Press; 1988.
109. Mansbridge J. Public spirit in political systems. In: Aaron H, editor. Values and Public Policy. Washington, DC: Brookings Institution; 1994. pp. 146–172.
110. Kesler JT. Healthy communities and civil discourse: a leadership opportunity for public health professionals. Public Health Rep. 2000;115:238–242. doi: 10.1093/phr/115.2.238. [PMC free article] [PubMed] [Cross Ref]
111. Miles-Polka B. Investiment-based business plans for human service delivery: a new model takes shape in Des Moines, lowa. Natl Civ Rev. 2001;90:335–346. doi: 10.1002/ncr.90405. [Cross Ref]
112. Chrislip DD, Larson CE. Collaborative Leadership. San Francisco, CA: Jossey-Bass; 1994.
113. Alter C, Hage J. Organizations Working Together. Newbury Park, CA: Sage Publications; 1993.
114. McKinney MM, Morrissey JP, Kaluzny AD. Interorganization l exchanges as performance markers in a community cancer network. Health Serv Res. 1993;28:518–539. [PMC free article]
115. Weiner BJ, Alexander JA. The challenges of govering public-arivate community.
116. Winer M, Ray K. Collaboration Handbook: Creating, Sustaining, and Enjoying the Journey. Saint Paul, MN: Amherst H. Wilder Foundation; 1994.
117. Huxham C. Collaboration and collaborative advantage. In: Huxham C, editor. Creating Collaborative Advantage. London, England: Sage Publications; 1996. pp. 1–18.
118. Wandersman A, Florin PF, Meier R. Who participates, who does not and why? An analysis of voluntary neighborhood associations in the United States and Israel. Sociol Forum. 1987;2:534–555. doi: 10.1007/BF01106625. [Cross Ref]
119. Chinman MJ, Anderson CM, Imm PS, Wandersman A, Goodman RM. The perceptions of costs and benefits of high active groups versus low active groups in community coalitions at different stages in coalition development. J Community Psychol. 1996;24:263–274. doi: 10.1002/(SICI)1520-6629(199607)24:3<263::AID-JCOP6>3.0.CO;2-Y. [Cross Ref]
120. Goodman RM, Speers MA, McLeroy K, et al. Identifying and defining the dimensions of community capacity to provide a basis for measurement. Health Educ Behav. 1998;25:258–278. [PubMed]
121. Minkler M, Thompson M, Bell J, Rose K. Contribution of community involvement to organizational-level empowerment: the federal Healthy Start experience. Health Educ Behav. 2001;28:783–807. [PubMed]
122. Heitzmann CA, Kaplan RM. Assessment of methods for measuring social support. Health Psychol. 1998;79:75–109.
123. Barrera A. Social support research in community psychology. In: Rappaport J, Seidman E, editors. Handbook of Community Psychology. New York, NY: Kluwer Academic/Plenum Publishers; 2000. pp. 215–245.
124. Gambone MA. Challenges of measurement on community change initiatives. In: Fulbright-Anderson K, Kubish AC, Connell JP, editors. New Approaches to Evaluating Community Initiatives: Theory, Measurement, and Analysis. Washington, DC: Aspen Institute; 1999.
125. Sigmond RM. Back to the future: partnerships and coordination for community health. Front Health Serv Manage. 1995;11:5–36. [PubMed]
126. Simon BL. Rethinking empowerment. J Progressive Hum Serv. 1990;1:27–39. doi: 10.1300/J059v01n01_04. [Cross Ref]
127. Arnstein SR. A ladder of citizen participation. J Am Inst Planners. 1969;35:216–224.
Articles from Journal of Urban Health : Bulletin of the New York Academy of Medicine are provided here courtesy of
New York Academy of Medicine