It Takes a Community to Solve a Health Problem

Expanding the Community Health Information Project

From 1993 to 2001, George Washington University Medical Center, Washington, developed and implemented Community Health in Focus, a program designed to use the convening role of the Robert Wood Johnson Foundation (RWJF) to stimulate action on health care issues identified by local communities.

Project staff convened 16 meetings during its funding. The funding also covered an evaluation of the project.

Key Results

  • During the pilot phase two mid-size communities with a significant number of past and current RWJF grantees planned and held one to one-and-a-half day public meetings to advance work on a significant local health issue. The communities and topics were:
    • Pittsburgh/Allegheny County (alternatives to the State's Medicaid-managed care program).
    • San Antonio/Bexar County (exploring consolidation of city and county public health services to address access problems for the underserved).
  • A renewal grant extended the model to four mid-sized cities and one large city:
    • Atlanta (implications of managed care for the uninsured).
    • Birmingham (exploring process to make a city a healthy community).
    • Minneapolis (prevention of youth homicide).
    • St. Louis (the state's Medicaid managed care demonstration program).
    • New York City (developing policy recommendations for assessing Medicaid managed care's impact on recipients).

Evaluation

The Lewin Group — a health care consulting firm — evaluated the Community Health in Focus program. The assessment described results and lessons learned from all of the meetings from 1994 through 1996.

  • It concluded that the model works best in communities already poised to develop a consensus approach.

Extending the Model
RWJF subsequently awarded a grant to extend the model to up to nine additional communities:

  • Providence, R.I. (policy-makers' meeting on the state's uninsured).
  • Bristol, Conn. (underage drinking).
  • Mobile, Ala. (youth violence prevention).
  • Berkeley, Calif. (breast health access for women with disabilities).
  • Duluth, Minn. (substance abuse intervention and prevention).
  • New Britain, Conn. (experiences of grief and loss by children and youth).
  • Lowell, Mass. (childhood asthma).
  • Hayes, Kan. (dental care for low-income children).
  • Harrisburg, Pa. (HIV/AIDS in the African American community).

Three of these communities (Providence, R.I.; Lowell, Mass.; and Harrisburg, Pa.) applied for and received follow-up matching funds of $25,000 from the project to continue the work begun at the initial meetings.

Conclusion

The final grant allowed project staff to compare two sites that availed themselves of the follow-up funding to two that waived the opportunity in order to determine factors that might help predict which collaborations might successfully mobilize a community.

  • Project staff concluded that the leadership was key in the development, management and continuation of a collaborative initiative.

Funding

RWJF supported this work with four grants totaling $1,787,787 from April 1993 to October 2001.

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