When establishing structures to support the work, it is useful to begin with the end in mind. It is difficult for partnerships that retain one structure for doing the work to succeed across the range of challenges they will face. Successful partnerships and work groups let their priorities determine their structure, whether the priority is an overarching goal such as equity or sustainability or a core commitment such as community engagement or strategic communication.
Equity deserves and requires multiple forms of support. Equity is an important and humbling aspiration. The rigors of achieving health equity require extraordinary focus and effort from healthy community partnerships and leaders. Partnerships driven by white, middle- class leaders need to be even more attuned to equity challenges and opportunities. Short-cut solutions, such as inviting “representative” partners or establishing a separate committee addressing equity, don’t work and can even damage relationships and credibility when they are perceived as insincere. Success is difficult and not guaranteed even with well-intentioned attempts by sincere leaders to hire community organizers that support healthy community partnerships in low-income neighborhoods, or to include resident leaders on all action teams, or to train and use paid “promotoras” to conduct assessment, education, recruitment and mobilization efforts. This is because multiple barriers and constraints to ongoing participation sometimes make execution difficult. Partnerships with a strong commitment to equity can benefit from additional structural supports as well, such as an equity charter to guide all goals, strategies, measures and decisions; a leadership-training curriculum and learning network for emerging resident leaders; or an action-oriented youth council with training for adult partners. Whatever the specific combination of resources for equity, a robust combination with structural support is advisable.
Sustainability involves much more than new grants. Partnerships that see sustainability as a broad-based effort to embed change in the community are often more successful at continuing the change process and increasing their impact. Such an effort involves intentionally building capacity and increasing impact for healthy community change along social, environmental, policy and economic spectrums of the work. It could also involve promoting key allies to influential positions, electing them to public office, or creating a permanent staff position within a key agency or institution. It could mean building a new health-promoting facility with a good maintenance budget, winning a new policy or establishing a permanent advisory council. It could also mean a dedicated funding stream or funder consortium to advance a strategy or initiative, or any other combination of supports that deepen change and increase impact over time. Whatever the specific mix of priorities and pathways, it is useful to pursue sustainability along multiple paths and experience the kinds of interim success that provide for the future.
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