Collective Impact in Health – Webinar Questions Answered Part Two

In a recent FSG webinar discussion on collective impact in health Christy Reeves, director of the Blue Cross and Blue Shield of Louisiana Foundation, Dr. Victoria Rogers, director of Let’s Go! in Maine, and Karen Ordinans, executive director of the Children’s Health Alliance of Wisconsin joined FSG’s John Kania to explore how collective impact initiatives are creating impact to increase health and well-being in their communities.

This is the second post in a 3-part blog series in which all four continue the discussion, answering questions submitted by webinar participants on how broad cross-sector coordination can be effective in addressing the continuing complexity of the health space. In this post, Christy discusses additional details about the Challenge for a Healthier Louisiana initiative and FSG discusses the coordination of multiple backbones.

Q: How do you coordinate in a community with multiple organizations that may be the “backbone” organization for an initiative?

FSG: We’ve had the pleasure of talking to and working with multiple backbone organizations that have worked together to coordinate the collective impact work in a given region. One example is the seven backbones that partner with, and receive support from, the Greater Cincinnati Foundation. This cohort of backbone organizations (which includes Agenda 360, Green Umbrella, LISC, Partners for Competitive Workforce, Strive, Success by 6, and Vision 2015) use a monthly meeting time of their leadership to support one another, try to tackle tough commonly faced problems, and negotiate how to avoid repeating each other’s work where similar goals exist.

In some cases this coordination has sparked them to work together, for example, with Strive and Success by 6, and also with Vision 2015 and Agenda 360. So as with a single collective impact initiative, when multiple organizations play a leadership and consensus building role, continuous communication is key. As an example, Agenda 360 and Vision 2015 – who focus on economic opportunity in Cincinnati and Northern Kentucky’s regional priorities, respectively – work closely on numerous projects including the development of the Regional Indicators Report series, which presents a broad-based, fact-driven comparison of their communities and eleven other areas with which they compete for companies, jobs and residents.

Memphis Fast Forward is another example of how backbone organizations can coordinate work to achieve a broad common agenda – in this case accelerated economic growth and improved the quality of life in Memphis. Memphis Tomorrow serves as the umbrella for the backbones that support work in five different issue areas. Each issue-specific backbone has its own backbone leader, steering committee and working groups. Yet they are able to come together effectively to support their larger goals. Blair Taylor, president of Memphis Tomorrow, discusses the importance of these connections noting that, “the premise of Fast Forward has been that you can’t move education along if you don’t at the same time deal with safety in the neighborhood and you can’t have economic development and jobs if you aren’t addressing workforce. These things are inextricably linked. That was part of the premise, but then also linking the communication and conversations around the work so that the work is integrated.”

Another aspect of this question is how the role of one “backbone” can be spread across a number of organizations. We’ve seen this achieved by the Magnolia Place Community Initiative, where a local nonprofit (Children’s Bureau of Southern California,), independent consultant, and university (UCLA) combine their efforts and play to their strengths to provide the backbone functions. Jeff Edmondson of Strive Together discusses this concept of the backbone function being shared across multiple organizations in his blog on the topic.

These are some of the main examples we’ve seen recently of backbone organizations that have worked together to coordinate collective impact work in a given region. What other examples have you seen?

Q: In our state we’re interested in how local health alliances (we have over 20) can work with our foundations to create collective impact/shared funding models in our state. Were BCBSLA’s strategies top-down or bottom-up?

Christy Reeves: BCBSLAF set the long term outcomes for the Challenge for a Healthier Louisiana. We knew we wanted projects to address communities getting their citizens involved in healthier eating and active living. So, we set those long term outcomes from the beginning of the project. How communities reached these two outcomes was up to them—although we did require that they use evidenced-based approaches. We allowed flexibility of the communities to determine the way their project would work best in their respective communities.

Q: Can you speak more about measurement? What is Healthy Louisiana using for long term evaluation? Do you measure changes in density or incidence of obesity statewide? What are some examples of outcomes you’re expecting to see? At what levels are you measuring outcomes? What common indicators/metrics have the partners in the Louisiana model agreed to measure?

Christy Reeves: Challenge for a Healthier Louisiana grants have to focus efforts on two long term outcomes of healthier eating and active living. We are looking for changes in behavior. More specifically, we expect to see that as a result of the Challenge Grant programs, people are eating more fruits and vegetables and are exercising more than before they were exposed to the funded programs or infrastructure. To measure these outcomes, all partners are implementing a set of survey questions at the start of their programs/infrastructure and again 12-18 months later. It is a pre-post design that will follow participants in order to measure behavior change over time. The survey questions were compiled from existing tools that are validated and used on a larger scale (e.g., BRFSS).

In other words, we are collecting data that is being collected statewide (and has been collected in past years) so that we can compare our findings to a larger data set that is publically available. In addition to these common questions, our survey measures exposure to and participation in grant funded activities (e.g., Are you aware of the xyz farmers market? If yes, have you participated?). With this information, we hope to see relationships between participation in grant funded programs/infrastructure and behavior change.

All partners have tailored evaluation plans that include the aforementioned survey, as well as more community/project specific evaluations to help guide program improvement. For example, partners keep track of attendance at community events, participant satisfaction in programs/infrastructure, progress on policy change, etc.

About Christy Reeves – At Blue Cross and Blue Shield of Louisiana, Christy serves in a dual capacity as Director of Community Relations and as the Executive Director of the Blue Cross and Blue Shield of Louisiana Foundation, the company’s charitable subsidiary. Christy also leads the Foundation’s strategic grant-making and its two signature programs, the Angel Award and Smart Bodies.



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