Implementation evaluation of a collective impact initiative to promote adolescent health in Oklahoma County, USA

Background The teenage birth rate in the USA has considerably decreased in recent decades; however, more innovative, collaborative approaches are needed to promote adolescent health and prevent teenage pregnancy at the community level. Despite literature on the promising results of the collective impact (CI) model for health promotion, there is limited literature on the model’s ability to reduce teenage pregnancies in a community. The Central Oklahoma Teen Pregnancy Prevention Collaboration is applying the CI model to foster collaboration among multiple stakeholders with the goal of increasing community and organizational capacity to improve adolescent health outcomes. This paper reports the findings from the initiative’s implementation evaluation, which sought to understand whether the CI model improved collaboration among organizations and understand barriers and facilitators that affected program delivery. Methods Program implementers and evaluators jointly developed research questions to guide the intervention and evaluation design. The Consolidated Framework for Implementation Research (CFIR) was used to assess program components including the intervention characteristics, organization setting, community setting, facilitator characteristics, and the process of implementation. Primary sources of data included performance measures, meeting observations (n = 11), and semi-structured interviews (n = 10). The data was thematically analyzed using CFIR constructs, community capacity domains, and the five constructs of CI. Results Key findings include the need for shortened meeting times for meaningful engagement, opportunities for organizations to take on more active roles in the Collaboration, and enhanced community context expertise (i.e., those with lived experience) in all Collaboration initiatives. We identified additional elements to the core constructs of CI that are necessary for successful implementation: distinct role identification for partner organizations and incorporation of equity and inclusivity into collaboration processes and procedures. Conclusions Results from this implementation evaluation provide valuable insights into implementation fidelity, participant experience, and implementation reach of an innovative, systems-level program. Findings demonstrate the context and requirements needed to successfully implement this innovative program approach and CI overall. Additional core elements for CI are identified and contribute to the growing body of literature on successful CI initiatives.

Agency at Play for Collective Impact in Human Services Systems

Responses to urban human services issues such as housing and unemployment often overlook lived experiences through these systems and are formulated from a top-down (systems, services, or policy-level) perspective. This study integrates systems thinking and design justice principles for centering the voices of those experiencing these issues towards exploring ‘agency'—the capacity to act—from the bottom-up and top-down in responding to these issues. An agency typology encompassing various bottom-up and top-down agencies is developed through an analysis of Digital Games for Change (DG4C) for the various agencies they can initiate. The agency typology's contributions are threefold—in research (as a method and analytical tool), in practice (as design principles) and in education (for teaching collective action, impact). The agency typology can drive ‘concerted agency' or collective action, where top-down and bottom-up agencies work together, enabling multipronged targeted approaches to complex social issues and maximizing social justice efforts through collective impact.

Collective impact of scrap, random breakdown, overtime and discontinuous issuing on batch production planning in a supply-chain environment

This research explores the collective impact of overtime, random breakdown, discontinuous issuing rule, and scrap on batch production planning in a supply-chain environment. In today’s global business environment, manufacturing firms encounter numerous operational challenges. Externally, they must promptly satisfy the customers’ various requests, while internally, they must cautiously manage several inevitable issues in the fabrication process. These issues might be concerned with scrap, random breakdown, etc. Resolving such issues is crucial for meeting the due dates of customers’ orders, adhering to the expected manufacturing schedules, product quality, and minimizing the total fabrication-transportation-inventory costs. The study develops a model to characterize the system’s features mentioned above and assist the manufacturers with batch fabrication planning. The model proposes a solution process with an algorithm seeking an optimal runtime for the system. Additionally, it gives a numerical illustration depicting the collective and individual impacts of these special features on the operating policy and other performance indices. This model and the research findings can facilitate manufacturers’ decision-making for green batch fabrication and enhance competitive advantage.

Using Collective Impact to Develop a Community-Led Initiative for Improving Black Infant Mortality

The United States has one of the highest infant mortality rates among developed countries. When stratified by race, disparities are more evident: Black infant mortality rates are 2.5 times higher than non-Hispanic white infants. Structural, systemic racism is a contributing cause for these racial disparities. Multisector collaborations focused on a common agenda, often referred to as collective impact, have been used for infant mortality reduction interventions. In addition, community-based participatory approaches have been applied to incorporate those with lived experience related to adverse pregnancy outcomes. This article critically describes the transition of an infant mortality collective impact initiative from being led by a multisector organizational group to being community led over a 5-year period, 2015–2020. A 34-member community leaders group was developed and determined four priorities and corresponding strategies for the initiative. Findings show that community participatory approaches are a way to address racial equity for public health initiatives.

From Awareness to Social Action: The Role of Dementia Friends in Sustaining Dementia Inclusiveness

According to the World Dementia Council, three components are important to effectively engage a community to become dementia inclusive, 1) raising awareness and consequently decreasing stigma, 2) enabling participation, and 3) providing support—including in health and care settings. Too many times these components are separate initiatives thus limiting their effectiveness and sustainability. By applying the collective impact model and utilizing the Dementia Friends program as the link between the three, all dementia inclusive efforts can be enhanced and sustained regardless of the range of activities and approaches a community chooses to adopt. This symposium provides both evidence and examples of how to personalize and employ the Dementia Friends program to optimize the process, outcome, and impact of dementia inclusive initiatives. By engaging the entire community, awareness is raised, the structure is in place to enable action, and cross-sector collaboration will ensure continuation and sustainability of these important efforts.

Developing a Shared Language to Describe the Age-Friendly Ecosystem

While multiple sectors—cities and communities, education, employment, health, and public health—have identified and implemented strategies to promote age-friendly systems, their efforts have mainly advanced in siloes. Each sector has met goals specific to its constituents, however, the major transformations required to realize systemic inclusivity and well-being among diverse groups of older adults remains indefinable. To begin to address this gap, we have engaged age-friendly sectors in a process of coordinated planning to define and operationalize an age-friendly ecosystem (AFE) that advances cross-sector and age-friendly solutions to meet the needs of all older adults. Our process borrows from Kania and Kramer (2011) who describe conditions to achieve substantial collective impact when coordinating efforts across sectors: a common agenda, shared measurement systems, mutually reinforcing activities, and continuous communication. In this presentation, we describe our stepwise process to set a common agenda, by engaging older adults and working with experts across sectors, to agree on a series of characteristics that define an AFE. Specifically, we surveyed older adults about their perceptions of an age-friendly ecosystem as well as conducted a review and analysis of relevant activities (i.e., policies, programs, and practices) associated with five age-friendly sectors. Next, activities were organized by common and defining characteristics. We then convened more than 40 international experts representing diverse age-friendly sectors to review and revise the AFE characteristics. Through structured and facilitated group processes, we worked with experts to identify and define six critical AFE characteristics as well as examples of corresponding activities.

Can a collective-impact initiative improve well-being in three US communities? Findings from a prospective repeated cross-sectional study

IntroductionCommunities are seeking to learn if and how they can improve the well-being of their residents. We therefore examined the impact of a community-led, collective-impact initiative, deployed through Blue Zones Project by Sharecare, aimed at improving health and well-being in one set of US communities.MethodsWe used data from cross-sectional surveys of the Well-Being Index (2010–2017) to assess how the Life Evaluation Index (LEI) in Hermosa Beach, Manhattan Beach and Redondo Beach in California (Beach Cities) changed over time and how this change compares with change for similar cities (Beach Cities-like) and for the USA as a whole. We examined types of interventions, perceived impacts, and relationships between intervention type and change in LEI.ResultsThe Beach Cities experienced greater increases in LEI than Beach Cities-like communities and the nation. The entire portfolio of interventions was positively associated with change in LEI in the Beach Cities (+1.12, p=0.012), with process-oriented interventions most closely associated with improvement.ConclusionsCommunity-led collective action that leverages community engagement and activation, strategic use of programming and large-scale built-environment and policy change can improve health and well-being at scale.