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.

Can labor-standards advocacy by transnational civil society organizations interact with the power of labor to improve labor standards in global supply chains? A case study of the Cambodian garment industry

Recent research shows that the focus of labor-standards advocacy by transnational civil society organizations (CSOs) has shifted to building the organizational capacity of workers’ organizations in developing countries, suggesting cooperation between transnational CSOs and local trade unions potentially improving working conditions in global supply chains. However, scant attention has been paid to how the two actors interact in practice. Based on fieldwork in Cambodia, including in-depth interviews with garment sector stakeholders, this article examines the interaction between transnational CSOs and trade unions in improving working conditions in the garment industry. The data analysis shows that transnational CSOs and trade unions have distinct comparative advantages in improving working conditions. Rather than the conflicting relationship between CSOs and trade unions as suggested in the literature, this article demonstrates a complementary relationship between the two, indicating the significance of the cooperation between these actors in improving working conditions within global supply chains.

Women's Voices in Civil Society Organizations: Evidence from a Civil Society Mapping Project in Mali

How does women's engagement in civil society organizations (CSOs) differ from that of men, and what factors predict women's willingness to hold the state accountable? We analyze these questions in the context of rural and urban Mali, leveraging face-to-face data collected as part of a civil society mapping project during February -- March 2020 and December 2020, and an in-depth survey conducted with leaders from a randomly-selected subset of these CSOs during January -- March 2021. First, we explore the characteristics of women's groups compared to other CSOs. Second, we explore their likelihood of sanctioning a hypothetical corrupt mayor. We use an embedded survey experiment to try to understand these groups' willingness to report on the mayor as well as the payments they expect to receive from the mayor in order to not share information about the mayor's corruption. We find that women in Mali are often highly organized at the local level---frequently in self-help groups or organizations related to gendered economic activities. However, these more economically-focused groupings of Malian women frequently do not translate into civic activity. They are not typically recognized by outside actors as viable CSOs that could incentivize better governance; their strong networks and group infrastructure represent untapped social capital. We also find that CSOs comprised of women have lower informational and technical capacity, especially due to lower levels of political knowledge, and incur a higher cost of sanctioning public officials---though they have greater mobilization capacity. Women's engagement in decision-making in the home also predicts one's CSO being more hierarchical and having greater technical capacity, as well as having higher expected transfers from the mayor---findings that do not vary with respondent or CSO gender. Turning to the extent to which women involved in CSOs are willing to sanction the state, we find that they are generally less willing than men to sanction, but become more likely when their CSO is less hierarchical, when their technical capacity is higher, and when their political knowledge is greater. However, priming their importance as a CSO (by telling them they were identified by well-connected citizens as being influential) actually reduces sanctioning---perhaps by making them fear that those recommending them will engage in reprisals. Overall, our findings provide useful evidence on the organizational capacity of women and how it is likely to affect the state.

Organizational networks and sustainable urban water practices in US local governments

Organizational networks are regarded as key in policy innovation for sustainable development. They are thought to enhance innovation through access to first-hand experience, enhanced trust within a community, and exposition to role models and competitors. Despite theoretical pertinence, organizational networks have not been studied as much as other drivers of innovation, such as organizational capacity, leadership, and the socio-political environment. This empirical study explores how networks affect the implementation of Sustainable Water Management Practices (SUWM) at the local level. Using data from 110 local governments in five US regions, we examine the relationship between the social interaction and the implementation of SUWM, and how this relationship depends on the types of interaction partners. Our findings show that local governments with larger organizational networks implement more SUWM practices. Collaboration with non-governmental organizations, particularly water sector associations, is strongly associated with an increase in use of SUWM practices. Overall, our findings suggest that creating and maintaining a robust organizational network of other government agencies and non-governmental organizations, especially water sector associations, increases the chances that a local government will implement more SUWM practices.

Strengthening health promotion practice: capacity development for a transdisciplinary field

The growing burden of non-communicable and newly emerging communicable diseases, multi-morbidity, increasing health inequalities, the health effects of climate change and natural disasters and the revolution in communication technology require a shift of focus towards more preventive, people-centred and community-based health services. This has implications for the health workforce, which needs to develop new capacities and skills, many of which are at the core of health promotion. Health promotion is thus being mainstreamed into modern public health. For health promotion, this offers both opportunities and challenges. A stronger focus on the enablers of health enhances the strategic importance of health promotion’s whole-of-society approach to health, showcases the achievements of health promotion with regard to core professional competencies, and helps build public health capacity with health promotion accents. On the other hand, mainstreaming health promotion can weaken its organizational capacity and visibility, and bears the risk of it being absorbed into a traditional public health discourse dominated by medical professions. To address these challenges and grasp the opportunities, it is essential for the health promotion workforce to position itself within the diversifying primary care and public health field. Taking the transdisciplinary status of health promotion and existing capacity development systems in primary and secondary prevention and health promotion as reference points, this paper considers the possibilities to integrate and implement health promotion capacities within and across disciplinary boundaries, arguing that the contribution of health promotion to public health development lies in the complementary nature of specialist and mainstreamed health promotion.