Community Engagement: READII Coalition’s Use of Public and Private Partners J. Gabriel Rendón and Joan Clayton-Davis Academy for Educational Development Washington, D.C.

Learning Objectives Discuss the benefits of using a Community Action Plan to engage, recruit, and retain key stakeholders to meet READII programmatic goals List and distinguish benefits of engaging public and private partners Describe key factors in sustaining engagement of public and private partners

In July 2002, HHS and CDC launched READII Racial and Ethnic Disparities in Adult Immunization Initiative (READII) In July 2002, HHS and CDC launched READII A multi-year demonstration project Five sites Public and private partnerships Culturally appropriate, community-based interventions The Department of Health and Human Services (DHHS) made the elimination of racial and ethnic disparities in influenza and pneumococcal vaccination coverage for people 65 years of age and older a priority. To address these disparities and assist in reaching the 2010 national health goal of 90% influenza and pneumococcal vaccination rates among people age 65 years and over. This initiative facilitated idea and information exchange among the five health departments. The communication between and among the sites is one method of how they learned about non-traditional resources (i.e., pharmacists) and develop ideas for public and private partnerships. Sites also had the opportunity to developed new or in some cases strengthen alliances with key stakeholders, such as the local department on Aging and the Aging Services Network. CDC’s continued long-standing relationships with CMS assisted the sites to incorporate interventions such as standing orders and take advantage of reimbursement increases for vaccines. Other key partners include: HHS, HRSA, AoA, and AHRQ The Guide to Community Preventive Services has served as a model for evidence-based interventions, as has research done in the adult immunization field. Provider focused efforts, shown to be effective, are among the strategies each of the sites has emphasized. HS Note: I’d delete “A” from the first bullet point (for consistency with the rest of the list)

The Five Sites and their Target Populations Here is a map of the five sites and the target populations that each site served over the two-year initiative.

Community Action Plans Engaged collaborative partners in developing strategic direction for READII activities in local communities Provided opportunity to identify and recruit new strategic partners Secured buy-in for implementation and evaluation of interventions (e.g., provider, outreach, mass immunization clinics, media campaigns) Each READII demonstration site engaged a wide range of likely (traditional) and non-traditional partners who helped develop the strategic direction of the program in their local communities. The strategic direction was outlined in a Community Action Plan that (1) looked at the latest data on adult immunizations and previous efforts to address immunization coverage rates for targeted population groups (African Americans or Hispanics) in their areas; (2) outlined goals, objectives, and key interventions/activities; (3) outlined roles for public and private partners; (4) approved a blueprint for implementation of chosen interventions, and (5) provided opportunities to identify, recruit and engage new strategic partners. Each Community Action Plan set an initial framework for involving public partners such as local public health departments, federally qualified health centers, local government entities/departments, etc., and private partners such as grocery store chains, pharmacy chairs, retail stores, etc. and securing partner buy-in for the overall READII effort. HS Note: Shouldn’t the second bullet point be plural: “opportunities”?

Public Partners Examples Chicago: Cook County Bureau of Health Services; CMS Region V Office, Chicago Department on Aging, African American Health Coalition, Chicago Hispanic Health Coalition San Antonio: Alamo Area Council of Governments, City of San Antonio Community Initiative Milwaukee: City of Milwaukee Department of Health, FQHCs Each READII site brought together a wide range of public partners. For example, in Chicago, public partners included the Cook County Bureau of Health Services, CMS Region V Office, the Illinois Foundation for Quality health Care, Chicago Department on Aging, and the Chicago Housing Authority. In San Antonio, public partners included the Alamo Council of Governments In Milwaukee, City of Milwaukee Department of Health and numerous other public entities were engaged in developing and implementing READII. Rochester, NY and Mississippi Delta also engaged a wide range of public partners. HS Note: 1) close extra space after colon in first bullet point (before Cook); 2) use semicolons instead of commas between all partners’ names to reduce potential for confusion; 3) spell out “FQCH”

Private Partners Examples Mississippi Delta: Kroger Pharmacies serving a 19 county area San Antonio: HEB Grocery Chain Pharmacists, Oakdell Pharmacists Rochester, NY: Private provider practices Each READII demonstration site engaged a number of private provider groups such as: Kroger grocery stores and pharmacies in a number of Mississippi Delta counties Pharmacy groups in San Antonio such as the HEB Grocery Chain pharmacies and Oakdell Pharmacists. Rochester, NY engaged private practices. Other public and private partners included health organizations such as American Health Association, American Diabetes, AARP, medical societies and other professional organizations, as well as media outlets (electronic, print, and web-based) that served their local communities. HS Note: in first bullet point should be “a 19-county area” (add hyphen)

Benefits for Public and Private Partner Engagement More efficient use of limited resources through collaborative efforts Public exposure for public health goals and community service efforts Increased opportunities to reach agency or corporate goals Training and technical assistance for partners that would build individual and community capacity to reach target audiences and achieve common goals Public and private groups consider partnering or entering into collaborative relationships around efforts that provide clear benefits to them. With READII partners, public or private, engagement as a key partner was less challenging when there was: an opportunity to use resources more efficiently through working with others in the community An opportunity to reach more people in the community and as well as the target audience An opportunity to gain public/media exposure for public health goals, goals on participating agencies/groups and services provided by each partner An opportunity for increase business opportunities. For example, when the Kroger Grocery Chain in Mississippi Delta Counties become a partner, its involvement allowed the company to serve communities with pharmacy services and provide mass immunization sites at their store locations and in partnership with other READII partners, but it also expressed a benefit to involvement in READII as an opportunity for more people to come to their stores and potentially increase sales at participating locations. An opportunity to build individual and community capacity to reach the target audience and achieve common health goals for the community. HS Note: Delete “More” from first bullet so that it is similar in construction to bullets that follow; in second bullet, choose another word for “public” to eliminate redundancy; in final bullet point, delete “that would” and replace with “to” and then place a comma after capacity.

Key Factors in Sustaining Partner Engagement Engage partners whose agency, organizational, or corporate mission or goals are compatible with immunization or community health goals Establish relationships with public health providers, targeted communities, private groups, and others to foster a prevention mindset Develop a Community Action Plan that guides program activities (coalition/partnerships roles and responsibilities, activities, evaluation, etc.) Provide benefits to involvement in immunization efforts that matter to partners Some suggested key factors that will aid in sustaining partner engagement and involvement in immunization efforts such as READII include: First, engage partners who have compatible mission or goals as your immunization efforts or are compatible with community health goals. Second, establish strategic relationships that will foster a prevention mindset Third, develop a Community Action Plan that will serve as a framework and guide for program activities. The Community Action Plan will help all partners stay focused, outline roles and responsibilities, outline interventions or activities, and provide a plan for evaluating your immunization efforts or initiatives. HS Note: Can you make font just a little smaller or not bold so that there’s more space on this page? Also, in first bullet, change to “corporate mission/goals” to make more room, and in final bullet, change to “Provide benefits for…” (instead of “to”)

What’s Next? Sites will use evaluation data to assess how well public and private partners were engaged and continue to be engaged in efforts to reduce disparities in adult immunization Some sites will engage new strategic public and private partners to enhance local interventions, activities, or partnership functioning Dissemination of findings Extended from 2 years initially to a include a THIRD flu season; Process/Outcome evaluation efforts have begun but at the close of the project, will involve sites, partners (i.e., CMS), CDC/NIP staff & AED – we’ve begun discussions to ascertain the resources that will be required and the time-line expected to complete formal evaluation activities of the READII project. Taking a more in-depth look at community engagement, sites will use evaluation data to assess how well public and private partners were engaged and whether that engagement was sustained over the life of the demonstration period and into the future. Additionally, some sites will use what they have learned from the demonstration period to bring in new strategic public or private partners who can help their local efforts achieve greater results, or engage those representing target population groups more effectively over time. New partners (Aging Services Network) are on board and many programs see the need to address adult/disparity issues in an evidence-based, cost-effective & efficient manner. Upon completing and evaluating READII efforts, CDC plans to share as widely as possible the results/findings. And to the extent that resources might be identified, we would hope that successful interventions/models for community engagement could be replicated in more sites across the country. HS Note: Suggested changes: Bullet 1: “Sites will use evaluation data to assess public and private partners’ engagement and continuation of engagement in efforts to reduce disparities…” Bullet 2: Change “functioning” to “functions” Bullet 3: Needs to be same grammatical construction as previous two bullets. I’d recommend: “Team will disseminate findings,” or “Sites will disseminate findings” (something like that).

Representing READII Each of the five READII Demonstration sites (Rochester, San Antonio, Mississippi Delta, Milwaukee, Chicago) brought together both public and private partners who worked together to develop a Community Action Plan that served as the overall guide and framework for reducing disparities in their community or region, that provided benefits for partner engagement and involvement, and set the stage for sustaining collaborative efforts in their community or region in years to come. I’d suggest (if you can) moving the top right logo down and slightly to the left, so it’s in the same position as READII Rochester. Right now it looks like it’s up a little too far…

Thank You J. Gabriel Rendón Marketing and Communications Specialist Academy for Educational Development 1825 Connecticut Avenue, N.W. Washington, D.C. 20009 jrendon@aed.org Joan Clayton-Davis Senior Technical Advisor 1225 Ninth Avenue North Nashville, TN 37208 jclayton@aed.org >We have enjoyed working on this important demonstration project, and are looking optimistically ahead to the rest of this year’s activities. HS Note: Need consistency in addresses: We use NW (no periods) after Connecticut Avenue, so shouldn’t Joan’s be Ninth Avenue, N. (at any rate, put a comma after avenue and, if necessary, spell out North) Also no periods between the D and C when using the abbreviation in an address… should just be “DC”