1. Building and Sustaining a Multicultural Partnership
Noel J. Chrisman, PhD, MPH University of Washington
Valerie Baldisserotto, BSN, RD, CD Sea Mar Community Health Centers
Cheza C. Garvin, PhD, MPH, MSW Public Health: Seattle & King County
Roxana Chen, MPH Public Health: Seattle & King County
Chrisman:

2. Funded by the Centers for Disease Control and Prevention Grant # U50/CCU022163-03

3. Building and Sustaining a Multicultural Partnership
Types of Partnerships
CBPR
Methods
Planning
Stages of Coalition Growth
Challenges & Bridges
Conclusion

4. I. Types of Partnerships
Chrisman et al. 2002
A well organized, differentiated structure with great longevity.
A coalition that extends its work to multiple goals.
Collaborative
Greater organizational strength and longevity.
Diverse organizations that work together to achieve a common goal.
Coalition
Perhaps an initial step toward other structures.
Loose linkages among organizations. Effective for sharing information.
Network
Can include any of the structures below.
Agencies possess equal power over decision making.
Types of PARTNERSHIPS
Structure
Definition
Organization

5. II. Community-Based Participatory Research
Community-Based Participatory Research involves a collaborative partnership in a cyclical, iterative process in which communities of identity play a lead role in: identifying community strengths and resources; selecting priority issues to address; collecting, interpreting, and translating research findings in ways that will benefit the community; and emphasizing the reciprocal transfer of knowledge, skills, capacity and power.
Israel et al. 2000

6. III. Participatory Evaluation with Ethnographic Field Techniques
Semi-structured interviews
Participant-observation
Document analysis

7. Evaluation Criteria for Multicultural Coalitions
Trust
Communication
Decision Making
Diverse and Appropriate Membership
Cultural Competence
Shared purpose/mission
Formalization of rules/procedures
Competent leadership
Perceived Benefits of participation
Perceived Costs
Active participation and accountability
Retain staff/ define member-staff relations

8. REACH 2010 Coalition Agencies Public Health Quality Assurance
University/HMC
Clinics
Diverse Partnership at the Table: Average attendance in 2000 was 25; 17 in 2005.

9. IV. Joint Planning as Power Sharing
University/HMC: literature search for evidence, Coalition evaluation.
Community Clinics: agree to register participants in the electronic data base.
Multiethnic Agencies: conduct community summits.
Quality Assurance: statewide data base on Medicare.
Public Health: epidemiological data, coordination, grant writing, fiscal agent.

10. Asian/Pacific Islander
REACH 2010 Coalition
Community Clinics
African American
Asian/Pacific Islander
Latino
Clinic/Health Provider Change
DEMS Registry
Case Management
Provider Training
Patient Education
Individual Behavior Change
Peer Educators
Support Groups
Education Classes
Self Management Training Classes
Community Systems Change
Make community environment more favorable to diabetics
Community Capacity Building
REACH Coalition
Organizational Networking
Provider/Patient Training
Environment & Systems Change
Interventions

11. V. Stages of Coalition Growth: The Essential Foundation for Sustainability
Formation: Mission, rules, roles, procedures established within four months. Strong sense of common purpose.
Butterfoss et al. 1996

12. Stages of Coalition Growth: The Essential Foundation for Sustainability
Implementation: This stage took nearly two years. Each agency had to develop its culturally tailored plan to deliver the intervention. There was some competition among agencies. Each agency had personnel turnover.
Butterfoss et al. 1996

13. Stages of Coalition Growth: The Essential Foundation for Sustainability
Implementation: This stage took nearly two years. Each agency had to develop its culturally tailored plan to deliver the intervention. There was some competition among agencies. Each agency had personnel turnover.
Butterfoss et al. 1996

14. Stages of Coalition Growth: The Essential Foundation for Sustainability
Implementation: This stage took nearly two years. Each agency had to develop its culturally tailored plan to deliver the intervention. There was some competition among agencies. Each agency had personnel turnover.
Butterfoss et al. 1996

15. Stages of Coalition Growth: The Essential Foundation for Sustainability
Implementation: This stage took nearly two years. Each agency had to develop its culturally tailored plan to deliver the intervention. There was some competition among agencies. Each agency had personnel turnover.
Butterfoss et al. 1996

16. Stages of Coalition Growth: The Essential Foundation for Sustainability
Maintenance: By 2003 individual-level interventions were well established, cultural sharing and anti-racism norms were in place, and the sustainability committee was under way. Very little progress toward system- and community- level interventions.
Butterfoss et al. 1996

17. Stages of Coalition Growth: The Essential Foundation for Sustainability
Outcomes: Grant application submitted that expands the coalition, promotes outreach to new ethnic groups, adopts new health problems, and explicitly examines organization-level change. Each suggestion was the result of work by the sustainability committee. There is increased movement toward a collaborative from a coalition.
Butterfoss et al. 1996

18. VI. Key Challenges Agency competition Science vs. service
Coalition decision-making
Interethnic interaction styles
Process vs. product

19. VI. Bridges to Understanding
Joint problem-solving
Capacity building
Meeting agency objectives
Mutually agreed upon decision rules
Communication and relationships

20. VII. Conclusion
The key factors are:
Trust,
Respect, and
Great organizational skills