A regional model for organizing and sustaining community-based coalitions

Background: The Appalachian Regional Commission, the Centers for Disease Control, and the Center for Rural Health at Marshall University have collaborated to support 51 community-based diabetes coalitions throughout the Appalachian Region since 2001.

Objectives: to describe a regional model for sustaining community-based coalitions in rural, underserved counties; to present lessons learned over seven years; and to synthesize insights from this project that can be applied in other regions.

Methods: The model has five components: 1) federal, state and local partnerships, 2) training, 3) start-up grants, 4) regional-level technical assistance and 5) monitoring and reporting. The defining characteristics of this model are that grants are made to coalitions based on community representation not goals and objectives; coalition members are trained in writing objectives and implementation plans as the first step after receiving a grant; although a coalition only receives a onetime grant of $10,000 there is no end date. Training, technical assistance and team building continues for as long as a coalition functions and requests assistance.

Results: 51 coalitions have been funded from 2001 to the present. Forty five of the coalitions are currently active. The five coalitions funded in 2001 have remained active for seven years. In calendar year 2006 thirty eight leaders were trained to teach chronic disease self-management skills; 7,197 people participated in support groups; 14,145 people participated in healthy eating training; and $419,680 was generated as in-kind contributions.

Conclusion: a regional model can support sustainable coalitions, with a focus on training, technical assistance and team building.