Online Program

‘Black Box' surrounding community coalition-led interventions to reduce health disparities in racial and ethnic minority populations: Excerpts from a Cochrane systematic review

Tuesday, November 3, 2015 : 11:10 a.m. - 11:30 a.m.

Carolynne Shinn, RN, MS, PhD, Disability Determination Unit, New Hampshire Department of Health and Human Services, Concord, NH
L. Kendall Krause, MD, MPH, Epidemiology & Surveillance, Bill & Melinda Gates Foundation, Seattle, WA
Joyce Buckner-Brown, PhD, MHS, RRT, Centers for Disease Control and Prevention, Atlanta, GA
A popular approach to reducing health disparities in minority populations is mobilization of community coalitions that include representatives of target populations to foster change at a local level.  A systematic review of coalition-led interventions assessed their effects on improving health or reducing health disparities. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population, and at least two community public or private organizations were included.

The 58 included studies differed in coalition characteristics, as well as characteristics of interventions implemented. Coalitions were coded as one of three types: “grass root” partnerships of predominantly community based organizations; academic institution partnerships with communities; or public health agency partnerships with predominantly public agencies. In addition to coalition typology, a logic model based on Community Coalition Action Theory identified variables of coalition structure and process salient to understanding the effectiveness of community coalition-led interventions. With few exceptions, these variables were reported with insufficient detail to assess their influence on intervention success or failure. In particular, discussion of coalition member-engagement was rarely addressed.

The evidence in this review provides some support for use of coalition-driven interventions to improve health and reduce disparities
in racial and ethnic minorities, but it does not provide an explanation for the underlying mechanisms of the beneficial effect on health and social care systems, which is critical to understanding whether a coalition-led intervention adds value to other community engagement intervention strategies.

Learning Areas:

Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the theoretical rationale underlying community coalition-led interventions as a public health strategy Identify characteristics of coalition structure and process salient to coalition effectiveness List critical gaps in research relevant to understanding effects of community coalition-led interventions on improving health and reducing disparities among racial and ethnic minority populations

Keyword(s): Community-Based Partnership & Collaboration, Vulnerable Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have had a 40-plus year career in public health with special expertise in services to vulnerable populations, specifically HIV-STD prevention, and Childhood Lead Poison Prevention. My doctoral dissertation was on incorporating authentic community voice in community health partnerships; my dissertation research helped inform development of the protocol for a Cochrane Systematic review on Community Coalition-led interventions to reduce health disparities in vulnerable populations, which I co-authored and am submitting for presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.