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

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.