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The Future of the Public’s Health in the 21st Century
relationship between partners committed to pursuing both an individual and a collective benefit.” According to Berkowitz (2000), collaboration is “a method used by members of communities when developing coalitions, by organizations when doing strategic planning, and by researchers who desire the partnership of those being studied.” Feighery and Rogers (1990) define a coalition as “an organization of individuals representing diverse organizations, factions or constituencies who agree to work together in order to achieve a common goal.”
Collaborations are attractive for a number of reasons. They emphasize communitywide behavioral change through the use of a “multicomponent, multisector” approach to changing the environments that establish and maintain behaviors (Roussos and Fawcett, 2000). Success in affecting today’s public health problems and their determinants requires the resources and trust relationships of a broad-based coalition of partners (Green et al., 2001). Bringing together people with different perspectives increases the potential to identify new and better ways of thinking about health issues (Lasker, 2000). Additionally, governmental financial and programmatic constraints require health partnerships, coalitions, and shared resources to achieve public health objectives (Baker et al., 1994).
What makes for a successful collaboration? The results of a study conducted by Kegler and colleagues (1998) to identify factors that contribute to coalition effectiveness suggest that coalitions with higher-quality action plans are better able to mobilize resources and implement activities, and that good communication, devotion of sufficient staff time to the coalition, a sense of cohesion, and a defined structure with multiple task forces appear to be related to the ability to implement activities. Such findings support the idea that developmental or formative activities are important for project success. Butterfoss and colleagues (1993) suggest that coalitions develop in stages (formation, implementation, maintenance, and outcomes) and that different sets of factors may be important to coalition functioning at each stage. For example, articulation of a clear mission, a spirit of cooperation, and positive expectations of outcomes are important during the formation stage, whereas formalization or definition of operational procedures, a strong central leadership, pooling of member assets (e.g., staff support, fundraising capability, meeting space, and access to relevant policy makers), the degree of membership participation, the continued perception of the partners that the benefits outweigh the costs of participation, and skills training are important during the implementation and maintenance stages.
Active involvement by many different parts of the community is believed to increase the likelihood of success for collaborative efforts (Feighery and Rogers, 1990; Israel et al., 1998; Lantz et al., 2001; Seifer and Krauer, 2001). Coalitions take time to coalesce; and the issues to be addressed