Cross-Sector Responses to Obesity: Models for Change: Workshop Summary (2015)

4

Leadership

Leadership is the “secret sauce of cross-sector work,” said Debra Oto-Kent, executive director of the Health Education Council. “It can make or break collaborative efforts.”

The Health Education Council has worked with nontraditional partners in a variety of health initiatives, including obesity prevention, and has sought input from key stakeholders who “exemplify leadership,” according

to Oto-Kent. She focused in particular on the work of the South Sacramento Healthy Eating, Active Living (HEAL) Zone, an initiative supported by Kaiser Permanente.

THE THREE Ts

Oto-Kent began by discussing what she called the three Ts: terminology; time, including timing; and trust.

With respect to terminology, Oto-Kent noted that cross-sector partnerships focused on obesity can involve multiple sectors and foci, including law enforcement and public safety, housing, financing and economic development, education and workforce development, parks and recreation, obesity, food insecurity, community development, public health, clinical health care, transportation, and regional planning. Each has its own terminology and jargon, and “it can be difficult to gain common understanding when there’s such varied lingo and interpretation of meaning in each sector,” said Oto-Kent. As an example, she mentioned the word “safety.” For some partners in the HEAL Zone, safety means violence prevention or gang intervention. Business and retail partners tend to see safety in relation to property crime, loitering, or crime against business. Partners focused on addressing improvements in the built environment see safety in terms of creating safe parks and public places. And school partners focus on Safe Routes to School. “We need to invest in understanding the terminology and language of other sectors, what they mean, and recognize that their language may not be the same,” said Oto-Kent.

With respect to time and timing, cross-sector collaboration requires an intentional investment of time to become familiar with the language of other sectors, how they view the problem, and their reasons for being involved. When the South Sacramento HEAL Zone collaborative started several years ago, the partners were not spending enough time together to develop synergy and leverage the great work going on, Oto-Kent said. Since then, the partners have been meeting monthly, communicating through updates, and deepening their understanding of what community health means for each partner. Timing also is a factor, in that the timing for cross-sector partnership needs to be right. Partners must be ready to break out of their silos, which requires leadership at the organizational, program director, or staff level. Also, opportunities can sometimes arise that cause collaboration to gel. The South Sacramento HEAL Zone has one of the highest crime rates in Sacramento, and violence peaks during the summer months. In response, a program called Sacramento Summer Night Lights was launched by a number of organizations, each with its own reason for wanting to be part of the program (see Figure 4-1). Over the summer, the collaborative organized 42 nights of activities over 14 weeks from May to

FIGURE 4-1 The Summer Night Lights program in Sacramento brought together multiple sectors to work toward overlapping goals.
NOTE: HEAL = Healthy Eating, Active Living; HEC = Health Education Council.
SOURCE: Oto-Kent, 2014. Reprinted with permission.

August, every Thursday through Saturday, including meals, games, entertainment, basketball, and other activities for residents, youth, and the partners. The results “have been dramatic,” Oto-Kent reported. Calls to police and business security, loitering, property crime, arrests, and emergency room visits for violence-related trauma all declined. “Most importantly, not a single homicide [occurred] in the zone over the summer,” said Oto-Kent. “Our partners at the Sacramento Police Department told me that they can’t remember the last time in the HEAL Zone there wasn’t a homicide.”

Finally, with regard to trust, Oto-Kent said that when she started working with African American churches, she was told she needed to build trust, history, and relationships. “Trust is time-driven. It doesn’t happen overnight,” she said. This interplay between time and trust is essential, she emphasized. For example, she encourages her staff members to attend meetings held by other sectors to understand their perspectives and develop relationships. As Hinkle-Brown had pointed out earlier, sustainability is about connections, and relationships help make things happen (see Chapter 3).

THE ROLE OF LEADERSHIP

All of the above factors (terminology, time and timing, and trust) are key to leadership in cross-sector collaborations, said Oto-Kent. Leadership builds the commitment to learn terminology, recognize solutions, and develop trust. “Leadership work is central to the creation, maintenance, and success of cross-sector collaborations.”

Oto-Kent listed the characteristics of good leaders based on her observation of cross-sector collaborations, noting that many are based on values and attitudes rather than skills:

• A leader is a strong relationship builder, “someone who deeply values collaboration, respects others’ expertise, and strongly believes that separate efforts to address obesity or health have not worked and cannot solve the problem.”
• A leader recognizes that champions come from many levels and provides both formal organizational and informal leadership.
• The best leaders are those who let go of their ego and believe in shared leadership and ownership. “They build understanding of why everyone needs to be at the table. They gain the trust of the collective group and of individual partners.”
• A leader is results oriented, understands the process of collaboration, and sets milestones to be achieved.
• A leader understands that a sweet spot exists among learning, listening, and taking action.

• A leader is flexible, working toward a collaboration that can adapt to changing circumstances, but also stays focused and moves forward strategically.
• A leader understands that the type of leadership needed in cross-sector work may change over time and is constantly asking who else needs to be at the table.
• Leaders “keep their eye on the prize, and that prize, for us, is always driven by community and resident needs, as opposed to organizational needs and objectives.”
• A leader is an influential communicator who recognizes that conflict is common in partnerships and uses relationships and strategies to equalize power and seek solutions. “The reality is that there’s a lot of self-interest, there’s a lot of competition, there’s protection of interests, and there are money, recognition, and competing barriers that get in the way of cross-sector collaboration.” A leader believes that everyone has an important voice.

Oto-Kent also called attention to the importance of resident leadership in addition to organizational leadership. Resident leaders have the power to change neighborhoods in ways that organizations may not. “We believe that changing the narrative must include strong resident-led and -driven advocacy in creating a new community narrative,” she observed. For example, in the evolution of the Summer Night Lights program, several residents commented on the benefits of changing the community narrative. As one community member told Oto-Kent, “It’s so nice to not hear all the bad things happening in our community. This was very positive for our neighborhood.”

Collaboration can be unclear and messy, Oto-Kent concluded, but “it is the right thing to do.”

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