Building a Culture of Health at the Neighborhood Level Through Governance Councils

Abstract

To explore facilitators and barriers to developing and sustaining collaboration among New York City Department of Health and Mental Hygiene's Neighborhood Health Action Centers and co-located partners, who share information and decisionmaking through a Governance Council structure of representative members. Semi-structured interviews were conducted in 2018 with 43 Governance Council members across the three Action Centers of East Harlem (13), Tremont (15), and Brownsville (15), New York City. Governance Council members identified collaboration through information-and resourcesharing, consistent meetings and continuous communication as valuable for fostering a culture of health in their communities. Immediate benefits included building relationships, increased access to resources, and increased reach and access to community members. Challenges included difficulty building community trust, insufficient advertisement of services, and navigation of government bureaucracy. The Governance Councils forged collaborative relationships among local government, community-based organizations and clinical providers to improve health and well-being in their neighborhoods. Sharing space, resources and information is feasible with a movement towards shared leadership and decision-making. This may result in community-driven and tailored solutions to historical inequities. In shared leadership models, some internal reform by Government partners may be required.

Resident Experiences With a Place-Based Collaboration to Address Health and Social Inequities: A Survey of Visitors to the East Harlem Neighborhood Health Action Center

“…Conducted as part of a mixed-methods evaluation, 28 the effort to survey visitors to the East Harlem Action Center contributed to a more robust understanding of this initiative by providing insight into client characteristics and experiences with Action Center services and programs. Most visitors surveyed reported positive experiences, with key indicators of satisfaction with the provider from their visit nearly universally met, including perceptions of receiving high quality care, being treated with respect, being made to be feel comfortable, and receiving effective communication.…”

“…In qualitative interviews conducted across the Action Centers, partners reported that being part of the Action Center meant that their clients received increased access to community resources and referrals, and that many clients responded to positively to the Action Center’s aim to serve as an open space and came in repeatedly to access resources. 28 …”

“…These findings support results from the qualitative partner interviews in which partners expressed the need to increase awareness of the Action Center. 28 …”

“…A qualitative component of this evaluation comprised of interviews with Governance Council members was previously published. 28 This paper shares findings from a visitor survey component of the evaluation. The aims of this survey were multifold.…”

Cities and COVID-19: navigating the new normal

“…This was a place-based model designed to cater to the historic inequities in the city. Such models, through information and resource sharing, are found to encourage continuous and organic collaboration within and beyond the councils and include external community organizations such as New York City agencies which aid in health services delivery (Dannefer et al, 2019; Pierre et al, 2020).…”