Community Voice in Cross-Sector Alignment: Concepts and Strategies from a Scoping Review of the Health Collaboration Literature

Abstract

BackgroundHealth care access is an important driver of population health, and factors beyond health care also drive health outcomes. Recognizing the importance of the social determinants of health (SDOH), different actors in the health care, public health, and social service sectors are increasingly collaborating to improve health outcomes in communities. To support such collaboration, the Robert Wood Johnson Foundation recently developed the cross-sector alignment theory of change. According to the cross-sector alignment theory of change, community voice is critical for helping collaboratives address community health needs. Yet research on health collaboratives offers little guidance on how community voice should be understood, or which community voice strategies are most effective.MethodsThis study addresses a gap in the literature with a systematic scoping review of research on health-oriented collaboration and community voice. By scanning key academic journals, searching three academic databases, and obtaining documents from across our professional networks, we identified 36 documents that address community voice in health collaboratives. The review reveals several concepts of community voice and a range of community voice strategies.ResultsWe find that community voice strategies fall into two broad approaches: active and passive. These vary in the level of engagement required from the community and in the level of power shared between communities and collaborators, and this in turn has implications for community health outcomes. We also find that while most strategies are discussed in the context of short-term collaboration, many also lend themselves to adoption in the context of sustainable collaboration and, ultimately, cross-sector alignment.ConclusionThis review provides a characterization and conceptualization of community voice in health-oriented collaborations that provides a new theoretical basis for future research. Passive and active community voice strategies can be studied in more detail for their expected impact on health outcomes and disparities. The increased attention to active community voice can help practitioners achieve improved health outcomes and researchers understand the pathways to health improvement through collaboration.

International Scientific Conference “New Challenges in Economic and Business Development – 2022: Responsible Growth” : Proceedings

“…In such a context, governance arrangements are changing and rely more on inclusion, participation and co-production. Petiwala, A., et al (2021) This study addresses a gap in the literature with a systematic scoping review of research on health-oriented cross-sector collaboration and community voice.…”

How Aligning Sectors Builds Resilient, Equitable Communities

“…The centrality of these factors is the major differentiating point from the project's original theory of change 7. They are as follows: Community voices : The organizations involved intentionally ensure that priorities and solutions are driven by the community, with representation, leadership, and decision making by members of the community 8 Equity : The organizations involved work to ensure everyone has the opportunity to be as healthy as possible and center this framing in the processes of building shared purpose, data, financing, and governance. Power dynamics : The organizations involved shift power dynamics between sectors and within communities to ensure underrepresented voices drive change by following the lead of community members who are furthest from opportunity and the organizations those people trust most. Trust : The organizations involved work together and with the community in transparent and honest ways. …”

“…Community voices : The organizations involved intentionally ensure that priorities and solutions are driven by the community, with representation, leadership, and decision making by members of the community 8…”

“…leadership, and decision making by members of the community 8. • Equity: The organizations involved work to ensure everyone has the opportunity to be as healthy as possible and center this framing in the processes of building shared purpose, data, financing, and governance.…”