Eric Conrad, Meghan Shewmake, Courtney Shows, and Jen Nickelson
Sustainable community partnerships require more than good intentions, necessitating the facilitation of true collaboration to be successful (Blouin & Perry, 2009). McLean and Behringer (2008) assert that for a truly equitable partnership to exist, each party involved must both contribute to, and receive benefits from, the relationship. These contributions from students, campus partners, and communities provide meaningful experiences that result in reciprocal benefits among all partners. Practices that enable equitable collaborations include the establishment of personal relationships, reciprocity, flexibility in adapting to unexpected outcomes, and collaboration to overcome barriers (King, Williams, Howard, Proffitt, Belcher, & McLean, 2004). Fostering these practices result in increased sustainability with the potential to expand collaborative efforts.
The Holt Health Fair is a community event with the goal of providing health screenings and information dissemination to the community of Holt, Alabama. The inception of this annual event was developed through the formation of a collaborative between The University of Alabama (UA) students within the Delta Xi Chapter of the Eta Sigma Gamma (ESG) National Health Education Honorary, and members of the Holt community. Through the maturation of this partnership, stakeholder capacity has increased through mutual support and empowerment. This evolution is the direct result of a partnership that strongly values community voice and input. The following is a student perspective illustrating pertinent community engagement principles, as adapted from McLean and Behringer (2008), and their application in the development of the Holt Health Fair and community partnership.
Partnerships Thrive on Personal Connections
Two commonly asserted theoretical approaches to community change are that of “cultural invasion” and “cultural synthesis.” Cultural invasion occurs when external institutions or academics impose values and agendas with brazen disregard for community voice. Cultural synthesis necessitates those same external forces support and supplement community efforts to collaboratively solve community need (Green & Kreuter, 2005). The primary distinction between these theoretical approaches is in the formation of personal connections within the community. Development and fostering of these relationships demonstrate an investment in the community’s well-being that extends beyond the cessation of singular research projects and funding.
In 2008, a collective of concerned citizens established the Holt Community Partnership (HCP) in an effort to develop initiatives within Holt that “transform lives through opportunity, education, unity, and safety” (HCP, 2010). The HCP was comprised of Holt community members, local law enforcement, religious leaders, board of education affiliates, as well as faculty and staff from UA. This partnership established a foundation in which personal connections between UA and the Holt community could be fostered through cultural synthesis.
The establishment and cultivation of this relationship led to the inclusion of UA student associations, such as the ESG health organization. Since the integration of ESG and Holt, students have been afforded the opportunity to foster relationships within the community through interaction and participation at HCP meetings as well as through additional community collaboratives and initiatives. This community immersion is a transformative process in which programs and initiatives are no longer simple extracurricular activities, but vested experiences in which tangible change can result within the community where these relationships are formed.
Participation and Communication Requires Reciprocity
A true collaborative is one that includes an empowering and power-sharing dynamic that promotes an equitable partnership (Israel, Schulz, Parker, Becker, Allen, & Guzman, 2008). This dynamic may be challenging for academics due to the relinquishment of power or the perceived threat to validity, but is necessary to ensure cultural synthesis and capitalize on community expertise to enhance initiatives and improve outcomes. Support for this synergistic relationship can be achieved through the mobilization and utilization of university resources to supplement community efforts. The reciprocal nature of an equitable partnership ensures community collaborators have input in the development and implementation of programs that can be tailored to meet the diverse needs of the community (Ahmed & Palermo, 2010).
Prior to the inception of the health fair, the HCP and UA collaborators established a community festival within Holt. Over time, attendance and participation in the festival waned, necessitating a reevaluation of the initiative which ultimately resulted in the conclusion that the festival was no longer feasible and meeting the needs of the community. Collaborators began an iterative process to develop a new initiative within Holt to maximize the collective capacity of UA stakeholders and the community. Consistent with the theoretical approach of cultural synthesis, this cyclical method emphasized concerns created by community members and the capacity of stakeholders to address this need. The outcome of this reciprocal dynamic was a community proposal for the establishment of a Holt Health Fair and the creation of processes to support the initiative. Critical to this process was the explicit attention to the knowledge and expertise of community members and emphasis on empowerment inclusive of information sharing, decision-making power, resources, and support within the partnership.
The importance of reciprocity does not diminish following the approval of the initiative, but must be maintained throughout its entirety. As a health education organization, ESG was enthusiastic regarding the community initiated proposal for a health fair within Holt. While well intentioned, unbridled enthusiasm may result in an overzealousness that neglects or excludes community input and precipitates cultural invasion. Eta Sigma Gamma student and faculty representatives perpetuated an equitable dynamic through attendance at HCP sessions to ensure continued communication that emphasized community-initiated development, implementation, and evaluation. Respect for the unique perspective and expertise of Holt collaborators produced a reciprocal transfer of knowledge, skills, and resources that enhanced the capacity of all stakeholders.
Communication and Cooperation Overcome
Partnerships sustained through personal relationships that prioritize reciprocal communication and power facilitate leveraging of collective capacity to overcome project barriers (Green & Kreuter, 2005). A significant challenge following the decision to develop a health fair was creating a suitable event on an abbreviated timeline. Previously established relationships with the HCP facilitated efficient role delineation, allowing for the attainment of resources and services necessary for event implementation. Following the initial implementation of the Holt Health Fair, a stakeholder evaluation identified further barriers that adversely affected project outcomes. Promotion efforts in year one were primarily managed by ESG students which utilized radio and television broadcasts, as well as flyer distribution, yet intended reach was lower than expected. Year two of the initiative improved these processes through increased community involvement in the dissemination, utilizing the cultural influence of local church networks and businesses. Collaborations with Holt High School teachers and coaches resulted in presentations from high school students as well as performances by the dance team and band. The expansion of entertainment activities and the addition of childcare were incorporated to increase event appeal and facilitate easier access to services for community participants with children. Auxiliary barriers that were also addressed included the improvement of issues in regards to venue, transportation, as well as the expansion of vendors and services. Addressing and reducing barriers throughout the evolution of the health fair was expedited through cooperative mechanisms that prioritized continual communication and assessment between ESG, the HCP, as well as UA and community organizations.
Progress Necessitates Increased Capacity
The readiness of the partnership to be adaptable and amenable to increase contributions to the program strengthens the collaborative and improves program success (Sandy & Holland, 2006). Compared to the health fair, the Holt Festival required less resources and investment from each collaborator in the partnership. During the initial conception of the Holt Health Fair, the partnership determined current stakeholders needed to expand their capacity to accomplish the successful implementation of the initiative. The UA stakeholders increased capacity through incorporation of ESG student members and the expansion of university collaborators able to provide resources and health services. Barriers identified served as the impetus for increased community contributions resulting in systematized processes to increase promotion and engagement. Maintaining the equitable relationship through this expansion necessitated that each collaborator augment their contribution to improve the initiative and preserve reciprocity.
Expanding capacity to increase contributions of the partnership should also result in increased benefits to all stakeholders (King et al., 2004). Through the development and improvement of the Holt Health Fair, offerings were expanded from each collaborator which in turn increased the benefits each party received. University students within ESG and other collaborating organizations were provided the opportunity for experiential learning in their respective disciplines. Through application of classroom content, students benefit from deeper understanding of course material and are afforded the opportunity to strengthen cultural competency, leadership attributes, and self-efficacy (Powell & Conrad, 2015). Community members gained the expertise of UA students and faculty, access to health services through the university and external organizations, as well as media coverage and publicity. The benefits resulting from increased capacity were cultivated through relationships that foster trust and reliance in the collaborative process. The increased contribution and capacity can then be extended and utilized in other community partnerships.
Successful Partnerships Breed Successful Partnerships
The principles and benefits of equitable partnerships are transferable regardless of initiative, event, or program (Rhodes, Malow, & Jolly, 2010). The same practices of fostering and sustaining partnerships of reciprocity through cultural synthesis serve to reinforce relationships facilitating initiative success. Partnerships capable of overcoming project barriers promote capacity building through multidirectional learning on an individual or community level. Cultivating improved competence and proficiency through existing partnerships result in increased knowledge, skills, and expertise that enhance diverse community initiatives.
In addition to being active partners of the Holt Health Fair, ESG is also involved in additional health related initiatives within the Holt community. One such coalition is the Holt afterschool program in which ESG members educate elementary students regarding health topics in collaboration with the community organization Tuscaloosa’s One Place. An additional initiative is the Holt Health Lab in which UA and Holt collaborators aim to empower the community to meet health needs through screening, education, and policy. Similar to the Holt Health Fair, these initiatives incorporate processes to ensure community voice and reciprocity to enhance program success. Lessons learned in each initiative may serve to build on successful aspects and avoid barriers that other projects may have encountered. In this way, the expertise and capacity of each partnership is extended beyond itself to ultimately benefit the community through pervasive processes.
Partnership Length Increases Success
Successful partnerships that provide meaningful contributions and benefits to the community and university is a long-term process that requires commitment from both parties (Israel et al., 2008). Cultural synthesis asserts that the establishment and maintenance of trust and rapport among communities necessitate that commitments extend beyond single projects or funding. This prioritization on relationships over outcomes mediate an equitable power-sharing dynamic in which the partnership can more efficiently overcome barriers and increase capacity to achieve goals. These approaches allow for the development of an infrastructure that promotes longevity and sustainability which increases partnership and project success.
The successes of the Holt Health Fair and other community initiatives are direct results of an equitable partnership facilitated through cultural synthesis. Utilizing this approach, UA collaborators prioritized people over processes to develop and strengthen relationships among the Holt community. Through this genuine engagement and interaction within Holt, ESG student perspectives were altered from a mentality that prioritized a tangible product to a mindset that strongly desired an increase in community wellness, well-being, and empowerment. This vested interest fostered reciprocity among ESG students, UA faculty, and Holt community partners through the establishment of processes that respected community voice and perspective. Utilizing the collective strengths of the partnership, event deficiencies were identified and barriers were surmounted as each stakeholder evaluated and subsequently expanded contributions to the initiative, increasing student and community capacity. Lessons learned from the development, implementation, and evaluation of the Holt Health Fair can be applied in diverse community initiatives to further transform lives through opportunity, education, unity, and safety. Establishing an equitable partnership within Holt did not deny differences among multiple perspectives, but embraced diversity by affirming undeniable support through cultural synthesis to create improved outcomes in community engagement.
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About the Authors
Eric Conrad is a doctoral student, Meghan Shewmake is working on a master’s degree, Courtney Shows is an undergraduate student, and Dr. Jen Nickelson is an associate professor, all in the Department of Health Science at the University of Alabama.