• Research Review
• Journal Summary

Authors: E Barnidge, C Brownson, E Baker, G Shetty

Reference: The Diabetes Educator 2010; 36:190
http://tde.sagepub.com/cgi/content/abstract/0145721709359089v1

Reviewer: Carlos Mendoza Montano, PhD, ProCor contributing editor; President, Guatemalan Association for the Prevention of Heart Diseases (APRECOR), Guatemala City, Guatemala

Reviewer comments: The purpose of this article is to introduce tools developed by the Diabetes Initiative of the Robert Wood Johnson Foundation to assess partnerships development and to facilitate changes to improve the partnerships. The Diabetes Initiative used a group process with program grantees to better delineate the phases of partnership development that contribute to the achievement of a shared long-term goal. Overall, these tools seek to aid partnerships in achieving the best possible chronic disease outcomes. Here it is presented a summary of the article.

Practitioners and researchers working on the prevention and control of chronic disease know that partnership is essential. As a result, there are a number of tools to assess these characteristics. It is not always clear, however, how partnerships contribute to intermediate and/or long-term goals. This article introduces a framework for building partnerships that lends itself to evaluation of partnership contributions toward accomplishment of outcomes, and checklist tools to help partnerships examine the process of partnership across phases of the framework.

Location of study: United States

Context: From 2003 to 2006, the Robert Wood Johnson Foundation funded the Diabetes Initiative to improve care and support for diabetes self-management. The Building Community Supports for Diabetes Care (BCS) component of the initiative demonstrated how clinic-community partnerships of various types can promote self-management more comprehensively and seamlessly than any partner could do alone. During the early stages of the project, eight BCS grantees from across the country met regularly with Diabetes Initiative National Program Office (NPO) staff to share information about their partnership projects. As the partnerships matured, partnerships were functioning well, and scores on the annual survey were consistently high. Yet, NPO staff and grantees recognized that changes in the projects and in the partnerships were not being captured on the annual assessment. They identified a need to understand the unique contributions clinic-community partnerships make to supporting self management and controlling diabetes.

The framework: An expanded workgroup comprising BCS grantees, expert consultants, and Diabetes Initiative staff attempted to translate the experience of the BCS clinic-community partnership projects into a framework of phases, beginning with the formation of a partnership and ending with the eventual long-term outcomes of effective partnerships at the various ecological levels. The resulting Framework for Building Clinic-Community Partnerships to Support Chronic Disease Control and Prevention reflects the BCS experience and understanding of the way partnerships influence change. The model describes essential partnership attributes that affect capacity within and between organizations, which, in turn, affects achievement of specified intermediate and long-term outcomes.

Partnership attributes checklist: The purpose of the Partnership Attributes checklist is to help partners plan and/or assess the partnership's function and infrastructure. The items are based on previous work in the field. Those related to function include leadership and management, collaboration, and synergy, whereas the items related to infrastructure include leadership and resources.

Organizational capacity checklist: The Organizational Capacity checklist draws from various tools and is divided into two sections. Your Organization's Capacity allows partners to assess how their individual organization's abilities have changed as a result of participating in the partnership. Capacity Between Partner Organizations asks respondents about the impact of the partnership on capacity across organizations.

Intermediate outcomes checklist: The purpose of this checklist is to assess what has happened at the individual, organizational, partnership, and community levels as a result of the partnership that will eventually lead to the achievement of the intended long-term outcomes. The Partnership Level deals with how the partnership itself has changed over time.

Taking Action-Making Improvement: As a complement to the checklists, Taking Action-Making Improvement is an additional tool that poses questions to the partnership that are intended to help them move from assessment to action in areas identified for improvement.

Conclusion: A fairly extensive and iterative development and piloting process produced a reasonably brief, user-friendly set of tools to enhance the ability of partnerships to achieve positive outcomes in chronic disease prevention and control. Partnering agencies working on diverse issues and different conditions are encouraged to use these tools for planning, self-assessment, and quality improvement of their partnership work. The framework and checklists are publicly available from the Web site of the Diabetes Initiative at http://diabetesinitiative.org/support/partnershipTools.html.

Additional references:
M Granner, P Sharpe. Evaluating community coalition characteristics and functioning: A summary of measurement tools. Health Educ Res 2004; 19:514-532. http://her.oxfordjournals.org/cgi/content/short/19/5/514

E Weiss, R Anderson, R Lasker. Making the most of collaboration: exploring the relationship between partnership synergy and partnership functioning. Health Educ Behav. 2002; 29:683-698. http://heb.sagepub.com/cgi/content/short/29/6/683