This document, like the first edition of Principles of Community Engagement, provides nine guiding principles for organizations to apply when working with community partners. These principles give organizational leaders a framework for shaping their own culture, planning engagement, conducting outreach, and interacting with communities. However, principles by themselves do not offer an engagement model or process for their application. The principles are certainly compatible with existing community mobilization processes, such as those outlined by the National Association of County and City Health Officials in Mobilizing for Action through Partnership and Planning (2011), but compatibility per se is not enough. To date, there has been no clear guidance on how to organizationally or operationally support the use of these nine principles or the array of community mobilization models.
Community Coalition Action Theory
As noted in Chapter 1, Butterfoss et al. (2009) articulated CCAT on the basis of research on the collaborative engagements of coalitions. In laying out CCAT, they provided 21 practice-based propositions that address processes ranging from the formation of coalitions through institutionalization. Like the principles of community engagement, however, CCAT does not identify the structural capacity and management support required to facilitate and guide the processes it recommends.
Among the frameworks used in the synthesis offered in this chapter, CCAT occupies a unique and important role because it ties community engagement to theory. In fact, it is a particularly appropriate theoretical framework because the CCAT developers are specifically interested in what Butterfoss (2007) describes as “formal, multipurpose, and long-term alliances”, which are distinct from the activities of short-term coalitions that coalesce to address a single issue of concern and disband after it is resolved. Although CCAT is designed primarily to understand community coalitions, community engagement is not limited to coalition processes. Even so, CCAT and community engagement have a common focus on long-term relationships, and CCAT offers propositions that are clearly relevant for undertaking and sustaining collaborative processes for community engagement. Additionally, CCAT addresses the full range of processes from initiation of new collaborative activities to institutionalization of mature relationships. Finally, CCAT propositions supports the nine principles of community engagement.
The third framework described here is drawn from the organizational practice of constituency development; that is, the process of developing relationships with community members who benefit from or have influence over community public health actions. Constituency development involves four practice elements (Hatcher et al., 2008):
- Know the community, its constituents, and its capabilities.
- Establish positions and strategies that guide interactions with constituents.
- Build and sustain formal and informal networks to maintain relationships, communicate messages, and leverage resources.
- Mobilize communities and constituencies for decision making and social action.
This framework provides a parsimonious set of tasks that must be undertaken for community engagement. The question we seek to answer is how these tasks can be carried out in accordance with the principles of community engagement and CCAT. To specify the capacity required to support this effort, we use the categories of structural capacity delineated by Handler and colleagues (Handler et al., 2001), which include five kinds of resources: human, informational, organizational, physical, and fiscal. In Public Health: What It Is and How It Works, Turnock elaborates on these capacities as they apply to health systems (2009):
- Human resources include competencies such as leadership, management, community health, intervention design, and disciplinary sciences.
- Information resources span data and scientific knowledge, including demographic and socioeconomic data, data on health risks and health status, behavioral data, data on infrastructure and services, and knowledge-based information like that found in the intervention and disciplinary sciences that is used to guide health and community actions.
- Organizational resources include organizational units and missions; administrative, management, and service-delivery structures; coordinating structures; communication channels and networks; regulatory or policy guidance; and organizational and professional practices and processes.
- Physical resources are the work spaces and places, hardware, supplies, materials, and tools used to conduct business.
- Fiscal resources include the money used to perform within an enterprise area like health as well as the real and perceived economic values accumulated from the outputs of an enterprise. Fiscal resources are seldom discussed in literature regarding the health and community engagement enterprise within the public sector. The investment of money and time to engage communities in public sector processes, however, has many potential returns, including leveraging of the resources of partners, development of community services that may accrue income for reinvestment, synergistic actions that achieve the objectives of an enterprise, increases in social capital, and population health improvements that have economic value. As with all investments, those who commit to long-term and sustained community engagement most often accrue the greatest returns.