Community Partnership Strategies: Let’s Work From the Same Playbook

Although collaborative, community-based partnerships serve as a fundamental launching pad for eliminating health disparities, individual partner values, roles, rules, and language are not automatically shared, understood, and accepted.¹ This essay argues that when academicians, researchers, community leaders, public health officers, and clinicians collaborate in community-based settings, contention is inevitable unless they are all using the same “playbook.” In sports, particularly football, playbooks serve as a blueprint plan for teams, the way textbooks serve as a blueprint, or guide, for academic teams.

Playbooks describe possible strategies, plays, and tactics to be used by a team to win the game.² The key components are up-to-date adaptability, situational analysis of scenarios, and goals and roles of players and coaches. Language that is understood, accepted, and used by all members of the team is another winning feature of the team’s playbook.

Entities that refer to themselves as community partnerships may use scrappy players and hidden agendas while making and changing rules as their standard operating procedures. Such partnerships may achieve short-term results yet fail to achieve long-term success in terms of community-level outcomes.² Partnerships that value trust, and allocate time and attention for mutual understanding and consensus, flexibility, and shared governance are better at the art and science of collaboration and community health promotion.³ By strategizing early for win–win results using consensus decision making, community partnerships can minimize team/partner reliance on late-game heroics like the Hail Mary Pass in football.

Working collaboratively and equitably with diverse communities takes time. The very process of eliminating health disparities involves tackling complex issues, being adaptable, and exhibiting courageous leadership. All successful partnerships require developing rapport and believing in the fundamentally good nature and capacity of community partners. This is not achieved when rushing partners to positions without everyone understanding their power, roles, and responsibilities, as well as using a common language.

As guest editors, we bring to this special issue of PCHP over 30 years of experience working in academic research centers, community-based organizations, and local, state, and national health agencies. Our collective experience has taught us a great deal about community-based participatory research (CBPR) partnerships. For example, there is language familiar to researchers that creates confusion and alienation when used with community and nonacademic partners such as “key informants, outcomes, investigators, data, conflicts of interest, cost–benefit ratio, community engagement, resources, work in progress, and leadership lines of authority.”⁴

Failure to establish a mutually understandable language among community leaders, academic researchers, program evaluators, and community health workers hinders the progress we can and must make. Terms like “informants” and “investigators” have strong negative connotations in communities and we are wise to avoid using these terms. While a Principal Investigator for a REACH program, I was asked the following question by well-respected faith leader, “What are you investigating and who are your informants?” This language in health science research textbooks is designed for academic researchers and can threaten the ultimate goal of building credible, long-term, healthy relationships among partners. “Community organizers” and “community health workers” are examples of terms that convey different meanings to different people. Persons who have a history as long distance runners for justice in their communities may not match the formal textbook definition, prescribed role, and scope of community health worker. How can we be on the same page if we are not using the same playbook to achieve big community health goals?

The REACH CBPR initiatives described in this issue offer important insight into what it takes to make real progress in community health partnerships. In the Work-in-Progress and Lessons Learned sections, we see several examples of REACH US initiatives that have developed complex models to share governance and implement strategies to eliminate health disparities.^5,6,7,8,9,10 Bravo!

A partnership’s success depends on the developmental stages of CBPR partnerships and their collective core values. Known and unknown rules directly influence the partnerships’ health outcomes. By creating a shared playbook to maximize understanding of the...