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PART SEVEN Former surgeon general Joycelyn Elders used to say that to the skeptic, a partnership was an unnatural act between nonconsenting adults. And indeed, many of us have seen partnerships (or more formal coalitions) fall apart when they have come together primarily because of a stipulation of funding and do not represent any genuine shared concern with working collaboratively to help bring about change. Even when the commitment is there, moreover, the challenges to coalitions are many. As public health leader Lawrence W. Green (2000) points out, for example, “Most organizations will resist giving up resources, credit, visibility and autonomy.” Further, “not everyone insists on being the coordinator, but nobody wishes to be the coordinatee” (64–65). Although the challenges to coalitions and related partnerships are indeed numerous, as this part makes clear, done well, and particularly when grounded in a strong theory base, coalitions and other partnerships can not only function effectively but also make a real impact in terms of community and policy change on both the short- and longer-term levels (Wallerstein et al. 2002; Wolff 2010). We begin in chapter 17 with Fran Butterfoss and Michele Kegler’s widely used coalition for community action theory (CCAT). Building on Feighery and Rogers (1990), they define coalitions as “formal, long-term collaborations that are composed of diverse organizations, factions, or constituencies who agree to work together to Building, Maintaining, and Evaluating Effective Coalitions and Community Organizing Efforts achieve a common goal.” They stress in particular the action orientation of community coalitions and the importance of a guiding theory that is not simply an academic exercise but rather aimed at improving how coalitions work in practice. After introducing the multiple theories that contributed to CCAT, Butterfoss and Kegler discuss the benefits and costs of coalitions and then lay out a set of constructs and “practice-proven propositions” for understanding coalition development, maintenance , and effective functioning. The various stages of coalitions, and the tasks associated with each, are described, with attention to such key issues as coalition context, leadership and staffing, and so forth. Finally, the authors come full circle to stress the need for careful documentation of both short-term successes and longer-term impacts, once again, toward the end of improving practice. Many of the propositions and challenges laid out in chapter 17 are illustrated within a real-world context in the chapter that follows. In chapter 18, Adam Becker and his colleagues present a case study of coalition building and community organizing to address the problem of childhood obesity in the largely Puerto Rican Humboldt Park area of Chicago. Often referred to as one of the most serious and difficult public health issues of our time, the childhood obesity epidemic (one in five children is now clinically obese) is particularly problematic in low-income communities of color, where a host of environmental and other factors conspire against healthy eating and physical activity (Ogden et al. 2010; Bell and Lee 2011). Yet such neighborhoods are also replete with strengths, including, in Humboldt Park, a determined community member who translated her personal need for exercise into the Muévete walking club, which then expanded to include other activities. Indeed, a strength of this coalition, which also posed challenges, was its conscious decision to have an organic, local approach to planning and (evolving) intervention development, rather than a more formal initial assessment process. Although chapter 18 does indeed illustrate a number of the propositions laid out in Butterfoss and Kegler’s CCAT, it challenges others, providing some of the additional “real world” testing that can in turn help guide further theory refinement. Finally, Becker and his colleagues beautifully illustrate the importance of a true ecological approach to addressing complex health and social problems. Through its Producemobile, the Muévete walking club, a farmers’ market, rooftop gardens at local schools, and such policies as allocating new park land for urban agriculture, the COALITIONS AND COMMUNITY ORGANIZING EFFORTS 306 Humboldt coalition’s many activities helped create sustainable change on multiple levels. Although not without difficulties—some coalition partners, for example, dropped out because of the primacy of the focus on the Puerto Rican community—this case study well illustrates the power of a strong, if informal, coalition. Indeed, substantial reductions in childhood obesity rates over the six years of the coalition’s work, at a time when obesity rates in boys were continuing to climb nationally (Ogden et al. 2010)—stand as an important testament to the effectiveness of the Humboldt...


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