Community Voice in Strategic Planning for Health Equity Gail Brandt, MPH, EdD Washington State Department of Health Emily Turk, MPHc University of Washington University of Washington

PurposePurpose Develop a tool to assess department practices that advance or impede health equity work with partner organizations and agencies Understand how successfully the department engages with community partner organizations to advance health equity projects

“Does the Washington State Department of Health Office of Healthy Communities (OHC) meaningfully and respectfully engage with its community partners in developing and evaluating health equity programs?” Research question

Methods Literature reviews of assessment models Identified participant selection criteria Recruited participants Created interview questions Conducted 21 phone-interviews

BARHII recommendations for participant selection Community representation Provide critical services Pre-existing relationship Various types, locations, issues, and positions “Local Health Department Organizational Self-Assessment for Addressing Health Inequities: Toolkit and guide for implementation”

Interview questions Tell me how well the health department involves community organizations like yours in meeting its mission “…to work with others to protect and improve the health of all people in Washington”? What has been going well in collaborating with the state health department? What has not been going well in collaborating with the state health department? Based on your experience, what are some ways the department can streamline processes to help you?

Interview questions Based on your experiences, how well do you see internal DOH programs working with each other to serve you? How well do you feel state health department staff members stay aware of community issues? Is there anything else I should have asked you about your experience working with the state health department?

Phone interviews 21 conducted Participants sent project overview, consent statement, and interview questions Phone interviews were minutes Interviews were recorded, if consent given

Results 140 partners identified based on selection criteria 30 partners invited to participate 21 interviews completed 8 no response after 2 invitations, 1 no-show 60% non-profit organizations (including direct services, health clinics) 40% LHJs and government agencies (including tribes)

Results – common themes 1.Involve people of color at all levels and early 2.Concern that turnover undermines capacity to build strong, trust-based relationships with community partners that endure. 3.Delays in contract approvals and other procedures signals a lack of respect 4.Appreciate efforts to collaborate

Quotes from interviews “…let us know about grant opportunities. Invite people earlier on to the planning committee – include people of color from the beginning.” “Based upon relationships – some are great, then they’ll leave and we may not have a good relationship... we have to start-over building a relationship with someone else.” “There are layers that we have to go through for approvals – we are still expected to complete a project in time, though I got the contract 3 months late. We give everything they ask for at 5pm on a Wednesday, but I had to wait 3 months for a contract.” “A lot of efforts went into establishing networks with various organizations. There is a lot more engagement today... opportunities to provide feedback. and assessments of how things are going.”

Limitations Small sample size Strength of conclusions Interviews conducted via telephone versus in person

Recommendations Avoid tokenism – “participation without authority” Gate-keeping – control the flow of access to information and resources Turnover – mitigate the harmful effects of turnover on partners by insuring adequate transition Improve response time signaling to partners they are important The People’s Institute:

Next steps Internal review Community Partner review Identify actions Pilot interventions Evaluate

Outcomes Department to develop an Indian Tribal resource guide to help with internal staff transitions Discussions underway to address recommendations Partner focus group planned

Gail Brandt Emily Turk