Using Collective Impact to Advance Birth Equity: A Comparison of Two Cross-Sector Efforts in California

Martha J Decker; Melisa Price; Salish Harrison; Solaire Spellen; Nicole Hutchings; Erica Martinez; Shira P Rutman; Amber Shaver; Linda S Franck; Claire D Brindis; Jonathan Fuchs

doi:10.1007/s10995-022-03528-w

Using Collective Impact to Advance Birth Equity: A Comparison of Two Cross-Sector Efforts in California

Matern Child Health J. 2022 Dec;26(12):2517-2525. doi: 10.1007/s10995-022-03528-w. Epub 2022 Nov 8.

Authors

Martha J Decker^{1

2}, Melisa Price³, Salish Harrison⁴, Solaire Spellen⁵, Nicole Hutchings⁶, Erica Martinez⁷, Shira P Rutman⁴, Amber Shaver⁷, Linda S Franck⁸, Claire D Brindis^{4

9}, Jonathan Fuchs^{5

10}

Affiliations

¹ Philip R. Lee Institute for Health Policy Studies, the University of California, San Francisco, USA. mara.decker@ucsf.edu.
² Department of Epidemiology and Biostatistics, the University of California, San Francisco, USA. mara.decker@ucsf.edu.
³ Cinical and Translational Science Center, the University of California, Davis, USA.
⁴ Philip R. Lee Institute for Health Policy Studies, the University of California, San Francisco, USA.
⁵ California Preterm Birth Initiative, the University of California, San Francisco, USA.
⁶ Fresno Economic Opportunities Commission, Fresno, USA.
⁷ California State University, Fresno, USA.
⁸ School of Nursing, the University of California, San Francisco, USA.
⁹ Adolescent and Young Adult Health National Resource Center, the University of California, San Francisco, USA.
¹⁰ San Francisco Department of Public Health, San Francisco, USA.

PMID: 36348213
DOI: 10.1007/s10995-022-03528-w

Abstract

Background: Preterm birth, defined as birth at gestational age before 37 weeks, is a major public health concern with marked racial disparities driven by underlying structural and social determinants of health. To achieve population-level reductions in preterm birth and to reduce racial inequities, the University of California, San Francisco's California Preterm Birth Initiative catalyzed two cross-sector coalitions in San Francisco and Fresno using the Collective Impact (CI) approach.

Purpose: The purpose of this study is to compare two preterm birth-focused CI efforts and identify common themes and lessons learned.

Methods: Researchers conducted in-depth interviews (n = 19) and three focus groups (n = 20) with stakeholders to assess factors related to collaboration. Transcripts were coded and analyzed using modified grounded theory. Findings were compared by year of data collection (first and second cycle in each location) and geographic location (Fresno and San Francisco) and discussed with CI participants for input.

Results: Although both communities adopted the core tenets of CI to address preterm birth and racial inequities, each employed distinct organizational structures, strategic frameworks, and interventions. Common themes emerged around the importance of authentic community engagement, transparency in the process of prioritization and decision-making, addressing racism as a root cause of disparities in birth outcomes, and candid communication among partners.

Conclusion: Future CI efforts, particularly those catalyzed by academic institutions, should ensure community members are active partners in program development and decision-making. CI efforts focused on combatting racial health inequities should center racism as a root cause and build capacity among coalition partners.

Keywords: California; Collective Impact; Community participation; Health status disparities; Intersectoral collaboration; Premature birth; Racism.

MeSH terms

Female
Focus Groups
Humans
Infant
Infant, Newborn
Premature Birth*
Racial Groups
Racism*
San Francisco

Grants and funding

Marc and Lynne Benioff Foundation/Marc and Lynne Benioff Foundation