Key Factors for Successful Implementation of HIV Prevention Services by THRIVE Community Collaboratives

Objective The Targeted Highly Effective Interventions to Reverse the HIV Epidemic (THRIVE) demonstration project created collaboratives of health departments, community-based organizations, and clinical partners to improve HIV prevention services for men who have sex with men (MSM) and transgender women (TGW) of color. We administered an online survey from September 2018 through February 2019 to assess the collaboratives. Methods We used a Likert scale to measure agreement on collaborative characteristics. We used Fisher exact tests to compare success ratings by health department employment and funding status. We created a radar chart to compare the percentage agreement on key characteristics of the most and least successful collaboratives. We used a general inductive approach in the qualitative analysis of open-ended question responses. Results Of 262 survey recipients, 133 responded (51%); 49 (37%) respondents were from health departments. Most respondents (≥70%) agreed that their collaborative is diverse, cooperates, meets regularly, has realistic goals, has effective leadership, and has effective communication. Most respondents (87%) rated their collaborative as successful in implementing HIV prevention services for MSM and TGW of color. Comparison of the most and least successful collaborative found the greatest difference in respondent agreement in the presence of effective leadership, communication, and adequate resources. The most commonly cited challenge in the open-ended questions was inadequate resources. The most commonly cited success was increased provision of services, particularly preexposure prophylaxis. Conclusions Community collaboratives were considered successful by most collaborative members and may be an effective part of HIV prevention strategies.

Grassroots Community Collaboratives

Grassroots community initiatives can be vital to the education and stabilization of vulnerable populations experiencing problems, such as chronic disease and socioeconomic issues. A historical overview of the origins of some grassroots initiatives in the United States are explored. The potential effectiveness of grassroots initiatives used in the past and implemented in the current healthcare environment is examined for purposeful use in resolving health disparities. While, historically, there have been multiple interventions to resolve the problem of health disparities, the problem of socioeconomic and racial injustices still prevent change. Nonetheless, change is possible and can be accomplished.

The Use of Ripple Effect Mapping to Understand Successes of the SC Pregnancy Assistance Fund: A Participatory Evaluation Approach

Objectives The South Carolina Pregnancy Assistance Fund (SCPAF) funded four counties to increase the amount, quality, and awareness of services for young parents; increase educational attainment among expectant and parenting youth; reduce the number of repeat teen pregnancies among youth; and improve parenting skills. The purpose of this paper is twofold: (1) to describe our application of the Ripple Effect Mapping (REM) technique as an innovative evaluation strategy to gather perspectives from SCPAF stakeholders and (2) to share key findings generated by participants in REM sessions on the perceived success of local SCPAF community collaboratives. Methods REM, an innovative evaluation strategy, was used to gather perspectives from SCPAF stakeholders. Five REM sessions were conducted with 52 participants. REM sessions included partner interviews and collective development of visual maps to illustrate stakeholder perspectives of program successes. Visual maps, as well as transcripts of discussions, were analyzed using an inductive approach. Results Stakeholders reported that the connections to resources, supports, and services provided through SCPAF had the potential to alter the life trajectories of expectant and parenting teens (EPT). Stakeholders also described that SCPAF fostered growth in collaboration among partners and reduced duplication of services in funded communities Conclusions for Practice This paper describes how an innovative evaluation strategy was used to provide a space for stakeholders to dialogue, synthesize their experiences, and construct a collective narrative of key program successes. This paper also illustrates how such approaches can be applied to complex community initiatives.

Sustainability Through Accountability: The Accountable Community for Health Model

This chapter opens by posing the issue that public and private funders have long supported community collaboratives to address a wide range of health issues. Although these collaboratives accomplish important goals, they rarely continue beyond the funding stage or yield lasting systems change. The chapter describes the Accountable Community for Health Model as a model for sustaining community collaborations. The chapter identifies seven key elements for success. The Wellness Fund is a unique component, though many of the success factors and lessons learned are in alignment with other models.