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Community Partnering for Behavioral Health Equity: Public Agency and Community Leaders' Views of its Promise and Challenge.
Ethn Dis. 2018; 28(Suppl 2):397-406.ED

Abstract

Objective

To understand potential for multi-sector partnerships among community-based organizations and publicly funded health systems to implement health improvement strategies that advance health equity.

Design

Key stakeholder interviewing during HNI planning and early implementation to elicit perceptions of multi-sector partnerships and innovations required for partnerships to achieve system transformation and health equity.

Setting

In 2014, the Los Angeles County (LAC) Board of Supervisors approved the Health Neighborhood Initiative (HNI) that aims to: 1) improve coordination of health services for behavioral health clients across safety-net providers within neighborhoods; and 2) address social determinants of health through community-driven, public agency sponsored partnerships with community-based organizations.

Participants

Twenty-five semi-structured interviews with 49 leaders from LAC health systems, community-based organizations; and payers.

Results

Leaders perceived partnerships within and beyond health systems as transformative in their potential to: improve access, value, and efficiency; align priorities of safety-net systems and communities; and harness the power of communities to impact health. Leaders identified trust as critical to success in partnerships but named lack of time for relationship-building, limitations in service capacity, and questions about sustainability as barriers to trust-building. Leaders described the need for procedural innovations within health systems that would support equitable partnerships including innovations that would increase transparency and normalize information exchange, share agenda-setting and decision-making power with partners, and institutionalize partnering through training and accountability.

Conclusions

Leaders described improving procedural justice in public agencies' relationships with communities as key to effective partnering for health equity.

Links

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Authors+Show Affiliations

Bromley E
Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; Desert Pacific MIRECC Health Services Unit, VA Greater Los Angeles Healthcare System, Los Angeles, CA.
Figueroa C
Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA.
Castillo EG
University of California, Los Angeles, David Geffen School of Medicine, Los Angeles County Department of Mental Health, Los Angeles, CA.
Kadkhoda F
Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA.
Chung B
Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; RAND Corporation; Los Angeles Biomedical Research Institute; Healthy African American Families II, Los Angeles, CA.
Miranda J
Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA.
Menon K
Los Angeles County Department of Mental Health, Los Angeles, CA.
Whittington Y
Los Angeles County Department of Mental Health, Los Angeles, CA.
Jones F
Healthy African American Families II, Los Angeles, CA.
Wells KB
Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; RAND Corporation; University of California, Los Angeles School of Public Health, Los Angeles, CA.
Kataoka SH
Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; UCLA Division of Child and Adolescent Psychiatry, Los Angeles, CA.

MeSH

Health EquityHumansIntersectoral CollaborationMental HealthQuality ImprovementResidence CharacteristicsSocial Determinants of HealthSocial JusticeUnited States

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30202193

Citation

Bromley, Elizabeth, et al. "Community Partnering for Behavioral Health Equity: Public Agency and Community Leaders' Views of Its Promise and Challenge." Ethnicity & Disease, vol. 28, no. Suppl 2, 2018, pp. 397-406.
Bromley E, Figueroa C, Castillo EG, et al. Community Partnering for Behavioral Health Equity: Public Agency and Community Leaders' Views of its Promise and Challenge. Ethn Dis. 2018;28(Suppl 2):397-406.
Bromley, E., Figueroa, C., Castillo, E. G., Kadkhoda, F., Chung, B., Miranda, J., Menon, K., Whittington, Y., Jones, F., Wells, K. B., & Kataoka, S. H. (2018). Community Partnering for Behavioral Health Equity: Public Agency and Community Leaders' Views of its Promise and Challenge. Ethnicity & Disease, 28(Suppl 2), 397-406. https://doi.org/10.18865/ed.28.S2.397
Bromley E, et al. Community Partnering for Behavioral Health Equity: Public Agency and Community Leaders' Views of Its Promise and Challenge. Ethn Dis. 2018;28(Suppl 2):397-406. PubMed PMID: 30202193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Community Partnering for Behavioral Health Equity: Public Agency and Community Leaders' Views of its Promise and Challenge. AU - Bromley,Elizabeth, AU - Figueroa,Chantal, AU - Castillo,Enrico G, AU - Kadkhoda,Farbod, AU - Chung,Bowen, AU - Miranda,Jeanne, AU - Menon,Kumar, AU - Whittington,Yolanda, AU - Jones,Felica, AU - Wells,Kenneth B, AU - Kataoka,Sheryl H, Y1 - 2018/09/06/ PY - 2018/9/12/entrez PY - 2018/9/12/pubmed PY - 2019/10/12/medline KW - Behavioral Health KW - Care Coordination KW - Community Partnering KW - Health Equity KW - Procedural Justice SP - 397 EP - 406 JF - Ethnicity & disease JO - Ethn Dis VL - 28 IS - Suppl 2 N2 - Objective: To understand potential for multi-sector partnerships among community-based organizations and publicly funded health systems to implement health improvement strategies that advance health equity. Design: Key stakeholder interviewing during HNI planning and early implementation to elicit perceptions of multi-sector partnerships and innovations required for partnerships to achieve system transformation and health equity. Setting: In 2014, the Los Angeles County (LAC) Board of Supervisors approved the Health Neighborhood Initiative (HNI) that aims to: 1) improve coordination of health services for behavioral health clients across safety-net providers within neighborhoods; and 2) address social determinants of health through community-driven, public agency sponsored partnerships with community-based organizations. Participants: Twenty-five semi-structured interviews with 49 leaders from LAC health systems, community-based organizations; and payers. Results: Leaders perceived partnerships within and beyond health systems as transformative in their potential to: improve access, value, and efficiency; align priorities of safety-net systems and communities; and harness the power of communities to impact health. Leaders identified trust as critical to success in partnerships but named lack of time for relationship-building, limitations in service capacity, and questions about sustainability as barriers to trust-building. Leaders described the need for procedural innovations within health systems that would support equitable partnerships including innovations that would increase transparency and normalize information exchange, share agenda-setting and decision-making power with partners, and institutionalize partnering through training and accountability. Conclusions: Leaders described improving procedural justice in public agencies' relationships with communities as key to effective partnering for health equity. SN - 1049-510X UR - https://www.unboundmedicine.com/medline/citation/30202193/Community_Partnering_for_Behavioral_Health_Equity:_Public_Agency_and_Community_Leaders'_Views_of_its_Promise_and_Challenge_ DB - PRIME DP - Unbound Medicine ER -