Collaboration in Public Health Coalitions: The Roles of Coordinators, Ethics, and Relationships
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Public health coalitions (PHCs) are a common public health strategy used to address complex public health problems. Stakeholders who join coalitions hope to leverage the advantages of partnering with others (e.g., more resources, greater influence, efficiencies) to have greater impact. Very little research attention has been dedicated to the individuals that provide the “coordinating” services for PHCs, despite recognition that their services are indispensable for well-functioning coalitions. The exploratory research featured in this dissertation used interviews with PHC coordinators reflecting on their practice experiences (in the northeastern United States) to explore two areas. First, how coordinators help to recruit and engage their stakeholders – in particular, to share their individual or organizational assets, like resources, skills, knowledge, social networks, and power/influence (Chapter 2). Second, from coordinators’ perspectives, how is collaboration in a coalition created and sustained by the provision of “gains and outcomes” to stakeholders (Chapter 3). The fourth chapter used perspectives of PHC stakeholders in one county in upstate New York, to focus on the ethical aspects of coalition practice. It explores what ethical issues they feel are most relevant to PHCs and how they navigate ethical complexity, both individually and in groups. A central, cross-cutting theme throughout this research is the importance of relationships. Not only do relationships help facilitate “gains and outcomes” between stakeholders, but they are an end in themselves. A particularly desirable type of relationship for coalition stakeholders is a strong relationship -- those that are deep, respectful, and ensure various aspects of individual well-being. This type of relationship also appears to magnify the positive impacts of other gains and outcomes stakeholders derive from participating in PHCs. Finally, relationships are key to how PHC stakeholders prioritize and individually manage ethically complex decisions and are a key outcome that they feel that coalitions should prioritize when managing disputes between stakeholders. These findings suggest that both coordinators and coalitions should seek to foster strong, trusting relationships between stakeholders when possible. The findings also highlight the presence of major nuance gaps in the PHC and PH ethics literature that may be addressed by partnering with practitioners and PHCs.
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Besharov, Marya
Leak, Tashara