OVERVIEW

Introduction

This section presents the results of the questionnaire completed by members of the Heart Health Regional Coalition in the summer of 1998. The purpose of this questionnaire was to give members of the Regional Coalition an opportunity to reflect on their experiences working on the Heart Health Regional Coalition and to think about how the work of the partnership has had an impact on either them personally or the organization which they represent. Specifically, members were asked to reflect on issues related to member involvement, communication, values, meeting logistics, participation, decision making, meeting environment, personal satisfaction, leadership, staffing, and organizational involvement and change.

Development and Distribution of the Questionnaire

The questionnaire was developed by staff of Heart Health Nova Scotia based on indicators from the literature on coalitions as well as input from the Regional Coalition. Input from the Regional Coalition was obtained by asking members of the Coalition, "If our Coalition was successful, what would it look like?" Responses from this question were grouped into like themes by the Research Working Group and indicators were then developed. The main dimensions of coalition functioning include: member involvement, communication, values, meeting logistics, participation, decision making, meeting environment, personal satisfaction, leadership, and staffing. Issues related to organizational involvement and change were also included on the questionnaire. Questions were then developed by staff from Heart Health Nova Scotia by adapting questions from surveys previously used by other groups to assess coalition functioning. In addition, issues which arose during the story sharing exercise with the Coalition were incorporated into the questionnaire. The Research Working Group reviewed the questionnaire and adaptations were made based on their input.

Questionnaires were sent to all members of the Coalition. Eighteen questionnaires were sent out and 17 returned for a response rate of 94%. Members either returned their questionnaire by mail or dropped them off in a box provided at Coalition meetings.

Data Analysis

The questionnaire results were entered into a database using EpiInfo, a data entry and analysis package for calculating frequencies and other meaningful statistics. Frequency tables and charts were used to summarize the results that could be quantified, and written descriptions were used to summarize responses to open-ended questions.

RESULTS

Involvement

Members were asked about their involvement in the Coalition. The average number of months members were involved with the Coalition was 15 with a range of 4-20 months. It was found that 11 (74%) out of 15 members attended 81-100% of Regional Coalition meetings and 11 (79%) of 14 members attended 81-100% of Working Group meetings. On average, seven members (47%) spent 13-18 hours each month working on activities related to accomplishing the goals and objectives of the Heart Health Partnership Project.

Coalition Functioning

Communication

Members were asked to rate how satisfied they were with the Coalition's communication on a five point scale with one being very dissatisfied and five being very satisfied. The majority of members were satisfied with the Coalition's communication, with only one member clearly indicating dissatisfaction with communication among members. Members were also satisfied with information provided on issues and available resources, although more members circled 3 when asked about information provided to members on available resources, indicating neutrality (Table 1).

Table 1.

Members were then asked to rate communication among and between individuals in more detail based on the following criteria: how good it is; how informative it is; frequency; awkwardness; and effectiveness. The majority of members felt communication among members was informative and effective and only one respondent indicated that communication was awkward. The majority of members felt communication between Heart Health staff and Coalition members was frequent and informative with only one member feeling it was awkward and ineffective.

Coalition members were asked to comment on how they thought communication could be improved among members. One individual stated that a key concern is that communication is on an “individual basis, and it would be nice to see or hear more interaction between organizations”. This person suggested that information about “any partnering that is taking place between organizations should be presented at Coalition meetings.” Another member echoed this concern and suggested that a directory of organizational resources (people and materials) would be useful. One member mentioned the use of more small group work and “checking language/jargon use” as a means of improving communication at meetings. Another member indicated that communication tended to be one way at meetings and suggested that more time be dedicated for discussion during meetings. Another member voiced that the Coalition seems to engage in a lot of “paperwork” versus action. Similar ideas were presented for improving communication between Heart Health staff and Coalition members. Electronic means such as a chat group on the Internet, e-mail, and a website were suggested as methods of improving communication between meetings.

Mission and Values

The members were asked to reflect on the vision, mission, and values of the Regional Coalition. Table 2 illustrates that the majority of members agreed with the mission, felt the values were respected, and felt the vision and mission were clearly stated. The majority agreed with the process used to establish both the values and the mission. However, one member indicated that he/she was dissatisfied with the process used to establish the mission, whereas no one indicated dissatisfaction with the process used to establish the values.

A couple of members felt that the process used to establish the mission/values was long, but one person indicated it was time well spent. Another member stated that he/she felt the process of establishing the mission and values took twelve months which he/she felt was too long, especially for action-oriented members. This individual suggested a two day session may have been more appropriate. One person felt that the mission and values were pre-determined by the key partners, especially in the case of the mission where the development was more of a “wordsmithing exercise” for Coalition members. Two members also suggested that the values and mission should be reviewed for new members, volunteers, and regular members since a year has passed since they were discussed. Only one member indicated that he/she did not completely agree with the mission. This individual stated that the mission reflects the work of the Coalition at the community level and not at the organizational level. Therefore, this individual felt that a more accurate mission would be:

To establish if organizations, which develop skills and attitudes of community mobilization, have access to sound heart health resources and collaborate with other organizations with similar goals, are effective in supporting the communities they serve to develop strategies which will improve their heart health.

Meeting Logistics

As outlined in Table 3, members were asked to comment on various issues related to meeting logistics. The majority of members were generally positive (circling either 4 or 5) in ranking the Coalition when it came to meeting logistics. Members were more neutral or negative when responding to the statements: meetings start and stop on time, routine matters are handled quickly and members have a good record of attendance.

Participation and Decision Making

Members were then asked to comment on the participation of others in discussions and decision making (Table 3). About half of the members (n=8) responded positively when asked if everyone (not just a few) participate in discussions while nine members were positive when asked if everyone (not just a few) participate in decision making. It is noteworthy that two respondents were more negative (i.e., circled 2) in response to these statements. Thirteen members indicated they agreed (circled 4 or 5) that interest is generally high. However, respondents were more negative or neutral when asked if members seem well-informed, up-to-date, and understand what is going on at all times. Almost all of the respondents (n=14) agreed (circled 4 or 5) that working group updates and/or other reports are routinely made at meetings. Of note, four individuals disagreed (circled 2) that adequate time is allowed for discussion of important issues with only one member strongly agreeing.

Meeting Environment

The remaining issues largely related to the meeting environment (Table 3). Thirteen members believed that meetings have free discussions and all fifteen respondents answered positively (circled 4 or 5) that the atmosphere is friendly, cooperative, and pleasant. One member did, however, disagree that there is no fighting for status or hidden agendas. At the same time, eight people strongly agreed with this statement. The majority of members responded positively (n=13) that conflicts are handled in an appropriate manner with no respondents indicating a negative response. Four respondents disagreed that technical terms are clearly defined and understood by all and four were neutral (circled 3). When asked if new members feel supported, two members responded negatively (circled 2), six agreed (circled 4 or 5), and seven were neutral (ranked 3).

Table 3

Diversity of Membership

Eleven members did agree that diversity among membership is respected with only four individuals remaining neutral (Table 3). Coalition members were asked which groups or segments they felt could be better represented on the Coalition and/or Working Groups. The following groups were mentioned:

Table 4 shows that all respondents felt that the Coalition/Working Groups had clearly written goals and objectives and provided a supportive environment for members. The majority (93%) felt that the Coalition engages in planning for the future and most (83%) felt that orientation was provided for new members. Eleven members (75%) felt that the Coalition reviews its mission, goal, and objectives periodically, however, four (27%) did not agree with this statement. Only seven members (54%) felt that the Coalition had clear procedures for leader selection.
Table 4

Personal Satisfaction

The members were asked to rate their satisfaction with being a Coalition and/or Working Group member on a five point scale (see Table 5). Overall, the majority of members appeared to be satisfied with their participation on the Coalition. When asked about issues related to their own contribution (e.g., abilities are used effectively, their time is well spent, work accomplished by the project has met their goals, and satisfaction with accomplishments of the project) most members responded positively. Only one member disagreed that their time was well spent and five members (33%) were neutral when asked if they were satisfied with the accomplishments of the project (Table 5) .

Coalition members were then asked about issues related to commitment and decision making. It is noteworthy that no one strongly agreed that they were committed to the project and, in fact, seven (47%) were neutral. However, all members responded quite positively when asked if they cared about the future of the project (nine strongly agreed). When asked if they understood the project plan, 11 (73%) agreed (circled 4 or 5) and four were neutral (Table 5). The final questions asked about issues related to the Coalition environment (e.g., enjoying meetings, feeling appreciated, confident to express opinions, valued by other members). It appears that the majority of members agree that the Coalition provides a comfortable and safe environment in which to express their ideas and opinions (Table 5).

Members were also asked to reflect on what they gained personally as a result of being a member of the Coalition. Individuals indicated that their greatest personal gain was in the area of knowledge and skills development and most specifically in the following areas: health promotion, community mobilization, leadership, public speaking, and research. Over half of the members stated that they gained a chance to network and make new contacts, share information, and develop friendships. One individual indicated that she/he now has a clearer understanding of the issues, geography and communities within the Western Region as a result of involvement on the Coalition. A couple of members gained confidence in knowing that they had much to share with others. A couple of individuals indicated they appreciated having access to a supportive network and resources such as workshops, conferences, and recipes. One member stated that their participation on the Coalition gave them the “opportunity to focus on prevention rather than treatment,” while another said that the Coalition has provided them with “more opportunities to spread heart health messages.”

Only a few members suggested changes to improve their input. One individual stated that more time was needed during meetings to complete tasks while another felt that having regularly scheduled meetings would make scheduling easier for other work commitments. Finally, a couple of people appreciated being involved in planning and facilitating meetings as well as receiving minutes and background material prior to meetings.
Table 5

Coalition Leadership

The members were asked to indicate their level of agreement with a series of statements about the leadership of the Coalition (Table 6). Fourteen members (93%) responded positively (i.e., circled 4 or 5) when asked if the Coalition had strong competent leadership with eight strongly agreeing. Six members (40%) strongly agreed that there are opportunities for Coalition members to take leadership roles with another eight (53%) circling 4 as their response to this question. One member disagreed (i.e., circled 2) that members are willing to take on leadership roles with only two members strongly agreeing with this statement. The majority (thirteen members circled 4 or 5 with two circling 3) felt that Coalition members trusted one another.

Table 6

Staffing

Members were asked a series of questions about staff support. All respondents rated support from Heart Health staff as either a 4 or 5 on a scale where 3 was moderate and 5 was excellent. When asked the nature of this support, respondents listed the following: transportation, information sharing, positive feedback, guidance, advice on planning, organizational issues, and projects and resources (articles, overheads, contacts). Very few respondents provided suggestions as to how support from Heart Health staff could be improved. One member did suggest that the Regional Coalition Coordinator’s role be reviewed to determine priorities among the Community Action Groups, the Working Groups, and the Regional Coalition.

Organizational Issues

Organizational Involvement

Members were asked about their organization’s involvement in the Regional Coalition and any benefits/barriers to participation. Responses were rated on a five point Likert scale as shown in Table 7. The majority of members (n=12) responded positively when asked about their organization’s interest in both heart health and health promotion issues. The majority (n=12) also responded positively when asked if their organization supported the work of the Coalition and saw the benefits of involvement. However, fewer responded positively when asked about their organization’s awareness (n=8) and endorsement (n=7) of the mission and goals of the Coalition. There were more neutral responses (i.e., a 3 on the scale) and one negative response to the awareness and endorsement question. Fewer (n=9) also responded positively to a question about whether their organization acknowledged their involvement in the Coalition and, in fact, two responses were 1 (i.e., not at all). When asked whether their organization saw the Coalition as a resource for heart health or health promotion issues only about half (seven and eight respectively) of the responses were positive. In fact, three people (20%) did not think their organization saw the Coalition as a resource for heart health issues.
Table 7

Members were asked to what extent their organizations contributed to the activities of the Coalition/Working Group (Table 8). Again, respondents rated their responses on a five point Likert scale. The majority of members (13) responded positively when asked to what extent their organization contributed their time to the Coalition. In fact, this was the greatest contribution made by organizations to the Coalition. In-kind resources appears to be the next major contribution with eight members (54%) responding positively. Most members responded either in a neutral manner (n=5) or negatively (n=6) when asked whether their organization contributed other staff time to the Coalition. Just under half (n=7) indicated their organization had not contributed money to support joint activities. It appears that several members lack management support as six responded negatively and five were neutral. Just under half (n=6) were positive when asked about Board support while one person was neutral and four were negative. One member responded to the other category and stated now that the project is moving to a more action-oriented phase, it would be beneficial to attempt to engage other organizational representatives.

The members were asked to reflect on any factors within their organization which prevented them from working on the Coalition/Working Group activities. Some members stated they had competing priorities and work responsibilities which prevented them from working on the Coalition. One member found her/his work with the Coalition was not given high priority by her/his organization. Another member said there were staff shortages while another indicated it was difficult to travel across such a large region. One member indicated she/he lacked Board support and another individual stated that her/his organization may not value partnering.

Coalition members were asked whether the issues of time and public recognition were difficulties for their organizations. Forty percent of members (n=6) felt that time spent on the Coalition did not keep them from doing their work, whereas six (40%) felt it did, two were neutral and one did not know. Fifty-seven percent (n=8) felt their organization received enough public recognition for their work on the Coalition/Working Group, three (21%) were neutral, and one felt they didn’t.

Coalition members were asked to compare the benefits versus the challenges of being a member of the Coalition. Seventy-three percent (n=11) found there were more benefits than difficulties in belonging to the Coalition (n=11) and 14% (n=2) found there were a few more difficulties than benefits. Two members felt there were the same amount of benefits and difficulties.

Capacity Building

Members were asked about what both they and their organizations had gained from participating on the Coalition (see Table 9). Respondents ranked several statements on a five point scale with 1 being not at all and 5 being quite a lot. It appears that the greatest individual gain has been in building their own knowledge and skills in both heart health promotion and health promotion. The majority of members responded positively when asked about building their own knowledge and skills. However, more respondents (n=6) were neutral when asked about building their organization’s capacity. The next major benefit appears to be in learning about and sharing with other organizations, and learning how organizations work together. Most members (n=12) were positive when asked if the work they complete for the Coalition helps them to do their work with no individuals responding negatively. Just over half were positive when asked if their participation on the Coalition helped their organization move towards their goals.

Networking and Collaboration

Respondents were asked about issues related to networking and collaboration. Although there appears to be learning and sharing of resources between members, more members were neutral when asked about getting to know other agencies, developing collaborative relationships with others, and learning about opportunities and events. One comment made at the end of the questionnaire illustrates this finding that although there is sharing between members, collaboration between organizations is not as evident. This individual stated: “We need to develop more opportunities between organizations, not just sharing among individuals at Coalition meetings. What are member organizations doing to improve our capacity for heart health and what are other members doing to help that organization?”

It appears that the areas of least benefit to the member organization are related to profile in the region, getting help from other organizations, obtaining organization funding, and having access to “target” populations.

Table 9

Organizational Changes

Members were asked to describe any changes within their organizations as a result of being involved with the Coalition. Some members indicated more incorporation of heart health/health promotion messages/activities within their organizations and staff:

• organization endorsed physical inactivity as a priority for action;
• more focus on heart health in health promotion projects, displays, information, handouts;
• more attention to nutritional standards in meetings/workshops;
• changes can be seen in attitudes about health promotion. Some staff members have a better understanding about the processes needed to create effective health promotion;
• staff have taken the opportunity to work in an area other than their normal focus;
• the members have become (more) aware of the Heart Health project, personal interest where they live/work (their own communities).

• a feeling that we should be doing more health promotion;
• has provided a great springboard from which we can analyze how we work within health reform, how we incorporate health promotion principles into everything we do--it has people talking!;
• clarification of needs/supports/issues within own network of members, re: organization capacity; starting to work on these.

• more awareness of other community work;
• individuals, through the Community Action Groups, have the opportunity to network and work with communities as well as access education opportunities.

DISCUSSION

The results of the questionnaire provided members of the Coalition with valuable information about the level of involvement of member organizations and how members feel the Coalition is functioning. Members also discussed changes that had occurred within their organization as a result of their involvement in the Coalition.

Involvement

Members were asked questions about how long they have been involved in the Coalition, percent of meetings attended and time contributed to the work of the Coalition. The responses indicate a good record of attendance at meetings and illustrate the tremendous number of hours that members spend working on activities related to accomplishing the goals and objectives of the Project.

Coalition Functioning

In reflecting on communication issues, it appears that, overall, members were satisfied with the Coalition’s communication. Responses indicate that more time is needed for discussion particularly around important issues, and technical terms and jargon need to be defined and explained. Some members offered suggestions for improving communication at meetings such as using small group work. A couple of respondents indicated the need to improve communication within member organizations and between organizations.

Most members agreed with the vision, mission and values of the Coalition and a few respondents indicated that they did not agree with the process of establishing the vision, mission and values. These individuals indicated the process was long and one felt that these were pre-determined by the key partners. A couple of people felt that the mission and values should be revisited.

Questions about meeting logistics were answered positively by most respondents. Meeting logistics refers to issues such as: meetings start and stop on time, the purpose of each task or agenda item is defined and kept in mind, routine matters are handled quickly, materials for meetings are prepared adequately and in advance of meetings, minutes accurately reflect the proceedings of the meeting, notification of meetings is timely, and members have a good record of attendance at meetings.

In reflecting on participation, only half of the members were positive that everyone participates in discussions and decision making, indicating that more members could be making contributions in these areas. In addition, although respondents felt that interest was generally high, responses indicate that not all feel that members are informed and understand what is going on all the time. Given the complex nature of this project, this is perhaps not a surprising finding. If a member happens to miss a meeting or two it may be difficult to stay engaged in all aspects of the project.

It was encouraging to note that the majority feel that the meeting environment is supportive and safe, and members feel comfortable expressing their ideas and opinions. However, responses indicate that more effort needs to be made to ensure new members feel supported.

While most felt that diversity among membership is respected, several suggestions were offered about who could be better represented on the Coalition including: Acadians/French population, seniors, youth, community representatives, Community Health Boards, Regional Health Boards, Municipal Recreation Directors and people with heart disease.

In examining issues related to personal satisfaction it is encouraging that most members appear satisfied with their participation, however, few indicated a strong commitment to the project. This finding is surprising as most indicated that they cared about the future of the project and had gained personally from their participation. Most members indicated they had gained knowledge and skills in a number of areas such as health promotion, community mobilization, public speaking and research. The opportunity to network was also mentioned as a personal gain by over half of the members.

Coalition members were questioned about issues related to leadership and staffing. In general, respondents were positive about both issues. Members did feel that the process for leader selection needed to be clarified.

Organizational Issues

After reflecting on issues related to coalition functioning, members were asked about issues related to organizational involvement. These questions asked about issues such as: the organization’s interest in heart health/health promotion, awareness of the mission, endorsement of the mission, acknowledgment of members’ involvement on the Coalition; and management and/or Board support. Although it appears that organizations are interested in health promotion/heart health, and see the benefits of involvement, responses indicate that the Coalition needs to strengthen organizational commitment to the project. However, it is important to understand that the Coalition has been together for only 18 months and a great deal of that time has been spent on developmental work such as establishing the vision, values and mission. It takes time to foster trust and support among individuals and organizations. In addition, there is variability in level of involvement in heart health/health promotion among Partnership organizations. Some organizations have a specific mandate for heart health/health promotion while others wish to incorporate more heart health/health promotion activities into their goals. Based on this diversity, it is not surprising that there are varying degrees of commitment to the project.

While it appears that most members of the Coalition have built their own capacity in health promotion/heart health, few organizations appear to have enhanced their capacity. However, capacity building opportunities are just beginning to be offered. Therefore, given that the Coalition has been together for only 18 months, and that knowledge and skills opportunities have just begun to be offered, it is not surprising that organizational capacity building has not occurred to a great degree. Over the next two years, organizational capacity building will be a major focus of the Knowledge and Skills Working Group. Another area for improvement appears to be collaboration between organizations. Most respondents indicated that the Coalition had provided valuable networking and sharing opportunities but felt that collaboration between organization could be strengthened.

Most Coalition members felt there were more benefits than difficulties in being involved in the Coalition. It appears that the areas of least benefit to the member organizations are related to profile in the region, getting help from other organizations, obtaining organization funding, and having access to “target” populations.

The final portion of the questionnaire asked members to describe changes that have occurred within their organization as a result of being involved with the Coalition. As previously discussed, since the Coalition has been together for only 18 months, it may be too early to expect organizational changes. Therefore it was encouraging that several members discussed changes that they had observed in their organization such as more incorporation of heart health/health promotion messages/activities, increased reflection about health promotion and partnering, increased awareness about opportunities for networking and education, and improved communication and cooperation amongst staff.

Summary

The results of the questionnaire indicate that the Coalition is functioning well and most feel that the Coalition provides a safe and comfortable environment for members. Respondents offered several suggestions to further strengthen how the Coalition operates. For example, suggestions for improving communication and decision making were offered which will help the Coalition as it moves into action oriented activities. It appears that most Coalition members have gained knowledge and skills and networking opportunities as a result of their involvement in the Coalition. However, capacity building has occurred to a lesser extent within organizations and some Coalition members appear to need greater support for their work on the Coalition from within their organization. Over the next two and a half years the Coalition can work to strengthen member organization capacity for heart health promotion. Reports on organizational capacity currently being completed by the Research Working Group will be the basis for the development of this capacity. This information will be used by both the Knowledge and Skills Working Group and the organizations on the Regional Coalition as they work together to build commitment and capacity for heart health promotion within the Western Health Region of Nova Scotia.

SECTION 4--RECOMMENDATIONS

The following recommendations have been developed by members of the Regional Coalition based on the findings of the story sharing exercise and the questionnaire. After reviewing the findings, Regional Coalition members participated in an exercise to identify the major issues which emerged from the two reports, discuss gaps, and develop strategies to address the gaps. The information generated became the “Recommendations” which are summarized below. The Regional Coalition then prioritized the issues and will begin addressing the top issues immediately and continue to address all of the issues over the next two and a half years.

COALITION FUNCTIONING ISSUES

Communication

• ensure information sharing happens at every meeting and share any information on partnering that is taking place between Coalition member organizations
• ensure individuals who present use language and terms that will be understood by all
• coalition members have the responsibility to ask for clarification if they do not understand terminology
• provide ongoing check-ins with individuals, especially new members
• do small group work at every meeting

• review values and mission regularly

• review the role of each group in decision making (revisit the structure - Regional Coalition, Key Partners, Working Groups, Heart Health staff, Ad Hoc Committees -- how do all these relate?)
• update Working Group plans as required
• provide a balance between action and process
• provide more time for reflection on important decisions (the Regional Coalition must consider the pros/cons of decisions and more information is needed about issues that require decision making)
• ensure all voices are heard in decision making (to make a more comfortable environment for decision making and to ensure everyone has a word in decision making the Coalition could use red, green, and yellow flags instead of going around the table for consensus)
• discuss whose role it is to spend funds and who makes these budget decisions

• continue to create and maintain a safe environment so people feel comfortable speaking freely
• continue to do team building activities
• continue to do ice breaker activities
• continue to have fun

• discuss the procedure for adding new members and how to support new members
• provide a buddy system for new members
• discuss how people define diversity and what this means to members of the Coalition

• discuss process for selection of the Chair

Organizational Involvement

• identify key groups/individuals within each organization and have several Coalition members present to them
• recognize that engaging organizations is an education process and the Coalition is at the beginning of this process
• use the video and give presentations to encourage greater buy-in
• involve other staff members from organizations in project activities and show them the link to help them accomplish their work
• identify each organization’s challenges to being involved and use the resources of Coalition members to brainstorm how to resolve these challenges (and how some have already resolved them)
• have Coalition members share with other members their progress/ accomplishments regarding broadening the support in their organization and how they are presenting information to their organization
• include the Heart Health Project as a topic at staff/organizational meetings
• show organization staff/volunteers what they can do on a personal level
• conduct brainstorming exercises with organization staff/volunteers about how they can be more involved in the Project
• develop a plan for each organization so they see the benefits of the Heart Health Coalition (eg. learning/development plans)
• include other volunteers/staff in Coalition meetings -- e.g., they could come and present on a special topic
• discuss the challenges/barriers to keeping organizations informed, engaged, and committed

• collect information on the resources of each organization (Knowledge and Skills and the Research Working Group are currently doing this)
• market the resources of the Coalition
• use the Knowledge and Skills system to transfer individual capacity to organizations
• use the video, awareness package, overheads to communicate and educate
• formalize how we report to our organizations
• use some of the strategies that have been learned at Coalition meetings within organizations (e.g., shared planning, facilitation)
• provide opportunities for members to work on facilitation skills (which will help to ensure that everyone has a voice)

• make use of partners on the Coalition for advocacy efforts and to support advocacy within Coalition organizations
• be aware of other health promotion initiatives that the Coalition could advocate for and support
• be on each other’s mailing lists
• establish newsletter to increase communication among organizations or a one page bulletin to present opportunities for collaboration (training, programs, etc)
• have Coalition members communicate their need to access a particular group/population - other Coalition members may be able to assist
• put funding requests before Coalition

• use newsletters and web pages of organizations to increase the profile of the Partnership and its member organizations
• give credit to other Coalition organizations for resources that are used
• use press releases
• use display, video, information packages
• ensure each organization has Partnership letterhead, overheads

• discuss the community activation process and the link between organizations on the Regional Coalition and the communities
• discuss how the work of the Coalition is advancing the mission as it doesn’t reflect the work of the Coalition at the organizational level (organizations vs. community)
• provide a profile of the composition of the Community Heart Health Action Teams
• discuss how to increase support for the communities and increase Coalition member involvement in the Community Heart Health Action Teams
• provide more opportunities for information and resource sharing between organizations-- this could also be helpful for Community Heart Health Action Teams and facilitators of these Teams

REFERENCES

Butterfoss, F.D., Goodman, R.M. and Wandersman, A. 1993. “Community coalitions for prevention and health promotion.” Health Education Research. 8(3): 315-330.

Clark, N.M., Baker, E.A., Chawla, A. and Maru, M. 1993. “Sustaining collaborative problem solving: Strategies from a study in sic Asian countries.” Health Education Research. 8(3): 385-402.

Community Health Promotion Network Atlantic (CHPNA). 1997. Strengthening Communities through Story-Sharing. Western Regional Health Board, Western Region Project Working Group.

Dulhy, M.J. with the assistance of Kravitz, S.L. 1990. Building Coalitions in the Human Services, Sage, Newbury Park, CA.

Fawcett, S.B., Lewis, R.K., Paine-Andrews, A., Franciso, V.T., Richter, K.P., Williams, E.L. and Copple, B. 1997. “Evaluating Community Coalitions for Prevention of Substance Abuse: The Case of Project Freedom.” Health Education and Behavior. 24(6): 818-828.

Florin, P., Mitchell, R. And Stevenson, J. 1993. “Identifying training and technical assistance needs in community coalitions: A developmental approach.” Health Education Research. 8(3): 417-432.

Flynn, B.C., Ray, D.W., Rider, M.S. 1994. “Empowering communities: Action research through healthy cities.” Health Education Quarterly. 2(3): 395-405.

Labonte, R. and Feather, J. 1996. Handbook on Using Stories in Health Promotion Practice. Health Canada. Minister of Supply and Services.

Orlandi, M.A., Landers, C., Weston, R. and Haley, N. 1990. “Diffusions of Health Promotion Innovations.” In K. Glanz et al. (eds.) Health Behavior and Health Education: Theory, Research and Practice, Jossey-Bass Inc., San Francisco.

Schwartz, R., Smith, C., Speers, M.A., Dusenbury, L.J., Bright, F., Hedlund, S., Wheeler, F. and Schmid, T.L. 1993. “Capacity building and resource needs to state health agencies to implement community-based cardiovascular disease programs.” Journal of Public Health Policy. Winter: 480-494.