INTRODUCTION "The opportunity to interact with people from related programs strengthens my day-to-day work. Now I know who to refer my clients to and where to go for advice when I need it." "Without the coordination that this coalition provides, we never would have accomplished such a broad policy objective." "Another meeting? I'd like to attend but I have real work to do." "This coalition used to be worthwhile, but now I find it a waste of time." Health professionals attend numerous meetings and sometimes assume that they understand everything it takes for working groups to succeed. Often, however, groups fail or, perhaps worse, flounder. To avoid this type of experience, which only erodes faith in collaborative efforts, people need to sharpen the skills that are necessary to build and maintain coalitions. This paper contributes to the discussion of group processes by offering an eight-step guide to building effective coalitions. This paper is written from the perspective of an organization considering initiating and leading a coalition but can be helpful to anyone eager to strengthen a coalition in which he or she participates. WHAT IS A COALITION? A coalition is a union of people and organizations working to influence outcomes on a specific problem. Coalitions are useful for accomplishing a broad range of goals that reach beyond the capacity of any individual member organization. These goals range from information sharing to coordination of services, from community education to advocacy for major environmental or policy (regulatory) changes. In this Eight Step Guide, the word coalition is used in a generic sense to represent a broad variety of organizational forms that might be adopted. The approach outlined in this paper is intended to be used by any collaborative group seeking to influence outcomes or goals (see Figure A). A coalition can be an effective means of achieving a coordinated approach to injury prevention. For example, many agencies that focused primarily on providing direct services after the occurrence of violent incidents wanted to join together to develop effective ways to prevent violence. As a result, government and agency leaders established the Violence Prevention Coalition (VPC), a network of county organizations and community agencies dedicated to the prevention of abuse and violence. The Injury Prevention Coalition (IPC) was formed a few years later by groups focusing on other injury issues (e.g. crib death, drowning, car crashes). These groups wanted to develop a broad campaign emphasizing that "injuries are no accident."1 Although coalition building has become a popular approach, the concept of coalition building is not new. In 1840, Alexis de Tocqueville, the first noted international researcher on the American society remarked that "... Americans are a peculiar people... If, in a local community, a citizen becomes aware of a human need that is not met, he thereupon discusses the situation with his neighbors. Suddenly a committee comes into existence. The committee thereupon begins to operate on behalf of the need, and a new community function is established. It is like watching a miracle."2 Figure A provides working definitions of various types of group processes.
Figure B defines terms that are often used with respect to coalitions.
ADVANTAGES OF COALITIONS: Coalitions offer numerous potential advantages over working independently.
It is important to note that a coalition is not appropriate in every situation and is only one of a variety of effective tools for accomplishing organizational goals. A lead agency should consider carefully the responsibilities of developing and coordinating a coalition. The success of a coalition is usually uncertain. In addition, lead agencies tend to underestimate the requirements needed to keep coalitions functioning well, especially the commitment of substantial staffing resources. Coalitions also require significant commitment from the members, who frequently must weigh coalition membership against other important work. Potential results need to be measured against their costs, keeping in mind that results of coalition efforts often diverge from the initial expectations of the organizations that created the coalition. Furthermore, some tasks are inappropriate for coalitions because they may require quick responses that are unwieldy for coalitions or an intensity of focus that is difficult to attain with a large group. Before initiating a coalition, it is important to determine if related groups already exist within the community. There are times when it will be far more effective to participate in an already existing group with compatible goals than to form a new coalition. TIP: People and organizations often define terms differently. It is important to define clearly the type of group that will be set up, including its mission, membership, and structure, and to make sure that all participants understand and agree with this definition.
THE EIGHT STEPS Step 1: Analyze the program's objectives and determine whether to form a coalition Three different situations may cause an organization to consider whether or not to form a coalition: 1) the organization recognizes a community need or responds to community leaders' requests to facilitate an effort, 2) the organization recognizes that a coalition will help it fulfill its own goals, or 3) the process of building a coalition is required, for example, by a grant mandate or as the outcome of a conference. Recently, many grants have required organizations to establish coalitions. Consequently, the initiation of a coalition may be in response to the grantor rather than as a result of recognizing that it is the best solution to a problem. Therefore, the organization's objectives may be based on an assessment of data, may stem from an existing programmatic emphasis, or may be set by a funding mandate. Sometimes a coalition is established by "spontaneous combustion" based on the joint decision of a group of individuals and organizations, without a lead agency. These coalition organizers should approach the eight steps to effective coalition building as though they share the responsibility as the lead agency. Between them, they must achieve the responsibilities that are delineated throughout this paper for the lead agency. Sometimes these shared efforts can capitalize on the energy of their beginnings and can achieve remarkable results. A potential lead agency must assess its credibility in and capacity for providing neutral facilitation. On some issues, the organization may have the credibility and resources to provide the lead. In other situations, history, turf issues, or lack of resources might prevent the achievement of a cohesive effort. In these cases, the group should consider designating a different lead agency, if a coalition is still going to be developed. When deciding whether or not to form a coalition, first consider whether or not a coalition is the appropriate tool to serve the organization's needs. Then consider the resources needed, from the lead agency and from coalition members. Finally, consider whether or not coalition efforts represent the best use of these resources. To answer these questions, it is important to examine the objectives and to determine specific strategies that could help achieve those objectives. To determine whether or not to form a coalition, the following steps should be undertaken: a) Clarify the objectives and appropriate activities. One tool that is useful for planning objectives is the Spectrum of Prevention (see Figure D), which describes six types of interventions that can be used. Each part of the Spectrum depends on the others to work best, and generally, coalitions that aim to accomplish a combination of the spectrum's strategies are most effective. By grouping these separate approaches together, a preventive health program builds on the strengths of each and promotes permanent, effective change. For example, environmental changes, which are key in injury prevention, generally result from changing organizational practices or advocating policy and legislation. As a specific example, an educational program aimed at decreasing bicycle-related injuries will be enhanced if a local ordinance requires bicyclists to wear helmets and a civic program is implemented to change the environment by developing off-street bicycle paths. Often policy advocacy requires the resources of several organizations within a community and may necessitate the formation of a coalition.
Take a broad, creative look at activities that can accomplish the objectives. In many prevention programs, efforts center primarily on education. Yet, individual and community education is not enough. A child can drown in minutes, even with an attentive caretaker nearby who knows that water is dangerous. A fence around a pool, however, is an effective safeguard that helps prevent such tragedies by physically separating the child from the danger. In this case, promoting an ordinance requiring proper pool fencing will be a more effective method of reducing childhood drownings than funneling all of the coalition's resources into individual and community education. Critical questions to consider are the breadth of what the group may accomplish and the scope of the coalition's activities. For example, should the effort focus on car seats or on all childhood injuries? Will the coalition focus on a specific injury (e.g. sports-related injuries) or on a cross-cutting issue (e.g. improvement of data access)? The direction the coalition will ultimately take depends on the vision and interests of the lead agency and on the likelihood of success in meeting the identified objectives. The coalition's direction will also depend on the composition and interests of the membership (see Step 3). For each approach, it will be important to have at least a general understanding of the roles of particular members in accomplishing the objectives. Different members may be better suited to different activities. b) Assess community strengths and weaknesses. How do the proposed approaches of the coalition fit into the context of the community's strengths and weaknesses? Look at the community in terms of potential barriers and supports. Is there a history of success or failure in dealing with similar problems in the community? Are there organizations that have similar objectives? Are there organizations (or even coalitions) that deal with closely-related issues? Are there individuals or organizations that could be enlisted to provide support or overcome potential barriers? Are there organizations from other geographic regions with whom collaboration could occur? Are there individuals and organizations that may be opposed to the objectives or may view the coalition as competition for scarce resources? c) Determine the costs and benefits to the lead agency. How great will the resource drain be? How much will the coalition's results coincide with the organization's overall goals? What will a coalition provide to the lead agency's program? Determine if adequate resources are available. If not, the objectives must be revised, or perhaps the coalition should not be created. Step 2: Recruit the right people "The main factor in unproductive business meetings is one of the most fundamental: Having the wrong people present."4 Membership type: Determine the membership type based on the coalition's goals. Most coalitions should have diverse membership. Of course, a coalition aimed at providing citizen input might consist only of citizens, a coalition designed to ensure that government departments coordinate their efforts effectively might consist only of those departments, and a coalition aimed at eliminating duplication of services might only include the service providers. Coalitions with less diverse membership may communicate and work more quickly because members' objectives may be more alike. These coalitions, however, may be weaker in their ability to comprehend other factors that contribute to the problem that lay beyond the purview of their member organizations. Member organizations: Start by identifying organizations that already work on the identified issue and look broadly for other organizations that should be involved. Consider those who have influence, those who will be supportive, and even those who may put obstacles in the coalition's path. Are there important citizen or client groups that should be included? For example, the VPC became far more effective in elevating the importance of violence prevention in their community when the group "Parents of Murdered Children" began to participate in the coalition. Individual members: Many coalitions welcome individuals in their membership. Individual members may be community members, community leaders, or people who have directly experienced the problem. Unless there is a reason not to, it is a good idea to include individuals who are not affiliated with an organization, because they can perform functions that may differ from other coalition members. For example, individual members may be perceived by the media as having less of a vested interest and, therefore, more credibility. In addition, individual members can provide advice and outreach from a different, and perhaps more personal, perspective. As a specific example, the IPC members who had been injured were the best spokespeople for legislative hearings and meetings with the press. Competitors and adversaries: Decide whether to include or exclude potential competitors and adversaries, based on the sincerity of their commitment to the coalition's goals and whether they will be more of an impediment to the coalition if included or excluded. For example, the VPC did not allow a gun manufacturing company to join its coalition because the work of the company directly opposed the objectives of the coalition to reduce firearm use. However, the VPC did allow a toy company to join the coalition in the hopes that the coalition's efforts would encourage the company to produce alternatives to toy guns. Organization representatives: Having identified key organizations, consider who will best represent each organization on the coalition. Agency directors are often more effective at making policy decisions and establishing credibility as coalition representatives. They often have broader experience on certain coalition issues and a wider network of connections in the community. On the other hand, line staff are frequently more committed, enthusiastic, and available than top leaders and are often more in touch with the issues related to "hands on" service delivery. It is important for agency directors to appoint these staff to represent their organization. In so doing, the directors validate the time employees spend doing coalition work. In addition, the directors will be more likely to provide latitude to their representatives when decisions need to be made by the coalition "on the spot." Organization representatives with strong skills or interests should be recruited to serve on the coalition steering committee, asked to chair or facilitate, or given other positions of responsibility. In situations in which only top organizational leaders have the clout to play an effective role, recognize that their attendance may be irregular, but that the coalition is receiving the benefit of key individuals. Often, participation from both top leadership and line staff is essential to achieving coalition goals. For example, a VPC member who directed the county's probation department had the clout to convene the other top leaders, such as the sheriff and the chief of police, to make decisions about procedures for child abuse cases. Counselors, who were more familiar with actual cases, also met regularly to identify problems of coordination between departments, discuss individual problems, conduct trainings, and propose solutions to the coalitions's leadership. Membership size: Consider the desired number of organizations and the diversity of membership when selecting organizations to approach about joining the coalition. A coalition developing a curriculum on boating safety may need fewer members than a coalition that is attempting to change community pool fencing ordinances, because writing curriculum is a less complex task than influencing policy. TIP: A group larger than 12-18 people requires more resources and will sometimes take longer to develop group identity and common purpose. Some coalition experts recommend calculating size based on organizational purpose. William Riker has introduced the notion of "the 'minimum winning coalition'... participants create coalitions just as large as they believe will ensure winning and no larger." 5 At times it is preferable to bring together a narrow group with more closely defined interests (e.g. service providers). This group would accomplish objectives quickly. Frequently, this type of beginning leads to broadening the coalition at a later and more appropriate time. Step 3: Devise a set of preliminary objectives and activities for the coalition In step one, the lead agency's objectives were examined. It is important to meld these objectives with the objectives of other members. Defining coalition goals and objectives and how to implement them requires the inclusion of all coalition members in discussions. Therefore, the lead agency will need to broaden and modify its objectives. A written mission statement can be a useful tool to achieve clarity about coalition goals. However, it is important to avoid getting too bogged down in the semantics of the statement early in the coalition's life. Melding the objectives of the member groups: Some coalitions arise with a number of commonalities among the member organizations, minimizing the need to convince members of the benefits of the coalition. More typically, however, each member organization has its own goals, which may vary widely from those of other member organizations. It is important to create options that mutually satisfy the lead organization's objectives as well as the goals of other coalition members, to propose mutually productive activities, and to structure both objectives and activities in such a way that other coalition members feel included in the decision-making process. The coalition's original objectives must be kept in the forefront of all planning at the same time that a balance is struck between those objectives and the concerns and interests of each member group. Until trust is established, avoid issues and activities that will set up turf struggles or exacerbate existing turf issues between coalition member agencies. More importantly, the coalition should be careful not to become another competitor to its member agencies, but rather should play a complementary role. For example, the IPC did not publish a newsletter because doing so might reduce the subscriptions to the newsletter of the Safe Toys Association. Instead, IPC members wrote a monthly column in the Safe Toys newsletter and encouraged people interested in the IPC to subscribe. TIP: It is not always possible to avoid turf struggles. However, a coalition should try not to exacerbate these areas of overlap and competition. At times, a coalition can be a constructive meeting place for openly discussing problem areas, establishing ground rules, and resolving turf issues. Formal and informal opportunities to understand the differences in agency history, mandates, and funding issues may soften turf struggles. Coalition goals and objectives: While dealing with long-term objectives over time, set some objectives that can be addressed by all member organizations more immediately. However, always keep the long range objectives clearly in mind. "Far too often... the effectiveness of a coalition decreases as the breadth of its agenda increases."6 In some cases, broad goals can be accomplished best by joint activities with other coalitions, rather than by a single coalition. For example, the IPC, the VPC, and the Alcoholism Prevention Forum joined together on a media campaign focusing on the risks associated with alcohol abuse. While regular meetings of all of the coalitions in one broad group would prove unwieldy to the members, it was in everyone's interest to work cooperatively on a specific issue. At times, coalitions find it valuable to send representatives to one another's meetings and to have reports regularly included on one another's agendas. TIP: It may be helpful for staff of lead agencies to communicate on a regular basis, clarifying objectives and assisting one another with strategies. Coalition activities: Develop a variety of well-defined activities that meet the needs of participating organizations and make use of the skills of coalition representatives. Identify some activities that will result in short-term successes, such as a press release announcing the organization's formation and purpose, or a report outlining the group's initial findings. These products increase members' motivation and pride while enhancing coalition visibility and credibility. Initial successes can be achieved without massive effort. For example, information sharing is typically part of initial coalition meetings as members get to know one another. The VPC recorded descriptions of the types of services provided by each of its member organizations and distributed this information in an attractive chart format, thereby fulfilling the need for a simple inventory of member services. There can be advantages in dealing with a myriad of issues since approaches to different types of injuries may be related to one another. Regardless of the breadth of issues, keep the original coalition objectives foremost in all planning, lest members lose interest or enthusiasm. Bear in mind that what keeps a coalition going is the commitment of the individual representatives and the support of the organizations they represent. Generally, the more directly coalition activities relate to the specific objectives of the participating organizations, and the more each member is able to enjoy and be proud of their individual participation and contributions, the more the coalition will accomplish and the more it will flourish. TIP: Select activities that members will experience as successful -- activities in which they have something unique to contribute. Make objectives compelling. Be sensitive to the fact that coalition work is not the main job of coalition members and keep assignments simple and achievable. Keep reminding people that it is okay to say no or to set limits. In some cases, coalition objectives or activities may be at cross-purposes with those of an individual organization. Based on these cross-purposes, one or another organization may elect not to participate in the coalition. It is important to find out why groups decline to participate. When forced to choose between groups, encourage the coalition to select criteria which put the needs of the community's citizens first. This is appropriate at all times and cannot fail to win respect. Step 4: Convene the coalition There are three ways that coalitions are typically initiated: 1) through a meeting; 2) at a conference; or 3) at a workshop. TIP: The notion that members of a coalition will self-select at a conference or workshop and form a viable coalition is wishful thinking. Workshops or conferences can sometimes be used to initiate a coalition. However, they will require more resources than a single meeting and will not produce the carefully selected membership that a planned meeting will. As a result, the likelihood that members will participate on a consistent basis is slim. Two examples of the rare exceptions to this rule might occur when, one, distance is such that people can receive approval to attend a conference workshop but not a meeting or, two, when a political mandate leads to a highly visible event where coalition organizers can capitalize on the energy of the situation to create a coalition. In any case, identifying potential coalition members at workshops and conferences may prove valuable. To convene the coalition for the first time, hold a meeting of potential members. At this meeting, the lead agency should clearly define the purpose of the coalition, and members should specify their expectations. In addition, the invited organizations and their representatives should have a chance to introduce themselves, state what they see as their role on the coalition, and consider what their organization's interest is in participating in the coalition. Potential members should be given an opportunity to define what they perceive as the purpose and goals of the coalition and to recommend others who they think should be involved. To succeed, the lead agency should arrive at the first meeting with a strong proposal for the coalition's structure, including its mission and membership. Although many components of a coalition's structure are negotiable, the lead agency should be clear about the particular elements that are not. While being specific about how the coalition will operate, the lead agency should also explain where there is room for modification based on member input. Furthermore, the lead agency should ensure that all participating organizations understand and agree with the definition they give to the coalition. Of course, not all potential members will find the coalition worth their time and energy. Two determinants will be the specific activities the coalition chooses to undertake and the worth of the coalition as seen by the management of the member organizations. Therefore, once coalition activities are clarified, it is important to reconsider membership. Any well-designed coalition will be broad-based and may have different organizations participating in different activities. Nevertheless, the decision by an organization not to participate in the coalition may be an appropriate one from its perspective. Step 5: Anticipate the necessary resources Effective coalitions generally require minimal financial outlay for materials and supplies, but require substantial time commitments from people. The ability to allocate considerable staffing is one of the most important considerations for organizations providing coalition leadership. Occasionally, the coalition can call upon its members for operational tasks. However, the lead agency generally provides the majority of staff time. Lead agencies may benefit by reallocating some of their staff time to coordinate coalition activities, because their investment is often repaid by the successes achieved by the coalition. While staff time may be provided by many coalition members, it is important for the lead agency not to be too optimistic and to allocate a significant amount of its own staff time to the coalition. Preparation for coalition meetings requires substantial staff effort. To assure meeting attendance and success, extensive work must be done prior to the meetings, including agenda preparation and written and phone contact with the representatives. A coalition succeeds when staffing is adequate to handle the detail work. It is important to recognize that coalition members' time is the most valuable contribution they can make. When this resource is discussed during coalition meetings, commitments are sometimes made in response to the enthusiasm of the meeting and seem less realistic when members return to their regular jobs. At other times, coalition members will fulfill their commitments but may resent the extra work. Both situations can have a long-term, destructive impact on the coalition. Periodic discussions about resources, support, and time limitations of the members can minimize potential problems. Also, it is important to re-evaluate the objectives and activities in order to monitor which are achievable, given the coalition's staffing and resources, which may change over time. The more the coalition's objectives complement those of its members' agencies, the less member time will seem like "extra" work. TIP: Estimate how much of the footwork will be the responsibility of the lead agency and how much to expect realistically of members. Anticipate that members will not always fulfill their commitments. Be appreciative of what is done, rather than "moralistic" when people cannot accomplish everything they planned.
Financial resources: Financial concerns can be distracting, particularly to a new coalition. Although it may be costly to establish and maintain a coalition, particularly in terms of staff time, the cost of achieving overall results should be less than if the lead agency attempted to accomplish these same objectives on its own. Frequently, coalitions spend thousands of dollars of personnel time in order to raise much smaller amounts of cash. While raising small amounts of money may provide members with a sense of accomplishment, these efforts must be minimized. Furthermore, careful attention should be paid to minimizing financial obligations for members. For example, a conference held at a community site with volunteer speakers may be planned for a nominal cost. Additionally, five possible sources for supplementing coalition resources, whether in the form of cash or donated services, are the media, foundations, local service clubs, students and trainees, and volunteers.
Step 6: Define elements of a successful coalition structure The technical details of the coalition's structure are vital to achieving success. As with other coalition considerations, it is important to have well-developed ideas as well as the flexibility to allow for input and modifications by coalition members. Structural issues to consider are: a) coalition life expectancy; b) meeting location, frequency, and length; c) membership parameters; d) decision-making processes; e) meeting agendas; and f) participation between meetings. There are no set rules about how a coalition should be structured, but each of the following six elements should be focused on thoughtfully. a) Coalition life expectancy: The coalition's goals should dictate its longevity. Although an open-ended time frame may seem attractive to the lead agency, member organizations and their representatives often prefer coalitions with a specific life expectancy. For example, VPC members decided to meet every two months for two years to establish conflict resolution programs in all local school districts. The disadvantage of this approach is that some members may become dissatisfied if a decision is made to maintain the coalition after the specified time. Generally, it is best to meet two or three times to clarify potential coalition objectives, and then determine duration. b) Meeting location, frequency, and length: Attention to meeting location(s), time of day, comfort of the site (size of room, lighting, chairs, ventilation, etc.), and regularly scheduled dates can all contribute to enhanced member participation. In addition, a time for refreshments prior to meetings, during breaks, or after the meeting provides an opportunity for less formal conversation and builds group cohesion and morale. To promote an atmosphere of equal contribution, consider holding coalition meetings on neutral territory, such as the local library. Rotating the meeting to different members' sites can add interest, although at times meetings are delayed when people get lost or confused by varying locations. Other than an ad hoc emergency situation -- such as a legislative deadline -- coalitions should not meet more frequently than once a month. In some cases, attendance levels are more likely to be maintained by meeting once every two months. When coalitions meet less frequently, members are generally more willing to participate in subcommittees between general meetings. However, coalition commitment and continuity can suffer when meetings occur less than once per month. Groups separated by distance will meet less frequently (e.g. quarterly). If some members travel a great distance, longer but less frequent meetings make the travel time a better investment. Certain kinds of groups meet annually with subcommittee meetings and conference calls in between, but their effectiveness can suffer unless members are highly motivated. Remember, people's time is valuable: generally, 1.5 - 2 hour meetings are best. Do not permit coalition meetings to run over the planned time. TIP: Poll members to see which times and locations present the least conflict in terms of both personal and work commitments. Avoid meeting times that cause members to face traffic jams and sites where parking is difficult. The next time they receive a notice about a coalition meeting, they should not think of the traffic as much as the content of the meeting. c) Membership parameters: As Step 2 points out, membership is critical. Coalition members must decide to what extent new members will be included. How defined should the membership be versus how open? In many cases, a compromise solution in which certain people are recruited and encouraged, but no one is excluded is best. Open meetings lead to greater variability in attendance and a potentially unwieldy group, but this is generally of less concern than the danger of excluding, or creating the impression of excluding, important supporters. For example, conference organizers who invite only certain, specially selected people to attend may face significant backlash from others who feel that their participation in the conference would be valuable. A large group can be "layered" so that effectiveness is maximized. For example, VPC executive directors met separately to discuss policy issues, and task forces were developed on school curricula and on state legislation, thereby reducing the number of general meetings. TIP: New members add vitality to the coalition. Providing an orientation session for new members often reduces their need to interrupt coalition meetings to "catch up" with the topics. Whether a broad cross-section or a more narrowly-defined group of members is chosen, it is worth analyzing the potential contributions of various disciplines (e.g., churches, business organizations, local government, school districts, etc.) in relation to the purpose and goals of the coalition. For example, the VPC initially consisted of service providers. After the VPC formed, the coalition membership decided to include church groups, police, women's associations, block associations, and interested citizens. This expansion better served the coalition's public education and policy goals. It is important to consider to what extent organizations should be asked to join and to become "official" members of the coalition. A general rule of thumb is not to seek official recognition (which typically means official action by the Board of Directors of a member organization) until the coalition has a clearly defined purpose or specific activities that would be strongly enhanced by this recognition. While official approval may add some clout to the coalition, a more loosely-formed coalition will initially minimize the need for by-laws and formal decision-making structures, which can prove cumbersome and pose an early barrier to cooperation. More formalized membership procedures may become an issue when, and if, the coalition wishes to make public statements or endorse policy measures. Individuals who are official members (e.g. with their names on the coalition's letterhead) are more likely to be concerned about making public statements. Although a more deliberate decision-making process, involving more time, will be required in order to take a stand on an issue, the resulting statement will have more credibility because it has more supporters. Official membership works best when the coalition is smaller and the organizations are represented by "higher-ups" who can make decisions on the spot. Due to the inter-organizational nature of coalitions, public statements can become very complicated, particularly those statements that individual members cannot make without the approval of their Board of Directors. Even when individual members agree on a statement, the difficulty in obtaining Board approval often impedes the possibility of making a public statement in a timely manner. TIP: Sometimes, the positions of the coalition can be kept at "arms length." For example, a letter may state that the coalition's position represents the opinion of the majority of participating groups, but does not necessarily reflect the position of any particular organizational member or group. d) Decision-making methods: In "Social Policy," S.M. Miller identifies good decision-making procedures as key to coalition success. He recommends establishing a specific decision-making process before problems occur. "You cannot count on stamina...," he writes, "Make clear early in the life of the coalition...how decisions are going to be made."7 It is important, however, that discussions on how decisions are made not become a barrier to coalition effectiveness. Sometimes coalitions become so involved in these kinds of discussions they lose track of their fundamental purpose. It may be helpful to ask: Is this particular decision-making structure vital to the functioning of the coalition? Bear in mind that some members may find lengthy decision-making discussions distracting and, as a result, may decrease their attendance. Therefore, avoid discussions that are too detailed or cumbersome. Decisions can be made by consensus. However, this process can become unmanageable. To avoid this, define consensus as an approach that the majority supports and others can live with. Health-based coalitions are usually happy to relinquish some of the detailed decision making in exchange for simplicity and reasonable results. On the other hand, sensitivity must be exercised, especially on "charged" issues, such as decisions related to money, policy, and turf. There will be cases in which consensus cannot be reached and the group must either vote or accept that there will be no action on a certain issue. Sometimes having the group clarify in advance the kinds of issues that are charged (e.g., grants, turf, or legislation) will help to avoid problems later. TIP: Coalitions often gravitate toward discussing their own internal workings and processes rather than resolving the community issue they came together to address. Avoid this "identity crisis." Though some coalition decisions require a group process to reach "closure," the true purpose of the coalition must not get lost. e) Meeting structure: One of the most important ingredients for an effective coalition is a good meeting agenda. A clear agenda structure, which may be modified by those present at the beginning of the meeting, can reinforce the coalition's purpose and foster collaboration. To achieve such positive results, the agenda must be carefully planned and, ideally, should be distributed prior to the meeting. A regular agenda format will help the coalition get focused, thereby giving members a sense of direction and momentum. Different formats will work better for some groups, but most agendas begin with agenda modification, a review of the previous meetings' minutes (if minutes are kept), and introductions, "check-ins," or announcements. Many meetings conclude by evaluating the meeting, setting a date for the next meeting, and listing items for the next meeting's agenda. The heart of the agenda will vary between groups depending upon their missions and the role of members identified in the structure of the coalition. A focus, for instance, on legislation would require a place on the agenda for updates on policy efforts, while a group that is concentrating on community outreach and education might have a section on the agenda for "community action." Large, broad-based coalitions may have a variety of committees, and therefore a section for committee reports would be important. Inviting guest speakers or adding presentations by coalition members can enliven the agenda. The lead agency, or whoever is responsible for developing the meeting's agenda, needs to discuss with the meeting facilitator how the agenda should be organized. They should anticipate which topics could generate controversy, who should lead the discussion on each item, which items require a decision, how much time should be allotted, and what would be the best "process" for each item (eg. brainstorm, small group discussion, refer to committee, report only, etc.). The agenda that is distributed to members prior to a meeting is often just an outline, with suggested times for each item. The facilitator will bring an annotated agenda with notes about who will guide each section, what process will be used, and any other notes that will ensure that the meeting moves smoothly through the agenda in the allocated time. For long meetings, or meetings where the agenda is substantially altered from what was initially distributed, the facilitator may write a revised agenda on butcher paper taped to the wall. Bringing materials like pens, butcher paper, audio visual equipment, and tape is generally the lead agency's responsibility, but these materials may also be provided by staff at the meeting site. f) Participation between meetings: Successful coalitions generally have active planning groups or subcommittees, formal and informal, that carry out coalition activities. Based on time constraints, commitment, and relevance to their organization's own objectives, different members may show markedly different levels of involvement. Unless coalition objectives are closely related to the objectives of the membership, it is not wise to expect more than a few hours of additional commitment between meetings. Often members have less time available than what is realistically needed to make a coalition work. Be sensitive to the fact that coalition work is not the main job of coalition members. Some people volunteer far more than is appropriate both because of their enthusiasm at the time and because there may be group pressure for everyone to contribute. Keep reminding people that it is okay to say "no." Remember that coalition members will not always fulfill their commitments. The more directly coalition activities are related to the specific objectives of the participating organizations, the more the coalition will accomplish and flourish. It may be helpful to encourage the most active participants in the coalition to form a steering committee, which provides leadership by discussing long-range goals and the steps and strategies to achieve them. A steering committee often works well as an informal open body. For example, lunch meetings between coalition sessions can bring together key participants and allow them to provide their best input while increasing their buy-in. Members of a steering committee may be selected by the group as a whole or, in less formal situations, the lead agency may encourage members to attend the lunch meetings. It is important not to exclude anyone from participation. Coalitions are not just for fun, but when members enjoy working together, the coalition can achieve more of its objectives. One of the main concerns organizations voice when participating in coalitions is that the coalition utilizes too much staff time, which is at a premium in this era of cutbacks in health and human services. Hence, the simpler the design of a coalition, the better. Furthermore, encouraging members to participate in activities of their own choosing minimizes the possibility of some members overcommitting their time and burning out. In all areas of coalition "anatomy," the same rules apply: minimize complications, maximize relevance, and encourage participation. TIP: Nothing is better for coalition morale than healthy refreshments! Step 7: Maintain coalition vitality Coalition building is a craft, requiring broad vision and careful attention to detail. Leadership in coalition building requires knowing not only how to create a coalition structure, but also how to recognize the warning signs of problems that may arise. The ability of coalition leaders to do both will greatly increase the coalition's chances for success. It is important for leaders to work hard at maintaining the vitality and enthusiasm of the coalition. Warning signs may be difficult to recognize because even the most successful coalition has ebbs and flows. By dealing with potential problems as they emerge, however, the vitality of the coalition can be maintained. For example, at the June VPC meeting, a member noticed that attendance had decreased again. In fact, two subcommittees had no reports because hardly anyone had attended the meetings. The member said that he was too worried about his agency's budget to do anything to help solve the attendance problem. VPC members were not able to fix this fundamental problem, but did discuss it and decided to reduce coalition objectives and lengthen the coalition's timeline. In addition, the VPC sent a letter to the Board of Supervisors decrying the negative impact of the budget cuts and asking the Board to reinstate funds to the agencies. In addition, the VPC focused its summer meeting specifically on a budget forum and postponed subcommittee meetings to conserve member time and resources. TIP: A group attempting to coordinate services or embark on a joint advocacy effort should expect more pitfalls than a group formed solely for the purpose of information sharing, as the former tasks are more complex and demand more commitment. Several activities that are important for maximizing coalition vitality are described below. These include: noting and addressing coalition difficulties; sharing power and leadership; recruiting and involving new members; promoting renewal by providing training and by bringing challenging, exciting new issues to the group; and celebrating and sharing successes. Addressing coalition difficulties: One clear indication that a coalition is having difficulties is a decline in coalition membership. While earlier warning signs are less obvious, they might show up as: repetitious meetings or meetings which consist primarily of announcements and reports; meetings which become bogged down in procedures; significant failures in follow-through; ongoing challenges of authority and/or battles between members; lack of member enthusiasm; or an unacceptable drain on lead agency resources as a result of attempts to bolster the coalition. "Coalition artists" must watch for warning signs, be aware of the conditions that can have a negative impact on coalition effectiveness, and constantly work to minimize the difficulties. The most common difficulties include: 1) poor group dynamics, including unnecessarily draining decision making and "power dynamics," such as tension over leadership, decisions, or turf; 2) membership/participation concerns such as a difficult agency or member, changes in the needs of participating agencies, shifts in staff assignments, changes in available resources, or member burnout; 3) coalition emphasis on too many long-term goals without short-term objectives to generate short-term wins that add energy to the group; 4) ineffectiveness in achieving coalition activities due to inadequate planning or resources; or 5) changes affecting the coalition's mission, such as new legislation that has an impact on the objective reality of the issue the coalition was formed to address. Although the lead agency will not always be able to overcome these challenges, effective management of the problem is an essential first step. The lead agency should identify and respond to significant problems, issues, or changes that appear to impede the coalition. It is the lead agency's responsibility to bring identified problems to the attention of coalition members and to encourage collaborative solutions. The most valuable source of information about negative coalition conditions is input from the coalition members themselves. Therefore, it is crucial to maintain open communication among the members so that problems surface quickly. Furthermore, it is important to be flexible regarding how objectives will be met. Sharing the power and leadership: Many coalition members will readily defer power to the lead agency in order to facilitate smooth functioning. However, if the coalition solidifies as an independent entity and develops a body of work that it performs or creates collectively, members will expect greater involvement in decision-making. It is at this point that the coalition becomes a more independent group and requires less guidance from the lead agency. Ironically, the characteristics which indicate a strong coalition -- a heightened sense of collective identity and a high degree of interest in, and commitment to, work which is developed collaboratively -- can also exacerbate tensions in defining the direction of the coalition. It is important to deal with these issues directly. Negotiating issues of a power imbalance in decision-making, especially when a coalition has achieved this state of maturity, requires sensitivity and may require setting aside extra time to clarify. Recruiting and involving new members: Membership changes are to be expected. Sometimes an organization's mandate will change; other times staff members simply have personal interests and priorities that draw them away from the coalition. It is worthwhile to develop new leadership and support periodically. Distributing coalition minutes and information widely outside the coalition is one way to inform a broad group of potential members. Attention must be paid to ensure that new members are welcomed and oriented to fulfill vital functions on the coalition. They will add new energy and enthusiasm to the coalition's ongoing activities. It is important to attend to the ways that the coalition can be inclusive, as many people leave coalitions after one or two meetings because they feel that they have nothing special to offer. An invitation to join a sub-committee can be helpful. Promoting renewal by providing training and by bringing challenging, exciting new issues to the group: Coalition building and injury prevention each require their own set of skills, and some members will be more experienced than others. Every member will bring to the coalition his or her own perspective. Therefore, a broad framework, a common vocabulary, and a set of principles for preventing injury must be presented early on in the coalition's formation. Remember, too, that new members will need to be brought up to speed. Further training, encouraging coalition members to attend conferences, and bringing in guest speakers can be helpful. This approach will ensure that members share the big picture of the problem as well as the underlying philosophy of the coalition. Everyone involved in the coalition, both lead agency staff and members, can and will benefit from training, consultation, and the opportunity to discuss what is and is not working. Coalition work is frustrating and exhausting at times. Therefore, retreats, trainings, opportunities to discuss coalition building with others, and recognition of lead agency staff are all essential in preventing burnout. Recognizing that lead agency staff are a critical resource required for coalition effectiveness, it is important to provide them with support and encouragement. Lead agency staff and coalition members need exposure to new information on their chosen issue in order to stimulate creative ideas and to reinvigorate coalition efforts. Celebrating and sharing successes: Maintaining morale and a sense that the coalition is playing a vital role in addressing the problem is essential. Too often, coalitions focus on problems and next steps without pausing to appreciate their accomplishments. Keys to boosting coalition morale include implementing effective activities that result in tangible products, giving coalition members credit for coalition successes, celebrating short-term successes with publicity or awards, re-examining objectives, and taking a brief respite from coalition meetings and activities. Step 8: Make improvements through evaluation Coalition evaluations can provide the assigned staff person, lead agency, and coalition members with important feedback. Components of coalitions that should be evaluated include objectives, activities, processes, and unanticipated events. By assessing the processes, outcomes, and impacts associated with coalition activities, staff can improve their outreach and coordination skills, and members can determine which strategies help the coalition achieve its ultimate goals most effectively. The results, if positive, can also help the coalition improve its reputation within the community and can be included in future resource development proposals. Furthermore, when a coalition modifies its efforts to eliminate problems pinpointed by an evaluation, the coalition's credibility can improve significantly. Coalitions can employ two basic types of evaluations. These are named formative and summative evaluations. Formative evaluations focus specifically on the coalition's process objectives. For example, a coalition may want to encourage the media to promote bicycle safety. A formative evaluation would analyze the process by which the coalition attempted to achieve this goal. Questions in the formative evaluation might include: How many members actively monitored the local media on a regular basis? How many times did staff and members meet with local media representatives to encourage safe bicycling pictorials? How many times did the coalition submit press releases or letters to the editor? The results of formative evaluations help staff and members improve the functioning of the coalition. Summative evaluations help coalition members to determine whether or not the coalition's strategies resulted in the desired consequences. Summative evaluations help assess both outcome and impact objectives. To evaluate outcome objectives in the example described above, a summative evaluation would include questions like the following: Did the local media organizations that the coalition contacted change their practices to include photos of safe bicycling? How many coalition sponsored activities received coverage in the local press? To assess impact objectives, the summative evaluation might include a component that analyzed changes in parents' and children's attitudes and behaviors after reading coverage of coalition activities. Were parents, for example, influenced to purchase bicycle helmets after reading the coalition's articles? The answers to summative evaluation questions help coalition members make strategic decisions about strengthening promising interventions and discontinuing ineffective ones. Evaluating coalition efforts is not simply a matter of evaluating the effect of the coalition's planned activities on injury prevention. What can be overlooked are the myriad effects a coalition can have, whether it achieves its stated goal or not. Because coalition building stimulates a variety of interventions and activities, evaluation results must be interpreted thoughtfully. Critical to any evaluation planning is the documentation of unintended successes. For example, as a result of the VPC's trainings on school-based violence prevention, the state's health education curriculum was revised to include violence prevention. This was an unanticipated result of the coalition's efforts that was nevertheless quite significant. Furthermore, a coalition's visibility may increase public awareness and the community's perception of the problem. For example, a toy store manager who read about IPC's pedestrian safety campaign in the newspaper encouraged the toy store's corporate headquarters to sponsor the campaign in its stores. For a limited time, all customers received free bumper stickers encouraging safe driving practices. These examples represent the types of side-effects that often occur as a result of coalition efforts. Other spin-offs might include: liaisons between agencies that previously had not worked together, increased rates of cross referral, and improvements in the skills and morale of coalition participants. These effects can augment more formal evaluation results, thus enhancing the coalition's sense of effectiveness and legitimacy. Sometimes these results are difficult to judge. A new coalition may experience "textbook success" or "textbook failure." But usually not all of the outcomes could have been predicted at the initiation of the effort. Therefore, all facets of coalition life must be taken into account in a summation of efficacy. Evaluation is an on-going process throughout the life of a coalition. Every major coalition event should be evaluated. Surveys of coalition members will give lead agencies an idea of the level of involvement of each member. It is ideal to evaluate whether or not further collaboration between members may occur in addition to their participation in the coalition. This information may be especially useful for formative evaluations. Likewise, simple pre/post tests and satisfaction surveys work well for trainings, courses, and conferences. Content analysis of meeting agendas, minutes, and attendance lists will help determine if process, outcome, and impact objectives were met and will help identify unintended successes. Taking the time to evaluate the effectiveness of coalition efforts is a way of acknowledging that the skills and contributions of coalition members are important. Honest reflection also assures that the coalition grows from its experiences, regardless of the programmatic outcome. Evaluating a coalition can lead to changes in a coalition's approach. In addition, evaluation can increase a coalition's effectiveness and can assure that the community and participants benefit from the coalition's activities. Coalition evaluation is a newly emerging field, and more work needs to be done. However, the availability of evaluation tools is increasing, and current evaluation efforts are strengthening the on-going work of coalitions. CONCLUSION Coalitions do not last forever. Sometimes a coalition can be repaired, and sometimes, the effort to do so is not justified. Be ready to dissolve a coalition if it does not achieve satisfactory goals or if it is no longer effective. Sometimes it is best to walk away with a handshake and a smile. At other times a celebration at the conclusion of a successful campaign is a great way to acknowledge the relationships forged during the life of the coalition. Remember, virtually every carefully-crafted coalition will have an impact. "An effort may fail, then partially succeed, then falter, and so on. Since mutual trust is built up over a period of time, coalition organizers should avoid getting so caught up in any one effort as to view it as "make or break." Every effort (at cooperation among groups) prepares the way for greater and more sustained efforts in the future."8 Coalitions consist of people. Therefore, shared efforts leave us with surprises, memories, and mutual respect. Acknowledgments "Developing Effective Coalitions: An Eight Step Guide" was originally developed at the Contra Costa County (California) Health Services Department Prevention Program to assist public health programs in developing effective community coalitions for injury prevention. The ideas presented in this paper are an outgrowth of a Special Project of Regional and National Significance (SPRANS) grant awarded to the Contra Costa County Health Services Department by the U.S. Department of Health and Human Services Maternal and Child Health Division. It was edited and printed by the Children's Safety Network at the National Center for Education in Maternal and Child Health. An earlier version of the paper was also published in the Injury Awareness and Prevention Centre News, Vol. 4, No. 10, Alberta, Canada, December 1991. Larry Cohen is founder and Executive Director of Prevention Institute, a nonprofit organization committed to building a stronger movement and methodology for prevention nationwide. He provides training, consultation, and facilitation related to health promotion, strategy and policy development, coalition building, and injury and violence prevention. Mr. Cohen developed the Spectrum of Prevention, a strategy tool that promotes a systematic approach for effective prevention. He is Senior Advisor to the Federal Office of Maternal and Child Health, Health and Human Services through the Children's Safety Network and teaches at the School of Public Health at the University of California at Berkeley. Citation information: Cohen L, Baer N, Satterwhite P. Developing effective coalitions: an eight step guide. In: Wurzbach ME, ed. Community Health Education & Promotion: A Guide to Program Design and Evaluation. 2nd ed. Gaithersburg, Md: Aspen Publishers Inc; 2002:161-178. For further information or permission to reprint or distribute this paper, please contact Prevention Institute: Prevention Institute
Footnotes 1 The Violence Prevention and Injury Prevention coalitions (VPC and IPC) do not actually exist. They do, however, consist of composites of actual groups which have been selected to elucidate the discussions. 2 Alexis de Tocqueville, "Democracy in America," Vol. 2 (1840). 3 Developed by the Prevention Program from the work of Marshall Swift, PhD, Hahnemann College, Philadelphia, PA. A paper, "The Spectrum of Prevention" and a video demonstrating this methodology, "Beyond Brochures: New Approaches to Prevention," are available through the Prevention Program. 4 Lynn Oppenheim, Wharton Center for Applied Research, as described in New York Times article by Daniel Goleman, "Why Meetings Sometimes Don't Work" (June 7, 1988):B1. 5 William Riker, "The Theory of Political Coalitions" in Weisner, "Notes on Policy and Practice," Yale University Press, New Haven, CT (1962). 6 Terry R. Black, "Coalition Building -- Some Suggestions," Child Welfare, Vol. LXII, #3, (May, 1983):266. 7 "Coalition Etiquette: Ground Rules for Building
Unity," Social Policy, Vol. 14, #2 (Fall, 1983): 49.
8 Cherie R. Brown, "The Art of Coalition Building
-- A Guide for Community Leaders," published by the American Jewish
Committee (1984).
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