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Prioritizing Equity: Exploring Conditions Impacting Community Coalition Efforts

Purpose: There is a critical push toward addressing equity in health care. Community coalitions are uniquely situated to heed this call by tackling issues of equity and well-being that are the most relevant for their local context. This article analyzes internal and external contextual factors that...

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Autores principales: Domlyn, Ariel M., Coleman, Shemekka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6705445/
https://www.ncbi.nlm.nih.gov/pubmed/31440737
http://dx.doi.org/10.1089/heq.2019.0061
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author Domlyn, Ariel M.
Coleman, Shemekka
author_facet Domlyn, Ariel M.
Coleman, Shemekka
author_sort Domlyn, Ariel M.
collection PubMed
description Purpose: There is a critical push toward addressing equity in health care. Community coalitions are uniquely situated to heed this call by tackling issues of equity and well-being that are the most relevant for their local context. This article analyzes internal and external contextual factors that may affect coalitions' prioritization of equity. Methods: Data were collected from 18 coalitions participating in a national, U.S.-based initiative aimed at strengthening community coalition work through the principles of equity and inclusion. A hybrid qualitative–quantitative method (qualitative comparative analysis [QCA]) was conducted using the direct method of calibration and fuzzy set QCA and to obtain casual sufficiency results. Results: Coalitions located in states that did not expand Medicaid after the Affordable Care Act were most likely to prioritize equity, as were coalitions who were both working with marginalized populations and had low organizational readiness for the initiative. However, only one case demonstrated the latter causal solution; the former accounts for greater coverage of the outcome. Conclusion: This study illustrates the use of QCA for evaluation and underscores the critical role of contextual factors for affecting meaningful community-level change. Coalitions are willing and able to prioritize tackling health inequities across settings, but those in settings with low state-level support may be more likely to emphasize inequities in their work.
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spelling pubmed-67054452019-08-22 Prioritizing Equity: Exploring Conditions Impacting Community Coalition Efforts Domlyn, Ariel M. Coleman, Shemekka Health Equity Original Article Purpose: There is a critical push toward addressing equity in health care. Community coalitions are uniquely situated to heed this call by tackling issues of equity and well-being that are the most relevant for their local context. This article analyzes internal and external contextual factors that may affect coalitions' prioritization of equity. Methods: Data were collected from 18 coalitions participating in a national, U.S.-based initiative aimed at strengthening community coalition work through the principles of equity and inclusion. A hybrid qualitative–quantitative method (qualitative comparative analysis [QCA]) was conducted using the direct method of calibration and fuzzy set QCA and to obtain casual sufficiency results. Results: Coalitions located in states that did not expand Medicaid after the Affordable Care Act were most likely to prioritize equity, as were coalitions who were both working with marginalized populations and had low organizational readiness for the initiative. However, only one case demonstrated the latter causal solution; the former accounts for greater coverage of the outcome. Conclusion: This study illustrates the use of QCA for evaluation and underscores the critical role of contextual factors for affecting meaningful community-level change. Coalitions are willing and able to prioritize tackling health inequities across settings, but those in settings with low state-level support may be more likely to emphasize inequities in their work. Mary Ann Liebert, Inc., publishers 2019-08-21 /pmc/articles/PMC6705445/ /pubmed/31440737 http://dx.doi.org/10.1089/heq.2019.0061 Text en © Ariel M. Domlyn and Shemekka Coleman 2019; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Domlyn, Ariel M.
Coleman, Shemekka
Prioritizing Equity: Exploring Conditions Impacting Community Coalition Efforts
title Prioritizing Equity: Exploring Conditions Impacting Community Coalition Efforts
title_full Prioritizing Equity: Exploring Conditions Impacting Community Coalition Efforts
title_fullStr Prioritizing Equity: Exploring Conditions Impacting Community Coalition Efforts
title_full_unstemmed Prioritizing Equity: Exploring Conditions Impacting Community Coalition Efforts
title_short Prioritizing Equity: Exploring Conditions Impacting Community Coalition Efforts
title_sort prioritizing equity: exploring conditions impacting community coalition efforts
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6705445/
https://www.ncbi.nlm.nih.gov/pubmed/31440737
http://dx.doi.org/10.1089/heq.2019.0061
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