A Balance of Power
To thrive in changing environments where there are no known solutions requires adaptive leadership. Palm Health Foundation turns time and again to the words of Marshall Ganz:
“Leadership is accepting the responsibility to create conditions that enable others to achieve shared purpose in the face of uncertainty.”
Flexibility, patience and accepting a balance of power between residents and system partners is necessary. In community change work, there has to be balance between the voices of resident and system partner leaders—a change that requires taking people outside their comfort zones to assess and address challenges together.
Community members are often not accustomed to being heard. Some feel invisible. Others don’t trust that their opinions matter. In the early days of Healthier Together, emphasis on transparency from system partners showed that they had their own vulnerabilities. They didn’t know everything, and they let residents see how much they valued their voice to create solutions together. Galvanizing the voices of community members to give them the confidence they were on equal footing with system partners became one of the most significant investments in building resident leader capacity.
Cultivating Community Leaders
In many ways, Healthier Together is about investing in people who are closest to the challenges their communities face. To engage people in traditional, organizational ways doesn’t work. In order to establish trusting, safe environments to show up as their authentic selves means working differently. It means creating an inclusive process which shows flexibility and adaptability to respond to issues as they arise. It means going where the energy is, where the community believes there is a sense of urgency and where there is momentum.
Communities need to find their shared aspiration, their shared purpose and their shared goals. The process looks to leaders who can navigate the uncertainty of this process and guide the work in a way that continues to adapt to communities’ contexts and shifting conditions.
Building a community’s capacity for action means:
- Community stakeholders are engaged
- Strong community-based organizations are identified, nurtured
- Robust alliances/ networks are established
- Stakeholders participate in the political process, representing own interests
- Communities and leadership are organized to engage constituencies
- Effective leadership is in place and cultivated continuously
Investing in Residents
Cultivating adaptive leaders takes a commitment to six types of capital as shared on the “Our Roadmap” page. Far more than financial investment, it includes social, intellectual, human, physical and spiritual capital.
Investments across all six types of capital in learning opportunities and learning communities have elevated skill sets and knowledge for leading change.
The Tamarack Institute, a trail blazer in community change work, has trained nearly 450 Healthier Together residents, leaders and partners through conferences and workshops. Local learning opportunities were developed in partnership with Community Partners of South Florida and NeighborWorks America. The investment represented a shift from investing in systems to investing in residents, strengthening their influence, authority and ability to create change across the community, no matter the issue.
In addition to annual community leadership workshops, learning communities have been established and supported by Palm Health Foundation.
Project Director Learning Community
The six Healthier Together project directors meet six times each year to share learning among themselves and with foundation staff. Project directors also engage in a formal coaching program adapted from the NeighborWorks Achieving Excellence Program which applies outcomes-focused thinking and performance-related strategies to learn skills for navigating challenges.
Steering Committee Learning Community
Early in the process, the foundation convened Healthier Together steering committees twice a year to network among communities, giving newer communities an opportunity to learn from the more established communities and vice versa.
Foundation staff has created a supportive environment to work closely with individual project directors as they navigate the community change work.
Cultivating adaptive leadership among trustees is equally as important as developing residents. For Healthier Together, adaptive leadership at the board level occurred over several years and was a result of emphasizing learning over impact and measurement. A shift has occurred from expecting empirical data showing clinical improvements to identifying wins as signals for change. A deeper understanding of complexity and adaptive systems change work has also resulted in moving from a five-year, place-based endeavor to a long-term commitment to support and amplify local community change networks.
Five key points provided the rationale for why the foundation was on the right path:
- Shifting from funding clinical care—which only accounts for 10% of health outcomes—to addressing the other social determinants of health can yield better outcomes and return on investment.
- A broad range of social, economic and environmental factors shape individuals’ opportunities and barriers to engage in healthy behaviors. Both race and health equity are central to the work.
- Place matters. Healthy people and healthy places go together.
- There is a national growing movement and evidence to support healthy communities that push for changes in the physical, economic, social and service environments.
- Complex adaptive work requires dynamic approaches to the learning and evaluation process. Collaborative work is not linear. It is cyclical.
Guidance from leaders in evaluating learning cultures has supported trustee understanding. In particular, Tanya Beer from the Center for Evaluation Innovation, provides direction on thinking through what accountability looks like. Asking “What are we learning and how are we applying what we’re learning?” requires a mindset change from pre-set indicators of success. It places focus on understanding the shifts of why and how change is happening and who is better off by reviewing qualitative data. Our evaluation efforts were designed to share different aspects of the learning and the various kinds of wins that could be achieved—insight, capability and outcomes around policy, health, behavior changes and building capacity.
Spending time in the field getting proximate with communities is another critical learning experience for trustees embarking on working in complexity. Palm Health Foundation trustees attend community meetings with residents and speak one-on-one with resident leaders, providing valuable first-hand insight about the initiative. Inviting project directors and resident leaders to board meetings offers additional opportunities for trustees to learn about Healthier Together’s impact, and gives them a realistic, transparent view of the good work and challenges along the way.