A qualitative exploration of alternative strategies for building community health partnerships: collaboration- versus issue-oriented approaches.

Broad-based community partnerships are seen as an effective way of addressing many community health issues, but the partnership approach has had relatively limited success in producing measurable improvements in long-term health outcomes. One potential reason, among many, for this lack of success is a mismatch between the goals of the partnership and its structure/membership. This article reports on an exploratory empirical analysis relating the structure of partnerships to the types of issues they address. A qualitative analysis of 34 "successful" community health partnerships, produced two relatively clear patterns relating partnership goals to structure/membership: (1) "collaboration-oriented" partnerships that included substantial resident involvement and focused on broader determinants of health with interventions aimed at producing immediate, concrete community improvements; and (2) "issue-oriented" partnerships that focused on a single, typically health-related issue with multilevel interventions that included a focus on higher-level systems and policy change. Issue-oriented partnerships tended to have larger organizations governing the partnership with resident input obtained in other ways. The implication of these results, if confirmed by further research, is that funders and organizers of community health partnerships may need to pay closer attention to the alignment between the membership/structure of a community partnership and its goals, particularly with respect to the involvement of community residents.