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Here’s a confession: when we first began developing the Community Action Model, we asked ourselves whether the community health field really needed another framework.

How many people were using the ones that already existed? And how helpful were these hypothetical structures when applied to real, messy, on-the-ground strategies?

But then we spent a year reconnecting with community leaders whose efforts we had supported in health improvement initiatives that ranged from two to five years. We asked them about how their work has evolved, what actions had led to sustained success, and what they’d have done differently if they could go back. Some of those stories are shared in the Communities in Action feature of the model.

The commonalities that emerged were so compelling, and so clear, that we knew we needed to share what we’d learned.

One of the most powerful themes we heard was the need to develop an equitable process of change. Given our field’s evolving understanding of health equity and how it is impacted by the social determinants of health, the specific strategies that coalitions use to improve health are myriad and must be tailored to each community’s context. However, we saw core practices that had contributed to success despite differences in what community members wanted to address and how they did it. We launched the Community Action Model in April 2016 as a visual representation of those lessons. Because of that distinction, the model has continued to highlight what it takes to create sustained, healthy change in communities, regardless of the specific health issues being addressed.

Here’s another confession: we realized the model’s structure still didn’t reflect how it was being used by local leaders.

In spring 2018, we refined it further to illustrate even more clearly what we know to be true: community change doesn’t happen in a step-by-step, orderly process. It happens in fits and starts, in cycles of two steps forward and one step back, between sectors that are learning to communicate with each other, and among partners with priorities that don’t always align. The only clear place to start is with community members themselves—by shifting power to people who are experiencing the health disparities we seek to end.

That’s why the Community Action Model is rooted in a process that ensures decisions are made by and with residents, not for them; why it is anchored within a community’s context; and why there is no clear entry or exit point. Each community is already making changes in one way or another, with varying strengths and different opportunities for growth. We designed the Community Action Model to be flexible so that community leaders can adapt it to improve work that is already happening, while retaining an uncomplicated clarity that underscores our unwavering belief in the importance of ultimately addressing each component of it.