The 3P Action Cycle reflects a community change process that is intended to be iterative, and not necessarily linear.
The process ensures intentionality about partnership, preparation, and progress strategies to change policies, systems, and environments for improved community health. Leaders of healthy community change initiatives can determine their own communities’ strengths and weaknesses within each step and address any gaps accordingly.
PARTNER
- Engage the Community
- Strengthen Multidisciplinary Coalitions
Partner with others to address complex issues. While positive community changes are often championed by strong and passionate individuals and organizations, sustained and impactful efforts require broader multi-disciplinary coalitions that set collective priorities and act in concert. Each participant brings a valued perspective. The Partner step involves the development—and dedicated maintenance—of a cohesive coalition with community members as authentic partners. This coalition meets and communicates regularly; creates a structure and organization that makes sense for the participants and the group’s mission; is driven by the needs of the community; and makes progress toward achieving goals and objectives. Successful coalitions comprise:
- An effective coordinating entity (for example, a “backbone" organization)
- Both emerging and experienced community leaders
- Professionals, advocates, and volunteers with varied expertise
- Community members who are most likely to be impacted by the issue the coalition is addressing
PARTNER Resources:
- Download the Essential Practice Wheels, which offer concrete examples of how to sustain community-led action to improve community health.
- Community Collaboration Services
- Growing a Movement: Partner Collaboration Was Critical for Success (p. 10)
- Investing in Healthy Community Change: Funders Need Friends (p. 23)
PREPARE
- Assess, Re-Assess, and Evaluate
- Prioritize and Plan
- Build Capacity
- Leverage Resources
Prepare continuously to succeed. While Preparation is clearly critical during the early stages of a community-change initiative, it is not just an up-front strategy. Rather, it is an ongoing and deliberate process of collecting data to plan, prioritize, and specify action steps; identify measures of success; evaluate an initiative; conduct listening sessions; provide appropriate training for partners; and pursue financial and in-kind resources to build capacity. Success should be determined by routine assessments of a partnership’s processes (e.g., partner engagement and satisfaction), impacts in the community (e.g., improved health-promoting environments), impacts on individuals (e.g., changes in health status), and other outcomes that best utilize available expertise and resources.
PREPARE Resources:
- Download the Essential Practice Wheels, which offer concrete examples of how to sustain community-led action to improve community health.
- Lessons for Leaders: Community Capacity Building, Create Structure(s) and Multiple Paths to What You Value Most (p. 20), and Advancing Policy/Systems Change (p. 46)
- Four Things We Learned from Evaluating Our Impact
- From AHA Community Health Improvement — Community Health Assessment Toolkit Resources
- From the Centers for Disease Control and Prevention — Community Planning for Health Assessment: Frameworks & Tools
PROGRESS
Identify and Implement Practical Strategies
Progress by identifying and implementing practical strategies. Just as each community exists in its own unique context, placed-based community change initiatives may not all follow the same formula for change, and some strategies will result in varying levels of impact and sustainability. Healthy community strategies must be practical within the context of each community. In a robust and sustainable community change initiative, the following strategies work to mutually reinforce each other by including a mix of "quick wins," interim milestones, and those with the potential for long-term support from organizations and systems. This strengthens aspects of each strategy to create impacts that are greater than the sum of their parts.
Promotions and Programs
Promotions increase awareness and encourage individuals to engage in healthy behaviors and create environments that support good health. Programs directly serve individuals or small groups by providing education or opportunities for healthy behaviors. Examples include cooking classes and walking clubs. While these strategies alone do not lead to sustainable community change, they can build public interest and support and help mobilize community members. Ideally, promotions and programs are implemented in a way that complements more sustainable policy, systems, and environmental strategies and help increase the use and sustainability of public places such as parks, farmers’ markets, and other gathering spaces.
Policy and Environmental Changes
A focus on policies and environments is a long-term strategy to support individuals’ personal choices by ensuring that communities are places where healthy behaviors are convenient, routine, and safe. Policy strategies influence government ordinances, regulations, and protocols. Changes in informal policies, like organizational practices, processes, or protocols, are also critical for lasting impact. Environmental strategies strive to make the physical spaces in our organizations, public places. They are often integrated with promotions and programs to improve health outcomes. Policy and environmental change strategies typically lead to longer-term impacts and can be initially implemented as pilot projects, which are valuable for testing new procedures or projects on a small scale.
Systems Changes
Strategies that emphasize changing larger systems can also lead to sustainable impacts. When communities have an integrated web of supports—including mutually reinforcing policies, environments, programs, funding, and organizational practices—healthy change strategies are institutionalized. “Health in All Policies” is one systems-level approach for governments to address existing norms or establish new ones, and to align indicators, accountability measures, and fiscal decisions to prioritize the health of the community in everyday decisions.
PROGRESS Resources:
- Download the Essential Practice Wheels, which offer concrete examples of how to sustain community-led action to improve community health.
- Growing a Movement, Policy and Environmental Change was Critical to Building a Culture of Health (p. 23)
- Lessons for Leaders: Advancing Policy/Systems Change (p. 46); Sustain the Policy Effort Through Implementation and Beyond (p. 58); and Embrace Complexity – Think About Strategy and Systems (p. 58)
- Investing in Healthy Community Change: Remember the Forest if Focusing on the Trees (p. 6)
- From North Carolina Department of Health and Human Services — NC Guide to Incorporating Health into Comprehensive Plans