Context
Rural communities face unique challenges including fewer healthcare providers and
restricted access to nutritious foods, likely leading to poor health outcomes. Community
health coalitions are groups of local organizations partnering to address local health
needs. Employing such coalitions is one strategy for implementing policy–system–environment
changes for improving rural health. However, their success is variable without standardized
evaluation. In this review, rural community health coalitions were retrospectively
assessed using the W.K. Kellogg Foundation Logic Model. Community health coalition–reported
pathways through this model were explored using market basket analysis.
Evidence acquisition
During Spring 2018, PubMed, Web of Science, ScienceDirect, CINAHL, and PsycINFO were
searched for (coalition) AND (rural) AND (health) AND (effectiveness OR impact OR outcome OR logic
model). Full-text, peer-reviewed, English articles meeting PICOS criteria (Population, rural
communities; Intervention, presence of a community health coalition; Comparator, the
coalition over time; Outcomes, logic model pathways) were reviewed. During Summer
and Fall 2018, coalition-reported pathways were categorized according to logic model
inputs and resources; internal and external activities; outputs; short-, medium-,
and long-term outcomes; and impact. Market basket analysis was conducted during Winter
2018.
Evidence synthesis
The 10 most frequently reported pathway items were partner diversity; organizational
structures; implementing pilot studies, programs, and interventions; funding; community
engagement and outreach; university partners; holding regular meetings; having working
groups and subcommittees; operating under or partnering with a regional research initiative;
and conducting a community health and needs assessment. Half of community health coalitions
reported 4 or more of the following: funding; partner diversity; university partners;
organizational structures; community engagement and outreach; and implementing pilot
studies, programs, and interventions.
Conclusions
Many rural community health coalitions reported inputs and capacity building; few
impacted health. Recommending common early phase logic model pathways may facilitate
downstream success.
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