Article type
Year
Abstract
Background: A popular approach to reducing health disparities in minority populations is mobilization of community coalitions that include representatives of target populations to foster change at the local level.
Objectives: To assess the effects of community coalition-driven interventions on improving health status or reducing health disparities among racial and ethnic minority populations.
Methods: A systematic review of 58 studies from the USA, Australia, Canada, the UK, and the Netherlands assessed the effects of coalition-led interventions on improving health or reducing health disparities. Outcomes addressed an array of conditions including asthma symptoms, tobacco use, body weight, cancer screening, alcohol and drug use, and HIV/AIDS risk behaviors. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population, and at least two community public or private organizations, were included. Studies were restricted to cluster randomized controlled trials, randomized controlled trials, quasi-experimental designs, controlled before-after studies, interrupted time-series studies, and prospective controlled cohort studies.
Results: Broad health and social care system-level change strategies produced positive small effects. Lay health outreach worker interventions produced fairly consistent positive effects. Group-based health education led by peers produced inconsistent effects of inconsistent magnitude. Group-based health education led by professional staff produced consistently positive effects of moderate magnitude.
Conclusions: coalition-led interventions connect multi-sectoral networks of health and human service providers with ethnic and racial minority communities in ways that benefit a diverse range of individual health outcomes and behaviors, as well as health and social-care delivery systems. The evidence does not provide an explanation for the underlying mechanisms of the beneficial effects, which is critical to understanding whether a coalition-led intervention adds value to other community engagement intervention strategies.
Objectives: To assess the effects of community coalition-driven interventions on improving health status or reducing health disparities among racial and ethnic minority populations.
Methods: A systematic review of 58 studies from the USA, Australia, Canada, the UK, and the Netherlands assessed the effects of coalition-led interventions on improving health or reducing health disparities. Outcomes addressed an array of conditions including asthma symptoms, tobacco use, body weight, cancer screening, alcohol and drug use, and HIV/AIDS risk behaviors. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population, and at least two community public or private organizations, were included. Studies were restricted to cluster randomized controlled trials, randomized controlled trials, quasi-experimental designs, controlled before-after studies, interrupted time-series studies, and prospective controlled cohort studies.
Results: Broad health and social care system-level change strategies produced positive small effects. Lay health outreach worker interventions produced fairly consistent positive effects. Group-based health education led by peers produced inconsistent effects of inconsistent magnitude. Group-based health education led by professional staff produced consistently positive effects of moderate magnitude.
Conclusions: coalition-led interventions connect multi-sectoral networks of health and human service providers with ethnic and racial minority communities in ways that benefit a diverse range of individual health outcomes and behaviors, as well as health and social-care delivery systems. The evidence does not provide an explanation for the underlying mechanisms of the beneficial effects, which is critical to understanding whether a coalition-led intervention adds value to other community engagement intervention strategies.