The UFH coalition’s efforts over a two-year period resulted in five new community gardens, three new pop-up produce markets, one new farmers’ market, and three farmers’ markets with expanded EBT access. Community gardens ranged in size (< 300–1500 ft2 with 3–30 gardeners). All pop-up markets had cooking demonstration components with educational events for community members—two were implemented in front of or inside a faith-based organization. During the two-year period, the pop-up markets reported selling over 13.5 tons of produce.

UFH coalition: participation, engagement, strengths, and maturation

Overall, 18 UFH coalition meetings were held monthly between January 2013 and September 2014 (duration range: 2–3 h). Attendance, a proxy for participation, was consistently high and stable by organization—an average of 33 individuals attended each meeting (range: 21–37 individuals per meeting).

Main meeting agenda topics consisted of roundtable discussions, project updates, and opportunities for coordination and collaboration. Roundtable discussions were on issues directly and peripherally affecting intervention implementation from members’ perspectives (e.g., economic development, gentrification). A retreat was held in November 2012 and 2013.

According to WCFI results, the UFH coalition underwent three stages in a classic process of group development and collaboration, namely: forming, storming, and norming [37]. During the formation period, optimistic scores suggest partners were committed to working together and shared a mutual purpose since the mean purpose score was > 4.0. During storming, the group identified key barriers and challenges to collaboration and implementation, which may have resulted in decreased scores for all categories except communication. Toward the end, perspectives seemed to normalize as members expressed a realistic view of coalition strengths and weaknesses and scores for all WCFI categories improved from midpoint. Table 1 includes the mean scores for each WCFI category at each data collection wave.

Table 1 Wilder Collaboration Factors Inventory (WCFI) mean scores by category, completed by United for Health coalition members at three waves (2012, 2013, 2014)

WCFI results indicate the UFH coalition grew stronger in nearly all categories over time. Membership characteristics and communication improved from potential strengths/weaknesses to strengths—suggesting the legitimacy of these groups in their communities and that communication strategies were foundational to coalition growth and maturation.

During interviews and meetings, most members said they valued working together in a large, diverse collaborative. Several respondents said the diversity and non-competitive atmosphere were strengths that promoted a sense of group identity as mentioned by a CHC staff member, “The collaborative itself demonstrates that CBOs can work in a non-competitive atmosphere to pool our collective knowledge, skills, and leverage relationships for the betterment of our communities.” CHC and other partners provided technical assistance and learning opportunities that also emerged as strengths. Project updates during monthly meetings were said to be a primary vehicle for inter-organizational and cross-community learning.

Coalition and implementation challenges and barriers

WCFI results found collaboration resources was the sole category that decreased from beginning to end—likely due to the end of external funding. Time and scheduling constraints, insufficient funding/monetary resources, and limited staff capacity were persistent challenges to participating in coalition activities. At the beginning, several respondents said that scheduling a meeting time was difficult and some felt overwhelmed by the frequency of meetings/contact.

Project implementation challenges included limited time and resources (i.e., staff, funding), lack of community health planning knowledge, and social context barriers. Nearly all members said limited time on interventions and being short staffed were key barriers. Other challenges in the first year were a lack of knowledge about municipal licensing and application processes and difficulty navigating permit application processes. Some participants said adding EBT access was more challenging for pop-up produce markets compared to farmers’ markets due to administrative hurdles, as described by a participant from L.A. Works: “Getting EBT access is a huge barrier. Obtaining an EBT account has a lot of requirements, and it is difficult.”

Social context barriers emerged as well. For example, expanding EBT access to existing farmers’ markets was particularly contentious in a neighborhood undergoing gentrification. Respondents believed resistance stemmed from market managers discriminating against low-income customers and individuals experiencing homelessness.

Leadership development, intra-organizational change, and community impact

According to LLSA survey results, a majority (74%) said they believed participating in the UFH coalition had moderate to long-term impacts on their leadership development. A participant from Esperanza Community Housing Corporation commented, “UFH has helped my organization diversify leadership under the grant period. It has certainly helped strengthen the power and confidence to lead.” Younger UFH participants said they felt increasingly confident speaking up in meetings as they gained experience, confidence, and knowledge—a finding supported by the increased frequency of speech among younger participants over time.

Over 50% of participants reported their engagement in the coalition directly or indirectly influenced organizational, program, and systems changes in their communities. Only 13% reported being aware of related policy changes (see Table 2).

Table 2 United for Health coalition member perceptions of the coalition’s impact on organizational, program, systems, and policy changes, Leader Learning Self-Assessment (LLSA), September 2014 (N = 23)

In terms of organizational change, participants generally said the coalition led to increased funding, staffing, and intervention development skills. A coalition member from Special Service for Groups, Inc. said, “[UFH] allowed our staff size to grow, which consequently led us to build more projects and relationships to further our growth.” A participant from Families in Good Health said they were, “able to gain skills to improve access to healthy foods through farmers’ market development.” Many members also spoke of the power and value of the coalition to enact environmental changes and to modify the built environment to improve access to nutritious food with the addition of new retailers and community gardens.

An area where participants were unsure of the impact of the coalition was policy change—61% reported being unsure if the coalition influenced policy. Qualitative data suggests the coalition may have laid the groundwork for policy change by providing a means for learning about policy options, establishing relationships across communities, and promoting intra-community dialogue about policy as reflected in the following quote by an individual from Esperanza Community Housing Corporation:

Witnessing residents’ commitment to maintaining the garden and making healthier food choices is concrete evidence that this project has served its purpose. The community gardens we have established have also helped us foster social responsibility by engaging families in beautifying their community and creating dialogue around policy change.

Culturally adapting interventions and community health planning skills

Emergent themes focused on learning and knowledge obtained through coalition activities consisted of increased 1) awareness of the importance of culturally adapting interventions, and 2) knowledge of community health planning topics.

Process evaluation data reveals several UFH members began integrating community perspectives and preferences into interventions to increase their cultural relevance. Participants from one organization implementing pop-up markets and cooking demonstrations said they learned about the importance of culturally adapting recipes to include traditional foods preferred by customers to increase intervention success. One said they increased the availability of culturally relevant products for Filipino and Latino communities after coalition meeting discussions on the importance of eliciting food preference perspectives from customers.

Some participants reported increasing their awareness of different racial/ethnic groups and gained cultural competence skills—growing their awareness of the importance of conducting assessments on cultural food preferences as part of intervention design. Participants from the Los Angeles Community Action Network and Esperanza Community Housing Corporation commented on the value of asking community members for their preferences:

We incorporate what folks say about what they want to grow and why they want to grow it—certain chilies, fruits, herbs native to their cultures and experiences in life. We have an educational exchange. We don’t always have experience in growing what the community wants to grow, so they teach us.

For the garden, we made sure we had herbs and other plants Latinos [use] and got feedback from community meetings to see what they wanted. The next garden will be predominantly Ethiopian and African American. They want okra and greens so we took an assessment prior to building the garden as well as introducing them to new foods.

Participants said having adequate time to experiment and test out innovative strategies as part of implementation was important. A participant from L.A. Works explained the value of testing out ideas: “Sometimes we have a fusion, like I featured collard tacos to combine African American popular ingredients with Latino dishes so we could engage and attract and appeal to everybody that comes to the markets. I got interesting feedback. Some people loved it and some never thought about doing something like that. Some walked away shaking their heads.” A participant from Jubilee Consortium said, “it has been a good experience for us to do two years of training to understand what works and what didn’t and to see what others are doing.”

Many respondents also said they obtained knowledge of community health planning topics and activities. A majority reported experiencing a shared sense of identity as a group, improving their community planning skills, and expanding their professional network across neighborhoods.

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