Key Words coalition, community and systems change, environmental change, community health improvement, population health improvement s Abstract Collaborative partnerships (people and organizations from multiple sectors working together in common purpose) are a prominent strategy for community health improvement. This review examines evidence about the effects of collaborative partnerships on (a) community and systems change (environmental changes), (b) community-wide behavior change, and (c) more distant population-level health outcomes. We also consider the conditions and factors that may determine whether collaborative partnerships are effective. The review concludes with specific recommendations designed to enhance research and practice and to set conditions for promoting community health.

Although community capacity is a central concern of community development experts, the concept requires clarification. Because of the potential importance of community capacity to health promotion, the Division of Chronic Disease Control and Community Intervention, Centers for Disease Control and Prevention (CDC), convened a symposium in December 1995 with the hope that a consensus might emerge regarding the dimensions that are integral to community capacity. This article describes the dimensions that the symposium participants suggested as central to the construct, including participation and leadership, skills, resources, social and interorganizational networks, sense of community, understanding of community history, community power, community values, and critical reflection. The dimensions are not exhaustive but may serve as a point of departure to extend and refine the construct and to operationalize ways to assess capacity in communities.

Models of community empowerment help us understand the process of gaining influence over conditions that matter to people who share neighborhoods, workplaces, experiences, or concerns. Such frameworks can help improve collaborative partnerships for community health and development. First, we outline an interactive model of community empowerment that describes reciprocal influences between personal or group factors and environmental factors in an empowerment process. Second, we describe an iterative framework for the process of empowerment in community partnerships that includes collaborative planning, community action, community change, capacity building, and outcomes, and adaptation, renewal, and institutionalization. Third, we outline activities that are used by community leadership and support organizations to facilitate the process of community empowerment. Fourth, we present case stories of collaborative partnerships for prevention of substance abuse among adolescents to illustrate selected enabling activities. We conclude with a discussion of the challenges and opportunities of facilitating empowerment with collaborative partnerships for community health and development.

The dual purposes of applied research-contributing to understanding and improvement-are only partially served by method systems that encourage studying (with increasing precision) a narrow range of questions of modest societal importance. To optimize contributions to challenging societal problems, a field's cherished standards should be adapted to support more adventuresome forms of community research and action. This paper outlines 10 values for community research and action, based on insights from the fields of behavioral and community psychology. These values-reflect the goals and challenges of establishing collaborative relationships with research participants, determining research goals and methods, designing and disseminating interventions, communicating research findings, and advocating for community change. Critical challenges are outlined, and implications for the field and its clients are discussed.

When people with disabilities, ethnic minorities, older adults, women, and others lack power, they usually experience adverse conditions disproportionate to other members of society. Empowerment--the process by which people gain some control over valued events, outcomes, and resources--is an important construct for understanding and improving the lives of people of marginal status. This manuscript presents a contextual-behavioral model of empowerment and its application in collaborative research with people with physical disabilities. The eight case studies illustrate 18 tactics for promoting empowerment that flow from the model. The case studies show the use of different combinations of empowerment tactics in a variety of contexts: (a) setting improvement agendas from the perspective of people with disabilities, (b) enforcing ordinances that preserve access to parking spaces designated for people with disabilities, (c) enabling access to homes through housing modifications, (d) enhancing support available through mutual-aid groups, (e) developing skills for recruiting mentors, (f) promoting self-directed behavior change with personal and health concerns, (g) enhancing skills for personal self-advocacy, and (h) building the capacities of groups of people with disabilities for systems advocacy. Finally, we discuss issues that may contribute to research and action related to empowerment.

Community coalitions are prominent mechanisms for building local capacities to address health and social concerns. Although there are case studies and descriptive reports on coalitions, there is little empirical information about coalition process and outcome. This paper describes a case study using a methodology for monitoring and evaluating community health coalitions. Data are fed back to coalition leaders and members, funding agents, and other relevant audiences as part of the development process. The monitoring system provides data on eight key measures of coalition process and outcome: the number of members, planning products, financial resources generated, dollars obtained, volunteers recruited, services provided, community actions and community changes. Illustrative data are presented for two different community health coalitions. Finally, challenges and opportunities in evaluating community coalitions are discussed.

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In the United States alone, there are over two thousand community coalitions to address