Advancing Coalition Health Equity Capacity Using a Three-Dimensional Framework

Purpose: We examined coalition health equity capacity using a three-dimensional conceptual framework in a 3-year study (2011-2014) of 28 local coalitions engaged in health promotion. Methods: Coalition health equity capacity was defined according to (1) conceptual foundations, (2) collective action and impact, and (3) civic orientation. This framework was used to qualitatively assess progress in capacity building efforts at two time points. Coalition materials and archival documents were analyzed qualitatively for indications of each dimension of coalition health equity capacity. Results: The overall cohort of coalitions was initially determined to be near mid-range in conceptual foundations, above mid-range on collective impact, and below mid-range on civic orientation. As part of ongoing training and technical assistance, coalitions were offered examples of high coalition health equity capacity in each dimension. At time point two, growth in health equity capacity was observed in a majority of coalitions. Conclusions: These findings indicate that a multidimensional approach to coalition health equity capacity can be useful for both analysis and practical purposes of community capacity building, which may, in turn, produce long-term gains in health equity.