Trilogies: Lessons from 50 Years Facilitating Community-based Health Assessments and Planning in Appalachia

Involvement of community and organizational groups is fundamental to most public ventures. Most social, health, economic, and educational improvements in Appalachia have been characterized by successfully integrating community input and finding ways to encourage organizational change and collaboration. Managing group process and related facilitation skills are fundamental competencies for public health professionals and others guiding change efforts. Groups from communities and organizations can get stalled in their deliberations; a facilitator frequently must think quickly to diagnose the situation and propose alternative approaches. Creative and flexible approaches, learned through practice experiences, can blend with theories and frameworks learned in academic preparation from multiple disciplines in order to effectively encourage group progress. Over a 50-year career (1972-2022), sets of three related concepts were formed as trilogies and used during work with groups of diverse compositions, in multiple locations, and addressing varied topics. The trilogies proved helpful in encouraging group tasks related to assessment, planning, monitoring, and evaluation. Trilogies also were deployed as a facilitation technique to pose thoughtful options as groups considered difficult issues and maneuvered through stagnant or conflict-prone situations. This paper presents twelve trilogies organized around six common group-process questions. A reference for the source of each trilogy is provided, and several Appalachian-specific examples of how trilogies were deployed are described.