Transcript of Episode 8: Community Engagement 

with host David Richards [DR] and guest Jennifer Sweeney [JS] 
Listen to the audio

[DR] This week on the Healthy Communities Podcast we’re going to talk about community engagement with Jennifer Sweeney, Senior Advisor at the National Partnership for Women and Families. We’ll see why effective public health initiatives take much more than just, “build it they will come.”

[DR] Welcome to the Healthy Communities podcast; a public health-themed podcast that breaks down common health issues in our communities, and how Healthiest Cities & Counties Challenge projects aim to address them. I am your host, David Richards from APHA. This is Episode 8: Community Engagement. 


[DR] Well, thank you so much for joining me. I’m here with Jennifer Sweeney from the National Partnership for Women and Families. Please, can you introduce yourself? Welcome to the podcast. 

[JS] It’s so good to be here. Thank you so much for inviting me. As you said, I’m Jennifer Sweeney. I’m a senior advisor for an organization called the National Partnership for Women and Families. I’ve been at the National Partnership for almost 15 years and in my current role for about two years. We were founded in 1971; we’re located in Washington, DC, and we are a nonprofit nonpartisan advocacy group. We have two main portfolio groups: Workplace issues and healthcare. Within our healthcare portfolio, we work to ensure access to affordable, quality healthcare. 

[DR] What is your background? How did you get started in that? 

[JS] I’m actually a community organizer by background. I spent many years out in the field working on healthcare issues and engaging the community on healthcare issues. It’s one of the reasons why the National Partner is so supportive of the Healthiest Cities & Counties Challenge. This is just a tremendous opportunity for us to be involved and to support the finalists in their work to advance better health in their communities. 

[DR] Let’s get into that. Community organizing for whom? 

[JS] When I was a community organizer, back in the day, in my early days, my role was to go into the community and engage members of the community in lots of different healthcare initiatives: healthcare quality improvement initiatives, healthcare delivery reform initiatives, public health like the Healthiest Cities & Counties Challenge, and my role has been in all the work that I’ve done is to ensure the community is in a leadership role at the table, to work with other stakeholders, to design, implement and evaluate programs. And to make sure that they meet their needs and the community’s needs. 

[DR] And this was for a national audience, local audience? 
[JS] The biggest project that I worked on was funded by the Robert J. Wood Foundation called the lining forces for equality. It took place in about 16 communities around the country. We worked for about eight years to engage the entire community around healthcare policy improvement. 

[DR] So, nationally?

[JS] Yes, all over the US.        

[DR] The reason why, as you mentioned, you were brought on for the Challenge is because your extensive background in community organizing, and you’ve seen this play out in the Challenge for projects that are trying to up their engagement and to inspire their community for these health projects. What is community engagement, how would you define that? 

[JS] I’m glad that you asked the question because I think that there are a lot of varying definitions out there and I’ve been so impressed in the way at which the Aetna Foundation, the American Public Health Association and the National Association of Counties have been really intentional in the way that you all have defined community engagement for the this initiative. In our work, this is how we’ve been defining it. Community members are active in the leadership, and they’re engaged in the design, the implementation and the evaluation of the work.      

[DR] Can you give me some examples of that? 

[JS] When you apply that definition to a public health perspective or to a public health project, that means that the community’s public health needs and priorities are front and center, and that they work with other stakeholders. Maybe it’s the public health department or local businesses or lawmakers, they work with them to craft interventions and programs to advance health in the community and really to create positive health impacts. 

[DR] The biggest question is how do you do this? Where do you even start? How do you activate you community to tackle something so large and widespread?

[JS] I think I try to distill it down to two main tenets: one is to listen and two is to be curious. I think we can’t actually know what it is the community actually needs and wants without sitting down and talking with them, and being really curious about what are their healthcare priorities, what are their barriers and challenges when trying to achieve their priorities, and that takes listening. What I’ve seen in the Challenge is really phenomenal. I’ve seen the finalists survey the entire community to better understand what their priorities, their needs and their challenges are. I’ve seen them sit down in listening sessions and really take the time to understand what it is the community wants when they say health and what it is they’re looking for in the Challenge. I’ve also seen them go to neighborhood association meetings after neighborhood association meetings and really take the time to listen and to ask them in their best case scenario, what would you like to see from this Challenge and how would you like it to affect you and your neighbors. That’s what community engagement is and it’s been so wonderful to see the finalists do this work in a really meaningful way. 

[DR] I’m going to challenge you here: what if there’s an impasse in what the health department wants verse what the community wants?

[JS] You are talking to someone who thinks that if a project is going to be truly inclusive and aimed at the community, then the public health department has to really take into account what they want. I have actually seen so many projects over the years unfortunately fail because they think that there’s this sense of well if we build it, they’ll come. In reality, anything related to health and related to humans, requires that humans trust one another. Coming into a community and building something for people verses with them is not an effective way to build relationships and trust. What I’ve seen time and time again is that in fact those community members reject those types of projects. I think it takes negotiation; it takes listening on both sides and trying to find a win-win. What does the public health department want that overlaps with what community members want? And what is it that community members want that they can negotiate with the public health department. Everyone needs to come to the table listening and interested in trying to find common ground to advance health in the community. 

[DR] That’s a great answer. Thank you. So let’s talk about how. You mentioned listening sessions and surveying, how do those work?

[JS] I like to think of them as not overly structured. I think asking questions, telling us about your lived experiences in this community. Are you able to access the things that make us healthy? Is the built environment, built in a way that can help you walk as much as possible? Are there grocery stores in a close proximity to where you live where you can access healthy foods? Those are a couple of examples. I don’t like to go into those listening sessions in a scripted way. I think it’s really important for there to be dialogue. It’s also an opportunity for the community to ask questions of any type of initiative that’s being planned like what are you hoping to get out of this, and how can we play a part as community members in making this successful. It’s really a two-way street and real dialogue. 

[DR] One thing that we’re seeing in the Challenge at least is there is community engagement or there’s an active partnership. What’s the difference between the two and are they the same? 

[JS] That’s a good question. I think they can be similar. I also think that they can be different. I think of active partnerships as organizations and community groups that are coming to the table on a regular basis with some kind of in kind contribution to the effort. That might be faith-based organizations that are saying that we want to be in this with you for the long haul. We are going to participate in your leadership group. We are going to provide space in our mosque, church or synagogue for us to meet here and there. We’re also going to connect you with the members of our congregation or group of some kind. Those I think of as community partnerships. Partnerships mean that they also share financial resources with the effort. I think community engagement is a little bit different. In some cases and ideally, you’ll have members of the community involved in the leadership. It might be harder for them to bring to the table more than just their time. They may not have access to a room for people to meet. They might not have the financial resources to devote to the project, but what I’ve seen in the Challenge is an incredible number of members who have said that this work is really important to us and to the community and I’m going to devote time to it. There’s one finalist who has 700 community members working with them on a regular basis. That’s pretty incredible. 

[DR] It is very impressive. How do you maintain that? How do you have the stamina to keep your community empowered? 

[JS] I think you can’t not have the stamina. The moment that you decide that the project is no longer for the community and with the community, you’re in danger of losing the sustainability of the project overall. There are a couple of things that I would advise. One is to never launch an initiative like this without having a community engagement plan in place. In that way, throughout the course of the initiative, have a set of ways in which to engage the community. You’ve already figured out what those will be. A couple of ideas off the top of my head make sure that you’re finding ways to highlight the community and their involvement. That might be, if you’re meeting with lawmakers about the initiative, make sure community members are standing right beside you as that meeting is taking place. If you’re going to be featured in a local, state or even national news story of some kind about this great work that you’re doing, make sure that community members are with you being quoted in talking about their experiences in the initiative. I think that is a great way to keep people inspired and motivated to work with you. Then, I think the two other things I would say, is to make sure that through the course of the initiative, there’s an opportunity for community members to way in and share their thoughts and experiences with the initiative. You know, you don’t want to be trucking along with your work and never ask the community, “How is this going? Are we still on the right track? Should we keep on going the way that we’re going or do we need to pivot and do something differently.” We get into trouble when we barrel forward without checking in and making sure that we’re heading in the right direction. 

[DR] That’s great. To that sustainability point, what’s the end goal?

[JS] I think the end goal can be different depending on the initiative. Some initiatives by their very nature are time limited and that’s okay. If you set out to achieve something, for example, to make sure that there’s a grocery store in an area where that community has never had one before and you achieve that, that’s phenomenal. You may not want to sustain the work beyond that or you want to find a way to build on that success to make inroads on other public health areas. In the case of other initiatives, you might be supported by this Challenge for two years, and then at the end of the two years you need to figure out how you’re going to sustain this work. We’ve just sort of begun, this is a long-term initiative that’s going to take us 10 years to achieve our goal. I would say that you want to find ways to diversify your funding and to look for additional partners perhaps, they can be helpful also in diversifying that funding. The other key part in sustainability is looking at what you’ve done at what has worked what you should continue, and what hasn’t that you really need to change up. Because you can’t sustain something that has Swiss cheese holes all the way throughout it, and there really is no reason to. I think sustainability is about all of those things. 

[DR] Of course. You touched on this earlier, but I wanted to go back to it. You talked about community leaders. Who are those people? 

[JS] I think community leaders really vary throughout communities. It can be tempting to assume that community leaders are the heads of community organizations or the priest at the head of the church, when in fact, many communities have leaders who have just lived in the community, living and working there for 25-30 years, even 5 years who are incredible invested in where they live and who want to play a role in making sure that the community is as healthy as possible. These are people who, I like to think of as extreme extroverts. They know everyone in the community; they have a way to connect with neighbors and friends and faith-based groups and other community organizations. Their ear is always to the ground in terms of what the community is thinking and what they’re hoping for in the initiative. I would be as broad as possible when you’re thinking about community leaders. Then, of course, there are all your standard community leaders that you would think of: the head of a business organization, certainly they are going to be heads of the community that you’d want to engage. I’ve mentioned faith based organizations several times. Certainly, you’d want to involve them as well. I also wouldn’t leave out groups like AARP for example. There are so many different community organizations available that are really interested in health and health promotion and I would reach out to them as well. 

[DR] Let’s turn to the Challenge. What has been your role on working with the Challenge?

[JS] My role with the Challenge, and our role from the National Partnership, has been to support the finalists in their community engagement work and helping them be successful in engaging the community in meaningful ways. 

[DR] What are you seeing?

[JS] I am so happy with the work that the finalists have done to really engage the community in their efforts, everything from making sure community members are part of their leadership and sitting side by side with them to determine what this Challenge looks like and how it’s rolled out to being part of the evaluation of these initiatives. Again siting side by side with community members and the leadership to say this is working or this isn’t working or we’ve collected this data and it looks good but here is what we need to do moving forward. Those are best practices when it comes to community engagement. I’ve also seen some really innovative things in some of the finalists. I love the finalists that have looked at the youth in their community and seen the possibility and made sure to be proactive about engaging their youth in their work. Because looking at what we just talked about a moment ago with sustainability, the best way to make an initiative and healthcare and health a priority in the community is to make sure that the next generation sees it as a priority. The projects that have done great work to engage that next generation, I think have been incredibly smart and innovative. The other thing that I’ve been impressed with the Challenge and the finalists is their commitment to equity and working on healthcare disparities. That’s a challenging initiative to take on and they haven’t shied away from it at all. I’ve loved how these finalists have gone into communities where there are significant disparities in health outcomes. There are major barriers to health and they have found ways to address them whether that’s going to corner stores and making sure that they’re stocked with healthy food and making sure the community has access to them to changing the built environment to ensure that people can truly move their bodies in healthy ways to building community gardens where the entire community from the youngest to the eldest can play a part in nourishing each other with healthy food. That’s beautiful and it’s been wonderful to see. 

[DR] So I’ve heard that you have some good advice. Please share with me your advice either for the finalists or in general. 

[JS] I’m most interested in giving advice on community engagement itself. I’ll be honest; I don’t think that the finalists need advice. They’ve really knocked it out of the park. It’s been such a joy to be part of this work and to see their successes when it comes to community engagement. If there are others out there who are listening to the podcast and are hoping to achieve success in community engagement, I have two closing thoughts that I’ll share: One is that I would not launch a public health initiative without creating a community engagement plan and being really specific in the plan about how you will intentionally and meaningfully engage community members. When I say engage, I mean in leadership, in designing the project itself and then in implementation and evaluation. All of those components are really important. I think the second piece of advice I would give is to abolish this mindset of, if we build it, they will come because we’ve seen over and over again that that’s not the case in both public health and healthcare. It’s perfectly natural for well-meaning folks to want to create something to enhance public health but without doing it in collaboration with the community, we’re really setting ourselves up for failure. My advice would be to follow these Challengers and finalists and look at what they’ve done and take a page out of their book and do some great work in your community.                                     


[DR] That’s the show this week! Thank you to my guest Jennifer Sweeney, and thank you all for listening. Links to more resources can be found on the Healthiest Cities & Counties Challenge website at healthiestcities.org under about the challenge, podcast. I’ll see you next time.