We outline the process and development of the Well Connected Communities health initiative as undertaken in three Utah communities. This transformative community-focused alternative to addressing public health issues through Extension situates local communities as the origin for health decision making. The initiative recognizes the need for varied community statuses (i.e., planner, implementer, and innovator) based on varying levels of readiness and diversity of populations. We concluded that the Utah Well Connected Communities initiative aligns well with the 2014 Extension Committee on Organization and Policy National Framework for Health and Wellness. Replication requirements and implications for other Extension programs are presented

Garcia, Zurishaddai

Jensen, Christine E.

MacArthur, Stacey

Prevedel, Suzanne

Sulzer, Sandra H.

Voss, Maren Wright

English

Clemson University: TigerPrints

Journal of Extension Volume 58 Number 2 Article 11 April 2020 Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative Sandra H. Sulzer Utah State University Stacey MacArthur Utah State University Zurishaddai Garcia Utah State University Christine E. Jensen Utah State University Suzanne Prevedel Utah State University See next page for additional authors This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License. Recommended Citation Sulzer, S. H., MacArthur, S., Garcia, Z., Jensen, C. E., Prevedel, S., & Voss, M. W. (2021). Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative. Journal of Extension, 58(2). Retrieved from https://tigerprints.clemson.edu/joe/vol58/iss2/11 This Ideas at Work is brought to you for free and open access by TigerPrints. It has been accepted for inclusion in Journal of Extension by an authorized editor of TigerPrints. For more information, please contact kokeefe@clemson.edu. Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative Authors Sandra H. Sulzer, Stacey MacArthur, Zurishaddai Garcia, Christine E. Jensen, Suzanne Prevedel, and Maren Wright Voss This ideas at work is available in Journal of Extension: https://tigerprints.clemson.edu/joe/vol58/iss2/11 April 2020Volume 58Number 2Article #v58-2iw1Ideas at WorkScaling Community Health Coalitions: The Well ConnectedCommunities Pilot InitiativeAbstractWe outline the process and development of the Well Connected Communities health initiative as undertaken inthree Utah communities. This transformative community-focused alternative to addressing public health issuesthrough Extension situates local communities as the origin for health decision making. The initiative recognizesthe need for varied community statuses (i.e., planner, implementer, and innovator) based on varying levels ofreadiness and diversity of populations. We concluded that the Utah Well Connected Communities initiativealigns well with the 2014 Extension Committee on Organization and Policy National Framework for Health andWellness. Replication requirements and implications for other Extension programs are presented.Keywords: opioids, wellness, community health, youth, 4-H    IntroductionIn 2014, the Extension Committee on Organization and Policy introduced and disseminated a nationalframework for health and wellness (Braun et al., 2014). Soon after, the Robert Wood Johnson Foundationpartnered with Cooperative Extension and the National 4-H Council to launch a community-based healthinitiative known as Well Connected Communities (WCC). This initiative was designed to launch, grow, andsustain health coalitions to conduct needs assessments, develop action plans, and transform communities.Utah State University was one of the first five pilot-funded institutions.Sandra H. SulzerAssistant Professor ofHealth and WellnessDirector of the Officeof Health Equity andCommunity OutreachUtah State UniversityLogan, Utahsandra.sulzer@usu.edu@DrSulzerStacey MacArthurExtension AssociateProfessorUtah State UniversityLogan, Utahstacey.macarthur@usu.edu@4hvolproZurishaddai GarciaExtension AssistantProfessorUtah State UniversityKaysville, UtahZuri.garcia@usu.eduChristine E. JensenExtension AssociateProfessorUtah State UniversityCastledale, Utahchristine.jensen@usu.eduSuzanne PrevedelExtension AssistantProfessorUtah State UniversityRoosevelt, Utahsuzanne.prevedel@usu.eduMaren Wright VossProfessional PracticeExtension AssistantProfessorUtah State UniversityProvo, Utahmaren.voss@usu.eduEach institution selected three communities designated as planner, implementer, and innovator forimplementing the WCC initiative. The labels reflect increasing levels of community readiness in terms ofcommunity health coalition infrastructure. Planner communities were required to develop a coalition andconduct a needs assessment. Implementer communities were to grow a coalition and complete a needsassessment and action plan. Innovator communities did all of the above and executed an action plan whilealso training volunteers.Here we outline the implementation and outcomes of the Utah program. We identify challenges, solutions,and results that occurred in the communities related to the process of establishing, growing, and sustaininghealth coalitions at different levels of readiness. Lastly, we provide experience-based guidance for otherswishing to further the work of operationalizing Extension as a backbone for health promotion (Parisi et al.,2018).Program LaunchOur team comprising a health and wellness specialist, a 4-H specialist, and four faculty members withhealth and wellness expertise reviewed competitive WCC applications from interested Utah communities.The three counties selected were distinct with regard to cultural, demographic, and geographiccharacteristics, and each had a unique self-selected health focus. We placed the majority of grant funding atthe county level, including funding for half-time local coordinators, recognizing that community effortsshould be led from within.Community-Building ProcessThe starting point, challenges, and solutions for each county are outlined in Table 1.Table 1.Community CharacteristicsCountyReadinesslevelHealthfocus Context Challenges Solution(s) ResultsEmery Planner Opioids Second highest innumber of opioid-relatedemergencydepartmentencounters(Harrison, 2017)Fourth highest innumber of peoplewho have diedfrom opioidpoisoning(Harrison, 2017)Stigmapervadedcommunityefforts.Communityawareness ofthe issue waslimited.Grantadministrationwas a newprocess.Partneringwith aneighboringcounty'scoalitioneffortsHeldcoalitionkickoffmeeting byMay 2018Placednaloxone kitsin everyschool andcounty officeHeld a drugtake-backIdeas at Work Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative JOE 58(2)©2020 Extension Journal Inc. 1No programs orcoalitions toaddress opioidmisuseeventUintahandDuchesneImplementer DiabetespreventionandmanagementNative Americansdisproportionatelyaffected by type2 diabetesLacking in healthprograms thatengage youthsalong with adults,which areparticularlyeffective amongNative Americans(Chambers et al.,2018).Youthperspectiveslacking inpreexistingcoalitionNonnativestaff andpositionturnoverimpairedconnectingwith localyouths.Youths attendmultipleschools in abroadgeographicarea.Few nativeyouthsparticipate intraditionalcounty 4-Hclubs.Very fewnativevolunteerleaders werein place.Hiring of alocal memberof tribe tobring coalitionback on trackPrioritizingprofessionaldevelopmentfor new staffin generalUtah 4-Hmethodology,4-H HealthyLivingprogramming,and YouthMental HealthFirst AidprogramWorking withmunicipaland triballeaders tocreate awalking pathfor safeexerciseExpandedyouth-ledfocus toincludecreatingcommercialtobaccopolicies forthe Ute Tribeand mentalhealthDavis Innovator(changed toImplementer)Latino teenmentalhealthThird mostpopulous county;10%Hispanic/LatinoWell-establishedcommunity healthcoalitionsLatino needshad not beendefined.A strongstigma existsaround thetopic ofmental healthAdjustingstrategies toinclude youthand adultguidance onculturallyresponsivepracticesShifted toImplementerlevelmidyear, asdeterminedwith nationalgrantevaluatorsIdeas at Work Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative JOE 58(2)©2020 Extension Journal Inc. 2Suicidepreventionidentified bycounty as a toppriorityMental healthservices often noteffective withoutculturallyresponsiveapproaches(Gary, 2005)in the Latinocommunity.Existingcoalitionswere notfocused onbeingculturallyresponsive.HighlightingLatinoadvisorycouncil workat coalitionmeetingsWorking toprovidecommunityeducationnights toincreasementalhealthawarenessAdded equityadvisorycouncil tonew 5-yearcommunityhealthimprovementplan toimproveculturallyresponsivepracticesImplications for ExtensionReplication requirements based on our experiences are outlined in Table 2. Elements covered by stateinfrastructure or matches, versus what was provided through grant support, are explained. Overall,communities at varying levels of readiness required different levels of support and achieved different goals.Table 2.Replication RequirementsProgram need State infrastructure Grant supportPersonnel 2.0 full-time-equivalent match National evaluatorFunding County travel budgets $89,000Partners Community coalitions, 4-H youths Extension field staff buy-inTechnical support Professional development trainers National 4-H Robert Wood Johnson FoundationOnline resources Master Health Volunteer Program (MHVP)a Well Connected Communities dashboard Community health rankingsaOur MHVP is online; some states may offer training in person. Selected MHVPIdeas at Work Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative JOE 58(2)©2020 Extension Journal Inc. 3modules are available for download from the Well Connected Communities nationalleadership.Every community was successful in securing additional external funds to continue its work, ranging fromstate and regional support to funding from the Substance Abuse and Mental Health Services Administrationand U.S. Department of Agriculture. The successes and challenges of our implementation of this initiativehave implications for others in Extension:National and local health prevention issues have a place in Extension programs.County Extension faculty have the capacity to lead the creation of or enhance existing coalitions thataddress local health priorities through youth–adult partnerships.Creating dialogue among community members and health organizations and agencies leads to moreculturally responsive and sensitive prevention/intervention programming.Extension can provide community health coalitions with a network of community contacts, meeting andevent facilities, educational resources, needs assessments, grant writing support, budgetary support,professional guidance, and mentorship.Those resources Extension can provide may lead to new community partnerships, including withbehavioral health agencies, hospitals, law enforcement, criminal justice units, and many others.In our tribal community, our team struggled to move forward until we had a local cultural guidecoordinating efforts, and in Davis County efforts stalled until members of the Latino community weremore fully brought into the existing health coalition. Having personnel who can serve as community-relevant cultural guides is a key to success.The Utah Well Connected Communities launch suggests that the Cooperative Extension System is ready topartner on public health initiatives on a larger scale. Scaling that work to the readiness of individualcommunities is a key to success. Communities new to this effort may require more resources and moresubstantial support to achieve their goals; conversely, the payoff to working in these communities may bemore pronounced once a coalition is established.AcknowledgmentsWe would like to thank Utah State University Cooperative Extension for funding two full-time-effort positionsfor the duration of the grant, allowing the great work described herein to happen. In particular, we aregrateful for the administrative support of Dr. Brian Higginbotham and Ms. Margie Memmott in spearheadingthe application process and supporting the team throughout the process as well as Vice President Ken Whiteand Dr. Gretchen Peacock for hosting the national team during site visits. Lastly, we are grateful to themembers of the Ute tribal community who hosted our team for a harvest session and to the Latino teencoalition for hosting us and kicking off our efforts in the Clearfield neighborhood.ReferencesIdeas at Work Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative JOE 58(2)©2020 Extension Journal Inc. 4Braun, B., Bruns, K., Cronk, L., Fox, L. K., Koukel, S., Le Menestral, S., . . . Warren, T. (2014). CooperativeExtension's national framework for health and wellness [Issue brief]. Retrieved fromhttps://nifa.usda.gov/resource/national-framework-health-and-wellnessChambers, R., Rosenstock, S., Walls, M., Kenney, A., Begay, M., Jackson, K., . . . Barlow, A. (2018).Engaging Native American caregivers in youth-focused diabetes prevention and management. PreventingChronic Disease, 15, Article E85. doi:10.5888/pcd15.170521Gary, F. (2005). Stigma: Barrier to mental health care among ethnic minorities. Issues in Mental HealthNursing, 26(10), 979–999. doi:10.1080/01612840500280638Harrison, B. (2017). Utah's opioid crisis consequence and resource assessment. Salt Lake City, UT: UtahDepartment of Human Services, Division of Substance Abuse and Mental Health.Parisi, M., Northcutt, J., McKendry, J., Sherrill, W., Dye, C., & Snow, J. (2018). Extension: The backboneorganization in statewide population health management. Journal of Extension, 56(2), Article v56-2iw1.Available at: https://joe.org/joe/2018april/iw1.phpCopyright © by Extension Journal, Inc. ISSN 1077-5315. Articles appearing in the Journal become theproperty of the Journal. Single copies of articles may be reproduced in electronic or print form for use ineducational or training activities. Inclusion of articles in other publications, electronic sources, or systematiclarge-scale distribution may be done only with prior electronic or written permission of the Journal EditorialOffice, joe-ed@joe.org.If you have difficulties viewing or printing this page, please contact JOE Technical SupportIdeas at Work Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative JOE 58(2)©2020 Extension Journal Inc. 5

Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative

DigitalCommons@USU

Utah State University DigitalCommons@USU Extension Research Extension 4-2020 Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative Sandra H. Sulzer Utah State University, sandra.sulzer@usu.edu Stacey MacArthur Utah State University, stacey.macarthur@usu.edu Zurishaddai Garcia Utah State University, zuri.garcia@usu.edu Christine E. Jensen Utah State University, christine.jensen@usu.edu Suzanne Prevedel Utah State University, suzanne.prevedel@usu.edu Maren Wright Voss Utah State University, Maren.Voss@usu.edu Follow this and additional works at: https://digitalcommons.usu.edu/extension_research  Part of the Social and Behavioral Sciences Commons Recommended Citation Sulzer, Sandra H.; MacArthur, Stacey; Garcia, Zurishaddai; Jensen, Christine E.; Prevedel, Suzanne; and Voss, Maren Wright, "Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative" (2020). Extension Research. Paper 7. https://digitalcommons.usu.edu/extension_research/7 This Article is brought to you for free and open access by the Extension at DigitalCommons@USU. It has been accepted for inclusion in Extension Research by an authorized administrator of DigitalCommons@USU. For more information, please contact digitalcommons@usu.edu. 5/7/2020 Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiativehttps://joe.org/joe/2020april/iw1.php 1/6April 2020Volume 58Number 2Article #v58-2iw1Ideas at WorkScaling Community Health Coalitions: The Well ConnectedCommunities Pilot InitiativeAbstractWe outline the process and development of the Well Connected Communities health initiative asundertaken in three Utah communities. This transformative community-focused alternative toaddressing public health issues through Extension situates local communities as the origin for healthdecision making. The initiative recognizes the need for varied community statuses (i.e., planner,implementer, and innovator) based on varying levels of readiness and diversity of populations. Weconcluded that the Utah Well Connected Communities initiative aligns well with the 2014 ExtensionCommittee on Organization and Policy National Framework for Health and Wellness. Replicationrequirements and implications for other Extension programs are presented.Keywords: opioids, wellness, community health, youth, 4-H    IntroductionIn 2014, the Extension Committee on Organization and Policy introduced and disseminated a nationalframework for health and wellness (Braun et al., 2014). Soon after, the Robert Wood JohnsonFoundation partnered with Cooperative Extension and the National 4-H Council to launch acommunity-based health initiative known as Well Connected Communities (WCC). This initiative wasdesigned to launch, grow, and sustain health coalitions to conduct needs assessments, develop actionSandra H. SulzerAssistant Professor ofHealth and WellnessDirector of the Officeof Health Equity andCommunity OutreachUtah State UniversityLogan, Utahsandra.sulzer@usu.edu@DrSulzerStacey MacArthurExtension AssociateProfessorUtah State UniversityLogan, Utahstacey.macarthur@usu.edu@4hvolproZurishaddai GarciaExtension AssistantProfessorUtah State UniversityKaysville, UtahZuri.garcia@usu.eduChristine E. JensenExtension AssociateProfessorUtah State UniversityCastledale, Utahchristine.jensen@usu.eduSuzanne PrevedelExtension AssistantProfessorUtah State UniversityRoosevelt, Utahsuzanne.prevedel@usu.eduMaren Wright VossProfessional PracticeExtension AssistantProfessorUtah State UniversityProvo, Utahmaren.voss@usu.edu5/7/2020 Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiativehttps://joe.org/joe/2020april/iw1.php 2/6plans, and transform communities. Utah State University was one of the first five pilot-fundedinstitutions.Each institution selected three communities designated as planner, implementer, and innovator forimplementing the WCC initiative. The labels reflect increasing levels of community readiness in termsof community health coalition infrastructure. Planner communities were required to develop acoalition and conduct a needs assessment. Implementer communities were to grow a coalition andcomplete a needs assessment and action plan. Innovator communities did all of the above andexecuted an action plan while also training volunteers.Here we outline the implementation and outcomes of the Utah program. We identify challenges,solutions, and results that occurred in the communities related to the process of establishing,growing, and sustaining health coalitions at different levels of readiness. Lastly, we provideexperience-based guidance for others wishing to further the work of operationalizing Extension as abackbone for health promotion (Parisi et al., 2018).Program LaunchOur team comprising a health and wellness specialist, a 4-H specialist, and four faculty members withhealth and wellness expertise reviewed competitive WCC applications from interested Utahcommunities. The three counties selected were distinct with regard to cultural, demographic, andgeographic characteristics, and each had a unique self-selected health focus. We placed the majorityof grant funding at the county level, including funding for half-time local coordinators, recognizingthat community efforts should be led from within.Community-Building ProcessThe starting point, challenges, and solutions for each county are outlined in Table 1.Table 1.Community CharacteristicsCountyReadinesslevelHealthfocus Context Challenges Solution(s) ResultsEmery Planner Opioids Second highest innumber of opioid-relatedemergencydepartmentencounters(Harrison, 2017)Fourth highest innumber of peoplewho have diedfrom opioidStigmapervadedcommunityefforts.Communityawareness ofthe issue waslimited.GrantadministrationPartneringwith aneighboringcounty'scoalitioneffortsHeldcoalitionkickoffmeeting byMay 2018Placednaloxone kitsin everyschool andcounty office5/7/2020 Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiativehttps://joe.org/joe/2020april/iw1.php 3/6poisoning(Harrison, 2017)No programs orcoalitions toaddress opioidmisusewas a newprocess.Held a drugtake-backeventUintahandDuchesneImplementer DiabetespreventionandmanagementNative Americansdisproportionatelyaffected by type 2diabetesLacking in healthprograms thatengage youthsalong with adults,which areparticularlyeffective amongNative Americans(Chambers et al.,2018).Youthperspectiveslacking inpreexistingcoalitionNonnativestaff andpositionturnoverimpairedconnectingwith localyouths.Youths attendmultipleschools in abroadgeographicarea.Few nativeyouthsparticipate intraditionalcounty 4-Hclubs.Very fewnativevolunteerleaders werein place.Hiring of alocal memberof tribe tobring coalitionback on trackPrioritizingprofessionaldevelopmentfor new staffin generalUtah 4-Hmethodology,4-H HealthyLivingprogramming,and YouthMental HealthFirst AidprogramWorking withmunicipaland triballeaders tocreate awalking pathfor safeexerciseExpandedyouth-ledfocus toincludecreatingcommercialtobaccopolicies forthe Ute Tribeand mentalhealthDavis Innovator(changed toImplementer)Latino teenmentalhealthThird mostpopulous county;10%Hispanic/LatinoWell-establishedcommunity healthLatino needshad not beendefined.A strongstigma existsaround theAdjustingstrategies toinclude youthand adultguidance onculturallyShifted toImplementerlevelmidyear, asdeterminedwith national5/7/2020 Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiativehttps://joe.org/joe/2020april/iw1.php 4/6coalitionsSuicidepreventionidentified bycounty as a toppriorityMental healthservices often noteffective withoutculturallyresponsiveapproaches(Gary, 2005)topic ofmental healthin the Latinocommunity.Existingcoalitionswere notfocused onbeingculturallyresponsive.responsivepracticesHighlightingLatinoadvisorycouncil workat coalitionmeetingsgrantevaluatorsWorking toprovidecommunityeducationnights toincreasementalhealthawarenessAdded equityadvisorycouncil tonew 5-yearcommunityhealthimprovementplan toimproveculturallyresponsivepracticesImplications for ExtensionReplication requirements based on our experiences are outlined in Table 2. Elements covered by stateinfrastructure or matches, versus what was provided through grant support, are explained. Overall,communities at varying levels of readiness required different levels of support and achieved differentgoals.Table 2.Replication RequirementsProgramneed State infrastructure Grant supportPersonnel 2.0 full-time-equivalent match National evaluatorFunding County travel budgets $89,000Partners Community coalitions, 4-H youths Extension field staff buy-inTechnical support Professional development trainers 5/7/2020 Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiativehttps://joe.org/joe/2020april/iw1.php 5/6National 4-H Robert Wood Johnson FoundationOnline resources Master Health Volunteer Program(MHVP)aWell Connected Communitiesdashboard Community health rankingsaOur MHVP is online; some states may offer training in person. Selected MHVP modules areavailable for download from the Well Connected Communities national leadership.Every community was successful in securing additional external funds to continue its work, rangingfrom state and regional support to funding from the Substance Abuse and Mental Health ServicesAdministration and U.S. Department of Agriculture. The successes and challenges of ourimplementation of this initiative have implications for others in Extension:National and local health prevention issues have a place in Extension programs.County Extension faculty have the capacity to lead the creation of or enhance existing coalitionsthat address local health priorities through youth–adult partnerships.Creating dialogue among community members and health organizations and agencies leads tomore culturally responsive and sensitive prevention/intervention programming.Extension can provide community health coalitions with a network of community contacts, meetingand event facilities, educational resources, needs assessments, grant writing support, budgetarysupport, professional guidance, and mentorship.Those resources Extension can provide may lead to new community partnerships, including withbehavioral health agencies, hospitals, law enforcement, criminal justice units, and many others.In our tribal community, our team struggled to move forward until we had a local cultural guidecoordinating efforts, and in Davis County efforts stalled until members of the Latino communitywere more fully brought into the existing health coalition. Having personnel who can serve ascommunity-relevant cultural guides is a key to success.The Utah Well Connected Communities launch suggests that the Cooperative Extension System isready to partner on public health initiatives on a larger scale. Scaling that work to the readiness ofindividual communities is a key to success. Communities new to this effort may require moreresources and more substantial support to achieve their goals; conversely, the payoff to working inthese communities may be more pronounced once a coalition is established.AcknowledgmentsWe would like to thank Utah State University Cooperative Extension for funding two full-time-effortpositions for the duration of the grant, allowing the great work described herein to happen. Inparticular, we are grateful for the administrative support of Dr. Brian Higginbotham and Ms. MargieMemmott in spearheading the application process and supporting the team throughout the process as5/7/2020 Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiativehttps://joe.org/joe/2020april/iw1.php 6/6well as Vice President Ken White and Dr. Gretchen Peacock for hosting the national team during sitevisits. Lastly, we are grateful to the members of the Ute tribal community who hosted our team for aharvest session and to the Latino teen coalition for hosting us and kicking off our efforts in theClearfield neighborhood.ReferencesBraun, B., Bruns, K., Cronk, L., Fox, L. K., Koukel, S., Le Menestral, S., . . . Warren, T. (2014).Cooperative Extension's national framework for health and wellness [Issue brief]. Retrieved fromhttps://nifa.usda.gov/resource/national-framework-health-and-wellnessChambers, R., Rosenstock, S., Walls, M., Kenney, A., Begay, M., Jackson, K., . . . Barlow, A. (2018).Engaging Native American caregivers in youth-focused diabetes prevention and management.Preventing Chronic Disease, 15, Article E85. doi:10.5888/pcd15.170521Gary, F. (2005). Stigma: Barrier to mental health care among ethnic minorities. Issues in MentalHealth Nursing, 26(10), 979–999. doi:10.1080/01612840500280638Harrison, B. (2017). Utah's opioid crisis consequence and resource assessment. Salt Lake City, UT:Utah Department of Human Services, Division of Substance Abuse and Mental Health.Parisi, M., Northcutt, J., McKendry, J., Sherrill, W., Dye, C., & Snow, J. (2018). Extension: Thebackbone organization in statewide population health management. Journal of Extension, 56(2),Article v56-2iw1. Available at: https://joe.org/joe/2018april/iw1.phpCopyright © by Extension Journal, Inc. ISSN 1077-5315. Articles appearing in the Journal become theproperty of the Journal. Single copies of articles may be reproduced in electronic or print form for usein educational or training activities. Inclusion of articles in other publications, electronic sources, orsystematic large-scale distribution may be done only with prior electronic or written permission of theJournal Editorial Office, joe-ed@joe.org.If you have difficulties viewing or printing this page, please contact JOE Technical Support

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Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative

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