14 The community transformation map: tracking and planning coalition-lead community change

• Published in: BMJ open quality 2020-12, Vol.9 (Suppl 1), p.A15-A16
• Main Authors: Domlyn, Ariel, Ramaswamy, Rohit, Lewis, Niñon, McPherson, Marianne E
• Format: Article
• Language: English
• Subjects: Collaboration; Health disparities; Health promotion; Public health; Quality of care
• ISSN: 2399-6641
• DOI: 10.1136/bmjoq-2020-IHI.14

BackgroundCoalitions are promising structures for tackling health inequities. Supporting community health calls for self-administered tools where coalitions can measure their capabilities, determine priorities, set goals, and assess progress. Maturity models map detailed, sequential stages of idealized progress. The Community Transformation Map (CTM) is maturity model where users self-assess and chart a trajectory for improvement. We describe the development, application, and evaluation of the CTM, a collaborative planning tool developed within the 100 Million Healthier Lives community transformation initiative.ObjectivesWe will (1) describe the theoretical and methodological basis for the CTM, (2) present CTM content, administration, and scoring process, (3) highlight lessons learned and strategies for practical application.MethodsIterative, participatory action methods guided CTM development and use. The 40-item CTM captures three components of community transformation: Improvement, relationships, and equity. Eighteen coalitions used the CTM at four time-points, selecting areas for improvement deemed salient to their context. Each created action plans to address these areas. Ten semi-structured interviews assessed CTM use and contextual validity.ResultsCoalition’s CTM scores were averaged across three community transformation dimensions. This revealed wide variation in scores with context-specific strengths and weaknesses; with the exception of one outlier, no coalitions displayed consistent strengths across dimensions. Interviews revealed the CTM used as intended: collaboratively, inclusively, and for strategizing improvements. Users perceived the CTM’s greatest value as a needs assessment that operationalized systemic change concepts into descriptive indicators.ConclusionsThe CTM is an actionable collaboration tool for coalitions that has recently been adapted into a validated self-assessment for communities to understand improvements in health and equity. As the first translation of maturity models for coalition use, the CTM represents a promising structure for user-led, community-level planning.