Satisfaction with diversity and inclusion of coalition membership in the HEALing communities study

Abstract

Context
Engaging community coalitions to implement evidence-based interventions with an intentional focus on health equity may help address opioid use disorder related disparities; however, research is needed to elucidate how core elements of coalition capacity can be strengthened to facilitate these efforts.
Objective
To evaluate satisfaction with diversity of coalition membership following enhancements promoting health equity under the HEALing Communities Study (HCS).
Setting
The HCS was a community-level, cluster-randomized trial; the primary objective was to evaluate the effectiveness of the Communities That HEAL intervention on reducing opioid overdose deaths across four states.
Design
The HCS was implemented in two waves. Cross-sectional surveys from two timepoints in each wave from 66 HCS coalitions were analyzed.
Participants
1,082 unique coalition members representing 66 communities.
Intervention
The CTH intervention was enhanced for Wave 2 to improve promotion of health equity. This study focuses on coalition membership diversity.
Main Outcome
Participants rated satisfaction with the diversity and participation of: influential people, community residents, general diversity, and racial and ethnic diversity of coalition members.
Results
Satisfaction with racial and ethnic diversity improved in Wave 2; satisfaction with the racial and ethnic diversity of coalition increased as the proportion of racial and ethnic members increased. However, less than 51% of members reported satisfaction with racial and ethnic diversity in either wave. Survey response rates ranged from 36% to 52%.
Conclusion
Community coalitions addressing the opioid overdose epidemic should incorporate explicit approaches for focusing health equity. Simply increasing diversity does not guarantee equitable representation or meaningful engagement.