In Spring 2013, we are on the precipice of dramatic, disruptive change in the health field that offers an unprecedented opportunity and challenge to transform health care and population health. We know that traditional public health approaches along with more and better health care are not enough to improve health outcomes, equity, and cost. We must also: - implement sustainable, fundamental "upstream" changes that address the root causes of disease and disability; and - transform the way we deliver health care to ensure access to quality, affordable health care for all. Enjoy this keynote presentation from Lalitha Vaidyanathan of FSG, which was presented at the 2013 Annual Leadership Conference, co-sponsored by the Center for Health Leadership (CHL) and the California Pacific Public Health Training Center (CALPACT) at UC Berkeley's School of Public Health. To learn more about this event, please visit: http://calpact.org/index.php/en/events/leadership-conference Learn more about CALPACT: http://calpact.org/ Learn more about the CHL: http://chl.berkeley.edu/

1. Boston | Geneva | Mumbai | San Francisco | Seattle | Washington
FSG.ORG
Collective Impact
for Upstream Innovation
May 31st, 2013
Annual Leadership Conference
UC Berkeley School of Public Health

2. 2
© 2013 FSG
FSG.ORG
Juvenile Justice in New York
$286,000 89% recidivism rate=

3. 3
© 2013 FSG
FSG.ORG
The NYJJ System Is Significantly Fragmented

4. 4
© 2013 FSG
FSG.ORG
There Are Several Types of Problems
Source: Adapted from “Getting to Maybe”
Simple Complicated
Baking a Cake Sending a Rocket
to the Moon
Social sector treats problems as simple or
complicated
Complex
Raising a Child

5. 5
© 2013 FSG
FSG.ORG
Complex Problems Require a
Collective Approach
Isolated Impact Collective Impact

6. 6
© 2013 FSG
FSG.ORG
Collective Impact Involves Five Key Elements
Common Agenda
Shared Measurement
Mutually Reinforcing Activities
Continuous Communication
Backbone Support
Source: Channeling Change: Making Collective Impact Work, 2012; FSG Interviews

7. CONFIDENTIAL
7
© 2012 FSG
Addressing Health Issues “Upstream” Requires
Collaboration Between Diverse Actors
Breadth
of
Target
Popula1on
Patient in
hospital
Community
Member
Diversity
of
Actors
Medical
Staff
Policy-
makers/
Support
services
CBOs
Primary
Prevention
Secondary
Prevention
Acute
Care
• Public health depts.
• Governments
• Payers
• NGOs
• Pharmaceutical or
medical device
companies
• Employers
• Public schools
• Professional associations
• Medical education
providers
Partners

8. FSG.ORG
8
© 2013 FSG
58% of Adults and 25% of Children in Colorado Are
Overweight or Obese
LiveWell Colorado recognized that obesity is not simply an outcome of individual
choices, but also a product of limited access to healthy opportunities
Source: https://about.livewellcolorado.org/what-is-livewell/who-we-are; FSG Interviews and Analysis
If Trends Continue, Only 33% of Coloradans Will Be at a Healthy Weight by 2017

9. FSG.ORG
9
© 2013 FSG
Collective Impact in Practice: LiveWell Colorado
LiveWell’s Addresses Demand and Supply Factors through a Dual Approach
Inspire individual behavior
change
Improve access to and
opportunity for healthy habits
3 Mutually Reinforcing Strategies:
Fund local
community
coalitions
Advance policy
efforts at local,
state, national
levels
Influence healthy
behavior changes
1 2 3
LiveWell Addresses Supply, Demand and Engages
Diverse Stakeholders
Source: LiveWell Colorado-Annual Report 2011; FSG Interviews and Analysis

10. 10
© 2013 FSG
FSG.ORG
LiveWell supports 22 multi-sector coalitions in the state
Each coalition has its own steering committee made up of local stakeholders
Individual Communities
Funding
and
Guidance
(with
Flexibility)
Fund local community
coalitions
Advance policy efforts
at local, state, national
levels
Influence healthy
behavior changes
1 2 3
Funders: Colorado Health Foundation, Kresge Foundation, Kaiser Permanente, and Department of
Public Health and Environment
Livewell Brings Together Statewide Resources,
Knowledge, and Expertise
LiveWell Colorado is the Backbone (10 staff members)
Connector, catalyst, coordinator, and convener of all obesity
prevention efforts in the state
A Community Investments Advisory Council comprised of LiveWell staff and
community coordinators helps connect local and statewide efforts
Collective Impact in Practice: LiveWell Colorado
Regular
Communication
Improved Data
Collection and
Evaluation to
measure
progress
Source: LiveWell Colorado-Annual Report 2011; FSG Interviews and Analysis

11. 11
© 2013 FSG
FSG.ORG
LiveWell’s Efforts Are Resulting in Significant
Change
Collective Impact in Practice: LiveWell Colorado
Fund local community
coalitions
Advance policy efforts
at local, state, national
levels
Influence healthy
behavior changes
1 2 3
ü Colorado's House Bill
11-1069 was passed,
which establishes the
amount of physical activity
time in elementary school
ü Food Systems Advisory
Council was created to
improve access to healthy
food throughout the state
ü Updates to USDA’s
Nutrition Standards in the
National School Lunch and
School Breakfast Programs
were incorporated
ü Statewide Bicycle and
Pedestrian Plan was
established in collaboration
with Colorado Department
of Transportation
ü More than 500K
Coloradans benefitted
from LiveWell’s Partner
Communities
ü Healthy Eating, Active
Living (HEAL) Library, a
online collection of
resolutions and policies to
help communities build
environments that support
access to healthy eating
and active living, was
created
ü Social Media campaign
enabled more than 200K
Coloradans to conduct
“gut checks” to understand
their own level of health at
their current weight
ü 187 food service staff
across 45 school districts
were trained through
Culinary Boot Camps,
thereby reaching 311K
students
ü Go, Slow, Whoa program
established, which helps
children identify and choose
healthy foods
ü LiveWell@Work Group
established to advance
wellness at the workplace
Source: http://www.fsg.org/KnowledgeExchange/Blogs/CollectiveImpact/PostID/173.aspx; LiveWell Colorado-Annual Report 2011; FSG Analysis

12. 12
© 2013 FSG
FSG.ORG
Addressing Childhood Asthma Requires a
System of Actors to Work in Concert
Asthma Management
Trigger Reduction
Healthy Behavior

13. 13
© 2013 FSG
FSG.ORG
Backbone
Convener
& Funder
Using Collective Impact to Address Childhood
Asthma in Texas
Steering Committee
School Districts & Day Care
Health Clinics and Hospitals Neighborhood & Community Organizations
Government Agencies Faith-Based Organizations

14. 14
© 2013 FSG
FSG.ORG
Prerequisites for Launching Collective Impact
Source: Channeling Change: Making Collective Impact Work, 2012; FSG Interviews and Analysis
Financial Resources
Influential Champion
Urgency for Change!

15. FSG.ORG
15
© 2013 FSG
Develop group,
structure
communication and
decision making
Map the landscape
and use data to make
case
Facilitate community
outreach
Create infrastructure
(backbone and
processes)
Facilitate and refine
Analyze baseline data
to ID key issues and
gaps
Components
for Success
Create common agenda
(goals, strategy)
Engage community and
build public will
Establish shared metrics
(indicators, measurement,
and approach)
Support implementation
(alignment to goal and
strategies)
Continue engagement,
conduct advocacy
Collect, track, report
progress (process to
learn and improve)
Governance &
Infrastructure
Strategic
Planning
Community
Involvement
Evaluation &
Improvement
Collective Impact Efforts Tend to Develop over
Three Key Phases
Source: Channeling Change: Making Collective Impact Work, 2012; FSG Interviews and Analysis
Phase II
Organize for Impact
Phase III
Sustain Action & Impact
Phase I
Initiate Action

16. FSG.ORG
16
© 2012 FSG
Backbone Organizations Are Critical to All
Collective Impact Efforts
Guide Vision and Strategy
Build Public Will
Support Aligned Activities
Mobilize Funding
Establish Shared Measurement Practices
Advance Policy
Source: FSG Interviews and Analysis

17. 17
© 2013 FSG
FSG.ORG
Discussion
1. What resonated most about collective impact?
2. What health issues in your community do you think
will require a cross-sector collaborative approach?
3. Do you think your community is ready to take a
Collective Impact approach to address this issue? Is
there an influential champion? Financial resources?
A sense of urgency about the problem?
4. What are key next steps you will take? What support
do you need?

18. 18
© 2013 FSG
FSG.ORG
Thank You!
To talk more with FSG about Collective Impact:
Lalitha Vaidyanathan, Managing Director
lalitha.vaidyanathan@fsg.org
Collective Impact resources available on FSG’s website
www.fsg.org