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Community health initiatives across the country seek ways of ensuring community engagement. One method is through shared governance, an alternative to more traditional governance structures, like a board of directors, that aims to promote a mutual understanding of the collaborative decision-making process. Children’s Mercy designed a shared governance framework for decision-making around healthy eating and active lifestyles and applied it to a recent food access initiative in a low-income community in Kansas City, KS. Our objectives were: 1) to explore how a framework for shared governance facilitates collaborative decision making in community health initiatives; 2) to identify and define effective participatory methods of collaboration for use in a revised governance framework.


A Mobile Market Community Council (MMCC) was established to guide the development of a mobile market to increase food access. The MMCC was made up of over a dozen community members, including resident members, organizational members, and neutral members (facilitators). The MMCC was introduced to our shared governance framework. The Wilder Factors of Collaboration Inventory (WCFI) measured collaboration among the group with a 5-point Likert scale (1= “Strongly Disagree to 5= “Strongly Agree) to evaluate 44 statements across 21 Collaboration Factors. It was administered at baseline (May 2018) and project end (fall 2019).


Across all Collaboration Factors, 82% of responses were rated as either “agreed” or ‘Strongly Agreed’. A large increase was seen over time in perceived collaboration across 10 statements (e.g. from ‘Agree’ to ‘Strongly Agree’), and a decrease in 2 statements. The largest improvement was the statement, “Each of the people who participate in decisions in this collaborative group can speak for the entire organization they represent, not just a part” (average score at baseline-=2.7, at project end=4.0). The highest scoring statement was, “The people in this collaborative group are dedicated to the idea that we can make this project work”, (4.9) and increased by 0.7 between the two surveys. Other statements that scored highly were, “Everyone who is a member of our collaborative group wants this project to succeed” (4.9), and “This group has the ability to survive even if it had to make major changes in its plans or add some new members in order to reach its goals” (4.8).


This evaluation showed a governance framework can be a useful tool to guide decision making and increase collaboration for long term success of community health initiatives.

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An Evaluation Of Shared Governance In A Mobile Market Setting