Putting Trust at the Center

The Delta Center has released a new guide written by Delta Center coach Deborah Riddick, JD, RN: Building Consumer Partnerships to Advance Health Equity: A Guide to Embracing Power Sharing for Mutually Beneficial and Sustainable Change. Developed to support state primary care associations (PCAs) and behavioral health state associations (BHSAs), the guide lays out a clear approach for how they can use power sharing as a distinct strategy to advance equity.

Power sharing has gained traction in recent years as organizations recognize that traditional top-down approaches often fall flat in practice. In the gap between intention and implementation, there are significant barriers that result in policies and practices that at best are ineffectual, and at worst, cause harm by undermining trust or straining relationships.

That is why this guide, which emerged from Ms. Riddick’s unique intersectional position, is instrumental. She brings her experience as a direct practitioner (i.e., as a registered nurse and nurse educator), a public health policy analyst, and a director of health policy for state and local organizations. Her vision of power sharing is not an abstract ideal, but rather is responsive to the policy and organizational environment, and rooted in the realities of the lived experiences of consumers receiving health services. 

The strategies in the guide are illustrated by a collaborative engagement in North Carolina. There, the i2i Center for Integrative Health and the North Carolina Community Health Center Association (Delta Center grantees) recognized that unless the state's care management program was rooted in consumer voice, the services would likely be underutilized. They set out to change that through a consumer engagement collaborative. Their efforts are noteworthy not only for what they did, but how they did it. Rather than an exercise in checking boxes, the effort was deliberately designed to bring heart and humanity into the process.

You can hear that difference from how community members describe their experiences in the accompanying video. People reflected: “It had a different feel to it” and “I started to feel comfortable sharing.” One woman shared, “Being part of this collaboration made me that brave.”

While many efforts seeking to advance community engagement and health equity are often presented as stepwise, it is rarely that straightforward. Addressing power and undoing the conditions that create inequities in the first place is often messy and uncomfortable. It is critical that initiatives not only address the challenges when they arise, but anticipate them. This, too, is reflected in the perspective of one individual who shared: “The basic idea of this project was very very simple. But simple does not mean easy.”