May 30 2017 As vaccine hesitancy grows, diverse stakeholders must collaborate

By Todd Faubion, Immunization Manager, WithinReach

The value of cross-sector partnerships has always been a common trope in the professional environment, but these partnerships have become exceptionally popular in the past decade with the rise of models like collective impact. Anyone who has actually worked in a cross-sector partnership, however, knows that the reality is often messy, agendas don’t always align, and putting the concept of a partnership into an actionable agenda is no small feat. And yet, when they work and are well managed, these types of collaborations can produce remarkable results. I am excited to share one such partnership with you: Vax Northwest.

Vax Northwest is a cross-sector partnership founded in 2008 to address the challenge of vaccine hesitancy in Washington State. We use “vaccine hesitant” to refer to parents who are unsure about immunizing their children on-time per the Centers for Disease Control’s recommended schedule. It’s an intensifying problem throughout the United States that is leaving our communities vulnerable to outbreaks of disease. Children’s health leadership in Washington State recognized the acute, pervasive nature of this problem a decade ago and sought to address it in an incredibly thoughtful and comprehensive way, by bringing all of the right voices to the table.

Vaccine promotion and delivery requires broad stakeholder engagement: government bodies at all levels, health plans, clinics, non-profit partners, schools, and more. So it stands to reason that we should not rely exclusively on our governmental public health departments (the common practice) to develop solutions for problems that extend across sectors and have roots in values, infrastructure, financing, and so on. This is why Vax Northwest is composed of Kaiser Permanente Washington, Seattle Children’s Hospital, the Washington Chapter of the American Academy of Pediatrics, the Washington State Department of Health, and WithinReach (which staffs and supports the partnership). Together, we have expertise in preventive medicine, infectious disease, public health, social marketing, health behavior, and resource development, among other fields.

Partnerships of any type require constant attention and nurturing, a truth I have found especially applicable to cross-sector partnerships, where not only might our needs and interests differ, but the actual terms of success might also diverge.

So, what has made us successful? First, the right partners are present. Second, we conducted research to understand the problem, developed interventions based on our initial research, and then tested them. We bring expertise to meetings but never assume that we know the answer — Our answers emerge through a robust research process. But conducting this research doesn’t just happen; it requires tremendous resources, which all partners have been responsible for marshaling through their respective networks.

Recently, we published the results of a project called the Immunity Community, which has been shown to change — with statistical significance — attitudes and beliefs about immunizations. Interestingly, our intervention itself embodies a cross-sector approach. Rather than telling communities how they should address the challenge of vaccine hesitancy, we ask trusted parents how best to engage their unique communities in developing public will for vaccines through whatever sectors make the most sense to them. Whether it be writing an op-ed, attending a health fair, meeting with the health department, or posting ads at the aquatic center, we have found that community initiatives thrive when they are provided with resources and technical assistance, but not a prescription.

So, a decade in, what can we learn from Vax Northwest?

• To be successful, partnerships need a designated organization to staff and support the work. A partnership that relies exclusively on good intentions of members has limited potential. WithinReach, with its long history of hosting coalitions, knows how to do this work well.
• A common goal is necessary but insufficient — Providing member organizations with strategies to engage around that goal will ensure forward motion.
• Cross-sector partnerships require constant attention, especially because different sectors have different needs. Being candid about varied interests and having a space to routinely and honestly discuss them is crucial for maintaining trust.
• Never underestimate the importance of trust.
• Adding partners adds complexity and may not always be healthy. There is sometimes a decreasing return to increasing numbers.
• Value has many forms. Not all partners can be expected to bring money to the table, but all partners can be expected to contribute substantively, especially by leveraging their respective networks.
• Successes must be celebrated. In the chaos of constant work pressures, we can forget about how much we’ve accomplished together. Taking time to ground the group annually in all we have accomplished keeps everyone motivated and engaged.

Partnerships of any type require constant attention and nurturing, a truth I have found especially applicable to cross-sector partnerships, where not only might our needs and interests differ, but the actual terms of success might also diverge. Staying focused on the common goal and having routine check-ins about the means of achieving those goals has proven to be a healthy model for Vax Northwest. For instance, in times past we have had to address situations where partners appear to be more-so representing their own organizations’ agendas as opposed to our collective goals. Talking openly about this uncomfortable reality was difficult, but it ultimately meant refocusing on the work and finding balance in the partnership. Currently we are revisiting important questions like, “Who are we?”, “What is our focus?”, and “What are our longterm goals?”, which are questions to ask routinely. Having check-ins like this ensures that the work remains the paramount concern and that we evolve to meet the needs of our community.

If you’d like to learn more about Vax Northwest, please see our website. And feel free to reach out with any questions.

Todd Faubion, PhD, is the Immunization Manager at WithinReach, a nonprofit organization that builds pathways to help families access critical services to keep them safe and healthy. He oversees the work of the Vax Northwest partnership, which promotes immunization confidence and conducts research into the origins of, and possible solutions to, vaccine hesitancy.