“One of the initiatives that we put in place was our local forums. And in each one of the counties that we established a local forum which brought in representatives from the community, from health care, government, and smaller community agencies, educators, and the whole purpose of those forums was to come together, identify what the issues might be in their particular community, and then work together in creative ways to come up with some solutions.”

– ACH Staff, WA

Key Takeaways

MSCs can facilitate collaboration by building shared purpose across different partners, sectors, communities, and geographies.
Agreeing on an MSC’s shared purpose can be more challenging when the MSC serves racially, ethnically, or geographically diverse communities.
Almost all survey respondents said they were committed to their MSC’s vision but fewer said they could describe the vision and even fewer said they could describe how their MSC’s vision would be achieved.

Development of a shared purpose answers the critical question: What are we, as an MSC, trying to accomplish together? While it may seem like a simple question, collaborative efforts often require a negotiation of different goals, expectations, and values among partners.⁴⁶ If an MSC’s partners can’t agree upon shared goals, expectations, and values at the beginning of a project, then their competing understandings of success and productive work can prevent progress. In theorizing what makes an MSC sustainable, motivation for the MSC’s shared purpose was a critical component of long-term success among the MSCs we studied.

MSCs can bring people and organizations together to develop a sense of shared purpose. This can happen through outreach, community meetings, and trainings, where people are able to get a sense of what their community needs for the future. Efforts to develop shared purpose should be cognizant of the diversity of people and groups participating in and impacted by the collaborative work, since different groups of people may have different perspectives on what is important to achieve and how the MSC should go about achieving these goals. In PHIL’s Aligning Systems for Health research, we saw that not everyone had the same confidence in describing the shared purpose of their MSC, with certain groups, like those who worked for the MSC, having greater confidence. Crucially, people tended to be less confident in describing how the MSC would achieve its goals. Therefore, shared purpose should be understood as more than just agreeing on a problem and solution but also on a path between the present and the future.

Survey Findings

88% of respondents agreed that they can describe their MSC’s vision (n=433).
78% of respondents agreed that they can describe how their MSC’s vision will be achieved (n=377).
96% of respondents agreed that they are committed to helping achieve the vision of their MSC (n=469).

“We truly worked in silos, even governmental agencies didn’t really cross collaborate… So we have two hospitals that work together, we have them working with our local nonprofits on finding solutions, and we are all at the table when it comes to what needs to be worked on. There have been times where one agency…said, ‘Hey, we’re going to go after this,’ and so all of our partners rallied… we are going to support them with this, and we’re going to help them obtain the funding that they need, and get this lifted off the ground for our community.”

– ACH Staff, CA

Perceptions of Shared Purpose

As evidenced by survey results, MSC participants had mixed feelings about the clarity of their MSC’s shared purpose. Perceptions of shared purpose varied by different local contexts and participant backgrounds. We found that:

Not every MSC’s efforts at shared purpose were seen as equally effective.
MSCs that served larger geographic areas tended to have better perceptions of shared purpose.
MSCs with public funding tended to have better perceptions of shared purpose.
People from tribal communities and nations, as well as people who worked with the MSC, tended to have better perceptions of shared purpose, while people who worked in social services and public health tended to have worse perceptions.
MSC staff tended to have better perceptions of shared purpose than MSC leadership, committee members, and community residents, with informal participants and contracted partners having the most negative perceptions.

Influencing Shared Purpose

Shared purpose was most strongly influenced by participants’ perceptions of trust and equity, as well as participants’ income, with these three factors having a positive association with participant perceptions of shared purpose.

“So us giving the money and saying: you can do with this what you want. But what is important to us is that you work on your health equity, you work on your cross-sector collaboration, that’s what’s important and that’s what we want you to focus on. What we’ve really heard is that’s what they’ve done, and it’s been really valuable to them.”

– ACH Staff, WA

Related Resources

Powering Change Curriculum: Building Healthy, Equitable Communities Together, a Population Health Innovation Lab (PHIL) and California Accountable Community for Health Initiative (CACHI) curriculum for multisector collaboratives (2021)

View all references for the Data Walk.