Challenge

Generate Health St. Louis is a community-based non-profit coalition that seeks to improve birth outcomes, build healthy families and promote healthy communities by uniting and mobilizing the St. Louis region. Since 2001 they have served as a backbone convener to help partners conduct collaborative planning and collective action targeted on reducing disparities in maternal and child health, and infant mortality in particular. As such, Generate Health has significant health sector and social justice advocates engaged in their FLOURISH St. Louis initiative to reduce alarming rates of infant mortality in the region. Generate Health has an established reputation for being both system-focused and resident-driven, and they wanted to examine upstream social determinants through pursuit of the national BUILD Health Challenge. BUILD stands for Bold, Upstream, Integrated, Local, and Data-driven, and the challenge is funded by 12 foundations, including Robert Wood Johnson, Kresge and de Beaumont. Generate Health proposed to improve maternal and infant health outcomes by targeting transportation access for pregnant women and new parents in north St. Louis. The exploration of transportation as a social determinant required engagement of new sectors and BUILD required in-kind match from hospital partners. Essentially, Generate Health had to convince large health systems to contribute their finite resources to go far upstream to impact a system that had previously been out of their wheelhouse (transportation), while at the same time actively coordinating activities across several healthcare market competitors (e.g., hospitals, health centers, managed care organizations). Finally, the project had to reflect the priorities and assets of resident leaders who had been consulted to identify factors contributing to racial disparities in infant mortality, as well as actively engage these leaders as drivers and decision-makers throughout the project period. There were a lot of disparate agendas to align and a swift time frame in which to achieve consensus for both the BUILD competition and subsequent implementation of project activities.

Solution

• Synthesized input from project partners and identified aligned evidence-based models that reflected the race equity lens and trauma-informed framework desired for the project
• Facilitated meetings of hospital partners, transportation advocates and action team residents to identify priorities and co-create a scaffolding between the vernacular and agendas of the engaged system “reformers” and community organizer “revolutionaries”
• Designed logic model for the overall project, driver diagrams for individual work groups, stakeholder messaging strategy and project rationale document to support partner engagement
• Developed concept papers tailored to hospitals to demonstrate ROI of investing in transportation as a social determinant of health and identify potential in-kind match
• Worked with Generate Health’s established collective impact infrastructure to build out ad hoc working groups to manage and implement new, connected aspects of the two year project
• Developed detailed Memoranda of Understanding (MOUs) for three partnering hospital systems that satisfied the funding entity and the legal teams of each hospital and health system
• Prepared and continually revised the comprehensive collective impact implementation plan to reflect changes in the environment and new insights from resident leaders
• Conducted research and developed synthesis documents to advise policy agenda regarding non-emergency medical transportation (NEMT) and public transportation access and feasibility
• Identified leverage points in the transportation system and advised public testimony and stakeholder input to influence existing transportation planning and processes
• Maintained centralized project management platform for key staff, data sharing work group and externally facing partners during proposal development and launch phase of project
• Provided recap and analysis of project achievements, new connections and structural challenges for quarterly reports and broad amplification via blogs and conference presentations
• Supported development of supplemental grant proposals that leverage the initial BUILD investment and the momentum that was achieved by the national award

Grant Awards