Creating a Culture of Health Through Cross-Sector Collaboration

At Civic Hall Labs, we design and build technology for the public good, and we help others do the same.

As part of our mission to build technology that creates a more democratic, just, and equitable society, we believe we have a responsibility to widely share our research and development processes so that others can build on our successes and learn from our failures.

In March of 2017, with the generous support of the Robert Wood Johnson Foundation, Civic Hall Labs took an important step in the development of our Health Lab. Our Lab supports public interest organizations that want to use civic tech as a tool to address systems-level barriers to building a strong culture of health. To identify promising partnerships and ideas for our Health Lab to invest in, we organized a pair of collaborative convenings that would foster the kind of cross-sector dialogue needed to address these wider, systems-level challenges to achieving a culture of health.

These convenings reflect our belief that in order to create comprehensive solutions to health inequities, we need to leverage the power and creative potential of cross-sector ideation. We hoped these tools would be valuable in developing our process, but would also speak to the learning and strategic goals of all our collaborators. We partnered with Aspiration on our first convening and gained significant learnings from employing their model for designing and delivering participatory events.

These two events brought together our best Assess & Focus strategies for creating cross-sector dialogue. None of these strategies are new, nor are we the first to use them for this purpose. However, the type of space we created felt new to many of our partners, and we wish to share our thinking back with them in order to support them in leveraging cross-sector collaboration and ideation tools in their work.

Below, we detail how we implemented problem-solving around adjacent possibilities and refined the collaborative design processes of our Health Lab. Please contact us if you’d like to learn more about how to implement our processes or if you’d like to partner with us to build a healthy public for all communities as we continue this work - info@civichalllabs.org.

Summary

Civic Hall Labs wanted to develop our Assess & Focus methodologies in order to refine our cross-sector, collaborative design process that addresses community health inequities while building a culture of health. We wanted to determine the extent to which user-informed design, appreciative inquiry, and systems-based methods, when combined with key stakeholder engagement, could create innovative and impactful solutions to address the civic roots of community health inequities.

With support from the Robert Wood Johnson Foundation, Civic Hall Labs held two events in New York City.


First, we hosted a “Civic Health Ideation Retreat” which called on community health practitioners, technologists, and funding partners to come together, build collective knowledge, and ideate on ways to address the civic roots of community health inequities. The retreat created an opportunity for each participant to use their knowledge and experience in order to illuminate a piece of a broader, systemic issue. Our hope was that this intersection of ideas would produce more comprehensive solutions to problems threatening the health of the public.

In partnership with sector experts, we then identified the project idea emerging from the retreat with the most potential for development in the Health Lab. The proposed project builds off a product in development by Heat Seek, which would incorporate data from open city health and housing data—an addition to the current version of their tool—in order to more efficiently identify at-risk tenants and neighborhoods and direct tenant’s rights organizers and community health programming to them more efficiently.


At our second event we hosted a “Housing Data Tool Workshop” where workshop participants iterated on Heat Seeks’ Housing Data Tool and envisioned a product with far more inclusive reach and expansive impact.

The work produced at the workshop is now informing the Health Lab’s discovery phase process for this cross-sector product.


The concept for a more robust, cross-sector data tool that emerged from these events demonstrates the immense value in bringing together varied and diverse professional experiences and perspectives from civic technology, community health, and philanthropy. It also verified that our underlying assumptions about how to collaboratively build innovative, impactful digital tools that not only produce results, but deserve greater investment and refinement.

Recommended Practices

After running our cross-sector, collaborative process in partnership with Aspiration, we identified several key takeaways and practices we suggest others use in running similar events.


Pre-Process

Only exceptional facilitation will lead to success: Mediocre facilitation is the same as poor facilitation and will sink the spirits of your participants and the outcomes of your event.

Participant-informed design, always: Event attendees should always participate in design of the outcomes of the events. This builds buy-in and fosters an environment for meaningful participation.

Be in a supportive environment: The event space should be an open, accessible, and comfortable physical space for all participants.

Be intentional about the voices in the room: Recruit participants who are eager to learn, represent a diversity in organizational power, want to build partnerships, and are invested in success of the event.


Execution

Ideation requires openness: Modeling openness and vulnerability fosters group cohesion and creates a supportive setting where participants can take risks in sharing ideas.

Start big to dream big: Have participants start at a systems-level so that their interventions come from a cross-sector perspective.

Finding intersections builds stronger approaches: Enlisting the perspectives from adjacent fields allows groups to see the different sides of the same problem and to come up with a more comprehensive solution.



“This was fantastic! Public health should always be discussed with a multi-disciplinary group like this.”
    — Civic Health Ideation Retreat Participant

60% of attendees completed a post-event survey. 100% of survey participants felt that we successfully created a cross-sector collaborative space for retreat participants.


Our Cross-Sector, Collaborative Design Process

Pre-Process

In our planning process, we wanted to validate the conditions necessary to reach our event goals while utilizing our cross-sector, collaborative process. We identified the following four conditions as key to creating the necessary foundation to this process.

  1. Only exceptional facilitation will lead to success
  2. Participant-informed design, always
  3. Be in a supportive environment
  4. Be intentional about the voices in the room

Only exceptional facilitation will lead to success

Mediocre facilitation is the same as poor facilitation and will sink the spirits of your participants and the outcomes of your event.

As many folks have experienced, poor to mediocre facilitators are abundant and expert and exceptional facilitators are both elusive and over-booked. Our team spoke with colleagues, friends, and individuals in their broader networks to find recommendations for the right facilitator for our process. Throughout our various circles, we continued to hear praise for Allen Gunn, or “Gunner”, from Aspiration. Given the overlap in our organizational principles around user-informed design and collaborative building, there could not have been a better fit for our purposes.

Aspiration describes itself as:

“A global leader in the design and delivery of innovative gatherings for nonprofit and nongovernmental audiences. Our event philosophy and facilitation focus on maximizing collaboration and peer sharing, while making sparing use of one-to-many and several-to-many session formats such as presentations and panels. We believe the ultimate potential and power of any convening lie in the collective untapped knowledge and experience of the participants, and we strive to tap that vast store by maximizing dialog, creativity and idea exchange...

We are committed to integrating principles of social justice analysis into all the work we do. We strive to consider the class, power and privilege dynamics associated with technology in service of social change, and seek to hold those privileged by their technology skills and access to technology resources accountable to and co-equal with the full range of stakeholders working for positive social change.

We remain humble to the people and the communities that technology leaves out, those both most impacted and marginalized but also offline and not able to be part of the sprawling virtual dialogs that are shaping our present and our futures.”

During the planning period, our team worked closely with Gunner to define the goals and outcomes of the event series. Together, we created an arc of participation for the event series. We wanted to design a journey for our event participants that began with pre-event engagement and buy-in, real thought-partnership, and strong relationships emerging out of the event series.

Participant-informed design, always

Event attendees should always participate in design of the outcomes of the events. This builds buy-in and fosters an environment for meaningful participation.

Our organization methodology focuses on public-centered design practices. We build with, not for communities, so as to avoid the challenges of inequity and the potential for misrepresentation when creating solutions for public challenges. We credit and thank civic engagement and community technology expert Laurenellen McCann for her leadership on this issue.

We integrated this approach into designing our agenda and event goals with our participants. Thus, in efforts to solidify pre-event engagement and buy-in from attendees, we provided our retreat goals and asked each participant to give their considered feedback.

Given our goal was to generate the most relevant and valuable agenda for all involved, we asked participants:

  1. From your perspective, do the above goals make sense and sound like the right ones to focus on? If not, what's missing or needs addressing?
  2. your opinion, what would be the most important things for the group as a whole to achieve at this event?
  3. What do you personally want to get out of the event? Phrased differently, what will make your time feel well spent, and what outcomes will be most beneficial to you and the work you are doing? Specific and concrete answers are most appreciated here.
  1. What specific topics do you want to make sure are addressed in the agenda? Are there particular experiences, knowledge or perspectives you want to contribute to the proceedings?
  2. What topics do you think this group of public health-focused stakeholders and technologists might be likely to disagree on or desire to debate in consider new technology solutions to public health needs and challenges?
  3. Do you have any other questions or concerns about the event?

Additionally, we connected with key partners at the retreat and asked them to weigh in greater detail on the design of our event activities. Nearly 70% of retreat attendees responded with their thoughts and feedback, which we then incorporated into our agenda and action-plan for the day.

For our second event in the series, we held pre-workshop check-in meetings with each of the 12 participants. We walked them through the purpose of the day, our goals and potential outcomes, what we hoped they could contribute, and asked for feedback on each of these parts.

Be in a supportive environment

The event space should be an open, accessible, and comfortable physical space for all participants.

It is well-established that someone’s physical environment can greatly affect their well-being. Knowing this, we wanted to be incredibly intentional in choosing locations that would be feel warm, welcoming, and accommodating to all of our participants. Along with budget considerations, we focused on finding a space that was housed within an organization with an aligned mission, was transit accessible & ADA compliant, had bright natural light, and the appropriate amount of space to feel open and inviting. Finding a space to meet these requirements was challenging, but luckily we discovered the collaborative event space at LMHQ for our first event and utilized the community board room at Civic Hall for our second event workshop. At both of our events, we also provided healthy and nourishing meals, accommodating many dietary restrictions, and of course, lots and lots of coffee.

Be intentional about the voices in the room

Recruit participants who are eager to learn, represent a diversity in organizational power, want to build partnerships, and are invested in success of the event.

To start our attendee recruitment, we first identified thought-leaders, influencers, and innovators in the fields of community health, civic technology, emerging technology, and philanthropy who would be interested in participating. Although asking folks to attend a full-day and highly-interactive retreat could have easily been a difficult sell, we anticipated and addressed this potential barrier by connecting with key partners in each of the participant spaces. We asked them to connect and vet our process and values as an organization. In our invitation, we also chose to clearly identify what our participants would gain from attending the event. As our list of attendees grew, we worked hard to ensure that a truly balanced and diverse range of participants were represented, both in terms of demographics and organizational roles.

“Gunner was INCREDIBLE. The thought behind the facilitation/what went into the retreat was obvious and thank you so much for that…”
    — Civic Health Ideation Retreat Participant

“It was absolutely wonderful! I feel a personal and professional recharge. Please let me know how I can help for future events and in incubating the ideas that came out of this day. Thank you.”
    — Civic Health Ideation Retreat Participant

Executing

Civic Health Ideation Retreat

In our first event on March 16, 2017, we brought together nearly 50 community health practitioners, engaged technologists, and funding partners to innovative on impactful ways to address the civic roots of community health inequities.

Organizations represented included the NYC Department of Health and Mental Hygiene, NYC Office of the Mayor, PolicyLink, Bronx RHIO, University of Orange, United Neighborhood Houses New York, Justice Codes, Public Lab, Bureau Blank, Way to Wellville, Snips AI, Participatory Budgeting Project, Heat Seek, JustFix.NYC, Civic Hall, Robert Wood Johnson Foundation, and Helmsley Charitable Trust.

Bringing together such a wide-ranging and diverse group of attendees was both exciting and intimidating. Working with our talented facilitator, the day was designed to feel interactive, highly-collaborative, fast-paced, but well-balanced. In order to create a collaborative and inclusive physical setting, participants were asked to sit in a full-circle, single row, breaking up into smaller groups throughout the day, but they always returned to the full-circle for group share-backs until the end the day. There were no handouts presented and no screens allowed; participants were asked to be as fully-presented as possible and use only the materials provided by our team.

  1. Critiquing the Health Lab Theory of Change
  2. From Big Picture Problems to Targeted Interventions - Part I
  3. Emerging Technologies Q&A
  4. From Big Picture Problems to Targeted Interventions - Part II
  5. Closing the Day

Activity 1

Critiquing the Health Lab Theory of Change

In our first small-group session of the day, our goal was to spark critical thought and establish tone and cohesion between participants. Prior to the retreat, we shared a drafted statement we referred to as our Health Lab Theory of Change with 10 participants and asked them to provided their thoughts and feedback on the statement. We integrated their language and suggested edits with the purpose of seeding the groups with folks who already had familiarity and buy-in into the statement. We then presented a knowingly problematic and working draft of our Health Lab approach and asked small groups of participants to provide as critical feedback as possible. We wanted to test if we could build rapid cohesion between participants by asking folks to bond over providing immediate and real criticism, collectively.

Ideation requires openness: Modeling openness and vulnerability at the onset helps fosters group cohesion and creates a supportive setting where participants can take risks in sharing their ideas.

Activity 2

From Big Picture Problems to Targeted Interventions - Part I

In our second small-group session of the day, our goal was to identify interest among potential pilot partners in various systemic community health issues and crowdsource pilot, product, and research ideas from the group. We first provided the group a list of pre-identified, systemic community health issues including: low-income tenant intimidation in gentrifying neighborhoods; mass incarceration; low civic participation; low-income tenant displacement; voter-suppression; police brutality in communities of color; travel bans and Islamophobia; toxic masculinity; “war on the poor” social policies; deportation and separation of families; and, food/bank/resource deserts in low-income neighborhoods. Participants then added their name to the issue area they wished to work on. We then narrowed down the topic areas and re-grouped participants into 10 small groups. In each group, participants were asked to use their subject matter expertise to collaborate and identify possible research questions, project ideas, or interventions that could be explored by the Health Lab.

Start big to dream big: Have participants start at a systems-level so that their interventions come from a cross-sector perspective.

Activity 3

Emerging Technologies Q&A

To break-up the pace of work and re-energize participants after our lunch break, we provided a 30-minute Q&A with technologists in the fields of blockchain, Internet-of-Things (IoT), and artificial intelligence (AI). Six attendees volunteered to hold three, 10-minute sessions on their area of expertise. We hoped that small groups would gain a baseline understanding of these emerging technologies that could be referenced in the final ideation session of the day.

“I learned about really interesting applications of AI (Claudia was great!) and much more about how Blockchain works. Really helpful and useful for such a limited amount of time.”
    — Civic Health Ideation Retreat Participant

Activity 4

From Big Picture Problems to Targeted Interventions - Part II

In our final working session for the day, we reconvened the small groups from that morning with the goal of further refining their pilot, product, and research ideas into possible paths toward a measurable proof of concept. Participants were asked to collaboratively and collectively design intervention prototypes and/or research strategies around refined and targeted solutions within their initial systemic community health issue areas.

Finding intersections builds stronger approaches: Enlisting the perspectives from adjacent fields allows for groups to see the different sides of the same problem and to come up with a more comprehensive solution.


  • Four groups focused their solutions on increasing civic engagement by using either 311 or other open data to activate everyday citizens into civic action.
  • Three groups focused their solutions on addressing low-income tenant displacement and landlord intimidation through open data and predictive modeling.
  • One group proposed using digital media as community driven tool to fight prejudiced misperceptions in America.
  • One group proposed creating a bulk-ordering system in low-income housing buildings to increase access to affordable groceries and household goods.

“I learned that there are many civic data players in the city and that innovations are something people are interested in creating for civic good. It was very encouraging to see the momentum already underway.”
    — Civic Health Ideation Retreat Participant

Activity 5

Closing the Day

Our goal as we closed out the retreat was to have participants find connections between their proposed solutions. We also wanted them to feel appreciated and acknowledged for the tremendous amount of work they accomplished. To achieve this, we had participants move through the room while one representative from each group engaged in a Q&A style conversation about their work. We asked participants to consider how best to build on the work done and ideas generated, and to establish other bridges to post-event collaboration. Finally, as a large group, we closed by summarizing key outcomes from the day and sharing appreciations.

“Phenomenal day. It was great to be in a thoughtful and productive space working with people I did not have shared language or background with. This challenged me to check my assumptions and pushed me to stretch my thinking. I also really appreciated that "tech" was being discussed as a tool for civic good/social change and not the solution. Thank you!”
    — Civic Health Ideation Retreat Participant

Housing Data Tool Workshop

For four weeks after the Civic Health Ideation Retreat, our team explored every idea proposed and examined possibilities and opportunities for each solution. We reviewed a tremendous amount of literature, spoke to sector experts, and interviewed possible users for various use cases.

In particular, we identified immediate interest and need around the work of the group composed of participants from the Robert Wood Johnson Foundation, NYC Department of Health and Mental Hygiene (DOHMH), and the tenant rights’ nonprofit JustFix.NYC. This group proposed a product that builds off of Heat Seek’s recently developed housing rights data tool, which brings together data from 10 different open-data sources related to housing issues, such as 311, HPD, and DOB. As a group, they identified risk indicators based on housing data and community health data, such as asthma rates, infant mortality, and emergency room visits, to demonstrate the level of harm experienced by tenants. Their discussion led into ways that data and technology could support housing court lawyers, HPD, DOHMH, and social workers to identify at-risk tenants, buildings, and neighborhoods and prioritize those facing the greatest risk and harm.

On May 4th, as part of our design process to further explore this idea, we reconvened with the majority of the participants from this group and brought in additional subject matter experts in housing rights organizing and health and housing data. Representatives from DOHMH, JustFix.NYC, Heat Seek, Housing Conservation Coordinators, Robert Wood Johnson Foundation, and Ford Foundation participated in this full-day discovery and design workshop. Collaboratively the group challenged and validated our use-case assumptions for this tool, helping to inform a larger product roadmap.

  1. User Personas and Journey Mapping
  2. Prototype Design Studio

Activity 1

User Personas and Journey Mapping

Our goal in our first activity was to use cross-sector participation to identify data pain points for two separate use cases and then determine possible overlap of these points.

In this session, we divided the participants into two groups: one focused on decision-making using community health data and the other focused on decision-making using housing data. The majority of each group was comprised of subject matter experts on either community health or housing, but each group had a least one representative from the other subject matter area. Groups were then asked to design a fictional user persona and then walk through a day-in-the-life of this persona and their data-informed decision making process.

Housing Journey Map

Groups shared back their journey maps and then paired with a participant from the other field to compare and identify overlapping data issues, distinct data pain points, and overall themes. (Click to view full size version.)

Activity 2

Prototype Design Studio

Our goal in our second activity was to create a space where participants could creatively and collaboratively design the look and feel of a potential data tool.

Participants were paired again with someone from the other field to design a prototype of a data dashboard tool which could serve the use-cases for the user personas created in the first half of the day. Groups then shared back their sketches and models and we again discussed overlapping features and themes that should be explored.

Next Steps

Thanks to the incredible work created by our event participants, we are identifying key stakeholders, users, and possible partners for piloting a housing and health data tool in NYC. We are also entering a research and discovery process around the important issues of civic agency, narrative building for community resiliency, and equitable access to resources identified by groups at the events.


Change and Growth Point

We received all-around positive praise and affirmation from the participants at our events, but there were was one important change and growth point we took away from running our process:

We should be in community when we are thinking about communities.

We asked participants to ideate on solutions to address issues affecting communities harmed by historic and continued structural violence in NYC and beyond, yet a majority of our participants were not from the communities served by the proposed solutions. Considering this, we are looking for thought-partners who will participate in helping us address how we can be accountable to the communities served by our projects, and how we can equitably design and build in community with each other in the future.


Acknowledgements

This work would not have been possible without the partnership and support from the Pioneering Team at the Robert Wood Johnson Foundation and Aspiration.

We would like to thank the NYC Department of Health and Mental Hygiene, NYC Office of the Mayor, PolicyLink, Bronx RHIO, University of Orange, United Neighborhood Houses New York, Justice Codes, Public Lab, Bureau Blank, Way to Wellville, Snips AI, Participatory Budgeting Project, Heat Seek, JustFix.NYC, Housing Conservation Coordinators, Civic Hall, Ford Foundation, and Helmsley Charitable Trust for sending their incredible representatives to our events.

Finally, thank you to all of the brilliant builders and innovators who attend our events and continue to make our work possible.

About Civic Hall Labs

As the nonprofit R&D arm of Civic Hall, Civic Hall Labs seeks to reimagine civic participation for the 21st century; expand the field of civic tech; and demonstrate a collaborative, cross-sector approach to designing and building technology for the public good.

We define civic tech as the use of technology for public good, and we define public good as issues connected to the welfare and well-being of the general public. Distinct from our private lives, the public good deals with shared challenges and opportunities at a societal level.