How explicit is your organization about advancing equity—when considering your own programs and your work with partners? 

Council on Foundation Title Slide

Designing With, Not For

We reflect on this question daily at The BUILD Health Challenge® (BUILD) and it grounds our efforts to advance health equity in America. These efforts took on an even greater sense of urgency over the past year amidst the pandemic, the growing social justice movement, and economic instability that affected every community across the country in some way. 

BUILD stakeholders, including funders, awardees, and partners, used this moment in BUILD’s evolution to rethink, redesign, and reconsider what a grant-funded program centered on community health could be. To lead this thinking, we set out to develop a listening tour involving key stakeholders with the goal of better understanding where communities are in terms of needs, goals, and strategies for advancing health equity. Key questions we asked included: 

  • What do “community-forward” and “racial-equity centered” terms mean to community stakeholders in the context of a program like BUILD? 
  • How has capacity within community collaborations shifted? 
  • How has community engagement evolved during this time of uncertainty? 

Designed as a listening tour rather than an evaluation, this process was co-created by BUILD in partnership with funders and past awardees. Participants represented a wide array of experiences across issue areas, geographies, and professions. (To learn more about the process we undertook, including collaboration with awardees and the role of the co-facilitators, see this blog post on the BUILD website.) 

We plan to use the insights from this learning journey to inform not only program planning for a potential fourth BUILD cohort, but also, more broadly, our future strategies within the philanthropic sector and practices within community health.  

Because many of our foundation peers expressed interest in the listening tour and our findings, the Council on Foundations invited BUILD to share insights at their annual meeting on June 16 called “Leading Together 2021.” I was joined by two funding collaborative members who played a key role in the development of the listening tour — Sandy Doughton from the Methodist Healthcare Ministries of South Texas, Inc. and TC Duong from the Blue Shield of California Foundation. It is our hope that this conversation will spotlight how this collaborative co-development process can serve as a galvanizing platform for programs and organizations to align efforts and goals more effectively and efficiently. 

3 Key Learnings:

Below are three key insights we learned through the listening tour and shared during our Council on Foundations presentation. We plan to share the complete analysis and learnings in September.  


Listening Tour Areas of Exploration

Centering on Community Co-creation, Racial Equity and Racial Justice, Collaborative Capacity and Systems Change

Centering community co-creation: A theme throughout the conversations was that power sharing is essential, and it goes beyond traditional community engagement tactics. A diverse set of people with lived experience must become recognized decision-makers, and partners and institutions must yield their power and learn how to work with people with lived experience. Figuring out how to set conditions for and operationalize power sharing, however, can be elusive. This conversation is pushing BUILD to redesign its own internal structures and processes. 

Racial equity and racial justice: While BUILD’s goal has always been grounded in the pursuit of health equity, participants shared that when racial equity is centered, better questions are asked, decision-making processes shift, leaders become more diverse, and interventions become more equitable. The conversation didn’t stop at racial equity either. There was a clear desire by participants to ensure that the systems change BUILD is supporting would be sustainable and ultimately support the advancement of racial justice. 

Collaborative capacity and systems change: Although participants acknowledged that community-based organizations (CBOs) need to strengthen their capacities to center people with lived experience, participants believe that CBOs are still the best entity to the lead BUILD efforts (with support from local public health departments and hospitals/health systems) because they serve as effective bridges between the community and institutions. This was helpful to hear as we look at a new fourth cohort and the potential variations on cross-sector collaboratives that make up the BUILD network.  

While we have not yet completed the listening tour, one thing has already become clear: process in this case is just as important as the outcomes. The design process that structured the listening tour along with initial learnings have fundamentally changed how BUILD and many of its funding collaborative members and partners are thinking about systems change. It has inspired us to center equity more fully in the way we approach our goals and strategies, beyond the listening tour. This includes shifts in governance policies and changes in how materials and content are created, reviewed, and produced. We’re excited for what’s to come and hope you’ll share your own journey and learnings with us as well! 


Special thanks to the Success Measures team at NeighborWorks America for helping to conceptualize and implement the listening tour. Success Measures is an evaluation consulting group whose work is grounded in community development and health.