| Abstract: | Between the years 1993 and 2000, the W. K. Kellogg Foundation sponsored the Comprehensive Community Health Models (CCHMs) Initiative in three Michigan counties. CCHMs was comprised of three closely related community initiatives carried out in the midst of a failed national health care reform effort and the continued penetration of managed care arrangements into many health care systems. This experimental initiative set out to test the hypothesis that traditional healthcare system animosities and exclusionary practices could be overcome by stakeholder participation in an ongoing, structured, collaborative dialogue about improving access to health services. In the process of collecting data through surveys, interviews, content analysis, and observation, we were struck by the occurrence of several overarching tensions that we perceive to exist in our data. The present article elucidates five such tensions and suggests how third parties such as communication researchers, evaluators, and practitioners can facilitate community health improvement initiatives and better their own data interpretation by acknowledging and understanding these tensions. |
