Facilitators

Strong, stable leadership in health center and partner organizations

High staff retention, buy-in, and institutional knowledge

Diverse coalitions built on trust among public, private, nonprofit sector entities, each with clear roles and responsibilities

Diverse funding sources to initiate projects

Incorporation of activities into service delivery to ensure sustainability

Ongoing data collection and analysis, community needs assessments, use of surveillance data, and program evaluation

Position in a larger context that is conducive to public health initiatives

Inhibitors

Lack of a champion or leadership changes in partner organizations

Staff turnover in health center and partner organizations

Bureaucratic delays and funding opportunities that impede collaborations and progress

Competition between partner organizations for limited funding streams

Inability to sustain project beyond grant period because of lack of reimbursement for public health activities

Limited integration and interoperability of data sources, within health centers as well as between health centers and partner organizations

Social and political factors at the local, state, or national levels