Table 4.

Common Themes in Barriers to Partnership Sustainability and Corresponding Illustrative Quotations From Focus Group (Phase II) Participants

Theme	Theme description	Illustrative quote(s)
External factors influencing participation and operations	External factors outside of partnership’s control that affected individual participation and partnership operations, such as geographic distance and historical trauma related to research participation.	“What has helped us in regard to continuing relationship is some critical awareness of the forces that are making things hard for people. Concepts of shared social justice … there is a broader picture when you’re interacting with populations who have been on the social exclusion historical experience, you need to include, and respect, and instill that it’s a systemic challenge that we face together, and that we want to change and not just some sort of Band-Aid.” [Participant 9E] “When we looked to put the community health workers into community organizations and have them pair with our health care partners in our clinics, they don’t have — they can’t process the data. They can’t do HIPAA-compliant management of the data. They can’t talk to the electronic health record systems, and those are the big barriers that our community-based organizations have.” [Participant 2D]
Conflicting role of funding	Acknowledgment that partnership sustainability depends heavily on the ability to secure ongoing funding, but partnerships cannot make an impact on patients’ lives and health by focusing only on funding as a form of sustainability.	“Yes, it is more than just funding, but you always have to remember that funding is a part of the partnership sustainability, so is it joint funding or joint looking for funding or is that based on one of the partners is going to work on funding and the other ones are just a part of the partnership? Because even though we don’t want to say that it’s based on funding, really, the projects are based on funding whether we like it or not.” [Participant 1B] “The work is our vision, and we’ll find a way, and somehow, we did [laughs]. But it was always something and remains looming in the periphery about whether we can make long-term goals or should be focused on what, you know, funding there is.” [Participant 9E]
Lack of institutionalization	Inability to secure ongoing funding from parent organizations, sometimes leading to dissolution of partnership.	“I think that [the community health worker model] is a piece that institutions have really not gotten, even though it’s been around for so many years and it’s been used in Latin America, Central America, and China, I mean, just hundreds of years that this model’s been out there. So, for me, that was a failure in sustaining partnerships and something that I felt was so important, and it just crushed my heart to know that at this institutional level it wasn’t important enough to sustain in any form, even the partnership piece of it, afterward.” [Participant 2B]