Consumer involvement is critical to the success of the consortium. With almost all grantees reporting consumer participation on the consortium, the importance of their involvement appears to be well understood. Although consumer involvement in their consortia was common, grantees were constantly challenged to ensure regular and ongoing consumer participation.

All grantees (100 percent) used at least one strategy to facilitate consumer involvement in their consortium. Almost all grantees (97 percent) actively recruited consumers to participate in the consortium. Other common strategies to motivate consumer involvement were to provide nutritional supplements (91 percent) and to schedule meetings at convenient locations (84 percent) or at convenient times (81 percent). Grantees used an average of six facilitating strategies to bring consumers to the consortium.

Grantees that provided nutritional supplements, used convenient meeting locations, and provided transportation asissistance were more likely to perceive that their consumer membership reflected the target population. Grantees that strongly agreed their consumer membership was culturally representative of the target population had more strategies (mean = 6) to encourage consumer participation in the consortium than grantees that somewhat agreed (mean = 5) or somewhat disagreed (mean = 5). These findings suggest an association between the use of facilitating strategies and the adequacy of cultural representation on consortia.

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The goal of consumer involvement in Healthy Start is to create a vocal, participating cohort of active consumers who have leadership skills and are able to effectively advocate for change on behalf of the target population. Actively engaging consumers in the consortium is the first step toward creating increased consumer voice and developing a consumer leadership base in the community. Grantees were asked to report the various strategies that they used to promote leadership among consumers.

The mean number of strategies employed by grantees was three, and the most common strategies were inviting consumers to serve on subcommittees (75 percent), sending consumers to conferences (70 percent), and conducting training sessions for consumers (66 percent). Less than five percent of grantees did not engage in any activites to promote leadership among the consumers on their consortia.

Healthy Start projects focus on systems changes as well as traditional delivery of services. Systems change aims to provide long-term solutions, such as policy change or service integration, to the problems affecting the target population. The consortium is a major vehicle for this type of change because it involves a wide range of MCH stakeholders in the target community. The survey gathered information on grantees’ perceptions of the accomplishments of their consortia in bringing about systems change in Healthy Start communities.

Among the 11 possible consortia-related accomplishments included in the survey, grantees reported six accomplishments on average. The most common accomplishment was an increased awareness of infant mortality (86 percent), followed by enhancing the community’s ability to address disparities (70 percent) and creating sustainable partnerships between member agencies that are expected to endure beyond the Healthy Start contract period (70 percent).

Nearly all grantees reported challenges that they believed limited the effectiveness of their consortia. On average, four challenges were identified by each grantee. Some consortia were challenged by internal difficulties such as irregular attendance, insufficient leadrship, and competition among members. Others felt that external conditions, such as State or local politics and government resources, were obstacles to the consortium meeting its goals. The two most frequent challenges were the irregular attendance by key members (50 percent) and insufficient resources at the State or local level (48 percent). Other frequently reported challenges included insufficient staff time dedicated to consortium efforts (43 percent), lack of consumer involvement (43 percent), and lack of resources (42 percent) (data not shown).

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