Process evaluation and Lessons Learned from the Formation of a Multi-Sector Partnership: The Healing Experiences of Adversity among Latinos (HEALthy4You) Study

Clare Viglione^1,2Amy Westermann¹Job Godino³Kyung Rhee⁴Blanca Melendrez⁵Xin Tu⁶David L. Boyle⁷Michael Hogarth¹Gregory A Aarons^10,8,9Noe C. Crespo^11,12Pradeep Gidwani¹³Margarita Holguin¹⁴Cynthia Juarez³Deysi B. Merino-Gonzalez¹⁵Liliana Osorio⁵Herminia Ramirez¹⁵Micaela Smith¹⁶Alec Terrana¹⁷Gary Firestein^1*Eric Hekler^18,2*

• ¹Altman Clinical and Translational Research Institute, School of Medicine, University of California, San Diego, La Jolla, California, United States
• ²Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, United States
• ³Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, CA., San Diego, United States
• ⁴Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California, United States
• ⁵Center for Community Health, Altman Clinical and Translational Research Institute, University of California San Diego, San Diego, California, United States
• ⁶Division of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, United States
• ⁷Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California, United States
• ⁸Department of Psychiatry, School of Medicine, University of California San Diego, San Diego, California, United States
• ⁹UC San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, San Diego, United States
• ¹⁰Child & Adolescent Services Research Center, San Diego, California, United States
• ¹¹School of Public Health, San Diego State University, San Diego, California, United States
• ¹²Institute for Behavioral and Community Health, College of Health and Human Services, San Diego State University, San Diego, California, United States
• ¹³American Academy of Pediatrics, California Chapter 3, San Diego, California, United States
• ¹⁴Consulting Solutions, LLC, San Diego, United States
• ¹⁵Vista Community Clinic, Vista, California, United States
• ¹⁶YMCA of San Diego County, San Diego, United States
• ¹⁷Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington, United States
• ¹⁸Design Lab, University of California San Diego, San Diego, California, United States

The Healing Experiences of Adversity Among Latinos (HEALthy4You; H4Y) study was a multi-sector partnership (MSP) between an academic research institution, a Federally Qualified Health Center (FQHC), and a multi-sector collective impact coalition focused on childhood obesity prevention. The goal of HEALthy4You was to develop community-centered and culturally appropriate precision interventions within FQHCs for Latino families to address predictors of adverse child experiences (ACEs) and treat childhood obesity. A multidisciplinary and multi-sector research, clinical, and community team (N=29) was formed in September 2020 to co-design the study, which launched in June 2022. The team utilized a co-creation approach combined with the Exploration, Preparation, Implementation and Sustainment (EPIS) framework1,2 to facilitate a collaborative design process. We conducted an internal and retrospective process evaluation in March 2023 to identify antecedents and situational factors associated with project formation, with a focus on understanding tensions and challenges with a broad partnership structure. We outline the team's co-creation process and describe internal challenges and pitfalls that emerged when developing the project. We sought to better understand the impact of differing perspectives, priorities, and goals between disciplines, sectors, and roles; differing approaches to evidence and evidence production; and team strategies to mitigate and manage competing pressures and priorities. This case report describes lessons learned, with the goal of sharing insights to support future development of best practices in project, partner, and team formation between researchers, clinicians, and community members. More specifically, these lessons could help inform community-led research endeavors between academic institutions, FQHCs, and community-based organizations (CBOs).