A Scan of Partnerships Between Community-Based Organizations and Healthcare Providers in North Carolina

Background

North Carolina is at the forefront of the Food is Medicine (FiM) movement, in particular those approaches integrating nutrition into health care through community-based initiatives. By prioritizing food security and dietary interventions, FiM programs help prevent and manage chronic illnesses, improving overall well-being and reducing health care costs, especially for at risk communities. These programs emphasize prevention, education, and access to nutritious food to tackle health challenges at their root.

Collaboration between health care organizations (HCOs) and community-based organizations (CBOs) is key to FiM’s success in our state. HCOs provide medical oversight and screenings while CBOs focus on food access, affordability, and education through local resources like food pantries and farmers markets. Blue Cross NC Foundation has been a catalyst for these efforts in recent years by funding 10 community-based FiM programs throughout the state to better understand their impact and support their growth, helping to ensure their long-term effectiveness in addressing nutrition-related health concerns.

Complementing this support, the Foundation initiated a multi-year exploration, led by Seeds of Change and Food Insight Group, to gather insights from participating CBOs and HCOs) with the goal of better understanding the nature and nuances of these partnerships and what facilitates or hinders delivery of FiM programs.

This report examines how FiM partnerships in North Carolina can evolve beyond basic referrals, fostering deeper collaboration between health care providers and community-based organizations to improve patient outcomes and create sustainable, integrated support systems.

Approach

The evaluation was conducted in two distinct phases. Phase I focused on developing interview guides and survey tools to understand the roles and contributions of CBOs, laying the groundwork for strategic decision-making. Phase II built upon these efforts with in-depth interviews and surveys of CBOs, HCOs, FiM program participants and Foundation staff, identifying key challenges and strategies to improve program effectiveness. The analysis provides recommendations to enhance FiM collaborations and their long-term impact.

What Was Learned

The effectiveness of FiM programs relies heavily on strong partnerships between CBOs and HCOs. These collaborations integrate community trust, medical expertise, and referral systems to enhance access to nutritious food. Each partner offers unique insights into the key factors that drive FiM success and identified necessary strategies to address existing challenges and improve long-term impact.

What Partners Had to Say

• CBOs: CBOs shared insights about the significant challenges in resource allocation, emphasized the importance of community engagement and culturally tailored interventions, and established networks and strong relationships that enhanced their ability to deliver services effectively.

• HCOs: HCOs emphasized the need for long-term commitment, alignment with clinical workflows, and the importance of communication and trust in fostering successful collaborations with CBOs.

• Foundation Staff: Perspective from the Foundation staff focused on importance of financial backing, program sustainability, and the chal­lenges of measuring long-term impact while also stressing the need for flexible funding models, effec­tive evaluation frameworks, and collaborative partnerships to address the broader social determi­nants of health and ensure the success of FiM initiatives.

What Makes Partnerships Between CBOs and HCOs Successful

• Communication and Trust: Effective partnerships were marked by transparent communication and mutual trust, which facilitated problem-solving and adaptability.

• Shared Goals: Successful partnerships had clearly defined, shared goals that were regularly revisited and adjusted as needed.

• Innovation and Flexibility: Partnerships that embraced innovative approaches and maintained flexibility in their strategies tended to be more resilient and impactful.

• Shared Vision: The foundation of any suc­cessful partnership, partic­ularly between CBOs and HCOs, lies in aligning on a shared vision and mutually agreed-upon objectives.

• Training and Support: Successful collaborations be­tween CBOs and HCOs often rely on ongoing training and support to build the necessary skills and understanding for effective partnership work.

What is Standing in the Way of Success

• Resource Constraints: Both CBOs and HCOs strug­gled with limited financial and human resources, impacting their ability to fully engage in and sustain partnerships.

• Organizational Barriers: Differences in organization­al cultures, priorities, and administrative processes created friction and slowed down collaborative efforts.

• Measurement Challenges: Difficulty in evaluating and measuring the outcomes of FiM programs led to uncer­tainties in demonstrating value and securing continued support.

Why It Matters

Research shows that integrating nutrition into health care strategies reduces medication use, improves health outcomes, and in-turn lowers costs of care. A holistic approach that addresses both the immediate and long-term needs of the community by embedding nutrition and wellness into the fabric of local healthcare systems not only improve individual health outcomes but also strengthen community resilience. By working together more efficiently, CBOs and HCOs can overcome barriers like resource limitations and administrative challenges, expanding the reach and effectiveness of FiM initiatives. Streamlining processes, ensuring stable funding, and establishing supportive policies will help create sustainable systems that support both public health and the local economy, ultimately fostering healthier communities, enhancing food security, and improving overall well-being for everyone.

Access the full report to learn more.