Report date
August 2018

What has been most instrumental to your progress?

A comprehensive website/webpage specific to the purpose of the grant project was very important. The website served to provide key information ahead of meetings and activities. The site served as a landing page for individuals seeking information about our work in North Dakota, including progress reports. We used the website to publish results of our Community Awareness & Attitudes Survey. This data was critical when focusing stakeholders thoughts and attention toward possible solutions. Throughout the course of the grant, we were often asked about the difference between our work generally and the community innovation work. The website helped bring clarity. Thus, we are able to differentiate our state initiative work from our local operations; keeping key stakeholders focused.
Face It TOGETHER had an operational and relational presence across the state. Our previous work and our relationships were quite helpful when seeking involvement in various activities. We were fortunate to have local team members ingrained in or directly from many different North Dakota communities. This gave us a greater level of credibility and authenticity of voice, especially when attempting to collaborate.
We utilized listening sessions, gap analysis, and ecosystem analysis to help structure the work and identify ways to collaborate. Each of the listening sessions included a participant survey to understand where a community lacked necessary services. We sought discussion on community strengths, challenges, and needs. The gap analysis report incorporated learnings from listening sessions and the survey. Every subsequent conversation with stakeholders was informed by this knowledge. Stakeholders felt included in the process and collaboration was more meaningful. We engaged Augustana Research Institute (ARI) to conduct an ecosystem analysis of the state of North Dakota. ARI's work provided an assessment of care gaps, challenges, and barriers from which recommendations were outlined for a statewide approach to macro and micro solutions. Each set of analysis moved our work toward more meaningful actions.

Key lessons learned

As reported previously, the addiction problem is well known with little attention on solutions. Many ND cities and towns have active coalitions led by mayors, law enforcement, and others. Increased attention on addiction allowed us to learn what was immediately important. We learned that some communities were not interested in the same conversations of the past; they wanted to focus on solutions and action — even if it those solutions came from outside their community. Our work began in 2015 just as numerous mayors announced the creation of blue ribbon panels and task forces on addiction. These groups' actions, in some respects, competed with our listening sessions and other activities. In Grand Forks, for example, we collaborated with the Mayor’s office to augment their town hall meetings with our listening session. Despite good communication in the community, unfortunately, our listening session may have caused confusion. Nonetheless, more voices came to the issue, whether through our efforts or other efforts. We were thrilled to see more community members get engaged in the conversation. This was an absolutely positive effect of the work.
The biggest challenge for our work was something we could not anticipate: the Governor and First Lady of North Dakota announced addiction as their primary public health issue. The announcement was positive for the cause, generally, given the size and scope of the problem. However, much of the momentum and attention we were building was somewhat impaired -- specifically, when attracting members to a statewide task force. Through the convergence of all the activities occurring around the state, we were able to invite both Governor and First Lady Burgum to our Fargo Listening Session. Both graciously shared their time and vision for a state that has solved addiction. Their message was simple: a solution will require everyone’s involvement. Our intended outcome through this process had to be modified. Over the course of the grant period, we sought opportunities to engage communities where the need was big but had little attention — smaller towns and rural areas. As time went on and we continued to engage and seat our desired task force, the work at the state level started to overcome our intentions.

Reflections on the community innovation process

The most important element of the community innovation process through the end of the grant has been inclusiveness and generating ideas. Nearly all communities we visited and held a listening session, a common theme was that people felt listened to. Most felt like they had an actual say in the generation of ideas for solving the problem. Attendees to the listening sessions were actively engaged in identifying their specific community needs. The listening sessions were facilitated by a neutral party. This permitted self-directed dialogue without an agenda or motivations biased by our organization. The community awareness & attitudes survey allowed for an extensive variety of voices to be heard. The gap analysis supports the broad and open engagement directed toward solutions. The analysis illustrated attendees' sensitivity toward important stakeholders not present at the listening sessions; e.g., business owners. By identifying sectors of the community needed to be part of addressing addiction in their community, we are given pathways for next steps.

Progress toward an innovation

The community innovation process, unfortunately, did not result in the wide-scale innovation we were hoping to achieve. However, because of the activities in Fargo, in particular, we attracted greater attention to our specific organization's work. The result has been increasing demand for our services in Fargo, as well as, an extension of our work to Grand Forks via a contract with the GF Department of Public Health. Our broader objective to expand solutions beyond the typical public sector activities never manifest. We sought to include more private sector leaders in solution generation and activation -- that did not happen. It seems that timing was a major factor in our approach. If executed today -- with a few minor modifications -- we would be closer to achieving greater impact.

What it will take to reach an innovation?

We tried to address an innovation across the entire state. If we could continue or regroup, we'd probably break the state up into 4 or 5 regions and systematically work through each region. Another thing we'd do is approach private and public stakeholders together as much as possible; i.e., invite collaboration across sectors much sooner. Last, we believe a more clearly defined process and desired outcome should be presented up front. We feared spelling out too much of the process would hinder collaboration -- however, we think the direction would foster greater, more meaningful involvement.

What's next?

We are currently working with our two affiliates in Fargo and Bismarck to improve organizational collaboration for community-based strategies. The community innovation grant gave us a solid framework. Our intention is to use the process and learnings to improve how individuals navigate other services and community based resources.

If you could do it all over again...

The advice we would give ourselves is really twofold. First, we'd tell ourselves to provide greater clarity on the strategic plan. People want to know what they are signing up for. Second, we'd tell ourselves to identify local champions earlier. We found ourselves having to work harder to move action -- a local champion could help overcome this negative inertia.