title: Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.
abstract: OBJECTIVE
  Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program.
  
  
  METHODS
  Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically.
  
  
  RESULTS
  Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas.
  
  
  CONCLUSIONS
  Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration when programs are funded and implemented in the community.
authors.affiliation: Clinical and Rehabilitation Sciences, Faculty of Health Sciences, University of Sydney, 74 East Street, Lidcombe, NSW 2141, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dennis
authors.affiliation: Exercise & Sports Science Australia, 327 Sandgate Road, Albion, Qld 4010, Australia.
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Hetherington
authors.affiliation: South Western Sydney Medicare Local, Level 3, 1 Bolger Street, Campbelltown, NSW 2560, Australia.
authors.forename: Jerrad A
authors.initials: JA
authors.lastname: Borodzicz
authors.affiliation: Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Oshana
authors.initials: O
authors.lastname: Hermiz
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Zwar
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D003299:Cooperative Behavior; D004032:Diet; D006293:Health Promotion / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D016730:Program Development