title: Place-Based Initiatives to Improve Health in Disadvantaged Communities: Cross-Sector Characteristics and Networks of Local Actors in North Carolina.
abstract: To examine the leadership attributes and collaborative connections of local actors from the health sector and those outside the health sector in a major place-based health initiative.
  
  
  
  We used survey data from 340 individuals in 4 Healthy Places North Carolina counties from 2014 to assess the leadership attributes (awareness, attitudes, and capacity) and network connections of local actors by their organizational sector.
  
  
  
  Respondents' leadership attributes-scored on 5-point Likert scales-were similar across Healthy Places North Carolina counties. Although local actors reported high levels of awareness and collaboration around community health improvement, we found lower levels of capacity for connecting diversity, identifying barriers, and using resources in new ways to improve community health. Actors outside the health sector had generally lower levels of capacity than actors in the health sector. Those in the health sector exhibited the majority of network ties in their community; however, they were also the most segregated from actors in other sectors.
  
  
  
  More capacity building around strategic action-particularly in nonhealth sectors-is needed to support efforts in making widespread changes to community health.
authors.affiliation: Matthew E. Dupre, Alicia Nelson, Janese M. Willis, and Mina Silberberg are with the Department of Community and Family Medicine, Division of Community Health, Duke University, Durham, NC. James Moody is with the Department of Sociology, Duke University. Lori Fuller and Allen J. Smart are with Kate B. Reynolds Charitable Trust, Winston-Salem, NC. Doug Easterling is with the Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Dupre
authors.affiliation: Matthew E. Dupre, Alicia Nelson, Janese M. Willis, and Mina Silberberg are with the Department of Community and Family Medicine, Division of Community Health, Duke University, Durham, NC. James Moody is with the Department of Sociology, Duke University. Lori Fuller and Allen J. Smart are with Kate B. Reynolds Charitable Trust, Winston-Salem, NC. Doug Easterling is with the Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem.
authors.forename: James
authors.initials: J
authors.lastname: Moody
authors.affiliation: Matthew E. Dupre, Alicia Nelson, Janese M. Willis, and Mina Silberberg are with the Department of Community and Family Medicine, Division of Community Health, Duke University, Durham, NC. James Moody is with the Department of Sociology, Duke University. Lori Fuller and Allen J. Smart are with Kate B. Reynolds Charitable Trust, Winston-Salem, NC. Doug Easterling is with the Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem.
authors.forename: Alicia
authors.initials: A
authors.lastname: Nelson
authors.affiliation: Matthew E. Dupre, Alicia Nelson, Janese M. Willis, and Mina Silberberg are with the Department of Community and Family Medicine, Division of Community Health, Duke University, Durham, NC. James Moody is with the Department of Sociology, Duke University. Lori Fuller and Allen J. Smart are with Kate B. Reynolds Charitable Trust, Winston-Salem, NC. Doug Easterling is with the Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem.
authors.forename: Janese M
authors.initials: JM
authors.lastname: Willis
authors.affiliation: Matthew E. Dupre, Alicia Nelson, Janese M. Willis, and Mina Silberberg are with the Department of Community and Family Medicine, Division of Community Health, Duke University, Durham, NC. James Moody is with the Department of Sociology, Duke University. Lori Fuller and Allen J. Smart are with Kate B. Reynolds Charitable Trust, Winston-Salem, NC. Doug Easterling is with the Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem.
authors.forename: Lori
authors.initials: L
authors.lastname: Fuller
authors.affiliation: Matthew E. Dupre, Alicia Nelson, Janese M. Willis, and Mina Silberberg are with the Department of Community and Family Medicine, Division of Community Health, Duke University, Durham, NC. James Moody is with the Department of Sociology, Duke University. Lori Fuller and Allen J. Smart are with Kate B. Reynolds Charitable Trust, Winston-Salem, NC. Doug Easterling is with the Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem.
authors.forename: Allen J
authors.initials: AJ
authors.lastname: Smart
authors.affiliation: Matthew E. Dupre, Alicia Nelson, Janese M. Willis, and Mina Silberberg are with the Department of Community and Family Medicine, Division of Community Health, Duke University, Durham, NC. James Moody is with the Department of Sociology, Duke University. Lori Fuller and Allen J. Smart are with Kate B. Reynolds Charitable Trust, Winston-Salem, NC. Doug Easterling is with the Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem.
authors.forename: Doug
authors.initials: D
authors.lastname: Easterling
authors.affiliation: Matthew E. Dupre, Alicia Nelson, Janese M. Willis, and Mina Silberberg are with the Department of Community and Family Medicine, Division of Community Health, Duke University, Durham, NC. James Moody is with the Department of Sociology, Duke University. Lori Fuller and Allen J. Smart are with Kate B. Reynolds Charitable Trust, Winston-Salem, NC. Doug Easterling is with the Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem.
authors.forename: Mina
authors.initials: M
authors.lastname: Silberberg
mesh_terms: D057191:Capacity Building; D018672:Community Health Planning / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D003299:Cooperative Behavior; D003659:Decision Making, Organizational; D006265:Health Care Coalitions / Q000458:organization & administration*; D006291:Health Policy; D006292:Health Priorities; D006302:Health Services Research; D006801:Humans; D007857:Leadership; D009657:North Carolina; D009937:Organizational Objectives; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations