Strengthening community voices: implementing Local Health Equity Action Teams (LHEATs) to address health disparities

Abstract

Background: The COVID-19 pandemic intensified existing health and social inequities, disproportionately impacting rural and under-resourced urban communities. Community-led coalitions that leverage the experiences and strengths of diverse stakeholders can play a crucial role in addressing these disparities. Methods: The Communities Organizing to Promote Equity (COPE) project, implemented across 20 Kansas counties, utilized community coalitions known as Local Health Equity Action Teams (LHEATs) as the primary intervention strategy. Comprising community residents, social service representatives, and community health workers (CHWs), LHEATs identified and prioritized local inequities to guide their activities. To examine the development and implementation of LHEATs and to identify factors influencing their effectiveness, we conducted a mixed-methods study. Results: Between March and September 2022, 216 members completed surveys that captured demographics, social identities, and participation motivations. Semi-structured interviews (N = 117) were conducted between August 2022 and September 2023, guided by the Consolidated Framework for Implementation Research. Most (82.4%) identified as female, with over half participating due to job-related roles. Members reported diverse social identities and a shared commitment to their communities. Thematic analysis highlighted contributors to LHEAT effectiveness, including involving individuals with firsthand experience of inequities, the involvement of individuals connected to local services, and the presence of CHWs with dedicated, paid time. CHWs played a key role in recruiting and retaining LHEAT members with lived experience. Participants emphasized the importance of strong academic support, organized meetings, inclusive dialogue, and shared decision-making. Conclusions: Findings underscore the need for structured support, inclusive leadership, and clearly defined roles to sustain effective, community-driven responses to health inequities. This model holds promise for large-scale, locally driven change with meaningful community engagement and sustained outcomes.