ORIGINAL PAPER The Culture of Health Survey: A Qualitative Assessment of a Diabetes Prevention Coalition Cecilia B. Rosales • M. Kathryn Coe • Nancy R. Stroupe • Anna Hackman • Jill Guernsey de Zapien Published online: 24 October 2009 Ó Springer Science+Business Media, LLC 2009 Abstract In the past two decades, the fields of public health and social services have increasingly turned toward collaborative and community-based approaches to address complex health and social issues. One aspect of these approaches has been the development and implementation of community coalitions. Coalitions have been used to successfully address a wide range of issues, including cancer prevention, tobacco use, HIV/AIDS, youth violence, heart disease, diabetes, and sexual exploitation of youth runaways. In south Tucson, Arizona the SEAH coalition was developed to address diabetes and substance abuse prevention. Using a qualitative interview guide, the Culture of Health Survey, this study was aimed at identifying community perceptions of the coalition and its effective- ness in the areas of community leadership, partnerships, trust, and movement towards positive change. We also sought to document the dissemination, throughout a com- munity, of information on the activities and functioning of a community based coalition and whether or not it was seen as one that held fast to the community values and not to individual agendas. Results highlight the importance of outreach, education, trust, and partnerships in promoting diabetes prevention through a community coalition. Keywords Coalition building Á Partnerships Á Qualitative evaluation Background and Significance In the past two decades, the fields of public health and social services have increasingly turned toward collabora- tive and community-based approaches to address complex health and social issues [1–3]. These approaches arose from growing community dissatisfaction with traditional applied research paradigms in which the ‘‘outside researcher largely determines the questions asked, the tools employed, the interventions developed and the kinds of results and outcomes documented and valued’’ [3, 4]. While expertise and quantitative data are important, and traditional research has yielded valuable information for prevention science, statistical data alone do not yield all of the answers to complex problems [5, 6]. Additionally, when outside experts and service providers are the primary research decision makers, problems are often narrowly viewed solely within professional boundaries and the knowledge, skills, concerns and resources of people and organizations from the community are ignored. Without these community assets, it is difficult to identify what residents actually want, need and will utilize or adopt, and it is almost impossible to frame issues in ways that make sense to or are of value to community members. In other words, without such involvement it is not possible to develop and implement solutions that work effectively and in a sustainable manner in the local community [5, 6]. Based on the limitations of utilizing traditional research and intervention approaches, there are compelling reasons to supplement these approaches with those that promote broad and active community participation in addressing C. B. Rosales (&) Á N. R. Stroupe Á A. Hackman Á J. G. de Zapien Division of Community, Environment, and Policy, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA e-mail: crosales@email.arizona.edu M. K. Coe Division of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA 123 J Community Health (2010) 35:4–9 DOI 10.1007/s10900-009-9198-9