Seven Questions with Melissa Monbouquette

This article is pulled from an interview with Melissa Monbouquette , Executive Director of the Build Health Challenge. For a podcast version, listen to Do Tank Presents on Apple, Spotify, Google Podcasts, or our custom RSS feed.

Early last month, we joined a Zoom call with Melissa Monbouquette , Executive Director of Build Health Challenge? (BUILD), to discuss BUILD, a premiere organization working to improve community health.?

BUILD supports community leaders who are taking ownership of health outcomes and the fight for equitable resources. In our years of partnering with BUILD, they’ve partnered with over 68 communities—but that’s just the start.

In this interview, we talk with Melissa about BUILD and the road ahead, thanks to the official release of their Community Health Workbook.

If you want to partner with BUILD, pay them a visit at Buildhealthchallenge.org, and if you need help creating workbooks, playbooks, or visual exercises of your own, contact us at dotankdo.com.

What stories from BUILD communities inspire you the most?

At BUILD, we see so many things. Our communities are working on a whole variety of different issues. They choose what they want to work on. That can look like access to housing, healthy food, transportation, education, social isolation, and wellness—all sorts of different things that impact your long-term health outcomes.

One example is a team from New Brunswick, New Jersey. They initially started with BUILD working on a community health worker model that connects residents to health and social services and trained community health workers. They’ve shifted that model to include a tenant's association that advocates for housing and support in this community.

During COVID, housing became incredibly important. People were in their homes a lot and didn’t have access to resources within these neighborhoods. Last year, community members (after receiving advocacy training and building knowledge about what their rights were) were able to go to the city council and testify and get a policy passed around price gouging for utilities like water.

When given resources to think big and do the work, communities will jump at it in a minute. - Melissa Monbouquette

Price gouging was impacting rentals there, and it was something community members wanted to work on. The community council members even said, “This is what the process is supposed to look like.” That training ultimately helped them have better health because they have a safer home to live in and can't be taken advantage of, like so many communities are.

BUILD stands for bold, upstream, integrated, local, and data-driven. I think the UPSTREAM piece is really important. Not just providing health services and healthcare but thinking about what drives health in a community.?

The bold piece is also really important: What can you do not just to change one or two people's health but affect community-wide systems that have a bigger impact? When given resources to think big and do the work, communities will jump at it in a minute.

What are the goals of the BUILD Health Challenge? What do you hope participants walk away with?

BUILD is a national initiative that supports community-centered partnerships. We foster collaboration between community-based organizations and residents with health departments, hospitals, and health plans to address community priorities. These priorities often create systemic changes that improve equitable health outcomes down the line and drive long-term positive health outcomes in specific communities.

Our model is built around community-based organizations. These are the organizations providing social services and connecting to residents. We make sure these organizations have a voice at the table and are heard by the institutions that support health in our communities.?

Healthcare partners, like hospitals, health systems, health plans, and local public health departments, have a strong interest in ensuring quality community health. BUILD encourages partners to collaborate, addressing the real priorities of community members.

How does the BUILD Health Challenge promote sustainable partnerships? What should coalition partners be considering before they collaborate on this work?

BUILD offers flexible, unrestricted funding for this type of work. Funding is the backbone support of these partnerships. We also incentivize others to make similar commitments.

Oftentimes, more importantly, we provide resources and a network to support the work of community partnerships. If we’re providing funding, we want to make sure community partners have everything else they need to succeed. That includes access to technical assistance, coaching, and a peer network where they make connections with national and local players.

Because our work is challenging and long-term, it's really important to have all this support. Funding is not the only solution. We need to figure out everything these communities need to thrive.?What coalition partners should really consider is adopting a learning mindset.

Flexibility and commitment are really important to the long-term success of these partnerships and communities. - Melissa Monbouquette

A lot of us are experts in our own fields. It’s fantastic, but it also makes cross-sector collaborative work uniquely challenging and complex. You’re entering a room where everyone has a different mindset, approach, and set of resources. I urge partners to be realistic about their commitment to the work and to get creative.

Partners also need to be flexible. If we've learned anything since 2020, it's that the best-laid plans rarely go as expected. Regardless of the external situation, you need to be able to say, “This is what's happening, and this is how we can adapt.” Flexibility and commitment are really important to the long-term success of these partnerships and communities.

Some of the BUILD partnerships have a long history of working together; for others, it's the first time community residents are at the same table as health systems. Both bring really important perspectives and resources, but they may not be used to working together. Acknowledging the value of the other person at the table is really important.?

You’re a bit of an industry-expert, then?

These are things we think about all the time. BUILD has been around since 2015, and we have supported 68 communities to do this work. Our goal at BUILD is to take those cross-cutting learnings from the work that's being done on the ground by the community partners that are at the table.

Inclusive health equity work is inherently Human-Centered. Can you speak to the role of community members in these coalitions? Why is their inclusion essential?

Community members are really the heart of BUILD partnerships. Co-developing solutions with community members aren't just a nice thing to do; it’s essential for these solutions to make a real impact. Community members need to be a part of decision-making, planning, and evaluation processes.

Community members help bring to light issues that well-intentioned health departments and hospitals don’t always see. Community-based organizations have these feedback loops, but they don't always capture what's really happening and translate it into ground-up community initiatives.?

They [community members] have the ultimate expertise: Lived experience. - Melissa Monbouquette

I think people want to thrive. They know exactly what’s holding them back and what they need to move forward. They have the ultimate expertise: Lived experience.

Why wouldn't you want all the experts at the table? There are a lot of reasons why people can't always participate and speak up in these kinds of initiatives. But if you design space for communication, provide incentives for it, and eliminate the barriers to it, then folks are willing to share their perspective, experience, and knowledge on how to go forward.

What has been the biggest benefit of utilizing these tools throughout the strategic planning process?

We designed these tools to support the coalitions that are doing the work on the ground. BUILD is also a funding collaborative. So, we have a number of different funders—from big national funders (household names) to local funders that have really deep ties to the communities where they're working.?

We need to practice what we preach to bring all of these perspectives together. We use the same tools as our communities to design our own BUILD approach. It’s the ultimate learning tool and the backbone of this type of work.

Visual tools are great at resolving common issues that come up early and keeping folks on the same path; they ask important questions to keep our visions aligned. - Melissa Monbouquette

Coming up on ten years of existence, we use these tools to ask: What can we see across 68 communities? What are the learnings that we can use to elevate BUILD??

It’s a very cyclical learning practice. We embrace what we learn from communities, provide resources so that they can continue on that work, then use the tools to validate our methods.

What is the benefit of encouraging the coalitions to work with visual tools??

Partnership work is hard. As I mentioned earlier, successful partnerships are based on challenging each other. They require commitment, time, trust, ambition, and flexibility. Visual tools are great at resolving common issues that come up early and keeping folks on the same path; they ask important questions to keep our visions aligned.

Questions like: Do we understand each other's roles, capacities, and limitations? Who needs to be at the table? How do we make sure they can be there??

Visual roadmaps help folks have those first tough conversations that often separate and divide partners before the work even gets started. They serve as the bridge between planning and doing, fostering practical-thinking and addressing stumbling blocks before they become an issue.

As you take the helm of this project, what are your hopes for the future of BUILD Health??

I’ve been with BUILD since it started in a number of different roles and stepped into the executive director position at the start of this year.

When we first started working with Do Tank in 2019, the first tool we made was about envisioning what you hope your work will be by drafting the dream future “headline” about your initiative—and we did that. We went through the envisioning process with our funding collaborative and our staff.

The headline was something like “BUILD Sunsets Because Communities No Longer Need These Resources.”?The dream is to put ourselves out of a job because we don't BUILD anymore. We no longer need philanthropic funding.

The dream is to put ourselves out of a job. - Melissa Monbouquette

I think it's this big, ambitious goal that justice is achieved, health inequity is diminished, community power lives in community hands, and healthcare spending can be cut because we’ve increased our focus on effective and community-driven social supports.

Ultimately, BUILD’s goal is to reframe health, understand the social, economic, and cultural context of where we live, and increase the likelihood of achieving optimal health.

We know this will take a very long time. We know BUILD is just a small cog in that wheel. But I'm inspired by our communities daily and hope that BUILD can show others out there that this collaborative, community-centered approach to improving health does work.?