Exploring Opportunities for Engaging Public Health Organizations in Transportation Planning

Abstract

Despite a call for collaboration, there remain challenges to engaging the public health community in the regional transportation planning process. Using an integrated framework of network theory and collaborative planning, we explore collaboration barriers and opportunities between transportation and public health communities. Analysis of primary data collected from a focus group and secondary data from 43 national case studies suggests that major perceived barriers include a lack of formal and informal mechanisms and knowledge management practices that facilitate collaboration. Coordination of policies at multiple levels, leadership, trust, and data sharing are recognized as important tools for collaboration. Implications are discussed.

Keywords

network collaboration collaborative planning regional transportation planning public health

Introduction

Significant changes have been made in the past several decades in the transportation planning process and infrastructure development. Since the passage of the National Environmental Policy Act (NEPA) of 1969 and subsequent major transportation and environmental legislations, much attention has been given to environmental impacts of transportation planning and infrastructure development. There have been guidelines on processes, procedures, methods, and best practices to assist state Departments of Transportation (DOTs) and Metropolitan Planning Organizations (MPOs) to consider environmental factors in transportation planning and to meet the NEPA conformity requirements. However, most environmental factors have been limited to impacts of transportation on air and water quality, noise, wildlife, wetland, and social equities. Much remains to be known about health impacts of transportation. Although research has recognized the role of transportation in health outcomes and called for collaborative action between the planning and public health communities (American Planning Association [APA], 2004; Cohen, Boniface, & Watkins, 2014; Corburn & Bhatia, 2007; Frank et al., 2006; Wier, Sciammas, Seto, Bhatia, & Rivard, 2009), there remain challenges to engaging the two professional communities in collaboration.

Drawing on scholarly work in network theory and collaborative planning, we explore collaboration barriers and opportunities between the planning and public health communities. Specifically, we ask, how can network theory and the collaborative planning literature help in such an investigation? What collaboration barriers and opportunities exist in engaging the public health community in the regional transportation process? And how do the findings of this study inform future research in network theory and collaborative planning?

We address these questions using an integrated research approach including both qualitative and quantitative methods. We conduct a content analysis of the primary and secondary data gathered from a focus group interview of leaders in both communities in the Dallas/Fort Worth (DFW) Metroplex and 43 successful cases of collaboration nationwide. The focus group interview and case studies provide rich information on organization collaboration for regional transportation planning. The findings from the content analysis are later used in an Internet survey, which will be published in a separate article.

The DFW Metroplex is selected as the case study for this research because it is an area where both communities are facing significant transportation and public health challenges, and there are few formal regulations requiring the involvement of the public health community in the transportation planning process. The age-adjusted all-cause mortality rates in Dallas and Tarrant counties, the two major counties in the DFW area, are higher than the ones in the State of Texas and the United States, according to the 2009 data by Tarrant County Public Health (TCPH). Heart disease is the number one cause of death and the mortality rates of heart disease in both counties are also higher than the rates for the State of Texas and the United States. Chronic lower respiratory disease and diabetes are among the major causes of death (TCPH, 2012). Concurrently, DFW area ranks as the sixth in the nation in terms of travel delay, according to the 2012 Mobility Report (Schrank, Eisele, & Lomax, 2012). Yet the region has only about one fourth of the financial resource required for the region’s transportation needs (North Central Texas Council of Governments [NCTCOG], 2013). These challenges faced by both communities are hardly unique for the DFW area, though the extent of the challenges may vary in other metropolitan areas. The findings from the DFW area can shed light on the integration of public health in regional transportation planning in other metropolitan areas that share similar characteristics of regulatory environment and challenges in both public health and transportation communities.

Engaging the public health community in the regional transportation process is critical to fully address the broader impacts of transportation development on public health and social equity. Despite the recognition of such importance, questions remain as to what challenges and opportunities exist in engaging public health organizations in transportation planning. This study attempts to discover the causes of disconnection between the two communities in achieving overall sustainability from a network, multicentric organizational perspective. This study is also a test of network theory in its applicability to a specific field of public work that is beyond the conventional realm where network theory has been applied. The findings also have practical implications for those responsible for facilitating collaboration across the nation in regions that share similar transportation and public health challenges.

In the remaining sections, we provide a brief history of collaboration between transportation planning and public health communities, discuss issues faced by the two communities, describe our data methodology, and present results of the focus group interview and empirical evidence of successful collaborations. The article concludes with a summary of the findings and their practical and theoretical implications, and a discussion of future research directions.

Public Health and Transportation: The History and Issues

The separation of public health and transportation can be traced back to the beginning of the 20th century (Corburn, 2004). The industrialization and urbanization brought not only rapid growth in America but also some harmful effects. Dark, crowded cities and sooty places, along with breeders of various communicable diseases, caused high morbidity and mortality. Interventions by decision makers in the late 19th century were initially through the use of public health ordinances to create light, air, space, and hazard removal. Zoning became a way to separate the health hazard from population. Developments in transportation technologies and infrastructure enabled the implementation of zoning as a way to address public health problems. However, by the end of the 19th century, public health started following the germ theory and medical model, which had dominated the practice of public health for more than half of the 20th century. Urban planning and transportation, however, had followed an expansion path, highlighted by the construction of the national highway system and rapid growth in suburbanization during the same period. These developments had resulted in two very separate areas of research and practice (Corburn, 2004).

Both transportation and public health communities are now facing numerous challenges. The proautomobile transportation policies focusing on highway expansions in the postwar period, along with other public policies in housing, land use, taxation, and finance, have resulted in a great expansion in highways, diminution of public transit, increases in traffic congestion, as well as other undesirable impacts on the nation’s economic, environmental, and social sustainability. Low density, solitary-use developments enabled by highway expansion have created a built environment that makes it difficult to reach places without a car. Despite the progress in the last several decades, there remain challenges for the transportation community to address the safety and mobility needs of all social groups, economic viability, environmental sustainability, as well as the efficiency of transportation system and project delivery as evidenced in the new transportation legislation: Moving Ahead for Progress in the 21st Century (MAP-21).

Concurrently, public health is facing numerous challenges in disease prevention and health disparity. Chronic diseases are now the leading causes of death and disability in the United States (Centers for Disease Control and Prevention [CDC], 2014). The medical cost of treating diseases, especially chronic diseases, has been escalating. According to the newest data released by the Bureau of Economic Analysis (BEA) in 2014, Americans spent about 17% of their personal consumption expenditures on health care in 2013, an increase of 2% from 2006.¹ Apart from the increase in cost of health care, there exists mounting evidence of health disparities among different demographic and social groups (Braveman & Gottlieb, 2014). The public health and planning literature suggests that the built environment may play a significant role in health outcomes, which contribute to an increase in cost of health care (CDC, 2014; Cohen et al., 2014). Specifically, studies indicate that ozone and air pollution resulting from excessive vehicle emissions are factors triggering and linking with asthma exacerbation, premature death, and circulatory and respiratory diseases. An overly automobile-dependent development, the lack of public transit, and a pedestrian/biker-unfriendly street design, along with other factors, all limit the ability of citizens to reach destinations without a car and reduce exercise opportunities, which in turn play a role in obesity and other chronic diseases, mental illness, safety, and health disparities (Cohen et al., 2014). Some studies also suggest that transportation planning is a critical process in which health indicators can be included (Corburn, 2009; Frank, Engelke, & Schmid, 2003; Frumkin, Frank, & Jackson, 2004; Hynes & Lopez, 2009).

Some planners, health professionals, and decision makers have recognized the need for the two professional silos to return to the same planning table and called for collaborative action and reconnecting the silos. However, there remain challenges to engaging the two communities in the regional transportation planning process (Braveman & Gottlieb, 2014; Corburn, 2004).

Data Collection and Analysis

Using network theory and the literature on collaborative planning as a framework, we analyze data from the focus group interview of transportation and public health leaders in the DFW Metroplex to identify barriers to and supporting factors for collaboration. We then contrast the perceptions from the focus group participants with empirical evidence from the best practices in collaboration for transportation planning to fortify findings on perceived barriers.

Focus Group Interviews

Through key informants in the respective communities, we identified and contacted about three dozen leaders of the transportation and public health communities in the DFW area, among whom 14 individuals confirmed their availability to participate. Because of last-minute cancellations, 12 people participated in the focus group interview on June 10, 2011. Those who could not participate in the focus group interview were invited to participate in the Internet survey during the period of late 2011 and early 2012. It should be noted that the participation of only one third of the invited leaders in the focus group interview might present a nonresponse bias. However, we don’t know if their absence was due to a lack of interest in collaboration, negative collaboration experiences, or other reasons. We simply don’t know the views of those who did not participate, which might be different from the views of those who did.

The focus group participants represented all types of organizations in the sample pool, including city and county public health agencies, hospitals, university public health researchers, special district/quasigovernmental transportation service providers, state, regional, city transportation planning agencies, planning consultants, and bicycle/nonauto advocates. The group was also geographically representative, composed of agencies located across the DFW Metroplex, and diverse in gender with seven men and five women present. However, no representation of racial or ethnic minority group was observed.

The focus group was conducted at the NCTCOG office, a central location in the Metroplex. Prior to the discussion, the participants were informed about the Institutional Review Board (IRB) approval for the research, the participants’ rights, and the focus group discussion procedure. The participants also signed the IRB consent form. The research team facilitated the focus group. After self-introduction and a few quick opening questions about organization collaboration, the participants were led to discuss their experience and opinions about the benefits and barriers to collaboration between transportation and public health organizations. The discussion concluded by giving the participants an opportunity to offer their insights into collaboration and share any other concerns or topics not addressed.²

Best Practices in Collaboration for Transportation Planning

The main data and literature sources of the best practices in organizational collaboration for transportation planning were case study publications by the Transportation Research Board (TRB)/Transportation Research and Information Database (TRID), the American Public Health Association (APHA), and the Journal of Environmental Health (JEH). We selected publications for our content analysis based on three criteria:

relevancy to the subject of interest,

outcome of collaboration, and

recentness of the publication.

Specifically, we included only those publications that focused on collaboration for transportation planning, had been identified as examples of effective collaboration by transportation and/or public health researchers, and had been published in the last 10 years.³ The search yielded 43 case studies of the best practices (see the appendix).

Despite the variation in the number of collaborations, the selected case studies represent states in all four census regions according to the definition of the U.S. Census Bureau. Quite a few states have multiple cases. However, there are only two case studies from the Northeast region and one from the West North Central division of the Midwest region. The case studies cover a variety of project scales, types of planning activities, modal focus, and a wide range of objectives and project outcomes. For instance, project scales of the case studies range from small neighborhood-level projects to large multiple-state projects. The planning activities and modal focus that are covered in these case studies include both long- and short-range transportation plans, corridor project of highway segments, bridges, and interchanges, as well as nonmotorized projects and other city-, community-based development planning and decision-making processes.

Key Forces Driving Collaborations: Network Theory and Collaborative Planning

Network theory and the literature on collaborative planning offer insights into the investigation of challenges and opportunities for collaboration. We integrate the two to create a framework for the analysis. The literature on collaborative planning focuses on the importance of bottom-up, process-based factors, especially the power of authentic dialogue among participants, in successful collaborations (Booher & Innes, 2002; Innes & Booher, 2010; Margerum, 2011). Typically, the collaborative planning literature has focused on interactions between planners or government agencies and citizens or affected public. Agranoff’s (2007) work on network theory concentrates on organizational characteristics of collaboration along the dimensions of network management, structure, knowledge, decision making, and performance. Specifically, it posits why a network is formed, how it works, what can improve network power, what outcomes result from network actions, and what overall characteristics a successful network would exhibit (Agranoff, 2007). The network theory is valuable as it shifts focus to consider situations where organizations may have equal power to act in accordance with agency-specific mandates, but when operating as a network, these power arrangements may change. Both planning and network theories share several similarities including horizontal relationships among participants, communicative rationality, and equal empowerment among participants through interactive learning, consultation, conflict resolution, and consensus-building processes among diverse actors for decision making and collective actions. Figure 1 illustrates the essential elements of the network model and collaborative planning, specifically pertaining to the issues being investigated in this research.

Figure 1.

Key characteristics of successful network collaboration.

Network Composition

Gray (1985, 1989) affirmed that broad stakeholder involvement is a condition for organizational collaboration. Similarly, Innes and Booher (1999, 2010 ) argued that diversity and independence are the building blocks for effective collaboration. In a diverse network, independent participants can bring in a “wide range of life experience, interests, knowledge, and resources” that are foundations for mutual learning, building shared identity and agreement, and leading to innovations. The importance of political support, leadership, and financial resources has been documented in studies of various collaborations (Austin, 2000). Agranoff (2007) furthered this line of thought and offers a network model in which network composition, leadership, pooled authority, and resources are delineated in the core dimension of network management. According to Agranoff, networks rely extensively on horizontal, rather than hierarchical, relationships and pooled authority among multiple network participants. Consequently, a network is made of a mixture of actors and resources. In a network, managers are replaced by network champions and promoters, namely, those who can exert political and technical influence to foster the network effort and inform the issue that the network seeks to address. Furthermore, network purposes and actions are influenced by the vision of network participants and those promoters or champions that can provide political support and resources to network efforts.

Formal Mechanisms

For a network to form, sustain, and work effectively, it requires certain mechanisms, formal or informal—conceptualized as structural elements in the network theory, to bring participants together and to take and coordinate actions. Formal mechanisms could be formal legal requirements, whether they are federal mandates, state regulations, or local ordinances that require involvement and collaboration among relevant organizations and individuals (Agranoff, 2007). Formal mechanisms, if designed properly, provide not only legal requirements for collaboration but also policy guidance and financial resources/incentives for collaboration. In situations where there is no legal requirement in place, a memorandum of understanding (MOU) could be an alternative force for network formation and actions.

Informal Catalysts

While formal mechanisms are top-down forces that drive network formation and collaboration, informal catalysts are grassroots, bottom-up forces that motivate individual organizations to join a network and to act together. It is believed that in the absence of legal mechanisms, common goals, shared beliefs and norms, mutual dependency or interdependence to reach reciprocal benefits, known as reciprocity by Booher and Innes (2002), are forces that draw organizational or individual stakeholders together. These mechanisms can serve as a base for building trust among network participants and committing their resources and expertise to network joint actions. In addition, as network participants, regardless of their roles in a network, are essentially partners and there is no direct authority over each other, they are expected to mutually respect each other, be able and willing to adopt a fairness attitude to maintain the stability of the network, and work efficiently (Agranoff, 2007; Booher & Innes, 2002; Innes & Booher, 1999, 2010).

Facilitation Factors

Network collaboration cannot sustain and succeed without authentic dialogue, knowledge sharing, mutual learning, and consensus building. Booher and Innes (2002) argued that authentic, namely, open, inclusive, and informative dialogue is a precondition for effective network collaboration. Equal, free, rational, and reasonable dialogue enables reciprocity, trust, and effective democratic planning (Stein & Harper, 2003). Without sincere, accurate, comprehensive, and legitimate communication, it is impossible for network participants to learn from each other’s interest and expertise, and to create common identities, language, and knowledge. Consequently, there will be few opportunities for innovation, new heuristics, and reciprocity from collective actions for solving problems (Booher & Innes, 2002; Innes & Booher, 2010).

Agranoff (2007) discussed these factors in the dimensions of knowledge and decision making. According to Agranoff, competency or expertise is a necessary condition for problem solving. A collaborative network provides a platform for mutual learning and knowledge sharing. In a network, participants contribute data and information that can be converted into knowledge as relevant to the purpose. Knowledge development in a network requires not only explicit data and information, such as geographic information systems (GIS), study reports, and information portals, but also those tacit sources such as perceptions, senses, or experiences that are difficult to express or describe. Tacit knowledge requires conferences, workshops, and other useful approaches/techniques/tools to transform to explicit knowledge that are useful to the network’s specific purpose. Successful network collaborations should exhibit knowledge-sharing activities and tools or approaches facilitating the exchange of data and information and mutual learning processes among network actors to create knowledge. The effect of explicit and tacit knowledge sharing and mutual learning on collaborative planning is discussed by Goldstein and Butler (2010) in a case study of the U.S. Fire Learning Network initiative.

Decision making in a network is best described as a horizontal process that requires the use of different interactive and continuing processes to identify issues and reach resolutions. Opportunities for mutual learning, negotiation, compromise, or consensus building must be included in the network’s decision-making process. Effective network decision making is typically the result of ongoing information and knowledge sharing among actors/participating organizations and participant’s commitment to network solutions (Agranoff, 2007). Examples of such commitments include, but are not limited to, an individual organization’s willingness to compromise and their ability to adjust their internal structure and policies to aid collective network actions. For the process of producing satisfactory solutions, various techniques and tools including traditional group meetings, visioning workshops, as well as those Internet-enabled two-way communication techniques are often used in the decision-making process. Margerum (2011) characterized knowledge sharing and decision-making processes as communication, consultation, conflict resolution, and consensus building. He extends the typology of network collaboration to include cooperation and coordination as important implementation requirements for successful collaboration and further discusses three pathways to “translate products into results” at individual, organization, and policy levels.

The four elements in Figure 1 are mutually supportive. Network composition is a condition for effective collaboration. Formal mechanisms can set policies and programs to guide and support collaborations. Informal catalysts are roots that motivate collaboration from organizations. Facilitation factors provide platforms for collaboration engagement.

Challenges and Opportunities for Collaboration

The literature on network theory and collaborative planning suggests that the aforementioned factors are preconditions or characteristics of successful collaboration, and the presence or absence of such factors can promote collaboration or hinder it. Based on such a premise, we apply this framework to analyzing the data from the focus group and case studies. The findings are presented in concurrence with the theory outlined in Figure 1.

Network Composition

Focus group participants did not mention specific barriers related to network composition. However, they believed that leadership, similar to the champion/promoter in network theory, was critical to collaboration between transportation and public health organizations. When asked what they would do as a leader to promote collaboration between transportation and public health, the participants indicated that they would be advocates of reaching out, opening dialogue, and participating in the discussion of transportation and public health. One representative of public health said,

I have to be more available to participate in discussion just like this. . . . I have to make sure my staff is able to participate in discussions just like this because this is a new area. . . . As a leader, I have to put myself in a position of being a convener of discussions just like this, through health summits, through our think tanks . . . we have a lot to learn, but the leadership role has to be open, proactive . . .

Another planner added that “I could advocate for public health participation, maybe even invite their participation in zoning and planning commissions.”

In addition, a more inclusive approach for collaboration was suggested as a management tool in the discussion. “Make sure that the umbrella is really big because there are people who are very involved in affecting transportation and health but may not even realize [it],” said an advocate. School districts, transit providers, developers, and academia were given as examples of such organizations. In addition, focus group participants saw that “an ecosystem model can be used to help guide who needs to sit at the table, how to get them engaged, and how to be more inclusive.” Moreover, the group felt that inclusive approach and useful guiding principles could draw diverse independent organizations and recourses for collaboration.

Empirical evidence supports the perception of a need for diversity and leadership in promoting collaboration. It is clear that in all the previous case studies of best practices, networks were composed of a wide range of stakeholders. Transportation agencies mostly led collaborations for projects with a focus on motorized transportation and to a lesser extent for projects with multimodal focus. However, public health and other nontransportation agencies typically led collaborations for health impact assessment (HIA) projects. Among the 13 cases involving public health organizations, 10 were led by county and city public health departments, university, nonprofit, citizen groups, and joined leadership.

Formal Mechanisms

Focus group participants saw regulation dissimilarity as a barrier to collaboration and felt mandates were an important tool to encourage collaboration between transportation and public health organizations. They considered variations in funding, regulatory requirements, clientele, and service provision of individual organizations as factors that make collaboration and coordination difficult, as regulations usually dictate the amount and the use of funding resources in organizations. The discussion was highlighted with an example offered by a participant representing a paratransit provider:

as for [a] barrier to collaboration, what we are facing is [that] the regulations for each agency are so different as far as their funding, their clients, and the type of transportation services, whether it is a volunteer network or their in-house service.

Concurrently, the participants felt that transportation “shall’s,” namely, mandates at the policy level, to be an important tool for encouraging collaboration between transportation and public health organizations. One participant stated that “I think important tools are mandates that come from organizations to tell transportation agencies how they have to build roads . . . ” Another participant agreed,

something that pushes us like what you said is a “shall” mandate. In our case, a federal mandate or federal policy pushes those agencies to actually do it and to start trying to at least engage in a dialogue on how to do it.

A related suggestion at the policy level was to coordinate public policies, specifically to link transportation/health collaboration issue to other movements and policies, such as green transportation and alternative energy at the national level. An advocate for active transportation proposed that

we have to take advantage of a bigger promise that is going on with industry and government right now, [which is] independence of foreign oil. All the different folks are coming to the table for that purpose. It is an opportunity.

Others added that “when the big door opens up at the national level, we need to be there.” “It is a big paradigm shift.”

The necessity of regulatory requirements was evidenced when focus group participants shared their experience of collaboration. They remarked that most of their collaboration experience with other organizations came from some requirements through a grant or government mandate. For example, a participant representing the transportation community said that bike lanes were “driven by regulations or people that have authority over our work.” Other planners added that “public outreach . . . that really is because of the NEPA.” “In 1990, the Clean Air Act amendments brought us into non-conforming for air quality . . . another one which really bumped up our level of collaboration was the 1991 Intermodal Surface to Transportation Efficiency Act (ISTEA).”

The notion of mandate as a mechanism for promoting organization collaboration is evidenced in the best practices. About half of the case studies explicitly mentioned that collaborations were in response or to comply with mandate requirements. Federal mandate was a primary motivation for forming or joining a network in such cases as the Binghamton Metropolitan Transportation Tomorrow Plan (TRB, 2010a), Puget Sound Region TIP (TRB, 2010h), and many others (see, for example, TRB, 2010c, 2010d, 2010e, 2010f, 2010i, 2010j). In addition to federal mandates, state and local mandates are also motivations for network formation and engagement. For example, in the NJ-31 study, the smart growth principles issued by the state were mentioned as one of the reasons for collaboration (TRB, 2010f). Other examples include Oregon’s state law requirement of land use planning/transportation planning integration and Oregon Administrative Rule 660-015-0000 on public involvements (TRB, 2010g). In San Francisco, the local resolution 081397, which was a result of a grassroots movement in November 2008, has become a local mandate for the planning and public health organizations to work with communities on transportation development decisions (Corburn & Bhatia, 2007; San Francisco Department of Public Health [SFDPH], 2011).

Informal Catalysts

One of the most discussed barriers was variation in organizational goals and objectives between transportation and public health organizations. The lack of common goals/objectives, according to the focus group participants, was a barrier to collaboration: “Obviously I think that [how to link our public transportation systems and our health goals] is the more difficult conversation because it’s not always the same goal and target in mind,” said a representative of public health. A bike activist gave an example of unequal weight for transportation and health:

the goals are not equal in the playing field. The set of goals is so entitled to particularly moving cars on most transportation projects. Just getting public health as part of the discussion as a legitimate goal, it needs to be given some weight so when there is a choice, we might reduce capacity a little bit to make room for a bike facility.

Other examples were the goal of moving traffic versus preserving pedestrian access and the conflict of economic benefits of moving cars versus impacts on public health. Some, mostly from health organizations and advocates, felt that priority given to cars based on economic considerations is at the expense of health even though health does have significant economic impact. The sentiment is reflected in this statement: “Our society is driven by the economy. So if you get 10,000 more cars through a day, that’s improved economy . . . ”

Competition for money and information, rather than mutual dependency on sharing cost and data, was seen as a big barrier for data sharing. As stated by an advocate,

One of the biggest barriers to data sharing is the old adage that “data is power.” I’ve got mine, and dollars are hard to get today through grants and other ways. If I’ve got my data and this plan, I can get my money and be the first one in, that is a great barrier and we have to figure out how we can break it.

“Paradigm shift” was mentioned again as a requirement for overcoming the barrier.

In contrast with trust, fear of litigation for promoting healthy transportation was also mentioned as a barrier to collaboration in the focus group discussion. This was evidenced from an example involving local school districts to promote active transportation. “Some schools are actually discouraging kids from riding their bikes because of liability to the school,” said a transportation planner. “There’s a concern that if a kid is riding his/her bicycle on a bicycle lane to school and [get] hit, the school can get sued . . . ” Safety/security was mentioned as a factor that prevents schools from supporting kids to walk to schools as promoted by public health.

Focus group participants saw the role of built environment and promoted building a walkable community as a shared goal between transportation and public health. [By focusing on arterial connection], “we are limiting physical activities because we have to get [into] the car. We are limiting transportation choices for people who can’t drive. . . . I would argue that we need to [build] neighborhoods that kids can function without [a car],” said a planner. [As a leader], “I would go a lot more for shared communities, shared development, . . . We need to change our development pattern. By doing that, we will cut down a lot our long distant transportation need,” said an active transportation advocate. Providing transit services for everyone, especially the most needing communities, and enabling short reach to healthy food were also mentioned as a shared goal by a public health professional. Participants also felt the need to stress the economic impact of public health and equalize it with economic impacts of transportation.

Working together to build trust was a notion that emerged from the discussion for promoting collaboration between transportation and public health communities. Learning to view environmental studies as something other than a burden was seen as a way to work together. Being involved, advocating, showing, and sharing expertise were mentioned as ways to build trust. In addition, participants recognized the need for time, effort, and approach to build trust. [We] “have to cultivate [trust], . . . not just about one agency, but all across the state, across the country.” “We have to be persuasive.” “We need to be at the table and not be afterthought.”

That is not going to happen in just a month or two months. But we have got to start having little success with . . . changes in community design and if they see that in some small projects, we will get it wide into a party for a bigger type project design.

The phrase “paradigm shift” was used repeatedly to describe the needed changes in goals and actions to cultivate trust between transportation and public health communities.

Participants regarded grassroots efforts by activists and communities as reasons for changes in organizational priorities and mandates, which eventually led to collaboration.

The priorities change . . . only because of the more informal collaboration that happens apart from the regulators and really it’s political, it’s the bicycle organizations, and the activists who are able to begin to make an impact on elected officials . . . So you begin to see priority shift in a kind of dramatic way. (A consultant)

Another transportation planner shared a story about change in street and pedestrian facility design standards as a result of the combined community activities and experience from peer cities. The grassroots effects were also observed by a public health professional: “if it is a small, iterative change and if it’s brought from the bottom up to the top, you have gotten the acceptance and people from the community to be a part of the collaboration.”

Shared belief is also evident in many cases of best practices as a common force driving network formation and collaboration. For example, in the case of Wichita’s Health & Wellness Coalition, the network was initiated by “a group of passionate health advocates” who shared the same desire of “living in a healthy lifestyle every day.” This common desire drew these organizations together to engage in many collaboration actions (Health and Wellness Coalition, 2010). In Chicago, shared interest in pedestrian safety united the Chicago Police Department, the Chicago Department of Transportation, the Office of Emergency Management and Communications’ Traffic Management Authority, and the new Mayor’s Pedestrian Advisory Council to engage in collective effort to reduce pedestrian accidents through application of safety technologies, an extensive public-awareness campaign, and traffic law enforcement (City of Chicago, 2010).

Building and maintaining trust is another key character of successful collaboration. Building trust through transparent processes was cited by many case studies as an important component for organizational collaboration. For example, building trust that was previously broken was a large component of the NJ-31 Land Use and Transportation Plan (TRB, 2010f). To build trust in a new comprehensive collaborative process, the Idaho Transportation Department developed an internal understanding of collaboration before moving forward (TRB, 2010d). Similarly, in the cases of Puget Sound, WA, and Binghamton, NY, officials reported that high levels of trust and understanding before project collaborations were factors contributing to success (TRB, 2010a, 2010h).

Mutual dependency is evidenced in many case studies of successful collaboration. For example, in the cases of the Woodrow Wilson Bridge and the U.S.-24 project, organizations in the network had to rely on each other to resolve project issues associated with state boundary crossing and multiple regulatory authorities because these projects were in different states and more than one party had regulatory authority (TRB, 2010j, 2010k). Mutual dependency among network participants was also evidenced in small scale, active transportation-focused case studies such as the Kirkland case study (City of Kirkland, 2009).

Facilitation Factors

Several knowledge gaps were noticed in the focus group discussion. One was a lack of understanding between the two professions about the connection between transportation and public health. During the discussion, a transportation planner asked,

coming from the transportation side, we think that access is . . . access to the hospital . . . What else do you need for transportation? . . . I don’t know that we’ve ever had the conversation as to what do you need us to provide . . . one of the things that I am really interested in this study is what we could do better?

Participants from the public health community commented, “public health doesn’t promote itself.” “There needs to be a lot more understanding of what is public health and how public health is connected to the economy of a community and the social and cultural determinants of a healthy community. It’s a significant piece.” They attributed the knowledge gap to inefficient use of information for communication and education. Another gap was the lack of common or mutually understandable language between the two fields with acronyms and language types. As one participant stated, “We need to make sure that we do the same speak-ease because oftentimes when you are with transportation planners and public health . . . they don’t always know what acronyms are floating around.” The language barrier was also felt in communication with the public as “people take it the wrong way [if not being] careful [about] how you say it.”

In addition, the lack of data and information sharing was noted in the focus group discussion. One example was the lack of coordination in data collection among organizations and the resulting data inconsistency. The participants recognized the several efforts made by NCTCOG to collect crash data and the DFW Hospital Council to collect health data, but declared that “right now there is no collaboration between public agencies with the kind of information that you need.” “Tarrant County does it [crash statistics] one way, Dallas County does it another way and the records don’t match. There’s no consistency. . . . You just can’t merge them.” Another example was the lack of data linking transportation to public health benefits. The participants stated,

we don’t go back after the fact and quantify our benefits. One of the best ones is safety . . . We don’t put it in a health consideration but it is [the] same thing with traffic calming. When you bring speeds down, you also bring down the severity of accidents.

The difficultly in quantifying public health benefits was also mentioned. “We struggle to quantify the (economic) benefit to the extent necessary for those who invest the dollars to feel like it’s a justifiable trade-off.” This comment was echoed by others. One participant further affirmed that data on the economic benefits of healthy community have not been accepted.

We have to improve data. . . . It is so new to people that they don’t want to accept it. . . . I see the data there. It’s telling me the right story. I can have economic development but still have a healthy community, too.

The focus group participants saw the importance of sharing such data. One said that to “have a fact basis and having that information transparent is critical.” Another added that “sharing data is going to become more important . . . As data are shared, you begin to see holistically that you really are getting results that are beneficial.” Others mentioned the cost saving benefit of data sharing. “Holistically, there is a cost saving.” A solution for the issues was a better data repository, according to the participants. The need for best practices in collaboration repository was mentioned.

We need to have some sort of repository for evidence-based policies and best practices . . . when it comes to public health, population-based community health, things with transportation and the built environment, we need to really get that so that we can go online and have a ready-made access . . . these are some of those evidence-based policies, these are some of the parameters they were looking at, [these are] some of the obstacles they had to hurdle, and here are some of those best-practice strategies . . .

Health Impact Assessment (HIA) and Glossary were seen as tools to help connect the transportation and public health community and to aid planning.

We need to develop, particularly between planning, transportation, and public health, a glossary if you will. We need to make sure public health becomes more well-versed in Health Impact Assessments . . . so that we can begin to share some of those with people. (A public health professional)

The need and importance of knowledge sharing for organization collaboration are evidenced in all case studies. Tacit knowledge, in the form of feedbacks, concerns, inputs, and opinions among stakeholders, is seen in all case studies regardless of project focus, scale, or network actors and promoters. Explicit knowledge and data sharing, in the form of information, analysis/modeling results, maps, or raw data sets, are also common in many case studies. For instance, in the case of Highway 280 in San Francisco, CA, People Organizing to Demand Environmental and Economic Rights (PODER), a grassroots, environmental justice organization based in San Francisco’s Mission District, collaborated with SFDPH, UC Berkeley School of Public Health, the Chinese Progressive Association, and community residents to collect data and conduct a community-based health impact assessment of transportation in the neighborhood. The organizations in the collaboration contributed and shared both tacit and explicit knowledge about issues and concerns through door-to-door community survey, oral histories, and community photography, as well as traffic, safety, health, census, air quality, and other environmental data. The organizations and community members also contributed their expertise and experience to the development and creation of community knowledge, by modeling and analyzing data. Through these collective efforts and interactions, the network actors were able to understand the environmental health challenges faced by the community and to identify solutions to address the challenges (Corburn & Bhatia, 2007; SFDPH, 2010; Wier et al., 2009).

Mutual learning/negotiation/consensus building process is also evidenced in case studies of successful collaboration. Concerns over a particular issue and recognition of the need for multiple areas of expertise are motivations to reach out to organizations for collaborative action. For example, in Grand Rapids, MI, the state DOT needed to rebuild the deteriorating bridge quickly, but issues of needed bridge capacity, historical resource preservation, access to downtown, and impacts to downtown businesses were concerns raised from various organizations and communities. The concerns provoked the DOT to enlist these organizations in the planning network. In addition, to address these concerns, the state DOT reached out to the local government, university, business groups, and other organizations to perform the desirable aesthetic designs for the S-Curve structure and worked with the local transit provider to ensure extra buses brought commuters downtown (TRB, 2010b). The process is also observed in many other case studies, such as network collaboration in Denver, CO (Roof & Maclennan, 2008), Ingham County, MI (Roof & Glandon, 2008), and Delaware County, OH (Roof & Sutherland, 2008).

Other Factors

Several additional constraints also emerged from the focus group discussion. Silo within organization was seen as a barrier. The participants commented that large bureaucracies were slow to change, like “turning the battleship,” and that there was a slow process of change even if something was directly mandated. “Accessibility design, even though it’s mandated now for cities to provide for accessible design on the street, is not coming along fast.” Moreover, government departments often functioned in silos, focusing on specific tasks. “A large organization,” as described by focus group participants, “is bureaucratic in nature. It is very easy to get tunnel vision.” The situation could be best described by the metaphor “everybody is on their own island.” In addition to organization structure issues, organizations also faced other issues associated with staff turnover, which could cause interruption of collaboration as organizations needed resource and time to allocate and train manpower to fill the vacancy.

Another perceived barrier was the time horizon for transportation planning. “The time horizon becomes a barrier in many ways.” Participants reasoned that policy and goals changed significantly over a 20-year period; for a long-term transportation project, by the time it reached construction, many objectives may have changed. The long timeline for transportation planning hindered change. Focus group participants also discussed barriers at the individual level. Examples of such barriers included fear of change and unwillingness to share resources, information, or power.

Connecting transportation and public health was seen as a solution to collaboration. For example, a planner stated that “what we could do is to emphasize [transportation and health] connection all the time. . . . We need to . . . always include public health as a top priority goal.” “I will turn methods of transportation back to the hike and bike trails, . . . and add health into that,” remarked an active transportation advocate. “We need to begin to make that [transportation] connection back to health,” echoed a consultant. She continued to remark,

I suspect at the level [of health services delivery], there is never any connection between health and transportation or health and the way we live. . . . I think that is where you have to begin to get that into people’s mind.

Personal relationship was seen as an additional tool for making connection and facilitating mutual learning. “At the local level . . . our tools would be of a contractual nature with those agencies to coordinate transportation.” “The biggest tool is the individual relationships . . . people want to learn more about what each other is doing.” These findings seem to be in accordance with the social capital discussion in the planning literature as suggested by Dempwolf and Lyles (2012). Social network and mutual dependency among actors influence collective actions and governance (Dempwolf & Lyles, 2012; Scholz, Berardo, & Kile, 2008).

Summary of Findings

In short, the focus group interviews yield a number of observations with regard to potential barriers to and tools for supporting collaboration between transportation and public health communities. The findings are supported by the existing studies on collaboration for transportation planning and project development. These observations are summarized in Table 1.

Table 1.

Summary of Findings.

Core elements to collaboration	Focus group perceptions		Case study findings
Core elements to collaboration	Barriers	Supports/tools	Best practices
Network composition		LeadershipInclusive approachEcosystem as a model for engagement	DiversityLeadership
Formal mechanisms	Regulation dissimilarityVariation in funding and service provision	MandatesPolicy coordination	Legal mandatesMOUs
Informal catalysts	Lack of common goals/objectives.CompetitionFear of litigation	Walkable community as a shared goalCultivation of trustGrassroots effort	Shared beliefMutual dependenceTrust
Facilitating factors	Knowledge gapsLack of data and information sharing	Data repositoryHIA and glossary as tools	Knowledge sharingMutual learningNegotiationConsensus building
OthersOrganization issuesPlanning constraintsIndividual constraints	Silos within organization, staff turnoverLong time horizon fortransportation planningFear of changeDenial of sharing	ConnectionPersonal relationship

Note. MOUs = memorandums of understanding; HIA = health impact assessment.

Barriers

This research identifies a number of barriers in formal mechanisms from the top, informal catalysts from the bottom, facilitation factors, and additional organizational and individual factors.

Formal mechanisms: At the policy level, regulation dissimilarity and variation in funding provisions, clientele, and service requirements, in the view of focus group participants, make collaboration difficult.

Informal catalysts: At the organization level, mismatches or sometimes conflicting organization goals and objectives rather than common goals or shared belief, competition for or lack of funding to support collaboration efforts, as well as the lack of trust due to fear of litigation and competition for resources among organizations are viewed as obstacles to collaboration between the two communities.

Facilitation factors: Additional perceived barriers include the lack of common language and mutual understanding of the respective needs and the lack of explicit data and tacit knowledge sharing.

Other factors: In addition to the elements outlined in network theory and participatory research, this research uncovers several components that could create difficulty for collaboration. Specifically, the focus group participants believe that operation in silos and slow response to change inherited from the existing structure within an organization are barriers to collaboration. Fear of change and unwillingness to share resources, information, and power at the individual level are also seen as potential barriers to collaboration. Furthermore, the long-term horizon of planning and implementation may prevent collaboration as many unforeseen factors may affect collaboration formation and stability.

Critical Elements for Collaboration

Focus group interviews also bring to light a number of tools or supporting factors that are critical to collaboration.

Network composition: In the view of the focus group participants, leadership and an inclusive approach are critical to collaboration. Ecosystem is suggested as a model to guide outreach efforts and to expand the current practices to ensure broader participation and engagement in collaboration.

Formal mechanisms: The participants see the necessity of government mandates explicitly geared toward overcoming the barriers identified above, and the need for coordination of public policies to promote the common goal of sustainability.

Informal catalysts: In addition, they see that making connections, building trust, and cultivating individual relationships for mutual learning are important for facilitating and supporting collaboration.

Facilitation factors: Other tools include HIA, data repositories, and glossaries specifically for linking transportation and public health. Moreover, a “paradigm shift” is recognized as a requirement for overcoming barriers to collaboration between transportation and public health organizations.

Empirical evidence from the case studies supports the focus group findings, as each of the successful collaboration case studies exhibits some characteristics of the critical elements outlined in network and collaborative planning theories.

Implications for Collaborative Planning Research

While it is premature to assert that the perceived barriers identified in this study are factual and universal to all areas, the study provides fundamental information for further research on this subject. Our study indicates that network theory, along with the literature on collaborative planning, provides a useful framework for guiding the research design and is a valuable tool for identifying barriers to organization collaboration, as many of the perceived barriers identified in this research are in opposition to the relevant factors driving network formation and actions in the network model. Furthermore, it can help us better understand cases where authenticity in collaboration is necessary between agencies and organizations with equal authority. However, the research also points to the limitations of network theory in application to the study of barriers to collaboration for transportation planning. The main value of the network model is to describe network collaborations. It focuses on policy- and organization-level factors, especially interactions and interrelationships among those participating organizations in a network setting. Our findings suggest that barriers to organizational collaboration, especially in the specific areas of transportation and public health, may be beyond the scope of the current network theory. The barriers include not only factors at the organization level and the interaction between organizations but also factors internal to participating organizations themselves and those within the leaders of organizations. These are areas for future research in which social network analysis may be applied (Dempwolf & Lyles, 2012).

Network theory is also limited in its capacity to explain the interrelationship among the elements in different dimensions of collaboration networks. The model provides means to conceptualize the dimensions of network operation. The collaborative planning literature, however, emphasizes the importance of empowerment to achieve true collaboration. Both literatures offer insights into what factors or forces must exist to realize collaboration. However, they have not explicated if any factors take precedence over others and if so, what interdependency among the factors may be. In a study of the federal transportation programs for welfare participants, Blumenberg (2002) found that the federal mandate and resources had encouraged interagency collaboration but the effect was limited due to diverse agency goals and approaches to the issue. Our focus group discussion also touched on the relationship between grassroots effort and formal regulation. The relationship is also seen in the case of San Francisco with regard to the development of a local resolution on public health (SFDPH, 2011). These findings suggest that there may be some relationships among forces influencing organizational collaboration decisions, especially the relationship between formal and informal mechanisms. Informal mechanisms such as trust and mutual dependency may be the result of previous formal mechanisms that have bound distinctively different communities together around a particular issue over time or vice versa. There may be circumstances where one type of mechanism influences the other type. To extend the application of network theory to the study of barriers to organization collaboration, further research is needed to explore these issues and to enhance theories related to successful collaboration. Research on the interrelationship among forces driving collaboration will also have practical implications for strategies for action.

Footnotes

Appendix

Acknowledgements

The comments provided by the two anonymous reviewers significantly enhance the quality of this article and are greatly appreciated. The authors would also like to thank the project manager Kenneth Petty from U.S. Department of Transportation and Tamara Cook from the North Central Texas Council of Governments for their leadership and guidance. We appreciate the help from our graduate research assistants Michele Berry, Brian Price, and Sina Kahrobaei.

Authors’ Note

The contents of this article reflect the views of the authors, who are responsible for the facts and the accuracy of the information presented herein. The contents do not necessarily reflect the official views or polices of the U.S. Department of Transportation.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This article is based on a research project sponsored by the U.S. Department of Transportation (U.S. DOT). The authors wish to thank U.S. DOT for its financial support.

Notes

Author Biographies

Jianling Li is professor in the School of Urban and Public Affairs at the University of Texas at Arlington. Her recent research examines the impacts of transportation planning and policies on organization and individual decision-making, as well as on economic, social, and health outcomes.

Colleen Casey is an associate professor in the School of Urban and Public Affairs at the University of Texas at Arlington. She has a PhD in Public Policy Analysis and Administration. Her research focuses on urban and community development policy, with a particular emphasis on social capital, organizational networks and policy outcomes.

Lou K. Brewer is the former director of Tarrant County Public Health. She has a PhD in Urban Planning and Policy from the School of Urban and Public Affairs at the University of Texas at Arlington.

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