The co-authors bring diverse perspectives shaped by professional expertise and lived experience, and they share a commitment to addressing health equity through collaboration with communities. Authors 1, 2, 3 & 5 are members of the backbone organization. They have over 25 years of community engaged research experience that spans a range of socioeconomic conditions. While all have lived in Indianapolis, none reside in DIP-IN partner communities. Author 4 is a resident steering committee member and CHIP leader.

A set of process measures are used to monitor implementation of the three main prevention aims and the capacity building aim. Data are collected in an ongoing manner using REDCap electronic data capture tools hosted at Indiana University (40). The tools were set up by members of the backbone organization, with some of the data entered by CHWs and project managers. CHIP proposals and progress reports are completed by CHIP leaders, and voting forms are completed by SC members. This subset of process measures are indicators of capacity building: (1) Number of individuals who have served as resident steering committee members; (2) Number of CHIPs reviewed and approved by SCs; (3) Number of DIP-IN person encounters associated with CHIPs; and (4) Number of organizations that a DIP-IN project manager or CHW met with for purposes of building the network of community resources and supports. (Each organization is counted only once for each community, but in some cases may be counted in more than one community). For a detailed explanation of how the other aims are assessed and integrated into a comprehensive view of the project’s impact, please refer to our manuscript on project design (24).

Rather than studying capacity building among participants who are the recipients of intervention components (e.g., CHW clients, CHIP participants), this study assessed the project’s impact on individual and organizational participants (e.g., “partners”) who support the components. We conducted 60-minute semi-structured, one-on-one program evaluation interviews (n = 28) with DIP-IN partners. Eligible participants were adults who had collaborated with DIP-IN to advance project aims at any point during implementation, had been involved for at least 2 years, and represented four distinct roles (Table 1). All 28 partners contacted agreed to participate. Interviews were conducted in person or via Zoom between 2022 and 2024 (project years 5–7). Each individual was eligible for one interview per year, and completing one interview fulfilled participation requirements for the study. The data presented here reflect the first and only interview for all participants. Each participant received a $10 gift card funded by the study as a token of appreciation. All interviews were conducted by Author 1.

The interview guide covered three areas: (1) partner and community context, (2) DIP-IN experiences and community impact, and (3) individual and organizational impacts (see Appendix for Interview Guide). We did not pilot this specific interview guide; however, we adapted a similar guide that had been developed and used in multiple studies conducted by Author 1 on participants’ experiences in health equity initiatives. This reflective interview approach supports participants in making sense of past experiences, rather than simply describing them (41, 42). As such, participants tend to highlight the most impactful, meaningful aspects of experience, which speak more to the long-term impacts of interest when studying capacity building. Interviews were audio recorded and transcribed. Interview procedures were deemed exempt by the Indiana University Institutional Review Board.

To contextualize interviews about capacity-building, we report on related process measures for the period from Year 2 Quarter 1 to Year 7 Quarter 3 – a total of 23 quarters. In that period, 57 residents served as members of one of the three SCs. These SCs reviewed 98 proposals for CHIPs, approving 74 of them. With the understanding that the same individuals may have interacted with CHIPs more than once, we estimate over 46,000 participant encounters associated with these 74 projects, for an average of 622 encounters per project. Furthermore, DIP-IN project managers and neighborhood CHWs met with 456 organizations for the purposes of building a network of community resources and supports. This is an average of 152 organizations unique to each community; an organization is counted only once per community though multiple meetings may occur. These meetings often lead to CHIP proposals and increased collaboration.

While process measures indicate that capacity is being built, interviews shed light on how these same processes work, from the perspectives of those most involved (SC members and project staff). Overall, they reported positive experiences with DIP-IN processes, compared to less favorable experiences with other initiatives. Residents explained the contrast in terms of how they were treated—with DIP-IN truly embodying its core CE principles. This suggests CE principles are facilitators of long-term engagement and capacity building. Below we share partner reflections on DIP-IN experiences, organized by CE principles, followed by a summary of barriers to capacity building.

DIP-IN engaged residents throughout the project, not just the beginning. One resident recalled a leader of a different project asking for resident input up front but not further “down the line.” Another resident described the importance of having a project with a longer timeline. She said, if a project is not at least 3 to 5 years, “we do not need it at all in our community.” Initially funded for 5 years, DIP-IN was later extended.

Residents expressed initial distrust of DIP-IN’s intentions, referencing previous groups in the area with a “savior mentality” or those that aimed to “mine” the community. One noted some other groups just want a “check mark that they have worked in a Black community,” while another described other projects as being “shoved down your throat.” Residents saw DIP-IN as different—one noted it “did it differently” by listening first. Similarly, a resident said that before DIP-IN, she had never experienced a listening-first approach. Another resident said his involvement with DIP-IN fit with his own, larger mission to “push neighborhood empowerment to be able to control our own destiny.” Staff echoed this, with a former CHW explaining that DIP-IN trusted residents “to know for themselves what could work,” rather than acting like outside experts “here to save the day.”

Residents described DIP-IN as a space that genuinely supports “resident-driven” decision-making, and “leveling the playing field” with partners, including funders. One resident shared she never felt “belittled” or “beneath” funders, which gave her confidence. She contrasted DIP-IN with “surface level” CE, where neighborhood voices are invited but not truly factored into decisions. A former CHW affirmed this, saying it is vital to listen to the SC because “their voices are being heard, and they matter.” Honorariums and budget control reinforced their value—one resident noted, “How many not for profits actually have a funding purse?… now you have the ability to hold the purse strings and pick and choose what it is in your neighborhood…”

Residents were initially skeptical about whether DIP-IN would truly benefit them or be transparent with outcomes. In contrast to DIP-IN, one resident criticized other groups as “inspirational” but not “transformational,” praising DIP-IN as a rare exception to those that “claim they are doing good for the people but are really doing good for themselves.” He emphasized, “every dollar that’s invested in is actually something that’s going to help the residents.”

DIP-IN SCs unite neighborhood groups with distinct histories, which can challenge cohesion. One resident shared, “I’d love to see us pull together more… more cohesive, a better relationship and more trust in one another.” Committees also faced difficulties in recruiting members who reflect the community’s diversity. Residents and staff noted the need to engage more Hispanic residents, men, and youth. As one resident put it, “We need to be able to be neighbors to them… they experience the same issues we do.” A former CHW added, “I do not think it was a diverse enough sampling… to be more impactful.”

One resident reflected on the need to “adjust, reorient, and re-acclimate” amid shifting circumstances like COVID and member turnover. Early on, the “train” of DIP-IN was “slow to start moving,” as one member put it. Now, it is “picking up passengers and delivering things.” Staff echoed this, noting difficulties in how to “move” and prioritizing projects, perceiving residents as focusing on marketing / visibility rather than impact and sustainability. One CHW said, “as beautiful as it is to be community centered and neighbor centered, in a way, also made it very, messy” and challenging to get things done.

Two former neighborhood CHWs felt discouraged by not knowing if they were making an impact and desired “tangible” results. For one, this contributed to “burn out” in a job they were passionate about. They also cited the toll of taking on additional responsibilities as a CHIP leader. Another CHW wished for more resources and training for the complex role. However, she realized later that the DIP-IN lead was “giving us an opportunity to build it.”

DIP-IN leadership development carried over to other community activities. One resident, president of her neighborhood association, said she developed “true leadership” as she became someone “in the mix” at the grassroots level. Another said, “you guys have enlightened me and set a fire up under me to do more.” While the SC is itself a leadership role, five of seven residents interviewed also became CHIP leaders. One SC elected chairs to lead meetings, a role fulfilled by project staff in the other two committees.

Residents shared their leadership and expertise beyond the SC. Some presented at a national leadership conference, where other communities were “very interested” in replicating DIP-IN. Communities hosted international employees from DIP-IN’s funding organization who sought to learn from residents. One said, “They were very impressed with the community… we have international footprints.”

One SC resident said, “every single community organization should be run the same way,” referring to resident decision-making. Another emphasized, “Funders can make things move… it’s up to us as residents to get them to want to do it.” She also warned that future efforts from different groups might get “watered” down compared to DIP-IN.

One resident SC member became a DIP-IN project manager and is now a director in city government. He views the world through a “health lens” and follows the “DIP-IN way of doing things,” prioritizing community voices for transformative change. A former CHW now supervises similar staff, at the city-level. DIP-IN “fueled a fire” to address health disparities through community work. A representative of the funding organization had a significant leadership shift. She adopted DIP-IN’s shared decision-making approach and now prioritizes “listening and deferring” to staff. Learning about local health disparities was a “wakeup call” and remains central to her professional “why.”

Participants described a range of organizational capacity-building outcomes (Table 2). We explore DIP-IN’s role through the perspectives of three organizations, differing in terms of size, existing capacities, and pathways to outcomes. We highlight ways DIP-IN’s impact on organizations might have broader implications for community capacity building and even systemic transformations.

The Sunday Suppers community dinner series has been funded annually in one SC since 2022, growing significantly and attracting additional funders. It has sparked indirect, ripple effects including improvements in the immediate area, suggesting a broader community impact. According to the project lead, the relationship with DIP-IN provided a “trust factor” for securing additional funding. DIP-IN influenced her to hire staff dedicated to health and wellness. She stated, “DIP-IN is helping us build a little bit of capacity… so we can focus on the health disparities that are really prevalent in our community and what our part is in trying to combat that.”

Since 2022, the nutrition education services department has received annual CHIP funding from all three SCs, expanding access to existing programming. Their director reflected, DIP-IN “made it easy” by having already “set up infrastructures in the communities.” SCs have guided program locations, and the DIP-IN evaluation team assisted in designing a post-class survey. A staff member noted, “The surveys have been a good way for us to get a better understanding of…the voice of the people, what did they want?” Due to the partnership, the department has allocated more resources to DIP-IN areas. For this CHIP and others, DIP-IN funding ensured a consistent presence in the community, demonstrating long-term commitment and informing ongoing improvements that supported better health outcomes.

The public hospital system, which manages health system CHWs, described how DIP-IN strengthened staffing structures and workflows. The CHW supervisor said, “DIP-IN is sustainable workflow that works… you know how often you should engage a patient, how often (you) should be following up.” Structures have been adapted for other projects, including adapting the model for a successful CDC grant application. They also noted improved data sharing with the health department—a systems-level impact that reinforces CE infrastructure.