Implementation of a Multisector Collaborative to Improve Service Coordination for Individuals with Sickle Cell Disease
Alexis N Gorden, Renisha N JamesAbstract
Background
Sickle Cell Disease (SCD) is a chronic genetic condition that requires coordinated, multidisciplinary care; however, services for SCD warriors and their families are often fragmented across healthcare, social services, and community systems. These silos contribute to unmet needs related to social determinants of health, limited access to specialty care, and low community awareness of SCD. To address these challenges, the Sickle Cell Foundation of Tennessee (SCFT) implemented Collaborative Conversations, a structured, community-driven initiative designed to operationalize cross-sector collaboration, expand service linkages, and create a replicable framework for SCD-focused partnerships.
Methods
Collaborative Conversations is implemented through a series of planned, facilitated convenings that bring together healthcare providers, community-based organizations, advocacy groups, and social service agencies. Each convening follows a standardized agenda focused on identifying existing services, mapping service gaps, and developing practical referral and coordination pathways for SCD warriors and families. Interactive engagement methods, including guided discussions and partner mapping activities, are used to promote shared accountability and action planning. The SCFT’s established partnership with Delta Sigma Theta Sorority is leveraged to recruit partners, disseminate SCD education, and identify additional community resources. A formal partner focus group is convened from this network to develop a strategic implementation plan for an SCD collaborative project and a step-by-step instructional guide outlining roles, processes, and sustainability strategies. Implementation data include attendance logs, partner contributions, documented service pathways, and qualitative feedback from participants. Data are summarized descriptively, with qualitative data analyzed thematically to inform ongoing implementation improvements.
Results
Implementation of Collaborative Conversations resulted in the establishment of an active, multidisciplinary partner network and the initiation of concrete service-coordination activities. Partners identified and categorized available services across healthcare access, social support, education, and care navigation, creating practical avenues for linking SCD warriors and families to specialty care. The structured convenings increased partner readiness to collaborate and improved understanding of SCD-specific needs and system barriers. Community awareness of SCD expanded as partners disseminated information through their organizational networks, supporting broader reach and engagement. The focus group successfully initiated development of a strategic plan and implementation guide to support replication of the collaborative model. Gender considerations are integrated into implementation planning, with the project designed to serve men, women, and children with SCD. Planned collection and disaggregation of participation and service utilization data by gender and age will inform equitable implementation and ensure services address gender-specific needs where applicable.
Conclusions
Collaborative Conversations provides a practical, implementation-focused model for breaking down SCD service silos through structured community engagement and partnership building. By translating collaboration into actionable service pathways and shared implementation tools, the initiative strengthens prevention, care, and support for SCD warriors and their families. Incorporating gender-responsive planning and addressing social determinants of health enhances the relevance and equity of services. The resulting strategic plan and instructional guide position this model for scalability and sustainability, with implications for improving coordinated SCD care in diverse community settings.