Challenges of Implementing Sociotechnical Infrastructure in Data-Centric Organizations: Learnings From a Community Initiative in Colorado, USA

In 2016, a partnership between the University of Colorado’s Colorado Clinical & Translational Sciences Institute (CU-CCTSI) and local municipal leaders and the leadership of the local hospital was formed to tackle the siloed nature of social care services being delivered by over 90 community-based organizations (CBOs) and a set of local City departments. The City recognized that an inability to know who was receiving services from whom and a lack of communication among the entities resulted in large inefficiencies and difficulties in anticipating and fully meeting the needs of social care seekers. The CU-CCTSI team emphasized co-design of sociotechnical infrastructure based on Community-Based Participatory Research (CBPR) principles. CBPR emphasizes shifting the usual power relationships between academic researchers and communities using principles including: (1) Sees the community as a unit of identity. (2) Builds on strengths and resources in the community. (3) Facilitates collaborative, equitable partnerships. (4) Integrates and achieves a balance between research and action for the benefit of all partners. (5) Emphasizes local relevance of public health problems and ecological perspectives that recognize and attend to the multiple determinants of health and disease. Authentic partnerships require time in relationship development grounded in participatory, CBPR principles in order to promote authentic engagement. The importance of relationship building in CBPR parallels the emphasis in sociotechnical approaches of designing infrastructure that supports relational engagement and mutual learning. Ultimately in our initial City engagement, their singular focus on data integration to the exclusion of these key elements led to the cessation of our work with that City.