ALIGN for Health and Well-Being Toolkit

Advancing Local Insight, Generational Investment, and Narrative

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Introduction to the Toolkit

Communities play a central role in promoting health and well-being.[1] Locally driven programs, policies, and decisions regarding resource allocation, as well as the actions of community leaders, are all essential to the physical, mental, and social health of community populations. The ALIGN (Advancing Local Insight, Generational Investment, and Narrative) for Health and Well-Being Toolkit is intended to assist community leaders in their efforts to promote health, address social contexts, and tackle equity issues that are critical to health.[2] It also aims to embed the concept of health within a broader understanding of well-being, which encompasses the full variety of assets and capabilities necessary for individuals and communities to thrive and create meaningful futures. This community toolkit and its exercises and examples are primarily geared toward U.S. communities, but there are insights that might be useful for communities outside the United States.

  1. For the purposes of this toolkit, we use communities to refer to geographically specified areas. We recognize that communities also can refer to spaces or groups organized by culture or social context.
  2. If you are concerned about the use of such terms as equity in your community context, see Module 1 for some advice about alternative ways to approach the concept.

Why Is the ALIGN Toolkit Needed Now?

This toolkit is a timely and necessary asset to aid the health and well-being needs of communities for several reasons. First, communities are grappling with increasing concerns about chronic diseases, diseases of despair, and the rising costs required for people to live healthily (Graham, 2023; Benavidez et al., 2024; U.S. Centers for Medicare & Medicaid Services, 2024). Second, communities are increasingly focusing on factors that influence the production of positive health outcomes more broadly—such as quality of life, resilience, and other determinants—rather than concentrating solely on disease management (Gallup, 2021; Omeyr and Montes-Diaz, 2024). Finally, communities want to invest in actions that help individuals thrive and flourish while strengthening connections among people (WIN Network, undated).

Organization and Basis of the Toolkit

The toolkit is organized into a series of modules that are focused on the pillars of health equity and collective well-being (defined in Module 1). These modules guide community leaders through discussion prompts and exercises meant to provoke conversation and identify opportunities for and challenges to advancing health and well-being in their community. Participants will engage with key health and well-being concepts and analyze their own efforts to center these concepts in their planning, including examining instances when their efforts were not as effective or did not move as quickly as they would have liked.

The toolkit builds on the Sentinel Communities project, a collaborative effort between the Robert Wood Johnson Foundation and RAND that seeks to understand how communities are building health and well-being narratives, tracking progress toward improved health, and strengthening systems that actively bolster well-being. The Sentinel Communities project produced key insights that underpin this toolkit’s focus areas (narrative, measurement, and investment). These insights can be summarized as follows:

  • Community narratives on health equity and collective well-being are still developing. Although some communities recognize that health inequity and structural racism exist, they struggle to turn awareness into sustained action that can address these issues. Additionally, discussions about individual well-being are emerging, but there is limited attention paid to collective well-being, a concept that recognizes intersections between people and place in the context of well-being. Communities also find it challenging to tie health equity to other priorities, such as economic development.
  • Communities face difficulties in gathering actionable information to use during decisionmaking processes. The data that are used often reflect organizational performance or health outcomes and lack indicators of community action and investment. There is also a shortage of measures that could produce meaningful insights about positive health and well-being for informed decisionmaking.
  • Communities often fail to align their investments with their health and well-being goals. Local government investments frequently do not match leaders’ rhetoric, and these resources are insufficient to address such issues as equity or structural racism, even if those issues are prioritized. Such misalignments hinder the sustainability of health initiatives.

More information about the Sentinel Communities project and how it informs this toolkit is provided in the annex. The toolkit uses findings from these communities and a series of workshops that pilot-tested its elements.

Is This Toolkit for Your Community?

This toolkit is for any community that wants to learn more about the following concepts and apply them locally:

  • well-being: the full range of assets and capabilities that people need to thrive and create meaningful futures. Well-being is multifaceted, and this toolkit places emphasis on collective well-being, which is the expression of the connections between individual and community well-being. When communities (e.g., places or cultures) are characterized by a strong collective well-being, they have the collective will and connected experiences to allow community members to work together to address systemic harms and build a future together.
  • narrative: the critical frames and resulting stories and messaging that influence and inform the way people and communities see and describe the world. A narrative helps to articulate a way of understanding the world and informs how people then act.
  • measures: ways of categorizing something to assess, track, or understand it. This toolkit focuses principally on measures that capture positive health and well-being, collective well-being, and the social context for health, including health equity.
  • investments: the allocation of community resources, which includes financial resources, community policies, and time dedicated by community leaders.

What Will You Gain from Using This Toolkit?

The ALIGN for Health and Well-Being Toolkit provides community leaders with

  • usable terms, definitions, and concepts, including health equity and collective well-being
  • ideas for organizing community action, especially in areas in which communities tend to get stuck when trying to advance health and well-being work
  • techniques for how to frame health and well-being for a variety of groups and interests (i.e., narrative)
  • ways to identify progress that is happening in the areas that matter (i.e., data and measures)
  • strategies to better align and integrate activities and initiatives that can maximize benefits to health and well-being (i.e., resources and investments)
  • a set of considerations and thought-provoking questions to help community leaders understand why actions on health and well-being—particularly health equity and collective well-being—might not be progressing quickly or effectively enough in their communities.

Who Would Benefit from This Toolkit?

This toolkit is designed for a variety of community leaders who have an introductory to intermediate familiarity with health and well-being concepts. It will be useful to your community if you are new to health and well-being, or if you want to expand your work in health equity and/or collective well-being specifically. Individuals and groups that may find this tool useful include

  • government departments or agencies (e.g., health, public works, community development, finance, public safety)
  • community-based organizations (e.g., nonprofits, businesses, faith-based groups, human service organizations)
  • community-based philanthropic organizations (e.g., community foundations or trusts)
  • individuals working on health topics and those who care about the well-being of their community.

To determine whether this toolkit is right for your community, consider the following questions:

  • Have your efforts to promote health and well-being been “stop and start” (i.e., based on planning or grant cycles)?
  • Have your efforts focused on specific urgent health issues rather than a holistic agenda that is related to well-being or health equity?
  • Have you felt stalled or stuck in your efforts to make progress on promoting health and well-being?
  • Are you thinking about ways that you can integrate a more holistic approach to positive health and well-being in your community?

This toolkit is meant to facilitate both individual understanding of and group discussion about health and well-being. Although individuals can benefit from working through the toolkit on their own, given the nature of its discussion prompts and exercises, this toolkit is best suited for cross-sector groups of community leaders, particularly those who represent the perspectives and interests of different organizations and government and nongovernment entities.

We recommend designating a point person (or people) from an organization in your community to convene such a group to work through the toolkit together. The point person (or people) should have strong leadership and effective communication skills, a collaborative mindset, knowledge of local issues, cultural competence, and facilitation skills. The toolkit can also be facilitated by using a “leader for the day” format that rotates module facilitation among people or community organizations. See the Group Leader Guide for more information.

Here is a list of possible groups to engage before starting:

  • health care (e.g., pediatrics, hospitals, prenatal clinics, mental health, community health centers)
  • education (e.g., early childhood, primary and secondary, postsecondary)
  • housing and community planning (e.g., housing and homelessness, urban design)
  • safety and justice (e.g., juvenile or family courts, police)
  • child welfare (e.g., foster care, protective services)
  • social or human services (e.g., income supports, such as Temporary Assistance for Needy Families and other family financial assistance; nutrition support, such as the Special Supplemental Nutrition Program for Women, Infants, and Children or food banks)
  • environment (e.g., water districts, conservancies, air quality)
  • parks and recreation (e.g., parks, libraries, outdoor venues, art spaces)
  • workforce development (e.g., workforce investment boards)
  • business (e.g., chambers of commerce, small businesses, large employers, tech firms)
  • faith-based services or programs (e.g., churches, missions)
  • civic groups (e.g., League of Women Voters, Boys and Girls Clubs)
  • elected government (e.g., mayors’ offices, council people).

Download the Group Leader Guide and Participant Workbook

How Should I Proceed Through This Toolkit?

The toolkit is divided into the following modules

We recommend that groups proceed through the modules sequentially, though module elements can be spread out over separate sessions. After completing the modules, groups can return to them at any time as a resource or refresher for their community.

  1. Module 1 Making the Case

    Why Health Equity and Collective Well-Being Matters

  2. Module 2 Walking the Talk

    Advancing a Community Narrative That Supports Health and Well-Being, Particularly Health Equity and Collective Well-Being

  3. Module 3 Measuring for Action

    Promoting Data for Health Equity and Collective Well-Being

  4. Module 4 Connecting Intention to Action

    Aligning Investments for Health Equity and Collective Well-Being

  5. Module 5 Taking Action

    Steps to Connect the Dots in Narrative, Data, and Investments for Health and Well-Being

Toolkit Legend

Throughout each module, we include these key features with corresponding icons to enhance your understanding and to guide action. You can return to these icons via the Legend tab at the top of the toolkit.

  • Key Terms
    Key Terms
    An explanation of key terms, concepts, or motivations for a topic
  • Discussion
    Discussion
    Prompts for discussion
  • Group
    Group
    Group exercises
  • Facilitator Instructions
    Facilitator Instructions
    Instructions and suggested materials for facilitators
  • Reminder
    Reminder
    A reminder to document key takeaways or action items from the module
  • Talking Points
    Talking Points
    Talking points, including different ways of thinking about or approaching a topic
  • Visual
    Visual
    A graph or figure that can be used in a visual or slide to share
  • Forest
    Forest
    This perspective focuses on how to express a new health and well-being narrative for your community broadly
  • Tree
    Tree
    This perspective focuses on how to link work on a specific community issue or problem to your health narrative

What Materials Do You Need for In-Person Workshops?

This toolkit was developed following pilot-testing sessions with communities that participated in a series of in-person workshops. If you gather a group of community leaders to work through the toolkit in person, you might want to have a few supplies on hand:

  • A computer or mobile device: Because the toolkit is on a digital platform, it is most beneficial if each participant has a computer or mobile device to follow along with the materials. If that is not possible, see the Group Leader Guide for instructions on how to download or print the toolkit materials. A computer can also be used to display some of the visuals (e.g., graphs, images) to the group.
  • A whiteboard or a large easel pad: Place this item in a central location for use during group exercises.
  • Additional easel pads: Ensure that there are enough for each small group to use during the group exercises.
  • Markers: Ensure that there are enough for each small group to use during the group exercises.
  • Printouts of the resources provided at the end of the toolkit: These resources include the Participant Workbook and glossary and can be provided as handouts. Consider also supplying printouts of the module pages for those who do not have a computer or mobile device.
  • Sticky notes or notepads: These are optional and can be used for individual brainstorming.
  • Pens, markers, and paper: These are optional and can be used for notetaking.

As noted, some of the materials from this toolkit can also be downloaded, transferred to presentation software, and projected via computer in a group meeting to facilitate discussion.

Although there are clear benefits to working through this toolkit in person to facilitate meaningful interactions, some exercises can be completed virtually (if needed) using breakout rooms and virtual whiteboards.

What Are Principles to Keep in Mind During These Module Discussions?

  • There is no right or wrong answer to the questions or exercises. This toolkit is intended to help your community members work through processes and discussions that make sense for them.
  • It is important that different perspectives are included in the discussion, and it is critical that these discussions are conducted with a spirit of openness to new ideas, even if those ideas are contrary. The principle that guides this toolkit is to approach with openness and a sense of wonder.

Up Next

Module 1 Making the Case
Why Health Equity and Collective Well-Being Matters
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For feedback on this toolkit and to share how you are using it in your community, please send an email to:

ALIGN@rand.org