CORONAVIRUS (COVID-19) RESOURCE CENTER Read More

enLACE (Leadership and Civic Engagement) Academy

State: CA Type: Promising Practice Year: 2019

Spanning from the Pacific coast to the inland farmlands in central California, Monterey County is a community of 437,9072. Located in Salinas, the largest city in the county, the Monterey County Health Department (MCHD) tackles health issues reflective of its diverse county population. Agriculture in Monterey County contributes $8 billion annually to the local economy and the surrounding Salinas Valley is known as the Salad Bowl of the World.” Yet, the median annual income for farmworkers is $25,000. Overall, 55% of the population is Hispanic/Latino, 33% are White (not Hispanic), 6% are Asian, 3% are Black/African American, and the remaining 3% are Other with 53% of the population not speaking English at home. Monterey County has a 17% poverty rate and 1 in 10 of the county's public school children are homeless.

Community engagement has been identified as a potentially useful strategy to reduce health inequities. Disadvantaged groups systematically suffer from worse health outcomes such as lower life expectancy than non-disadvantaged groups. Engaging members of disadvantaged communities in public health initiatives has been suggested as a way to reduce health inequities. 

The goal is to spur community engagement through civic engagement trainings with a health-focus so that community residents can take a more participatory role in their communities. In order to prepare and engage community residents, enLACE participants learn about the social determinants of health, community engagement and their relationship to the health of the community. As they use a health lens for each of the eight-modules, participants connect with county and city staff to learn about their local government systems and how programs and policies impact the social determinants of health and health outcomes.    

The program is an eight-week course of two-hour weekly modules based on the cohort learning model. The program is tailored for each community. Participants learn about their own community's local government, current events and local community engagement opportunities. Currently, 11 cohorts have been offered in Spanish and three have been offered in English with the cohorts taking place in 7 different cities throughout Monterey County (including one cohort for youth). Food and childcare are provided during the program.

Given the goals and objectives, the enLACE program seeks to influence the following performance measures: the participant's personal view of making a difference in their community, the participant's knowledge of how to participate in the local school district, and the participant's knowledge of how to participate in local government. Survey results of 64 pre/post matched surveys collected up to 2016 showed the following results: Eighty-nine percent of participants entered the program believing they could make a difference in their community. Despite their beliefs, only 48% initially reported knowing how to participate in the local school district and only 22% in local government. Participants demonstrated their greatest learning around how to participate in local government systems, a 67% increase; this was followed by a 50% increase in knowing how to participate in their local school system. 


Upon review and reflection, a number of factors could have led to the success of the enLACE program: the program is tailored to the specific community; the program is accessible in its location, time, language, literacy level, and the provision of childcare and food/light snacks; it is held in familiar and safe community spaces; and participants are directly connected to local community leaders and community engagement opportunities (minimizing the preparation-action gap). Additionally, the program was tailored to the cohort's local community—meaning the issues that were discussed were local issues, the leaders that they met with were local leaders, etc.—and the program managers built relationships with the local community leaders, which may have made them more willing to participate in the program. Finally, no such programs existed in the County to learn about community engagement, local government systems, and how it relates to the overall health of the community. enLACE fills a need in the community and has considerable public health impact through a more engaged and advocacy-oriented population.

enLACE website: http://www.co.monterey.ca.us/government/departments-a-h/health/hd-initiatives/enlace

The problem being addressed is health inequity. Community engagement has been identified as a potentially useful strategy to reduce health inequities. Disadvantaged groups systematically suffer from worse health outcomes such as lower life expectancy than non-disadvantaged groups. Engaging members of disadvantaged communities in public health initiatives has been suggested as a way to reduce health inequities.

The target population is the residents of Monterey County (population: 437,907). Largely agriculture-based (an annual 8 billion-dollar industry in Monterey County ), 55% of the population is Hispanic/Latino, 33% are White (not Hispanic), 6% are Asian, 3% are Black/African American, and the remaining 3% are Other with 53% of population not speaking English at home. Monterey County has a 17% poverty rate and 1 in 10 of the county's public school children are homeless. enLACE is particularly meant for residents who have less systems-based empowerment or involvement in local politics. Although enLACE is open to anyone who is interested, nominations of motivated community members by community leaders is encouraged in order to better target residents that will be receptive to the program and will use what they learn to better their community. As of August 9, 2018, 148 Monterey County community members have participated in enLACE (including the enLACE Academy for youth's 12 participants).

Until enLACE, no Monterey County program attempted to directly address health equity through community civic engagement. The 2013 Monterey County Community Health Assessment sought to assist health and social services providers, elected officials, and community members in monitoring health trends and disparities, determining priorities among numerous health issues, prioritizing resources, and taking actions to provide health equity in Monterey County. Also, the 2014-2018 Community Health Improvement Plan for Monterey County established the importance of health equity and the disparities that health inequities cause. The Improvement Plan established health equity as a fundamental Monterey County Health Department value, which then drives decisions on resource allocation and intervention strategies—like enLACE.

The enLACE program's civic engagement trainings with a health focus presents an innovative method for empowering residents to improve health outcomes. enLACE addresses the social determinants of health, community engagement and their relationship to the health of the community. Participants connect with county and city staff to learn about local governments systems and how programs and policies impact the social determinants of health and health outcomes. In addition, enLACE alumni are connected to community engagement opportunities in their local community. The program is unique in that it provides a space for local city and government leaders to learn from the community and the community to learn about and from local  city and government leaders.

The enLACE program takes a creative approach to community leadership and civic engagement, where participants take Health in All Policies' existing idea of a health lens” and apply it throughout the program. Whereas other community engagement programs focus on education about local government systems, enLACE introduces the community to local city governments while using a health lens in each module in order to influence policy.

The enLACE program applies principals learned in the CDC's Healthy Communities Program and is supported by numerous research studies that show that civic engagement is fundamental in building healthy communities. The CDC and HHS have published articles, such as The Role of Community Engagement in Community Health Improvement” (2012) and Community Engaged Leadership to Advance Health Equity and Build Healthier Communities” (2016), respectively, that support enLACE's approach to community engagement for the purpose of improving health equity.

The goal is to spur community engagement through civic engagement trainings with a health-focus in order to prepare and engage community residents to take a more participatory role in their communities in an effort to improve the overall health and quality of life of their community.,

The program is an eight-week course of two-hour weekly modules based on the cohort learning model. Participants connect with county and city staff to learn about local government systems and how programs and policies impact the social determinants of health and health outcomes. The program is tailored for each community; participants learn about their own community's local government, current events and local community engagement opportunities. Currently, 11 cohorts have been offered in Spanish and three have been offered in English with the cohorts taking place in 7 different cities throughout Monterey County (including one cohort for youth). Food and childcare are provided during the program.

A Monterey County Health Department – Planning, Evaluation, and Policy Unit employee was assigned implementation and management of the enLACE program full-time. This staff person researched civic engagement and public health equity principles to inform development of the curriculum. The curriculum was reviewed by several staff involved in community interventions and modified throughout successive implementations based on participant feedback. The allocation of staff resources to the program reflects the County's commitment to the program and community engagement.

The enLACE program is open to all community members who desire to get more involved in their local school and city government and want to create healthier communities. Although everyone is welcome to apply, enLACE works primarily by nomination. The program accepts nominations for participants currently involved in their community and who have potential for community leadership after program completion.

enLACE began in 2014. It is an eight-week course of two-hour weekly modules. Since its development, enLACE has occurred at a pace of three program offerings per year, rotating around the county to different communities within any given year.

Besides the community member-participants themselves, many of the community stakeholders have been involved with and have supported enLACE. Various County and city staff who are leaders in different sectors teach participants about local government systems and how programs and policies impact the social determinants of health and health outcomes. Other stakeholders who helped develop the initial plans included: local school district partners, local city government partners, local Health in All Policies partners and community leaders who understand the value of community engagement, as well those partners that understand how community engagement relates to the overall health of the community (such as Building Health Communities – Salinas). Finally, local community leader's roles included supporting the enLACE program being offered in their communities and creating supportive learning spaces that often included no-cost to use the space and free childcare, and sharing their knowledge and expertise during the modules.


For a program with such a big impact, the start-up costs were relatively small. For a 15-student cohort, the estimated cost is as follows:

  • Materials (binders, binder dividers, pens, and graduation certificates): $160, one-time cost
  • Snacks (bottled water, granola bars, fruit, and/or sandwiches): $100, per module
  • Space: Free, provided via a partnership with local schools (but if a rental was necessary, about $100 per module was budgeted)
  • Childcare: Free, provided via a partnership with local schools (but if paid services were necessary, about $40 per module was budgeted)
  • Staff Time (to include setup, cleanup, purchasing food, preparing the modules, and planning and executing the module/program): 112 hours per cohort at $42.96 per hour
  • Total Estimate for an 8-week enLACE cohort: $5,771.52 (or $6,891.52 if the space and childcare needed to be paid for)

The goal is to spur community engagement through civic engagement trainings with a health-focus in order to prepare and engage community residents to take a more participatory role in their communities.

Given the goals and objectives, the enLACE program sought to influence the following performance measures: the participant's personal view of making a difference in their community, the participant's knowledge of how to participate in the local school district and the participant's knowledge of how to participate in local government.

Survey results of 64 pre/post matched surveys collected up to 2016 showed the following results: Eighty-nine percent of participants entered the program believing they could make a difference in their community. Despite their beliefs, only 48% initially reported knowing how to participate in the local school district and only 22% in local government. Participants demonstrated their greatest learning around how to participate in local government systems, a 67% increase; this was followed by a 50% increase in knowing how to participate in their local school system.  In addition, participants have continued their interest in civic engagement as alumni and have become engaged in community improvement activities post graduation. These activities have included joining community advisory groups, applying for small community grants, and developing park clean up events.


The data was collected by the enLACE program manager via a paper survey given in person and developed by the program coordinator. Data analysis was provided by a department evaluation specialist using Excel spreadsheets to develop simple descriptive statistics.

As enLACE continued (and continues) some modifications were made in order to maintain currency and relevancy. For instance, a guide was developed for presenters in order to keep them on-time, on-point, and to cover the necessary information and the survey was updated to be more user-friendly and streamlined. Ongoing alumni support to encourage community civic engagement has also been added to the duties of the program coordinator.  Alumni have also begun to participate as volunteers at other events that are occurring throughout the year in their community and where MCHD plays a role, such as active street events.

Many of the factors that have led to enLACE's success are the results of lessons learned: the program is tailored to the specific community, the program is accessible in its location, time, language, literacy level, childcare and food/snacks are provided, and it is held in familiar and safe community spaces. Additionally, it's been helpful that participants are directly connected to local community leaders and community engagement opportunities, minimizing what fear or confusion may surround a community engagement opportunity. Also, a few keys to building a positive environment for the program have been identified: recognize participants' assets (skills, knowledge and experience), identify their goals for their community and enLACE, identify shared goals, seek to grow relationships within the cohort during and after the program, and celebrate small wins. Finally, although the level of community engagement varies for each participant after the enLACE program, the continuing support, the County-cohort relationship, and advertising community engagement opportunities has resulted in continued excitement among graduates about getting involved in their community and has provided the push” that many of them have needed to stay involved. 

There were also some important lessons learned in regards to partner collaboration. Beyond needing to actively build and maintain partnerships and seek continued support, it is vital that the diverse partners understand their role in health during and after enLACE. Also, a partner (usually community leaders and module presenters) who do not share enLACE's goals are often counterproductive, so it's critical to invest the time to find the right speaker for the right topic. Finally, especially in rural areas, it is important to assess the area's resources and speaker availability early on in order to properly plan the module's content.

A formal cost/benefit analysis was not conducted, but it is easy to see that time invested in community members will help to more effectively address equity more than developing policy alone without authentic community empowerment. enLACE has planted and will continue to plant advocates and allies who will advocate for programs and/or policies that create healthier, safer and stronger communities.

There is sufficient stakeholder commitment to continue enLACE—there continues to be a need to address health equity and residents and local government leaders continue to request enLACE in their community (for example, a School District recently requested that enLACE come to its community). Because enLACE is for the community, the program manager is respectful of the student's time and considers factors like agricultural workers' seasonal schedules and participants' community engagement commitments. MCHD continues to support enLACE and to provide a program coordinator on staff. In addition, community engagement-based grants are continually sought out, with enLACE often satisfying the requirements.

At a NACCHO conference