Over the past eight years, Milwaukee’s multisector collaborative working to cut the city’s alarming teen pregnancy rate has delivered a lot of educational messages, none more memorable than the “pregnant boys” campaign. The late 2000s campaign—emblazoned on bus shelters and billboards, and in other public places—featured photos of shirtless teenage boys with baby bumps and the tag line, “It shouldn’t be any less disturbing when it’s a girl.”

The city’s residents paid attention. In 2006, Milwaukee had the second-highest teen birth rate in the nation. By 2013, that rate dropped by 56 percent—surpassing the collaborative’s ambitious, original goal of a 46 percent drop. While teen pregnancy rates have been falling across the country, Milwaukee’s has come down far faster.

Though it got underway well before John Kania and Mark Kramer coined the term collective impact, Milwaukee’s fight against teen pregnancy is a classic collective-impact initiative, albeit one with a narrower goal than some. It brings together stakeholders from a range of sectors—education, public health, business, and media—to focus on an ambitious, shared goal, using data to measure its progress and led by a “backbone” organization, the United Way.

A 2012 report on community collaboratives by the Bridgespan Group and the White House Council for Community Solutions, featured this initiative as one of 12 that produced measureable improvement of at least 10 percent on a challenging community issue such as teen pregnancy, youth violence, and poor educational achievement.

Recently, we went back to these communities to see if there were any patterns of persistence or progress, and write a follow-up report. We found that, with one exception, all of these communities continue to collaborate and that most continue to improve outcomes. However, these “needle-movers” have faced a set of common challenges, forcing them to learn and evolve in different ways. These include:

  • Getting and keeping stakeholders at the table. Milwaukee essentially has the same partners and operates in the same way as it did when it started. Other collaboratives have had to make changes to keep the right people at the table. In Orlando, for example, the Parramore Kidz Zone—which focuses on reducing juvenile crime, teen pregnancy, and high-school dropout rates in the city’s highest-poverty neighborhood—originally held very frequent partner meetings to develop the initiative. But as Lisa Early, director of Orlando’s Families, Parks, and Recreation Department (which runs the Parramore Kidz Zone) told us, “Now everyone would just prefer to focus on getting the work done. We meet more on an as-needed basis, and this lighter-touch process works for us and keeps partners engaged.”
  • Managing changes in the external environment. These collaboratives have kept going through significant external leadership transitions—such as a new mayor, school superintendent, or police chief. “We’re on our third school superintendent,” said Nicole Angresano, community impact vice president at United Way of Greater Milwaukee. And given the role of the district in sex-education efforts in schools, “We understand that we’re very dependent on the superintendents being on our side,” she added. The initiative’s oversight committee has multiple close links to the city’s leadership, and its leaders have spent time with each superintendent to discuss the initiative’s work and what it has achieved. Almost every collaborative we studied has managed these big external changes by closely involving either civic leaders or community members, or both.
  • Getting community buy-in. Milwaukee recognized that adult behavior—not just teen behavior—needed to shift and that teens had to invest in changing it. The initiative developed messaging targeted at adult men, and recruited teens for focus groups and guerilla marketing efforts—such as the installation of imitation diaper vending machines in several schools as a way to drive home the high cost of supporting a baby. Another collaborative, the San Jose Mayor’s Gang Prevention Task Force, has taken a broader approach to engagement; the collaborative works closely with a community-engagement subcommittee, regularly meets with faith leaders and community volunteers, and conducts neighborhood outreach when violence erupts. “This is a community issue that takes a community response,” noted Mario Maciel, the task force’s division manager.
  • Using data to improve and communicate results. Milwaukee can use a single measure—the teen pregnancy rate—to set a goal and measure progress. But other kinds of efforts need to track multiple measures. “Cradle to career” success, for example, must track kindergarten readiness, third-grade reading, college-completion rates, among other measures. Indeed, some of the needle movers in our study still struggle with reporting and using data in a way that spurs positive action.

The people involved in these collaboratives have chosen to invest their time, talent, and resources for the long haul. On average, the collaboratives have operated for 12 years, making persistence the common denominator for achieving real progress. Beyond this, we have much to learn about what the long game requires. What infrastructure is needed to maintain and improve results over time, and under what conditions should these initiatives sunset? Answers will emerge as these collaboratives carry their missions forward.