Beyond Philanthropy: The Power of Cross-Sector Collaborations that Advance Access to Care

AstraZeneca Foundation team with evaluation partners, NORC at the University of Chicago, at the APHA 2025 Annual Meeting & Expo.

By: Shannon Fyalkowski, Senior Manager, Programs & Operations, AstraZeneca Foundation

“Making the Public’s Health a National Priority” was the theme of the American Public Health Association (APHA)'s 2025 Annual Meeting & Expo in Washington, D.C., with an estimated 12,000 public health professionals and partners in attendance working to address today’s most pressing health challenges. Amidst the vibrant exchange of ideas and innovative initiatives, the AstraZeneca Foundation presented its unique cross-sector collaboration approach to improving access to care through its signature grantmaking program, Creating Health Access for Next Generation Equity (CHANGE).

The Foundation’s CHANGE program stands out by dismantling traditional philanthropic hierarchies, positioning grant awardees, the evaluator and the Foundation as co-equals in both implementation and evaluation. This innovative approach harnesses the collective resources and expertise of all parties to work toward the shared goal of equitable access to quality healthcare.

To offer deeper insights into this transformative work and the Foundation’s prominent presentation, this blog features a discussion with Colleen Reese, MPA, Director of Programs at the AstraZeneca Foundation and Michelle Johns, PhD, MPH, Senior Research Scientist at NORC of the University of Chicago and CHANGE evaluator. They share their perspectives on the program's unique partnership model and its impressive impact.

Addressing Critical Healthcare Access Challenges

Question: Healthcare access remains a critical challenge in the U.S. According to a recent study, 38% of US adults report skipping or postponing needed care in 2025¹. How does the CHANGE program address this ongoing need?

Colleen: Since 2023, the AstraZeneca Foundation has awarded grants through its CHANGE program to US-based nonprofit organizations working to improve access to quality healthcare for populations experiencing health disparities. Our partnership goes beyond grant dollars, working hand-in-hand with funded organizations to help amplify their efforts. We’ve integrated a Community Advisory Board structure where grant awardees meet regularly as a collective with the Foundation and the evaluation team to design a comprehensive reporting and evaluation framework that measures improvements in access to care and provide capacity building support. What makes this partnership model so unique is our emphasis on shared decision making and collaboration.

Michelle: To design this evaluation model, we leaned on principles of culturally responsive evaluation, specifically working to center the voices of those closest to the programs and services. Rather than telling organizations how to evaluate the success of their initiatives, we work with them to identify the most effective ways to measure and reflect the work they're doing. We want data collection techniques to complement the reality of the CHANGE awardee organizations and not be another task without any direct value for their work. This means we’re co-designing evaluation questions, co-developing reporting and evaluation instruments and co-analyzing data alongside the Foundation and awardees—truly emphasizing that collaboration is the foundation of a strong evaluation.

Benefits of the Partnership Model

Question: What are some of the benefits you have observed from this partnership model?

Colleen: A positive benefit we have witnessed are the relationships that have formed between funded organizations through the Community Advisory Board meetings. In several cases, we’ve seen this peer-to-peer knowledge sharing contribute to enhanced service delivery. When organizations can learn from each other's successes in real-time, they can make mid-course corrections to adapt and improve their approaches. Several awardees have shared the value in having nonprofit colleagues to lean on that are experiencing similar challenges and can troubleshoot together. They now have a peer network they can turn to beyond the work of this grant.

Michelle: In the first year of the evaluation, we had key informant interviews with grant awardees to hear their feedback on exactly this question! On top of the cross-organizational relationship building, grant awardees really appreciated the wide variety of ways they could work with the Foundation and NORC on capacity building. For example, NORC hosted office hours, both group drop-in sessions and one-on-one conversations, where grant awardees could bounce ideas off of evaluation and Foundation staff to problem-solve new challenges they might be experiencing in the field. What was particularly rewarding for the evaluation team is that the learning flowed both ways—office hours also helped us deepen our understanding of the on the ground realities of the programs and services.

Key Outcomes and Impact

Question: Can you share some of the key outcomes of the CHANGE program you’ve seen so far?

Colleen: The numbers speak to the scale of impact we're achieving together. In year one alone, our awardees collectively reached over 29,800 patients through direct services, events and programming – exceeding their collective annual goal by 46%. This is a tremendous accomplishment for the first year. Additionally, all six awardees demonstrated meaningful improvements in healthcare access through strategies such as expanding service offerings, integrating care coordination and addressing barriers to care, like transportation.

Michelle: What's also particularly meaningful is who we're reaching. Among five awardees collecting patient-level data, 96% of their patients were previously medically underserved and 91% lived in poverty or with low incomes. Of the nearly 30,000 patients reached by all six organizations, 71% were persons of color. These numbers underscore that the CHANGE program is making an impact where the need is the greatest, serving populations facing the largest inequities in healthcare access.