The Office of Diversity and Equity Finalizes Their Theory of Change Process

The Office of Diversity and Equityadvances health equity in behavioral health outcomes of marginalized communities throughout San Mateo County.png

In Spring 2017, the Office of Diversity and Equity (ODE) underwent a Theory of Change process. The intention of the process was to help clarify, shape, and improve the impact of ODE’s efforts.  This was done by identifying expected and desired change, and then mapping out how those changes can be achieved.   

Why a Theory of Change Process?


ODE Director, Dr. Jei Africa in TOC process

Theory of Change (TOC) is a comprehensive description of an expected and desired change. It is focused on mapping out what a program does and how this will lead to the desired change. It does this through a process of backwards mapping, identifying outcomes, indicators that demonstrate when the outcomes have been achieved and interventions to bring forth the indicators. Through this process, the link between activities and achievements are better understood.  

Because ODE plays a lead role in transforming BHRS’ services to promote equity, cultural humility and inclusion, investing in a TOC process was viewed as a necessary step for creating a shared roadmap and understanding of how the various pieces of ODE’s work contribute to achieving its goals.

The TOC process for ODE was conducted over the course of six months, including an initial survey with stakeholders, two large meetings with over 40 community stakeholders and ODE staff and several additional meetings with smaller groupings of stakeholders and ODE staff.


Theory of Change Process

Through this process, ODE developed a long term goal for the next ten years: In collaboration with and for communities, advance health equity in behavioral health outcomes of marginalized communities by influencing systems change and prioritizing lived-experience.

Based on the assumptions that overall systems need redesign, lived-experience matters and the need to center a value-based approach, ODE selected four streams of outcomes:


The Office of Diversity and Equity’s 4 Priority Strategies

The Theory of Change process reinforces for ODE the need to invest more in strategies that address social determinants of health including community capacity building; strategic partnerships; institutional transformation; and policy and advocacy. While health education and awareness campaigns (e.g. stigma reduction, recognizing the signs of mental health issues) continue to be important strategies to decreasing barriers to care, root causes of inequities such as systemic and community biases and lack of social supports need to be prioritized.


Image Credit: Robert Wood Johnson Foundation

Some of ODE’s programs that address these root causes or social determinants of health
include the Lived Experience Academy, Health Ambassador Program and the Health Equity Initiatives (HEI’s).ODE will continue prioritizing programs and strategies that get to the core of inequalities in mental health outcomes.

This work will require a commitment beyond the current structure and funding for ODE’s work. It will require strategic partnerships and a long-term investment expecting that the outcomes will come ten, twenty, fifty years out. Given this, and as part of the Theory of Change planning it was important that ODE reach out to current partners from various interests and perspectives including community based organizations, clients, family members, health policy, substance use, public health, education, cultural groups. Through the process, the need for expanding partnership to non-traditional sectors, including diversification of funding to deepen the work, and identifying a clear path for both partner engagement and ODE’s engagement in key community initiatives. This theme is in three of the four streams of outcomes, Policy & Systems Change, Community Empowerment and Partnerships & Collaboration.

The dialogue must continue. ODE is committed to showing up at the table to address health inequities as efforts must come from all sectors, government, healthcare, community-driven, non-profits, education, justice system, funders, and others. And, as ODE embarks in a process to achieve the realization of our Theory of Change goals, we invite you to the table. Whether it’s as strategic planning partners, getting involved in initiatives and projects like Health Equity Initiatives, Storytelling Series, etc. or developing your own agencies cultural humility and inclusion plans and practices; we can’t do this work alone.

To read the Office of Diversity and Equity’s full Theory of Change report, view here.

To learn more about the Office of Diversity and Equity visit their website here.