Philanthropic Foundation Strategies to Advance Systems Reform: Perceptions from Frontline Change Implementers

This article examines the strategies and processes pursued by one foundation aimed at accelerating systems change reform efforts in four states. The findings suggest four strategies the Foundation employed in reform efforts: partnering with state policy actors to accelerate systems change efforts, providing technical assistance to support implementation, leveraging the reputation of the Foundation toward systems change goals, and facilitating the dissemination of innovation to states and localities. This study contributes to the literature by documenting the combination of strategies the Foundation applied in their effort to advance systems change, and by exploring the perspective of system professionals on what Foundation activities were viewed as more or less successful. Because systems change entails both policy and operational change, this study suggests foundation strategies need to harness both traditional approaches, such as targeting policy change, as well as approaches less traditionally used that may require new skill sets for foundations, including field building activities that enable system professionals to implement the change effectively.