Engaging Partners in a Virtual Space

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Introduction

This toolkit is intended to enhance a health agency’s virtual engagement practices. The steps for intentional and impactful virtual engagement serve as a foundation that can be applied to both internal and external engagement. Public health professionals can use virtual engagement and facilitation skills to accomplish a range of goals, such as convening routine meetings, supporting a hybrid workplace culture, and conducting collaborative planning processes.

We have designed the toolkit for health agencies at all comfort levels of virtual engagement, providing examples and considerations for inclusive and accessible meeting design throughout. Novice and experienced facilitators will find ways to enhance participant experiences.

How to Use This Toolkit

Health agencies should use this toolkit to:

• Support administrative readiness: Virtual engagement is crucial in modern public health. Its principles can extend to all eight Foundational Public Health Services and are integral to both providing community-specific population health services and promoting equity.
• Develop awareness of inclusive and accessible design processes: While virtual engagement can improve accessibility for people with disabilities, it doesn’t automatically ensure equitable participation. Consider barriers participants might face and proactively determine solutions.
• Retain public health professionals: Maintaining a competent workforce through employee recruitment and retention relies on a health agency’s ability to operate as a hybrid workplace. Virtual environments can also support positive staff engagement strategies to build exceptional workplace culture and provide staff with action-oriented opportunities to advance equity.

Organizational Culture and Supports

Step 1: Become an informed advocate for equitable access.

People with disabilities may require accommodations to ensure equitable opportunities to participate in public health processes. A helpful way to understand disability and how to provide accommodations in virtual meetings is by looking at six core functioning domains that may cause functional limitation.

• Hearing
• Self-care
• Seeing
• Mobility
• Communication
• Cognition

Educate collaborators on the challenges participants may encounter when engaging with virtual content:

• Unreliable internet availability.
• Compatibility issues between communication devices and virtual platforms (e.g. phones, computers, and working microphones, cameras, and adaptive technology).
• Inaccurate automatic closed captioning or transcription features.
• Unavailable interpretation into ASL or other languages.
• Differing comfort or familiarity with navigating online collaboration and meeting platforms.
• Inability to be on camera due to home or work environments or self-care limitations.
• Concern with Artificial Intelligence (AI) notetakers or being recorded.

Most people think of verbal or hearing limitations as the only need for meeting accommodations; however, the CDC’s Behavioral Risk Factor Surveillance System defines cognitive limitations as “serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition.” In a crosstabulation of “yes” responses to the question by six-category age group in the Web Enabled Analysis Tool, almost two in every 10 adults aged 18 to 24 and 25 to 34 years reported living with cognitive limitations in 2021 (18.2% and 19.6%, respectively), which is a significant increase from 2013 (13.3% and 15.4%, respectively). There are many similar examples of limitations not readily apparent to others.

Universal design means the design of products and environments to be usable by all people, to the greatest extent possible, without adaptation and specialized design. Adopting universal design principles benefits all participants, regardless of abilities, living situation, or socioeconomic status. Access and functional limitations are often invisible and do not need to be disclosed in a work environment, so you may never know who benefits from your efforts.

Equitable Access Resources

• Addressing Accessibility for Equitable Virtual Participation by ASTHO: A one-page resource with sample virtual meeting accommodations and inclusive facilitation techniques.
• 10 Essential Questions for Disability Inclusion in Health Agencies by ASTHO: Apply these questions to virtual meetings throughout the planning process.
• Embedded by ASTHO: A series spotlighting disability and preparedness specialist stories.

Step 2: Review internal processes and procedures.

Meetings with external partners and community members are often the first setting people consider when exploring virtual engagement. However, internal relationships and partnerships are also important for administrative readiness. Review relevant internal meetings or events policies and procedures, and consider which of the activities and strategies in this toolkit would also be beneficial to internal engagement among agency staff to promote a positive and effective hybrid workplace culture.

Internal Process and Procedure Resources

• Administrative Policy Assessment and Gap Analysis Tool by ASTHO: A guide for public health agencies with several tools to assess existing administrative policies, identify and prioritize gaps, and apply a quality improvement lens to existing processes for administrative and operational policy development and review.
• Virtual Engagement Supports Administrative Readiness by ASTHO: A one-page summary with links to additional online resources to support administrative readiness.
• Benefits to the Public and the Workforce by ASTHO: A one-page list of examples of the benefits of quality and intentional virtual engagement practices.

Step 3: Establish hosting and facilitating roles and responsibilities.

Depending on the meeting’s objectives, desired outcomes, and available budget, the same individual may or may not fill the roles of host and facilitator. Internal facilitation is a cost-saving option with the ability to co-facilitate with a colleague, allowing one person to lead the discussion while the other manages administrative tasks. Contracting with an external facilitator could prove beneficial due to the individual’s expertise and when building consensus around an important issue that needs a neutral third party. Importantly, the host and facilitator should jointly prepare for the meeting and have a regular meeting cadence for consistent progress and communication.

If you determine the need for an external facilitator:

• Establish the scope of work with the specific skills, frameworks, models, and/or experience necessary for the role (i.e., virtual engagement, inclusive design, creating State Health Improvement Plans or other specific types of reports or plans, etc.).
• Consider how long it will take to follow your agency’s procurement procedures to solidify the contract and build that time into your project plan.

Hosting and Facilitating Resources

• Hosting Versus Facilitating by ASTHO: A one-page resource that delves into the responsibilities of hosts, facilitators, and support staff, as well as ideas on objectives and desired outcomes.
• Introduction to Virtual Facilitation for Collaboration, Section 4 by NACCHO: Examples of virtual facilitation activities.

Creating the Conditions for Success

Step 1: Engage early and often.

You must set up events with enough time for participants to plan on attending and schedule them with the type of participant in mind. Some partners may want or need to be engaged before a meeting is planned to weigh in on how they’d like to participate and offer guidance on the project or topic at hand. Asking partners and community members for their input ahead of time can be a critical component of trust building, which takes time. Understanding the historical context behind why some communities might have trouble trusting government entities, particularly health agencies, is an important first step in fostering a welcoming and authentic environment for participation. Hosts/facilitators should approach this with humility, flexibility, and openness to feedback, adjusting when participants don’t feel heard.

This is a multi-layered and complex topic. Organizations often look for community involvement for their own benefit—such as accreditation or grant funding—without consideration of the direct benefit to the community. To build genuine partnerships, look for opportunities to offer meaningful reciprocal support to the community. This could include compensating community members for their time, expertise, and stories, or engaging in customary practices like exchanging gifts (in cultures where it is appropriate).

Following up with participants individually, especially those invited who didn’t ultimately attend the meeting, may be necessary to establish and maintain relationships. You should not interpret lack of attendance as lack of interest.

Engagement Resources

• Timing and Scheduling Considerations by ASTHO: A one-page list of questions to ask when determining the date and time of a meeting.
• Transformational Community Engagement to Advance Health Equity by Health Equity Solutions: A resource to support establishing and maintaining trust through community engagement to improve accessibility and quality of services.
• Steps to Engage Partners in a Virtual Space by ASTHO: A one-page overview of the steps contained in this toolkit.

Step 2: Provide clear, consistent, and inclusive communication.

Being aware of respectful and inclusive communication fosters long-term and supportive relationships between peers, colleagues, teams, and organizations. To promote equitable participation, establish a discussion agreement at the start of the meeting. This agreement should emphasize respectful communication and a growth mindset, ensuring that everyone can speak without interruption, all voices are heard, and people can give and receive feedback on how to improve communication with humility.

Clear and consistent communication begins before the virtual call with timely meeting invitations, reminders, and links to relevant materials or resources. While on-camera participation can be beneficial, remember that some participants may not be comfortable with participating due to home or work environments or self-care limitations. You could include a reminder in the meeting invitation that on-camera participation will be available; this way, attendees have an opportunity to prepare their environment ahead of time.

Ensure there are clear instructions for how to join or participate in all meeting materials and event invitations, and include technical support contacts in case they are needed. The meeting invitation should contain this access information as well as the agenda, pre-meeting materials, and resources or templates to use during the meeting. After the meeting, send a follow-up communication that recaps key points, meeting materials, shared resources, notes, and action items to foster transparency.

Communication Resource

Create a Team Agreement from Lucid: An overview of the types of information, communication, and collaboration questions to ask a team to establish meeting and team agreements.

Step 3: Plan for quality improvement and evaluation.

Maintaining organized documentation and recordkeeping supports successful meeting outcomes and sustains collaboration. It also helps track progress, promotes accountability, and makes it easier to revisit key discussions and decisions. Tracking participation, attendance, and communication delivery, as well as utilizing a shared drive for storage and collaboration platforms for document creation, are essential practices within the facilitation team.

Set yourself up to improve engagement, partner collaboration, and meeting productivity in between meetings by gathering feedback from participants and co-facilitators and establishing performance goals. Conducting a formal evaluation quarterly or biannually can also help ensure you are meeting your objectives. Surveys allow participants, community members, and coalition or committee partners the opportunity to provide feedback on what is working well and suggest areas for improvement. You can also apply simple tools for collecting feedback after each meeting, such as a Plus/Delta exercise. Debrief with any co-hosts, supporting staff, and facilitators after each meeting to identify what worked well and what could be improved in the next meeting.

Quality Improvement and Evaluation Resource

Evaluation of Virtual Meetings by ASTHO: A one-page summary with quality improvement and evaluation suggestions and links to additional resources, including sample evaluation questions.

Step 4: Plan ahead for accommodations.

To ensure you meet the needs of attendees with disabilities and lead an event that is inclusive for all, include a request for accommodation needs in the invitations, registration forms, and other communication materials. This allows participants to inform you of any specific requirements in advance, such as captioning, sign language interpretation, or alternative formats for materials. This proactive approach shows your commitment to inclusivity and allows time to arrange necessary resources.

Professional captioners are more accurate than automatic captions. To ensure accuracy for people who are Deaf or hard of hearing, plan and budget for professional captioning or ASL interpretation as needed.

Accommodation Resources

• Holding Inclusive Events by the Autistic Self Advocacy Network: A toolkit about designing inclusive meetings and materials.
• Tips and Tricks for Inclusive Virtual Meeting Planning by Washington Disability Inclusion Network: Tips for successful preparation for and implementation of accessible meetings.

Planning and Holding a Successful Meeting

Step 1: Develop a detailed agenda or “run of show.”

Creating an agenda is a good practice for any meeting. Facilitators may also benefit from designing two versions of the same agenda: one for the participants and one for the hosting/facilitation team.

• Include a period of about 15 minutes prior to the start of the meeting for a “tech check” with presenters, facilitators, and support staff to practice screen sharing, sharing screen control, and passing screen control back and forth among the team. This also allows the team to finalize any questions or considerations prior to the participants joining.
  • Enable a “waiting room” in your meeting platform if it is important that participants do not join early and inadvertently attend the tech check.
• If the meeting is one in a series, provide a similar agenda sequence across all meetings.
• Provide adequate time for connection, activities, report-out, group insights, and questions.
• Recruit support roles and assign responsibilities as needed.

Agenda and "Run of Show" Resource

Developing an Agenda or “Run of Show” by ASTHO: A one-page resource with examples of what to include in agenda and Run of Show documents, as well as a sample 60-minute agenda.

Step 2: Select meeting and/or collaboration platforms.

Over the last several years, there has been a proliferation of virtual tools and platforms designed to enhance collaboration in remote and hybrid environments. There are many types of online meeting platforms offering both free and paid services with features like video, messaging features, automatic closed captioning, breakout rooms, and participant engagement features like raising hands, participating via reactions, polling, whiteboards, and waiting rooms (e.g., Zoom, Microsoft Teams, Google Meet, WebEx, Adobe Connect, and GoToMeeting).

Online collaboration platforms are software applications that enable individuals to work together on the projects, documents, tasks, or ideas identified by the meeting objectives in your agenda, regardless of location. These tools support communication, file sharing, task management, and real-time collaboration among team members. Similar to meeting platforms, they vary in cost with many offering free versions. Be mindful of the limitations of the free versions and consider whether you can accomplish your meeting objectives within those constraints.

• Consider using the built-in features of meeting platforms to eliminate the need to switch between the meeting and collaboration tools, which can be particularly challenging for attendees using a phone or a single computer monitor.
• Identify alternative ways that a person can participate in a collaborative activity if they are unable to switch platforms during the meeting. Options may include using the raised hand or reactions features, unmuting, typing in the chat, or reaching out to the facilitator with comments before or after the meeting, depending on the desired outcomes.

The facilitator should either know in advance or be able to pivot if participants are using adaptive technology. It is important to understand how to incorporate that technology to ensure participants can communicate and engage while also being aware of any limitations of the selected collaboration platforms. Many platforms, like Mural, provide a list of known limitations on their websites.

Platform Selection Resources

• Selecting Virtual Meeting and Collaboration Platforms by ASTHO: A two-page resource with questions to encourage discussion when selecting between virtual platforms.
• Introduction to Virtual Facilitation for Collaboration, Section 3 by NACCHO: An overview of video conference platforms and features.

Step 3: Create templates and resources in advance.

Create an environment in which every participant can think, collaborate with their colleagues, and conduct any necessary research, ensuring they are well-prepared for the meeting. Keep in mind that last-minute changes are not easily navigated by all participants.

The agenda and discussion materials should be sent out at least a few days, ideally a week, in advance to allow participants time to reflect and prepare their responses. They should also be included in the calendar invitation for quick reference during the meeting. Materials might include:

• A resource document containing all relevant hyperlinks: Items shared in the chat can be difficult for participants using different technology to access during the flow of a meeting.
• An accessible PDF with polling response options and discussion questions: Participants can prepare their answers in advance and type their response into the chat during the meeting or send them to you beforehand for inclusion at the proper time.

This approach ensures that everyone can engage fully and without avoidable barriers. While not every person has access to a Word processor, PDF readers are often available free of charge and are standard on smartphones, tablets, and computers. Materials should be ADA-compliant.

Meeting Materials Resource

Accessibility Guidelines from the National Disability Rights Network: Recommendations for reviewing documents and presentations for accessibility.

Step 4: Utilize breakout rooms effectively.

Ensure the agenda includes time to provide clear instructions for breakout rooms and, if no support staff is assigned, select or provide instructions for selecting a breakout room leader or notetaker. Additionally, confirm that participants can access and are familiar with the collaboration platforms you choose. For instance, if breakout rooms are meant for brainstorming and notetaking activities and a participant uses speech generation aids instead of a keyboard, consider assigning a breakout room facilitator. The facilitator can guide the participants through a series of yes/no questions, offering opportunities to expand on topics as needed. Time breakout sessions to ensure participants can complete the tasks.

The host and/or facilitator should make sure that a notetaking template has been created and made available to breakout room facilitators and notetakers.

Breakout Room Resource

Effective Breakout Rooms by ASTHO: A one-page resource for successful breakout sessions.

Step 5: Give some breathing space.

For long online meetings, it’s essential to schedule regular breaks to maintain engagement and prevent fatigue. This allows for more thoughtful participation without overwhelming attendees. Incorporating these breaks also respects diverse needs, including those that may need to step away more frequently. A general guideline is to schedule a 10- to 15-minute break for every 60 to 90 minutes of meeting time. However, various factors might influence how you schedule or utilize your breaks in real time.

• A well-timed break can give a needed pause during disagreements among participants.
• The natural attention spans of the group may start to determine sooner or later breaks.
• If an activity or discussion is still active, you might postpone a break slightly.

Ensure that you empower participants to step away from their screens if they need a break outside of designated break times. If they feel comfortable doing so, they can use the chat feature to let either the group or the host and/or facilitator know they are stepping away and that they’ve returned.

Break Scheduling Resource

Managing Breaks in a Virtual Meeting by ASTHO: A one-page resource with tips for communicating about breaks during virtual meetings.

Printable ASTHO Resources

• Steps to Engage Partners in a Virtual Space
• Virtual Engagement Supports Administrative Readiness
• Benefits of Virtual Engagement
• Addressing Accessibility for Equitable Virtual Participation
• Hosting Versus Facilitating
• Timing and Scheduling Considerations
• Evaluation of Virtual Meetings
• Developing an Agenda or “Run of Show”
• Selecting Meeting and Collaboration Platforms
• Effective Breakout Rooms
• Managing Breaks in a Virtual Meeting

Special thanks to ASTHO's Health Initiatives team, Accessibility Workgroup members, and Workforce Development team, as well as Erima Fobbs with Collective Health Impact, for their contributions to this toolkit.