Partnership synergy: a practical framework for studying and strengthening the collaborative advantage

On Collaborative Governance: Building Consensus on Priorities to Manage Invasive Species Through Collective Action

Invasive forest pests can spread across large landscapes that include numerous land-use management jurisdictions. As such, forest pest invasions need to be addressed with collaborative efforts because a single entity is seldom able to respond to the full scope of the problem. A collaborative governance framework provides a collective decision-making process that allows diverse sets of actors who share an interest in a policy or management issue to work together towards mutually beneficial outcomes. Here, I apply a theoretical model of collaborative governance to understand the conditions in cooperative decision-making that led to a consensus on statewide priorities to control an important invasive pest in California, the Fusarium dieback invasive shothole borers (FD-ISHB) beetle-pathogen invasion. This provides (1) an empirical case study of collaborative governance in action throughout the stakeholder consensus building process and (2) interrogates that case study for theoretical contributions to the literature on collaborative governance, with special focus on invasive species management. Cohesive process outcomes were born out of effective principled engagement, participants' deep understanding and dedication to the system context, and the salient forces of leadership and interdependence baked in throughout the project. Ultimately, participants devoted their time and energy to a short but intensive planning process, resulting in more capacity for joint action, trust, interdependence, and a robust action plan that was quickly implemented.

Building Bridges Toward Common Goals - A Call for Greater Collaboration Between Public Health and Integrative, Complementary and Traditional Health Providers

This commentary makes the case for greater collaboration between public health professionals and integrative, complementary and traditional health practitioners (ICTHP). Previous partnerships have been successful, and more such collaborative work is needed to help overcome division, enhance the health workforce, and move all involved toward shared goals. ICTHP providers may be uniquely able to work across ideological differences and engage individuals and communities who are less trusting of public health, including those who are vaccine hesitant. Diverse partnerships can be difficult to maintain, but the application of equitable processes may aid their success. In the face of highly complex public health challenges, partnerships with ICTHP are critical.

Collaborative and integrated working between general practice and community pharmacies: A realist review of what works, for whom, and in which contexts

OBJECTIVES

Collaborative and integrated (C + I) working between general practice and community pharmacies has the potential to increase accessibility to services, improve service efficiency and quality of care, and reduce health care expenditures. Many existing studies report challenges and complexities inherent in establishing effective C + I ways of working. The aim of our review is to understand how, when and why working arrangements between General Practitioners (GP) and Community Pharmacists (CP) can provide the conditions necessary for effective communication, decision-making, and C + I working.

METHODS

We conducted a realist review to explore the key contextual factors and mechanisms through which GP-CP C + I working may be achieved. MEDLINE, Embase, CINAHL, PsycINFO, HMIC, Web of Science, IBSS, ASSIA, Sociological Abstracts, Sociology Database and the King's Fund Library Database were searched for articles and grey literature published between January 2000 and April 2022.

RESULTS

A total of 136 documents were included in the final synthesis. Our findings highlight the importance of mutually beneficial remuneration models to support effective integration of services; supportive organisational cultures and values; flexible and agile IT systems/technologies; adequate physical infrastructure and space design to support multidisciplinary teamworking; the importance of establishing patient's trust in collaborative processes between GP-CP; and the need to acknowledge, support and utilise effective triadic relationships.

CONCLUSIONS

Our research generates new insights regarding how, why and in which contexts C + I working can be achieved between GPs and CPs. The findings of our review can be used to inform future policy, research and clinical practice guidelines for designing and delivering C + I care.

Enhancing the experience and outcomes of children with complex care needs in acute paediatric settings: a realist review protocol

INTRODUCTION

The number of babies, children and young people with complex care needs (henceforth children with complex care needs (CCCN)) in England has increased in recent decades, and this has also been recognised globally. CCCN may have frequent and lengthy hospital admissions, but during these episodes, their needs are not always met, potentially resulting in suboptimal experiences and outcomes. Despite increased numbers of CCCN accessing acute care and displaying greater complexity, much of the contemporary literature has focused on primary care coordination between health, education and social care. Research specifically focused on CCCN in the acute care setting is largely absent. This realist review aims to understand how optimal experience and outcomes are achieved for CCCN during acute care, in different settings, for whom and why.

METHODS AND ANALYSIS

This realist review will proceed through six steps: (1) clarifying the scope of the review, (2) searching for evidence, (3) data selection and quality appraisal, (4) data extraction, (5) analysis and synthesis and (6) dissemination. We will search Medline, Cumulated Index in Nursing and Allied Health Literature and PsycINFO, alongside grey literature and other sources and will carry out citation tracking. Patient and public involvement and engagement have aided in the development of this protocol and will be maintained through regular consultations with a stakeholder group throughout the review. The review will result in a programme theory which will include context-mechanism-outcome configurations and provide data to support claims of generative causation.

ETHICS AND DISSEMINATION

Ethical approval is not required for this review as it does not involve primary research. The programme theory developed will be disseminated through peer-reviewed publications and relevant conferences. It will subsequently inform the development of an intervention to improve acute care for CCCN.

PROSPERO REGISTRATION NUMBER

CRD42024591231.

Exploration of trust in participatory health research partnerships across two timepoints: a network approach

BACKGROUND

The value of a participatory approach to the generation of evidence for health and social services from a moral, methodological and policy level continues to gain recognition globally. Trust is a crucial mechanism in the participatory health research (PHR) process and is strongly influenced by context. However, gaps remain in conceptualising and operationalising trust over time in PHR partnerships.

OBJECTIVE

This case study seeks to address these gaps by exploring the evolution of trust multidimensionally across two timepoints.

SETTING AND PARTICIPANTS

Participants in a PHR project called the Public and Patient Involvement (PPI) Ignite Network in Ireland (n=57 (T1); n=56 (T2)) were invited to complete a network survey at two timepoints. The PPI Ignite Network had local and national partners.

NETWORK MEASURES

Several core social network measures were calculated at both timepoints to characterise the differences between trust dimensions and between local and national partners.

RESULTS

Subtle changes were observed across most network measures over the two timepoints. While there was a slight decrease in the number of connections for each trust dimension throughout the PPI Ignite Network, connections that were consistently nominated in both timepoints increased slightly. Some trust dimensions, such as vulnerability and integrity, were more similar, while others, like integrity and shared values, visions and goals, differed greatly, where national partners consistently received more incoming connections compared with local partners.

CONCLUSION

These findings (1) provide empirical support for using social network analysis to operationalise trust comprehensively and multidimensionally over time in a participatory partnership, (2) offer nuanced insights into the trust development process within the PPI Ignite Network and (3) enhance our understanding of trust in the community-based participatory research model.

A scoping review of the roles of stakeholders and coordination mechanisms for enhanced multi-sectoral and multi-level interventions in COVID-19 response in Nigeria

BACKGROUND

Collaboration among multiple stakeholders from different sectors requires a coherent coordination mechanism in implementing responses to public health emergencies such as coronavirus disease 2019 (COVID-19) to improve the effectiveness and efficiency of countermeasures against the pandemic. The paper describes multi-stakeholder roles and the coordination mechanisms that were used at different levels of government in the COVID-19 response in Nigeria.

METHODS

A scoping review of documents on COVID-19 was undertaken between March 2021 and October 2022. Databases including Google Scholar, PubMed, Medline and Google were searched using "COVID-19", "Nigeria", "response" and "government" as the keywords. We included articles published from 30 January 2020 to 1 October 2022. The literature was extracted into Excel spreadsheets and analysed using the adapted WHO framework for multi-stakeholder preparedness coordination.

RESULTS

A total of 173 documents were reviewed. The review revealed that various stakeholders (state and non-state actors) at national and sub-national levels played complementary roles in the implementation of different countermeasures to COVID-19 in Nigeria. The multi-sectoral response to COVID-19 in Nigeria was coordinated through the Presidential and State Task Force Teams. However, there were very weak linkages between and across different task forces. In addition, the expert and advisory committees at national and sub-national levels apparently functioned independently without lines of communication amongst them to encourage information sharing and learning. More so, the processes of coordination of different actors and their activities were fragmented and constrained by poor communication of policies among stakeholders, poor planning and contextualization of response strategies, lack of data for evidence-informed planning and lack of accountability.

CONCLUSIONS

The coordination of multi-stakeholders and multi-sectoral response to COVID-19 at national and sub-national levels in Nigeria was weak. A systematic coordination framework involving multiple stakeholders working at varying capacities is needed for effective and efficient response during pandemics such as COVID-19, to reduce duplication of efforts, inequitable resource allocation and wastage of resources and time. It is recommended that a future systematic coordination framework and guidelines involve multiple stakeholders, including the private and non-health public sectors, working at varying capacities and levels, to ensure an effective and efficient response during pandemics.

Use of Rapid Qualitative Analysis to Support Collaborative Synergy Within a Community Coalition for Health Equity in Detroit

Introduction

A community coalition is an effective strategy for addressing complex health challenges. A citywide coalition of community and academic experts was formed to address Detroit's persistent health disparities. To foster collaborative synergy, we explored hyperlocal perspectives on health equity by applying rapid qualitative analysis (RQA) as a time-efficient and rigorous approach.

Methods

Twenty coalition members completed a key informant interview addressing five key areas: health equity meanings, Detroit's most pressing health problems, social ecological domains that influence health equity and outcomes, and strategies to achieve health equity. We used RQA to interpret interview data.

Results

Participants were majority female, Black/African American, and over 60 years old. Participants defined health equity as equal access to opportunities for a healthy life and emphasized the importance of individual choice in pursuing those opportunities. As an indication of their awareness of social determinants of health, participants articulated connections between various social ecological factors and health outcomes.

Discussion

This study highlights participants' recognition of both systemic factors and personal agency in achieving health equity, indicating their nuanced understanding of the complex interplay between social structures and individual health, which is crucial for community-driven multilevel health interventions. Furthermore, by fostering better communication and alignment, RQA is an efficient and effective method to enhance coalition synergy.

Health Equity Implications

By facilitating a shared understanding of health equity and its determinants, RQA can help coalitions ensure inclusion and integration of diverse perspectives in intervention planning and delivery, particularly in urban settings facing similar challenges.

Critical elements of successful partnership in public health-A case study

ISSUE ADDRESSED

Intersectoral action is integral in promoting population health and health equity. In South Australia, public health partnership authorities (PHPAs) are one mechanism to promote intersectoral collaboration for addressing complex public health issues. This case study examined contemporary evidence on the critical elements of successful partnerships, explored the role of formalisation in success, and examined how identified critical elements were operationalised over time in an existing PHPA.

METHODS

In the first phase, a scoping review was conducted. The second phase was a retrospective longitudinal case study of a government-academic PHPA agreement, involving partnership document review and key informant interviews. Data triangulation and iterative thematic analysis were performed.

RESULTS

The critical elements of successful partnership, triangulated through multiple data sources, are mutuality, governance, communication, resources, leadership, and interactions and relationships. These elements have a high degree of interdependence. Trust supports and is reinforced by these elements, particularly during times of change or crisis. Formalisation of a partnership supports success in many ways but is insufficient on its own.

CONCLUSION

Operating in dynamic environments, a partnership requires dedicated time and effort to be successful. Attention to the strength and interconnectedness of the critical elements over the course of a partnership is crucial. SO WHAT?: This case study describes how the elements of successful partnership can be applied to progress beyond transactional relationships towards authentic collaboration and overcome cross-border and cross-boundary public health challenges to promote population health and well-being.

Evaluation of a Participatory Action Project to Address Opioid Misuse: Breaking Down Barriers Through Partnership Processes

Community based participatory research and participatory action research are increasingly being used to engage communities in addressing social and health disparities. There is a need to develop broadly applicable evaluation methods that can be used across participatory project environments to identify the processes critical for addressing complex public health issues, as well as the productiveness of community research partnerships. We present a case study of a community participatory project conducted over three years and our evaluation approach. We used the Community Based Participatory Research Conceptual Model as the framework for the evaluation surveys (n=9) and interviews (n=7) with project participants, querying perspectives on the four model domains: community context, partnership processes, intervention and research and outcomes. In addition, we conducted a Ripple Effects Mapping (REM) exercise with ten community members to determine the broader impacts of the project on the community. This mixed-methods approach permitted us to confirm findings from quantitative surveys with qualitative findings from interviews and the REM. Key processes identified as facilitators to a productive partnership and positive outcomes include a context of trust, effective implementation of processes that establish equitable partner relationships and partnership synergy, a clearly defined focus for the partnership and a structured participatory research method that helped break down silos and mobilise the community for action. Our project evaluation approach, combining the CBPR model and REM, guided measurement of common metrics that are key to effective community engagement as well as exploration of unanticipated outcomes.

Appreciating the Complexity of Local Gender-Based Violence Needs Assessments: Some Key Considerations and Tensions in Context

Needs assessments can be a pragmatic method to shape interventions addressing gender-based violence. They are complex endeavors even-or especially-at the local level (e.g., rape crisis centers, domestic violence shelters). Focusing on the US context, we highlight examples of the ways needs assessments can support the gender-based violence movement, and key tensions and considerations within needs assessment practice. We explore decisions that practitioners make when pursuing needs assessments and highlight conceptual and design considerations. We also provide a general discussion of needs assessment approaches. This paper aims to support nascent practitioner and researcher/evaluator work in gender-based violence needs assessments.

Realist process evaluation of the knowledge translation programme of a patient-oriented research network

RATIONALE

The Knowledge Translation (KT) Programme of a pan-Canadian strategic patient-oriented research network focused on brain-based developmental disabilities aimed to mobilize knowledge relevant to the network members. The programme also promotes and studies integrated Knowledge Translation (iKT) approaches involving different interested parties, such as researchers, patient-partners and decision-makers, in all parts of the knowledge creation process.

AIMS AND OBJECTIVES

The objective of this study is to advance research programme evaluation methods through a realist evaluation of the process of implementing iKT activities.

METHODS

Realist process evaluation included: (1) development of initial programme theories (using the partnership synergy theory); (2) data collection and analysis; (3) synthesis and refinement of theories through engagement with literature; and (4) presentation of findings in context-mechanism-outcome (C-M-O) configurations. A range of project documentation records were reviewed for analysis, and three co-leads, a programme coordinator, and a senior research associate were consulted to contextualize the implementation process of relevant KT activities.

RESULTS

Based on the developed C-M-O configurations, we identified five key mechanisms of generating synergy in the iKT processes: (1) Visible shared leadership that embodies what iKT looks like; (2) Researchers' readiness for iKT; (3) Adaptation and flexible allocation of resources to emerging needs; (4) Power sharing to create practical and creative knowledge; and (5) Collective voice for potential transformative impacts at the policy level.

CONCLUSIONS

The current realist evaluation demonstrated how partnerships between researchers, patient-partners and other interested parties can synergistically generate new ways of thinking among all interested parties, actionable strategies to integrate users in research, and solutions to disseminate knowledge. In particular, we identified a pivotal role for patient-partners to act as equal decision-maker helps building and maintaining partnerships and consolidating KT strategies.

A practical approach to multifaceted perspectives for sustainable international collaboration on mosquito-borne diseases in Southeast Asia

The coronavirus disease 2019 pandemic highlighted the necessity and limitations of scientific collaboration and equitable and effective international research partnerships. The spread of mosquito-borne diseases (MBDs) presents severe public health challenges, particularly in Southeast Asia. Addressing these threats requires establishing regional priorities, bridging research gaps, and strengthening long-term international collaboration. We propose a practical approach to multifaceted perspectives to enhance collaboration across Asia. This study examines MBD-related scientific publications from nine Southeast Asian countries between January 2017 and June 2024, utilizing bibliometric analysis and data visualization to identify research trends, research capacities, key institutions, and international collaborative partners. Thailand and Singapore led the dengue research, followed by Malaysia and Indonesia. Vietnam and the Philippines demonstrated moderate research capabilities, whereas Cambodia, Laos, and Myanmar had lower capacities. Relationships with high-income countries drove international collaboration, whereas intra-regional collaboration in Southeast Asia increased. Furthermore, we identified directions for cooperative opportunities between South Korea and other Southeast Asian countries by analyzing their relative research capacities for infectious MBDs. We propose a practical approach to bridge research-capacity gaps and strengthen collaboration between low- and middle-income countries. These findings provide fundamental information for developing future infectious-disease-response strategies and international-collaboration research partnerships and facilitate the implementation of effective global public health preparedness policies and evidence-based decision-making, such as knowledge-transfer and resource-sharing.

Breaking Down Silos in the Workplace: A Framework to Foster Collaboration

INTRODUCTION

Employees are often placed within an organization based on their respective roles or duties, which can lead to vertical and horizontal organizational silos. Organizational silos may restrict information, resources, and stymie progress and innovation. This analysis presents a framework to mitigate silos and overcome communication barriers within an organization by increasing collaboration.

METHODS

The project team examined results from the Centers for Disease Control and Prevention (CDC), the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) 2020 Employee Viewpoint Survey Results and conducted 19 key informant discussions with NCCDPHP employees. Participants were asked to provide feedback on (1) understanding silos in the workplace and (2) best practices for reducing silos and fostering collaboration. A thematic analysis was conducted to understand organizational silos, the motivation to reduce silos, and identify best practices and strategies.

RESULTS

Respondents felt that siloing exists at the division and branch levels; however, 95% of respondents were motivated to reduce silos. Fifty-eight percent of respondents identified that institutional factors such as the organizational structure (n = 8) and red tape/bureaucracy (n = 3) contribute to siloing. Additional behaviors and actions that perpetuate silos were identified, and efforts to reduce silos were categorized to propose a model: Framework to Foster Collaboration for improving organizational collaborative efforts.

DISCUSSION AND CONCLUSION

Key themes included inclusion, shared goals and vision, bi-directional communication, and relationship building and developing trust as critical elements for improving collaboration and creating synergy across teams in efforts to reduce silos in the workplace.

Youth Engagement Synergy in Mental Health Legislation and Programming

Youth engagement in implementing mental health legislation and programming is an intuitive best practice. However, well-intentioned efforts to work inclusively with youth are often perfunctory. Drawing from select community partnership models and insights from providers, public health advisors, and youth, we examine the typology, processes, and outcomes of youth engagement. We critically apply the theory of partnership synergy to understand how the convergence of youth and adult experiences and knowledge can advance mental health programming beyond what could be achieved by a single group.

Integration of primary care and palliative care services to improve equality and equity at the end-of-life: Findings from realist stakeholder workshops

BACKGROUND

Inequalities in access to palliative and end of life care are longstanding. Integration of primary and palliative care has the potential to improve equity in the community. Evidence to inform integration is scarce as research that considers integration of primary care and palliative care services is rare.

AIM

To address the questions: 'how can inequalities in access to community palliative and end of life care be improved through the integration of primary and palliative care, and what are the benefits?'

DESIGN

A theory-driven realist inquiry with two stakeholder workshops to explore how, when and why inequalities can be improved through integration. Realist analysis leading to explanatory context(c)-mechanism(m)-outcome(o) configurations(c) (CMOCs).

FINDINGS

A total of 27 participants attended online workshops (July and September 2022): patient and public members (n = 6), commissioners (n = 2), primary care (n = 5) and specialist palliative care professionals (n = 14). Most were White British (n = 22), other ethnicities were Asian (n = 3), Black African (n = 1) and British mixed race (n = 1). Power imbalances and racism hinder people from ethnic minority backgrounds accessing current services. Shared commitment to addressing these across palliative care and primary care is required in integrated partnerships. Partnership functioning depends on trusted relationships and effective communication, enabled by co-location and record sharing. Positive patient experiences provide affirmation for the multi-disciplinary team, grow confidence and drive improvements.

CONCLUSIONS

Integration to address inequalities needs recognition of current barriers. Integration grounded in trust, faith and confidence can lead to a cycle of positive patient, carer and professional experience. Prioritising inequalities as whole system concern is required for future service delivery and research.

Building Cross-sectoral Collaborations to Address Perinatal Health Inequities: Insights From the Dutch Healthy Pregnancy 4 All-3 Program

BACKGROUND

Addressing perinatal health inequities is the joint responsibility of professionals working for local governments, the medical, social, and public health sector. Cross-sectoral collaboration between these professionals is challenging. For such collaborations to succeed, a transition, ie, a fundamental shift in the dominant structure, culture, and practices at the systems level, is necessary. We investigated facilitators and barriers for cross-sectoral collaborations, when addressing perinatal health inequities in the Netherlands. Additionally, we studied how cross-sectoral collaborations can be facilitated by action research.

METHODS

We used interview and questionnaire data of the Healthy Pregnancy 4 All-3 (HP4All-3) program, which resulted from action research in six Dutch municipalities. All interviews were coded using open codes related to facilitators and barriers for cross-sectoral collaboration and categorized into three subgroups: structural, cultural, or practical. The answers to the questionnaire were analyzed and summarized quantitatively.

RESULTS

We conducted 53 interviews with a total of 81 professionals. The most important ingredients for cross-sectoral collaborations mentioned by the interviewees were: (1) structural: having a solid network with a clear overview of professionals working in the different sectors, (2) cultural: having a joint vision/goal, and (3) practical: short lines of communication and timely sharing of information. A total of 85 professionals filled in (parts of) the questionnaire. Two-thirds to over 80 percent replied that the HP4All-3 program had an added value in building cross-sectoral collaborations.

CONCLUSION

Our research shows that cross-sectoral collaborations in the context of perinatal health are hampered by structural, cultural, and practical barriers. Analyzing facilitators and barriers at these three levels helps to identify bottlenecks in cross-sectoral collaboration. Action researchers can be of great advantage in facilitating collaboration, as they can offer an open setting for reflection and instigate a sense of urgency for building collaborations.

Challenges of biomedical research collaboration in India: Perceptions of Indian and international researchers

Biomedical research collaborations are to be contextualized in the larger global health agenda which also opens up new information pathways, expands research networks, and brings additional resources. A qualitative inquiry was employed to understand the perceived benefits and challenges of research collaborations by biomedical scientists from India (Global South [GS] country) and the Global North (GN). In-depth interviews were conducted with 47 biomedical scientists from India and 06 from the GN. The data was analyzed using the grounded theory approach. Complementarity of skills and resources, access to funds, improved quality of work, an opportunity to conduct multi-centric studies, development of collaborative networks, better and larger number of publications, mutual learning, opportunity to work with credible researchers, address common interests, leverage interpersonal and trusted relationships and larger societal good were some of the critical factors for eagerness of participants in joint scientific endeavors. However, the challenging aspects of dissent and disagreements were the power imbalance between the collaborators, the development of a trust deficit, and local administrative issues. The challenges reported in the current publication, also echoed in several previous publications can be surmounted and negotiated amicably when the rules of the game, law of the land, sharing of the credits, and interest of the collaborating parties are addressed and agreed up in a fair and just manner before the start of the collaboration. Overall biomedical partnerships are complex collaborations with its challenges, the processes are dynamic and outcomes are emergent. This requires constant and proactive evolution of the preparation, implementation and sustainability of the collaborative efforts be it national or international.

Examining the creation of synergy in community coalitions for smoke-free environments in Armenia and Georgia

Community coalitions depend on their members to synergistically pool diverse resources, including knowledge and expertise, community connections and varied perspectives, to identify and implement strategies and make progress toward community health improvement. Several coalition theories suggest synergy is the key mechanism driving coalition effectiveness. The Community Coalition Action Theory (CCAT) asserts that synergy depends on how well coalitions engage their members and leverage their resources, which is influenced by coalition processes, member participation and satisfaction and benefits outweighing costs. The current study used mixed methods, including coalition member surveys (n = 83) and semi-structured interviews with leaders and members (n = 42), to examine the process of creating collaborative synergy in 14 community coalitions for smoke-free environments in Armenia and Georgia. Members, typically seven per coalition representing education, public health, health care and municipal administration sectors, spent an average of 16 hr/month on coalition-related work. Common benefits included making the community a better place to live and learning more about tobacco control. The greatest cost was attending meetings or events at inconvenient times. Members contributed various resources, including their connections and influence, skills and expertise and access to population groups and settings. Strong coalition processes, greater benefits and fewer costs of participation and satisfaction were correlated with leveraging of member resources, which in turn, was highly correlated with collaborative synergy. Consistent with CCAT, effective coalition processes created a positive climate where membership benefits outweighed costs, and members contributed their resources in a way that created collaborative synergy.

Music Therapy in the Neonatal Intensive Care Unit: A Center's Experience with Program Development, Implementation, and Preliminary Outcomes

BACKGROUND

The role of music in the NICU continues to evolve, with recent studies documenting the positive impact of music therapy for hospitalized infants and families. With many potential benefits and no substantial adverse effects reported to date in medically stable infants, we aimed to create a clinical guideline to integrate this therapy into the NICU operations.

METHODS

we launched and implemented a pilot music therapy clinical program within a subunit of a level-III NICU, building upon available evidence.

RESULTS

In this report, we describe our experience with initial program development and early outcomes in terms of population served, frequency of music therapy, and therapeutic modalities employed to implement service delivery.

CONCLUSION

we highlight the importance of establishing practices that are aligned with currently available data and recommendations, in order to facilitate delivery of a safe, evidence-based, meaningful therapeutic experience with monitoring of preliminary effects of the therapy on all those involved in the experience.

Trust-building in temporary public health partnerships: a qualitative study of the partnership formation process of a Covid-19 test, trace and protect service

BACKGROUND

Public health initiatives require coordinated efforts from healthcare, social services and other service providers. Organisational theory tells us that trust is essential for reaching collaborative effectiveness. This paper explores the drivers for initiating and sustaining trust in a temporary public health partnership, in response to a sudden health threat.

METHODS

This qualitative study analysed the formation process of a multisector partnership for a Covid-19 contact tracing service. Data was collected through 12 interviews, two focus groups, one feedback workshop, and an online survey with workforce members from all seven partner organisations. Purposive maximum variation sampling was used to capture the reflections and experiences of workforce members from all seven partner organisations. A deductive code scheme was used to identify drivers for building and sustaining trust in inter-organisational collaboration.

RESULTS

Relational mechanisms emanating from the commitment to the common aim, shared norms and values, and partnership structures affected trust-building. Shared values and the commitment to the common aim appeared to channel partners' behaviour when interacting, resulting in being perceived as a fair, reliable and supportive partner. Shared values were congruent with the design of the partnership in terms of governance structure and communication lines reflecting flat hierarchies and shared decision-making power. Tensions between partner organisations arose when shared values were infringed.

CONCLUSIONS

When managing trust in a collaboration, partners should consider structural components like governance structure, organisational hierarchy, and communication channels to ensure equal power distribution. Job rotation, recruitment of candidates with the desired personality traits and attitudes, as well as training and development, encourage inter-organisational networking among employees, which is essential for building and strengthening relationships with partner organisations. Partners should also be aware of managing relational dynamics, channelling behaviours through shared values, objectives and priorities and fostering mutual support and equality among partner organisations.

Unravelling collaborative governance dynamics within healthcare networks: a scoping review

In many countries, healthcare systems suffer from fragmentation between hospitals and primary care. In response, many governments institutionalized healthcare networks (HN) to facilitate integration and efficient healthcare delivery. Despite potential benefits, the implementation of HN is often challenged by inefficient collaborative dynamics that result in delayed decision-making, lack of strategic alignment and lack of reciprocal trust between network members. Yet, limited attention has been paid to the collective dynamics, challenges and enablers for effective inter-organizational collaborations. To consider these issues, we carried out a scoping review to identify the underlying processes for effective inter-organizational collaboration and the contextual conditions within which these processes are triggered. Following appropriate methodological guidance for scoping reviews, we searched four databases [PubMed (n = 114), Web of Science (n = 171), Google Scholar (n = 153) and Scopus (n = 52)] and used snowballing (n = 22). A total of 37 papers addressing HN including hospitals were included. We used a framework synthesis informed by the collaborative governance framework to guide data extraction and analysis, while being sensitive to emergent themes. Our review showed the prominence of balancing between top-down and bottom-up decision-making (e.g. strategic vs steering committees), formal procedural arrangements and strategic governing bodies in stimulating participative decision-making, collaboration and sense of ownership. In a highly institutionalized context, the inter-organizational partnership is facilitated by pre-existing legal frameworks. HN are suitable for tackling wicked healthcare issues by mutualizing resources, staff pooling and improved coordination. Overall performance depends on the capacity of partners for joint action, principled engagement and a closeness culture, trust relationships, shared commitment, distributed leadership, power sharing and interoperability of information systems To promote the effectiveness of HN, more bottom-up participative decision-making, formalization of governance arrangement and building trust relationships are needed. Yet, there is still inconsistent evidence on the effectiveness of HN in improving health outcomes and quality of care.

Developing and Evaluating a Data-Driven and Systems Approach to Health Promotion Among Vocational Students: Protocol for the Data Health Study

BACKGROUND

Vocational school students exhibit significant risk behaviors in terms of poor diet, frequent use of nicotine products, inadequate fruit and vegetable intake, low levels of physical activity, and poor mental health. This makes vocational students vulnerable to the development of noncommunicable diseases. Therefore, effective health promotion programs targeting vocational students are required.

OBJECTIVE

The Danish study "Data-driven and Systems Approach to Health Promotion Among Vocational Students" (Data Health) aims to develop, implement, and evaluate a systems approach to support vocational schools, municipalities, and local communities in implementing locally relevant health promotion actions among and for vocational students. This paper describes the Data Health program and how implementation and preliminary effectiveness will be evaluated.

METHODS

The Data Health program offers an iterative 5-step process to develop changes in the systems that shape health behavior and well-being among vocational students. The program will be implemented and evaluated in 8 Danish vocational schools in 4 municipalities. The implementation of the process and actions will be explored using a systems-based evaluation design that assesses contextual differences and the mechanisms through which the program leads to changes in the systems. Preliminary effectiveness at the individual level (students' self-reported health behavior and well-being) and organizational level (school organizational readiness reported by school staff) will be assessed using a quasi-experimental design, and cross-sectional data will be collected at all 8 schools simultaneously 4 times during the 2-year study period.

RESULTS

This study was launched in 2021, and data collection is expected to be completed in June 2024. The first results are expected to be submitted for publication in January 2024.

CONCLUSIONS

We expect that the Data Health study will make significant contributions to complex intervention research by contributing to the paucity of research studies that have used systems approaches in school settings. The study will also provide evidence of successful elements for systems change and effectiveness to determine whether a national scale-up can be recommended.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05308459; https://clinicaltrials.gov/study/NCT05308459.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/52571.

Alliance-building for equity and justice: An inter-organizational perspective

Cultivating alliances between specific sectors or fields with unrealized synergies is a promising strategy for systems change. Social network analysis is a useful tool for assessing whether such alliances build relationships between these previously disparate organizations. Two waves of valued network data were collected from the members (N = 25) of a justice system reform coalition composed of two types of community-based organizations: those involved in restorative justice practice and those involved in grassroots community organizing. Social network homophily analyses were employed to characterize the impact of alliance participation on relationships over time across three domains: working together, doing impactful work together, and sharing a philosophy about justice system reform. Results indicate marked increases in the prevalence of relationships between restorative justice and community organizing organizations across all domains, with the greatest increases occurring in perceptions of shared philosophy. Network structures at each time point differed by relational domain and organization type. Findings suggest that the alliance strengthened relationships between restorative justice and community organizing organizations, particularly in perceptions of shared philosophy, but that the magnitude of these changes varied depending on pre-existing interorganizational relationships and organization type. Findings challenge the idea that close working relationships between diverse members is critical to coalition effectiveness, pointing instead to the value of ambidextrous networks and alignment in members' philosophy and vision.

Preparation for implementation of evidence-based practices in urban schools: A shared process with implementing partners

Background

Shifting organizational priorities can negatively affect the sustainment of innovations in community settings. Shifting priorities can present barriers to conducting clinical research in schools if a misalignment occurs between school district priorities and the aims of the study. Often this misalignment occurs due to a shift during the period between when the study is submitted for funding and when research activities begin. Participatory research approaches can be employed to restore alignment between study processes and school district priorities. The purpose of the study is to describe data from a shared process with district partners. The shared process resulted in modifications to the main study's implementation processes and strategies in order to restore alignment with evolving school priorities while remaining faithful to the aims of the study.

Method

Data originated from qualitative interviews conducted with 20 school district and school personnel in a large urban school district. Qualitative themes were organized into categories based on a social-ecological school implementation framework. Data from team meetings, meetings with school district administrators, and emails served to supplement and verify findings from interview analyses.

Results

Themes included barriers and facilitators at the macro-, school-, individual-, team-, and implementation quality levels. Adaptations were made to address barriers and facilitators and restore alignment with school district priorities. Most adaptations to study processes and implementation strategies focused on re-training and providing more information to school district coaches and school-based staff. New procedures were created, and resources were re-allocated for the larger study.

Conclusions

Findings were discussed in relation to the implementation literature in schools. Recommendations for sustaining strong collaboration among researchers and school partners are provided.

Building Community Engagement Capacity in a Transdisciplinary Population Health Research Consortium

Community engagement has been named a research priority by the National Institutes of Health, and scholars are calling for community engagement as an approach to address racism and equity in science. Robust community-engaged research can improve research quality, increase inclusion of traditionally marginalized populations, broaden the impact of findings on real-life situations, and is particularly valuable for underexplored research topics. The goal of this paper is to describe lessons learned and best practices that emerged from community engagement in a multi-institution population health research consortium. We describe how a foundation was laid to enable community-engaged research activities in the consortium, using a staged and stepped process to build and embed multi-level community-engaged research approaches.. We staged our development to facilitate (a) awareness of community engagement among consortium members, (b) the building of solidarity and alliances, and (c) the initiation of long-term engagement to allow for meaningful research translation. Our stepped process involved strategic planning; building momentum; institutionalizing engagement into the consortium infrastructure; and developing, implementing, and evaluating a plan. We moved from informal, one-time community interactions to systematic, formalized, capacity-building reciprocal engagement. We share our speed bumps and troubleshooting that inform our recommendations for other large research consortia-including investing the time it takes to build up community engagement capacity, acknowledging and drawing on strengths of the communities of interest, assuring a strong infrastructure of accountability for community engagement, and grounding the work in anti-racist principles.

A scoping review of the globally available tools for assessing health research partnership outcomes and impacts

BACKGROUND

Health research partnership approaches have grown in popularity over the past decade, but the systematic evaluation of their outcomes and impacts has not kept equal pace. Identifying partnership assessment tools and key partnership characteristics is needed to advance partnerships, partnership measurement, and the assessment of their outcomes and impacts through systematic study.

OBJECTIVE

To locate and identify globally available tools for assessing the outcomes and impacts of health research partnerships.

METHODS

We searched four electronic databases (Ovid MEDLINE, Embase, CINAHL + , PsychINFO) with an a priori strategy from inception to June 2021, without limits. We screened studies independently and in duplicate, keeping only those involving a health research partnership and the development, use and/or assessment of tools to evaluate partnership outcomes and impacts. Reviewer disagreements were resolved by consensus. Study, tool and partnership characteristics, and emerging research questions, gaps and key recommendations were synthesized using descriptive statistics and thematic analysis.

RESULTS

We screened 36 027 de-duplicated citations, reviewed 2784 papers in full text, and kept 166 studies and three companion reports. Most studies originated in North America and were published in English after 2015. Most of the 205 tools we identified were questionnaires and surveys targeting researchers, patients and public/community members. While tools were comprehensive and usable, most were designed for single use and lacked validity or reliability evidence. Challenges associated with the interchange and definition of terms (i.e., outcomes, impacts, tool type) were common and may obscure partnership measurement and comparison. Very few of the tools identified in this study overlapped with tools identified by other, similar reviews. Partnership tool development, refinement and evaluation, including tool measurement and optimization, are key areas for future tools-related research.

CONCLUSION

This large scoping review identified numerous, single-use tools that require further development and testing to improve their psychometric and scientific qualities. The review also confirmed that the health partnership research domain and its measurement tools are still nascent and actively evolving. Dedicated efforts and resources are required to better understand health research partnerships, partnership optimization and partnership measurement and evaluation using valid, reliable and practical tools that meet partners' needs.

Development and Validation of a Measure to Assess Readiness to Advance Health and Equity: The Assessment for Advancing Community Transformation (AACT)

Multi-sector partnerships are core in efforts to improve population health but are often not as fully developed or positioned to advance health and equity in their communities as believed to be. Therefore, measuring the collaborations multi-sector partnerships undertake is important to document the inputs, processes, and outcomes that evolve as they work together towards achieving their goals, which ultimately creates a greater sense of shared accountability. In this study we present the development and validation of the Assessment for Advancing Community Transformation (AACT), a new tool designed to measure readiness to advance health and health equity. Development of the AACT included initial item pool creation, external evaluation from five subject matter experts, and pilot testing (including user feedback surveys) among 103 individuals. Validation of the AACT was performed using a series of confirmatory factor analyses on an expanded dataset representing 352 individuals from 49 multi-sector collaboratives across the United States. The results of our study indicate the items in the AACT align to six domains created during the scale development process, and that the tool demonstrates desirable measurement characteristics for use in research, evaluation, and practice.

A collective autoethnography of coproduction in mental health research by academic researchers and young people in Brazil

INTRODUCTION

Coproduction of mental health research and interventions involving researchers and young people is increasingly common. However, this model raises challenges, related, for instance, to communication, power and control. This paper narrates-from a collective first-person perspective-the lived experience of coproduction of a digital intervention by institutional researchers and young citizen researchers in Brazil.

METHOD

This study employed a collaborative autoethnographic methodology, utilising autobiographical data such as meeting recordings, individual notes and collective guided reflections on the coproduction process. Our analysis focused on challenges and solutions that arose during the process.

RESULTS

Throughout the project, we created formal and informal mechanisms for accountability, transparency and fair inclusion of multiple voices. We engaged in mutual capacity-building, invested in building interpersonal knowledge, and implemented practices to reduce overload and promote equitable participation. Through ongoing reflection and readjustment in response to challenges, we progressively embraced more democratic and egalitarian values. The collective care invested in the process fostered synergy, trust, and intergroup friendship.

CONCLUSION

Our experience points to the value of creating a space for multiple research identities: the citizen young person and the institutional researcher, both of whom critically reflect on their roles in the research process. Our focus on coproduced care calls into question participation metaphors that represent the process via a single axis-young people-who linearly progress from minimal participation to full autonomy. Instead, our analysis highlights the importance of a social and caring bond that supports the radical co-production of innovative health solutions in contexts of vulnerability.

Equilibrium in the governance of cross-sectoral policies: how does it translate into practice?

BACKGROUND

There is growing interest from health researchers in the governance of Health in All Policies (HiAP). Furthermore, the COVID-19 pandemic has re-ignited managers' interest in HiAP governance and in health prevention activities that involve actors from outside health ministries. Since the dynamics of these multi-actor, multi-sectoral policies are complex, the use of systems theory is a promising avenue toward understanding and improving HiAP governance. We focus on the concept of equilibrium within systems theory, especially as it points to the need to strike a balance between actors that goes beyond synergies or mimicry-a balance that is essential to HiAP governance.

METHOD

We mobilized two sources of data to understand how the concept of equilibrium applies to HiAP governance. First, we reviewed the literature on existing frameworks for collaborative governance, both in general and for HiAP specifically, in order to extract equilibrium-related elements. Second, we conducted an in-depth case study over three years of an HiAP implemented in Quebec, Canada.

RESULTS

In total, we identified 12 equilibrium-related elements relevant to HiAP governance and related to knowledge, actors, learning, mindsets, sustainability, principles, coordination, funding and roles. The equilibria were both operational and conceptual in nature.

CONCLUSIONS

We conclude that policy makers and policy implementers could benefit from mobilizing these 12 equilibrium-related elements to enhance HiAP governance. Evaluators of HiAP may also want to consider and integrate them into their governance assessments.

Community coalitions for smoke-free environments in Armenia and Georgia: A mixed methods analysis of coalition formation, implementation and perceived effectiveness

Effective models for aligning public health and civil society at the local level have the potential to impact various global health issues, including tobacco. Georgia and Armenia Teams for Healthy Environments and Research (GATHER) is a collaboration between Armenia, Georgia and U.S. researchers involving a community randomized trial testing the impact of community coalitions to promote smoke-free policy adoption and compliance in various settings. Community Coalition Action Theory (CCAT) was used to guide and describe coalition formation, implementation and effectiveness. Mixed methods were used to evaluate 14 municipality-based coalitions in Georgia and Armenia, including semi-structured interviews (n = 42) with coalition leaders and active members, coalition member surveys at two timepoints (n = 85 and n = 83), and review of action plans and progress reports. Results indicated successful creation of 14 multi-sectoral coalitions, most commonly representing education, public health, health care, and municipal administration. Half of the coalitions created at least one smoke-free policy in specific settings (e.g., factories, parks), and all 14 promoted compliance with existing policies through no-smoking signage and stickers. The majority also conducted awareness events in school, health care, and community settings, in addition to educating the public about COVID and the dangers of tobacco use. Consistent with CCAT, coalition processes (e.g., communication) were associated with member engagement and collaborative synergy which, in turn, correlated with perceived community impact, skills gained by coalition members, and interest in sustainability. Findings suggest that community coalitions can be formed in varied sociopolitical contexts and facilitate locally-driven, multi-sectoral collaborations to promote health. Despite major contextual challenges (e.g., national legislation, global pandemic, war), coalitions were resilient, nimble and remained active. Additionally, CCAT propositions appear to be generalizable, suggesting that coalition-building guidance may be relevant for local public health in at least some global contexts.

Conflict and synergy in health promotion partnerships: a Danish case study

Intersectoral partnerships constitute a central approach in health promotion. By combining different perspectives, knowledge and resources from different sectors, partnerships are important for addressing complex health problems. When successful, intersectoral partnerships create synergy, which is suggested to be a proximal outcome that links partnership functioning to health effects. Nonetheless, partnerships are also difficult and time-consuming and may result in conflicts, hostility and power struggles. Such antagonist outputs are expected to produce negative results. However, conflicts may also be a source of valuable learning. This article explores the relationship between conflict and synergy in health promotion partnerships. The empirical material is derived from an evaluation of a 4-year Danish government partnership program. Data consist of survey data collected from 35 partnerships and in-depth qualitative case studies of 10 partnerships. The analysis was inspired by realist evaluation. The qualitative data were coded, and cases written up. Cross-case analysis was conducted and triangulated with survey data. Surprisingly, disagreements and conflicts of interests between partners were common and associated with synergy creation. Moreover, the partnerships' experiences of synergy were often linked to their attribution of differences rather than to common goals or value congruences. The study identifies that a potential for synergy lays in the productive confrontation between partners different perspectives. Moreover, a key mechanism enabling productive conflicts was inclusive dialog, in which the partners' differences were valued, and all voices were included. The study thus builds on the existing synergy literature and adds nuance to the understanding of conflicts in health promotion partnerships.

Towards achieving interorganisational collaboration between health-care providers: a realist evidence synthesis

Background

Interorganisational collaboration is currently being promoted to improve the performance of NHS providers. However, up to now, there has, to the best of our knowledge, been no systematic attempt to assess the effect of different approaches to collaboration or to understand the mechanisms through which interorganisational collaborations can work in particular contexts.

Objectives

Our objectives were to (1) explore the main strands of the literature about interorganisational collaboration and to identify the main theoretical and conceptual frameworks, (2) assess the empirical evidence with regard to how different interorganisational collaborations may (or may not) lead to improved performance and outcomes, (3) understand and learn from NHS evidence users and other stakeholders about how and where interorganisational collaborations can best be used to support turnaround processes, (4) develop a typology of interorganisational collaboration that considers different types and scales of collaboration appropriate to NHS provider contexts and (5) generate evidence-informed practical guidance for NHS providers, policy-makers and others with responsibility for implementing and assessing interorganisational collaboration arrangements.

Design

A realist synthesis was carried out to develop, test and refine theories about how interorganisational collaborations work, for whom and in what circumstances.

Data sources

Data sources were gathered from peer-reviewed and grey literature, realist interviews with 34 stakeholders and a focus group with patient and public representatives.

Review methods

Initial theories and ideas were gathered from scoping reviews that were gleaned and refined through a realist review of the literature. A range of stakeholder interviews and a focus group sought to further refine understandings of what works, for whom and in what circumstances with regard to high-performing interorganisational collaborations.

Results

A realist review and synthesis identified key mechanisms, such as trust, faith, confidence and risk tolerance, within the functioning of effective interorganisational collaborations. A stakeholder analysis refined this understanding and, in addition, developed a new programme theory of collaborative performance, with mechanisms related to cultural efficacy, organisational efficiency and technological effectiveness. A series of translatable tools, including a diagnostic survey and a collaboration maturity index, were also developed.

Limitations

The breadth of interorganisational collaboration arrangements included made it difficult to make specific recommendations for individual interorganisational collaboration types. The stakeholder analysis focused exclusively on England, UK, where the COVID-19 pandemic posed challenges for fieldwork.

Conclusions

Implementing successful interorganisational collaborations is a difficult, complex task that requires significant time, resource and energy to achieve the collaborative functioning that generates performance improvements. A delicate balance of building trust, instilling faith and maintaining confidence is required for high-performing interorganisational collaborations to flourish.

Future work

Future research should further refine our theory by incorporating other workforce and user perspectives. Research into digital platforms for interorganisational collaborations and outcome measurement are advocated, along with place-based and cross-sectoral partnerships, as well as regulatory models for overseeing interorganisational collaborations.

Study registration

The study is registered as PROSPERO CRD42019149009.

Funding

This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. 6. See the NIHR Journals Library website for further project information.

Definition and Conceptualization of Collaboration in Drug Rehabilitation: Systematic Synthesis and Comparison Using a Scoping Review Approach

Objective

Although interagency collaboration in drug treatment and rehabilitation has been substantially studied, a lack of consensus on the nomenclature and definition of collaboration remains an unresolved issue in public health policy and practice. To facilitate further consensus, this review analyses previously used definition, conceptualization, and theorization on interagency collaboration in the field of drug rehabilitation.

Methods

We conducted evidence synthesis using a scoping review approach. This review is based on searches using the MEDLINE, CINAHL Complete, Embase, and PsychINFO databases and used the protocol proposed by Arksey and O'Malley.

Results

A total of 6,259 papers were retrieved from database and citation searches, 33 of which were eligible for inclusion in the analysis after screening and evaluation. Although the definitions varied, the common elements included (a) the presence of at least two entities, which were either services, programs or organizations; (b) these entities collaborated or shared resources; (c) partnership went through a development process; and (d) the intent of collaboration was to achieve a common purpose. There were five means of conceptualizing collaboration: (a) degrees, or level of intensity and formality; (b) elements, or the constitutive structure and activities; (c) stages, or the development of partnership over time; (d) levels, or the focus of the collaborative; and (e) type, or a distinction between collaboration on in policy and practice.

Conclusion

Scholarship in this field can benefit from studies that conceptualize collaboration not only crosssectionally through the description of degrees, elements, levels, and type, but also by considering the stages dimension of collaboration (i.e., evolution of collaboration initiative over time). Countries or jurisdictions may need to formalize a term and definition for collaboration as it applies to initiatives within their territories.

Business-nonprofit hybrid organizing: a dynamic approach to balancing benefits and costs

Introduction

Efforts to address complex public health challenges can benefit from cross-sector collaboration, while also fostering growing business sector engagement in promoting health equity. What form business-nonprofit collaboration should take, however, is a difficult question for managers and leaders. Hybrid organizational forms, which combine for-profit and nonprofit elements within a single organization in unconventional ways, offer an innovative and potentially promising approach. Yet, while existing typologies of cross-sector collaboration have identified hybrid forms at one end of a continuum of possible forms of collaboration, these typologies do not differentiate the diversity such hybrid forms may take, and the costs and benefits of these innovative hybrid forms are poorly understood. This leaves managers interested in promoting public health through business-nonprofit hybrid organizing with limited guidance about how to maximize potential merits while mitigating drawbacks.

Methods

We performed a qualitative comparative case study of three examples of business-nonprofit hybrid organizing. Data collection included 113 interviews with representatives from 42 organizations and observation of case study activities. We used thematic analysis within and across cases to characterize the form of hybrid organizing in each case and to examine benefits and costs of different forms for supporting initiatives.

Results

We identified two hybrid, collaborative forms - Appended and Blended forms. Each form had benefits and costs, the significance of which shifted over time contingent on changing strategic priorities and operating environments. Benefits and costs of particular forms become more or less important for establishing and sustaining initiatives under different conditions, requiring a dynamic view.

Discussion

No particular form of business-nonprofit hybrid organizing is inherently better than another. Optimizing hybrid organizing and ensuring resilient collaborations may mean allowing collaborative forms to evolve. Practitioners can manage tradeoffs between benefits and costs through an ongoing process of assessing the fit between a given collaborative form, strategic priorities, and relevant features of the operating environment. This dynamic view offers important insights for ensuring the resilience of business-nonprofit collaborative efforts to enhance public health.

Building resilient partnerships: How businesses and nonprofits create the capacity for responsiveness

Increasingly, businesses are eager to partner with nonprofit organizations to benefit their communities. In spite of good intentions, differences between nonprofit and business organizations can limit the ability of potential partnerships to respond to a changing economic and public health landscape. Using a retrospective, multiple-case study, we sought to investigate the managerial behaviors that enabled businesses and nonprofits to be themselves together in sustainable partnerships. We recruited four nonprofit-business partnerships in the Boston area to serve as cases for our study. Each was designed to address social determinants of health. We thematically analyzed qualitative data from 113 semi-structured interviews, 9 focus groups and 29.5 h of direct observations to identify organizational capacities that build resilient partnerships. Although it is common to emphasize the similarities between partners, we found that it was the acknowledgement of difference that set partnerships up for success. This acknowledgement introduced substantial uncertainty that made managers uncomfortable. Organizations that built the internal capacity to be responsive to, but not control, one another were able to derive value from their unique assets.

Children, young people and parent engagement in health intervention design and implementation: A scoping review

INTRODUCTION

Engaging children and young people (CYP) with and without their parents in health research has the potential to improve the development and implementation of health interventions. However, to our knowledge, the scope of engagement activities used with this population and barriers to their engagement is unknown. The objective of this review was to identify and describe CYP engagement with and without their parents in the development and/or implementation of health interventions.

METHODS

This scoping review included any primary research studies reporting on engaging CYP, with or without parents, in the design and/or implementation of health interventions. Healthcare professionals had to be involved over the course of the study and the study had to take place in either community, primary or tertiary care settings. The following databases were searched in May 2017, May 2020 and June 2021: Medline (OVID), CINAHL (EBSCO) and Embase (Elsevier). Two independent reviewers screened titles, abstracts and full-text articles and used a previously piloted extraction form to extract and summarize information from the included articles.

RESULTS

Twenty-eight articles discussing twenty-four studies were included. CYP engagement throughout the research cycle was limited. There were no observed differences in the reported presence of engagement, types of interventions or outcomes of engagement between studies engaging CYP or CYP and parents. Studies engaging CYP and parents contained limited information on how these relationships affected outcomes of engagement. Engagement was enabled primarily by the maintenance of resources and relationships among stakeholders.

CONCLUSIONS

Although CYP engagement often influenced health intervention and implementation design, they are inconsistently engaged across the research cycle. It is unclear whether parental involvement enhances CYP engagement. Future research should consider reporting guidelines to clarify the level of CYP and/or parent engagement, and enhance CYP engagement by fostering synergistic and sustainable partnerships with key stakeholders.

PATIENT OR PUBLIC CONTRIBUTION

A parent partner with codesign experience contributed to the creation of the research questions, screened titles, abstracts and full texts, helped with data extraction and provided feedback on the manuscript.

Embedding health literacy research and best practice within a socioeconomically and culturally diverse health service: A narrative case study and revised model of co-creation

BACKGROUND

Health literacy interventions and research outcomes are not routinely or systematically implemented within healthcare systems. Co-creation with stakeholders is a potential vehicle through which to accelerate and scale up the implementation of innovation from research.

METHODS

This narrative case study describes an example of the application of a co-creation approach to improve health literacy in an Australian public health system that provides hospital and community health services to one million people from socioeconomically and culturally diverse backgrounds. We provide a detailed overview of the value co-creation stages and strategies used to build a practical and sustainable working relationship between a University-based academic research group and the local health district focussed on improving health literacy.

RESULTS

Insights from our experience over a 5-year period informed the development of a revised model of co-creation. The model incorporates a practical focus on the structural enablers of co-creation, including the development of a Community of Practice, co-created strategic direction and shared management systems. The model also includes a spectrum of partnership modalities (spanning relationship-building, partnering and co-creating), acknowledging the evolving nature of research partnerships and reinforcing the flexibility and commitment required to achieve meaningful co-creation in research. Four key facilitators of health literacy co-creation are identified: (i) local champions, (ii) co-generated resources, (iii) evolving capability and understanding and (iv) increasing trust and partnership synergy.

CONCLUSION

Our case study and co-creation model provide insights into mechanisms to create effective and collaborative ways of working in health literacy which may be transferable to other health fields in Australia and beyond.

PATIENT AND PUBLIC CONTRIBUTION

Our co-creation approach brought together a community of practice of consumers, healthcare professionals and researchers as equal partners.

Protecting healthcare workers during a pandemic: what can a WHO collaborating centre research partnership contribute?

Objectives

To ascertain whether and how working as a partnership of two World Health Organization collaborating centres (WHOCCs), based respectively in the Global North and Global South, can add insights on "what works to protect healthcare workers (HCWs) during a pandemic, in what contexts, using what mechanism, to achieve what outcome".

Methods

A realist synthesis of seven projects in this research program was carried out to characterize context (C) (including researcher positionality), mechanism (M) (including service relationships) and outcome (O) in each project. An assessment was then conducted of the role of the WHOCC partnership in each study and overall.

Results

The research found that lower-resourced countries with higher economic disparity, including South Africa, incurred greater occupational health risk and had less acceptable measures to protect HCWs at the onset of the COVID-19 pandemic than higher-income more-equal counterpart countries. It showed that rigorously adopting occupational health measures can indeed protect the healthcare workforce; training and preventive initiatives can reduce workplace stress; information systems are valued; and HCWs most at-risk (including care aides in the Canadian setting) can be readily identified to trigger adoption of protective actions. The C-M-O analysis showed that various ways of working through a WHOCC partnership not only enabled knowledge sharing, but allowed for triangulating results and, ultimately, initiatives for worker protection.

Conclusions

The value of an international partnership on a North-South axis especially lies in providing contextualized global evidence regarding protecting HCWs as a pandemic emerges, particularly with bi-directional cross-jurisdiction participation by researchers working with practitioners.

Inclusionary Trials: A Review of Lessons Not Learned

The COVID-19 pandemic revealed weaknesses in the public health infrastructure of the United States, including persistent barriers to engaging marginalized communities toward inclusion in clinical research, including trials. Inclusive participation in clinical trials is crucial for promoting vaccine confidence, public trust, and addressing disparate health outcomes. A long-standing body of literature describes the value of community-based participatory research in increasing marginalized community participation in research. Community-based participatory research emphasizes shared leadership with community members in all phases of the research process, including in the planning and implementation, interpretation, and dissemination. Shared leadership between academic and industry with marginalized communities can assist with inclusive participation in vaccine trials and increase public trust in the development of the vaccines and other therapies used during public emergencies. Nevertheless, epidemiologic and clinical research do not yet have a strong culture of community partnership in the scientific process, which takes time to build and therefore may be difficult to develop and rapidly scale to respond to the pandemic. We outline practices that contribute to a lack of inclusive participation and suggest steps that trialists and other researchers can take to increase marginalized communities' participation in research. Practices include planning for community engagement during the planning and recruitment phases, having regular dialogues with communities about their priorities, supporting them throughout a study, and navigating complex structural determinants of health. Additionally, we discuss how research institutions can support inclusive practices by reexamining their policies to increase participation in clinical trials and instilling institutional trustworthiness.

How are health research partnerships assessed? A systematic review of outcomes, impacts, terminology and the use of theories, models and frameworks

BACKGROUND

Accurate, consistent assessment of outcomes and impacts is challenging in the health research partnerships domain. Increased focus on tool quality, including conceptual, psychometric and pragmatic characteristics, could improve the quantification, measurement and reporting partnership outcomes and impacts. This cascading review was undertaken as part of a coordinated, multicentre effort to identify, synthesize and assess a vast body of health research partnership literature.

OBJECTIVE

To systematically assess the outcomes and impacts of health research partnerships, relevant terminology and the type/use of theories, models and frameworks (TMF) arising from studies using partnership assessment tools with known conceptual, psychometric and pragmatic characteristics.

METHODS

Four electronic databases were searched (MEDLINE, Embase, CINAHL Plus and PsycINFO) from inception to 2 June 2021. We retained studies containing partnership evaluation tools with (1) conceptual foundations (reference to TMF), (2) empirical, quantitative psychometric evidence (evidence of validity and reliability, at minimum) and (3) one or more pragmatic characteristics. Outcomes, impacts, terminology, definitions and TMF type/use were abstracted verbatim from eligible studies using a hybrid (independent abstraction-validation) approach and synthesized using summary statistics (quantitative), inductive thematic analysis and deductive categories (qualitative). Methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).

RESULTS

Application of inclusion criteria yielded 37 eligible studies. Study quality scores were high (mean 80%, standard deviation 0.11%) but revealed needed improvements (i.e. methodological, reporting, user involvement in research design). Only 14 (38%) studies reported 48 partnership outcomes and 55 impacts; most were positive effects (43, 90% and 47, 89%, respectively). Most outcomes were positive personal, functional, structural and contextual effects; most impacts were personal, functional and contextual in nature. Most terms described outcomes (39, 89%), and 30 of 44 outcomes/impacts terms were unique, but few were explicitly defined (9, 20%). Terms were complex and mixed on one or more dimensions (e.g. type, temporality, stage, perspective). Most studies made explicit use of study-related TMF (34, 92%). There were 138 unique TMF sources, and these informed tool construct type/choice and hypothesis testing in almost all cases (36, 97%).

CONCLUSION

This study synthesized partnership outcomes and impacts, deconstructed term complexities and evolved our understanding of TMF use in tool development, testing and refinement studies. Renewed attention to basic concepts is necessary to advance partnership measurement and research innovation in the field. Systematic review protocol registration: PROSPERO protocol registration: CRD42021137932 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=137932 .

Health promotion partnership to promote physical activity in Swedish children with ASD and ADHD

Children with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) have a higher risk of inactivity, and efforts to promote physical activity among this population have been limited. Physical activity on prescription (PAP) may be a suitable tool for motivating participation in physical activity among children with these diagnoses. However, PAP calls for synergy and partnership between health care and other sectors of the community. The aim of this study was to describe a health promotion partnership for physical activity targeting children with ASD or ADHD. Data were obtained through individual interviews with professionals at CAP (n = 11) and three focus-group interviews with coaches from local sports clubs. We used the Bergen Model of Collaborative Functioning as the theoretical framework and used qualitative content analysis as the method of analysis to study partnerships between professionals from the Child and Adolescent Psychiatry outpatient clinic (CAP) and coaches from local sport clubs. The findings demonstrate that the partnerships included both positive and negative processes. Although the two partners shared values regarding the project, such as working for a good cause for the children and seeing the potential in the collaboration, there were doubts about sharing common resources and uncertainties about the sustainability of the PAP project. Challenges remain and further research is needed into developing, monitoring and evaluating health promotion partnerships when promoting physical activity for all.

How can community support be maintained during the COVID-19 pandemic?

This study aims to examine a structural equation model composed of the latent variables of collaboration, perceptions of benefits and costs, and community satisfaction to find a way to enhance community support for community development projects during the COVID-19 pandemic. Using a sample of 600 participants (57.8% male; 42% female) from 30 communities in South Korea, our findings show that collaboration as social cohesion has indirect effects on community support by mediating the perceived benefits and community satisfaction. The results show that perceived benefits and community satisfaction are crucial to enhance community support during times of uncertainty such as the COVID-19 pandemic. We suggest that policy makers and practitioners consider the relationships among collaboration, perceived benefits, and community satisfaction as a catalyst to enhance community support.

Community networks of sport and physical activity promotion: an analysis of structural properties and conditions of cooperation

BACKGROUND

The importance of intersectoral cooperation networks among community organizations located in people's immediate environments in addressing population health problems such as physical inactivity has come into focus in recent years. To date, there is limited evidence on how and why such networks emerge. Therefore, the aims of this study were (a) to analyze the structural properties and (b) to identify the conditions of cooperation in interorganizational community networks of sport and physical activity promotion.

METHODS

Survey data on cooperative relationships and organizational attributes of sports and physical activity providers as well as sports administrating organizations in two community networks located in urban districts in southern Germany were collected (Network I: n = 133 organizations; Network II: n = 50 organizations). Two quantitative descriptive procedures - network analysis and stochastic analyses of network modeling (exponential random graphs) - were applied.

RESULTS

Similar structures and conditions of cooperation were found in the networks (e.g. low density, centralization). The community sports administrations had the most central positions in both networks. Exponential random graph modeling showed that cooperation took place more frequently in triangular structures (closure effect) and revolved around a few central actors (preferential attachment effect). Organizations from different sectors cooperated more often than organizations from the same sector (heterophily effect).

CONCLUSION

The study provided valid and robust findings on significant mechanisms and conditions of interorganizational cooperation in community networks focused on sport and physical activity promotion. Based on the results, implications for the development and most efficient governance of these networks can be derived.

The Ecology of Engagement: Fostering cooperative efforts in health with patients and communities

CONTEXT

Patients and community members are engaged in nearly every aspect of health systems. However, the engagement literature remains siloed and fragmented, which makes it difficult to connect engagement efforts with broader goals of health, equity and sustainability. Integrated and inclusive models of engagement are needed to support further transformative efforts.

METHODS

This article describes the Ecology of Engagement, an integrated model of engagement. The model posits that: (1) Health ecosystems include all members of society engaged in health; (2) Engagement is the 'together' piece of health and healthcare (e.g., caring for each other, preventing, researching, teaching and building policies together); (3) Health ecosystems and engagement are interdependent from each other, both influencing health, equity, resilience and sustainability.

CONCLUSION

The Ecology of Engagement offers a common sketch to foster dialogue on engagement across health ecosystems. The model can drive cooperative efforts with patients and communities on health, equity, resilience and sustainability.

PATIENTS AND PUBLIC CONTRIBUTION

Three of the authors have lived experiences as patients. One has a socially disclosed identity as a patient partner leader with extensive experience in engagement (individual care, education, research, management and policy). Two authors have significant experience as patients and informal caregivers, which were mobilized in descriptive illustrations. A fourth author has experience as an engaged citizen in health policy debates. All authors have professional lived experience in health (manager, researcher, health professional, consultant and educator). Six patient and caregiver partners with lived experience of engagement (other than the authors) contributed important revisions and intellectual content.

The impact of coalition characteristics on outcomes in community-based initiatives targeting the social determinants of health: a systematic review

Background

Coalitions are a popular mechanism for delivering community-based health promotion. The aim of this systematic review was to synthesize research that has quantitatively analyzed the association between coalition characteristics and outcomes in community-based initiatives targeting the social determinants of health. Coalition characteristics described elements of their structure or functioning, and outcomes referred to both proximal and distal community changes.

Methods

Authors searched six electronic databases to identify peer reviewed, published studies that analyzed the relationship between coalition characteristics and outcomes in community-based initiatives between 1980 and 2021. Studies were included if they were published in English and quantitatively analyzed the link between coalition characteristics and outcomes. Included studies were assessed for quality using the Joanna Briggs Institute analytical cross-sectional studies assessment tool.

Results

The search returned 10,030 unique records. After screening, 26 studies were included from six countries. Initiatives targeted drug use, health equity, nutrition, physical activity, child and youth development, crime, domestic violence, and neighbourhood improvement. Community outcomes measured included perceived effectiveness (n=10), policy, systems or environment change (n=9), and community readiness or capacity (n=7). Analyses included regression or correlation analysis (n=16) and structural equation or pathway modelling (n=10). Studies varied in quality, with a lack of data collection tool validation presenting the most prominent limitation to study quality. Statistically significant associations were noted between community outcomes and wide range of coalition characteristics, including community context, resourcing, coalition structure, member characteristics, engagement, satisfaction, group facilitation, communication, group dynamics, relationships, community partnership, and health promotion planning and implementation.

Conclusion

Existing literature demonstrates that coalition characteristics, including best practice health promotion planning and evaluation, influence community outcomes. The field of coalition research would benefit from more consistent description and measurement of coalition characteristics and outcomes, and efforts to evaluate coalitions in a wider range of countries around the world. Further research using empirical community outcome indicators, and methods that consider the interrelationship of variables, is warranted.

Trial registration

A protocol for this review was registered with PROSPERO (CRD42020205988).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13678-9.

A Discourse on Foresight and the Valuation of Explicit and Tacit Synergies in Strategic Collaborations

One of the most important questions in business partners’ collaboration is whether their strategies create a collaborative synergy and thus add market value. This paper aims to develop a conceptual framework that will be useful for scholars and practitioners in developing foresight for explicit synergies and valuing tacit synergy in strategic collaborative ventures. The paper comprises a novel theoretical and empirical contribution to the foresight that is required for an explicit competence-based synergy in collaborative ventures from a resource-based view. It employs the ARCTIC framework and values a tacit competence-based synergy using simple and compound real options. Moreover, the paper makes several theoretical and empirical contributions to the study of strategic management, international business, and corporate finance disciplines. Finally, the paper discusses research limitations and future work.

Utilizing Causal Loop Diagramming to Explore a Research and Evaluation Capacity Building Partnership

The capacity to engage in research, evaluation and evidence-informed decision-making supports effective public health policy and practice. Little is known about partnership-based approaches that aim to build capacity across a system or how to evaluate them. This study examines the impacts of a research and evaluation capacity building partnership called the Western Australian Sexual Health and Blood-borne Virus Applied Research and Evaluation Network (hereafter, SiREN). SiREN aims to strengthen capacity across a system of clinical and medical services and government and non-government organizations. These organizations are connected through their shared aim of preventing and managing sexually transmissible infections and blood-borne viruses. To examine SiREN, systems concepts and methods were used. Data were collected from SiREN organizational documents (n = 42), a survey tool (n = 104), in-depth interviews (n = 17), a workshop and three meetings with SiREN stakeholders and used to develop two causal loop diagrams. Findings show engagement with SiREN was influenced by a complex interplay of contextual (e.g., organizational capacity) and process (e.g., presence of trusting relationships) factors. SiREN contributed to system level changes, including increased resources for research and evaluation, the development of networks and partnerships that led to more efficient responses to emerging health issues, evidence sharing, and sustainable research and evaluation practice. The use of causal loop diagrams enabled the identification of key leverage points that SiREN can use for continuous improvement or evaluation. The focus on how contextual factors influenced SiREN's ability to create change provides valuable information for researchers, policymakers or practitioners seeking to develop a similar partnership.

Insights from the national maternal and Child Health Workforce Development Center on Title V Teams' collaborative readiness and goal accomplishment

Purpose

State Title V programs collaborate with diverse partners to improve maternal and child health. Since 2014, the National Maternal and Child Health Workforce Development Center has trained Title V leaders in facilitating system change. This article describes aspects of initial collaborative readiness differentiating state and jurisdiction teams that later reported meeting their goals to greater or lesser degrees.

Description

We used quantitative data from initial team leader reports to characterize readiness to collaborate with external partners, and their responses twelve months later to a prompt about how fully they had accomplished their goals. In addition, we coded excerpts from team leader accounts six and twelve months into their work with the Center, and retrospective coach perspectives, to identify collaborative readiness patterns.

Assessment

Teams whose leaders reported higher goal accomplishment twelve months after beginning work with the Center had initially reported higher levels of collaboration with key partners. Our analyses suggest that such teams were also better able to use their cohort experience with the Center to improve collaboration, including information sharing with external stakeholders. Challenges working with Medicaid were reported both by teams with more and less goal accomplishment.

Conclusions

Title V teams with lower levels of initial collaborative readiness may benefit from additional support in skill development, connections to key partners, and convening power. Given the crucial and increasing role of Medicaid in maternal and child health systems, more attention may be warranted to supporting all Title V programs in partnering with this funder.

What is already known on this subject?

Prior research has identified the ability to convene diverse stakeholders as key to achieving partnership synergies, and in turn improved community outcomes.

What this study adds

State and territorial Title V programs may achieve greater synergies with external partners by initially assessing and strategically enhancing collaborative readiness. Training and technical assistance providers might enhance partnership synergies through focused assistance to states with lower initial levels of external collaboration. Title V leaders may improve outcomes by leveraging their strongest collaborations to foster relationships with additional stakeholders. Title V programs in general could benefit from support cultivating relationships with Medicaid.