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Hyatt A, Chan B, Moodie R, Varlow M, Bates C, Foliaki S, Palafox N, Burich S, Aranda S. Strengthening cancer control in the South Pacific through coalition-building: a co-design framework. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 33:100681. [PMID: 37181526 PMCID: PMC10166990 DOI: 10.1016/j.lanwpc.2022.100681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023]
Abstract
Background Cancer is a significant problem for the South Pacific region due to a range of complex health challenges. Currently gaps in diagnosis, treatment and palliative care are significant, and while governmental commitment is strong, economic constrains limit health system strengthening. Alliances have been successful in strengthening non-communicable disease and cancer control policy and services in resource constrained settings. A regional coalition approach has therefore been recommended as an effective solution to addressing many of the challenges for cancer control in the South Pacific. However, evidence regarding the effective mechanisms for development of alliances or coalitions is scarce. This study aimed to 1) create a Coalition Development Framework; 2) assess the use of the Framework in practice to co-design a South Pacific Coalition. Methods Creation of the Coalition Development Framework commenced with a scoping review and content analysis of existing literature. Synthesis of key elements formed an evidence-informed step-by-step guide for coalition-building. Application of the Framework comprised consultation and iterative discussions with key South Pacific cancer control stakeholders in Fiji, New Caledonia, Papua New Guinea, Samoa and Tonga. Concurrent evaluation of the Framework utilising Theory of Change (ToC) and qualitative analysis of stakeholder consultations was undertaken. Findings The finalised Coalition Development Framework comprised four phases with associated actions and deliverables: engagement, discovery, unification, action and monitoring. Application of the Framework in the South Pacific identified overwhelming support for a Cancer Control Coalition through 35 stakeholder consultations. Framework phases enabled stakeholders to confirm coalition design and purpose, strategic imperatives, structure, local foundations, barriers and facilitators, and priorities for action. ToC and thematic consultation analysis confirmed the Framework to be an effective mechanism to drive engagement, unification and action in alliance-building. Interpretation A Coalition to drive cancer control has significant support among key Pacific stakeholders, and establishment can now be commenced. Importantly results confirm the effective application of the Coalition Development Framework in an applied setting. If momentum is continued, and a regional South Pacific Coalition established, the benefits in reducing the burden of cancer within the region will be substantial. Funding This work was completed for a Masters of Public Health project. Cancer Council Australia provided project funding.
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Affiliation(s)
- Amelia Hyatt
- Cancer Control Policy, Cancer Council Australia, Sydney, NSW, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | | | - Rob Moodie
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Megan Varlow
- Cancer Control Policy, Cancer Council Australia, Sydney, NSW, Australia
| | - Chris Bates
- Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sunia Foliaki
- Research Centre for Hauora and Health, Massey University-Wellington Campus, Wellington, New Zealand
| | - Neal Palafox
- John A. Burns School of Medicine, University of Hawaii, University of Hawaii Cancer Center, Honolulu, United States
| | | | - Sanchia Aranda
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Department of Nursing, University of Melbourne, Melbourne, VIC, Australia
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Liaw ST, Godinho MA. Digital health and capability maturity models-a critical thematic review and conceptual synthesis of the literature. J Am Med Inform Assoc 2023; 30:393-406. [PMID: 36451257 PMCID: PMC9846694 DOI: 10.1093/jamia/ocac228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE A literature review of capability maturity models (MMs) to inform the conceptualization, development, implementation, evaluation, and mainstreaming of MMs in digital health (DH). METHODS Electronic databases were searched using "digital health," "maturity models," and related terms based on the Digital Health Profile and Maturity Assessment Toolkit Maturity Model (DHPMAT-MM). Covidence was used to screen, identify, capture, and achieve consensus on data extracted by the authors. Descriptive statistics were generated. A thematic analysis and conceptual synthesis were conducted. FINDINGS Diverse domain-specific MMs and model development, implementation, and evaluation methods were found. The spread and pattern of different MMs verified the essential DH foundations and five maturity stages of the DHPMAT-MM. An unanticipated finding was the existence of a new category of community-facing MMs. Common characteristics included:1. A dynamic lifecycle approach to digital capability maturity, which is:a. responsive to environmental changes and may improve or worsen over time;b. accumulative, incorporating the attributes of the preceding stage; andc. sequential, where no maturity stage must be skipped.2. Sociotechnical quality improvement of the DH ecosystem and MM, which includes:a. investing in the organization's human, hardware, and software resources andb. a need to engage and improve the DH competencies of citizens. CONCLUSIONS The diversity in MMs and variability in methods and content can create cognitive dissonance. A metamodel like the DHPMAT-MM can logically unify the many domain-specific MMs and guide the overall implementation and evaluation of DH ecosystems and MMs over the maturity lifecycle.
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Affiliation(s)
- Siaw-Teng Liaw
- WHO Collaborating Centre for eHealth (AUS-135), School of Population Health, UNSW Sydney, Sydney, Australia
| | - Myron Anthony Godinho
- WHO Collaborating Centre for eHealth (AUS-135), School of Population Health, UNSW Sydney, Sydney, Australia
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Decision-Making Dilemmas within Integrated Care Service Networks: A Systematic Literature Review. Int J Integr Care 2022; 22:11. [DOI: 10.5334/ijic.6458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
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Peeters R, Westra D, van Raak AJA, Ruwaard D. So Happy Together: A Review of the Literature on the Determinants of Effectiveness of Purpose-Oriented Networks in Health Care. Med Care Res Rev 2022; 80:266-282. [PMID: 36000492 PMCID: PMC10126450 DOI: 10.1177/10775587221118156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While purpose-oriented networks are widely recognized as organizational forms to address wicked problems in health care such as increasing demands and expenditure, the associated literature is fragmented. We therefore reviewed empirical studies to identify the determinants of the effectiveness of these networks. Our search yielded 3,657 unique articles, of which 19 met our eligibility criteria. After backward snowballing and expert consultation, 33 articles were included. Results reveal no less than 283 determinants of effective health care networks. The majority of these determinants are processual and involving professionals from the operational level is particularly salient. In addition, most studies relate determinants to process outcomes (e.g., improved collaboration or sustainability of the network) and only a few to members' perception of whether the network attains its goals. We urge future research to adopt configurational approaches to identify which sets of determinants are associated with networks' ability to attain their goal of addressing wicked problems.
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Jiménez DJ, Sabo S, Remiker M, Smith M, Samarron Longorio AE, Williamson HJ, Chief C, Teufel-Shone NI. A multisectoral approach to advance health equity in rural northern Arizona: county-level leaders' perspectives on health equity. BMC Public Health 2022; 22:960. [PMID: 35562793 PMCID: PMC9100312 DOI: 10.1186/s12889-022-13279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multisectoral and public-private partnerships are critical in building the necessary infrastructure, policy, and political will to ameliorate health inequity. A focus on health equity by researchers, practitioners, and decision-makers prioritizes action to address the systematic, avoidable, and unjust differences in health status across population groups sustained over time and generations that are beyond the control of individuals. Health equity requires a collective process in shaping the health and wellbeing of the communities in which we live, learn, work, play, and grow. This paper explores multisectoral leaders' understanding of the social, environmental, and economic conditions that produce and sustain health inequity in northern Arizona, a geographically expansive, largely rural, and culturally diverse region. METHODS Data are drawn from the Southwest Health Equity Research Collaborative's Regional Health Equity Survey (RHES). The RHES is a community-engaged, cross-sectional online survey comprised of 31 close-ended and 17 open-ended questions. Created to assess cross-sectoral regional and collective capacity to address health inequity and inform multisectoral action for improving community health, the RHES targeted leaders representing five rural northern Arizona counties and 13 sectors. Select open-ended questions were analyzed using an a priori coding scheme and emergent coding with thematic analysis. RESULTS Although leaders were provided the definition and asked to describe the root causes of inequities, the majority of leaders described social determinants of health (SDoH). When leaders described root causes of health inequity, they articulated systemic factors affecting their communities, describing discrimination and unequal allocation of power and resources. Most leaders described the SDoH by discussing compounding factors of poverty, transportation, housing, and rurality among others, that together exacerbate inequity. Leaders also identified specific strategies to address SDoH and advance health equity in their communities, ranging from providing direct services to activating partnerships across organizations and sectors in advocacy for policy change. CONCLUSION Our findings indicate that community leaders in the northern Arizona region acknowledge the importance of multisectoral collaborations in improving health equity for the populations that they serve. However, a common understanding of health equity remains to be widely established, which is essential for conducting effective multisectoral work to advance health equity.
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Affiliation(s)
- Dulce J Jiménez
- Center for Health Equity Research, Northern Arizona University, PO Box 4065, Flagstaff, AZ, 86011, USA.
| | - Samantha Sabo
- Center for Health Equity Research, Northern Arizona University, PO Box 4065, Flagstaff, AZ, 86011, USA
| | - Mark Remiker
- Center for Health Equity Research, Northern Arizona University, PO Box 4065, Flagstaff, AZ, 86011, USA
| | - Melinda Smith
- Center for Health Equity Research, Northern Arizona University, PO Box 4065, Flagstaff, AZ, 86011, USA
| | | | - Heather J Williamson
- Center for Health Equity Research, Northern Arizona University, PO Box 4065, Flagstaff, AZ, 86011, USA
| | - Carmenlita Chief
- Center for Health Equity Research, Northern Arizona University, PO Box 4065, Flagstaff, AZ, 86011, USA
| | - Nicolette I Teufel-Shone
- Center for Health Equity Research, Northern Arizona University, PO Box 4065, Flagstaff, AZ, 86011, USA
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Sustaining participation in multisector health care alliances: The role of personal and stakeholder group influence. Health Care Manage Rev 2021; 45:196-206. [PMID: 30138159 DOI: 10.1097/hmr.0000000000000216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cross-sectoral collaborative organizations (e.g., alliances, coalitions) bring together members from different industry sectors to ameliorate multifaceted problems in local communities. The ability to leverage the diverse knowledge and skills of these members is predicated on their sustained participation, which research has shown to be a significant challenge. PURPOSE The purpose of this study was to investigate how alliance member perceptions of decision-making influence relate to sustained participation in the alliance and its activities. METHODOLOGY An Internet-based survey of 638 members of 15 multistakeholder health care alliances participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality program was conducted. Ordinal logistic regression path analysis was used to estimate the relationship between two types of influence (personal influence and general stakeholder influence), perceived value of alliance participation, and intentions regarding future participation. FINDINGS Alliance members saw less participation value when their personal influence was believed to be lower than the influence of other alliance members (b = -0.09, p < .05). This type of influence was not significantly associated with the anticipated level of future participation. In contrast, imbalances in general stakeholder group influence was not significantly associated with perceived value, but greater imbalances were associated with a decreased likelihood of future participation (OR = 0.52, 95% CI [0.32, 0.83]). PRACTICE IMPLICATIONS Our findings highlight the important yet complicated task of balancing perceptions of influence; leaders must keep the desired outcomes in mind when considering what type of influence to attend to.
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Hearld LR, Alexander J, Shi Y, Wolf LJ. Member engagement in multi-sector health care alliances. Health Serv Manage Res 2021; 35:146-153. [PMID: 34232827 DOI: 10.1177/09514848211028708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many communities are developing innovative forms of collaborative organizations such as multi-sector health care alliances (MHCAs) to address problems of misaligned incentives among providers, payers, and community stakeholders and improve health and health care. Member engagement is essential to the success of these organizations due to their dependence on volunteer members to develop and implement strategy and provide material and in-kind support for alliance efforts, yet relatively little research has examined how alliances can foster engagement. This study examined behavioral indicators of member engagement (e.g., recruitment and retention of organizational and individual members) and how they are related to two foundational dimensions of alliance functioning - alliance leadership and community centrality. Using three rounds of an internet-based survey of alliance members from 14 alliances, the study found that organizational recruitment and retention increased over time, from 26.6% to 41.5% and 56.0% to 65.2%, respectively. Recruitment of individuals increased over the study period (38.3% to 47.2%, while retention of individual members declined over the study period (61.0% to 53.2%). Alliance leadership was associated with lower levels of recruitment (both organizational and individual members) but higher levels of organizational retention (both organizational and individual members). Collectively, our findings suggest that behavioral aspects of alliances are more effective at retaining members than relatively stable characteristics such as size and positioning in the community. Contrasting relationships between recruitment and retention, however, suggest that different forms of leadership may be required to simultaneously attract new members while retaining existing ones.
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Affiliation(s)
- Larry R Hearld
- University of Alabama, Department of Health Services Administration at Birmingham, Birmingham, AL, USA
| | - Jeffrey Alexander
- University of Michigan, Department of Health Management and Policy, Ann Arbor, MI, USA
| | - Yunfeng Shi
- Pennsylvania State University, Department of Health Policy and Administration, University Park, PA, USA
| | - Laura J Wolf
- Pennsylvania State University, Department of Health Policy and Administration, University Park, PA, USA
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Murray GF, D'Aunno T, Lewis VA. Critical issues in alliances between management partners and accountable care organizations. Health Care Manage Rev 2021; 46:237-247. [PMID: 36800403 DOI: 10.1097/hmr.0000000000000263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite widespread engagement of accountable care organizations (ACOs) with management partners, little empirical evidence on these alliances exists to inform policymakers or payers. Management partners may be providing a valuable service in facilitating the transition to population health management. Alternately, in some cases, partners may be receiving high fees relative to the value of services provided. PURPOSE The aim of this study was to use qualitative data to identify motivations for and critical issues in alliances between ACOs and management partners. METHODOLOGY/APPROACH We used qualitative data collected from seven ACOs (193 semistructured interviews and observational data from 12 site visits) to characterize the alliances between management partners and providers in ACOs. RESULTS We found that ACOs sought partners to provide financing, technical expertise, and risk bearing. Tensions in partnerships arose around resources (e.g., delivery on promised resources), control (e.g., who holds decision making authority), and values (e.g., commitment to safety net mission). Some partnerships persisted, whereas others dissolved. We found that there are two different underlying models of ACO-management partner alliances in our sample: (1) short-term partnerships aimed at organizational learning and (2) long-term partnerships based on complementarity. CONCLUSION Our results demonstrate how ACO alliances with management partners have unfolded as a kind of natural experiment in value-based payment reform. We expect that there is wide variation in quality, expertise, and delivery by management partners. Now multiple years into many of these alliances, we may address their value, strengths, and weaknesses from the perspective of providers as well as policy makers and payers. PRACTICE IMPLICATIONS Accountable care organization providers must determine whether a management partner is the best solution to the challenges they face and, if so, which alliance model to pursue. Policymakers and payers should consider short- and long-term implications of ACO-management partner alliances, including considering changing the regulatory environment.
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Alexander R, Estabrooks P, Brock DJP, Hill JL, Whitt-Glover MC, Zoellner J. Capacity Development and Evaluation of a Parent Advisory Team Engaged in Childhood Obesity Research. Health Promot Pract 2021; 22:102-111. [PMID: 31409144 PMCID: PMC11290559 DOI: 10.1177/1524839919862251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Guided by community-based participatory research principles, this mixed-methods process evaluation explored the experience and capacity of a newly formed Parental Advisory Team (PAT) engaged in childhood obesity research in a medically underserved region. Following the successful completion of a 3-month evidence-based childhood obesity treatment program (iChoose), 13 parents/caregivers who completed iChoose consented to participate in the PAT. Between June 2015 and March 2016, the PAT had nine monthly meetings and completed mixed-methods capacity assessments. They engaged in activities related to understanding iChoose outcomes, defining their role and purpose as a partnership, initiating content development, and pilot testing maintenance intervention components for future iChoose efforts. Assessments included a quantitative survey administered at baseline and 9 months, and a qualitative interview completed at 9 months. Results indicated that PAT members' perceptions of the identified capacity dimensions were positive at baseline (3.8-4.3 on a 5-point scale) and remained positive at follow-up (3.9-4.4 on a 5-point scale); changes were not statistically significant. Qualitative data revealed that PAT members were satisfied with group participation and desired to enhance their role in subsequent iChoose research. Understanding and promoting parental engagement in the research process fills an important gap in childhood obesity literature.
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David JL, Thomas SL, Randle M, Daube M. A public health advocacy approach for preventing and reducing gambling related harm. Aust N Z J Public Health 2019; 44:14-19. [PMID: 31777133 DOI: 10.1111/1753-6405.12949] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/01/2019] [Accepted: 09/01/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To develop a framework to guide the application of public health advocacy strategies aimed at preventing and reducing gambling-related harm. METHODS A narrative review of theories of change and public health advocacy literature. RESULTS An eight-step public health advocacy framework was created, which outlines the critical steps and considerations when developing and implementing successful change efforts. Implications for public health: To date, a clear public health advocacy approach to gambling harm prevention and reduction has not been well established. This study proposes a gambling-specific framework to guide future public health advocacy efforts to prevent and reduce gambling harm.
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Affiliation(s)
- Jennifer L David
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria
| | - Samantha L Thomas
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria
| | - Melanie Randle
- School of Management, Operations and Marketing, Faculty of Business, University of Wollongong, New South Wales
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Western Australia
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Gauld R, Asgari-Jirhandeh N, Patcharanarumol W, Tangcharoensathien V. Reshaping public hospitals: an agenda for reform in Asia and the Pacific. BMJ Glob Health 2018; 3:e001168. [PMID: 30588348 PMCID: PMC6278916 DOI: 10.1136/bmjgh-2018-001168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/15/2018] [Accepted: 10/23/2018] [Indexed: 01/17/2023] Open
Abstract
Hospitals in the Asia-Pacific today face the 'triple aim' challenge, proposed by the Institute for Healthcare Improvement, of how to improve quality of care and population health, while at the same time controlling healthcare costs. Yet, pursuing these challenges in combination is presently a remote prospect for many hospitals and, indeed, in a majority of countries in the region. The roles and functions of the public hospital sector within local health systems need redefinition and reform in the context of demographic and epidemiological transitions. Policymakers, managers and health professionals have an obligation to reshape the future of public hospitals. This article outlines actions for how public hospitals can be reshaped from a health system perspective. First, hospitals should be integrated into the fabric of the local health system; they can lead in this through working in alliances with other healthcare facilities, including primary care and private hospitals. Policymakers have a role in facilitating this as it contributes to health improvement of the population. Second, investments in system innovation, management improvement and information systems are required and their impact assessed. Such investments can contribute to cost control and efficiency. Public hospital sector investments should be strategic, efficient and should not bias investment in broader determinants of health. Third, reorienting health workforce competencies and appropriate skills should be central to hospital sector reforms, from policy to frontline services delivery. Creative thinking is needed to build and support flexible care delivery arrangements for services designed to respond to patients ' and providers' needs. Pivotal to achievement of each of these three areas of reform is good governance and leadership.
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Affiliation(s)
- Robin Gauld
- Otago Business School, University of Otago, Dunedin, New Zealand
| | - Nima Asgari-Jirhandeh
- Asia-Pacific Observatory on Health Systems and Policies, World Health Organization, Delhi, India
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Hearld L, Alexander JA, Wolf LJ, Shi Y. Funding profiles of multisector health care alliances and their positioning for sustainability. J Health Organ Manag 2018; 32:587-602. [PMID: 29969351 DOI: 10.1108/jhom-01-2018-0003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this paper is to examine the relationship between different aspects of alliance funding profiles (e.g. range of sources, dependence on specific sources) and participant' perceptions of how well the organization is positioned for the future. Design/methodology/approach A mixed method study in the context of eight alliances participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality program. Data collection approaches included surveys of alliance participants and semi-structured interviews with alliance leaders. Findings The findings indicate that dependence on grant revenues, in particular, may be problematic for how well alliances are positioned for sustainability. While a number of approaches were identified to reduce dependence on grants, implementing these strategies presented more of a challenge for alliances due to the contextual demands of their external environment and a need to strike a balance between pursuing alternative revenue sources and fidelity to the mission and identity of the organization. Practical implications Alliance leaders need to have not only a broad and accurate understanding of their external environment, but also an appreciation of the alliance's identity in that environment. Collectively, the findings can help organizational leaders be more informed about their funding choices and the implications those choices have for the future of their organization. Originality/value Collaborative forms of organizations (e.g. alliances, coalitions, networks) are increasingly viewed as an effective means of addressing complex, multifaceted health, and social challenges. For collaborative organizations that depend on the coordinated efforts of volunteers, addressing such complex issues is predicated on sustaining programmatic activities as well as the interest and participation of stakeholders over extended periods of time. This study sheds light on how leaders of these organizations may improve their prospects for sustainability.
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Affiliation(s)
- Larry Hearld
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham , Birmingham, Alabama, USA
| | - Jeffrey A Alexander
- Department of Health Management and Policy, School of Public Health, University of Michigan , Ann Arbor, Michigan, USA
| | - Laura J Wolf
- Center for Health Care and Policy Research, Pennsylvania State University , University Park, Pennsylvania, USA
| | - Yunfeng Shi
- Center for Health Care and Policy Research, Pennsylvania State University , University Park, Pennsylvania, USA
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Reid KS, Sekhobo JP, Gantner LA, Holbrook MK, Allsopp M, Whalen LB, Koren-Roth A. A mixed-method evaluation of the New York State Eat Well Play Hard Community Projects: Building local capacity for sustainable childhood obesity prevention. EVALUATION AND PROGRAM PLANNING 2018; 67:79-88. [PMID: 29275085 DOI: 10.1016/j.evalprogplan.2017.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/20/2017] [Accepted: 12/06/2017] [Indexed: 06/07/2023]
Abstract
This study used a mixed-method, comparative case study approach to assess the level of capacity built for childhood obesity prevention among seven New York State Eat Well Play Hard-Community Projects (EWPH-CP). Data were collected through a self-reported survey in 2007, semi-structured interviews in 2009, and EWPH-CP program documentation throughout the 2006-2010 funding cycle. Quantitative and qualitative analyses were used along with an integrative framework for assessing local capacity building to characterize the capacity built by the study coalitions. Four coalitions rated membership characteristics as a challenge at the beginning of the funding cycle. Towards the end of the funding cycle, all seven coalitions reported activities that were initially focused on building their membership (i.e., member capacity) or positive working relationships (i.e. relational capacity), before eventually pursuing support and resources (i.e., organizational capacity) for implementing their chosen community-oriented programmatic goals (i.e., programmatic capacity). Five coalitions reported environmental changes aimed at increasing physical activity or fruit and vegetable intake. Technical assistance provided to coalitions was credited with contributing to the achievement of programmatic goals. These results suggest that the coalitions succeeded in building local capacity for increasing age-appropriate physical activity or fruit and vegetables intake in the target communities.
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Affiliation(s)
- Kaydian S Reid
- University at Albany School of Public Health, State University of New York, United States
| | - Jackson P Sekhobo
- Division of Nutrition, New York State Department of Health, United States.
| | | | | | - Marie Allsopp
- University at Albany School of Public Health, State University of New York, United States
| | - Linda B Whalen
- Division of Nutrition, New York State Department of Health, United States
| | - Amy Koren-Roth
- Division of Nutrition, New York State Department of Health, United States
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Wilson ML, Strayer TE, Davis R, Harden SM. Informed Adaptations of a Strength-Training Program through a Research-Practice Partnership. Front Public Health 2018; 6:58. [PMID: 29552554 PMCID: PMC5840863 DOI: 10.3389/fpubh.2018.00058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 02/14/2018] [Indexed: 01/26/2023] Open
Abstract
Efficacy and effectiveness data for strength-training programs targeting older adults have been well established, but it is evident that they are not translated within practice-based settings to have a public health impact, as most (~90%) older adults are not meeting strength-training recommendations. Strength-training interventions developed, delivered, and evaluated in highly controlled settings (e.g., eligibility requirements, certified instructor, etc.) may not reflect real-world needs. One strategy to improve these outcomes is to work through an integrated research–practice partnership (IRPP) to plan and evaluate an intervention to better fit within the intended delivery system. The purpose of this study was to describe the IRPP method by which academic and practice representatives can partner to select and adapt a best-fit strength-training program for older adults. This work was planned and evaluated using the reach, effectiveness, adoption, implementation, and maintenance framework, applying the AIM dimensions to complement the methodology of the partnership. In this pragmatic work, members of the IRPP adapted the evidence-based program, Stay Strong, Stay Healthy (SSSH) into a new program, Lifelong Improvements through Fitness Together (LIFT). Of the health educators who agreed to be randomized to deliver LIFT or SSSH (N = 9), five were randomized to SSSH and four were randomized to deliver LIFT. Fifty percent of educators randomized to SSSH delivered the program, whereas 80% of the health educators randomized to LIFT delivered the program. The health educators deemed LIFT more suitable for delivery than SSSH, self-reported high rates of fidelity in program delivery, and intended on delivering the program in the following year. In conclusion, this study provides transparent methods for using an IRPP to adapt an intervention as well as preliminary outcomes related to adoption, implementation, and maintenance.
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Affiliation(s)
- Meghan L Wilson
- Department of Human Nutrition, Foods, and Exercise, Blacksburg, VA, United States
| | - Thomas E Strayer
- Translational Biology, Medicine, and Health, Blacksburg, VA, United States
| | - Rebecca Davis
- Virginia Cooperative Extension, Virginia Tech, Blacksburg, VA, United States
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Blacksburg, VA, United States
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Calancie L, Allen NE, Ng SW, Weiner BJ, Ward DS, Ware WB, Ammerman AS. Evaluating Food Policy Councils Using Structural Equation Modeling. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 61:251-264. [PMID: 29251343 PMCID: PMC7262635 DOI: 10.1002/ajcp.12207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
At least 282 Food Policy Councils (FPCs) are currently working to improve access to healthy foods in their communities by connecting food system sectors, gathering community input, and advising food policy. Empirical research on FPCs is limited. This study empirically evaluates FPCs to better understand the relationships between Organizational Capacity, Social Capital, and Council Effectiveness by testing a FPC Framework adapted from Allen and colleagues (2012). Members of all FPCs in the U.S., Canada, and Native American Tribes and First Nations were invited to complete the Food Policy Council Self-Assessment Tool (FPC-SAT). Structural equation modeling was used to test the FPC Framework. Three hundred and fifty-four FPC members from 95 councils completed the FPC-SAT. After slight modification, a revised FPC Framework was a good fit with the data (χ2 = 40.085, df = 24, p-value = .021, comparative fit index = 0.988, Tucker Lewis index = 0.982, root mean squared error of approximation = 0.044, p-close = .650). A moderation analysis revealed that community context influences the relationship between Social Capital and Council Effectiveness within the FPC Framework. The FPC Framework can guide capacity building interventions and FPC evaluations. The empirically tested framework can help FPCs efficiently work toward achieving their missions and improving their local food system.
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Affiliation(s)
- Larissa Calancie
- Center for Health Equity Research, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nicole E Allen
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bryan J Weiner
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - William B Ware
- Educational Psychology, Measurement and Evaluation, Learning Sciences and Psychological Studies, School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Tooher R, Collins J, Braunack-Mayer A, Burgess T, Skinner SR, O'Keefe M, Watson M, Marshall HS. Intersectoral collaboration to implement school-based health programmes: Australian perspectives. Health Promot Int 2017; 32:312-321. [PMID: 26822033 DOI: 10.1093/heapro/dav120] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Understanding the processes and the factors influencing intersectoral collaboration is vital for the ongoing success of programmes that rely on effective partnerships between sectors, such as the school-based immunization programme, the school dental health programme and health promotion interventions delivered in school settings. We studied school-based health programmes delivered by partnerships between health, education and the local government sectors. We used purposive sampling to identify 19 people working in school-based health programmes and interviewed them about the barriers and enablers of successful collaboration. Data were analysed thematically. We found that collaboration between complex systems was a skilled endeavour which relied on a strong foundation of communication and interpersonal professional relationships. Understanding the core business, operational context and intersectoral point-of-view of collaborative partners was important both for establishing good intersectoral programmes and sustaining them as contexts and personnel changed. Aligning divergent sectoral agendas early in the collaborative process was essential for ensuring that all partners could meet their core business needs while also delivering the programme outcomes.
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Affiliation(s)
- Rebecca Tooher
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Joanne Collins
- Vaccinology and Immunology Trials Unit, Womens and Children's Hospital, Adelaide, SA, Australia
| | | | - Teresa Burgess
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - S Rachel Skinner
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Maree O'Keefe
- School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Maureen Watson
- Department of Health, SA Health, Adelaide, SA, Australia
| | - Helen S Marshall
- Vaccinology and Immunology Trials Unit, Womens and Children's Hospital, Adelaide, SA, Australia
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Inrig SJ, Higashi RT, Tiro JA, Argenbright KE, Lee SJC. Assessing local capacity to expand rural breast cancer screening and patient navigation: An iterative mixed-method tool. EVALUATION AND PROGRAM PLANNING 2017; 61:113-124. [PMID: 28011433 PMCID: PMC5323072 DOI: 10.1016/j.evalprogplan.2016.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 11/08/2016] [Accepted: 11/15/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Despite federal funding for breast cancer screening, fragmented infrastructure and limited organizational capacity hinder access to the full continuum of breast cancer screening and clinical follow-up procedures among rural-residing women. We proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. We describe development and application of an iterative, mixed-method tool to assess county capacity to conduct community outreach and/or patient navigation in a partnership model. METHODS Our tool combined publicly-available quantitative data with qualitative assessments during site visits and semi-structured interviews. RESULTS Application of our tool resulted in shifts in capacity designation in 10 of 17 county partners: 8 implemented local outreach with hub navigation; 9 relied on the hub for both outreach and navigation. Key factors influencing capacity: (1) formal linkages between partner organizations; (2) inter-organizational relationships; (3) existing clinical service protocols; (4) underserved populations. Qualitative data elucidate how our tool captured these capacity changes. CONCLUSIONS Our capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs. Absent a vertically integrated provider network for preventive services in these rural counties, our tool facilitated a virtually integrated regional network to extend access to breast cancer screening to underserved women.
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Affiliation(s)
- Stephen J Inrig
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX75390-9066, USA.
| | - Robin T Higashi
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX75390-9066, USA.
| | - Jasmin A Tiro
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX75390-9066, USA; Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX 75390, USA.
| | - Keith E Argenbright
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX75390-9066, USA; Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX 75390, USA; Moncrief Cancer Institute, 400 W. Magnolia Ave, Fort Worth, TX 76104, USA.
| | - Simon J Craddock Lee
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX75390-9066, USA; Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX 75390, USA.
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Zoellner J, Hill JL, Brock D, Barlow ML, Alexander R, Brito F, Price B, Jones CL, Marshall R, Estabrooks PA. One-Year Mixed-Methods Case Study of a Community-Academic Advisory Board Addressing Childhood Obesity. Health Promot Pract 2017; 18:833-853. [PMID: 29039710 DOI: 10.1177/1524839916689550] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Using a community-based participatory research and systems-based approach, the purpose of this community case study is to describe the planning process and first-year experiences of community-academic advisory board (CAB) partners involved with the development of an evidence-based childhood obesity treatment program in a medically underserved region. METHOD Regional community partners ( n = 9; Pittsylvania/Danville Health District, Children's Healthcare Center, Danville Parks & Recreation, and Danville Boys & Girls Club) and academic partners ( n = 9) met monthly to select and adapt an evidence-based childhood obesity program, develop evaluation and recruitment protocols, and plan for program implementation. In the first 3 months, members developed a mixed-methods capacity evaluation, administered at 3 and 11 months following the first CAB meeting. RESULTS Most capacity dimensions were rated highly and demonstrated no significant change over time. However, perceptions of trust approached a significant increase ( p = .055), the ability to resolve conflicts significantly increased ( p = .018), and participation and influ-ence perceptions significantly decreased ( p = .001). Qualitative analysis elucidated members' experiences and key facilitator and barrier themes emerged. CONCLUSIONS Similarities and differences between community and academic members' experiences allowed synthesis of best practices and lessons learned. The methodological framework and best practices can inform the capacity development for new community-academic collaborations.
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Affiliation(s)
| | - Jennie L Hill
- 2 University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | | | - Fabiana Brito
- 2 University of Nebraska Medical Center, Omaha, NE, USA
| | - Bryan Price
- 4 Danville Parks & Recreation Department, Danville, VA, USA
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Abstract
Purpose– Coordinated school health programs (CSHPs), a type of health promoting school (HPS) program adopted by Canada and the USA, were developed to provide a comprehensive approach to school health in the USA. Community partnerships are central to CSHP and HPS efforts, yet the quality of collaboration efforts is rarely assessed. The purpose of this paper is to use Himmelman’s strategies for working together to assess the types of partnerships that are being formed by CSHPs and to explore the methodological usefulness of this framework. The Himmelman methodology describes four degrees of partnering interaction: networking, coordinating, cooperating, and collaborating, with each degree of interaction signifying a different level of partnership between organizations.Design/methodology/approach– Data were collected as part of the 2008-2009 and 2009-2010 CSHP annual Requests for Proposal from all 131 public school systems in Tennessee. Thematic analysis methods were used to assess partnerships in school systems. Descriptive analyses were completed to calculate individual collaboration scores for each of the eight CSHP components (comprehensive health education, physical education/activity, nutrition services, health services, mental health services, student, family, and community involvement, healthy school environment, and health promotion of staff) during the two data collection periods. The level of collaboration was assessed based on Himmelman’s methodology, with higher scores indicating a greater degree of collaboration. Scores were averaged to obtain a mean score and individual component scores were then averaged to obtain statewide collaboration index scores (CISs) for each CSHP component.Findings– The majority of CSHPs partnering activities can be described as coordination, level two in partnering interaction. The physical activity component had the highest CISs and scored in between coordinating and cooperating (2.42), while healthy school environment had the lowest score, scoring between networking and coordinating (1.93), CISs increased from Year 1 to Year 2 for all of the CSHP components. Applying the theoretical framework of Himmelman’s methodology provided a novel way to quantify levels of collaboration among school partners. This approach offered an opportunity to use qualitative and quantitative methods to explore levels of collaboration, determine current levels of collaboration, and assess changes in levels of collaboration over the study period.Research limitations/implications– This study provides a framework for using the Himmelman methodology to quantify partnerships in a HPS program in the USA. However, the case study nature of the enquiry means that changes may have been influenced by a range of contextual factors, and quantitative analyses are solely descriptive and therefore do not provide an opportunity for statistical comparisons.Practical implications– Quantifying collaboration efforts is useful for HPS programs. Community activities that link back to the classroom are important to the success of any HPS program. Himmelman’s methodology may be useful when applied to HPSs to assess the quality of existing partnerships and guide program implementation efforts.Originality/value– This research is the first of its kind and uses a theoretical framework to quantify partnership levels in school health programs. In the future, using this methodology could provide an opportunity to develop more effective partnerships in school health programs, health education, and public health.
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Hearld LR, Bleser WK, Alexander JA, Wolf LJ. A Systematic Review of the Literature on the Sustainability of Community Health Collaboratives. Med Care Res Rev 2015; 73:127-81. [DOI: 10.1177/1077558715607162] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 08/20/2015] [Indexed: 11/17/2022]
Abstract
Recent interest in community health collaboratives has been driven by the potential of these types of organizations to solve complex health problems at the local level by bringing together stakeholders that have traditionally operated independently, and often at cross-purposes. Much of the work that is central to the mission of collaboratives can take years to reach fruition, however, and there are a number of challenges to sustaining their activities. In this article, we systematically reviewed the theoretical and empirical literature on health care collaborative sustainability, focusing on definitions and antecedents of sustainability. Given the diversity and fragmentation of this literature, we used this review as a foundation to develop a synthesized definition, conceptual groups of antecedents, and potential research propositions to help guide future research, planning, and practice of sustainable community health collaboratives.
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Affiliation(s)
| | | | | | - Laura J. Wolf
- The Pennsylvania State University, University Park, PA, USA
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21
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Bess KD. Reframing coalitions as systems interventions: a network study exploring the contribution of a youth violence prevention coalition to broader system capacity. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 55:381-395. [PMID: 25828646 DOI: 10.1007/s10464-015-9715-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This longitudinal research conceptualizes community coalitions as events in local intervention systems (Hawe et al. in Am J Commun Psychol 43(3-4):267-276, 2009). It explores the potential contribution coalitions make, through the collaborative activities of their members, to the broader intervention systems in which they are embedded. Using social network analysis, it examines patterns of structural change in a network of 99 organizations focused on youth violence prevention (YVP) over a 5-year period in which 30 of the 99 organizations were involved in a local YVP Coalition. Both longitudinal modeling and cross sectional analyses are used to examine change in system capacity-strong interorganizational networks-related to patterns of network density, centralization, and hierarchy. Somewhat surprisingly, the study found that capacity in the broader YVP Intervention System actually diminished during the 5-year period of the coalition's operation, though part of the system-the sub-network that made up the YVP Coalition-was marginally strengthened. In this case, therefore, the evidence suggests that power and relational resources in the broader YVP Intervention System were redistributed. The article explores how the definition of capacity related to density and hierarchy may be contextually dependent. Implications for the role of coalitions in building system capacity are discussed.
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Affiliation(s)
- Kimberly D Bess
- Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, Peabody 90, Nashville, TN, 37203, USA,
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22
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Maras MA, Weston KJ, Blacksmith J, Brophy C. Examining statewide capacity for school health and mental health promotion: a post hoc application of a district capacity-building framework. Health Promot Pract 2014; 16:176-83. [PMID: 25351195 DOI: 10.1177/1524839914556091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Schools must possess a variety of capacities to effectively support comprehensive and coordinated school health promotion activities, and researchers have developed a district-level capacity-building framework specific to school health promotion. State-level school health coalitions often support such capacity-building efforts and should embed this work within a data-based, decision-making model. However, there is a lack of guidance for state school health coalitions on how they should collect and use data. This article uses a district-level capacity-building framework to interpret findings from a statewide coordinated school health needs/resource assessment in order to examine statewide capacity for school health promotion. Participants included school personnel (N = 643) from one state. Descriptive statistics were calculated for survey items, with further examination of subgroup differences among school administrators and nurses. Results were then interpreted via a post hoc application of a district-level capacity-building framework. Findings across districts revealed statewide strengths and gaps with regard to leadership and management capacities, internal and external supports, and an indicator of global capacity. Findings support the utility of using a common framework across local and state levels to align efforts and embed capacity-building activities within a data-driven, continuous improvement model.
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23
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Aarons GA, Fettes DL, Hurlburt MS, Palinkas LA, Gunderson L, Willging CE, Chaffin MJ. Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2014; 43:915-28. [PMID: 24611580 PMCID: PMC4294431 DOI: 10.1080/15374416.2013.876642] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team approach. Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare. Semistructured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment framework. Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration; competing priorities across levels of leadership; power struggles; and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. System-wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes.
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Affiliation(s)
- Gregory A Aarons
- a Department of Psychiatry , University of California, San Diego and Child and Adolescent Services Research Center
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Raine KD, Sosa Hernandez C, Nykiforuk CIJ, Reed S, Montemurro G, Lytvyak E, MacLellan-Wright MF. Measuring the progress of capacity building in the Alberta Policy Coalition for Cancer Prevention. Health Promot Pract 2013; 15:496-505. [PMID: 24334541 DOI: 10.1177/1524839913511627] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Alberta Policy Coalition for Cancer Prevention (APCCP) represents practitioners, policy makers, researchers, and community organizations working together to coordinate efforts and advocate for policy change to reduce chronic diseases. The aim of this research was to capture changes in the APCCP's capacity to advance its goals over the course of its operation. We adapted the Public Health Agency of Canada's validated Community Capacity-Building Tool to capture policy work. All members of the APCCP were invited to complete the tool in 2010 and 2011. Responses were analyzed using descriptive statistics and t tests. Qualitative comments were analyzed using thematic content analysis. A group process for reaching consensus provided context to the survey responses and contributed to a participatory analysis. Significant improvement was observed in eight out of nine capacity domains. Lessons learned highlight the importance of balancing volume and diversity of intersectoral representation to ensure effective participation, as well as aligning professional and economic resources. Defining involvement and roles within a coalition can be a challenging activity contingent on the interests of each sector represented. The participatory analysis enabled the group to reflect on progress made and future directions for policy advocacy.
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Affiliation(s)
- Kim D Raine
- University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Shandy Reed
- Alberta Policy Coalition for Chronic Disease Prevention, Edmonton, Alberta, Canada
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Southerland J, Behringer B, Slawson DL. Using the give-get grid to understand potential expectations of engagement in a community-academic partnership. Health Promot Pract 2013; 14:909-17. [PMID: 23539266 DOI: 10.1177/1524839913477657] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research suggests that stakeholder investment is maximized when partnerships understand the assumptions held by partners of the benefits to be derived and contributions to be made to the partnership. In 2011, representatives from seven rural county high schools and five university departments participated in a planning workshop designed to identify elements of an effective community-academic partnership to address adolescent obesity disparity in Southern Appalachia. The purpose of this investigation was to examine key elements of partnership building by way of the Give-Get Grid partnership tool. Content analysis was conducted to identify emerging themes. University representatives consistently identified more proposed program contributions as well as benefits than their high school partners. University personnel responses generally pertained to their level of participation and investment in the partnership, whereas high school personnel tended to identify contributions fundamental to both partnership and program success. Additionally, content analysis uncovered programmatic facilitators and potential barriers that can be instrumental in program planning and forming program messages. Findings suggest that although partners often share common goals, perceptions of the value of investment and benefits may vary. The Give-Get Grid can be used during the program-planning phase to help identify these differences. Implications for practice are discussed.
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26
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Cook WK, Weir RC, Ro M, Ko KL, Panapasa S, Bautista R, Asato L, Corina C, Cabllero J, Islam N. Improving Asian American, Native Hawaiian, and Pacific Islander health: national organizations leading community research initiatives. Prog Community Health Partnersh 2012; 6:33-41. [PMID: 22643786 DOI: 10.1353/cpr.2012.0008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Functionally, many CBPR projects operate through a model of academic partners providing research expertise and community partners playing a supporting role. OBJECTIVES To demonstrate how national umbrella organizations deeply rooted in communities, cognizant of community needs, and drawing on the insights and assets of community partners, can lead efforts to address health disparities affecting their constituents through research. METHODS Case studies of two Asian American, Native Hawaiian, and Pacific Islander national organizations. RESULTS Strategically engaging a diverse range of partners and securing flexible funding mechanisms that support research were important facilitators. Main challenges included limited interest of local community organizations whose primary missions as service or health care providers may deprioritize research. CONCLUSIONS Efforts to make research relevant to the work of community partners and to instill the value of research in community partners, as well as flexible funding mechanisms, may help to promote community-driven research.
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Christianson JB, Volmar KM, Alexander J, Scanlon DP. A report card on provider report cards: current status of the health care transparency movement. J Gen Intern Med 2010; 25:1235-41. [PMID: 20625849 PMCID: PMC2947645 DOI: 10.1007/s11606-010-1438-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 01/28/2010] [Accepted: 06/15/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Public reporting of provider performance can assist consumers in their choice of providers and stimulate providers to improve quality. Reporting of quality measures is supported by advocates of health care reform across the political spectrum. OBJECTIVE To assess the availability, credibility and applicability of existing public reports of hospital and physician quality, with comparisons across geographic areas. APPROACH Information pertaining to 263 public reports in 21 geographic areas was collected through reviews of websites and telephone and in-person interviews, and used to construct indicators of public reporting status. Interview data collected in 14 of these areas were used to assess recent changes in reporting and their implications. PARTICIPANTS Interviewees included staff of state and local associations, health plan representatives and leaders of local health care alliances. RESULTS There were more reports of hospital performance (161) than of physician performance (103) in the study areas. More reports included measures derived from claims data (mean, 7.2 hospital reports and 3.3 physician reports per area) than from medical records data. Typically, reports on physician performance contained measures of chronic illness treatment constructed at the medical group level, with diabetes measures the most common (mean number per non-health plan report, 2.3). Patient experience measures were available in more hospital reports (mean number of reports, 1.2) than physician reports (mean, 0.7). Despite the availability of national hospital reports and reports sponsored by national health plans, from a consumer standpoint the status of public reporting depended greatly on where one lived and health plan membership. CONCLUSIONS Current public reports, and especially reports of physician quality of care, have significant limitations from both consumer and provider perspectives. The present approach to reporting is being challenged by the development of new information sources for consumers, and consumer and provider demands for more current information.
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Affiliation(s)
- Jon B Christianson
- Division of Health Policy and Management, University of Minnesota, 420 Delaware Street SE, MMC 729, Minneapolis, MN 55455, USA.
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