J. Hope Corbin

What makes intersectoral partnerships for health promotion work? A review of the international literature

Abstract A Health in All Policies approach requires creating and sustaining intersectoral partnerships for promoting population health. This scoping review of the international literature on partnership functioning provides a narrative synthesis of findings related to processes that support and inhibit health promotion partnership functioning. Searching a range of databases, the review includes 26 studies employing quantitative (n = 8), qualitative (n = 10) and mixed method (n = 8) designs examining partnership processes published from January 2007 to June 2015. Using the Bergen Model of Collaborative Functioning as a theoretical framework for analyzing the findings, nine core elements were identified that constitute positive partnership processes that can inform best practices: (i) develop a shared mission aligned to the partners’ individual or institutional goals; (ii) include a broad range of participation from diverse partners and a balance of human and financial resources; (iii) incorporate leadership that inspires trust, confidence and inclusiveness; (iv) monitor how communication is perceived by partners and adjust accordingly; (v) balance formal and informal roles/structures depending upon mission; (vi) build trust between partners from the beginning and for the duration of the partnership; (vii) ensure balance between maintenance and production activities; (viii) consider the impact of political, economic, cultural, social and organizational contexts; and (ix) evaluate partnerships for continuous improvement. Future research is needed to examine the relationship between these processes and how they impact the longer-term outcomes of intersectoral partnerships.

Evaluation of a Community–Academic Partnership Lessons From Latinos in a Network for Cancer Control

Established in 2002, Latinos in a Network for Cancer Control is a community–academic network supported by the Centers for Disease Control and Prevention and the National Cancer Institute. The network includes >130 individuals from 65 community and academic organizations committed to reducing cancer-related health disparities. Using an empirically derived systems model—the Bergen Model of Collaborative Functioning—as the analytic frame, we interviewed 19 partners to identify challenges and successful processes. Findings indicated that sustained partner interaction created “meaningful relationships” that were routinely called on for collaboration. The leadership was regarded positively on vision, charisma, and capacity. Limitations included overreliance on a single leader. Suggestions supported more delegation of decision making, consistent communication, and more equitable resource distribution. The study highlighted new insights into dynamics of collaboration: Greater inclusiveness of inputs (partners, finances, mission) and loosely defined roles and structure produced strong connections but less network-wide productivity (output). Still, this profile enabled the creation of more tightly defined and highly productive subgroups, with clear goals and roles but less inclusive of inputs than the larger network. Important network outputs included practice-based research publications, cancer control intervention materials, and training to enhance the use of evidence-based interventions, as well as continued and diversified funding.

Grassroots volunteers in context: rewarding and adverse experiences of local women working on HIV and AIDS in Kilimanjaro, Tanzania

Many nongovernmental organizations in Africa rely on grassroots volunteers to provide critical health services. Considering context and the interplay of individual, organizational, and societal influences on the experience of volunteers, this paper addresses three questions: What do grassroots volunteers contribute? What organizational processes promote volunteer engagement? What are the positive and negative consequences of volunteering? Eighteen members and staff of the Tanzanian HIV and AIDS NGO, KIWAKKUKI, were selected from 6000+ women volunteers to be interviewed. The interviews were recorded, transcribed, and analyzed for themes. Within KIWAKKUKI, volunteers contributed time and local knowledge, leading to an indigenous educational approach building on local norms and customs. Volunteers’ engagement was motivated by the desire to support family members, reverse stigma, and work/socialize with other women. Benefits to volunteers included skills acquisition and community recognition; yet some volunteers also reported negative experiences including burnout, conferred stigma, and domestic violence. Positive organizational processes built on cultural practices such as collective decision-making and singing. The findings point to important considerations about context, including the synergistic effect training can have on local traditions of caring, complications of gender inequity, and how community health planning processes may need to be modified in extremely poor settings. This research also suggests good utility of the research framework (the Bergen Model of Collaborative Functioning) that was used to analyze volunteer engagement for service delivery in sub-Saharan contexts.

Health promotion research in the United Nations' Post-2015 agenda

The health promotion community has an important role to play in the development and implementation of global development goals. This issue of our Journal shows how we align our efforts with global relevance and a broad vision of health promotion research and action. The 65th Annual United Nations Department of Public Information/Nongovernmental Organization (DPI/NGO) conference took place at the UN headquarters in New York from 27 to 29 August 2014. The title this year—‘2015 and Beyond: Our Action Agenda’—reflected its goal of examining ‘The role of civil society in the post-2015 development agenda’ (UN DPI/NGO, 2014a). Over 4000 NGOs participated in person at the conference, with even more following sessions online (UN DPI/NGO, 2014b). The conference brought together diverse interest groups in sessions discussing poverty eradication, inequity, sustainable development, human rights, climate change and a range of other topics. The content of the conference was timely, but the process of participant engagement was equally of note. Twice-daily roundtable sessions were held where the Declaration Drafting Committee would take, entertain and discuss additions and deletions to the Conference Declaration, which would be the official recommendation of the conference participants on the Post-2015 agenda.

The International Union for Health Promotion and Education (IUHPE) Student and Early Career Network (ISECN): a case illustrating three strategies for maximizing synergy in professional collaboration.

The International Union for Health Promotion and Education (IUHPE) Student and Early Career Network (ISECN) was constructed upon a foundation of research, using the Bergen Model of Collaborative Functioning (BMCF) as a blueprint to inform its leadership, communication, structure, and culture. The BMCF consists of inputs (partners, mission, and financial resources), throughputs (operational processes), and outputs (synergy and antagony). In this commentary, we use the BMCF to describe the ISECN work, highlighting opportunities, successes, and challenges. We also put forward three strategies derived from the BMCF that have been purposefully employed by ISECN to maximize its production of synergy from the voluntary contributions of its members.

An Ecological Understanding of Caregiver Experiences in Palliative Care

ABSTRACT Palliative care is specialized health care to improve quality of life for patients with serious illness and their families through prevention and relief of suffering. A Palliative Care Institute was held in western Washington to capture community voices about diverse needs, strengths, and opportunities for improvement of palliative care. Researchers employed qualitative methods to obtain thematic data, provide real-time analysis, and engage in a multivoting technique to reflect stakeholder interest in individual themes and prioritize larger group interests. Bronfenbrenner’s ecological systems framework was used to explore caregiver experiences. Within the microsystem, caregivers reported difficulties in interactions with medical providers as a key challenge. Within the mesosysytem, interactions between patients and medical providers and the impact on caregivers were explored. Within the exosystem, caregivers reported lack of control over the schedules of personal care staff. Macrosystem influences included impact of local culture on the development of palliative care services. Chronosystem influences include de-medicalization of childbirth and its impact on perceptions of palliative care. Implications include the need for social workers to be proactive in fostering trust and effective communication between care providers and caregivers, and the demand for health care provider training in communication with patients and families.

Sustainable development goals for health promotion: a critical frame analysis

The Sustainable Development Goals (SDGs) lay the foundations for supporting global health and international development work for the next 15 years. Thirty years ago, the Ottawa Charter defined health promotion and outlined key principles for global action on health, including the importance of advocating, enabling and mediating for health equity. Advocacy underscores a human right to health and suggests political action to support its attainment. Enabling speaks to health promotions focus on the empowerment of people and communities to take control over their health and aspirations. Mediation draws attention to the critical intersectoral partnerships required to address health and social inequities. Underpinned by this approach, the aim of this paper is to consider how key health promotion principles, namely, rights, empowerment and partnership feature (and are framed) within the SDGs and to consider how these framings may shape future directions for health promotion. To that end, a critical frame analysis of the Transforming Our World document was conducted. The analysis interrogated varying uses and meanings of partnerships, empowerment and rights (and their connections) within the SDGs. The analysis here presents three framings from the SDGs: (1) a moral code for global action on (in)equity; (2) a future orientation to address global issues yet devoid of history; and (3) a reductionist framing of health as the absence of disease. These framings raise important questions about the underpinning values of the SDGs and pathways to health equity - offering both challenges and opportunities for defining the nature and scope of health promotion.