A multiple-case study of intersectoral collaboration in comprehensive school health promotion using the DIagnosis of Sustainable Collaboration (DISC) model

Abstract

Purpose – Intersectoral collaboration is often a prerequisite for effective interventions in public health. The purpose of this paper is to assess the facilitating and hindering conditions regarding intersectoral collaboration between health authorities, public health services (PHSs), public services stakeholders (PPSs) and the education sector in comprehensive school health promotion (CSHP) in the Netherlands. Design/methodology/approach – CSHP collaborations in five Dutch regions were studied using a questionnaire based on the DIagnosis of Sustainable Collaboration (DISC) model, focusing on: change management; perceptions, intentions and actions of collaborating parties; project organization; and factors in the wider context. Univariate and multivariate analyses with bootstrapping were applied to 106 respondents (62 percent response). Findings – A similar pattern of facilitating and hindering conditions emerged for the five regions, showing positive perceptions, but fewer positive intentions and actions. An overall favorable internal and external context for collaboration was found, but limited by bureaucratic procedures and prioritizing stakeholders’ own organizational goals. Change management was rarely applied. Some differences between sectors emerged, with greatest support for collaboration found among the coordinating organizations (PHSs) and least support among the financing organization (municipalities). Research limitations/implications – The generalization of the findings is limited to the initial formation stage of collaboration, and may be affected by selection bias, small sample size and possible impact of interdepartmental collaboration within organizations. Practical implications – The authors recommend establishing stronger change management to facilitate translation of positive perceptions into intentions and actions, and coordination of divergent organizational structures and orientations among collaborating parties. Originality/value – The results show that it is valuable for collaborating parties to conduct DISC analyses to improve intersectoral collaboration in CSHP.

Basic Criteria, Models, and Indicators of Intersectoral Collaboration in Health Promotion: A Scoping Study

“…Assessment of the applied models revealed that there was a fairly good variation in studies. The applied models were: DISC (17)(18)(19)(20), Bergen (11,14), Himelman (15), network analysis (16), social network analysis (10,21), act for life collaboration continuum (22), Tukman (23), collective impact approach (24), system analysis (25), and logic (26,27).…”

Effectiveness of a systematic approach to promote intersectoral collaboration in comprehensive school health promotion-a multiple-case study using quantitative and qualitative data

“…The trajectory started with DISC analyses, offering a thorough analysis of facilitating and impeding factors in five regional HSA collaborations spread across the Netherlands. The analyses showed that stakeholders’ positive perceptions about the HSA needed to be more fully translated into positive intentions and real actions and that change management and project management were hardly applied, even though they were considered crucial for this transition [ 19 ]. Based on these diagnoses, we advised the regional coordinators of the five HSA collaborations to focus on the development of effective change management and project management.…”

“…The increasing understanding of public health schools as social adaptive systems stimulates the study of intersectoral collaboration in CSHP. This perspective puts an emphasis on the need of joint work between relevant actors at different levels (individual, organizational, policy level) and from various sectors (health, education and authorities) to successfully implement CSHP [ 18 , 19 ].…”

Predictors and mediators of sustainable collaboration and implementation in comprehensive school health promotion

“…Multiple-case study based on the DISC model In 2008-2011, the DISC model and results of DISC questionnaires were used to support five Dutch regions in the systematic development of intersectoral collaboration in a two-year trajectory. The five HSA collaborations were diagnosed by means of a survey among the relevant stakeholders from health services, PHSs and municipal authorities (Pucher et al, 2015b). Regions independently indicated that adequately situating the HSA within the PHS and positioning it in the region together with PSSs should get priority.…”