Implementation of cross-sector partnerships: a description of implementation factors related to addressing social determinants to reduce racial disparities in adverse birth outcomes

Abstract

IntroductionTraditional perinatal care alone cannot address the social and structural determinants that drive disparities in adverse birth outcomes. Despite the wide acceptance of partnerships between healthcare systems and social service agencies to address this challenge, there needs to be more research on the implementation factors that facilitate (or hinder) cross-sector partnerships, particularly from the perspective of community-based organizations. This study aimed to integrate the views of healthcare staff and community-based partner organizations to describe the implementation of a cross-sector partnership designed to address social and structural determinants in pregnancy.MethodsWe used a mixed methods design (in-depth interviews and social network analysis) to integrate the perspectives of healthcare clinicians and staff with those of community-based partner organizations to identify implementation factors related to cross-sector partnerships.ResultsWe identified seven implementation factors related to three overarching themes: relationship-centered care, barriers and facilitators of cross-sector partnerships, and strengths of a network approach to cross-sector collaboration. Findings emphasized establishing relationships between healthcare staff, patients, and community-based partner organizations.ConclusionThis study provides practical insights for healthcare organizations, policymakers, and community organizations that aim to improve access to social services among historically marginalized perinatal populations.

Institutional Approaches for Studying System-Oriented Networks

“…PARTNER. Varda and colleagues developed a program to analyze, record, and track networks to enhance relationships (PARTNER) tool to systematically analyze cross-sector networks [11,41]. Using a survey methodology, the PARTNER tool captures data on the structure of networks as well as on four dimensions within a network that serve as a measure of quality: attribution, perceptions, agreement, and interrelationships [11,41].…”

“…Varda and colleagues developed a program to analyze, record, and track networks to enhance relationships (PARTNER) tool to systematically analyze cross-sector networks [11,41]. Using a survey methodology, the PARTNER tool captures data on the structure of networks as well as on four dimensions within a network that serve as a measure of quality: attribution, perceptions, agreement, and interrelationships [11,41]. These dimensions are used to develop a better understanding of network structure and effectiveness and inform decision-making on how to move the network from where it is to where the members of the network want it to be [11].…”

“…Bohnett et al [45] used data collected through PARTNER with an ERGM to understand the role of organizational resource contributions in creating and maintaining inter-organizational ties within Florida healthcare collaboratives. Similarly, Blebu et al [41] used the data collected through PARTNER to identify factors that promote or hinder partnerships between healthcare workers and community-serving organizations. Rimkunas and Mellin [44] argue that the PARTNER tool may be used to apply and test components of social capital theory, at least within the context of interprofessional collaborations.…”

“…Typical applications of the PARTNER tool incorporate a mixed-methods analytical approach, usually combining qualitative interviews with descriptive social network measures such as density and centralization; as an added bonus, the PARTNER tool also enables the researcher to measure factors such as trust within the network through the survey instrument [41,[49][50][51]. Other quantitative approaches have also been used along with the data collected through PARTNER.…”

Comprehensive Perinatal Substance Use Disorder Intervention—A Window of Opportunity to Prevent Child Maltreatment Equitably

“…Comprehensive perinatal SUD care that includes cross-sector collaboration and information sharing among primary care settings, obstetric clinicians, substance use treatment professionals, and social workers has shown improved outcomes for pregnant people and their families. 8 However, this approach requires adequate funding to support coordination efforts. Legal solutions to information sharing and reimbursement structures that reward clinicians for spending necessary time with patients are also still needed.…”