Khosla Nidhi, Marsteller Jill Ann, Hsu Yea Jen, Elliott David L
Department of Health Sciences, University of Missouri, USA.
Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, USA.
Soc Sci Med. 2016 Feb;150:85-94. doi: 10.1016/j.socscimed.2015.12.006. Epub 2015 Dec 15.
Agencies with different foci (e.g. nutrition, social, medical, housing) serve people living with HIV (PLHIV). Serving needs of PLHIV comprehensively requires a high degree of coordination among agencies which often benefits from more frequent communication. We combined Social Network theory and Relational Coordination theory to study coordination among HIV agencies in Baltimore. Social Network theory implies that actors (e.g., HIV agencies) establish linkages amongst themselves in order to access resources (e.g., information). Relational Coordination theory suggests that high quality coordination among agencies or teams relies on the seven dimensions of frequency, timeliness and accuracy of communication, problem-solving communication, knowledge of agencies' work, mutual respect and shared goals. We collected data on frequency of contact from 57 agencies using a roster method. Response options were ordinal ranging from 'not at all' to 'daily'. We analyzed data using social network measures. Next, we selected agencies with which at least one-third of the sample reported monthly or more frequent interaction. This yielded 11 agencies whom we surveyed on seven relational coordination dimensions with questions scored on a Likert scale of 1-5. Network density, defined as the proportion of existing connections to all possible connections, was 20% when considering monthly or higher interaction. Relational coordination scores from individual agencies to others ranged between 1.17 and 5.00 (maximum possible score 5). The average scores for different dimensions across all agencies ranged between 3.30 and 4.00. Shared goals (4.00) and mutual respect (3.91) scores were highest, while scores such as knowledge of each other's work and problem-solving communication were relatively lower. Combining theoretically driven analyses in this manner offers an innovative way to provide a comprehensive picture of inter-agency coordination and the quality of exchange that underlies collaborative ties. These methods together can identify areas that could be targeted to promote closer ties.
不同重点领域的机构（如营养、社会、医疗、住房）为艾滋病毒感染者（PLHIV）提供服务。全面满足艾滋病毒感染者的需求需要各机构之间高度协调，而这种协调往往得益于更频繁的沟通。我们结合社会网络理论和关系协调理论，研究了巴尔的摩艾滋病毒防治机构之间的协调情况。社会网络理论表明，行动者（如艾滋病毒防治机构）相互建立联系以获取资源（如信息）。关系协调理论认为，机构或团队之间的高质量协调依赖于沟通的频率、及时性和准确性、解决问题的沟通、对机构工作的了解、相互尊重和共同目标这七个维度。我们使用名册法收集了57个机构的联系频率数据。回答选项为从“完全没有”到“每天”的有序量表。我们使用社会网络测量方法分析数据。接下来，我们选择了至少三分之一的样本报告每月或更频繁互动的机构。这产生了11个机构，我们就关系协调的七个维度对其进行了调查，问题的评分采用1至5的李克特量表。网络密度定义为现有连接数与所有可能连接数的比例，考虑每月或更高频率互动时为20%。各个机构与其他机构的关系协调得分在1.17至5.00之间（最高可能得分5）。所有机构不同维度的平均得分在3.30至4.00之间。共同目标（4.00）和相互尊重（3.91）得分最高，而诸如对彼此工作的了解和解决问题的沟通等得分相对较低。以这种方式结合理论驱动的分析提供了一种创新方法，以全面了解机构间协调以及构成合作关系基础的交流质量。这些方法共同可以确定可以作为目标以促进更紧密联系的领域。
