Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA.
Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Montreal, QC, Canada.
Health Policy Plan. 2019 Nov 1;34(Supplement_2):ii7-ii17. doi: 10.1093/heapol/czz116.
The current body of research into multisectoral collaborations (MSCs) for health raises more questions than it answers, both in terms of how to implement MSCs and how to study them. This article reflects on current methodological gaps and opportunities for advancing MSC research, based on a targeted review of existing literature and qualitative input from researchers and practitioners at the 2018 Health Systems Research (HSR) Symposium in Liverpool. Through framework analysis of 205 MSC research papers referenced in a separately published MSC 'overview of reviews' paper, this article identifies six broad MSC question domains ('meta questions') and applies content analysis to estimate the relative frequency with which these meta questions and the research method(s) used to answer them are present in the literature. Results highlight a preponderance of research exploring MSC implementation using case study methods, which, in aggregate, does not seem to adequately meet policymakers' and practitioners' needs for generalizable or transferable insights. The content analysis is complemented by qualitative insights from HSR Symposium participants and the authors' own experience to identify six key methodological gaps in research on MSC for health. For each of these gaps, we propose areas in which we believe there are opportunities for methodological development and innovation to help advance this field of study, including: better understanding the role of power dynamics in shaping MSCs; development of a classification framework (or frameworks) of governance arrangements; exploring divergence of perspective and experience among MSC partners; identifying or generating theoretical frameworks for MSC that work across sectors and disciplines; developing intermediate indicators of collaboration; and increasing transferability of insights to other contexts. Collaboration with researchers outside of the health sector will enhance efforts in each of these areas, as will the establishment and strengthening of pluralistic MSC evidence networks also involving policymakers and practitioners.
当前，多部门合作（MSCs）在健康领域的研究数量不断增加，但该领域仍存在诸多问题，不仅包括如何实施 MSCs，还包括如何对其进行研究。本文基于对现有文献的针对性回顾，以及 2018 年在利物浦举行的卫生系统研究（HSR）研讨会上研究人员和实践者的定性投入，反思了当前方法学上的差距和推进 MSCs 研究的机会。本文通过对另一份 MSC“综述”论文中引用的 205 篇 MSC 研究论文进行框架分析，确定了六个广泛的 MSC 问题领域（“元问题”），并对这些元问题及其回答中使用的研究方法的相对频率进行了内容分析。研究结果表明，使用案例研究方法探索 MSC 实施的研究居多，但总体而言，这些研究似乎并不能充分满足政策制定者和实践者对可推广或可转移的见解的需求。内容分析补充了 HSR 研讨会参与者和作者自身经验的定性见解，以确定健康领域 MSCs 研究中存在的六个关键方法学差距。对于每一个差距，我们都提出了一些领域，我们认为在这些领域有机会进行方法学的发展和创新，以帮助推进这一研究领域，包括：更好地理解权力动态在塑造 MSCs 中的作用；制定治理安排的分类框架（或框架）；探索 MSC 合作伙伴之间观点和经验的分歧；为跨部门和学科的 MSC 确定或生成理论框架；开发合作的中间指标；并提高见解在其他背景下的可转移性。与卫生部门以外的研究人员合作，将增强这些领域的工作，同时建立和加强多元化的 MSCs 证据网络，其中还包括政策制定者和实践者。
