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建立用于慢性病预防的多方共同资助的多部门伙伴关系:对联邦政府公共卫生工作人员经验的定性调查

Developing co-funded multi-sectoral partnerships for chronic disease prevention: a qualitative inquiry into federal governmental public health staff experience.

作者信息

Johnston Lee M, Goldsmith Laurie J, Finegood Diane T

机构信息

Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada.

GoldQual Consulting, Toronto, Canada.

出版信息

Health Res Policy Syst. 2020 Aug 20;18(1):92. doi: 10.1186/s12961-020-00609-6.

Abstract

BACKGROUND

Multi-sectoral partnerships (MSPs) are frequently cited as a means by which governments can improve population health while leveraging the resources and expertise of the private and non-profit sectors. As part of their efforts in this area, the Public Health Agency of Canada (the Agency) introduced a novel funding programme requiring applicants to procure matched resources from private sources to support large-scale interventions for chronic disease prevention. The current literature on MSPs is limited in its applicability to this model of multi-sectoral engagement. The purpose of this study was to explore the experiences of Agency staff working with potential partners to develop programme applications, such that we might identify lessons from adopting this type of partnership approach.

METHODS

Semi-structured interviews were conducted with the 12 staff working in the MSP programme. Interviews were recorded, transcribed and analysed using thematic analysis. Preliminary themes were used to inform follow up focus-groups sessions. A second round of analysis was conducted guided by a coding paradigm focused on understanding process.

RESULTS

We identified "experiencing uncertainty" to be a central concept in participants' accounts of the MSP process, related specifically to the MSP programme's novel conditions, shifts that occurred in sectoral roles and demands for new capacities. In response, Agency staff employed strategies to clarify partner interests, build trust in inter-sectoral relationships, and support internal and partner capacity. Outcomes associated with this process include impacts on trust between the Agency and potential partners, a deeper understanding of other sectors, and programme adaptations and refinements to address challenges related to the programme model.

CONCLUSIONS

The co-funding model employed by the Agency is a potentially popular one for government bodies wanting to leverage funding from private sector sources. Our study identifies the potential challenges that can occur under this model. Some challenges are related to addressing material conditions related to partner capacity, whereas other challenges speak to deeper and more difficult to address concerns regarding trust and alignment of motivations and interests between partners. Future research exploring the challenges associated with specific models of MSP engagement is necessary to inform approaches to addressing complex problems through collaborative efforts.

摘要

背景

多部门伙伴关系(MSPs)常被视为政府改善民众健康的一种方式,同时可利用私营和非营利部门的资源与专业知识。作为其在该领域努力的一部分,加拿大公共卫生署(该署)推出了一项新的资助计划,要求申请者从私人来源获取匹配资源,以支持大规模慢性病预防干预措施。当前关于多部门伙伴关系的文献在应用于这种多部门参与模式时存在局限性。本研究的目的是探索该署工作人员与潜在伙伴合作制定项目申请的经验,以便我们能从采用这种伙伴关系方法中吸取经验教训。

方法

对多部门伙伴关系项目的12名工作人员进行了半结构化访谈。访谈进行了录音、转录,并采用主题分析法进行分析。初步主题用于指导后续焦点小组会议。第二轮分析在一个专注于理解过程的编码范式指导下进行。

结果

我们发现“经历不确定性”是参与者对多部门伙伴关系过程描述中的一个核心概念,具体与多部门伙伴关系项目的新条件、部门角色的转变以及对新能力的要求有关。作为回应,该署工作人员采取策略来明确伙伴的利益、建立部门间关系的信任以及支持内部和伙伴的能力。与这一过程相关的结果包括对该署与潜在伙伴之间信任的影响、对其他部门的更深入了解,以及为应对与项目模式相关的挑战而对项目进行的调整和完善。

结论

该署采用的共同资助模式对于希望利用私营部门资金的政府机构来说可能是一种受欢迎的模式。我们的研究确定了这种模式下可能出现的潜在挑战。一些挑战与解决与伙伴能力相关的物质条件有关,而其他挑战则涉及更深层次且更难解决的关于信任以及伙伴之间动机和利益一致性的问题。未来有必要开展研究,探索与特定多部门伙伴关系参与模式相关的挑战,以便为通过合作努力解决复杂问题的方法提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc21/7439681/c70944baa709/12961_2020_609_Fig1_HTML.jpg

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