Drexel University, Nesbitt Hall Room 458, 3215 Market St NW, Philadelphia, PA, 19104, USA.
Equal Measure, Philadelphia, PA, USA.
J Urban Health. 2021 Oct;98(5):654-664. doi: 10.1007/s11524-021-00535-0. Epub 2021 Mar 15.
Latino immigrants are disproportionately impacted by substance use, HIV/AIDS, domestic violence, and mental health (SAVAME). The burden of these syndemic conditions is influenced by limited access to health and social services to prevent and treat these conditions. The syndemic nature of these factors necessitates an integrated, coordinated approach to address them simultaneously. We analyzed characteristics of Latino-serving organizations in Philadelphia, PA, that provide SAVAME-related health and/or social services, and their interorganizational collaborations to meet the needs of Philadelphia's Latino communities. We surveyed Latino-serving organizations (N=43) identified through existing resource directories and key informants. Network analyses identified patterns and density of collaborative ties (i.e., referrals, administrative, or planning/advocacy) across organizations and characterized these ties by type of service. Density (expressed as percent of all possible ties) revealed a higher referral rate (40%) than administrative (29%) or planning (26%) coordination. Network sociograms display clusters of providers by geography. Examination of bonding (within-group) ties revealed comparable perceptions of high value among both South/Center Philadelphia (57%) and in North Philadelphia providers (56%), but bridging (between-group) ties suggest lower levels of high-value perceptions (24%). No evident clustering by type of service based on syndemic factor was observed. Density of bridging across types of providers was highest for referrals (38%) followed by planning (23%) and administrative coordination (20%). Interventions to promote collaboration between providers should focus on facilitating administrative and planning collaborations that leverage existing capacity of the network. Given the syndemic nature of these conditions, greater collaboration between providers of complementing SAVAME services is imperative.
拉丁裔移民不成比例地受到物质使用、艾滋病毒/艾滋病、家庭暴力和心理健康(SAVAME)的影响。这些综合征状况的负担受到获得预防和治疗这些状况的卫生和社会服务的限制的影响。这些因素的综合征性质需要采取综合协调的方法来同时解决这些问题。我们分析了在宾夕法尼亚州费城提供 SAVAME 相关健康和/或社会服务的服务于拉丁裔的组织的特征,以及它们为满足费城拉丁裔社区的需求而进行的组织间合作。我们通过现有的资源目录和关键知情人调查了服务于拉丁裔的组织(N=43)。网络分析确定了组织之间合作关系(即转介、行政或规划/倡导)的模式和密度,并按服务类型对这些关系进行了描述。密度(以所有可能关系的百分比表示)显示转介率(40%)高于行政(29%)或规划(26%)协调。网络社会图显示了按地理位置划分的提供者集群。对粘结(组内)关系的考察表明,无论是在南/中心费城(57%)还是在北费城提供者(56%)中,都对高价值的看法相当一致,但在桥接(组间)关系中,对高价值的看法较低(24%)。没有观察到基于综合征因素的服务类型的聚类。转诊(38%)的桥梁密度最高,其次是规划(23%)和行政协调(20%)。促进提供者之间合作的干预措施应侧重于促进行政和规划合作,利用网络的现有能力。鉴于这些情况的综合征性质,互补 SAVAME 服务提供者之间的合作至关重要。