School of Medicine, University of Colorado Anschutz Medical Campus, ACCORDS (Adult and Child Center for Outcomes Research and Delivery Science), Aurora, Colorado, USA.
Department of Health Systems, Management & Policy, Colorado School of Public Health, Aurora, Colorado, USA.
Health Serv Res. 2024 Feb;59 Suppl 1(Suppl 1):e14242. doi: 10.1111/1475-6773.14242. Epub 2023 Sep 28.
Assess changes in cross-sector collaboration between Nurse-Family Partnership (NFP) nurse home visitors and community providers in the United States.
We collected primary data via internet-based surveys of all NFP nursing supervisors in the United States in 2018, 2020, and 2021.
We conducted a panel survey to measure changes in cross-sector collaboration between NFP nurses and 10 provider types in healthcare and social services. We assessed relational coordination using the validated seven item Relational Coordination Scale and structural integration using four items adapted from the Interagency Collaboration Activities Scale. Responses over time were compared using one-way analysis of variances (ANOVAs) and pairwise t-tests. We used the Kruskal-Wallis rank test to assess differences in collaboration by implementing agency type.
All nursing supervisors from NFP implementing agencies in the United States were eligible for the study. Survey implementation was conducted using Qualtrics and administered to all eligible participants (N = 370 [2018], 383 [2020], 414 [2021]). Email reminders were sent every 7-10 days, followed by a final telephone outreach.
The response rate was 71% in 2018, 83% in 2020, and 74% in 2021. Relational coordination scores were calculated as a mean of the seven items and ranged from 1 to 5 (not at all to completely); integration scores were calculated as a sum of the four items and ranged from 4 to 20, where higher scores indicated greater sharing of resources. Coordination with women's care increased from 2018 to 2020 (M = 3.39 vs. 3.57; p < 0.01); while coordination (M = 3.23 vs. 3.01; p < 0.05) and integration (M = 6.50 vs. 5.28 vs. 5.43; p < 0.01) with parenting programs decreased.
Changes to cross-sector collaboration varied by provider type, likely due to the delivery of NFP and other services via telehealth during the COVID-19 pandemic. There is an opportunity to improve cross-sector collaboration in home visiting to better address family needs.
评估美国母婴家庭健康合作项目（NFP）家访护士与社区提供者之间跨部门合作的变化。
我们通过 2018 年、2020 年和 2021 年在美国进行的互联网调查，收集了所有 NFP 护理主管的主要数据。
我们进行了一项面板调查，以衡量 NFP 护士与医疗保健和社会服务领域的 10 种提供者类型之间跨部门合作的变化。我们使用经过验证的七项关系协调量表评估关系协调，使用来自机构间合作活动量表的四项指标评估结构整合。使用单向方差分析（ANOVA）和成对 t 检验比较随时间的响应。我们使用 Kruskal-Wallis 秩检验按实施机构类型评估合作差异。
美国所有实施 NFP 的机构的护理主管都有资格参加这项研究。使用 Qualtrics 进行调查实施，并向所有符合条件的参与者（2018 年为 370 名[2018 年]、2020 年为 383 名[2020 年]、2021 年为 414 名[2021 年]）进行调查。每隔 7-10 天发送电子邮件提醒，然后进行最后一次电话联系。
2018 年的回复率为 71%，2020 年为 83%，2021 年为 74%。关系协调得分计算为七个项目的平均值，范围为 1 到 5（完全不）；整合得分计算为四个项目的总和，范围为 4 到 20，得分越高表示资源共享越多。与妇女保健的协调从 2018 年到 2020 年有所增加（M=3.39 对 3.57；p<0.01）；而协调（M=3.23 对 3.01；p<0.05）和整合（M=6.50 对 5.28 对 5.43；p<0.01）与育儿计划减少。
跨部门合作的变化因提供者类型而异，这可能是由于 COVID-19 大流行期间通过远程医疗提供 NFP 和其他服务所致。有机会改善家访中的跨部门合作，以更好地满足家庭的需求。
