Faculty of Law, Economics and Governance, School of Governance, Utrecht University, Utrecht, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
PLoS One. 2024 Jul 11;19(7):e0305262. doi: 10.1371/journal.pone.0305262. eCollection 2024.
Advancing public health through prevention necessitates collaboration among public, private, and community actors. Only together can these different actors amass the resources, knowledge, and community outreach required to promote health. Recent studies have suggested that university medical centres (UMCs) can play a key role in regional prevention networks, given their capacity to initiate, coordinate, drive, and monitor large partnerships. Yet, the literature often refers to prevention activities in general, leaving underexplored what UMCs can add to primary, universal prevention networks specifically. Moreover, UMCs operate in a crowded field of other organizations with extensive experience in primary prevention, who will already have an idea about what role UMCs should play in the network. This article presents a case study examining the potential role of a UMC within a densely interconnected stakeholder environment in the surroundings of a large city in the Netherlands. Combining insights from public health studies and network governance research, and integrating data from various methods, this study concludes that UMCs can enhance their contributions to prevention by assuming the role of network servants rather than network leaders. Stakeholders consider public health authorities or municipal governments as more logical candidates for coordinating the network. Moreover, partners often perceive-deservedly or not-UMCs as overly focused on the medical aspects of prevention, potentially neglecting social interventions, and as favouring universal treatments over tailor-made community interventions. At the same time, partner organizations hope that the UMCs join collaborations within the community, using their expertise to measure the impact of interventions and leveraging their prestige to generate attention for primary prevention. By synthesizing theoretical insights from multiple disciplines and analysing the empirics of network leaderships through multiple methods, this study offers UMCs a contextually-informed perspective on how to position themselves effectively within primary prevention networks.
通过预防措施推进公共卫生需要公共、私营和社区行为体之间的合作。只有这些不同的行为体共同努力，才能汇集促进健康所需的资源、知识和社区外联。最近的研究表明，鉴于大学医疗中心（UMC）有能力发起、协调、推动和监测大型伙伴关系，它们可以在区域预防网络中发挥关键作用。然而，文献通常一般提到预防活动，而没有深入探讨 UMC 可以为特定的初级、普遍预防网络增加什么。此外，UMC 处于一个拥挤的领域，其他组织在初级预防方面拥有丰富的经验，他们已经对 UMC 在网络中应扮演的角色有了想法。本文通过案例研究，考察了荷兰大城市周边一个高度互联的利益相关者环境中 UMC 的潜在作用。本研究结合公共卫生研究和网络治理研究的见解，并整合了来自多种方法的数据，得出结论认为，UMC 可以通过扮演网络服务者而不是网络领导者的角色，来增强其对预防工作的贡献。利益相关者认为公共卫生当局或市政府是协调网络的更合理人选。此外，合作伙伴通常认为——无论是否合理——UMC 过于关注预防的医学方面，可能忽视社会干预措施，并且偏爱通用治疗方法，而不是针对特定社区的干预措施。同时，伙伴组织希望 UMC 利用其专业知识来衡量干预措施的影响，并利用其声望为初级预防引起关注，参与社区内的合作。通过综合多个学科的理论见解，并通过多种方法分析网络领导力的实证，本研究为 UMC 提供了一个关于如何在初级预防网络中有效定位自己的背景化视角。
