Loneliness is a major social concern with health consequences worldwide for populations across different demographic, cultural, social, economic, geographic, and environmental contexts. In March 2021, we launched Horizon 2020 European Commission-funded project, 'Reimagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces (RECETAS)' to reduce loneliness and promote health-related quality of life. In this paper, we present the project logic model, informed by stakeholder input, that aims to guide the initiative from its design and implementation to its evaluation in six cities across three continents, including Europe (Barcelona, Helsinki, Marseille, Prague), Australia (Melbourne), and South America (Cuenca). This model is being used to guide the implementation and evaluation of nature-based social prescribing interventions. Process and outcome measures will be used to compare outcomes in different settings and population contexts. The use of a logic model with stakeholder input ensures that the interventions are responsive to local needs, sustainable, and transferable to other geographic, social, economic, and cultural contexts. Knowledge translation will be central to maximising impacts on population health, civil society, and health and social systems in urban areas.

PURPOSE:This study marks the 50th anniversary of NAPCRG (formerly the North American Primary Care Research Group) by examining social connections among members. METHODS:This descriptive social network analysis was conducted via the Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) survey tool. RESULTS:Responses from 906 participants resulted in 1,721 individuals with 5,196 partner relationships. Most relationships (60%) were characterized as having an integrated level of collaboration. Many relationships led to a research paper (58%) or a grant (34%). CONCLUSIONS:This social network analysis of NAPCRG members' relationships described over 5,000 relationships, many producing publications, grants, and perceived advancements in primary care.

INTRODUCTION:The purpose of this study is to assess a cross-sector, interorganizational network addressing adverse childhood experiences (ACEs) in a rural Colorado community. We characterize the organizations in the network, assess their awareness of ACEs, and evaluate how they participate in the network. We also assess the network health. METHOD:Employing a social network analysis approach, we collected survey data from 45 organizations that support young children and their families, including nonprofits, health care clinics, and early childhood education centers, among others. RESULTS:On average, nonprofit organizations had relationships with a greater percentage of network members than other types of organizations. Network members engaged in relationships focused on a wide range of activities (e.g., client assessments, sharing information, providing services), with some organizational types leading the network in certain activities. Scores across all dimensions of trust and value were above 3 (range: 2.1-3.8), which is advantageous for a network and network relationships existed across a range of relational intensities (from awareness to organizational integration). DISCUSSION:Nonprofit organizations that reported high levels of connectedness in the network were able to effectively mobilize the ACEs network. Health clinics participated in a greater share of relationships involving assessment, service provision, and tool sharing than other types of organizations. As such, health care clinics may serve as leaders in directly serving children and families experiencing ACEs in rural communities. The rural context may also explain high levels of trust and value, which can serve as assets for future network development and mobilization. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background Veteran suicide remains a significant issue, as 17.5 Veterans die by suicide each day. The US Department of Veteran Affairs (VA) has implemented a robust suicide prevention program within its integrated behavioural health system. Further, the VA has increasingly contributed to suicide prevention in community settings, where a large proportion of Veterans receive health care and social services. One component integral to preventing suicide among Veterans receiving community services is ensuring that organisations are equipped with the latest evidence-based Veteran-specific suicide prevention strategies.Methods The Patient Safety Center of Inquiry-Suicide Prevention Collaborative piloted a Veteran suicide prevention learning collaborative in the Denver/Colorado Springs, CO region, spanning 16 months as a multimodal initiative to integrate community organisations and assist them in implementing Veteran suicide prevention strategies used within VA. Agencies completed social network analysis surveys at baseline (T1), year 1 (T2) and 16 months (T3) to examine social networks, partnerships and collaborations among community organisations and the VA over time.Results The quantity of learning collaborative relationships increased from 30 at T1 to 41 at T3 while the quality of relationships deepened over time from awareness and cooperative to more coordinated and integrated.Conclusion Improvement in relationship quantity and quality facilitates community organisation engagement in collaborating to strengthen their Veteran suicide prevention programming. Learning collaboratives work with the individual organisation for intraorganisational facilitation of implementing suicide prevention strategies and engage and enhance interorganisational partnerships. This multimodal intervention can engage community organisations and provide a stronger safety net for Veterans at risk for suicide.

Interorganizational coalitions or collaboratives in healthcare are essential to address the health challenges of local communities, particularly during crises such as the Covid-19 pandemic. However, few studies use large-scale data to systematically assess the network structure of these collaboratives and understand their potential to be resilient or fragment in the face of structural changes. This paper analyzes data collected in 2009-2017 about 817 organizations (nodes) in 42 healthcare collaboratives (networks) throughout Florida, the third-largest U.S. state by population, including information about interorganizational ties and organizations' resource contributions to their coalitions. Social network methods are used to characterize the resilience of these collaboratives, including identification of key players through various centrality metrics, analyses of fragmentation centrality and core/periphery structure, and Exponential Random Graph Models to examine how resource contributions facilitate interorganizational ties. Results show that the most significant resource contributions are made by key players identified through fragmentation centrality and by members of the network core. Departure or removal of these organizations would both strongly disrupt network structure and sever essential resource contributions, undermining the overall resilience of a collaborative. Furthermore, one-third of collaboratives are highly susceptible to disruption if any fragmentation-central organization is removed. More fragmented networks are also associated with poorer health-system outcomes in domains such as education, health policy, and services. ERGMs reveal that two types of resource contributions - community connections and in-kind resource sharing - are especially important to facilitate the formation of interorganizational ties in these coalitions.

Transitions from pediatric to adult care by young adults with chronic conditions are fraught with challenges. Poor transitions lead to discontinuities of care that are avoidable with better communication between providers. We tested whether exposure to providers with sustained patient-sharing relationships resulted in fewer emergent admissions of young adults with congenital heart disease (CHD). Care transitions are particularly important for young adults with CHD. Though it is not possible to avoid planned admissions for scheduled procedures, emergency admissions are avoidable with proper care. We tested whether several different patient-sharing relationship measures influenced emergent admissions and found that compared with less severe CHD patients, those with severe CHD experienced a 4 to 10 percentage point decline in emergent admissions given a 5 percentage point increase in practice-level patient-sharing relationships. These results are consistent with our hypothesis that patient sharing improves communication and continuity of care across providers, especially for severe CHD patients.

This study examines the perspectives, resources, role and services provided by community-based organisations (CBOs) in response to the integration of health and social services to address individual unmet social needs, as well as the impact on organisational carrying capacity related to the ability to receive referrals from health system partners. Mixed methods combining qualitative interviews with 24 organisations and Social Network Analysis with 75 organisations were completed in 2018 in two communities (Denton, TX and Sarasota, FL) with robust examples of health and social systems alignment. Findings suggest that while community organisations are embedded in robust cross-sector networks, the potential increase in referrals from clinical settings is not something they are fully aware of, or prepared for, as evidenced by inadequate funding models, misalignment between capacity and capability, and a lack of coordination on screening and referral activities. Misalignment between clinical and CBO understanding of demand, needs and capacity present a potential risk in building strategies that integrate health and social services to address unmet social need. Failing to build a strong cross-sector screening and referral infrastructure that considers CBO capacity from the start could undermine the goal of improving population health through the integration of clinical and social care.

Collaboration between foundations and other organizations is critical to the success of foundation-supported initiatives, but the power dynamics among foundations, grantees, and their broader communities can be challenging. Social network analysis is a tool to assess collaboration among organizations and its outcomes. A unique yet often underemphasized benefit of this method of analysis is its focus on dyadic relationships between organizations, which presents an opportunity for foundations to evaluate their role in a network and how they are perceived by the very organizations whose missions they support. This article leverages a social network analysis of community partners focused on addressing needs of people experiencing homelessness and housing shortages to illustrate how the results can constructively inform foundations on how they are viewed by community partners along dimensions of trust, value, resource contribution, activities, and contribution to outcomes. The analysis is conducted using an online network survey, analysis, and reporting tool called PARTNER — Program to Analyze, Record and Track Networks to Enhance Relationships. The analysis of survey responses captures over 600 unique dyadic partnerships across more than 40 community organizations, including their relationships with participating foundations. The PARTNER tool satisfies the need to evaluate both the impact of collaborative initiatives supported by foundations and foundations’ roles in these efforts. Support for this publication was provided by the Robert Wood Johnson Foundation through the Systems for Action National Coordinating Center, ID 75150.

Today, cross‐sector partners are working together and utilizing a systems approach to solve and tackle complex social problems facing their communities. While building cross‐sector organizational networks has become a best practice in solving complex problems, there is little guidance or evidence on how it can be accomplished without overburdening resource‐stressed systems. Social network analysis (SNA) is one method for evaluating networks using a quantitative approach to measure the strength of connections, how organizations position themselves in a network, leverage resources, and assess the quality and impact of exchanges within the network. The PARTNER Tool (Program to Analyze, Record, and Track Networks to Enhance Relationships) leverages concepts of network science and SNA to provide a validated survey, measures, and analysis tool for network evaluation. The PARTNER methodology assesses the strengths (and gaps) among member relationships, how members perceive trust and value in partnerships, the creation of member relationships and how they have evolved, and identifies needs and gaps based on agreement on outcomes and success at reaching network goals. This chapter provides specific steps to implement the PARTNER Tool Methodology, including customizing the validating survey, administration of the online survey, analyzing the results using the PARTNER evaluation framework, and translating the data to actionable strategies. Real‐world examples are presented to highlight the benefits that can be achieved by leveraging network science with a focus on developing evidence‐based strategies that yield significant results and allow cross‐sector organizations to document their collective progress over time.

As evidence emerges that health outcomes are determined by factors outside of the clinical health care delivery system, the nonprofit sector's relevance to supporting positive health outcomes grows through the delivery of community-based services. This paper examines whether nonprofit community-based organizations have the capacity to absorb new referrals from clinical partners. The expectation of increasing referral activity raises concerns over limited nonprofit community carrying capacity. Using Social Network Analysis, we analyze the network of partners that make up two such community systems and determine the prominence of the referral function, the resources most frequently contributed to the network, dependence on primary revenue sources directly related to the clinical health care delivery system, and the community-based organizations’ perceptions of their financial stability and ability to rapidly respond to increasing referrals. The results suggest steps by which referrals from the clinical health care delivery system to community-based organizations can benefit both parties and health outcomes.

Purpose: Outpatient ACHD QIs have been developed but little evidence exists on performance using US population data. Insight into how provider networks are associated with care quality is important to understanding healthcare delivery systems. This study evaluated receipt of high quality care by young adults with congenital heart disease (CHD) using a recently developed set of outpatient adult congenital heart disease (ACHD) quality indicators (QIs). The study also assessed the association between QIs and provider network measures. Methods: Young adults (ages 16-31) with complex/severe CHD were identified using ICD9 codes …

The Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services have implemented Million Hearts (MH), an initiative to coordinate efforts across the United States to promote cardiovascular health. This report examines the partnerships developed in MH, defines the practices and approaches to cardiovascular disease prevention that occurred as a result of the program, and provides suggestions for future MH activities.

Community resilience has grown in importance in national disaster response and recovery efforts. However, measurement of community resilience, particularly the content and quality of relationships aimed at improving resilience, is lacking. To address this gap, we used a social network survey to measure the number, type, and quality of relationships among organizations participating in 16 coalitions brought together to address community resilience in the Los Angeles Community Disaster Resilience project. These coalitions were randomized to one of two approaches (community resilience or preparedness). Resilience coalitions received training and support to develop these partnerships and implement new activities. Both coalition types received expert facilitation by a public health nurse or community educator. We also measured the activities each coalition engaged in and the extent to which partners participated in these activities at two time points. We found that the community resilience coalitions were initially larger and had lower trust among members than the preparedness communities. Over time, these trust differences dissipated. While both coalitions grew, the resilience community coalitions maintained their size difference throughout the project. We also found differences in the types of activities implemented by the resilience communities; these differences were directly related to the trainings provided. This information is useful to organizations seeking guidance on expanding the network of community-based organizations that participate in community resilience activities.

This article details the development and implementation of the Federal Emergency Management Agency (FEMA) Corps program, a federal interagency partnership. While many federal agencies partner through fee-for-service arrangements and contracts, few contemporary examples of interagency program creation and implementation are available. This article develops an interagency collaboration framework by drawing from the collaboration literature, as well as literature on institutions, to examine the development of this unique partnership. This research draws on key informant interviews and content analysis of documentation, including the interagency agreement (IAA), historical records, memos, meeting minutes, and participant observations. Findings suggest that even in formal IAAs, a strong history of informal institutional collaboration may be an important antecedent of forming and implementing collaborative arrangements. Similarly, the presence of a champion may play an important role in cultivating and developing both informal and formal institutions that create an opportunity to collaborate. Finally, the rules-in-use and the rules-in-form may vary at different levels of management. As the federal government increasingly employs interagency partnerships, this article provides lessons for developing relationships, identifying and understanding roles, crossing organizational boundaries, and merging both agency cultures and administrative processes.

ObjectiveTo summarize ways that networks of community-based organizations (CBO), in partnership with public health departments, contribute to community recovery from disaster.MethodsThe study was conducted using an online survey administered one and 2 years after Hurricane Sandy to the partnership networks of 369 CBO and the New York Department of Health and Mental Hygiene. The survey assessed the structure and durability of networks, how they were influenced by storm damage, and whether more connected networks were associated with better recovery outcomes.ResultsDuring response and recovery, CBOs provide an array of critical public health services often outside their usual scope. New CBO partnerships were formed to support recovery, particularly in severely impacted areas. CBOs that were more connected to other CBOs and were part of a long-term recovery committee reported greater impacts on the community; however, a partnership with the local health department was not associated with recovery impacts.ConclusionCBO partners are flexible in their scope of services, and CBO partnerships often emerge in areas with the greatest storm damage, and subsequently the greatest community needs. National policies will advance if they account for the dynamic and emergent nature of these partnerships and their contributions, and clarify the role of government partners. (Disaster Med Public Health Preparedness. 2018;12:635-643)

The Million Hearts initiative has been successful at the national level in bringing stakeholders together to address cardiovascular disease, but the network could be enhanced and the level of membership commitment and activity could be strengthened.

Objective: To assess the structure, content, quality, and quantity of partnerships that developed in response to a national cardiovascular health initiative, Million Hearts. Design: This study used a social network analysis (SNA) approach to assess the Million Hearts initiative network partnerships and identify potential implications for policy and practice. Setting/Participants: The Million Hearts network comprised a core group of federal and private sector partners that participate in Million Hearts activities and align with initiative priorities. To bound the network for the SNA, we used a list of 58 organizations (74% response rate) from a previously completed qualitative analysis of Million Hearts partnerships. Main Outcome Measures: We used the online PARTNER (Program to Analyze Record and Track Networks to Enhance Relationships—www.partnertool.net) survey to collect data on individual organizational characteristics and relational questions that asked organizations to identify and describe their relationships with other partners in the network. Key SNA measures include network density, centralizations, value, and trust. Results: Our analyses show a network that is decentralized, has strong perceptions of trust and value among its members, and strong agreement on intended outcomes. Interestingly, partners report a desire and ability to contribute resources to Million Hearts; however, the perceptions between partners are that resources are not being contributed at the level they potentially could be. The majority of partners reported that being in the network helped them achieve their goals related to cardiovascular disease prevention. The largest barrier to successful activities within the network was cited as lack of targeted funding and staff to support participation in the network. Conclusions: The Million Hearts network described in this article is unique in its membership at the national level, agreement on outcomes, its powerful information-sharing abilities that require few resources, and its decentralized structure. We identified strategies that could be implemented to strengthen the network and its activities. By examining a national-level public-private partnership formed to address a public health issue, we can identify ways to strengthen the network and provide a framework for developing other initiatives.

Current approaches to addressing the problems families face when navigating complex service systems on behalf of their children rely largely on state or nationally driven efforts around the development of systems of care (SOCs). However, operationalizing meaningful family involvement within SOCs remains a challenge, with little attention paid to the role of personal social support networks (PSSNs). Specifically, risk factors related to the variations in the social connectedness of family social support networks are difficult to identify, assess, and track over time. This paper summarizes families' descriptions of their PSSNs and describes the development of a social network analysis tool, the Person-Centered Network App (PCNA), used to measure and monitor the social connectedness of families of children with special health care and developmental needs. Twenty-nine families participated in the project and completed social network surveys, identifying a total of 38 unique types of support partners and 230 partnerships (dyadic relationships). Families identified a range of formal and informal members including primary care providers, medical specialists, family, friends, faith-based organizations, insurance providers, nurses, community organizations, early interventionists, school resources, other families, online support groups, and public resources, rating 61 percent of them as "very important." Informal network members (e.g., family, friends) provided emotional and day-to-day support. Primary care providers, medical specialists, and public resources provided health care services while early intervention and medical specialists provided therapies. PSSNs were characterized by high levels of trust but low levels of coordination. These findings inform providers and case workers that families can readily describe their social connectedness in ways that may affect health care access and utilization. Understanding how PSSNs function in the lives of families of children with complex health care needs provides opportunities for improving systems of care (e.g., medical homes) and ultimately, enhancing health and developmental outcomes.

Given the complexity of today's social and political dilemmas, a common method of program and policy implementation is surfacing in the form of interorganizational, cross-sector goal-directed networks. This article applies the "Core Dimensions of Connectivity" framework to analyze how the increasing inclusion of nonprofit organizations in public health goal-directed interorganizational networks is associated with goal achievement. Variables related to sector-based resource contributions and mission alignment were analyzed in their relation to outcomes in 177 networks. The findings indicate that significant differences exist across sectors. Compared to public and for-profit organizations, nonprofit organizations bring a greater number and diversity of resources to public health networks, and are perceived by their public and for-profit partners as having the strongest support of the network's mission. We also find that resource contributions and mission alignment affect outcome achievement. This article discusses practical challenges networks face and informs techniques for effectively managing interorganizational goal-directed networks.

When a disaster affects a community, dissipated (and ad hoc) social relationships often result, leading to new questions about how to identify and study social networks. Disasters have the ability to disorganize an entire social infrastructure, turning what is known about the way people relate, the way organizations behave, and the system of social and resource support into new questions that, if understood, could greatly impact people's abilities to deal with the consequences of disasters. These networks arise on different scales, from the individual to the community level, so researchers exploring network dynamics need to draw on a range of methodologies. To explore the impact of a disaster on social networks at all levels, innovative research designs and methodological tools that account for the unique social structures and their accompanying dynamics are required. What follows is a representation of a methodological framework for designing disaster network studies. That framework is followed by attention to units of analysis, levels of analysis, types of network links, approaches to analysis, network dynamics, and the main challenges faced in research on disaster networks. Specific types of questions that can be answered using a network analysis approach are identified throughout this chapter.