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Background: Lower socioeconomic status (SES) is associated with poorer dietary habits and fewer family meals. Therefore, initiatives to empower families with a lower SES to adopt healthier meal practices are employed. The objective of this study was to evaluate a nationwide intervention "Dinner is served at 1-2-3 euros", developed by a Belgian retailer in collaboration with social organizations. It targets families with a lower SES and aims to promote more balanced and freshly cooked meals by providing recipe booklets of affordable meals at a guaranteed price of 1, 2, or 3 euros per portion. The process evaluation aimed to gain insight into the implementation process (Reach, Recruitment, Dose-delivered, Context), the satisfaction with the intervention (Dose-received), and the perceived impact of intervention participation. Methods: A mixed-methods study combining qualitative (i.e., focus groups and individual interviews) and quantitative research (i.e., surveys) was conducted. An interview with the retailer (n = 1), three focus group interviews with the involved social organizations (n = 15), and interviews with participants of "Dinner is served at 1-2-3 euros" (n = 26) were carried out, as well as surveys among these social organizations and participants. Results: Social organizations were generally satisfied with the project and appreciated the collaboration with the retailer. The main barrier to implement the project was a lack of time to help participants subscribing. Participants appreciated the inspiration from the recipe booklets, and the recipes' ease of preparation, their healthiness, and the variety. However, the recipes were sometimes deemed too exotic for participants' children. Participants also appreciated the budget friendliness, although the price guarantee mechanism of 1, 2 or 3 euros per portion was not always clear. Positive effects were mentioned in areas such as perceived healthy cooking and eating, improved cooking skills and ideas, and reduced financial concerns. Conclusions: In general, participants and social organizations were satisfied with the delivery and implementation of the intervention. Participants also noted some positive effects on their meal practices. Future research should provide insight into the intervention's effectiveness and impact on the healthiness of participants' dietary choices. Trial registration: The study protocol was pre‑registered prior to data collection at Clinicaltrials.gov (NCT05595551–27/10/2022). [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND METHODS RESULTS IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY CONCLUSION This study evaluated stakeholders' perceptions regarding the initial implementation process of the health promoting school model proposed by the affordable health initiative (AHI HPS model) in schools of Belo Horizonte/BRA.The model has been implemented since 2019, by an implementation committee (IC) with members from university, health, and education sectors. Data were collected from records of the IC meetings (n = 10) and interviews with 5 IC members to evaluate the model's acceptability, adoption, appropriateness, and feasibility. The material was decomposed by content analysis.Two categories and 7 subcategories emerged, suggesting that stakeholders found the model straightforward and well‐suited to schools. Facilitators (teamwork, motivation, commitment, teacher's central role, inclusive decision‐making, intersectoral responsibility pact, model alignment with school context) and barriers (family involvement, time constraints for curriculum integration, financial resource, school infrastructure, records difficulties, university unawareness of the school context) to implementation were presented.The results highlight the need to involve civil society and decision‐makers to make the program feasible.Participants showed they accept and intend to contribute to implementing the model. They believe in the program's feasibility as long as teacher involvement is prioritized, and identified barriers are overcome. [ABSTRACT FROM AUTHOR]

\nSUMMARYThis research was conducted as part of an action research project supporting intersectoral care experiments in Flanders for minors in residential care. This article details some of the questions the stakeholders in this project had at the start of such a project, as well as the results from a scoping literature review conducted to answer these questions. This scoping literature review was conducted on four databases, returning 23 articles providing information on the effects of, good practices of, or barriers for intersectoral care for looked-after minors. Results show that research on this specific topic for this population is scarce, mostly qualitative, and mostly from the perspective of staff rather than clients. Reports on the effects of intersectoral initiatives seem cautiously encouraging. Many possible obstacles for coordinated or shared care have been identified, with difficulties in communication, information sharing and lack of shared vision as prominent ones. Many potentially good practices have however also been identified in this review that can help collaborative partners overcome several of the barriers. Intersectoral collaboration in the care for minors in residential settings seems to have positive effects like better permanency and staff wellbeingGood practices include getting to know people working in other sectors and having formal proceduresJoint case planning, intersectoral training and consultation options can lead to familiarity with people in other sectorsLack of communication and disagreements about decision making are frequently mentioned as hindering intersectoral care in this populationIntersectoral collaboration in the care for minors in residential settings seems to have positive effects like better permanency and staff wellbeingGood practices include getting to know people working in other sectors and having formal proceduresJoint case planning, intersectoral training and consultation options can lead to familiarity with people in other sectorsLack of communication and disagreements about decision making are frequently mentioned as hindering intersectoral care in this population [ABSTRACT FROM AUTHOR]

Issues Addressed: Aboriginal and Torres Strait Islander (Aboriginal) people in South Australia are overburdened by cardiovascular disease, diabetes and cancer. The South Australian Aboriginal Chronic Disease Consortium (Consortium) was established in June 2017 as a collaborative partnership to lead the implementation of three state‐wide chronic disease plans using a strategic approach to identifying key priority areas for action. Methods: In 2017–2018, the Consortium Coordinating Centre facilitated a priority setting process, which involved extensive consultation, including a prioritisation survey and stakeholder workshops. The Consortium's Aboriginal Community Reference Group was instrumental in leading the identification of priorities for action. Results: The Consortium RoadMap for Action identified seven across‐plan priorities and six condition‐specific priorities. It acknowledged that: strengthening social and emotional well‐being is central to improving health outcomes; prevention and early detection, acute management and ongoing management are all components of the continuum of care; and improving access to services, strengthening the workforce, and monitoring and evaluation are required across the continuum of care. Conclusion: Widespread implementation failure in the past across the health system and health services implementation and research translation highlights the value of the Consortium approach and its commitment to implementing the state‐wide chronic disease plans in a collaborative manner. The Consortium relies on and fosters cross‐sectoral alignment, with all key players including all public, private and Aboriginal Community Controlled health services, to progress its priorities and aspirations to improve health outcomes for Aboriginal people using evidence‐based strategies. So What?: Rigorous and transparent priority setting processes that bring together research, clinical practice, health services operations, policy and community perspectives can foster intersectoral collaboration and partnership and support the implementation of shared priorities. [ABSTRACT FROM AUTHOR]

The role of nurses in leading the design and delivery of primary health care services to address health inequities is growing in prominence, specifically in rural Australia. However, limited evidence exists to inform nurse‐led primary health care in this context. Based on a focus group with nursing executives and semi‐structured interviews with registered nurses we describe nurse experiences of leading the design of a primary health care service in rural Australia and nurse transition to and practice in this service. Nurse experiences were analysed using reflexive thematic analysis. The study reveals the centrality of relational integration in service design and nurse acquisition of relational practice as it relates to nurse to care recipient and nurse to nurse relationships. Tensions between primary health care nurses and their peers, and resultant de‐valuing of primary health care practice, are described. The acquisition of nurse professional agency draws attention to investments required to position nurses to lead and sustain care innovations external to hospital settings. The authors propose that relational approaches may provide nurses with the opportunity to reframe their leadership and service contributions towards community literate primary health care provision and provide a pathway to professional emancipation from constrained practice expectations. [ABSTRACT FROM AUTHOR]

Issue Addressed Methods Results Conclusion So What? Intersectoral action is integral in promoting population health and health equity. In South Australia, public health partnership authorities (PHPAs) are one mechanism to promote intersectoral collaboration for addressing complex public health issues. This case study examined contemporary evidence on the critical elements of successful partnerships, explored the role of formalisation in success, and examined how identified critical elements were operationalised over time in an existing PHPA.In the first phase, a scoping review was conducted. The second phase was a retrospective longitudinal case study of a government‐academic PHPA agreement, involving partnership document review and key informant interviews. Data triangulation and iterative thematic analysis were performed.The critical elements of successful partnership, triangulated through multiple data sources, are mutuality, governance, communication, resources, leadership, and interactions and relationships. These elements have a high degree of interdependence. Trust supports and is reinforced by these elements, particularly during times of change or crisis. Formalisation of a partnership supports success in many ways but is insufficient on its own.Operating in dynamic environments, a partnership requires dedicated time and effort to be successful. Attention to the strength and interconnectedness of the critical elements over the course of a partnership is crucial.This case study describes how the elements of successful partnership can be applied to progress beyond transactional relationships towards authentic collaboration and overcome cross‐border and cross‐boundary public health challenges to promote population health and well‐being. [ABSTRACT FROM AUTHOR]

Background: Policymakers across countries promote cross-sector collaboration as a route to improving health and health equity. In England, major health system reforms in 2022 established 42 integrated care systems (ICSs)—area-based partnerships between health care, social care, public health, and other sectors—to plan and coordinate local services. ICSs cover the whole of England and have been given explicit policy objectives to reduce health inequalities, alongside other national priorities. Methods: We used qualitative methods to understand how local health care and social services organizations are collaborating to reduce health inequalities under England's reforms. We conducted in-depth interviews between August and December 2022—soon after the reforms were implemented—with 32 senior leaders from NHS, social care, public health, and community-based organizations in three ICSs experiencing high levels of socioeconomic deprivation. We used a framework based on international evidence on cross-sector collaboration to help analyse the data. Results: Leaders described strong commitment to working together to reduce health inequalities, but faced a combination of conceptual, cultural, capacity, and other challenges in doing so. A mix of factors shaped local collaboration—from how national policy aims are defined and understood, to the resources and relationships among local organizations to deliver them. These factors interact and have varying influence. The national policy context played a dominant role in shaping local collaboration experiences—frequently making it harder not easier. Organizational restructuring to establish ICSs also caused major disruption, with unintended effects on the partnership working it aimed to promote. Conclusions: The major influences on cross-sector collaboration in England mirror key areas identified in international research, offering opportunities for learning between countries. But our data highlight the pervasive—frequently perverse—influence of national policy on local collaboration in England. National policymakers risked undermining their own reforms. Closer alignment between policy, process, and resources to reduce health inequalities is likely needed to avoid policy failure as ICSs evolve. [ABSTRACT FROM AUTHOR]

Introduction: Public-Private Partnerships (PPPs) are viewed as a solution for gaps in healthcare access, quality and affordability. Operational Cooperation (OC) is a common practice in haemodialysis services at regional hospitals in Indonesia. Aim: To analyse the implementation of OC for haemodialysis services at Regional Public Service Agency (RPSA) hospitals from the perspective of collaborative governance. Materials and Methods: This qualitative research utilised interviews, focus groups, and document analysis to explore the implementation of OC from a collaborative governance perspective. The study was conducted at Regional Hospitals, Regional Government Offices, the Ministry of Health, the Ministry of Home Affairs, Medical Device Companies, and the Association of Regional Hospitals of Indonesia from December 2021 to March 2022. Data were collected from indepth interviews and Focus Group Discussions (FGDs) with 15 informants, including policymakers, hospital managers, and partner companies. Other data included nine national-level and 29 regional-level policy documents. NVivo software was used for coding and to ensure data validity through triangulation. The parameters evaluated included system context, drivers, collaborative processes, and collaboration outcomes according to Emerson's collaborative governance framework. Results: The implementation of PPP for haemodialysis services at regional hospitals is driven by the need for these services and limited resources. Despite the incomplete policy framework, regional hospitals are taking steps to establish collaboration. Hospitals are streamlining operational process flows, creating a domino effect for other services. Even without a feasibility study, the implementation of PPP in regional hospitals in Indonesia has successfully addressed the community's need for access to haemodialysis services. Conclusion: The implementation of PPPs in the form of OC has successfully expanded access to haemodialysis services. However, challenges related to policy, human resources, and corruption pose significant obstacles to the implementation of OC. [ABSTRACT FROM AUTHOR]

Aims: This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions. Design: A complementary multi‐method study combining survey methods and qualitative interviews will be adopted. Methods: Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a 'framework analysis' will be performed. Discussion: This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building. Impact: Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts. Stakeholder Engagement: Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility. [ABSTRACT FROM AUTHOR]

Abstract Background Lower socioeconomic status (SES) is associated with poorer dietary habits and fewer family meals. Therefore, initiatives to empower families with a lower SES to adopt healthier meal practices are employed. The objective of this study was to evaluate a nationwide intervention “Dinner is served at 1-2-3 euros”, developed by a Belgian retailer in collaboration with social organizations. It targets families with a lower SES and aims to promote more balanced and freshly cooked meals by providing recipe booklets of affordable meals at a guaranteed price of 1, 2, or 3 euros per portion. The process evaluation aimed to gain insight into the implementation process (Reach, Recruitment, Dose-delivered, Context), the satisfaction with the intervention (Dose-received), and the perceived impact of intervention participation. Methods A mixed-methods study combining qualitative (i.e., focus groups and individual interviews) and quantitative research (i.e., surveys) was conducted. An interview with the retailer (n = 1), three focus group interviews with the involved social organizations (n = 15), and interviews with participants of “Dinner is served at 1-2-3 euros” (n = 26) were carried out, as well as surveys among these social organizations and participants. Results Social organizations were generally satisfied with the project and appreciated the collaboration with the retailer. The main barrier to implement the project was a lack of time to help participants subscribing. Participants appreciated the inspiration from the recipe booklets, and the recipes’ ease of preparation, their healthiness, and the variety. However, the recipes were sometimes deemed too exotic for participants’ children. Participants also appreciated the budget friendliness, although the price guarantee mechanism of 1, 2 or 3 euros per portion was not always clear. Positive effects were mentioned in areas such as perceived healthy cooking and eating, improved cooking skills and ideas, and reduced financial concerns. Conclusions In general, participants and social organizations were satisfied with the delivery and implementation of the intervention. Participants also noted some positive effects on their meal practices. Future research should provide insight into the intervention’s effectiveness and impact on the healthiness of participants’ dietary choices. Trial registration The study protocol was pre‑registered prior to data collection at Clinicaltrials.gov (NCT05595551–27/10/2022).

In recent decades, technological progress and the development of Artificial Intelligence (AI) have profoundly transformed the way modern societies operate, interact and ensure security. AI has become an essential tool in the field of public order, providing innovative solutions that have enabled law enforcement to accomplish their mission with increased efficiency and precision. This text explores the possible possibilities of AI in public policy, highlighting its use in crime prevention, predictive analytics, intelligent video surveillance, assisting in investigations, protecting critical infrastructure, managing emergencies and contributing to citizen engagement. Ethical and legal challenges associated with the integration of AI are also discussed, such as privacy and protection of personal data, algorithmic discrimination, impact on civil liberties, and cybersecurity vulnerabilities. The paper highlights the need for a balanced approach to the adoption of AI in public policy, which includes the development of responsible policies and regulations, ensuring transparency and accountability of authorities, as well as collaboration between policy makers, technical experts, human rights organizations and citizens, to promote . a just and secure society.

Introduction: Public-Private Partnerships (PPPs) are viewed as a solution for gaps in healthcare access, quality and affordability. Operational Cooperation (OC) is a common practice in haemodialysis services at regional hospitals in Indonesia. Aim: To analyse the implementation of OC for haemodialysis services at Regional Public Service Agency (RPSA) hospitals from the perspective of collaborative governance. Materials and Methods: This qualitative research utilised interviews, focus groups, and document analysis to explore the implementation of OC from a collaborative governance perspective. The study was conducted at Regional Hospitals, Regional Government Offices, the Ministry of Health, the Ministry of Home Affairs, Medical Device Companies, and the Association of Regional Hospitals of Indonesia from December 2021 to March 2022. Data were collected from in-depth interviews and Focus Group Discussions (FGDs) with 15 informants, including policymakers, hospital managers, and partner companies. Other data included nine national-level and 29 regional-level policy documents. NVivo software was used for coding and to ensure data validity through triangulation. The parameters evaluated included system context, drivers, collaborative processes, and collaboration outcomes according to Emerson’s collaborative governance framework. Results: The implementation of PPP for haemodialysis services at regional hospitals is driven by the need for these services and limited resources. Despite the incomplete policy framework, regional hospitals are taking steps to establish collaboration. Hospitals are streamlining operational process flows, creating a domino effect for other services. Even without a feasibility study, the implementation of PPP in regional hospitals in Indonesia has successfully addressed the community’s need for access to haemodialysis services. Conclusion: The implementation of PPPs in the form of OC has successfully expanded access to haemodialysis services. However, challenges related to policy, human resources, and corruption pose significant obstacles to the implementation of OC.

Abstract Background Policymakers across countries promote cross-sector collaboration as a route to improving health and health equity. In England, major health system reforms in 2022 established 42 integrated care systems (ICSs)—area-based partnerships between health care, social care, public health, and other sectors—to plan and coordinate local services. ICSs cover the whole of England and have been given explicit policy objectives to reduce health inequalities, alongside other national priorities. Methods We used qualitative methods to understand how local health care and social services organizations are collaborating to reduce health inequalities under England’s reforms. We conducted in-depth interviews between August and December 2022—soon after the reforms were implemented—with 32 senior leaders from NHS, social care, public health, and community-based organizations in three ICSs experiencing high levels of socioeconomic deprivation. We used a framework based on international evidence on cross-sector collaboration to help analyse the data. Results Leaders described strong commitment to working together to reduce health inequalities, but faced a combination of conceptual, cultural, capacity, and other challenges in doing so. A mix of factors shaped local collaboration—from how national policy aims are defined and understood, to the resources and relationships among local organizations to deliver them. These factors interact and have varying influence. The national policy context played a dominant role in shaping local collaboration experiences—frequently making it harder not easier. Organizational restructuring to establish ICSs also caused major disruption, with unintended effects on the partnership working it aimed to promote. Conclusions The major influences on cross-sector collaboration in England mirror key areas identified in international research, offering opportunities for learning between countries. But our data highlight the pervasive—frequently perverse—influence of national policy on local collaboration in England. National policymakers risked undermining their own reforms. Closer alignment between policy, process, and resources to reduce health inequalities is likely needed to avoid policy failure as ICSs evolve.

Abstract Background The healthcare system is under tremendous pressure. One possible solution towards relieving some of this pressure is to use Positive Health, which takes ‘health’ as a starting point, rather than ‘illness’. Positive Health provides opportunities for stimulating integrated care. Methods Three cases in the Netherlands are studied in this paper. Their way of working with Positive Health is investigated through semi-structured and narrative interviews, using realist-evaluation and thematic analyses. Results Seven ‘working elements’ are identified that enhance the chances of successfully implementing Positive Health in practice (part 1). The interviews show that healthcare professionals have noticed that people adopt a healthier lifestyle and gain a greater degree of control over their own health. This boosts job satisfaction for healthcare professionals too. The organisations and professionals involved are enthusiastic about working with Positive Health, but still experience barriers (part 2). Conclusions The results of this study imply that implementing Positive Health in practice can facilitate collaboration between organisations and professionals from different disciplines, such as healthcare, welfare, and municipal health services. Operating from the perspective of a shared goal, professionals from different disciplines will find it easier to jointly organise activities to foster citizens’ health. Additionally, more attention is paid to non-medical problems affecting people’s well-being, such as loneliness or financial problems.

Abstract Background There is a growing interest in the use of intersectoral collaborative (ISC) approaches to address complex health-related issues. However, relatively little empirical research exists on the challenges of implementing, fostering and sustaining these approaches. Our study explores the perceptions and experiences of programme implementers regarding the implementation of an ISC approach, focusing on a case study of nutrition programming in Assam, India. Methods We conducted qualitative semi-structured face-to-face in-depth interviews with eleven programme implementers from two selected districts of Assam, India. These participants were purposefully sampled to provide a comprehensive understanding of the experiences of implementing intersectoral collaboration. Following the interviews, an inductive thematic analysis was performed on the collected data. Results The study identified three main themes: operationalisation of ISC in daily practice, facilitators of ISC, and barriers to effective ISC. These were further broken down into six subthemes: defined sectoral mandates, leadership dynamics, interpersonal relationships and engagement, collective vision and oversight, resource allocation, and power dynamics. These findings highlight the complexity of ISC, focusing on the important structural and relational aspects at the macro, meso, and micro levels. Interpersonal relationships and power dynamics among stakeholders substantially influenced ISC formation in both the districts. Conclusion Despite challenges, there is ongoing interest in establishing ISC in nutrition programming, supported by political development agendas. Success relies on clarifying sectoral roles, addressing power dynamics, and engaging stakeholders systematically. Actionable plans with measurable targets are crucial for promoting and sustaining ISC, ensuring positive programme outcomes. The insights from our study provide valuable guidance for global health practitioners and policymakers dealing with similar challenges, emphasising the urgent need for comprehensive research given the lack of universally recognised policies in the realm of ISC in global health practice.

The COVID-19 pandemic undeniably impacted population health and several aspects of community organization, including service delivery and social cohesion. Intersectoral collaboration and equity, two key dimensions of community resilience, proved central to an effective and equitable response to the pandemic. Yet the factors that enabled or constrained communities' capacity to enact intersectoral collaboration and equity-focused action in such times of urgency and uncertainty remain poorly understood. This descriptive qualitative study aimed to (1) describe the processes through which intersectoral collaboration and equity-focused action were deployed during the first wave of COVID-19 and (2) identify factors enabling and constraining these processes. We conducted semi-directed interviews with 35 representatives of the governmental, institutional, and public and third sectors from four municipal regional counties of the Estrie region (Québec, Canada). We coded detailed interview notes following a codebook thematic analysis approach. We identified three processes through which intersectoral collaboration and equity-focused action were deployed: (1) networking; (2) adaptation, creation and innovation; and (3) human-centred action. Examples of levers which supported the deployment of these processes included capitalizing on pre-existing networks, adapting practices and services, and investing in solidarity and mutual aid. The influencing factors we describe represent concrete targets for resilience-building action. Although focused on the COVID-19 pandemic, our findings are relevant to other types of health, social, environmental or economic crises, and may guide health promotion and community development practitioners towards more effective community resilience-building responses. [ABSTRACT FROM AUTHOR]

Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF–LPF frameworks and suggestions to increase the transformative power of future studies. [ABSTRACT FROM AUTHOR]

Introduction: Scientific evidence indicates that the community-based rehabilitation (CBR) model is recommended for recovery from mental disorders. However, this approach encounters barriers and often lacks implementation strategies. Aim: The aim of this study was to create a strategy for the implementation of CBR for mental health in Colombia through the identification of barriers and facilitators, together with the expected outcomes, from the perspective of mental health decision-makers in Colombia. Methods: This study adopts a qualitative descriptive approach, using focus group data collection methods and thematic analysis to code and analyze the data. Results: A total of 208 individuals participated in the study, including mental health decision-makers and health care professionals. Intersectoral collaboration, contextualization, financial resources, and community commitment and autonomy were identified as barriers and facilitators. The element that was considered a priority for successful implementation was the contextualization of strategies. Conclusions: CBR needs to be strengthened through implementation science if these strategies are to be successfully developed and implemented in various contexts [ABSTRACT FROM AUTHOR]

Background: The healthcare system is under tremendous pressure. One possible solution towards relieving some of this pressure is to use Positive Health, which takes 'health' as a starting point, rather than 'illness'. Positive Health provides opportunities for stimulating integrated care. Methods: Three cases in the Netherlands are studied in this paper. Their way of working with Positive Health is investigated through semi-structured and narrative interviews, using realist-evaluation and thematic analyses. Results: Seven 'working elements' are identified that enhance the chances of successfully implementing Positive Health in practice (part 1). The interviews show that healthcare professionals have noticed that people adopt a healthier lifestyle and gain a greater degree of control over their own health. This boosts job satisfaction for healthcare professionals too. The organisations and professionals involved are enthusiastic about working with Positive Health, but still experience barriers (part 2). Conclusions: The results of this study imply that implementing Positive Health in practice can facilitate collaboration between organisations and professionals from different disciplines, such as healthcare, welfare, and municipal health services. Operating from the perspective of a shared goal, professionals from different disciplines will find it easier to jointly organise activities to foster citizens' health. Additionally, more attention is paid to non-medical problems affecting people's well-being, such as loneliness or financial problems. [ABSTRACT FROM AUTHOR]

Despite the increasing importance of intersectoral collaborations to address crisis situations, relatively little is known about how they are organised, managed and governed. Moreover, within the field of public administration, there is still much to learn about how governments can use intersectoral collaboration to effectively address crises. This paper examines the case of the Coordinated Donor Support initiative in South Africa's COVID‐19 vaccination programme to illustrate the value of multisectoral partnerships, especially for developing countries. This partnership involved donors and philanthropic organisations, non‐governmental and civil society organisations, and private sector organisations, yet it sought to partner with the government, rather than take over the government's role. The paper also explores the complexities, contradictions and threats to such partnerships, and what is required to optimise them. It argues that several measures need to be put in place in the pre‐crisis phase to ensure that such multisectoral collaborations can quickly be mobilised when crises occur. It also shows that partnerships which are forged in times of crisis can assist countries to address their ongoing developmental challenges. [ABSTRACT FROM AUTHOR]

Integrating multiple perspectives is key to successful co-design, yet often hampered by communication gaps arising from different epistemological backgrounds and lived experiences. This challenge is amplified when the design problem centres around experiences that are difficult articulate in words, such as those in Parkinson’s disease (PD). To explore alternative strategies for communication between diverse PD stakeholders, Piece of Mind brought together neuroscientists, performing artists and individuals with lived experience to co-create an interdisciplinary performance grounded in scientific and experiential knowledge. Participants met on Zoom over nine months, in which creative, embodied approaches were used to share scientific concepts, facilitate discussion, and identify key issues for the performance. We built on emergent themes through virtual and in-studio collaborations, culminating in a 45-min filmed and live performance. We conducted semi-structured interviews with a subset of participants regarding their co-design experience and take-aways, to identify elements of process, space and materials contributing to its success. We found that an embodied approach, in virtual space and incorporating multiple artistic media, enabled participants to leave their comfort zones and disciplinary boundaries to engage with one another through curiosity and generosity – and consider how these conditions facilitated disparate starting points to converge towards a common goal. [ABSTRACT FROM AUTHOR]

Background: There is a growing interest in the use of intersectoral collaborative (ISC) approaches to address complex health-related issues. However, relatively little empirical research exists on the challenges of implementing, fostering and sustaining these approaches. Our study explores the perceptions and experiences of programme implementers regarding the implementation of an ISC approach, focusing on a case study of nutrition programming in Assam, India. Methods: We conducted qualitative semi-structured face-to-face in-depth interviews with eleven programme implementers from two selected districts of Assam, India. These participants were purposefully sampled to provide a comprehensive understanding of the experiences of implementing intersectoral collaboration. Following the interviews, an inductive thematic analysis was performed on the collected data. Results: The study identified three main themes: operationalisation of ISC in daily practice, facilitators of ISC, and barriers to effective ISC. These were further broken down into six subthemes: defined sectoral mandates, leadership dynamics, interpersonal relationships and engagement, collective vision and oversight, resource allocation, and power dynamics. These findings highlight the complexity of ISC, focusing on the important structural and relational aspects at the macro, meso, and micro levels. Interpersonal relationships and power dynamics among stakeholders substantially influenced ISC formation in both the districts. Conclusion: Despite challenges, there is ongoing interest in establishing ISC in nutrition programming, supported by political development agendas. Success relies on clarifying sectoral roles, addressing power dynamics, and engaging stakeholders systematically. Actionable plans with measurable targets are crucial for promoting and sustaining ISC, ensuring positive programme outcomes. The insights from our study provide valuable guidance for global health practitioners and policymakers dealing with similar challenges, emphasising the urgent need for comprehensive research given the lack of universally recognised policies in the realm of ISC in global health practice. Key messages: The primary message from this research is the recognition that the success of ISC in health system goes beyond mere structural arrangements and policy directives. It is profoundly influenced by the quality of interpersonal relationships, leadership styles, and the equitable distribution of power and resources. Acknowledging and nurturing these softer aspects can significantly enhance the effectiveness and sustainability of ISC efforts, leading to more successful health interventions and outcomes. [ABSTRACT FROM AUTHOR]

The main aim of this study is to explore challenges faced by learners who are survivors of school violence and the implications for support structures. Many schools are branded with violence, gangsterism, substance abuse and general crime. The scourge of violence in schools is cause for concern, citing daily reports that appear in the written and electronic media about high levels of violence, physical and sexual abuse, and gang-related activities in schools. Qualitative research design and phenomenology as a mode of enquiry were employed in this study. The experiences and perceptions of various school principals and teachers were elicited through focus-group interviews, document review, and observations. The population comprised principals and teachers in five schools. Purposive sampling was used as a method of sample selection. The findings revealed that support is key, and lack of support can negatively impact on learners' access to schools and academic achievement in many ways. It was also found that most learners who leave school prematurely, through the fear of violence, do not report when they leave. The study recommended that support must be provided promptly, and parents, teachers as well as caregivers need to be capacitated to offer effective and efficient support. [ABSTRACT FROM AUTHOR]

Abstract Background Multisectoral collaboration is essential for advancing primary health care (PHC). In low- and middle-income countries (LMICs), limited institutional capacities, governance issues, and inadequate stakeholder engagement impede multisectoral collaboration. India faces similar challenges, especially at the meso-level (districts and subdistricts). Owing to its dependence on context, and insufficient evidence, understanding “How” to improve multisectoral collaboration remains challenging. This study aims to elicit specific recommendations to strengthen meso-level stewardship in India for multisectoral collaboration. The findings from this study may offer lessons for other LMICs. Methods Using purposive, maximum variation sampling, the study team conducted semi-structured interviews with 20 diverse participants, including policymakers, implementers, development agency representatives, and academics experienced in multisectoral initiatives. The interviews delved into participants’ experiences, the current situation, enablers, and recommendations for enhancing stakeholder engagement and capacities at the meso-level for multisectoral collaboration. Results Context and power are critical elements to consider in fostering effective collaboration. Multisectoral collaboration was particularly successful in three distinct governance contexts: the social-democratic context as in Kerala, the social governance context in Chhattisgarh, and the public health governance context in Tamil Nadu. Adequate health system input and timely guidance instil confidence among local implementers to collaborate. While power plays a role through local leadership’s influence in setting agendas, convening stakeholders, and ensuring accountability. To nurture transformative local leaders for collaboration, holistic, equity-driven, community-informed approaches are essential. The study participants proposed several concrete steps: at the state level, establish “central management units” for supervising local implementers and ensuring bottom-up feedback; at the district level, rationalise committees and assign deliverables to stakeholders; and at the block level, expand convergence structures and involve local self-governments. Development partners can support data-driven priority setting, but local implementers with contextual familiarity should develop decentralised plans collaboratively, articulating rationales, activities, and resources. Finally, innovative training programs are required at all levels, fostering humility, motivation, equity awareness, leadership, problem- solving, and data use proficiency. Conclusion This study offers multiple solutions to enhance local implementers’ engagement in multisectoral efforts, advocating for the development, piloting, and evaluation of innovative approaches such as the block convergence model, locally-led collaboration efforts, and novel training methods for local implementers.

Abstract Background Rare diseases are often complex, chronic and many of them life-shortening. In Germany, healthcare for rare diseases is organized in expert centers for rare diseases. Most patients additionally have regional general practicioners and specialists for basic medical care. Thus, collaboration and information exchange between sectors is highly relevant. Our study focuses on the patient and caregiver perspective on intersectoral and interdisciplinary care between local healthcare professionals (HCPs) and centers for rare diseases in Germany. The aims were (1) to investigate patients’ and caregivers’ general experience of healthcare, (2) to analyse patients’ and caregivers’ perception of collaboration and cooperation between local healthcare professionals and expert centers for rare diseases and (3) to investigate patients’ and caregivers’ satisfaction with healthcare in the expert centers for rare diseases. Results In total 299 individuals of whom 176 were patients and 123 were caregivers to pediatric patients participated in a survey using a questionnaire comprising several instruments and constructs. Fifty participants were additionally interviewed using a semistructured guideline. Most patients reported to receive written information about their care, have a contact person for medical issues and experienced interdisciplinary exchange within the centers for rare diseases. Patients and caregivers in our sample were mainly satisfied with the healthcare in the centers for rare diseases. The qualitative interviews showed a rather mixed picture including experiences of uncoordinated care, low engagement and communication difficulties between professionals of different sectors. Patients reported several factors that influenced the organization and quality of healthcare e.g. engagement and health literacy in patients or engagement of HCPs. Conclusions Our findings indicate the high relevance of transferring affected patients to specialized care as fast as possible to provide best medical treatment and increase patient satisfaction. Intersectoral collaboration should exceed written information exchange and should unburden patients of being and feeling responsible for communication between sectors and specialists. Results indicate a lack of inclusion of psychosocial aspects in routine care, which suggests opportunities for necessary improvements.

Establishing a robust One Health (OH) governance is essential for ensuring effective coordination and collaboration among human, animal, and environmental health sectors to prevent and address complex health challenges like zoonoses or antimicrobial resistance. This study conducted a mixed-methods environmental scan to assess to what extent Mexico displays a OH governance and identify opportunities for improvement. Through documentary analysis, the study mapped OH national-level governance elements: infrastructure, multi-level regulations, leadership, multi-coordination mechanisms (MCMs), and financial and OH-trained human resources. Key informant interviews provided insights into enablers, barriers, and recommendations to enhance a OH governance. Findings reveal that Mexico has sector-specific governance elements: institutions, surveillance systems and laboratories, laws, and policies. However, the absence of a OH governmental body poses a challenge. Identified barriers include implementation challenges, non-harmonised legal frameworks, and limited intersectoral information exchange. Enablers include formal and ad hoc MCMs, OH-oriented policies, and educational initiatives. Like other middle-income countries in the region, institutionalising a OH governance in Mexico, may require a OH-specific framework and governing body, infrastructure rearrangements, and policy harmonisation. Strengthening coordination mechanisms, training OH professionals, and ensuring data-sharing surveillance systems are essential steps toward successful implementation, with adequate funding being a relevant factor.

ABSTRACTThis study aimed to analyse intersectoral arrangements among the health, education and social assistance sectors in the operationalization of the Bolsa Família Program (BFP). A qualitative approach was carried out, in a peripheral region of a large urban centre of Southeast Brazil. Data content analysis was performed on the basis of reference in the Actor–Network Theory (ANT) using statements by the actors and considering ideas in dispute and work processes in the geopolitical territorial context. Seventeen managers of Municipal Secretariats of Health, Education and Social Assistance were interviewed, as were basic education, primary health care and social assistance professionals. One-off, episodic and discontinuous intersectoral actions were identified, with limited integration among sectors. Convergences and conflicts were found with respect to the institutional processes of BFP. The convergences referred to the conceptions shared among the actors about the role of intersectoral collaboration, as they recognize themselves as providing care to the same vulnerable population. Considering the multiple vulnerabilities of these families, the convergence of actions from different sectors can impact factors that condition inequalities. The conflicts were related to institutional conditions, to sectorized work processes and to a lack of understanding by professionals about the duties of their respective sectors.

Background: Rare diseases are often complex, chronic and many of them life-shortening. In Germany, healthcare for rare diseases is organized in expert centers for rare diseases. Most patients additionally have regional general practicioners and specialists for basic medical care. Thus, collaboration and information exchange between sectors is highly relevant. Our study focuses on the patient and caregiver perspective on intersectoral and interdisciplinary care between local healthcare professionals (HCPs) and centers for rare diseases in Germany. The aims were (1) to investigate patients' and caregivers' general experience of healthcare, (2) to analyse patients' and caregivers' perception of collaboration and cooperation between local healthcare professionals and expert centers for rare diseases and (3) to investigate patients' and caregivers' satisfaction with healthcare in the expert centers for rare diseases. Results: In total 299 individuals of whom 176 were patients and 123 were caregivers to pediatric patients participated in a survey using a questionnaire comprising several instruments and constructs. Fifty participants were additionally interviewed using a semistructured guideline. Most patients reported to receive written information about their care, have a contact person for medical issues and experienced interdisciplinary exchange within the centers for rare diseases. Patients and caregivers in our sample were mainly satisfied with the healthcare in the centers for rare diseases. The qualitative interviews showed a rather mixed picture including experiences of uncoordinated care, low engagement and communication difficulties between professionals of different sectors. Patients reported several factors that influenced the organization and quality of healthcare e.g. engagement and health literacy in patients or engagement of HCPs. Conclusions: Our findings indicate the high relevance of transferring affected patients to specialized care as fast as possible to provide best medical treatment and increase patient satisfaction. Intersectoral collaboration should exceed written information exchange and should unburden patients of being and feeling responsible for communication between sectors and specialists. Results indicate a lack of inclusion of psychosocial aspects in routine care, which suggests opportunities for necessary improvements. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic disproportionally impacted people experiencing homelessness, including people sleeping rough, people in temporary accommodation and those living in boarding houses. This paper reports on intersectoral responses across six health and social care agencies in Inner Sydney, New South Wales, Australia. Prior to the pandemic the six agencies had established an Intersectoral Homelessness Health Strategy (IHHS), in recognition of the need for intersectoral collaboration to address the complex health needs of people experiencing homelessness. Description: The governance structure of the IHHS provided a platform for several innovative intersectoral responses to the pandemic. A realist informed framework was used to select, describe, and analyse case studies of intersectoral collaboration. Discussion: The resultant six critical success factors (trust, shared ways of working, agile collaboration, communication mechanisms, authorising environment, and sustained momentum), align with the existing literature that explores effective intersectoral collaboration in complex health or social care settings. This paper goes further by describing intersectoral collaboration 'in action', setting a strong foundation for future collaborative initiatives. Conclusion: While there is no single right approach to undertaking intersectoral collaboration, which is highly context specific, the six critical success factors identified could be applied to other health issues where dynamic collaboration and integration of healthcare is needed. [ABSTRACT FROM AUTHOR]

Preventing people from experiencing homelessness is a complex task requiring the coordination of multiple actors. There are various frameworks for homelessness prevention; however, there is no published example of an Indigenous-led model. We present the Giiwe model for systems homelessness prevention led by M’Wikwedong Indigenous Friendship Centre in Owen Sound, Canada. Giiwe hosted regular in-person meetings that use ceremony, Indigenous Knowledges, discussion, and follow-up actions to increase service access among a network of over 20 organizations. Building on Giiwe’s experience, we discuss how Western and Indigenous worldviews impact inter-organizational collaboration. Giiwe’s success suggests funding and policy contexts mandating partnerships between Indigenous and non- Indigenous organizations could benefit from ceding space for initiatives affirming Indigenous collaboration approaches. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate occupational health (OH) primary-care patients' use of other health-care services and whether parallel use affects their likelihood to have sickness absences (SA) or disability pensions (DP). Methods: Primary-care services in Finland are provided through three parallel health-care sectors, all available to the working population: public, private and OH sectors. Patients may also be referred to secondary care. This follow-up study combines real-world medical record data containing SA data from a nationwide OH provider with health-care attendance data from public and private primary-care sectors and public secondary care, sociodemographic data and DP decisions. Patients between 18 and 68 years of age who used OH primary care at least once during the study years 2014–2016 were included. The total study population comprised 59,650 patients. Odds ratios were used to analyse association between parallel service use and SA or DP. Results: Females and patients with a lower educational level were more likely to use services in other health-care sectors in addition to OH than others. Those patients who used any other health-care sector in addition to OH primary care had an increased likelihood of having long SA or receiving DP. Conclusions: OH primary-care patients using the services of several health-care sectors in parallel have an increased likelihood of receiving disability benefits – either SA or DP. There is need for care coordination to ensure adequate measures for work-ability support. [ABSTRACT FROM AUTHOR]

IntroductionWestern Australia has one of the highest rates of Aboriginal children entering out-of-home care in Australia. Kinship care is the preferred culturally safe out-of-home care option for Aboriginal children, yet all jurisdictions, including Western Australia, are far from meeting best-practice national standards. Intersectoral collaboration is a key primary healthcare principle and internationally recognized for improving health systems and outcomes. This paper presents findings from a qualitative research project investigating Aboriginal primary healthcare workers’ experiences of intersectoral collaboration challenges and strengthening opportunities.MethodsConstructivist grounded theory guided this research involving 55 semi-structured interviews and four focus group discussions with Aboriginal primary healthcare workers. The research was guided by Indigenous methodologies and led by Indigenous researchers Participants were recruited from seven Aboriginal Community Controlled Health Organisations located across Perth metro, Pilbara, Midwest/Gascoyne and Southwest regions in Western Australia.ResultsKey themes identified around intersectoral collaboration challenges were communication, including information sharing and interagency meetings, and the relationship with the government sector, including trust and the importance of the perception of Aboriginal health service independence. Key themes around strengthening areas to improve intersectoral collaboration included strengthening service resourcing and coverage, including the availability of services, and addressing high program turnover. The need for a shift in approach, including more emphasis on Aboriginal-led care and aligning approaches between sectors, was another area for strengthening.DiscussionThis study addresses a significant research gap concerning out-of-home care, kinship care, and intersectoral collaboration in an Australian Aboriginal context. Findings highlighted the need to review the out-of-home and kinship models of care to strengthen the system, including creating more formal and structured modes of collaborating and better resourcing family support and kinship care.

Background: Due to the globally increasing demand for care, innovation is important to maintain quality, safety, effectiveness, patient sensitivity, and outcome orientation. Health care technologies could be a solution to innovate, maintain, or improve the quality of care and simultaneously decrease nurses’ workload. Currently, nurses are rarely involved in the design of health care technologies, mostly due to time constraints with clinical nursing responsibilities and limited exposure to technology and design disciplines. To ensure that health care technologies fit into nurses’ core and routine practice, nurses should be actively involved in the design process. Objective: The aim of the present study was to explore the main requirements for nurses’ active participation in the design of health care technologies. Design: An exploratory descriptive qualitative design was used which helps to both understand and describe a phenomenon. Participants: Twelve nurses from three academic hospitals in the Netherlands participated in this study. Method: Data were collected from semistructured interviews with hospital nurses experienced in design programs and thematically analysed. Results: Four themes were identified concerning the main requirements for nurses to participate in the design of health care technologies: (1) nurses’ motivations to participate, (2) the process of technology development, (3) required competence to participate (such as assertiveness, creative thinking, problem solving skills), and (4) facilitating and organizing nurses’ participation. Conclusion: Nurses experience their involvement in the design process as essential, distinctive, and meaningful but experience few possibilities to combine this work with their current workload, flows, routines, and requirements. To participate in the design of health care technologies nurses need motivation and specific competencies. Organizations should facilitate time for nurses to acquire the required competencies and to be intentionally involved in technology design and development activities.

Objectives: To describe the impact of Accountable Communities of Health (ACHs) on organizational and community partnerships and explore how ACHs contribute to systems change. Data Sources and Study Setting: The California Accountable Communities of Health Initiative (CACHI) was a 5‐year, $17 M investment in community health transformation in 13 ACH sites. Data sources include two surveys, key informant interviews, small group conversations, and ACH meeting observations and document review. Study Design: This was a mixed‐methods, observational study. Surveys conducted in 2021 and 2022 focused on ACH progress in building organizational and community partnerships and ACH impact on partners and systems, respectively. Interviews and small group conversations were conducted toward the end of the CACHI grant period and designed to complement the surveys. Data Collection: Survey respondents included ACH backbone agency staff and partner organization representatives (n = 141 in 2021 and 88 in 2022). Semistructured individual interviews and group conversations were conducted with 40 ACH backbone staff and partners. Documents were collected via grant reporting and directly from ACH staff. Data were analyzed descriptively and thematically. Principal Findings: ACHs appear to have supported organizational partnerships and collaboration. Seventy‐six percent of survey respondents reported that their ACH had strengthened organizations' ability to work together and 65% reported developing new or deepened connections. While ACH participants reported a better understanding of community needs and priorities, progress on community relationships, and greater attention to equity and racial justice, many saw room for improvement on meaningful community engagement. Systems changes and precursors of systems change observed across ACH sites included strengthened partnerships, enhanced knowledge, increased capacity, more collaborative ways of working, and new funding streams. Conclusions: The ACH model is effective at strengthening organizational partnerships and catalyzing other systems changes and precursors including enhanced knowledge, increased capacity, more collaborative ways of working, and new funding. [ABSTRACT FROM AUTHOR]

Diabetes is a global public health issue. The Public Health Agency of Canada published a Diabetes Framework 2022 which recommends collaborative work across sectors to mitigate the impact of diabetes on health and quality of life. Since 2020, the INMED-COMMUNITY pathway has been implemented in Laval, Québec developing collaboration between healthcare and community sectors through a participatory action research approach. The aim of this article is to gain a better understanding of the INMED-COMMUNITY pathway implementation process, based on the mobilization of network actor theory. Qualitative analysis of semi-structured interviews conducted from January to March 2023 with 12 participants from 3 different sectors (community, health system, research), were carried out using actor-network theory. The results explored the conditions for effective intersectoral collaboration in a participatory action research approach to implement the INMED-COMMUNITY pathway. These were: (1) contextualization of the project, (2) a consultation approach involving various stakeholders, (3) creation of new partnerships, (4) presence of a project coordinator, and (5) mobilization of stakeholders around a common definition of diabetes. Mediation supported by a project coordinator contributed to the implementation of an intersectoral collaborative health intervention, largely due to early identification of controversies. [ABSTRACT FROM AUTHOR]

Strengthening interorganizational collaboration is critical to mitigate the impact of adverse childhood experiences (ACEs) and improve community health. We examined change in interorganizational collaboration around ACEs within Peace4Tarpon's network and investigated factors influencing collaboration. We conducted a community‐wide social network analysis among 32 trauma‐informed organizations in 2016 and 2018, using network analysis methods to examine interorganizational cohesion (density, transitivity, triad census) over time, and multiple regression quadratic assignment procedure to investigate factors influencing collaboration. Network cohesion measures indicated small increases in collaboration level and greater network cohesion over time. Conducting ACEs screenings was a significant factor (b = 0.237; p < 0.01) predicting likelihood of interorganizational collaboration in 2016. No assessed ACEs practices predicted collaboration in 2018, suggesting variables assessed predicted a small proportion of variance in collaboration change. Results provide a foundation for understanding how ACEs/trauma‐informed practices influence collaboration and highlight implications of interorganizational collaboration. Peace4Tarpon's 2‐year progress provides insights for other trauma‐informed communities. [ABSTRACT FROM AUTHOR]

This study aimed to analyse intersectoral arrangements among the health, education and social assistance sectors in the operationalization of the Bolsa Família Program (BFP). A qualitative approach was carried out, in a peripheral region of a large urban centre of Southeast Brazil. Data content analysis was performed on the basis of reference in the Actor–Network Theory (ANT) using statements by the actors and considering ideas in dispute and work processes in the geopolitical territorial context. Seventeen managers of Municipal Secretariats of Health, Education and Social Assistance were interviewed, as were basic education, primary health care and social assistance professionals. One-off, episodic and discontinuous intersectoral actions were identified, with limited integration among sectors. Convergences and conflicts were found with respect to the institutional processes of BFP. The convergences referred to the conceptions shared among the actors about the role of intersectoral collaboration, as they recognize themselves as providing care to the same vulnerable population. Considering the multiple vulnerabilities of these families, the convergence of actions from different sectors can impact factors that condition inequalities. The conflicts were related to institutional conditions, to sectorized work processes and to a lack of understanding by professionals about the duties of their respective sectors. [ABSTRACT FROM AUTHOR]

The Global Initiative for Childhood Cancer (GICC) aims to increase the cure rate for children with cancer globally by improving healthcare access and quality. The Pan American Health Organization (PAHO), St. Jude Children’s Research Hospital (St. Jude), and collaborators have joined efforts to improve outcomes of children with cancer in Latin America and the Caribbean (LAC) using the CureAll framework. In this article, we describe the process of developing regional resources aimed at accelerating the GICC implementation in LAC. In March 2021, PAHO formed regional working groups to develop core projects aligned with CureAll pillars and enablers. Seven working groups emerged from regional dialogues: early detection, nursing, psychosocial, nutrition, supportive care, treatment abandonment, and palliative care. PAHO arranged regular online meetings under the mentorship and support of St. Jude regional/transversal programs and international mentors. Between April and December 2021, 202 multidisciplinary experts attended 43 online meetings to promote the dialogue between stakeholders to improve childhood cancer outcomes. Fourteen technical outputs were produced: four regional snapshots, four technical documents, two virtual courses, one set of epidemiological country profiles, one educational content series for parents/caregivers, and two communication campaigns. The ongoing dialogue and commitment of PAHO, St. Jude, LAC working committees, and international collaborators are essential foundations to successfully accelerate GICC implementation. This is achievable through the development of materials of regional and global relevance. Further research and evaluation are needed to determine the impact of these strategies and resources on childhood cancer outcomes in LAC and other regions.

Aim: The aim of the study is to reveal the level of cooperation in health informatics practices. Method: In order to reach the aim of the study by determining the level of cooperation between sectors in health informatics studies, the extent of research on the theme of ‘‘health informatics'' in health quality and performance congresses was examined. As a data source, academic studies published at various congresses held between 2009 and 2021 were analyzed. In accordance with the main purpose of the study, document analysis, which is a qualitative research method was carried out in the congress proceedings booklets. Results: According to the findings, it was seen that 66.1% of the academic studies in the field of health informatics were carried out only by university employees, while the rate of studies conducted in university-public cooperation was 16.1%. In addition, it was concluded that the work carried out by the employees of the Ministry of Health has a rate of 10.7%. While only 1.80% of the studies were carried out by private sector employees, it was observed that similarly, studies created through university-private sector cooperation constitute 1.80% of all studies. It has been seen that publications prepared in cooperation with the public-private sector constitute 0.90% of all publications, while publications prepared in cooperation with the university-other public sector constitute 0.90% of all publications at the same rate. Conclusion: The results of the study show that the level of cooperation is not sufficient, considering the importance of cooperation and the benefits that can be obtained from work done in cooperation. In this context, the study emphasizes the need to increase the encouragement of cooperation between health service providers in the field of health informatics and offers suggestions in this regard.

The study explored strategies that could be used to strengthen the integrated inter-sectoral collaboration among Early Childhood Care and Education (ECCE) providers in the Northern Cape province, South Africa. It is evidenced in the literature that early childhood education centers operate without maximum inter-sectoral collaboration. There is a need therefore for intersectoral collaboration among early childhood providers to ensure a smooth running of the program for children’s development. Semi-structured interviews with a sample of 12 seasoned ECCE providers from the public and private sectors were used to gather the data. Data were analyzed using thematic analysis, and themes were formed. The findings of the study among others indicate that a detailed provincial integrated Early Childhood Care and Education (ECCE) strategy is developed to ensure a properly resourced, coordinated, and managed Early childhood development (ECD) system that forms part of the national ECCE strategy. The study also found that the establishment of a financing model as a strategy can assist to strengthen the integrated inter-sectoral collaboration among ECCE providers.

AbstractObjective To explore how stakeholders in depression care view intersectoral collaboration and work participation for workers with depression.Design Focus group study applying reflexive thematic analysis using a salutogenic perspective.Setting and subjects We conducted seven focus group interviews in six different regions in Norway with 39 participants (28 women); three groups consisted of general practitioners (GPs), two of psychologists and psychiatrists and two of social welfare workers and employers (of which one group also included GPs).Results Stakeholders considered work participation salutary for most workers with depression, given the right conditions (e.g. manageable work accommodations and accepting and inclusive workplaces). They also highlighted work as an integral source of meaningfulness to many workers with depression. Early collaborative efforts and encouraging sick-listed workers to stay connected to the workplace were considered important to avoid long and passive sickness absences. Furthermore, stakeholders’ views illuminated why intersectoral collaboration matters in depression care; individual stakeholders have limited information about a worker’s situation, but through collaboration and shared insight, especially in in-person collaborative meetings, they (and the worker) can gain a shared understanding of the situation, thereby enabling more optimal support. Ensuring adequate information flow for optimal and timely follow-up of workers was also emphasized.Conclusions Stakeholders highlighted the salutary properties of work participation for workers with depression under the right conditions. Intersectoral collaboration could support these conditions by sharing insight and knowledge, building a shared understanding of the worker’s situation, assuring proper information flow, and ensuring early and timely follow-up of the worker.

Abstract Background Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants. Methods This theory-informed participatory research is co-created with socioculturally diverse research partners (refugees, asylum seekers and migrants without status, employees of community organizations, and employees of public organizations). We will utilize Mirzoev and Kane’s framework on health systems’ responsiveness to guide the four phases of a qualitative multiple case study (a case being an intersectoral initiative). These phases will include (1) building an inventory of intersectoral initiatives developed during the pandemic, (2) organizing a deliberative workshop with representatives of the study population, community, and public sector respondents to select and validate the intersectoral initiatives, (3) interviews (n = 80) with community and public sector frontline workers and managers, municipal/regional/provincial policymakers, and employees of philanthropic foundations, and (4) focus groups (n = 80) with refugees, asylum seekers, and migrants without status. Qualitative data will be analyzed using thematic analysis. The findings will be used to develop discussion forums to spur cross-learning among service providers. Discussion This research will highlight the experiences of community and public organizations in their ability to offer responsive services for refugees, asylum seekers, and migrants without status in the context of a pandemic. We will draw lessons learnt from the promising practices developed in the context of COVID-19, to improve services beyond times of crisis. Lastly, we will reflect upon our participatory approach—particularly in relation to the engagement of refugees and asylum seekers in the governance of our research.

Intersectoral collaboration is an essential component of the One Health (OH) approach, which recognises the interconnectedness of the health of humans, animals, and the environment. The OH European Joint Programme (OHEJP) developed a national foodborne outbreak table-top simulation exercise (SimEx) to practice OH capacity and interoperability across the public health, animal health, and food safety sectors, improving OH preparedness for future disease outbreaks. The Portuguese OHEJP SimEx highlighted strengths and weaknesses regarding the roles and functions of available systems, the constraints of existing legislation, the importance of harmonisation and data sharing, and the creation of common main messages adapted to each target sector. However, there is still a long way to go to ensure cooperation among the Public Health, Animal Health, and Food Safety sectors, as a OH approach relies not only on the awareness of “field experts” but also on political and organisational willingness and commitment.

Issue Addressed: The Ophelia (Optimising Health Literacy and Access to Health Services) process can be used as a practical tool for effective health promotion program delivery because of its multi‐sector and pragmatic approach to designing health interventions. An initial case study showed how its first phase was successfully adapted in a pilot community in Leyte, Philippines. In this study, the three phases of the Ophelia process were implemented in Leyte, along with additional communities in Mindoro and Surigao. Methods: After conducting needs assessment and community profiling in phase 1, the results were transformed into vignettes, hypothetical personas representing the health needs of the community. These were used in phase 2, which involved focus group discussions and workshops to cocreate intervention ideas with government organisations, practitioners, and community representatives. A rapid realist review was conducted in phase 3 to check for the feasibility of interventions. Results: Through this, the top evidence‐based health interventions for each life stage were listed and presented for prioritisation. Program implementation and impact evaluation plans were created for the top health intervention prior to implementation. Conclusions: The Ophelia process ensured that health promotion interventions addressed community needs and were designed using community resources and the wisdom of health practitioners that have been immersed in the local health system. So What?: The study demonstrated the usefulness of vignettes in presenting data to lay people and how the rapid realist review approach is a practical tool for policy‐makers to ensure that program plans designed by the communities and health practitioners are evidence‐based without sacrificing the timeliness of implementation. [ABSTRACT FROM AUTHOR]

Intersectoral collaboration (IC) plays a significant role in the delivery of diabetes care and treatment of patients with type 2 diabetes (DM2), as the treatment and care of these patients take place in both primary care and specialist settings. The collaboration involves a large number of actors from primary and secondary healthcare sectors, who are expected to fulfil various roles when they engage in IC. We explored the actors' roles by applying the framework of positioning theory with the aim of revealing seemingly embedded understandings of such roles. The empirical data consisted of individual and focus group interviews. Our results indicate that naturalised understandings of the roles of actors interact with the way in which health professionals, patients, managers and relatives strive to develop IC that aims to help and guide patients who live with DM2. [ABSTRACT FROM AUTHOR]

To explore how stakeholders in depression care view intersectoral collaboration and work participation for workers with depression. Focus group study applying reflexive thematic analysis using a salutogenic perspective. We conducted seven focus group interviews in six different regions in Norway with 39 participants (28 women); three groups consisted of general practitioners (GPs), two of psychologists and psychiatrists and two of social welfare workers and employers (of which one group also included GPs). Stakeholders considered work participation salutary for most workers with depression, given the right conditions (e.g. manageable work accommodations and accepting and inclusive workplaces). They also highlighted work as an integral source of meaningfulness to many workers with depression. Early collaborative efforts and encouraging sick-listed workers to stay connected to the workplace were considered important to avoid long and passive sickness absences. Furthermore, stakeholders' views illuminated why intersectoral collaboration matters in depression care; individual stakeholders have limited information about a worker's situation, but through collaboration and shared insight, especially in in-person collaborative meetings, they (and the worker) can gain a shared understanding of the situation, thereby enabling more optimal support. Ensuring adequate information flow for optimal and timely follow-up of workers was also emphasized. Stakeholders highlighted the salutary properties of work participation for workers with depression under the right conditions. Intersectoral collaboration could support these conditions by sharing insight and knowledge, building a shared understanding of the worker's situation, assuring proper information flow, and ensuring early and timely follow-up of the worker. [ABSTRACT FROM AUTHOR]