Inter-organizational relationships in rural smoke-free policy: A social network analysis

While the importance of inter-organizational partnerships in policy advocacy is recognized, there is little information about how these systems are structured. Network analysis was used to examine inter-organizational partnerships related to smoke-free policy development over time in 30 rural Kentucky communities. A network of 30 community coalitions (22 treatment and 8 control communities) and 29 individual and organizational partners was assessed through annual key informant interviews over a 3-year period. Partnership ties, support ties, and resource sharing ties were examined. The study was part of a five-year RCT to test the effects of a tailored, stage-based intervention on community readiness and policy outcomes. Network density and degree centrality were assessed. Density scores were consistently higher in Year 3 than in Year 1 for the treatment networks but not for those in control communities. A greater increase in average degree centrality was observed in the treatment group than in the controls. The results suggest that the intervention may have been effective in strengthening inter-organizational tobacco control networks in rural communities. These findings have both applied and theoretical implications. Community readiness interventions hold promise in building effective inter-organizational relationships to leverage resources for policy development in rural communities. Longitudinal network analysis can be used as an indicator of improvement in community capacity and readiness for policy change.