142nd APHA Annual Meeting and Exposition

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Analysis of inter-agency coordination among HIV agencies through dual use of social network techniques and relational coordination

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Nidhi Khosla, PhD, MPH , Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, MO
Jill A. Marsteller, PhD , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background: Agencies with different foci are involved in serving the needs of HIV positive people (e.g. nutrition, social, medical, housing). They need to have a high degree of coordination to prevent clients from “falling through the cracks”.

Method: We creatively employed two tools to capture the breadth and depth of inter-agency relationships among HIV service agencies in Baltimore, USA. We first used network analysis to capture the breadth of relationships among 55 agencies.  Next, we picked 11 agencies that had been reported by 1/3rd or more of the sample (18 or more) as agencies with which the rest had monthly or higher interaction. We administered a survey to these 11 agencies, that assessed the seven dimensions of relational coordination (frequency, timeliness, accuracy and problem-solving communication; knowledge of agencies’ work, mutual respect and shared goals) among these agencies.

Results: We found a density of 20% when considering interactions only of monthly, weekly or daily frequency. Relational coordination scores for agencies ranged between 1.17 to 5 (maximum possible score 5). The scores for different dimensions ranged between 3.3 to 4. Shared goals (4) and mutual respect (3.91) scores were highest, suggesting these were the strongest bases for coordination of care among these agencies. Frequency of communication was lowest (3.33).

Conclusions: Agencies should be encouraged to communicate more frequently to further improve coordination. Further, agencies that had lower mutual scores should examine their systems to identify gaps and rectify them. Use of such dual analyses can provide a comprehensive picture of inter-agency coordination.

Learning Areas:

Administer health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Demonstrate about the creative use of network analysis and relational coordination to capture coordination of health services. Compare the use of the two techniques in capturing coordination among agencies

Keyword(s): Health Care Delivery, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have studied and published about factors that affect collaboration among agencies that provide health and human services to vulnerable populations such as people infected by or at risk of HIV in the US. I have also been engaged in grant writing, program implementation and monitoring of collaborative community based projects and alliances on health and poverty alleviation for over 5 years in India and Bangladesh.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.