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Mobilising cross-sector collaborations to improve population health in US rural communities: a qualitative study
Journal article   Open access   Peer reviewed

Mobilising cross-sector collaborations to improve population health in US rural communities: a qualitative study

Xi Zhu, Paula Weigel, Jure Baloh, Mochamad Nataliansyah, Nichole Gunn and Keith Mueller
BMJ open, Vol.9(11), e030983
11/06/2019
DOI: 10.1136/bmjopen-2019-030983
PMCID: PMC6858126
PMID: 31699729
url
https://doi.org/10.1136/bmjopen-2019-030983View
Published (Version of record) Open Access

Abstract

ObjectivesThis study examines types and forms of cross-sector collaborations employed by rural communities to address community health issues and identifies factors facilitating or inhibiting such collaborations.SettingWe conducted case studies of four rural communities in the US state of Iowa that have demonstrated progress in creating healthier communities.ParticipantsKey informants from local public health departments, hospitals and other health-promoting organisations and groups participated in this study. Twenty-two key-informant interviews were conducted. Participants were selected based on their organisation’s involvement in community health initiatives.ResultsRural communities used different forms of collaborations, including cross-sector partnership, cross-sector interaction and cross-sector exploration, to address community health issues. Stakeholders from public health, healthcare, social services, education and business sectors were involved. Factors facilitating cross-sector collaborations include health-promoting local contexts, seed initiatives that mobilise communities, hospital visions that embrace broad views of health and shared collaboration leadership and governance. Challenges to developing and sustaining cross-sector collaborations include different institutional logics, financial and human resources constraints and geographic dispersion.ConclusionsRural communities use cross-sector collaborations to address community health issues in the forms of interaction and exploration, but real and lasting partnerships are rare. The development, operation and sustainment of cross-sector collaborations are influenced by a set of contextual and practical factors. Practical strategies and policy interventions may be used to enhance cross-sector collaborations in rural communities.

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