Using organizational network analysis to plan cancer screening programs for vulnerable populations

Abstract

Objectives: We examined relationships among organizations in a cancer screening network to inform the development of interventions to improve cancer screening for South Asians living in the Peel region of Ontario.

Methods: From April to July 2012, we surveyed decision-makers, program managers, and program staff in 22 organizations in the South Asian cancer screening network in the Peel region. We used a network analytic approach to evaluate density (range = 0%-100%, number of ties among organizations in the network expressed as a percentage of all possible ties), centralization (range = 0-1, the extent of variability in centrality), and node characteristics for the communication, collaboration, and referral networks.

Results: Density was similar across communication (15%), collaboration (17%), and referral (19%) networks. Centralization was greater in the collaboration network (0.30) than the communication network (0.24), and degree centralization was greater in the inbound (0.42) than the outbound (0.37) referral network. Diverse organizations were central to the networks.

Conclusions: Certain organizations were unexpectedly important to the South Asian cancer screening network. Program planning was informed by identifying opportunities to strengthen linkages between key organizations and to leverage existing ties.

FIGURE 1—

Response options for the collaboration network measure of organizations involved in cancer screening of South Asians living in Peel, Ontario: 2012.

FIGURE 2—

Networks of organizations involved in cancer screening for South Asians living in Peel, Ontario, by (a) communication network, (b) collaboration network, and (c) referral network: 2012. Note. CommHealthCent = community health center; ComServOrg = community service group; NCS = National Cancer Society; RCC = regional cancer center; RPHA = regional public health organization. Nodes represent the organizations. Node size represents the betweenness centrality measure (a and b) or degree centrality (c). Lines connecting nodes represent a relationship between the 2 organizations. In the communication and collaboration networks, the relationships were reciprocal, whereas in the referral network the direction of the line represents the direction of referral flow.