Implementation of cross-sector partnerships: a description of implementation factors related to addressing social determinants to reduce racial disparities in adverse birth outcomes

Abstract

Introduction: Traditional perinatal care alone cannot address the social and structural determinants that drive disparities in adverse birth outcomes. Despite the wide acceptance of partnerships between healthcare systems and social service agencies to address this challenge, there needs to be more research on the implementation factors that facilitate (or hinder) cross-sector partnerships, particularly from the perspective of community-based organizations. This study aimed to integrate the views of healthcare staff and community-based partner organizations to describe the implementation of a cross-sector partnership designed to address social and structural determinants in pregnancy.

Methods: We used a mixed methods design (in-depth interviews and social network analysis) to integrate the perspectives of healthcare clinicians and staff with those of community-based partner organizations to identify implementation factors related to cross-sector partnerships.

Results: We identified seven implementation factors related to three overarching themes: relationship-centered care, barriers and facilitators of cross-sector partnerships, and strengths of a network approach to cross-sector collaboration. Findings emphasized establishing relationships between healthcare staff, patients, and community-based partner organizations.

Conclusion: This study provides practical insights for healthcare organizations, policymakers, and community organizations that aim to improve access to social services among historically marginalized perinatal populations.

Keywords: cross-sector partnership; health disparities; implementation; prenatal care; social detereminants.

Figure 1

MAMA’S neighborhood partnerships (N = 80 unique partnerships). MAMA’S staff identified 51 organizations (nodes) as part of the network. These organizations identified 80 unique partnerships (arrows). Larger nodes indicate organizations with a greater number of relationships. The network includes 11 (22%) healthcare organizations, 35 (68%) social services organizations, and 5 (10%) public health organizations throughout Los Angeles County. A list MAMA’S Neighborhood partner organization names is included in Appendix 1.