Community-based organizations' perspectives on improving health and social service integration.

Health and social service integration High-risk populations Medicaid populations Social determinants of health

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
06 03 2021
Historique:
received: 26 11 2020
accepted: 10 02 2021
entrez: 7 3 2021
pubmed: 8 3 2021
medline: 22 5 2021
Statut: epublish

Résumé

Collaborations between health systems and community-based organizations (CBOs) are increasingly common mechanisms to address the unmet health-related social needs of high-risk populations. However, there is limited evidence on how to develop, manage, and sustain these partnerships, and implementation rarely incorporates perspectives of community social service organizations. To address these gaps, we elicited CBOs' perspectives on service delivery for clients, the impact of the Whole Person Care-Los Angeles (WPC-LA) initiative to integrate health and social care, and their suggestions for improving health system partnerships. Using stakeholder engaged principles and a qualitative Rapid Assessment Process, we conducted brief surveys and in-depth semi-structured interviews with 65 key informants from 36 CBOs working with WPC-LA. Major themes identified by CBOs included: 1) the importance of a holistic, client-centered, continuously engaged approach that is reliant on regional partnerships; 2) benefits of WPC-LA expanding capacity and networks; 3) concerns about communication and redundancy hindering WPC-LA; and 4) a need for more equitable partnerships incorporating their approaches. CBOs value opportunities for integration with health systems, bring critical expertise to these partnerships, and seek to strengthen cross-sector collaborations. Early, equitable, and inclusive participation in the development and implementation of these partnerships may enhance their effectiveness, but requires policy that prioritizes and incentivizes sustainable and mutually beneficial partnerships.

Sections du résumé

BACKGROUND
Collaborations between health systems and community-based organizations (CBOs) are increasingly common mechanisms to address the unmet health-related social needs of high-risk populations. However, there is limited evidence on how to develop, manage, and sustain these partnerships, and implementation rarely incorporates perspectives of community social service organizations. To address these gaps, we elicited CBOs' perspectives on service delivery for clients, the impact of the Whole Person Care-Los Angeles (WPC-LA) initiative to integrate health and social care, and their suggestions for improving health system partnerships.
METHODS
Using stakeholder engaged principles and a qualitative Rapid Assessment Process, we conducted brief surveys and in-depth semi-structured interviews with 65 key informants from 36 CBOs working with WPC-LA.
RESULTS
Major themes identified by CBOs included: 1) the importance of a holistic, client-centered, continuously engaged approach that is reliant on regional partnerships; 2) benefits of WPC-LA expanding capacity and networks; 3) concerns about communication and redundancy hindering WPC-LA; and 4) a need for more equitable partnerships incorporating their approaches.
CONCLUSIONS
CBOs value opportunities for integration with health systems, bring critical expertise to these partnerships, and seek to strengthen cross-sector collaborations. Early, equitable, and inclusive participation in the development and implementation of these partnerships may enhance their effectiveness, but requires policy that prioritizes and incentivizes sustainable and mutually beneficial partnerships.

Identifiants

pubmed: 33676470
doi: 10.1186/s12889-021-10449-w
pii: 10.1186/s12889-021-10449-w
pmc: PMC7937223
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

452

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Auteurs

Etsemaye P Agonafer (EP)

Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, USA. Etsemaye.P.Agonafer@kp.org.

Savanna L Carson (SL)

UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, USA.
UCLA CTSI Community Engagement and Research Program (CERP), Los Angeles, USA.

Vanessa Nunez (V)

David Geffen School of Medicine at UCLA, Los Angeles, USA.
Program in Medical Education Leadership and Advocacy (PRIME-LA), Los Angeles, USA.

Kelli Poole (K)

Los Angeles County Department of Health Services (LAC DHS), Los Angeles, USA.

Clemens S Hong (CS)

Los Angeles County Department of Health Services (LAC DHS), Los Angeles, USA.

Maria Morales (M)

UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, USA.
UCLA CTSI Community Engagement and Research Program (CERP), Los Angeles, USA.

Jessica Jara (J)

UCLA CTSI Community Engagement and Research Program (CERP), Los Angeles, USA.
Los Angeles County Department of Health Services (LAC DHS), Los Angeles, USA.

Sarmen Hakopian (S)

UCLA CTSI Community Engagement and Research Program (CERP), Los Angeles, USA.
Los Angeles County Department of Health Services (LAC DHS), Los Angeles, USA.
Olive View-UCLA Medical Center, Slymar, USA.

Tiffany Kenison (T)

Los Angeles County Department of Health Services (LAC DHS), Los Angeles, USA.

Ish Bhalla (I)

UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, USA.

Francesca Cameron (F)

UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, USA.
UCLA CTSI Community Engagement and Research Program (CERP), Los Angeles, USA.
Los Angeles County Department of Health Services (LAC DHS), Los Angeles, USA.

Stefanie D Vassar (SD)

UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, USA.
UCLA CTSI Community Engagement and Research Program (CERP), Los Angeles, USA.
Los Angeles County Department of Health Services (LAC DHS), Los Angeles, USA.
Olive View-UCLA Medical Center, Slymar, USA.

Arleen F Brown (AF)

UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, USA.
UCLA CTSI Community Engagement and Research Program (CERP), Los Angeles, USA.
Los Angeles County Department of Health Services (LAC DHS), Los Angeles, USA.
Olive View-UCLA Medical Center, Slymar, USA.

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