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Article
Publication date: 3 January 2017

Katharina K. Pucher, Math J.J.M. Candel, Nicole M.W.M. Boot and Nanne K. de Vries

The Diagnosis of Sustainable Collaboration (DISC) model (Leurs et al., 2008) specifies five factors (i.e. project management, change management, context, external factors, and…

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Abstract

Purpose

The Diagnosis of Sustainable Collaboration (DISC) model (Leurs et al., 2008) specifies five factors (i.e. project management, change management, context, external factors, and stakeholders’ support) which predict whether collaboration becomes strong and stable. The purpose of this paper is to study the dynamics of these factors in a study of multiple partnerships in comprehensive school health promotion (CSHP).

Design/methodology/approach

A Dutch two-year DISC-based intervention to support coordinators of five CSHP partnerships in the systematic development of intersectoral collaboration was studied in a pretest-posttest design. To uncover the determinants of sustainable collaboration and implementation of CSHP and to find possible mediators, the authors carried out multi-level path analyses of data on the DISC factors obtained from 90 respondents (response of approached respondents: 57 percent) at pretest and 69 respondents (52 percent) at posttest. Mediation mechanisms were assessed using joint significance tests.

Findings

The five DISC factors were important predictors of implementation of CSHP (explained variance: 26 percent) and sustainable collaboration (explained variance: 21 percent). For both outcomes, stakeholders’ support proved to be the most important factor. Regarding sustainable collaboration, mediation analysis showed that stakeholders’ support fully mediated the effects of change management, project management, external factors and context. This indicates that the extent of stakeholders’ support (e.g. appreciation of goals and high levels of commitment) determines whether collaboration becomes sustainable. The authors also found that the extent of stakeholders’ support in turn depends upon a well-functioning project management structure, the employment of change management principles (e.g. creation of a common vision and employment of appropriate change strategies), a favorable organizational context (e.g. positive experience with previous collaboration) and external context (e.g. positive attitudes of financing bodies and supporting health and educational policies). For the actual implementation of CSHP, partial mediation by the support factor was found. There was a direct positive effect of change management indicating that organizational knowledge is also necessary to implement CSHP, and a direct negative effect of project management, probably pointing to the negative effects of too much negotiation in the collaboration.

Research limitations/implications

A design lacking a control group, a small sample and a relatively early assessment after implementation support stopped limit the generalizability of the results.

Practical implications

Strategies targeting the DISC factors can enhance stakeholders’ support and thereby promote sustainable intersectoral collaboration and the implementation of CSHP.

Originality/value

The DISC model provides a fruitful conceptual framework for the study of predictors and processes in public health partnerships. The importance of stakeholders’ support and other factors in the model are demonstrated.

Details

Health Education, vol. 117 no. 1
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 23 August 2013

K.K. Pucher, N.M.W.M. Boot and N.K. De Vries

A systematic review of effects and mediators was conducted to determine whether school health promotion interventions (SHPIs) can enhance children's academic performance (AP).

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Abstract

Purpose

A systematic review of effects and mediators was conducted to determine whether school health promotion interventions (SHPIs) can enhance children's academic performance (AP).

Design/methodology/approach

PubMed and PsycINFO database searches and subsequent reference list reviews were conducted for papers published before 18 January 2012 with a standard form of eligibility criteria encompassing standardized measures of AP (e.g. grade‐point averages, end of year marks) and methodology sound studies (e.g. randomized controlled trials, cross‐over controlled trials, quasi‐experimental designs with pre‐ and posttest) of interventions addressing healthy lifestyles in the general school population. Information for the study description was extracted from the original article (e.g. country, study purpose, research design, effects on AP measures, components of Health Promoting School, author's explanations for observed effects). Effect sizes were calculated for effects on AP measures.

Findings

Remaining SHPIs targeted exclusively the maintenance of energy balance (physical activity (PA) and nutrition) and had small to large positive effects on AP; no negative effects were reported. Effects of different kinds of interventions varied across academic domains. One PA intervention reported large effects of vigorous activity on mathematics; another PA intervention had small to medium impact on language scores. Small to medium effects were found for interventions combining nutrition and PA elements; one affected mathematics and another both mathematics and language scores. Slight improvements in language scores were observed for breakfast provision in schools.

Limitations

The small number of interventions, little homogeneity in intervention components (content, length and measurement instruments), reporting bias and some inconsistent results should be considered when interpreting our results. Our review did not allow definite conclusions concerning mechanisms responsible for effects of SHPIs on AP.

Practical implications

Planned development of school health promotion will need to be based on evidence. Measures of AP should be included in evaluations of SHPIs. Schools and health professionals should be made aware of the importance of these measures.

Originality/value

We provide evidence that SHPIs promoting energy balance can affect AP, also if they do not target children at risk or with specific symptoms, nor employ elements directly connected to school education.

Details

Health Education, vol. 113 no. 5
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 1 June 2015

K.K. Pucher, M.J.J.M. Candel, N.M.W.M. Boot, A.J.A. van Raak and N. K. de Vries

Intersectoral collaboration is often a prerequisite for effective interventions in public health. The purpose of this paper is to assess the facilitating and hindering conditions…

Abstract

Purpose

Intersectoral collaboration is often a prerequisite for effective interventions in public health. The purpose of this paper is to assess the facilitating and hindering conditions regarding intersectoral collaboration between health authorities, public health services (PHSs), public services stakeholders (PPSs) and the education sector in comprehensive school health promotion (CSHP) in the Netherlands.

Design/methodology/approach

CSHP collaborations in five Dutch regions were studied using a questionnaire based on the DIagnosis of Sustainable Collaboration (DISC) model, focusing on: change management; perceptions, intentions and actions of collaborating parties; project organization; and factors in the wider context. Univariate and multivariate analyses with bootstrapping were applied to 106 respondents (62 percent response).

Findings

A similar pattern of facilitating and hindering conditions emerged for the five regions, showing positive perceptions, but fewer positive intentions and actions. An overall favorable internal and external context for collaboration was found, but limited by bureaucratic procedures and prioritizing stakeholders’ own organizational goals. Change management was rarely applied. Some differences between sectors emerged, with greatest support for collaboration found among the coordinating organizations (PHSs) and least support among the financing organization (municipalities).

Research limitations/implications

The generalization of the findings is limited to the initial formation stage of collaboration, and may be affected by selection bias, small sample size and possible impact of interdepartmental collaboration within organizations.

Practical implications

The authors recommend establishing stronger change management to facilitate translation of positive perceptions into intentions and actions, and coordination of divergent organizational structures and orientations among collaborating parties.

Originality/value

The results show that it is valuable for collaborating parties to conduct DISC analyses to improve intersectoral collaboration in CSHP.

Details

Health Education, vol. 115 no. 3/4
Type: Research Article
ISSN: 0965-4283

Keywords

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