SHAPING THE EVOLUTION OF THE INFORMATION FLOW: THE CENTRALIZING MECHANISMS IN THE EVOLUTION OF THE NORTH AMERICAN TOBACCO QUITLINE CONSORTIUM.

The research reported here is an analysis of the evolution of the relationships that comprise a single public health network, focusing especially on the position of the network administrative organization (Provan and Kenis, 2008) in the flow of knowledge among a large number of organizations providing similar services. Our study examines the North American Quitline Consortium (NAQC), a multi-sector network that spans the US and Canada and whose members provide telephone-based tobacco cessation services to anyone interested in quitting smoking. Data were collected using web-based surveys at three different points of time.

Comparison of dosage of intensive upper limb therapy for children with unilateral cerebral palsy: how big should the therapy pill be?

This study aimed to compare efficacy of two dosages of modified constraint induced movement therapy (mCIMT) and bimanual therapy on upper limb and individualized outcomes for children with unilateral cerebral palsy. This secondary analysis included two separate randomized trials that compared equal doses (high or low) of mCIMT to bimanual therapy; Study 1 (full dose--60 h) n=64 and; Study 2 (half dose--30 h) n=18 for children aged five to 16 years with unilateral cerebral palsy. Outcomes for both studies included the Melbourne Assessment of Unilateral Upper Limb Function, Assisting Hand Assessment, Jebsen Taylor Test of Hand Function and Canadian Occupational Performance Measure which were administered at baseline, three and 26 weeks.

Implementation of tobacco cessation quitline practices in the United States and Canada.

Objectives: We examined relationships between implementation of tobacco quitline practices, levels of evidence of practices, and quitline reach and spending.

Methods: In June and July 2009, a total of 176 quitline funders and providers in the United States and Canada completed a survey on quitline practices, in particular quitline-level implementation for the reported practices. From these data, we selected and categorized evidence-based and emerging quitline practices by the strength of the evidence for each practice to increase quitline efficacy and reach.

UP-BEAT (Upper Limb Baby Early Action-observation Training): protocol of two parallel randomised controlled trials of action-observation training for typically developing infants and infants with asymmetric brain lesions.

Introduction: Infants with asymmetric brain lesions are at high risk of developing congenital hemiplegia. Action-observation training (AOT) has been shown to effectively improve upper limb motor function in adults with chronic stroke. AOT is based on action observation, whereby new motor skills can be learnt by observing motor actions.

Awareness of Evidence-Based Practices by Organizations in a Publicly Funded Smoking Cessation Network.

This research examines the awareness of evidence based practices by the public organizations that fund services in the North American Quitline Consortium (NAQC). NAQC is a large, publicly funded, goal-directed "whole network," spanning both Canada and the U.S.

Mapping tobacco quitlines in North America: signaling pathways to improve treatment.

Objectives: This study was designed to better understand how the network of quitlines in the North American Quitline Consortium (NAQC) interact and share new knowledge on quitline practices.

Methods: Network relationship data were collected from all 63 publicly funded quitlines in North America, including information sharing, partner trust, and reputation.

Results: There was a strong tendency for US and Canadian quitlines to seek information from other quitlines in the same country, with few seeking information from quitlines from the other country.

Drawbacks and benefits associated with inter-organizational collaboration along the discovery-development-delivery continuum: a cancer research network case study.

Background: The scientific process around cancer research begins with scientific discovery, followed by development of interventions, and finally delivery of needed interventions to people with cancer. Numerous studies have identified substantial gaps between discovery and delivery in health research. Team science has been identified as a possible solution for closing the discovery to delivery gap; however, little is known about effective ways of collaborating within teams and across organizations.

Network formation, governance, and evolution in public health: the North American Quitline Consortium case.

Background: Collaborative networks of health organizations have received a great deal of attention in recent years as a way of enhancing the flow of information and coordination of services. However, relatively little is known about how such networks are formed and evolve, especially outside a local, community-based setting. This article is an in-depth discussion of the evolution of the North American Quitline Consortium (NAQC).

INCITE: A randomised trial comparing constraint induced movement therapy and bimanual training in children with congenital hemiplegia.

Background: Congenital hemiplegia is the most common form of cerebral palsy (CP) accounting for 1 in 1300 live births. These children have limitations in capacity to use the impaired upper limb and bimanual coordination deficits which impact on daily activities and participation in home, school and community life. There are currently two diverse intensive therapy approaches.

Research collaboration in the discovery, development, and delivery networks of a statewide cancer coalition.

This study examines and evaluates collaborative network involvement among 18 organizations within the Arizona Cancer Coalition. All were involved in one or more of three types of research activity: discovery, development, and delivery, consistent with the 3D continuum developed by the National Cancer Institute. Data were collected in 2007 using surveys of key informants in each organization.

Health care leadership academy: a statewide collaboration to enhance nursing leadership competencies.

Competency in leadership skills is necessary to manage in the current chaotic health care environment and proactively participate in the creation of a better environment. Although interest in pursuing a career in health care is growing, lack of leadership competence contributes to employee frustration and dissatisfaction, which directly and indirectly impacts the supply of health care workers. To addressthe lack of leadership competence and its disturbing consequences, the Arizona nursing community designed a model for nursing leadership and created a partnership to provide a high-quality, affordable leadership education program focused on enhancing the leadership competencies of frontline nursing supervisors.

Transdisciplinarity among tobacco harm-reduction researchers: a network analytic approach.

Progress in tobacco control and other areas of health research is thought to be heavily influenced by the extent to which researchers are able to work with each other not only within, but also across disciplines. This study provides an examination of the extent to which researchers in the area of tobacco harm reduction work together. Specifically, data were collected in 2005 from a national group of 67 top tobacco-control researchers from eight broadly defined disciplines representing 17 areas of expertise.

Health services delivery networks: what do we know and where should we be headed?

Networks of collaborating organizations have become critical mechanisms for the effective delivery of healthcare and related human services. Despite their importance, there is much about health networks that is not understood. The article by Huerta, Casebeer and VanderPlaat is an effort to discuss the importance of health services delivery networks and to point out ways in which such networks might best be studied.

Network structure and attitudes toward collaboration in a community partnership for diabetes control on the US-Mexican border.

Purpose: This study seeks to provide an examination of a health policy network operating in a single, small community along the US-Mexican border. The purpose of the paper is to discuss why and how this network evolved, and then to present findings on how the network was structured. Analysis will focus especially on agency involvement, or "embeddedness" in the network, and its relationship to attitudes held by network members regarding trust, reputation, and perceived benefit.

Building legitimacy and the early growth of health networks for the uninsured.

An integrated system of health care for serving the uninsured population of one community was followed from formation through early growth. Funding was provided through the Health Resources Services Administration's Community Access Program to bring together a diverse set of health care providers to form a collaborative network managed by a central administrative entity. Legitimacy building was critical for explaining how the network evolved and the effectiveness of the network in sustaining itself and building a patient base.

Network analysis as a tool for assessing and building community capacity for provision of chronic disease services.

A network analysis was conducted in spring 2000 by the Southwest Center for Health Promotion in the U.S.-Mexico border community of Douglas, Arizona.

Building community capacity around chronic disease services through a collaborative interorganizational network.

This article presents the findings of a study examining the evolution of a network of health and human service organizations operating in a rural community on the Southwest border. The aim of the network was to build the capacity of the community to provide chronic disease education, prevention, and treatment services by developing collaborative relationships among a broad range of organizations. The impetus for the effort was based on receipt of a Turning Point grant.

Collaboration and integration of community-based health and human services in a nonprofit managed care system.

This article reports the results of research on a single, urban system of health and human services delivery for clients with serious mental illness. The primary focus was to examine how collaboration and services integration among the more than 40 mostly nonprofit provider agencies were affected by the introduction of managed care. A critical factor in explaining the results was the role of the behavioral health authority in implementing and managing the system.

Behavioral health funding for Native Americans in Arizona: policy implications for states and tribes.

This article examines the principal structures and mechanisms used by federal and state government to fund the behavioral health needs of Native American Indians. Using Arizona as a case study, the article provides an overview of both federal and state programs, especially Medicaid, discussing the problems and strengths of each. The article concludes with a discussion of the policy implications of these programs for both states and tribes, focusing on issues concerning administrative complexity, tribal sovereignty, improving behavioral health services, and assignment of financial risk.

A cost-constrained model of strategic service quality emphasis in nursing homes.

This study employed structural equation modeling to test the relationship between three aspects of the environmental context of nursing homes; Medicaid dependence, ownership status, and market demand, and two basic strategic orientations: low cost and differentiation based on service quality emphasis. Hypotheses were proposed and tested against data collected from a sample of nursing homes operating in a single state. Because of the overwhelming importance of cost control in the nursing home industry, a cost constrained strategy perspective was supported.

Integration of community-based services for the severely mentally ill and the structure of public funding: a comparison of four systems.

Despite strong interest by health care services researchers in studying community-based service delivery to persons with severe mental illness, few understand the relationship between the structure of public funding and differences in how mental health care delivery systems are organized. In particular, the structure of public funding may have a substantial effect on the nature and extent of integration among the various service providers that comprise a community's delivery network. Such an understanding is critical if mental health policymakers are to use their influence on funding to guide the structure of service delivery.

Environmental and organizational predictors of adoption of cost containment policies in hospitals.

This study examined predictors of the adoption of cost containment policies in a national sample of 303 not-for-profit hospitals. Analysis of the full sample indicated that adoption of such policies was positively related to response to external regulation, cooperative interorganizational involvement, external orientation, number of beds, occupancy rate, and the influence of chief administrators on governing boards; adoption was negatively related to length of patients' stays. Additional exploratory analysis of the data revealed different combinations of characteristics that were unique to subgroups of hospitals with the lowest and highest levels of policy adoption.

Technology and interorganizational activity as predictors of client referrals.

The client referral activity of 41 human service agencies operating within the same community was examined using recently collected data. Hypotheses were developed focusing on agency service technology and interagency activity as predictors of referrals from and to other organizations. The hypothesis for technology was supported; hypotheses for interagency activity received mixed support.