Sustaining Participation in Multisector Health Care Alliances

The Role of Personal and Stakeholder Group Influence

Collaborative forms of organizations (e.g. alliances, coalitions, networks) are increasingly viewed as an effective means of addressing complex, multifaceted health, and social challenges (Nicholson 2013). However, sustainability is tenuous largely because these organizations depend on efforts of volunteer members to develop and implement strategy. Thus, a perennial question for leaders and sponsors of collaborative organizations is how to sustain member participation?

This study investigated how alliance member perceptions of decision-making influence – both personal and stakeholder group - relate to sustained participation in the alliance using an Internet-based survey of 638 members of 15 multistakeholder health care alliances participating in the Robert Wood Johnson Foundation’s decade-long Aligning Forces for Quality program.  The analysis revealed that alliance members saw less participation value when their personal influence was believed to be lower than the influence of other alliance members, but this was not significantly associated with the anticipated level of future participation. In contrast, imbalances in general stakeholder group influence were associated with a decreased likelihood of future participation.

These findings highlight the importance of alliance leaders seeking balance when considering the role of influence in shaping member attitudes and behaviors. Such a balancing act is complicated by the fact that many alliances may not begin as a collaboration of equals and efforts to establish perceptions of balanced influence are likely occurring in ever-changing environments (e.g., new health care policy, new funding opportunities).

Authors:  Larry Hearld, Jeffrey Alexander
Health Care Management Review. 2018 Aug 22. [Epub ahead of print]