Incite to Practice: Development of a Realist-Informed Program Theory to Support Implementation of Intersectoral Partnerships

摘要

Policy internationally is supportive of intersectoral partnerships (ISPs) for promoting positive outcomes among people with complex social, psychological, and physical needs. This realist-informed study describes the development of a program theory to provide insight into enactment of effective ISPs. Interviews were completed with 18 senior staff with leadership roles in six ISPs, including voluntary, statutory, and commercial organizations, supporting people with complex health and social care needs. An iteratively developed and refined program theory, termed the “Incite” model, was developed, with collaboration with participants and an advisory group, including people with lived experience. Important contextual conditions that emerged included organizational culture, historical perspectives, policy, and social determinants of health. Mechanisms included desire for change, creating safe psychological spaces, establishing shared values, and talking about power. Outcomes included transformed world view, increased psychological safety, clarity of purpose, fluidity of relationships, and power shifting. Three phases of partnership development were also identified within the model. This study has led to a clearer, more rigorous, and systematic understanding, with recommendations for how ISPs might be developed or expanded. How the Incite model may be operationalized is discussed, as well as implications for policy, practice, and research.