Fair process as a moderator in outcomes -based explanations of community health partnership participation.

Abstract

This study examined the relationship between benefits, fair process, and individual participation in community health partnerships. The model of partnership participation tested hypothesized that outcomes (in the form of benefits) and process would interact in influencing participation. The study sample consisted of 433 participants from 25 community health partnerships participating in the Community Care Network Demonstration Program. Study respondents completed the Partnership Self-Assessment Survey (PSAS) in 1998. Aspects of participation examined included both level of involvement and roles assumed. Outcomes included two types of both selective (individually-enjoyed) and collective benefits, while fair process included both procedural and interpersonal components. Overall, results showed strong evidence of direct effects of both selective and collective benefits and of fair process on different aspects of participation. These effects varied depending on whether benefits were broken out by type. The same was true for fair process, as only interpersonal fairness had a significant direct relationship with participation. There was evidence of interaction effects of fair process with benefits, and in particular interpersonal fairness with both types of selective benefits. These effects were largely positive. Finally, both direct and interactive influences on participation clearly varied between partnerships depending on their primary aims, suggesting that the outcomes-participation relationship may take different forms depending upon the organizational context. The results did not strongly support either self-interest or social identity-based accounts of the underlying mechanism of the outcome-process interaction effect. The implications of this for theory were discussed, and possible explanations based on recent procedural justice research were explored. The results suggest that partnerships need to strike a balance, working to attain outcomes while not neglecting process. Primary limitations of the study included its cross-sectional design, survey response favoring higher participating partnership members, and missing data.