Local Voluntary Organizations and Their Environments: a Study of Self-Help Groups of Parents of Children with Cancer.

Abstract

This research analyzes the relationship between organizational environments and internal characteristics of one type of local voluntary organization, self-help groups of parents of children with cancer. Previous research has focused on the internal dynamics of self-help groups, so application of the environmental perspective is a relatively new approach. Data for this analysis comes from a sample of 32 parent groups in 16 states. Information was collected in a comparative case-study approach, using intensive entry (1-2 days) and open-ended interviews with group members and medical staff in each site. The primary data source is the taped on-site interview; other sources include a follow-up mailed instrument, group records, and secondary data sources. Coding involved a complex process of transforming qualitative information into a form appropriate for quantitative comparative analysis. A typology of self-help groups is developed based on their internal characteristics. Self-help groups' environments are measured in three general categories: (1) community and medical-system settings; (2) integration with environments; and (3) support from the medical system. Results indicate that these groups vary systematically with regard to their environments. Size of the catchment area, population characteristics and the configuration of community and institutional relationships distinguish between groups with expressive and instrumental programmatic orientations. Those groups experiencing highest support from the medical system tend either to have professional leadership, or to be those with large-scale fundraising programs for research or services. Primary themes emerging from this analysis are organizational adaptation to an external environment, and establishment of relationships with that environment in order to obtain needed resources. These results argue for a new underst and ing of the rich diversity in approaches to self-help as a form of coping with personal and family crisis. Self-help groups may be understood as voluntary organizations which cooperate with institutional systems in the provision of care. Inter-organizational relations would profit from new collaborative professional roles to enhance the benefits of such groups for medical systems and patients.