Inter-organizational Collaborations Working to Change Policies that Affect Adolescents: A Qualitative Study of Three Youth-Serving Inter-organizational Collaborations.

Abstract

Differences in health status by race, ethnicity, and socioeconomic status have been well documented in the literature. Inter-organizational collaborations (IOCs) are a strategy used to address public health concerns and are useful in addressing differences in health status that are due to injustice. This study uses a social determinants of health framework, which describes how factors at the macro, community, interpersonal and individual levels contribute to inequities. Policy change is used to address these social determinants of health inequities. The purpose of this study is to identify factors that are challenges or facilitating factors to IOCs’ effectiveness and to describe how youth engage in policy advocacy initiatives. The study uses a case study design and data collection of interviews, a document review, and observations of events that were conducted in 2011. A grounded theory approach to data analysis was used. Interview transcripts were coded using in vivo coding techniques. Axial codes were developed based upon these codes and researcher memos. Documents and observation notes were then reviewed and memos were generated. This analysis led to the development of a theory that is grounded in the data. This theory describes the ways in which, within a social, economic, and political environment, IOCs apply resources (members, staff, youth, and financial resources) to conduct policy advocacy activities. These activities facilitate the development of relationships with various entities, including policy makers, media, funders, youth, and the community, to accomplish the intermediate objectives of increasing access to policy makers, resources, awareness of the issue, and the base of support. These intermediate objectives then lead to the IOC goals of a change in policy and social and institutional changes that addresses social determinants, leading to a reduction in health inequities. Implications for public health practitioners and researchers, policy makers, and entities that fund IOCs are discussed.