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Table 3 Description of DISC constructs (adapted from Leurs, Mur-Veeman et al. (2008)), reliability, response and linear mixed model regression analysis

From: Effectiveness of a systematic approach to promote intersectoral collaboration in comprehensive school health promotion-a multiple-case study using quantitative and qualitative data

Description of DISC clusters and DISC subclusters

DISC factors

Cronbach’s alpha

Pretest

Posttest

Linear mixed model of regression analysis

Effect size

 

(based on single-item or multi-item scales)

Number of items

Means

Means

     
  

(N)

alpha

N

Mean (SD)

N

Mean (SD)

b

SE (b)

F

corrected p-valuea

Cohen’s d

Collaborative support

            

The collaborative support can be assesed at the levels of perceptions, intentions and actions of the parties involved.

            

-Perceptions

            

Intersectoral collaboration envolves more smoothly when participating organizations share goals and interests, perceive positive outcomes supportive of their own goals, are able to reach consensus on the goal of the collaborative parties are involved in the collaborative process.

Goals

5

.876

90

4.17 (.77)

67

4.22 (.66)

-.021

.091

.051

1,644

0.03

Importance

3

.721

88

3.67 (.62)

65

3.73 (.75)

.023

.106

.046

0,83

0.03

Win-win

1

 

89

3.75 (.84)

66

3.73 (.94)

-.052

.141

.134

2.253

0.06

Ideological consensus

4

.859

90

2.92 (1.23)

67

3.60 (1.06)

.582

.171

11.649

.006**

0.50

Domain consensus

1

 

90

2.44 (1.26)

67

2.96 (1.19)

.482

.191

6.356

.065

0.39

Involvement

2

.662

87

2.25 (1.14)

67

2.64 (1.11)

.389

.180

4.696

.128

0.34

-Intentions

            

Parties involved should start with the intention to trust each other (if not present, this needs to be worked on first), the intention to commit themselves to the collaborative process and its subject and the intention to make changes within their own orgnization, if needed, in favor of the collaborative process.

Willingness to trust

1

 

90

2.74 (1.54)

67

3.03 (1.50)

.199

.224

.795

.0375

0.13

Willingness to commit

1

 

90

2.78 (1.36)

67

3.42 (1.20)

.633

.204

9.677

.008**

0.49

Willingness to change

2

.530

         

-Available room for change

  

90

2.62 (1.40)

67

2.82 (1.28)

.152

.205

.550

0.92

0.11

-Things have to change

  

90

1.94 (1.10)

67

2.27 (1.07)

.324

.175

3.440

.198

0.30

-Actions

            

The collaborative process nay induce a wide variety of actions, ranging from the implementation of major innovations within one’s own organizations to the inclusion of relatively minor adaptations of regular procedures. The actions may involve a reallocation of resources as well. Whatever actions results from a collaborative process, it is important that these are formalized in order to enhance sustainability. The level of formalization needed depends mainly on the type of action itself.

Changes

1

 

90

2.69 (1.55)

67

3.08 (1.33)

.459

.222

4.258

.084

0.31

Resources

2

.660

90

3.41 (1.28)

66

3.68 (1.09)

.289

.193

2.247

.136

0.24

Formalization

1

 

90

2.68 (1.29)

67

3.31 (1.13)

.657

.182

13.074

.003**

0.53

Change management

            

The aspired change requires management by one or a small group of leaders. Establishing a succesful collaboration requires individual and collective leadership skills to guide the developmental process. Change management strategies should fit the chosen innovation perspective, and be supportive of the health promotion subject. The most relevant actors are included and where missing, this is accomplished by extending the network of the leaders of the collaborative process.

Vision

3

.866

89

3.40 (1.15)

67

3.91 (1.02)

.495

.154

10.359

.008**

0.45

Innovation perspective

4

.694

89

2.55 (.97)

67

3.05 (.91)

.430

139

9.534

.009**

0.45

Change strategy

4

.714

89

2.36 (.99)

67

2.84 (.94)

.433

147

8.688

.008**

0.44

Network development

1

 

89

2.43 (1.40)

67

2.39 (1.11)

-.039

208

.035

.852

0.03

Project management

            

During the development and initial implementation phase, the collaborative process is dealt with as a project in a project management structure. This includes deciding who are the actors in the project, what they need to do and how they operate (planing procedures, evaluation, communications, etc.). This project management structure fades out when the subject of the collaborative process is being integrated (or close to being integrated) in regular work and the alliance becomes sel-supportive.

Actors. Task.

3

.860

89

2.44 (1.26)

66

2.97 (1.10)

.507

.180

7.962

.006**

0.44

Communicaton.

           

-Actors

  

89

2.43 (1.41)

67

3.04 (1.38)

.621

.221

7.887

.006**

0.44

-Tasks

  

90

2.44 (1.26)

67

2.96 (1.19)

.482

.191

6.356

.026*

0.39

-Communication

  

90

2.46 (1.33)

67

2.86 (1.36)

.351

.205

2.919

.180

0.26

Context

            

The collaborative process evolves in a context which can be influenced by the partners themselves. When parties have had positive experiences with each other in previous collaborative processes, need less energy for internal changes, have more research power and feel more supported by policies which they can influence as well, they will be more open to sustainable collaborative processes supporting intersectoral health promotion.

Organizational characterisctic

3

.489

         

-Open to innivations

  

89

3.80 (1.04)

67

3.96 (.96)

.160

.158

1.020

.942

0.16

-Organizational problems

  

89

2.78 (1.32)

67

1.94 (1.03)

-.788

.188

17.609

.00**

−0.66

-Positive experience with previous collaborationc

  

89

3.16 (1.45)

67

3.61 (1.35)

.455

.228

3.980

.192

0.32

Research power

1

 

89

3.38 (1.20)

67

3.46 (1.20)

.092

.194

.194

.636

0.32

Relevant policies

1

 

89

3.15 (1.35)

67

3.33 (1.20)

.182

.208

.208

.636

0.14

External factors

            

The collaborative process is influenced by a number of factors that are beyond the control or influence of the alliance itself.

            

Clear, preferably intersectoral policies, laws and regulations providing challenging and sound goals for health promotion, may enhance the collaborative process.

Policy and regulations

2

.600

90

3.29 (1.08)

67

3.83 (.90)

.552

.154

12,922

.000***

0.55

Limiting factors may be poorly defined boundaries between policy domains, contradictory policies of different public sectors and policies focusing on the transformation of public organizations into private.

            

An encouraging and accomodating attitude on the part of financing bodies and commitment to provide the necessary funding over a longer period to prevent brain drain during the initial developmental phase supports the collaborative process.

Attitude of financing organizations

1

 

89

2.64 (1.53)

67

2.73 (1.55)

.091

.250

.133

.716

0.04

Community notion can be regarded as an added value for the individual interests of each party and can additionally stimulate organizations to work together on coordinated school health promotion. Incentives, policies and regulations can increase community notion for coordinated school health promotion, as can parents, school staff and collaborating parties who show social interest in coordinated school health promotion.

Community notion

1

 

90

2.50 (1.38)

67

3.00 (1.37)

.362

.211

2.938

1.80

0.26

Sustainability

            

The colloborative process influences the development of the coordinated (school) health promotion and supports the move towards sustainability (goal): Under the continuous influence of the collaborative process an idea is elaborated and is formalized into regular working routine. During this process the subject of the collaborative process evolves: it ‘changes colour’ under the influence of the collaborative process itself.

Characteristics of HSA

6

.548

         

-Project vs. regular work

  

84

2.14 (1.16)

65

2.55 (1.26)

.429

.183

5.256

.072

.36

-Network support vs. individual actions

  

82

2.91 (1.20)

66

3.20 (.98)

.282

.135

2.380

.125

.26

-Research vs. practical

  

83

3.37 (.95)

64

3.80 (.78)

.522

.161

15.065

.000***

.59

-systematic vs. ad-hoc

  

81

3.38 (1.06)

66

3.74 (.93)

.389

.136

5.816

.010*

.39

-Practical vs.theoretical

  

82

3.20 (.90)

66

3.41 (.80)

.212

.166

2.422

.020*

.25

Single service points vs. fragmentation

  

80

2.85 (1.11)

66

3.29 (.97)

.487

.089

8.525

.030*

.46

  1. ap-values corrected according to Holm procedure: *p ≤.05, **p <.01, ***p <.001