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Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases

机译：跨部门公共卫生相关政策网络的结构整合与表现：跨政策阶段的分析

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Highlights ? To address environmental determinants of health, the policy sub-networks involved in policy development should be inter-sectorally composed. ? To address these determinants, during policy development actors should also be able to interconnect without direction from a central actor. ? Analysing sub-networks over time may shed new light on the relation between structural network characteristics and network performance. ? Analysing sub-networks in different policy phases may additionally contribute to the understanding of this relationship. Abstract Background Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as addressing environmental determinants of health. This study examines these relations in different phases of the policy process. Methods A multiple-case study was performed on four public health-related policy networks. Using a snowball method among network actors, overall and sub-networks per policy phase were identified and the policy sector of each actor was assigned. To operationalise the outcome variable, interventions were classified by the proportion of environmental determinants they addressed. Results In the overall networks, no relation was found between structural network characteristics and network performance. In most effective cases, the policy development sub-networks were characterised by integration with less interrelations between actors (low cohesion), more equally distributed distances between the actors (low closeness centralisation), and horizontal integration in inter-sectoral cliques. The most effective case had non-public health central actors with less connections in all sub-networks. Conclusion The results suggest that, to address environmental determinants of health, sub-networks should be inter-sectorally composed in the policy development rather than in the intervention development and implementation phases, and that policy development actors should have the opportunity to connect with other actors, without strong direction from a central actor.
机译：强调 ？为了解决卫生的环境决定因素，涉及政策制定的政策子网应跨部门组成。还为了解决这些决定因素，在政策开发中，参与者还应能够在没有中央演员的方向的情况下互连。还随着时间的推移分析子网可能揭示了结构网络特性与网络性能之间的关系。还分析不同政策阶段的子网可以另外有助于了解这种关系。摘要背景跨部门政策网络可能有效地解决了干预措施的环境决定因素。然而，关于结构网络特征（即，组成和集成）和网络性能之间的关系报告了矛盾的结果，例如解决健康的环境决定因素。本研究审查了政策过程不同阶段的这些关系。方法对四个公共卫生相关政策网络进行多案例研究。在网络演员中使用雪球方法，确定了每个政策阶段的整体和子网，并分配​​了每个演员的政策部门。要运作结果变量，干预措施按照他们所解决的环境决定因素的比例分类。结果在整体网络中，结构网络特性与网络性能之间没有找到关系。在大多数有效的情况下，策略开发子网的特征在于集成在于演员（低凝聚力）之间的相互关系，参与者（低密度集中）之间的更均匀分布的距离，以及在局部群中的水平集成。最有效的案例具有非公共卫生中央行动者，所有子网中的联系较差。结论结果表明，为了解决卫生的环境决定因素，子网应在政策制定中跨部门组成，而不是在干预开发和实施阶段，而政策制定行动者应该有机会与其他行为者联系，没有来自中央演员的强烈方向。

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