Research article

Diagnosis of sustainable collaboration in health promotion – a case study

Mariken TW Leurs^1,6 , Ingrid M Mur-Veeman² , Rosalie van der Sar^3,6 , Herman P Schaalma⁴ and Nanne K de Vries⁵

¹Youth Department, Netherlands Organization for Health Research and Development, P.O. Box 93245; 2509 AE The Hague, The Netherlands

²Health Policy and Economics Department, University Maastricht, PO Box 616, 6400 MD Maastricht, The Netherlands

³Health Promotion Department, Netherlands Organization for Health Research and Development P.O. Box 93245; 2509 AE The Hague, The Netherlands

⁴Psychology Faculty, University Maastricht, PO Box 616, 6400 MD Maastricht, The Netherlands

⁵Health Promotion Department, University Maastricht, PO Box 616, 6400 MD Maastricht, The Netherlands

⁶Regional Public Health Service Maastricht, The Netherlands

author email corresponding author email

BMC Public Health 2008, 8:382doi:10.1186/1471-2458-8-382

Published:	7 November 2008

Abstract

Background

Collaborations are important to health promotion in addressing multi-party problems. Interest in collaborative processes in health promotion is rising, but still lacks monitoring instruments. The authors developed the DIagnosis of Sustainable Collaboration (DISC) model to enable comprehensive monitoring of public health collaboratives. The model focuses on opportunities and impediments for collaborative change, based on evidence from interorganizational collaboration, organizational behavior and planned organizational change. To illustrate and assess the DISC-model, the 2003/2004 application of the model to the Dutch whole-school health promotion collaboration is described.

Methods

The study combined quantitative research, using a cross-sectional survey, with qualitative research using the personal interview methodology and document analysis. A DISC-based survey was sent to 55 stakeholders in whole-school health promotion in one Dutch region. The survey consisted of 22 scales with 3 to 8 items. Only scales with a reliability score of 0.60 were accepted. The analysis provided for comparisons between stakeholders from education, public service and public health.

The survey was followed by approaching 14 stakeholders for a semi-structured DISC-based interview. As the interviews were timed after the survey, the interviews were used to clarify unexpected and unclear outcomes of the survey as well.

Additionally, a DISC-based document analysis was conducted including minutes of meetings, project descriptions and correspondence with schools and municipalities.

Results

Response of the survey was 77% and of the interviews 86%. Significant differences between respondents of different domains were found for the following scales: organizational characteristics scale, the change strategies, network development, project management, willingness to commit and innovative actions and adaptations. The interviews provided a more specific picture of the state of the art of the studied collaboration regarding the DISC-constructs.

Conclusion

The DISC-model is more than just the sum of the different parameters provided in the literature on interorganizational collaboration, organization change, networking and setting-approaches. Monitoring a collaboration based on the DISC-model yields insight into windows of opportunity and current impediments for collaborative change. DISC-based monitoring is a promising strategy enabling project managers and social entrepreneurs to plan change management strategies systematically.