Levering Resources in Cross Sector Collaboration: The Role That Nonprofits Play in Public

Health Systems

Danielle Varda & Carrie ChapmanUniversity of Colorado at Denver,

School of Public Affairs

Disclosures No financial or non-financial relationships to

disclosure

Public Health System Membership An array of diverse partners are collectively and

systematically addressing complex public health problems and population health goals

Goal-directed networks are “intersectoral networks…specific purpose…evolve largely through conscious efforts to build coordination” (Provan & Kenis, 2007, 231). ◦ Public Health Department as convener◦ Membership from a wide range of organizations

Growing diversity = more opportunity for nonprofits

The Role of Nonprofits in Public Health System Networks

As the size and scope of the nonprofit sector grew over the last thirty years, so has the frequency with which nonprofits collaborate with other sectors (Yankey & Willen, 2010).

Increased documentation of the value that nonprofits bring to articulate the unique role, particularly in terms of: mission alignment and resource contributions◦ Mission Alignment: Flexible, mission driven partner◦ Resource Contribution: valuable resources (Provan &

Milward, 1995).

Purpose of this Research: To examine the associations between resource contributions and mission alignment in both nonprofit organizations and in overall network outcomes

Importance: A lack of clarity on these issues, competition, or variation

in value definitions, can result in miscommunication, lack of trust, reduced mission congruence, and confusion of members’ value (Milward & Provan, 2003).

Successful networks = mutual understanding of mission alignment and resource contribution (Milward & Provan, 2003).

Purpose & Importance

Research Questions

Research Questions: RQ1: Do nonprofit organizations contribute different

types of resources than public or private organizations in public health networks?

RQ2: Do nonprofit organizations differ in their perceptions of mission alignment from public and private organizations in public health networks?

RQ3: To what extent does the interaction between resource contributions and mission alignment affect outcome achievement in public health networks?

Theoretical Framework Number of specified variables

linked to outcomes in networks◦ sector-based resource contributions ◦ mission alignment

Hypotheses H1: Nonprofit organizations will have greater mission

alignment relative to public and private sector partners.

H2: Nonprofit organizations will have greater resource contribution relative to public and private sector partners.

H3: As resource contributions and mission alignment increase, greater outcome achievement in networks will also increase.

“Core Dimensions of Connectivity”

Framework (Varda et al. 2008)

Study Design Secondary Data Analysis PARTNER (Program to Analyze, Record, and Track Networks

to Enhance Relationships, www.partnertool.net) dataset◦ PARTNER is a social network analysis tool that is designed

to evaluate structural network variables in interorganizational networks Network “Manager” Administers the Survey Convenience sample

Full dataset includes:◦ ~400 whole networks◦ ~ 10K orgs,◦ ~70K dyads

Sample Population

177 Public Health Collaboratives (Whole Networks)◦ collectively represent 4,213 individual organizations.

Selected based on a set of common criteria: ◦ Goal-directed mission focused on public health, ◦ Organizations as the unit of analysis, and ◦ Use of the same or similar PARTNER survey

questions and response options.

Data Notes:◦ Collected between October 2009 and December 2012◦ No known differences exist across the sample ◦ Do not aim to generalize ◦ There were no noted changes to public health systems policy

Response Rates 4,213 organizations included for analysis 2,094 members responded to the survey

◦ which yields an average response rate of 49.7%

Variables Used Independent Variables:

◦ Hypotheses 1 and 2: Org Level Sector (public, private, nonprofit), Resource

contributions (summed total reported), perceptions of mission alignment

◦ Hypothesis 3: Network Level Resource Contributions, Mission Alignment, and

Organizational Diversity in Networks (Breadth), Density and Centralization

Dependent Variables:◦ Number of Outcomes◦ Agreement on Most Important Outcome

Descriptive Results Collaboratives included in this analysis ranged in size

from a minimum of 9 organizations to a maximum of 279 (mean=21; SD=27.65).

The mean density and centralization scores were 0.59 (SD=0.29) and 0.39 (SD=0.23), respectively, which indicate that, on average, collaboratives were moderately cohesive and loosely centralized.

Hypothesis 1: Difference of Resource Contributions by Sector

IT/Web*

Advocacy

Leadership

Decision Making

Community Connections

Other Expertise***

Health Expertise

Info/Feedback**

Data***

Volunteers*

Paid Staff

In-Kind***

Funding

0% 10% 20% 30% 40% 50% 60% 70%

Resource Contributions by Sector

Nonprofit

Private

Public

Mean Percentage Contributed

Type o

f R

esourc

e

• With the exception of volunteers, where nonprofit organizations contributed significantly more than their public and private partners (36%, p=0.10), differences were attributed to private organizations, which consistently provided fewer resources.

• Patterns: Nonprofit/Public organizations provided 6 types of resources more frequently when compared to other sectors

Hypothesis 2: Difference of Mission Alignment by Sector

Differences across sectors on whether mission alignment was important for collaborative success; No significant differences existed across sectors.◦ Yes: 60% NPOs, 57.4% of public; 54.7% private

However, when ranked by other sectors according to support of the collaborative’s mission, private organizations received significantly lower scores than either nonprofit or public organizations (F=159.29, p<0.0001).

Hypothesis 3:Mission Alignment/Resource Contribution on Outcomes

Size, Density & Centralization not sig in any model

DV: # of Outcome Identified: DV: Outcome Agreement

Discussion Sector Differences:

◦ NPOs bring a greater # and diversity of resources; Perceived as having the strongest mission alignment

◦ Despite being consistent with extant literature, findings are perhaps more subtle than previous research would suggest.

Resource Contribution/Mission Congruence: linked to Outcomes ◦ Greater breadth & Resources:

A wider array of outcomes identified Not entirely surprising, less likely to reach consensus

on the objectives viewed as most essential to the collaborative’s work

Discussion Cross-sector differences are expected More interesting = resource contributions and

mission alignment affect outcomes Substantiates the role of resource contribution

and mission congruence as a vital element of successful outcome attainment

Further, it gives credence to the opportunities for interorganizational goal-directed networks -> only goal-directed networks specifically suggest mission congruence as the motivation for collaboration

Study Limitations Convenience sample used for our analyses Because these data are cross-sectional,

causal arguments are necessarily limited ◦ Ideally, longitudinal data should be used to

improve causal certainty. Dataset does not contain information

pertaining to context

Implications for Theory and Practice Theory: substantiate the Core Dimensions of

Connectivity theory, which hypothesized that both greater resources and higher mission congruence would lead to better network outcomes

Practice: ◦ Nonprofits can provide leadership in mission congruence

and the contribution of more resources (not just support)◦ Validation for nonprofits in terms of their potential value in

interorganizational goal-directed networks◦ Knowledge by which network managers/leaders might

refer to when thinking about how to engage their nonprofit partners

Questions?CONTACTS

Danielle M. Vardadanielle.varda@ucdenver.edu

Carrie ChapmanCarrie.chapman@ucdenver.edu