Toolbox for Measuring Cross-Sector Alignment

The Project Background section includes four components: the Aligning Systems for Health with ACHs 2-pager (i.e., ‘main study), the main study project brief, the measurement study project brief, and the Framework for Aligning Sectors glossary. These documents are helpful to gain a general understanding of the study.

• Aligning Systems for Health with ACHs 2-Pager: This document provides an overview of the Population Health Innovation Lab’s (PHIL’s) research project, “Improving Understanding of Alignment of Social Services, Public Health, and Health Care by Exploring Outcomes in Accountable Communities for Health.” This research is a part of an initiative supported by the Robert Wood Johnson Foundation’s national Aligning Systems for Health, which is led by the Georgia Health Policy Center.
• Main Study Press Release: This press release provides a project summary of the research study titled, “Improving understanding of alignment of social services, public health, and health care by exploring outcomes in Accountable Communities of/for Health.”
• Measurement Study Press Release: This press release provides a project summary of the research study titled, “Developing measures for aligning in cross-sector collaboratives,” which builds on the main study.
• Framework for Aligning Sectors Glossary: This two-page document provides a list of terms and definitions for concepts in the Framework for Aligning Sectors. This is a useful reference when crossing unfamiliar concepts in this toolbox.

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The Measurement Overview section includes files that provide context for the measures used in PHIL’s Aligning Systems for Health research studies. This folder includes two documents which will be helpful references when examining the measurement validation component of this toolbox.

• Factor Overview: This document provides an overview of survey measures for aligning in multisector collaboratives including the aligning construct, latent variable, and observed measures that were examined in this study.
• Full Measure and Source Overview: This document provides a comprehensive overview of all measures used in the main study, including survey, interview, focus group, and document measures. 

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The Data Collection Instruments section contains the various data collection instruments used in both the main study and the measurement validation study. These tools will be useful to learn more about the respective studies and to be adapted for future research studies.

Main Study

• Survey Instrument: This survey was used to understand which aligning strategies work for improving health equity, achieving long-term sustainability, and transforming systems. ACH staff and participants were invited to respond to the survey. This may be useful to understand survey structure and questions to ask when tackling these questions and gain more context on the main study.
• Meeting Observation Guide: This is the meeting observation guide used by research team members when observing various ACH meetings. This can be used to learn more about how meeting observation was conducted through this study and how it could be implemented in future studies.
• Preliminary Interview Guide: This preliminary interview guide was used in the main study during the first round of interviews with ACH members and partners. This can be used as a learning and informational guide.
• Key Informant Interview Guide: This document illustrates the structure and questions used in the key informant interviews in the main study. This guide provides insight on guiding questions during the qualitative data collection phase of the study.
• Deep Dive Focus Group Guide: The deep dive focus group guide demonstrates the focus group overview, content, and questions used in the main study. This document is a context-provider and can be used when thinking of ways to do deep dive focus groups in other contexts.
• Document Measures: This document provides context on the AS4H document measure prioritization that was used to finalize document measures used in this research study. This can be used as a reference when solving prioritization challenges in other studies.

Measurement Validation

• Interview Guide 1: Aligning Concepts: This interview guide was used in the first round of interviews in the measurement study. This is a useful reference when conducting other studies about validating concepts.
• Interview Guide 2: Aligning Measures: This interview guide was used in the second round of interviews in the measurement study. This is a useful reference when conducting other studies about validating measures.
• Focus Group Guide 1: Feasibility & Utility: This focus group guide was used to better understand feasibility and utility of measurement approaches. This can be used as a research tool or reference for future measurement studies.
• Focus Group Guide 2: Data-Focused: This focus group guide was used to better understand how MSCs approach measurement. This can be used as a research tool or reference for future measurement studies.
• Measurement Validation Survey: This survey was created in Qualtrics as a validation tool. It can be used as a guide when creating validation surveys in future studies.

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The Data Analysis Code section includes four files that are helpful to understand the quantitative methods, analysis, and findings in these research studies.

• Exploratory Factor Analysis (EFA) R Script: This file contains the exploratory factor analysis R script for the study. This script can be used to reproduce models using your own data.
• Confirmatory Factor Analysis (CFA) R Script: This file contains the confirmatory factor analysis R script for the study. This script can be used to reproduce models using your own data.
• Structural Equation Modeling (SEM) R Script – Equity as Adaptive Factor: This file contains the structure equation modeling R script for the study, with equity included as an adaptive factor. This script can be used to reproduce models using your own data.
• Structural Equation Modeling (SEM) R Script – Equity as Outcome: This file contains the structure equation modeling R script for the study, with equity included as an outcome. This script can be used to reproduce models using your own data.

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The Additional Resources section contains resources that are outside the scope of the main and measurement studies but are useful references for those who wish to learn more about different aspects of multisector collaboratives (MSCs), ACHs, and other important concepts in Aligning Systems for Health.

• Powering Change Curriculum: This file contains the “Powering Change: Building Health, Equitable Communities Together” curriculum, which was designed by PHIL to help multisector collaboratives establish and refine practices for sustainable, successful operations. Whether you are starting out and need to know everything about standing up your collaborative, or have been doing this work for a number of years and need support in a few key areas, Powering Change is for you. Learn more about the Powering Change curriculum here.
• An Integrative Framework for Collaborative Governance: This scientific journal article provides a foundation for how we think about aligning across sectors for the public good. The framework, concepts, and indicators described in this article served as a starting point for our research. This article can be used as a reference to better understand the theoretical foundations behind PHIL’s approach to developing measures of aligning.
• Wilder Collaboration Factors Inventory: The Wilder Collaboration Factors Inventory is used by several ACHs in Washington state. It is a “practical tool for discovering how your collaboration is doing on the twenty factors that research has shown influence success” (Wilder.org). Learn more about the Wilder Collaboration Factors Inventory here.

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