Building intersectoral networks: the role of health brokers in a community health promotion program

Abstract

Abstract Background In community health promotion programs (HPP) aiming to improve health and reduce health inequities, health brokers can have a crucial role in building and sustaining intersectoral networks. These networks are pivotal for developing and implementing the HPP. However, the role of health brokers is new and there is little insight into the changes in the networks' size and composition over time and the processes that facilitate brokers' networks. The aim of this study was to map the brokers' network in detail and unravel the barriers and facilitators in network building. Methods To study the brokers' networks in a HPP in a Dutch socioeconomically deprived city district, in October 2017 and November 2019 the Composed Network Analysis (CNA) and the Coordinated Action Checklist (CAC) were used, as part of the action research accompanying the HPP. The CNA provides insight into the size and composition of the network and the CAC explores facilitators and barriers in network building and sustaining. Focus groups with the core network members (n = 6) were held to discuss and interpret results. Results The health brokers' network had expanded from an average of 100 contacts in 2017 to about 140 contacts in 2019. Existing contacts (e.g. social work, welfare work) had been strengthened and new partners, e.g. general practitioners and volunteers joined the network. This resulted in an increased attention for health on the agenda of these organizations and several joint activities as part of the HPP. Facilitators were working on a small scale, informal and formal, and frequent personal contacts. The most important barrier was change of partners. Conclusions The health brokers have been successful in and expanding their networks, putting health on the agenda of network partners and supporting activities. As such, the broker is essential in connecting a diverse range of partners and organizations in an intersectoral network in the city district. Key messages Working on a small scale, and with frequent personal, formal and informal contacts facilitated the health brokers network building and sustaining. A health brokers’ role, being initiator, facilitator and connector is essential for continuation of the community health promotion approach.