Abstract
IntroductionCross-sector community partnerships are a potentially powerful strategy to address population health problems, including health disparities. US immigrants — commonly employed in low-wage jobs that pose high risks to their health — experience such disparities because of hazardous exposures in the workplace. Hazardous exposures contribute to chronic health problems and complicate disease management. Moreover, prevention strategies such as worksite wellness programs are not effective for low-wage immigrant groups. The purpose of this article was to describe an innovative application of social network analysis to characterize interagency connections and knowledge needed to design and deliver a comprehensive community-based chronic disease prevention program for immigrant workers.MethodsUsing iterative sample expansion, we identified 42 agencies representing diverse community sectors (service agencies, faith-based organizations, unions, nonprofits, government agencies) pertinent to the health of Chinese immigrant workers. To capture data on shared information, resources, and services as well as organizational characteristics, we jointly interviewed 2 representatives from each agency. We used social network analysis to describe interagency network structure and the positions of agencies within the networks.ResultsAgency interconnections were established primarily for information sharing. In the overall interagency network, a few service-oriented agencies held central or gatekeeper positions. Strong interconnectedness occurred predominately across service, public, and nonprofit sectors. The Chinese and Pan-Asian service sectors showed the strongest interconnectedness.ConclusionNetwork analysis yields critical understanding of community structural links and assets needed to inform decisions about actual and potential community collaborations. Alternative intervention strategies may be needed to address health disparities among immigrant workers.
Highlights
Cross-sector community partnerships are a potentially powerful strategy to address population health problems, including health disparities
Agencies corresponded to diverse community sectors: Chinese service agencies, Chinese faith-based organizations (FBOs), Pan-Asian service agencies, labor unions, pan-ethnic nonprofit agencies, and public agencies
The interview was pilot tested with 1 Chinese FBO and 1 communitybased organization (CBO), which were not on the sample roster, and we found that minor wording refinement was needed
Summary
Hazardous exposures contribute to chronic health problems and complicate disease management. Prevention strategies such as worksite wellness programs are not effective for low-wage immigrant groups. Worksite prevention and wellness programs — promoted by the US Affordable Care Act [6] — are not effective for immigrant workers employed in low-wage jobs [7,8]. This deficiency is linked to the lack of effective methods to engage individuals in this vulnerable, hard-to-reach population
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