Local Collaboration Research Articles

"One Health" Approach for Health Innovation and Active Aging in Campania (Italy).

This article describes how innovations are exploited in Campania (Italy) to improve health outcomes, quality of life, and sustainability of social and healthcare services. Campania's strategy for digitalization of health and care and for healthy aging is based on a person-centered, life-course, “One Health” approach, where demographic change is considered capable of stimulating a growth dynamic linked to the opportunities of combining the “Silver Economy” with local assets and the specific health needs of the population. The end-users (citizens, patients, and professionals) contribute to the co-creation of products and services, being involved in the identification of unmet needs and test-bed activity. The Campania Reference Site of the European Innovation Partnership on Active and Healthy Aging is a flexible regional ecosystem to address the challenge of an aging population with a life-course approach. The good practices, developed in the context of research and innovation projects and innovative procurements by local stakeholders and collaborations with international networks, have been allowing the transfer of innovative solutions, knowledge, and skills to the stakeholders of such a multi-sectoral ecosystem for health.

Imperatives for Pastoral Livelihood Sustainability in the Mara Ecosystem, Kenya

The seventeen (17) Sustainable Development Goals (SDGs) form a firm foundation for livelihoods and ecologi-cal sustainability in biodiversity conservation. Of the 17 SDGs, five of them focus on promoting sustainable consumption and production patterns (SDG 12), promotion of actions at all levels to deal with climate change (SDG 13), protecting and restoring all terrestrial ecosystems to end biodiversity loss (SDG 15), achieving peaceful and inclusive societies, the rule of law, effective and capable institutions (SDG 16) and strengthening and enhancing the means of implementation and global partnership for sustainable development (SDG 17) form the bond within which other SDGs coalesce with the goal of attaining sustainability of planetary ecosystems. The Kenyan and Tanzanian constitutions also are aligned to the achievement of livelihood sustainability. The fragmentation of the Mau-Mara ecosystem and consequent loss of wildlife habitat, the occurrence of droughts due to fluctuating rainfall patterns, loss of woody vegetation, commercial agricultural land use, population growth, increase in human settlement, and associated poaching are some of the factors responsible for shrinking wildlife resources in the Mara. Climate change poses a serious challenge for the Mara due to its adverse effects on temperature and rainfall patterns. Several recommendations have been suggested in this paper regarding different ways of addressing these human-wildlife conflicts. They include growing wildlife as a cash crop with a bonus to the local community and collaboration with the private sector to enhance the free movement of livestock while also freeing space within wildlife corridors, among others. This paper attempts to examine how the Maasai pastoral livelihoods are changing and the strategies adopted to cope with climate change and competing land uses in the Mara ecosystem. Suggestions are also made on some practical solutions that could contribute to sustainable pastoral livelihood systems in the area if implemented. This paper relies on literature search and review of various research works carried out in the Mara-Serengeti to highlight key issues involving livelihoods’ sustainability in the Mara ecosystem. The research revealed the threat posed by climate change and underlined the need for adaptation ensure livelihood sustainability.

A Literature Review of the Impacts of Heat Stress on Human Health across Africa

Heat stress-related illness attributed to the changing climate, particularly the more frequent extreme high temperatures, is becoming a theme of public concern, especially in the most vulnerable regions, such as the African continent. Knowledge of the existing research directions and gaps on heat stress and human health is vital for informing future strategic research foci capable of influencing policy development, planning, adaptation, and mitigation efforts. In this regard, a bibliometric analysis was conducted, with an emphasis on Africa, to assess regional research contributions to heat stress impacts on human health. The goals of the study were to review publication growth and patterns of the scientific publications and to identify key players (especially collaborating institutions and countries) and the evolution of research themes on the African continent, while paying attention to global trends and emergent hot topics and methodology of heat stress research. Using the Web of Science (WoS) and Scopus core collection databases, a structured keyword search was undertaken, which yielded 463 and 58 research publications from around the world and Africa, respectively. The retrieved scientific documents, published between 1968 and 2020, were analyzed and visualized using a bibliometric analysis technique and the VOSviewer software tool. The results indicate low statistics and slow scientific growth in publication output, with the highest peak having been reached in 2018, resulting in 13 scientific publications. While global research collaborations are successfully reflected in the literature, there is a considerable gap in understanding heat stress and related collaborations between African countries and international institutions. The review study has identified key opportunities that can benefit Africa through the expansion of the scope of heat stress and human health research on the continent. These opportunities can be achieved by closing the following research gaps: (1) vulnerability assessments within demographic classes, such as the elderly, (2) personal exposure and associated risks, (3) Urban Heat Island (UHI) evaluation for urban environments, and (4) heat adaptation research, which will enable informed and targeted preventive actions that will limit future heat health impacts. The authors opine that the pursuit of such studies will be most impactful if the current knowledge gaps are bridged through transdisciplinary research supported by local, regional, and international collaborators.

The Water–Energy–Food Nexus Discovery Map: Linking Geographic Information Systems, Academic Collaboration, and Large-Scale Data Visualization

The Water–Energy–Food (WEF) Nexus framework for holistic sustainable development has spawned independent and academic communities around the globe that utilize the framework in research, implementation, policy development, and technological advancement. These communities, however, are geographically and topically segmented and lack large-scale databasing that clearly catalogs and classifies their work. Recognizing this need, the WEF Nexus Strategic Initiative program at The Pennsylvania State University has developed the WEF Nexus Discovery Map utilizing the Arc Geographic Information Systems’ (GIS) Online Dashboard creation toolkit. In real time, users are able to select from 5040 different combinations of filters with the ease of a few button pushes and see projects pop up or disappear from the map located on the dashboard. Projects can then be clicked on to view their specific information, such as the institution that produced the work, local collaborators, relevant web page, and point of contact. The WEF Nexus Discovery Map demonstrates the early new-age of data resource management with the intersection of visuals, advanced search with built-in filters, and community-driven data collection to provide users with exact needs and connections to better facilitate and deploy the holistic sustainability framework of the WEF Nexus.

Getting a Grip on the Performance of Collaborations: Examining Collaborative Performance Regimes and Collaborative Performance Summits.

Collaborative governance is popular among practitioners and scholars, but getting a grip on the performance of collaborations remains a challenge. Recent research has made progress by identifying appropriate performance measures, yet managing performance also requires appropriate performance routines. This article brings together insights from collaborative governance and performance management to conceptualize collaborative performance regimes; the collection of routines used by actors working together on a societal issue to explicate their goals, exchange performance information, examine progress, and explore performance improvement actions. The concept of regimes is made concrete by focusing on the specific routine of organizing a collaborative performance summit; a periodic gathering where partners review their joint performance. Such summits are both manifestations of the performance regime and potential turning points for regime change. Using three local public health collaborations as illustration, this article offers a framework for understanding collaborative performance regimes, summits, and the dynamics between them.

Reframing Madness with Avant-Garde Film: Lina Mangiacapre’s Feminist Collaboration at the Asylum

ABSTRACT This article addresses Lina Mangiacapre's avant-garde feminist filmography, a body of work that, despite recent growth in Italian feminist film studies, remains a neglected area of study. Specifically, the article investigates Mangiacapre's avant-garde featurette Follia come poesia (1979), the fruit of her two-year occupation of the local Frullone Asylum and artistic collaboration with the institutionalised women there. After situating Mangiacapre within the larger Italian radical psychiatry movement, the article distinguishes her subversive feminist theory and praxis from more mainstream sexual difference theory. Through a critical analysis of Follia come poesia, the article argues that Mangiacapre reframes the concept of madness as more than to-be-cured-ness through cinematography, editing, and sound. It concludes that through cinematic prowess, Mangiacapre provides an audiovisual exhibition of her subversive theory, interrogates conventions surrounding madness, foregrounds the individuality of each incarcerated woman, and constructs a representation of the institutionalised as active, mobile, creative subjects.

Does Experiencing International Research Collaboration Permanently Affect the Impact of Scientific Production? Evidence from Africa

Abstract This paper examines the effect of experiencing a research collaboration between African scientists and their international partners on the African scientists’ research impact, measured by scores based on the number of citations and journal impact factor. Using a difference-in-difference regression analysis on publication data of African scientists, the results show that international research collaboration in a given year has a positive and significant effect on research impact, which lasts in the subsequent years. The presence of such permanent effect suggests a sort of ‘permanent learning by international collaboration’. The positive effect of international collaboration on research impact, however, does not necessarily imply that the scientists with only local research collaboration are lesser scientists.

The Impact on Service Collaboration of Co-location of Early Childhood Services in Tasmanian Child and Family Centres: An Ethnographic Study.

Introduction:There is a global trend towards place-based initiatives (PBIs) to break the cycle of disadvantage and promote positive child development. Co-location is a common element of these initiatives and is intended to deliver more coordinated services for families of young children. This paper examines how co-locating early childhood services (ECS) from health and education in Child and Family Centres (CFCs) has impacted collaboration between services.Methods:This ethnographic study included 130 participant observation sessions in ECS between April 2017 and December 2018 and semi-structured interviews with 45 early childhood service providers and 39 parents/carers with pre-school aged children.Results:Service providers based in CFCs reported that co-location of services was facilitating local cooperation and collaboration between services. However, insufficient information sharing between services, prioritising client contact over collaborative practice and limited shared professional development remained barriers to collaborative practice. For parents, co-location improved access to services, but they experienced services independently of each other.Discussion and Conclusion:Co-location of ECS in CFCs contributed to greater cooperation and collaboration between services. However, for the potential of CFCs to be fully realised there remains a need for governance that better integrates service policies, systems and processes that explicitly support collaborative practice.

Nursing research and responsible partnership in the global setting.

In light of the increased research priorities set forth by both national and global funding sources, the goal of this project is to take a step towards deeper understanding of the responsibility of high-resource nurses conducting research in low-resource environments. A secondary goal is to understand the role of local collaboration partners in the development and implementation of research in their setting. A review of recent nursing research where the primary investigator was from a top-ranking U.S. university and the data collection took place in a low- or middle-income setting. The literature was examined for two areas of interest: 1) the presence of local partners as authors, and 2) the role of local partners in development of the research question and study design. This review is through the lens of a collaborative work between an American nurse who conducted her doctoral research in sub-Saharan Africa and an African nurse who is a faculty member at a U.S. university. Ten nursing schools were reviewed for faculty involved in global health research. Ninety-nine faculty were reviewed for global interests and thirty-two were found to conduct research in low-resource settings. Inclusion criteria for publications: Authorship of nurse researcher; Data collection in an LMIC; Published between 2013 and 2019; Full-text available. Systematic or literature review. Of the abstracts reviewed (N=248), 141 publications were excluded due to duplicates and research design, for a total of 107 articles included in this review. Seventy-nine percent of publications (N=85) included local authors, while 84% (N=90) included local ethical approval. Of publications with local authors, 53% did not state the role played, 27% stated local authors were involved in study conception, 40% stated local authors were involved in data collection/analysis, and 35% stated local authors reviewed/approved the final manuscript. More than half of published studies did not state the role of their local partners. Data collection/analysis are the major roles reported in the literature. To design more effective local studies and promote positive health outcomes, international partners should be involved in all stages of the research process, particularly study conception, and their roles acknowledged in all publications.

O81: MAMMA: MASTITIS AND MAMMARY ABSCESS MANAGEMENT AUDIT

Abstract Presenting Author Email: alona.courtney@imperial.ac.uk Research question Is there significant variation in the management of mastitis and breast abscesses between different hospitals in the UK and Ireland? Background and Aim Lactational mastitis affects a third of breastfeeding women, 11% of whom develop breast abscesses. Non-lactational mastitis affects 5-9% of women. Management of mastitis includes alleviation of milk stasis and antibiotics. Ultrasound-guided needle aspiration is the recommended method of treatment for breast abscesses. Despite guideline recommendations, there is evidence suggesting significant variation in practice, particularly concerning antibiotic prescribing, rates of incision and drainage and length of inpatient treatment. Considering that the majority of breast surgeons are no longer participating in the on-call roster and the acute presentation of primary breast infections, we hypothesise that such variation in practice indeed exists across the UK and Ireland, where patients are treated by non-breast specialist general surgeons. The aim of the MAMMA study is to describe the current practice in the management of mastitis and breast abscesses in the UK and Ireland and to provide recommendations for best practice. Design Patients: Inclusion criteria: all female patients over the age of 16 with symptoms of mastitis or breast abscess. Exclusion criteria: 1) male patients, 2) underlying breast cancer, 3) breast surgery within 90 days of presentation, 4) breast implant in situ on the ipsilateral side. Intervention / Comparator (or main explanatory variable in an observational study): The following guidelines will be used as audit standards: 1) WHO Mastitis Guidelines 2000, 2) GAIN Guidelines on the Treatment, Management & Prevention of Mastitis 2008, 3) ABM Clinical Protocol #4: Mastitis 2014, 4) NICE Clinical Knowledge Summaries: Mastitis and Breast Abscess MAMMA: Mastitis And Mammary abscess Management Audit Outcomes: Phase 1 will increase our understanding of the patient treatment pathways and ease of access to specialist breast services for patients with mastitis and breast abscesses. Phase 2 will collect prospective, real-time data on the management of mastitis and breast abscesses nationwide. Specifically, MAMMA will enable us to gather precise evidence on antibiotic prescribing, rate of operative versus radiological management, waiting time to ultrasound scan, rate of inpatient versus outpatient treatment, length of hospital stay and the rate of follow-up by breast surgeons. This highquality data will be instrumental in updating guidelines and help to standardise the management of mastitis and breast abscess across the UK and Ireland. Study design The study will be carried out in 3 phases with the support of a national trainee collaborative: 1) national practice survey, 2) prospective audit, 3) prospective re-audit. All acute hospitals that manage patients with mastitis and breast abscess will be invited to participate. All participating centres will be required to register this audit as per local protocol. All study data will be collected and managed using REDCap electronic data capture tool. Team and Infrastructure MAMMA National trainee collaborative will be established with the assistance of the Mammary Fold Academic and Research Committee and other regional research collaboratives. It will be the driving force behind this project. The trainee collaborative will be overseen by the MAMMA Steering Committee, convened from key stake-holders from a variety of medical and surgical specialties, allied health care professionals and patient representatives, who are directly involved in the management of patients with breast infections. MAMMA Study Management Group (SMG) will be responsible for audit management, data analysis, dissemination of results and drafting of publication. Regional trainee leads will represent each HEE region in the UK and Ireland and will be responsible for recruitment and coordination of local collaboratives; they will be directly accountable to the SMG. Local trainee collaboratives will consist of a local lead, maximum of two collaborators and one data validator. Further information is available on www.mammastudy.com.

Orbital advancement using the modified buttress technique in sub-Saharan Africa: A demonstrative case report

Surgery for craniosynostosis is not new worldwide. However, sub-Saharan Africa, particularly Nigeria, is yet to catch up with the rest of the world. We hereby present a 1 year 6 month old girl with severe left unilateral coronal craniosynostosis operated successfully. Although there are few previous cases of craniosynostosis operated upon in sub-Saharan Africa, to the best of our knowledge, this is the first documented case of Anterior Cranial Remodeling and Orbital Advancement in Nigeria. This single case report demonstrates the ability to improve surgical care through proper training and local multi-disciplinary collaboration.

The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews

BackgroundPolicymakers in many countries promote collaboration between health care organizations and other sectors as a route to improving population health. Local collaborations have been developed for decades. Yet little is known about the impact of cross-sector collaboration on health and health equity.MethodsWe carried out a systematic review of reviews to synthesize evidence on the health impacts of collaboration between local health care and non-health care organizations, and to understand the factors affecting how these partnerships functioned. We searched four databases and included 36 studies (reviews) in our review. We extracted data from these studies and used Nvivo 12 to help categorize the data. We assessed risk of bias in the studies using standardized tools. We used a narrative approach to synthesizing and reporting the data.ResultsThe 36 studies we reviewed included evidence on varying forms of collaboration in diverse contexts. Some studies included data on collaborations with broad population health goals, such as preventing disease and reducing health inequalities. Others focused on collaborations with a narrower focus, such as better integration between health care and social services. Overall, there is little convincing evidence to suggest that collaboration between local health care and non-health care organizations improves health outcomes. Evidence of impact on health services is mixed. And evidence of impact on resource use and spending are limited and mixed. Despite this, many studies report on factors associated with better or worse collaboration. We grouped these into five domains: motivation and purpose, relationships and cultures, resources and capabilities, governance and leadership, and external factors. But data linking factors in these domains to collaboration outcomes is sparse.ConclusionsIn theory, collaboration between local health care and non-health care organizations might contribute to better population health. But we know little about which kinds of collaborations work, for whom, and in what contexts. The benefits of collaboration may be hard to deliver, hard to measure, and overestimated by policymakers. Ultimately, local collaborations should be understood within their macro-level political and economic context, and as one component within a wider system of factors and interventions interacting to shape population health.

Moderating Uncertainty: The Reception of Refugee Children in the German Early Childhood Education and Care Sector

Abstract Located at the crossroads of integration and early childhood education and care (ECEC) policies, this article draws on empirical research conducted from the perspective of ECEC centres to provide insights into the local reception of refugee children in Germany. In recent years, the ECEC sector in Germany has faced the challenge of organizing access to childcare for many newly arrived children and their families—a process that has been shaped by uncertainty for policymakers and service providers alike. The article analyses data from the first survey among ECEC centres throughout Germany on this topic. It sheds light on enrolment patterns of refugee children, admission procedures, support structures and local collaboration. The results reveal the uncertainties that ECEC centres faced after the 2015 ‘refugee crisis’, and their diverse approaches. To better understand the role of ECEC centres as crucial actors in local integration processes, a conceptualization as ‘street-level’ organizations is suggested.

Whither geographic proximity? Bypassing local R&D units in foreign university collaboration

MNCs often engage in international research collaborations with foreign universities through one of their central R&D laboratories (at headquarters or elsewhere) even though they operate a local R&D unit close to that university, and hence forego the benefits of geographic proximity and local collaboration. Drawing on the knowledge-based theory of the firm, we hypothesize that the choice between distant and local collaboration systematically relates to the knowledge capabilities of the firms’ R&D units, the characteristics of the focal knowledge, and local knowledge leakage risks. Analysis of close to 13,000 research collaborations with foreign universities by the world’s major biopharmaceutical firms (1995–2015) confirms that collaboration at distance occurs if this allows the firm to benefit from scale and knowledge diversity advantages, if the central unit has strong basic research capabilities, and if collaboration is in a core research domain of the MNC while rival firms are locally present. Maturity of the focal research domain is associated with local collaboration. Our findings qualify the common arguments in favor of collaboration in proximity and suggest that (distant) central R&D units are important orchestrators of research collaboration with universities around the globe.

Deep reinforcement learning assisted edge-terminal collaborative offloading algorithm of blockchain computing tasks for energy Internet

In the regional distribution network, microgrid is often used to build local energy system to realize regional autonomy in the process of power generation, transmission, and consumption. Applying blockchain technology in microgrid can meet the needs of security and privacy in energy transactions, and can conduct secure point-to-point transactions between anonymous entities. However, blockchain nodes will generate numerous computing-intensive tasks in the process of mining, and cause high delay in energy transaction. Therefore, we take advantage of mobile edge computing (MEC) technology and propose an edge-terminal collaborative mining task processing framework to increase the computing ability of the blockchain system. This framework includes three working modes: local computing, user collaboration and edge node collaboration. Particularly, the trust value of collaborative user nodes is considered to avoid security threats caused by malicious nodes. Furthermore, we establish a delay-and-throughput-based blockchain computing task offloading model, and use asynchronous advantage actor-critic (A3C) algorithm to jointly optimize offloading decision, transmission power allocation, block interval and size configuration. Simulation results show that, compared with Only-MEC and Fixed-BlockSize algorithms, the proposed algorithm can reduce the average delay by 1.7% and 2.5%, and improve the average transaction throughput by 12.1% and 28.5% respectively.

Participatory simulation modeling to inform colorectal cancer screening in a complex remote northern health system: Canada’s Northwest Territories

Background & aimsColorectal cancer (CRC) mortality in the Northwest Territories (NWT), a northern region of Canada, could be reduced by implementing a CRC screening program. However, this may require additional colonoscopy resources. We used participatory simulation modeling to predict colonoscopy demand and to develop strategies for implementing a feasible and effective CRC screening program in this complex remote northern health system. MethodsUsing a participatory simulation modeling approach, we first developed a conceptual model of CRC screening with local collaborators. This approach informed our parameter adjustments of an existing microsimulation model, OncoSim-CRC, using data from a retrospective cohort review of CRC screening between 2014−2019 and secondary data. Model scenarios reflecting program implementation were run for 500 million cases. Validity was assessed, and outputs analyzed with collaborators. Alternative scenarios were developed to reduce colonoscopy demand and results were presented to end-users. ResultsWe estimated that colonoscopy demand with a CRC screening program phased-in over 5 years would surpass capacity within 2 years. If demand is met, screen-detected cancers would increase by 110 %, and clinically-detected cases would reduce by 26 % over the next 30 years. We also found that prolonging the phase-in period, or revising adenoma follow-up guidelines would reduce colonoscopy demand while still improving cancer detection. Both strategies were considered feasible by collaborators. The adjusted model was valid, and the projections informed local end-users plans for CRC screening delivery. ConclusionsUsing participatory simulation modeling, we projected that a screening program would improve CRC detection but surpass current colonoscopy capacity. Phasing-in the screening program and reducing endoscopic adenoma follow-up would enhance feasibility of a CRC screening program in the NWT and help maintain its effectiveness.

Collaborating in a Pandemic: Adapting Local News Infrastructure to Meet Information Needs

ABSTRACT As media outlets around the globe seek to play a constructive role in responding to the COVID-19 pandemic, this study looks at how local news initiatives in the U.S. city of Philadelphia attempted to respond to the information needs of marginalized communities. Using a communication infrastructure theory framework, it draws from focus groups with residents of two neighborhoods—one majority Black and one majority Latinx—as well as participant observation of and interviews with journalists in a city-wide local journalism collaboration and two community-centered projects. Through this it explores how the crisis affects links between local media and organizations, and how having community-centered projects and infrastructure for collaboration facilitated the circulation of information within and between storytelling networks in the region.

Understanding Local Water Collaboration for the Potential to Enhance Community Source Water Protection at Chippewas of the Thames First Nation

First Nations in Canada are disproportionately affected by chronic drinking water insecurity (Bakker, 2012). Aboriginal Affair and Northern Development Canada conducted an assessment of First Nations water and wastewater systems in 2001 and found significant risk to the quality and safety of drinking water on three- quarters of all systems (Johns and Rasmussen, 2008). Neegan Burnside (2011) classified four differentrisks that affect drinking water systems for First Nations, which include, no source water protection plan,deterioration of water quality over time, risk of contamination, and insufficient capacity to meet futurerequirements. This study found that the two highest risks were risk of source water contamination and thelack of a community source water protection plan (Neegan Burnside, 2011). Water security, sustainableaccess on a watershed basis to adequate quantities of water of acceptable quality to ensure human andecosystem health (Bakker, 2012), therefore requires source water protection and collaboration amongwater actors. Collaboration is defined as the pooling of resources by multiple stakeholders to solveproblems, which includes a balance of power among actors, mutually agreed upon objectives, is perceived as legitimate, and includes a wide variety of stakeholders (Ashlie, 2019; Van Der Porten, 2013; Spencer etal., 2016; Black & McBean, 2017).

Advancing Students’ Global Competency through English Language Learning in Romania: An Exploratory Qualitative Case Study of Four English Language Teachers

ABSTRACT An exploratory case study of four 5th- to 12th-grade English language teachers in a Romanian public, competitive, bilingual high school focused on how these English language teachers taught about American culture to enhance student growth in the areas of global competency. Specifically, the study explored: 1) How are English language teachers advancing and enhancing student growth in the area of global learning with little resources? (2) In what ways are teachers going beyond the usual topics (as required by the curriculum) to more complex conversations to advance their students’ global knowledge and enhance their global competency? The Global Teaching Model (GTM) was used as a conceptual framework. Qualitative data were collected through individual recorded interviews, classroom observations, teacher artifacts, and informal conversations for two weeks. Results showed that teachers attained the language goals for their students but needed further guidance on how to approach global issues at a transformative level. Teachers wanted more resources, sustained local and international partnerships and collaborations, and focused trainings toward a deep critical exploration of global education. Recommendations for future research involve an emphasis on action research-design studies that encourage reflexivity and self-examination toward sociocultural consciousness and global partnerships.

Understanding Local Water Collaboration for the Potential to Enhance Community Source Water Protection at Chippewas of the Thames First Name

First Nations in Canada are disproportionately affected by chronic drinking water insecurity (Bakker, 2012). Aboriginal Affair and Northern Development Canada conducted an assessment of First Nations water and wastewater systems in 2001 and found significant risk to the quality and safety of drinking water on three- quarters of all systems (Johns and Rasmussen, 2008). Neegan Burnside (2011) classified four differentrisks that affect drinking water systems for First Nations, which include, no source water protection plan,deterioration of water quality over time, risk of contamination, and insufficient capacity to meet futurerequirements. This study found that the two highest risks were risk of source water contamination and thelack of a community source water protection plan (Neegan Burnside, 2011). Water security, sustainableaccess on a watershed basis to adequate quantities of water of acceptable quality to ensure human andecosystem health (Bakker, 2012), therefore requires source water protection and collaboration amongwater actors. Collaboration is defined as the pooling of resources by multiple stakeholders to solveproblems, which includes a balance of power among actors, mutually agreed upon objectives, is perceived as legitimate, and includes a wide variety of stakeholders (Ashlie, 2019; Van Der Porten, 2013; Spencer etal., 2016; Black & McBean, 2017).