Research

A scoping literature review of collaboration between primary care and public health

Ruth Martin-Misener^a1 c1, Ruta Valaitis^a2, Sabrina T. Wong^a3, Marjorie MacDonald^a4, Donna Meagher-Stewart^a5, Janusz Kaczorowski^a6, Linda O-Mara^a7, Rachel Savage^a8, Patricia Austin^a9 and the Strengthening Primary Health Care through Public Health and Primary Care Collaborations Team ¹⁰

^a1 Associate Professor, School of Nursing, Dalhousie University, 5869 University Ave., Halifax, Nova Scotia, Canada

^a2 Associate Professor and Dorothy C. Hall Chair in Primary Health Care Nursing, School of Nursing, McMaster University, Hamilton, Ontario, Canada

^a3 Associate Professor, School of Nursing and Centre for Health Services and Policy Research, School of Public and Population Health, University of British Columbia, Vancouver, British Columbia, Canada

^a4 Professor, School of Nursing, Canadian Institutes of Health Research/Public Health Agency of Canada Applied Public Health Chair, University of Victoria, Victoria, British Columbia, Canada

^a5 Associate Professor, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada

^a6 Professor and Research Director, Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada

^a7 Associate Professor, School of Nursing, McMaster University, Hamilton, Ontario, Canada

^a8 Epidemiologist, Public Health Ontario, Toronto, Ontario, Canada

^a9 Research Coordinator, School of Nursing, McMaster University, Hamilton, Ontario, Canada

Abstract

The purpose of this scoping literature review was to determine what is known about: 1) structures and processes required to build successful collaborations between primary care (PC) and public health (PH); 2) outcomes of such collaborations; and 3) markers of their success.

Collaboration between PC and PH is believed to enable more effective individual and population services than what might be achieved by either alone.

The study followed established methods for a scoping literature review and was guided by a framework that identifies systemic, organizational and interactional determinants for collaboration. The review was restricted to articles published between 1988 and 2008. Published quantitative and qualitative primary studies, evaluation research, systematic and other types of reviews, as well as descriptive accounts without an explicit research design, were included if they addressed either the structures or processes to build collaboration or the outcomes or markers of such collaboration, and were published in English.

The combined search strategy yielded 6125 articles of which 114 were included. Systemic-level factors influencing collaboration included: government involvement, policy and fit with local needs; funding and resource factors, power and control issues; and education and training. Lack of a common agenda; knowledge and resource limitations; leadership, management and accountability issues; geographic proximity of partners; and shared protocols, tools and information sharing were influential at the organizational level. Interpersonal factors included having a shared purpose; philosophy and beliefs; clear roles and positive relationships; and effective communication and decision-making strategies. Reported benefits of collaboration included: improved chronic disease management; communicable disease control; and maternal child health. More research is needed to explore the conditions and contexts in which collaboration between PC and PH makes most sense and potential gains outweigh the associated risks and costs.

(Received May 03 2011)

(Accepted September 19 2011)

Keywords

• collaboration;
• interorganization;
• partnership;
• primary care;
• primary health care;
• public health

Correspondence:

^c1 Correspondence to: Dr Ruth Martin-Misener NP, PhD, Associate Professor, School of Nursing, Dalhousie University, 5869 University Ave., Halifax, Nova Scotia, B3H 4R2, Canada. Email: ruth.martin-misener@dal.ca

Footnotes

¹⁰  Names listed at http://strengthenphc.mcmaster.ca