Abstract
Background summary: Various integrated care initiatives exist on a neighborhood level in Western countries, yet many researchers seem to face challenges in continuously evaluating certain multi-stakeholder initiatives in a dynamic and uncertain environment.
Who is it for? Please explain who you would like to engage with: The cross-sectoral integrated community care initiative Plus Communities targets residents and health and social care providers of five neighborhoods in the region of South Limburg, the Netherlands. The aim of Plus Communities is to enhance overall health and well-being in the neighborhood. The approach seeks to create more cohesion between existing and new integrated care initiatives, to collaborate with and empower the role of residents in improving health and well-being, and to promote collaboration between the health and social care domain.
Who are you involving and engaging with? Plus Communities was initiated by a healthcare insurer and a GP care group. In the first year of the initiative development, the stakeholder group expanded and refined the Plus Communities concept through co-creation. An external project team was assembled to support neighborhoods in becoming Plus Communities. First steps are taken to involve a core group of stakeholders per neighborhood, which may include residents, healthcare and social care providers, and municipal authorities. Depending on the neighborhood, this core stakeholder group may vary to match local health and social care demand and supply characteristics. Researchers from Zuyd University of Applied Sciences and Maastricht University are involved in supporting an evidence-based design, implementation, and monitoring of Plus Communities.
What are you doing or propose to do? In each of the proposed research phases, we face challenges with regard to maintaining a flexible approach, preserving our objectivity as researchers, managing expectations, and providing timely feedback. Successfully navigating these challenges is important to ensure that our research is both scientifically robust, relevant, and actionable for stakeholders. To support the evidence-based design of Plus Communities, we are currently conducting a multiple case study on similar integrated community care initiatives. Herewith, we inform Plus Communities and gain insight into effective elements of integrated community care. Additionally, in co-creation with stakeholders of the five neighborhoods, we are developing a method to perform an integral neighborhood scan, incorporating both quantitative and qualitative data about the neighborhood. The quantitative aspect may encompass data such as demographics, health and lifestyle, environment, and available health and social amenities within the neighborhood. To enrich our understanding of the residents health needs and challenges, we will support the selection or development of methods for gathering qualitative data on residents' perceptions through interviews, observations, and other creative methods. Throughout the entire process, our research team will closely, and continuously evaluate the progress of the five neighborhoods as they become Plus Communities, further developing our program theory on what works for whom in what context. Drawing from effective components identified during this process, we will co-create a comprehensive toolkit, which will guide other neighborhoods in the Netherlands in adopting Plus Communities.
What is the question you want to ask international colleagues or the problem you want their help to solve? What are the experiences of other researchers on maintaining flexibility, objectivity, and balancing expectations of stakeholders, when continuously evaluating complex interventions in an uncertain and dynamic environment?