A realist evaluation of cross-sectoral collaboration in the intervention for expectant and new parents living with Psycho-social vulnerability in Northern Region Denmark

Theme: Management and leadership in maternity care

Sub-theme: Balance between women-centered care and organisation-centered care

Authors: Louise Thomsen*1, Marianne Stistrup Frederiksen1, Charlotte Overgaard1
1Department of Health Science and Technology, Research team for women's, child & family health, Aalborg University, 9220 Aalborg Øst, Denmark
*Presenting author

Key words: Continuity of care, interventions, leadership, parenthood, pregnancy, public health, qualitative

Title: A realist evaluation of cross-sectoral collaboration in the intervention for expecting and new parents living with Psycho-social vulnerability in The North Jutland Region of Denmark
Background: Early interventions may benefit the health and wellbeing of parents living with psychosocial vulnerability and thus birth outcomes and child health and wellbeing. However, knowledge of the workings of existing and new interventions is still sparse. When pregnancy is complicated by physical, social, and mental health risks the complexity of care increase. This complexity requires smooth transitions and continuity of care carried by good interprofessional collaborations. This study aims to contribute to the theory base of an early cross sectoral intervention for expecting and new parents in vulnerable positions, in the Northern Region of Denmark, entailing dialogue-based screening and referral to interdisciplinary parent-professional team-meetings and targeted supportive services.
Methods and Materials: In a realist evaluation approach, analysis of documents, 29 interviews and 9 workshops with stakeholders were conducted to build and refine the intervention theory and describe and explain the workings of the cross sectoral collaboration framing delivery of the intervention.
Findings: Preliminary findings show that dialogue-based screening for psycho-social vulnerability is an important entry to other services. Health visitors were introduced to parents earlier. Detrimental mechanisms of good collaboration to obtain smooth transitions and continuity of care are leadership and connectivity. Midwives and health visitors express the need for strengthened correspondence around cases and a need to familiarize and create shared goals and values, and to adapt the form and content of core collaborative components of the intervention to their local contexts of collaboration.
Conclusion: Management level leadership towards creating opportunities for interprofessional connectivity are essential mechanisms in support of interprofessional familiarity, creating shared goals, adapting collaboration to local contexts, and for common sparring and learning to reach team spirit and good collaboration across sectors.