Network structure and attitudes toward collaboration in a community partnership for diabetes control on the US-Mexican border

Purpose - This study seeks to provide an examination of a health policy network operating in a single, small community along the US-Mexican border. The purpose of the paper is to discuss why and how this network evolved, and then to present findings on how the network was structured. Analysis will focus especially on agency involvement, or "embeddedness" in the network, and its relationship to attitudes held by network members regarding trust, reputation, and perceived benefit. Design/methodology/approach - Data were collected from 15 public and nonprofit agencies trying to work collaboratively to influence local policy and services regarding the prevention of obesity-related chronic disease, especially diabetes. Embeddedness was measured in three different ways and both confirmed and unconfirmed networks were assessed. Network analysis methods were utilized as well as nonparametric correlation statistics. Findings - The network was found to be densely connected through unconfirmed linkages, but much less so when these links were confirmed. Strongest findings were found for shared information. Measures of agency embeddedness in the network were strong predictors of agency reputation, but findings for trust and perceived benefit were generally weak. Originality/value - From a practice perspective, the study points to the problems in building and sustaining community-based chronic disease health networks, especially in a small community with substantial health needs. The research also contributes to theory on embeddedness and to methodology for collecting and analyzing data on community health networks.