The Structure of Policy Networks for Injury and Violence Prevention in 15 US Cities

Abstract

Objectives: Changes in policy can reduce violence and injury; however, little is known about how partnerships among organizations influence policy development, adoption, and implementation. To understand partnerships among organizations working on injury and violence prevention (IVP) policy, we examined IVP policy networks in 15 large US cities.

Methods: In summer 2014, we recruited 15 local health departments (LHDs) to participate in the study. They identified an average of 28.9 local partners (SD = 10.2) working on IVP policy. In late 2014, we sent survey questionnaires to 434 organizations, including the 15 LHDs and their local partners, about their partnerships and the importance of each organization to local IVP policy efforts; 319 participated. We used network methods to examine the composition and structure of the policy networks.

Results: Each IVP policy network included the LHD and an average of 21.3 (SD = 6.9) local partners. On average, nonprofit organizations constituted 50.7% of networks, followed by government agencies (26.3%), schools and universities (11.8%), coalitions (11.2%), voluntary organizations (9.6%), hospitals (8.5%), foundations (2.2%), and for-profit organizations (0.7%). Government agencies were perceived as important by the highest proportion of partners. Perceived importance was significantly associated with forming partnerships in most networks; odds ratios ranged from 1.07 (95% CI, 1.02-1.13) to 2.35 (95% CI, 1.68-3.28). Organization type was significantly associated with partnership formation in most networks after controlling for an organization's importance to the network.

Conclusions: Several strategies could strengthen local IVP policy networks, including (1) developing connections with partners from sectors that are not well integrated into the networks and (2) encouraging indirect or less formal connections with important but missing partners and partner types.

Keywords: injury and violence prevention; organizational network; policy.

Figure 1.

Network composition and perceived importance, by organization type, for members of 15 injury and violence prevention policy networks in 15 large US cities, 2014. a, Mean percentage of each network by organization type. b, Mean percentage of organizations of each type in a network that were rated as important by the other organizations in the network. The 15 injury and violence prevention policy networks comprised local health departments from the Big Cities Health Coalition and its local injury and violence prevention policy partners. Data were collected from network members (n = 319) through an online survey conducted from August to November 2014. Error bars show 95% CIs.

Figure 2.

Example of an injury and violence prevention policy network comprising a local health department (LHD) from the Big Cities Health Coalition and its local injury and violence prevention policy partners, United States, 2014. Each node (circle) represents an organization in the network. Node size indicates the number of working relationships; the larger the node, the greater the number of working relationships. The white circle inside each node indicates the number of times that the organization was rated by others in the network as important or very important; the larger the white circle, the greater the number of importance nominations. Lines indicate a working relationship between 2 organizations. Data collected from network members through an online survey conducted from August to November 2014.

Figure 3.

Odds ratios of tie formation among members of 15 injury and violence prevention policy networks, with each network comprising local health departments from the Big Cities Health Coalition and its local injury and violence prevention policy partners, United States, 2014. Error bars indicate 95% CIs. Data collected from network members through an online survey (n = 319) conducted from August to November 2014. a, Odds of forming a working relationship by importance nomination for each jurisdiction. b, Odds of forming a working relationship with others in the network, by organization type, with government organizations as the reference group.