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Integrated Place-Based Primary Interventions: Levers and Tensions Related to Multilevel Governance for Community

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Collaborative governance enhances Integrated Place-Based Primary Interventions (IPPIs) in disadvantaged areas. This approach supports community-integrated pathways and ensures long-term benefits, overcoming challenges in service delivery.

Keywords:
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Area of Science:

  • Community health
  • Public health policy
  • Social determinants of health

Background:

  • Disadvantaged areas face complex challenges traditional services struggle to address.
  • Integrated Place-Based Primary Interventions (IPPIs) offer innovative, community-based solutions.
  • Effective governance is crucial for the success of these localized care pathways.

Purpose of the Study:

  • To explore the influence of governance modes on the performance of IPPIs.
  • To examine the relationship between governance structures and community-integrated pathways.
  • To identify factors contributing to the longevity and effectiveness of place-based interventions.

Main Methods:

  • Qualitative exploratory multiple-case study design.
  • In-depth examination of 4 IPPIs across 3 Quebec territories.
  • Data collection through observation and semi-structured interviews.

Main Results:

  • Governance modes significantly impact the performance of community-integrated pathways.
  • Collaborative and shared multilevel governance models show promising results.
  • Tensions and levers of action within governance structures were identified.

Conclusions:

  • Adaptive and collaborative governance is essential for the sustained success of IPPIs.
  • Shared multilevel governance, though demanding, fosters longevity and relevance of interventions.
  • Effective governance can prevent the questioning of IPPIs' value in vulnerable communities.