Your browser doesn't support javascript.
Cross-sector decision landscape in response to COVID-19: A qualitative network mapping analysis of North Carolina decision-makers.
Biddell, Caitlin B; Johnson, Karl T; Patel, Mehul D; Smith, Raymond L; Hecht, Hillary K; Swann, Julie L; Mayorga, Maria E; Hassmiller Lich, Kristen.
  • Biddell CB; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
  • Johnson KT; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
  • Patel MD; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
  • Smith RL; Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
  • Hecht HK; Department of Engineering, East Carolina University, Greenville, NC, United States.
  • Swann JL; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
  • Mayorga ME; Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, United States.
  • Hassmiller Lich K; Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, United States.
Front Public Health ; 10: 906602, 2022.
Article in English | MEDLINE | ID: covidwho-2022938
ABSTRACT

Introduction:

The COVID-19 pandemic response has demonstrated the interconnectedness of individuals, organizations, and other entities jointly contributing to the production of community health. This response has involved stakeholders from numerous sectors who have been faced with new decisions, objectives, and constraints. We examined the cross-sector organizational decision landscape that formed in response to the COVID-19 pandemic in North Carolina.

Methods:

We conducted virtual semi-structured interviews with 44 organizational decision-makers representing nine sectors in North Carolina between October 2020 and January 2021 to understand the decision-making landscape within the first year of the COVID-19 pandemic. In line with a complexity/systems thinking lens, we defined the decision landscape as including decision-maker roles, key decisions, and interrelationships involved in producing community health. We used network mapping and conventional content analysis to analyze transcribed interviews, identifying relationships between stakeholders and synthesizing key themes.

Results:

Decision-maker roles were characterized by underlying tensions between balancing organizational mission with employee/community health and navigating organizational vs. individual responsibility for reducing transmission. Decision-makers' roles informed their perspectives and goals, which influenced decision outcomes. Key decisions fell into several broad categories, including how to translate public health guidance into practice; when to institute, and subsequently loosen, public health restrictions; and how to address downstream social and economic impacts of public health restrictions. Lastly, given limited and changing information, as well as limited resources and expertise, the COVID-19 response required cross-sector collaboration, which was commonly coordinated by local health departments who had the most connections of all organization types in the resulting network map.

Conclusions:

By documenting the local, cross-sector decision landscape that formed in response to COVID-19, we illuminate the impacts different organizations may have on information/misinformation, prevention behaviors, and, ultimately, health. Public health researchers and practitioners must understand, and work within, this complex decision landscape when responding to COVID-19 and future community health challenges.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Front Public Health Year: 2022 Document Type: Article Affiliation country: Fpubh.2022.906602

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Front Public Health Year: 2022 Document Type: Article Affiliation country: Fpubh.2022.906602