Analyzing Network Collaboration Growth Among Community Partners Targeting Service Improvement for Urban Youth Who Are Substance Using, Homeless/Housing Unstable, and May be Pregnant or Parenting

Background: The SAMHSA-funded B’more SUCCEEDS project focuses on Baltimore youth (<25) with a substance use or co-occurring substance use and mental health disorder who are experiencing homelessness / housing instability, with a priority focus on youth who are pregnant and/or parenting. Eight partner agencies provide a range of services including drop-in case management, counseling, substance use prevention, recovery, and treatment, harm reduction, pregnancy and parenting support, and housing and healthcare access. Over 18 months, partners have collaborated to develop a comprehensive, coordinated, and integrated system to meet the complex needs of youth and increase their access to services with measurement of partnership built into the evaluation design. Consistent with the determinants framework of implementation science theory, we hypothesized that intentionally building a comprehensive network where providers meet regularly, learn about programs, and jointly give input on service needs across sectors, would increase collaboration leading to long-term sustainability of a youth-driven, trauma-responsive, and comprehensive service array. This presentation focuses on the use of network analyses to evaluate the growth in systems collaboration over time.

Methods: Ten B’more SUCCEEDS agencies provided data collected bi-annually (Fall 2018, Spring 2019, Fall 2019) using the “Levels of Collaboration Scale” (Frey, et al., 2008), which asks organizations to rate their collaboration with all other organizations (0=no interaction at all, 1=networking, 2=cooperation, 3=coordination, 4=coalition, and 5=collaboration). This was administered via a web-based link. R Studio was used to create network collaboration maps. Tableau was used to create matching heat maps. All agencies receive a rating even if they do not respond.

Results: There was variable response rates: Fall 2018 - 10 participants from 7 agencies; Spring 2019 - 6 from 4 agencies; Fall 2019 - 14 from 9 (often >1 response/agency). The mean level of collaboration increased from T1=1.5 to T3=2. The average number of connections increased from 6.2 to 8.2 and the percentage of relationships rated at levels 4-5 changed from 3.6% to 11.1%. Thus, the network grew in both volume and strength. Although T3 showed more relationships at lower levels, this is expected as new members join the network. Despite these expected fluctuations, the overall level of collaboration is still increasing.

Conclusion: Use of Network Analysis in community work is an effective way to monitor partnership growth. Results demonstrate positive increases in collaborations and an overall strengthened service delivery network across sectors that did not actively collaborate prior to this project. Quantitative data reflect changes in partnerships over time, (e.g. addition and attrition of partners, staff and leadership turnover, communication changes). By bringing partners together routinely they learned about one another. For example, providers have benefitted from hearing from and engaging more intentionally with a youth led organization, increasing understanding the youth perspective and how current services may not fit the homeless youth population. Results are shared bi-annually with partners as part of the ongoing continuous quality improvement efforts and allow partners to see the impact of their efforts. Next steps are to continue network analysis and connect it to referral and engagement data.