209 - The Role of Organizational Alignment in Improving Service Delivery and Outcomes for Families Impacted by Substance Use

Poster Number: 209
Publication Number: 209.320

Liza M. Creel, University of Louisville School of Public Health and Information Sciences, Louisville, KY, United States; Deborah Winders Davis, University of Louisville School of Medicine, Louisville, KY, United States; Yana Feygin, University of Louisville School of Medicine, Louisville, KY, United States; Madeline Shipley, University of Louisville, Louisville, KY, United States; Tiffany Cole Hall, Volunteers of America Mid-States, Louisville, KY, United States; stephanie hoskins, Volunteers of America Mid-States, Manchester, KY, United States; Chaly Downs, Volunteers of America Mid States, Louisville, KY, United States; Scott D. Duncan, University of Louisville, Louisville, KY, United States

Background: The opioid epidemic highlights the impact of substance use including prenatal exposure on neonatal and child health and development, as well as adverse effects on parenting and the family unit. The SHERO (Strengthening Health Equity in Recovery Outcomes) Study examines systems of care that serve pregnant and parenting women in recovery, assessing cross-sector alignment in rural and urban contexts. The study centers around Freedom House (FH), a model program providing residential substance use treatment and parenting support, focusing on the coordinated efforts with public health, healthcare, and social services organizations in two communities. The study is guided by the Robert Wood Johnson Foundation’s (RWJF) Framework for Cross-Sector Alignment.

Objective: The study uses network analysis to examine alignment between healthcare, public health, and social service organizations in addressing substance use and family well-being in two communities.

Design/Methods: Two networks were explored including current FH partners and other organizations in an urban and rural county in Kentucky (KY). Inter-organizational partnerships demonstrating collaboration, shared mission, data sharing, shared purpose, shared governance, and shared financing were documented. Social network analysis, performed using UCINET 6 and NetDraw, measured key outcomes including network density, which indicates how closely networks are tied together.

Results: Organizations serving FH clients in the urban area tend to have more differentiated missions, possibly due to competition and overlap in service delivery. There were closer ties within public health (density=1.0) and between the public health and social services sectors (density=0.8). A strong alignment exists among relationships requiring technical infrastructure, such as data sharing and shared finance. In the rural setting, organizations had closely tied missions, and network density was highest between the healthcare and public health (density=0.89) as well as within the public health sector (density=0.83). The rural county had stronger relationships around governance and shared purpose.Conclusion(s): The relationships between organizations serving pregnant and parenting women in recovery suggest that these networks may have elements of the RWJF Framework present, but that alignment in rural vs. urban settings differ. Stronger alignment between organizations may facilitate better service delivery across sectors, and ultimately individual, family, and community well-being.