Framework for Multisector Alignment Research

Context: Public health collaboratives are effective platforms to develop interventions for improving population health. Most collaboratives are limited to the public health and health care delivery sectors; however, multisector collaboratives are becoming more recognized as a strategy for combining efforts from medical, public health, social services, and other sectors. Program: Based on a 4-year multisector collaborative project, we identify concepts for widening the lens to conduct multisector alignment research. The goal of the collaborative was to address the serious care fragmentation and conflicting financing systems for persons with behavioral health disorders. Our work with these 7 sectors provides insight for creating a framework to conduct multisector alignment research for investigating how alignment problems can be identified, investigated, and applied to achieve systems alignment. Implementation: The multisector collaborative was undertaken in Maricopa County, encompassing Phoenix, Arizona, and consisted of more than 50 organizations representing 7 sectors. Evaluation: We develop a framework for systems alignment consisting of 4 dimensions (alignment problems, alignment mechanisms, alignment solutions, and goal attainment) and a vocabulary for implementing multisector alignment research. We then describe the interplay and reciprocity between the 4 dimensions. Discussion: This framework can be used by multisector collaboratives to help identify strategies, implement programs, and develop metrics to assess impact on population health and equity.