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BMC Health Services Research

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Open Access 01-12-2023 | Care | Research

Exploring the organisational structure of networks for exercise oncology provision: a social network analysis of OnkoAktiv

Authors: Annelie Voland, Maximilian Köppel, Stefan Peters, Joachim Wiskemann, Hagen Wäsche

Published in: BMC Health Services Research | Issue 1/2023

Abstract

Background

Structured exercise programs provide considerable health benefits for cancer patients. Therefore, various OnkoAktiv (OA) networks were established in Germany with the aim to connect cancer patients with certified exercise programs. However, knowledge about the integration of exercise networks into cancer care systems and conditions of interorganisational collaboration is lacking. The aim of this work was to analyse the OA networks to guide further network development and implementation work.

Methods

We used methods of social network analysis within a cross-sectional study design. Network characteristics were analysed such as node and tie attributes, cohesion and centrality. We classified all networks into their level of organisational form in integrated care.

Results

We analysed 11 OA networks with 26 actors and 216 ties on average. The smallest network counted 12 actors/56 ties, the largest 52/530. 76% of all actors operated within the medical/exercise sector, serving 19 different medical professions. In smaller “linkage” networks, several individual professionals were linked “from service to service”, whereas the more integrated networks revealed a core-periphery-structure.

Discussion

Collaborative networks enable the involvement of professional actors from different operational fields. This study provides an in-depth understanding of underlying organisational structures that provides information for further development of exercise oncology provision.

Trial registration

Not applicable, as no health care intervention was performed.

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Christensen JF, Simonsen C, Hojman P. Exercise Training in Cancer Control and Treatment. Compr Physiol. 2018;9(1):165–205. https://doi.org/10.1002/cphy.c180016. PMID: 30549018.CrossRefPubMed

Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019;51(11):2375–90. https://doi.org/10.1249/MSS.0000000000002116. PMID: 31626055.CrossRefPubMedPubMedCentral

Friedenreich CM, Wang Q, Neilson HK, Kopciuk KA, McGregor SE, Courneya KS. Physical Activity and Survival After Prostate Cancer. Eur Urol. 2016;70(4):576–85. https://doi.org/10.1016/j.eururo.2015.12.032. PMID: 26774959.CrossRefPubMed

Friedenreich CM, Stone CR, Cheung WY, Hayes SC. Physical Activity and Mortality in Cancer Survivors: A Systematic Review and Meta-Analysis. JNCI Cancer Spectr. 2020;4(1):pkz080. https://doi.org/10.1093/jncics/pkz080. PMID: 32337494.CrossRefPubMed

Ezenwankwo EF, Nnate DA, Usoro GD, Onyeso CP, Anieto IB, Ibeneme SC, Albertus Y, Lambert VE, Ezeukwu AO, Abaraogu UO, Shamley D. A scoping review examining the integration of exercise services in clinical oncology settings. BMC Health Serv Res. 2022;22(1):236. https://doi.org/10.1186/s12913-022-07598-y. PMID: 35189864.CrossRefPubMedPubMedCentral

Schmitz KH, Campbell AM, Stuiver MM, Pinto BM, Schwartz AL, Morris GS, Ligibel JA, Cheville A, Galvão DA, Alfano CM, Patel AV, Hue T, Gerber LH, Sallis R, Gusani NJ, Stout NL, Chan L, Flowers F, Doyle C, Helmrich S, Bain W, Sokolof J, Winters-Stone KM, Campbell KL, Matthews CE. Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer. CA Cancer J Clin. 2019;69(6):468–84. https://doi.org/10.3322/caac.21579. PMID: 31617590.CrossRefPubMedPubMedCentral

Understanding Goodwin N, Care Integrated. Int J Integr Care. 2016;16(4):6. https://doi.org/10.5334/ijic.2530. PMID: 28316546.CrossRef

Rimmer J, Lai B. Framing new pathways in transformative exercise for individuals with existing and newly acquired disability. Disabil Rehabil. 2017;39(2):173–80. https://doi.org/10.3109/09638288.2015.1047967. PMID: 26161458.CrossRefPubMed

Timm I, Rapp S, Jeuter C, Bachert P, Reichert M, Woll A, Wäsche H. Interorganizational Networks in Physical Activity Promotion: A Systematic Review. Int J Environ Res Public Health. 2021;18(14):7306. https://doi.org/10.3390/ijerph18147306. PMID: 34299760.CrossRefPubMedPubMedCentral

10.

World Health Organization. Global Action Plan on Physical Activity 2018–2030: More Active People for a Healthier World. Geneva: World Health Organization; 2019.

11.

Borgatti S. The Network Paradigm in Organizational Research: A Review and Typology. J Manage. 2003;29(6):991–1013. https://doi.org/10.1016/S0149-2063(03)00087-4.CrossRef

12.

Niyirora J, Aragones O. Network analysis of medical care services. Health Informatics J. 2020;26(3):1631–58. https://doi.org/10.1177/1460458219887047.CrossRefPubMed

13.

Wäsche H, Dickson G, Woll A, Brandes U. Social network analysis in sport research: an emerging paradigm. Eur J Sport Soc. 2017;14(2):138–65. https://doi.org/10.1080/16138171.2017.1318198.CrossRef

14.

Borgatti SP, Everett MG, Johnson JC. Analyzing social networks. 2nd ed. Los Angeles, London, New Delhi, Singapore, Washington DC, Melbourne: Sage; 2018.

15.

Pedersen PM, editor. Encyclopedia of sport management. Cheltenham, Northampton: Edward Elgar Publishing; 2021.

16.

Holland PW, Leinhardt S. Transitivity in Structural Models of Small Groups. Comp Group Stud. 1971;2(2):107–24. https://doi.org/10.1177/104649647100200201].CrossRef

17.

Harary F, Kommel HJ. Matrix measures for transitivity and balance*. J Math Socio. 1979;6(2):199–210. https://doi.org/10.1080/0022250X.1979.9989889.CrossRef

18.

Granovetter M. The strength of weak ties. Am J Socio. 1973;78(6):1360–80.CrossRef

19.

Bonacich P. Power and Centrality: A Family of Measures. Am J Sociol. 1987;92(5):1170–82.CrossRef

20.

Freeman LC. Centrality in social networks conceptual clarification. Soc Netw. 1978;1(3):215–39. https://doi.org/10.1016/0378-8733(78)90021-7.CrossRef

21.

Perry BL, Pescosolido BA, Borgatti SP. Egocentric Network Analysis. New York: Cambridge University Press; 2018.

22.

Borgatti SP, Everett MG. Models of core/periphery structures. Social Networks. 1999;21:375–95.CrossRef

23.

Ahgren B, Axelsson R. Evaluating integrated health care: a model for measurement. Int J Integr Care. 2005;5:1–9. https://doi.org/10.5334/ijic.134. PMID: 16773158.CrossRef

24.

Goodwin N. Managing across diverse networks of health care providers: Lessons from other sectors: Report to the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO). 2004.

25.

Leutz WN. Five laws for integrating medical and social services: lessons from the United States and the United Kingdom. Milbank Q. 1999;77(1):77–110, iv−v. https://doi.org/10.1111/1468-0009.00125. PMID: 10197028.CrossRefPubMedPubMedCentral

26.

Simock R. Principles and guidance for prehabilitation within the management and support of people with cancer. 2019.

27.

Harrison DA, Klein KJ. What’s the difference? diversity constructs as separation, variety, or disparity in organizations. AMR. 2007;32(4):1199–228. https://doi.org/10.5465/amr.2007.26586096.CrossRef

28.

Bell ST, Villado AJ, Lukasik MA, Belau L, Briggs AL. Getting Specific about Demographic Diversity Variable and Team Performance Relationships: A Meta-Analysis. J Manage. 2011;37(3):709–43. https://doi.org/10.1177/0149206310365001.CrossRef

29.

Karlsson C. Clusters, Networks and Creativity. In: Andersson D, Andersson Å, Mellander C, editors. Handbook of Creative Cities. Cheltenham: Edward Elgar Publishing; 2011.

30.

Bönisch S. Was bringt Vernetzung im Gesundheitswesen. Wiesbaden: Springer Fachmedien Wiesbaden; 2017.CrossRef

31.

Braithwaite J. Between-group behaviour in health care: gaps, edges, boundaries, disconnections, weak ties, spaces and holes. A systematic review. BMC Health Serv Res. 2010;10:330. https://doi.org/10.1186/1472-6963-10-330. PMID: 21134295.CrossRefPubMedPubMedCentral

32.

Retrum JH, Chapman CL, Varda DM. Implications of network structure on public health collaboratives. Health Educ Behav. 2013;40(1 Suppl):13S-23S. https://doi.org/10.1177/1090198113492759. PMID: 24084396.CrossRefPubMed

33.

Granger L, Connolly B, Denehy L, Hart N, Antippa P, Lin K-Y, Parry M. Understanding factors influencing physical activity and exercise in lung cancer: a systematic review. Support Care Cancer. 2017;25(3):983–99. https://doi.org/10.1007/s00520-016-3484-8.CrossRefPubMed

34.

Santa Mina D, Alibhai SMH, Matthew AG, Guglietti CL, Steele J, Trachtenberg J, Ritvo PG. Exercise in clinical cancer care: a call to action and program development description. Curr Oncol. 2012;19(3):e136–44. https://doi.org/10.3747/co.19.912. PMID: 22670103.CrossRefPubMedPubMedCentral

35.

Kennedy MA, Bayes S, Galvão DA, Singh F, Spry NA, Davis M, Chee R, Zissiadis Y, Hart NH, Taaffe DR, Newton RU. If you build it, will they come? Evaluation of a co-located exercise clinic and cancer treatment centre using the RE-AIM framework. Eur J Cancer Care (Engl). 2020;29(4):e13251. https://doi.org/10.1111/ecc.13251. PMID: 32495410.CrossRefPubMed

36.

Everett MG, Borgatti SP. Networks containing negative ties Soc Netw. 2014;38:111–20. https://doi.org/10.1016/j.socnet.2014.03.005.CrossRef

37.

Everett MG, Valente TW. Bridging, brokerage and betweenness. Soc Netw. 2016;44:202–8. https://doi.org/10.1016/j.socnet.2015.09.001. PMID: 28239229.CrossRef

38.

Valente TW, Fujimoto K. Bridging: Locating Critical Connectors in a Network. Soc Netw. 2010;32(3):212–20. https://doi.org/10.1016/j.socnet.2010.03.003. PMID: 20582157.CrossRef

39.

Long JC, Cunningham FC, Braithwaite J. Bridges, brokers and boundary spanners in collaborative networks: a systematic review. BMC Health Serv Res. 2013;13:158. https://doi.org/10.1186/1472-6963-13-158. PMID: 23631517.CrossRefPubMedPubMedCentral

40.

Borgatti SP, Jones C, Everett MG. Network measures of social capital. Connections. 1998;21(2):27–36.

41.

Schubert H. Netzwerkmanagement in Kommune und Sozialwirtschaft. Wiesbaden: Springer Fachmedien Wiesbaden; 2018.CrossRef

42.

Rogers EM. Diffusion of innovations. 3rd ed. New York, London: Free Press; Collier Macmillan; 1983.

43.

de Brún A, McAuliffe E. Social Network Analysis as a Methodological Approach to Explore Health Systems: A Case Study Exploring Support among Senior Managers/Executives in a Hospital Network. Int J Environ Res Public Health. 2018;15(3):511. https://doi.org/10.3390/ijerph15030511. PMID: 29534038.CrossRefPubMedPubMedCentral

44.

Kawamoto E, Ito-Masui A, Esumi R, Ito M, Mizutani N, Hayashi T, Imai H, Shimaoka M. Social Network Analysis of Intensive Care Unit Health Care Professionals Measured by Wearable Sociometric Badges: Longitudinal Observational Study. J Med Internet Res. 2020;22(12):e23184. https://doi.org/10.2196/23184. PMID: 33258785.CrossRefPubMedPubMedCentral

45.

Haines VA, Godley J, Hawe P. Understanding interdisciplinary collaborations as social networks. Am J Community Psychol. 2011;47(1–2):1–11. https://doi.org/10.1007/s10464-010-9374-1.CrossRefPubMed

46.

Hambrick ME, Svensson PG, Kang S. Using social network analysis to investigate interorganizational relationships and capacity building within a sport for development coalition. Sport Manage Rev. 2019;22(5):708–23. https://doi.org/10.1016/j.smr.2018.12.002.CrossRef

47.

Jansson SM, Benoit C, Casey L, Phillips R, Burns D. In for the long haul: knowledge translation between academic and nonprofit organizations. Qual Health Res. 2010;20(1):131–43. https://doi.org/10.1177/1049732309349808. PMID: 19801416.CrossRefPubMed

48.

Lawrence PR, Lorsch JW. Organization and environment: Managing differentiation and integration. 6. print. Boston: Grad. School of Business Administration Harvard Univ; 1976.

49.

Borgatti SP, Molina JL. Ethical and Strategic Issues in Organizational Social Network Analysis. J Appl Behav Sci. 2003;39(3):337–49. https://doi.org/10.1177/0021886303258111.CrossRef

50.

Henderson M, Johnson NF, Auld G. Silences of ethical practice: dilemmas for researchers using social media. Educ Res Eval. 2013;19(6):546–60. https://doi.org/10.1080/13803611.2013.805656.CrossRef

51.

Howison J, Wiggins A, Crowston K. Validity Issues in the Use of Social Network Analysis with Digital Trace Data. 2011. undefined.CrossRef

52.

Provan KG, Kenis P. Modes of Network Governance: Structure, Management, and Effectiveness. J Public Adm Res Theory. 2007;18(2):229–52. https://doi.org/10.1093/jopart/mum015.CrossRef

Title: Exploring the organisational structure of networks for exercise oncology provision: a social network analysis of OnkoAktiv
Authors: Annelie Voland
Maximilian Köppel
Stefan Peters
Joachim Wiskemann
Hagen Wäsche
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Care
Published in: BMC Health Services Research / Issue 1/2023
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-023-09572-8

2024 ASCO Annual Meeting

Springer Medicine

Exploring the organisational structure of networks for exercise oncology provision: a social network analysis of OnkoAktiv

Abstract

Background

Methods

Results

Discussion

Trial registration

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Discussion

Trial registration

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