摘要：Objectives. We studied 5 members of the National Network Consortium on Tobacco Control in Priority Populations. These networks, which consist of governmental and nongovernmental organizations, targeted lesbian, gay, bisexual, and transgender persons; Asian Americans, Native Hawaiians, and Pacific Islanders; American Indians and Alaska Natives; African Americans; and persons with low socioeconomic status, respectively. Methods. We used statistical network analysis modeling to examine collaboration among these national networks in 2007. Results. Network size and composition varied, but all 5 networks had extensive interorganizational collaboration. Location and work area were significant predictors of collaboration among network members in all 5 networks. Organizations were more likely to collaborate with their network's lead agency; collaborations with other agencies were more likely if they were geographically close. Collaboration was perceived to be important for achieving the goals of the national network. Conclusions. The similarity of collaboration patterns across the 5 networks suggests common underlying partnership formation processes. Statistical network modeling promises to be a useful tool for understanding how public health systems such as networks and coalitions can be used to improve the nation's health. Networks are ubiquitous in public health. People and agencies have long organized into collaborative systems or networks to tackle specific public health challenges. Funding agencies often require collaboration because organizations working together are thought to create systems changes and community capacity to address health issues and population needs more efficiently and responsively than when working independently. 1 , 2 Interorganizational collaboration is a relational system in which 2 or more organizations share information and resources to achieve a common goal. 3 Collaboration is especially valued in tobacco control, where organized networks are common at local, state, national, and international levels. 4 For example, community coalitions address tobacco use through the passage of local smoke-free laws, 5 comprehensive tobacco control programs develop multiple interorganizational strategies across a state, 6 – 8 the National Harm Reduction Network 9 and the Global Tobacco Research Network 10 connect tobacco control researchers nationally and globally, and the World Health Organization's Framework Convention on Tobacco Control coordinates an international response to combating the tobacco epidemic. 11 However, little is known about how these networks work together as collaborative systems, 4 , 12 , 13 although some research has examined specific characteristics (e.g., leadership or organizational climate). 14 This gap has been noted in calls for public health systems research. 4 , 12 , 15 , 16 Network analysis is a useful method for examining relationships among organizations. 4 , 17 This method has been used to describe public health network characteristics, such as level of collaboration among agencies providing chronic disease services, 18 role of peer influence in adolescent smoking behavior, 19 collaboration among tobacco harm reduction researchers, 9 and interorganizational relationships in state tobacco control programs. 20 Studies to date have largely been descriptive. Historically, most tobacco control efforts were organized at the state level. To complement existing state-level mechanisms, better address tobacco use and industry marketing disparities, and meet Healthy People 2010 goals, the Centers for Disease Control and Prevention's Office on Smoking and Health funded 6 priority population networks in the National Network Initiative, aiming to build capacity and infrastructure and provide leadership and expertise in population-specific initiatives and best practices. The population groups were African Americans; Hispanics and Latinos; lesbian, gay, bisexual, and transgendered persons; American Indians and Alaska Natives; Asian Americans, Native Hawaiians, and Pacific Islanders; and persons with low socioeconomic status. These groups and communities face significant tobacco-related disparities. For example, recent Asian immigrants and Native Americans smoke more than do other ethnic groups, but Native American rates vary by tribe. 21 Gays and lesbians have a higher smoking rate than do heterosexuals, 22 perhaps because of targeted advertising 23 and stigma. 24 Network analysis has been used to examine a range of issues across organizations in a network; new network statistical modeling techniques allow examination of predictors of collaboration processes and structures. 25 The Center for Tobacco Policy Research was contracted by the Office on Smoking and Health in 2007 to evaluate the National Network Initiative. The center used a systems approach to examine the structural properties of each national network. A primary goal of the evaluation was to determine how the organizations worked together as collaborative networks. 26 We analyzed data from this evaluation. We sought to (1) describe how common collaborations are among national networks addressing tobacco-related disparities and (2) identify specific organizational and structural predictors of network collaborative relationships. Our study moved beyond description of network characteristics and developed statistical models to examine collaboration processes and network structures. Our results may inform the emerging discipline of public health systems research. 27
