A Health in All Policies approach requires creating and sustaining intersectoral partnerships for promoting population health. This scoping review of the international literature on partnership functioning provides a narrative synthesis of findings related to processes that support and inhibit health promotion partnership functioning. Searching a range of databases, the review includes 26 studies employing quantitative (n = 8), qualitative (n = 10) and mixed method (n = 8) designs examining partnership processes published from January 2007 to June 2015. Using the Bergen Model of Collaborative Functioning as a theoretical framework for analyzing the findings, nine core elements were identified that constitute positive partnership processes that can inform best practices: (i) develop a shared mission aligned to the partners’ individual or institutional goals; (ii) include a broad range of participation from diverse partners and a balance of human and financial resources; (iii) incorporate leadership that inspires trust, confidence and inclusiveness; (iv) monitor how communication is perceived by partners and adjust accordingly; (v) balance formal and informal roles/structures depending upon mission; (vi) build trust between partners from the beginning and for the duration of the partnership; (vii) ensure balance between maintenance and production activities; (viii) consider the impact of political, economic, cultural, social and organizational contexts; and (ix) evaluate partnerships for continuous improvement. Future research is needed to examine the relationship between these processes and how they impact the longer-term outcomes of intersectoral partnerships.

Intersectoral partnerships have been identified as a useful mechanism for addressing the health challenges that face society. In theory, partnerships achieve synergistic outcomes that amount to more than can be achieved by individual partners working on their own. This study aimed to identify key factors that influence health promotion partnership synergy. Data were collected from 337 partners in 40 health promotion partnerships using a postal survey. The questionnaire incorporated a number of multidimensional scales designed to assess the contribution of factors that influence partnership synergy. New validated scales were developed for synergy, trust, mistrust and power. Pearson's correlations and multiple regression analysis were used to identify the significance of each factor to partnership synergy. Trust, leadership and efficiency were shown to be the most important predictors of partnership synergy. Synergy is predicated on trust and leadership. Trust-building mechanisms need to be built into the partnership forming stage and this trust needs to be sustained throughout the collaborative process. We need to develop systems where the best leaders are put forward for intersectoral partnerships. This should be consistent across all sectors and organizations.

Synergy is the degree to which a partnership combines the assets of all the partners in the search for better solutions and is generally regarded as the product of a partnership including vertical integration, shared know-how and shared resources. There has been very little research on the determinants and measurement of synergy in health promotion partnerships. This study was designed to describe how synergy is conceptualized in health promotion partnerships and to develop a synergy measurement tool. Five focus groups were organized with 36 health promotion partners in order to explore how synergy is conceptualized in their partnerships. Participants represented health, community, education, arts, sports and youth sectors. Focus groups were recorded and transcribed verbatim. A content analysis was carried out on the transcripts using counting and data reduction techniques. An item pool was generated from these findings and an eight-item five-point scale was developed called the Jones synergy scale. This scale was incorporated into an overall questionnaire on partnership functioning which was posted to 469 partners in 40 health promotion partnerships. A response rate of 72% was achieved for the postal survey (n = 337). The Jones synergy scale was subjected to reliability and validity tests. Cronbach's alpha was 0.91. Corrected item-total correlations ranged from 0.6 to 0.7 with a Cronbach's alpha if item deleted of 0.9 for all items. Principal components analysis (PCA) was the chosen factor analysis method. One component was extracted explaining 62% of the variance. Coefficients ranged from 0.83 to 0.70 with an initial eigenvalue of 4.94. The scale was subjected to item-convergent, item-discriminant and concurrent validity tests. All items correlated more strongly with their own scale than with any other scales used in the questionnaire. The Jones synergy scale was highly correlated (0.73, P < 0.01) with an existing synergy scale.

Developing and sustaining partnerships for promoting health has been identified as an important strategy for addressing the health challenges that face society. Trust is one of the most important factors that help partnerships function effectively. In health promotion partnerships, trust is an under-researched and poorly understood phenomenon. This study was designed to identify how trust is conceptualized in health promotion partnerships and to develop a trust measurement tool. Five focus groups were organized with 36 health promotion partners in order to explore how trust is conceptualized in their partnerships. Participants represented health, community, education, arts, sports and youth sectors. A content analysis was carried out on the transcripts and a 14-item, five-point scale, was developed from the findings. This scale was incorporated into an overall questionnaire on partnership functioning which was posted to 469 partners in 40 health promotion partnerships. A response rate of 72% was achieved (n= 337) for the postal survey. The trust scale was subjected to reliability and validity tests. Principal Component Analysis yielded two components, named positive trust and mistrust, explaining 59% of the variance. Coefficients ranged from 0.845 to 0.511 with eigenvalues before rotation of 6.58 and 1.66. Cronbach's alpha was 0.91. Further research is required to establish whether the scale can be used with other types of partnerships.

Partnerships between sectors can achieve better outcomes than can be achieved by individual partners working alone. Trust is necessary for partnerships to function effectively. Mistrust makes partnership working difficult, if not impossible. There has been little research into partnership functioning factors that influence trust and mistrust. This study aimed to identify these factors in health promotion partnerships. Data were collected from 337 partners in 40 health promotion partnerships using a postal survey. The questionnaire incorporated multi-dimensional scales designed to assess the contribution of factors that influence partnership trust and mistrust. Newly validated scales were developed for trust, mistrust and power. Multiple regression analysis was used to identify the significance of each factor to partnership trust and mistrust. Power was found to be the only predictor of partnership trust. Power, leadership, and efficiency were the most important factors influencing partnership mistrust. Power in partnerships must be shared or partners will not trust each other. Power-sharing and trust-building mechanisms need to be built into partnerships from the beginning and sustained throughout the collaborative process.