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Abstract：
BACKGROUND: Project ECHO® networks at Children\'s Health Queensland Hospital and Health Service (CHQHHS) are communities of practice designed to mitigate services and systems fragmentation by building collaborative partnerships addressing priority child and youth health needs. Aboriginal and Torres Strait Islander people experience the negative impacts of fragmentation in addition to historical challenges of absent or culturally inappropriate health services. Access to culturally safe and responsive services can be improved by engaging Aboriginal and Torres Strait Islander Health Workers and similar roles in an online community of practice, supporting the integration of cultural and clinical knowledge and self-determination of Aboriginal and Torres Strait Islander consumers in decisions affecting their health. Analysing professional support networks and knowledge sharing patterns helps identify enablers and barriers to partnerships. Using social network research, the multilevel network inclusive of ECHO network members and their colleagues was studied to identify interdisciplinary and cross-sector advice exchange patterns, explore the position of cultural brokers and identify common relational tendencies.
METHODS: Social network theories and methods informed the collection of network data and analysis of advice-seeking relationships among ECHO network members and their nominees. Registered members from two ECHO networks were invited to complete the Qualtrics survey. Networks analysed comprised 398 professionals from mainstream health, Aboriginal and Torres Strait Islander Community Controlled Health Organisation, education, disability and child safety service settings.
RESULTS: Brokers were well represented, both those who hold knowledge brokerage positions as well as cultural brokers who incorporate clinical and cultural knowledge enabling holistic care for Aboriginal and Torres Strait Islander patients (38 individuals, 17% of network). Professionals who occupy brokerage positions outside the ECHO network tend to be more connected with co-members within the network.
CONCLUSIONS: This study is the first application of contemporary social network theories and methods to investigate an ECHO network. The findings highlight the connectivity afforded by brokers, enabling the coordination and collaboration necessary for effective care integration. Inclusion of cultural brokers in an ECHO network provides sustained peer group support while also cultivating relationships that facilitate the integration of cultural and clinical knowledge.
METHODS: Social network theories and methods informed the collection of network data and analysis of advice-seeking relationships among ECHO network members and their nominees. Registered members from two ECHO networks were invited to complete the Qualtrics survey. Networks analysed comprised 398 professionals from mainstream health, Aboriginal and Torres Strait Islander Community Controlled Health Organisation, education, disability and child safety service settings.
RESULTS: Brokers were well represented, both those who hold knowledge brokerage positions as well as cultural brokers who incorporate clinical and cultural knowledge enabling holistic care for Aboriginal and Torres Strait Islander patients (38 individuals, 17% of network). Professionals who occupy brokerage positions outside the ECHO network tend to be more connected with co-members within the network.
CONCLUSIONS: This study is the first application of contemporary social network theories and methods to investigate an ECHO network. The findings highlight the connectivity afforded by brokers, enabling the coordination and collaboration necessary for effective care integration. Inclusion of cultural brokers in an ECHO network provides sustained peer group support while also cultivating relationships that facilitate the integration of cultural and clinical knowledge.
摘要：
背景：昆士兰儿童健康医院和健康服务（CHQHHS）的ECHO®项目网络是旨在通过建立合作伙伴关系来解决优先儿童和青少年健康需求，从而减轻服务和系统碎片化的实践社区。土著和托雷斯海峡岛民除了缺乏或文化上不适当的卫生服务的历史挑战外，还经历了分裂的负面影响。通过让原住民和托雷斯海峡岛民卫生工作者以及在线实践社区中的类似角色，可以改善获得文化安全和响应迅速的服务的机会，支持土著和托雷斯海峡岛民消费者在影响其健康的决策中整合文化和临床知识以及自决。分析专业支持网络和知识共享模式有助于确定伙伴关系的促成因素和障碍。利用社会网络研究，研究了包括ECHO网络成员及其同事在内的多层次网络，以确定跨学科和跨部门的咨询交流模式，探索文化经纪人的地位，找出共同的关系倾向。
方法：社会网络理论和方法为收集网络数据和分析ECHO网络成员及其被提名人之间的咨询关系提供了信息。来自两个ECHO网络的注册成员被邀请完成Qualtrics调查。分析的网络包括来自主流健康的398名专业人员，原住民和托雷斯海峡岛民社区控制的健康组织，教育,残疾和儿童安全服务设置。
结果：经纪人得到了很好的代表，持有知识经纪职位的人以及融入临床和文化知识的文化经纪人，能够为原住民和托雷斯海峡岛民患者提供全面护理(38个人，网络的17%）。在ECHO网络之外占据经纪职位的专业人员往往与网络内的共同成员有更多的联系。
结论：这项研究是当代社会网络理论和方法首次应用于研究ECHO网络。调查结果强调了经纪人提供的连通性，实现有效护理整合所需的协调和协作。将文化经纪人纳入ECHO网络可提供持续的同伴团体支持，同时还培养促进文化和临床知识融合的关系。
方法：社会网络理论和方法为收集网络数据和分析ECHO网络成员及其被提名人之间的咨询关系提供了信息。来自两个ECHO网络的注册成员被邀请完成Qualtrics调查。分析的网络包括来自主流健康的398名专业人员，原住民和托雷斯海峡岛民社区控制的健康组织，教育,残疾和儿童安全服务设置。
结果：经纪人得到了很好的代表，持有知识经纪职位的人以及融入临床和文化知识的文化经纪人，能够为原住民和托雷斯海峡岛民患者提供全面护理(38个人，网络的17%）。在ECHO网络之外占据经纪职位的专业人员往往与网络内的共同成员有更多的联系。
结论：这项研究是当代社会网络理论和方法首次应用于研究ECHO网络。调查结果强调了经纪人提供的连通性，实现有效护理整合所需的协调和协作。将文化经纪人纳入ECHO网络可提供持续的同伴团体支持，同时还培养促进文化和临床知识融合的关系。
