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collaborative decision-making, leadership, multisector alliances



  1. D'Aunno, Thomas
  2. Alexander, Jeffrey A.
  3. Jiang, Lan


Background: Multistakeholder alliances that bring together diverse organizations to work on health-related issues are playing an increasingly prominent role in the U.S. health care system. Prior research shows that collaborative decision-making and effective leadership are related to members' perceptions of value for their participation in alliances. Yet, we know little about how collaborative decision-making and leadership might matter over time in multistakeholder alliances.


Purpose: The aim of this study was to advance understanding of the role of collaborative decision-making and leadership in individuals' assessments of the benefits and costs of their participation in multistakeholder alliances over time.


Methods: We draw on data collected from three rounds of surveys of alliance members (2007-2012) who participated in the Robert Wood Johnson Foundation's Aligning Forces for Quality program.


Findings: Results from regression analyses indicate that individuals' perceptions of value for their participation in alliances shift over time: Perceived value is higher with collaborative decision-making when alliances are first formed and higher with more effective leadership as time passes after alliance formation.


Practice Implications: Leaders of multistakeholder alliances may need to vary their behavior over time, shifting their emphasis from inclusive decision-making to task achievement.