Applying the SFIC synergistic governance model to analyze determinants of multisectoral collaborative chronic disease management in Beijing’s district H

The prevalence of chronic diseases is influenced by multiple factors, making their management a complex social and multi-sectoral issue. China has implemented a multisectoral synergistic model for managing chronic diseases; however, enhancing its synergistic effectiveness remains necessary. This study aims to investigate the factors influencing multi-sectoral synergy in chronic disease management. We employed purposive sampling and multi-stage stratified sampling method to survey 160 personnel involved in chronic disease management across 10 departments of county-township-village three level in H District, Beijing. The SFIC (Starting Conditions, Facilitative Leadership, Institutional Design, and Collaborative Process) model served as the framework for the study, and structural equation modeling was conducted using AMOS 24.0 software to analyze the factors influencing the effectiveness of multisectoral collaboration in chronic disease management. The total effects of starting conditions, facilitative leadership, institutional design, and collaborative processes on the effectiveness of multi-sectoral collaboration in chronic disease management were 0.370, 0.638, 0.657, and 0.380, respectively. Among these factors, institutional design had the greatest impact on synergistic effectiveness (0.657). Additionally, the collaborative processes exhibited a mediating effect, contributing 0.525 to the total mediated effect. Starting conditions, facilitative leadership, institutional design, and collaborative processes all influence the effectiveness of multi-sectoral collaboration in chronic disease management, with the collaborative processes mediating these effects. Further efforts should focus on refining institutional design and facilitative leadership, while also considering the influence of the collaborative processes on synergistic effects.