The Ties That Bind: The Relationships Among Members in Nine Ohio HEALing Communities Coalitions

CONTEXT: Community coalitions in 9 Ohio counties implementing the Communities that Heal (CTH) intervention to reduce opioid overdose deaths in the HEALing Communities Study (HCS). OBJECTIVE: To evaluate 9 Ohio HCS coalition network structures using social network analyses to assess organizational positionality (eg, connectedness, centrality, density), perceptions of value and trust, and associations between positionality and trust and value. DESIGN: With Visual Networks Lab (VNL), cross-sectional data were collected during the early intervention from August 31, 2022, to November 8, 2022, using a validated survey tool and Program to Analyze, Record, and Track, Networks to Enhance Relationships (PARTNER) to measure organizational connections and attributes. SETTING: Nine counties located throughout Ohio that were randomized into the second wave of the HCS. PARTICIPANTS: 153 member organizations from across the 9 Ohio coalitions. Coalition size ranged from 16 to 27 member organizations. No organization served on more than one coalition. MAIN OUTCOME MEASURES: Count of organizational partnerships (ties), perceived value, and trust scores. RESULTS: Coalition structure varied across counties, displayed in network maps indicating the number and type of connections by organization. At the coalition level, the mean number of ties ranged from 2.94 to 7.13. Coalition connectedness (density) ranged from low (0.17) to moderate (0.31). Mean trust scores were higher: 3.25 to 3.53 (of 4) while mean value scores ranged from lower to fair: 2.61 to 3.07 (of 4). Degree centrality (most connections) ranged from 0.3 to 0.6; closeness centrality (shorter connections) ranged from 0.2 to 0.5. Trust and value were correlated in 8 coalitions; associations among centrality, trust, and value scores varied considerably. CONCLUSION: Variations in coalition structures likely reflect differences in community context. Understanding coalition structure, including by sector, and perceptions of trust and value, may enhance coalition leadership's ability to improve collaboration and enhance coalition capacity to meet objectives.