Collaboration between healthcare citizen initiatives and primary healthcare care providers: semi-structured interviews and focus groups with Dutch stakeholders

BACKGROUND: Healthcare and welfare citizen initiatives are citizen-led efforts to improve community well-being. Concerns have, however, been voiced about the effectiveness and inclusivity of these initiatives, suggesting that collaboration with primary healthcare providers could be beneficial to both. Nevertheless, elements that support collaborations between citizen initiatives and primary care providers remain understudied. Our study therefore focuses on delineating elements influencing such collaborations, as perceived by initiative initiators, primary care providers, disadvantaged citizens, and people acting as boundary spanners. Our research question is: What elements influence collaboration between healthcare and welfare citizen initiatives and primary health care providers? METHODS: A combination of semi-structured interviews and focus group discussions with community stakeholders was used. Transcripts were analysed thematically. RESULTS: A total of 35 people participated, of whom five were interviewed individually, four were interviewed in duo-interviews, and 26 participated in focus groups. We found that citizens' motives to establish or partake in citizen initiatives, and primary care providers' motives to collaborate with them, are dependent on the position of these stakeholders in the healthcare and welfare field, the degree of citizen and professional autonomy, and personal convictions. Furthermore, the inclusivity of citizen initiatives is an important element in increasing professionals' motivation to collaborate. Citizen initiators consider primary care providers as potentially valuable partners, but differences in perceived status, funding arrangements, and conceptions of professional distancing hamper collaborations. Moreover, elements that support the connectedness between citizen initiatives and primary care providers, e.g., using understandable language or personnel continuity, are largely comparable to those that support the inclusivity of initiatives. Nevertheless, institutional support is essential to facilitate key requirements for collaboration such as mutual learning opportunities, supportive accountability structures, and capacity to collaborate. CONCLUSION: Collaborations between healthcare and welfare citizen initiatives and primary care providers could be beneficial to both and require mutual change processes. Safely extending professional boundaries, appreciating citizen autonomy, exploring similarities between citizen-professional connectedness and inclusivity, and focusing on learning-by-doing to provide empirical evidence for institutional stakeholders will support these innovative collaborations.