gms | German Medical Science

Background: More than 700 randomized, controlled trials (RCTs) have shown significant positive effects of exercise interventions for cancer patients and survivors. The provision of oncological exercise programs increased rapidly over the last decade in Germany, but specialized programs are neither connected nor structurally organized. Therefore, OnkoAktiv aims to connect patients/survivors, clinics, cancer care centers and providers of certified community-based exercise programs, structured through regional OnkoAktiv centers. So far, effective coordination in health care systems has been a major challenge due to complex interdisciplinary teams, organizational hierarchies as well as heterogeneous health care organizations. Moreover, inter-organizational collaboration is often fragile and contingent on individual engagement. Current literature underlines the importance of homogeneity of network actor goals and the development of social capital on network level to facilitate organizational performance, coordination, collective action and innovation.

Aim: The aim of this work is to analyze inherent structures and relations between relevant professionals and organizations and the 10 regional OnkoAktiv centers through comparative egocentric network analysis. Further, we will combine all 10 egocentric-networks for a full network analysis. We seek to support further network development based on the theories of social networks and organizational network governance.

Methods: While SNA in health services research has increased, there has been little methodological research on how to use SNA in the field of exercise oncology. We deploy the method of egocentric SNA on each of the regional OnkoAktiv centers (n=10) within a cross-sectional, mixed-methods study design. First, we ask participants to list their most relevant contact persons and organizations in the field of exercise oncology and OnkoAktiv through deductive, pre-defined categories (medicine, science, associations in the fields of physical activity/exercise and oncology, education, finances) via name generators. We then apply name and relations interpreters including information about type (patient-related, influence, financial, public communication) and importance of relations, duration of collaboration and single important positions of individuals. Based on SNA, we execute an analysis of various structural parameters of centrality, cohesion and density, ego-alter/alter-alter similarity, overall homogeneity of attributes, structural holes (constraint, hierarchy) as well as types of brokerage on collected ego-networks. We visualize all ego-networks and the full network via network diagrams and perform analysis in the SNA programs Ucinet and Gephi.

Expectations: We expect detailed information about network structures of the regional OnkoAktiv centers and the full OnkoAktiv network. Structural strengths and weaknesses in different regions of Germany are supposed to be detected.

Practical implications: Our work is the basis for research-based strategies for organizational improvements and further expansion engaging stakeholders from different professional health-related fields.