title: Creating value for participants in multistakeholder alliances: The shifting importance of leadership and collaborative decision-making over time.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  Leaders of multistakeholder alliances may need to vary their behavior over time, shifting their emphasis from inclusive decision-making to task achievement.
authors.affiliation: Thomas D'Aunno, PhD, is Professor, Management and Public Health, New York University. Jeffrey A. Alexander, PhD, is Emeritus Professor, Health Management and Policy, University of Michigan. Lan Jiang, MS, is Health Services Research Scientist and Statistician, Providence Veterans Affairs Medical Center.
authors.forename: Thomas
authors.initials: T
authors.lastname: D'Aunno
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Alexander
authors.forename: Lan
authors.initials: L
authors.lastname: Jiang
mesh_terms: D003153:Community Health Services; D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D003657:Decision Making; D006265:Health Care Coalitions / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D007857:Leadership; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D014481:United States