Table 1 Matrix indicating the actors, targets, planned and realized practical strategies during the collaboration process and their match with theories, May 2006-December 2010

Strategic level

· Commitment

1. Steering committee and daily board, 4/yr, discussing progress and evaluating strategies

Number of meetings of Steering Committee respectively Daily Board of Collaborative:

ANT - creation of a new platform to communicate; stakeholders at strategic level in dialogue at the moment of problematization

· Joint decision making

2006 5 resp. 4 meetings, attendance 100%

Actors from policy: councillors, mayor, aldermen

· Create public attention

2007 2 resp. 7 meetings, attendance 90%

2008 2 resp. 8 meetings, attendance 80%

BB - a negotiated zone or ‘white space’at strategic level, to develop a climate of trust

2009 2 resp. 4 meetings, attendance 90%

2010 1 (1 cancelled due to extreme wheather) resp. 5 meetings, attendance 80%.

Actors from research: university board orprofessor ordirector of research institute

Lobbying efforts in 24 out of 34 min. Decisions were shared among all actors.

2. Contractual agreement

Signed by faculty governors, board of governors of PHS and local governments

IRD - decision on changing the rules of the game in global terms

3. Kick-off meeting, at start

March 21^th, 2007 (n=65 participants from the three domains, mainly from strategic and tactical levels). Spirit of innovation. Aldermen stressed focus on the lot of the downtrodden.

ANT - adding an new communication platform at the moment of problematization

Actors from practice: Public Health Service board and managing director

4. Symposium half way

May 28^th, 2009 (n= 115 participants from the three domains, from all levels). Spirit of active learning. Continuation of investments, promised by the dean of the faculty.

ANT - adding a new communication platform to inspire each other by crossing domain boundaries at the moment of problematization a

5. Ambassadors, 1 per project

In 2007 seven ambassadors. After municipal council elections in 2010 two ambassadors stayed in function.

IRD - giving the alderman a new task within the research domain

6. Content meetings between professors and alderman, 2-3/yr

Totally 10 meetings on topics like alcohol prevention, youth health problems, mental public health, population health forecast, preventive care for elderly, cardiovasculair disease prevention, the future of public health, health statistics, health in all policies, overweight prevention

ANT - creation of a new platform to communicate about complex public health problems

7. Newsletter, 10/yr

Totally 35 newsletters (n=500) members from the three domains, at all levels

ANT - adding a new communication channel to inform each other about activities at the nexus at the moment of problematization

8. Publications in local media and professional media, 2-8/yr

Totally 201 publications about research topics in practice or policy. Plus a book about four years experience within the Limburg collaborative. Local officials felt honored to be presented in the book.

ANT - regularly send out messages to inform partners about working at the nexus, also to maintain commitment at strategic level (PR-instrument)

9. Oral presentations at local and national podia about the collaborative, 2-3/yr

Totally 24 presentations. One presentation as keynote speaker at the national public health congress by the alderman of the city Maastricht.

IRD - new tasks for strategic, tactical and operational actors from policy and practice to present at research conferences, also to maintain commitment at strategic level (PR-instrument)

10. Interface meetings on content, 2-3/yr

Started in 2009, totally 6 (mean n=75 participants from the three domains, from all levels). Joint discussion on research findings related to questions based on real-life situations and local context.

IRD - new tasks for tactical and operational actors from policy, practice and research to present research results at interface meetings and to discuss these results from the perspective of policy, practice and research

11. Website

http://www.academischewerkplaatslimburg.nl

ANT - adding a new communication channel to the collaborative

Tactical level

· Reset culture of policy and practice into lifelong learning culture

12. Annual plans jointly made by 4 thematic groups led by PHS and university managers

Started in 2009, totally 3 annual plans in 2009. Quality: annual plan on Infectious Disease according standard quality, annual plans on Health Promotion/Local Policy respectively Youth Healh Care below standard quality. No annual plan for Preventive Care for the Elderly. No annual plans in 2010.

IRD - a new rule for each organization to make a joint annual plan

Actors from policy: managers of civil service departments

· Organize prerequisites for collaboration, mutual service delivery and (in)formal consultations between municipalities, PHS and university

· Use role models to share values and beliefs

Actors from research: professors as managers of research department

13. Preparation and submission of new practice-based research proposals

Totally 37 proposals submitted of which 29 were granted with a total budget of 8 million Euro (range 25.000 to 2.000.000 Euro).

IRD - a new rule for each organization to prepare and submit research proposals based on local context and policy or practice-based problems in public health

14. Dual-staff appointments for PHS-professionals

Totally 17 PHS-professionals have a dual-staff or honorary appointement at Maastricht University, giving them entrance to university library, research soft ware applications, training modules and expertise of university staff. Academics were given entrance to data.

IRD - a new facility for practitioners and policymakers to get entrance to the research domain

Actors from practice: Public Health Service managers

All masterclass students (n=21) had a dual-staff appointment during the period Jan. 2008 - Jan. 2010

ANT - a new linkage between actors from practice and research

IRD - a new facility for academics to use public health data sources

BB - to facilitate entrance to each others domain

15. Flexible workstations for PHS and university according needs

Totally 8 flexible workstations realized, availability according the needs

IRD - a new facility for practitioners and policymakers to become actively enrolled in the research domain

BB - to facilitate entrance to each others domain and culture

16. Role models

Three professionals from practice were awarded. Candidates for the Spreeuw Award (the best practice-based research), the Crebolder Award (research ranking highest in societal impact) and the Philipsen Award (the best article). Next, 16 masterclass students and 16 PhD-trainees function as a role model in newsletters and website.

ANT - communication about a new culture of lifelong learning and working beyond routine

17. Agendasetting in regular meetings with municipality staff, initiated by PHS staff, 4x/yr

Totally 33 topics in 14 meetings. Mainly informative, without deep discussion. Intensified collaboration between 3 municipalities to work out research proposals. One of the three proposal was accepted.

IRD - introduction of research issues in regular meetings between policy and practice domain

18. Facilitation of participation in masterclasses or PhD-training to upgrade competence of PHS professionals

Totally 16 particpants in practice-based research masterclass of whom 13 were supported by their employer. Totally 16 researchers in PhD training of whom 10 are facilitated by their employer to work in practice and combine regular work with PhD-research with job garantee. Six persons have a timely research position for 4 yrs.

IRD - a new facility to train professionals on the job

Operational level Actors from policy: civil servants

· Active learning and knowledge sharing

19. Participation in masterclasses or PhD training

Totally 16 particpants in practice-based research masterclass. Next, 16 researchers in PhD training of whom 10 spent 50% of time on research and 50% on regular work. Six researchers fully work at the university as PhD candidate, doing research in practice.

ANT - a new linkage between actors from practice and research with resources and cultures from other domains

· Sharing of capabilties/competences

· Broadening personal network

BB - giving access to the internal structure and culture of each other domain, mitigation of inequalities among partners, a negotiated zone to develop a climate of trust, active enrolment in each other domain

Actors from research: researchers

20. Multidisciplinary working groups around each PhD candidate, combining expertise from policy, practice and research

Totally 16 working groups started of which 8 combined professionals from the domains of policy, research and practice; 2 continued as such after 2010. The other 8 combined the domains of research and practice, 4 continued as such after 2010.

BB - giving acces to the internal structure and culture of each other domain, mitigation of inequalities among partners, a negotiated zone at operational and tactical level to develop a climate of trust

Actors from practice: practitioners

21. Oral presentations about research topics at national and international congresses 5/yr

Totally 117 oral presentations with published abstracts of practice-based research (international n=67, national n=50)

IRD - new tasks for practitioners and policymakers to present at research conferences

22. Peer-reviewed publications in (inter) national journals, 5/yr

Totally 73 peer-reviewed publications, majority focused on infectious disease, minority on school and community health promotion: 51 in international and 22 in national journals

IRD - new tasks for practitioners and policymakers to publish in peer-reviewed international journals

Switching between all levels

· Social entrepreneurship

23. Program leader

Appointment of program leader at full time base, paid by municipalities (80%) and university (20%)

BB - a mediator to develop a climate of trust and to support other partners in a process which requires considerable efforts over a rather long period of time