Academic-practice partnerships in public health workforce development in China: a comparative analysis of 12 purposively selected cases.

BACKGROUND

Academic-practice partnerships (APPs) are increasingly used in public health workforce development, but evidence on their institutional drivers and varied development pathways in China remains limited. This study examines how institutional pressures, interorganizational resource relationships, and boundary-spanning practices are reflected in the development of APPs in China.

METHODS

An exploratory multiple-case comparative design was adopted. Twelve APP cases were purposively selected across Chinese regions with diverse resource endowments. Drawing on institutional isomorphism, Resource Dependence Theory (RDT), and boundary-spanning theory, framework analysis was used to compare policy documents, authorized internal institutional records, and publicly available materials across documentary sources.

RESULTS

Cross-case analysis identified four forms of integration and boundary-spanning: institutional arrangements, spatial or practice-setting integration, collaborative training mechanisms, and educational-to-professional development pathways. Dual-mentor arrangements were a recurring mechanism in the documentary evidence. Variation among cases was observed in resource strategies, driving forces, and stated training objectives, including technology integration versus contextual resource activation, administratively initiated versus demand-driven development, and research-oriented versus applied workforce preparation.

CONCLUSION

APPs within China's public health workforce development constitute dynamic institutional arrangements shaped by macro-level institutional pressures, meso-level resource interdependence and collaborative governance, and micro-level boundary-spanning practices. Sustaining these partnerships appears to require institutionalized governance structures, competency-oriented training systems, and incentives that move collaboration beyond formal alignment toward substantive integration.