Meeting in the middle: Meso-level organizations working together for macro-level change

Introduction/Background: For Canada to realize the goal of high-quality integrated care, macro-level health system and policy changes are necessary, but these can take time. Researchers can partner with meso-level organizations to take immediate action on meaningful, collaborative and evidence-based change leading the way for larger scale improvements across the system. Approach: Applied health researchers serve as a critical link between meso-level organizations interested in working together to realize more integrated care for Canadians. Guided by the Participatory Research to Action (PR2A) Framework, we have engaged community organizations and provider partners in developing mutually beneficial relationships for innovative and action-oriented research in integrated care.Engaging partners involved establishing early strategic clarity and building new alliances to facilitate meaningful, trusting and authentic engagement to ensure research and innovation activities are reciprocal, with value for everyone involved. Creating strong and meaningful connections between community organizations through the lens of applied research can help to address long-standing integrated care challenges, including people/providers working in silos and the limited bandwidth of organizations to independently consolidate and implement evidence in new ways. Results: We will present two research examples where alliances with meso-level organizations were critical to addressing entrenched system issues and population health needs: a) integrating personal support (PS) providers into team-based home care, and b) promoting evidence-based mental health conversations between older adults, caregivers and providers in home and community care. Partners in these projects include two community-based Learning Health System organizations in Ontario, as well as 5 home and community care organizations operating across three Canadian provinces. These projects provide complementary insights into strategies applied health researchers can use to build authentic and meaningful working relationships with meso-level community health organizations. Implications: The most beneficial applied research leads to implementation, when researchers can work with meso-level organizations to demonstrate change and influences macro-level system progress. This presentation highlights successful meso-level partnerships, bringing together a) competing service provider organizations, as well as professional networks and government agencies to support adoption of a common practice framework for PS providers and b) 5 organizations reaching across sector and jurisdictional boundaries to build community capacity for supporting older adult mental health, demonstrating that market competition and provincial borders are not excuses for limited collaboration in research and innovation.Intentionally designed projects that foster strategic clarity among partner organizations can produce national solutions, which can be customized to unique jurisdictional contexts. Application of analytical and facilitative skillsets of applied health researchers can contribute to understanding which elements of a solution are micro-specific and which are applicable at a macro scale. Researchers leading government funded projects have an obligation to consider provincial and national solutions, rather than siloed approaches, to reduce research waste and produce meaningful, equitable change.