From stakeholder mapping to statistical modeling: An illustrative demonstration of end-to-end Net-Map methodology for health governance analysis

Abstract Background Coordinating primary cancer prevention in Europe requires alignment across the EU, national, and local actors. Yet governance relations are challenging to observe. We used a participatory network approach to make relationships visible and test which ties are associated with funding. This study serves as a methodological demonstration to illustrate the complete Net-Map research cycle from data collection to statistical analysis. Methods Three Net-Map sessions (January–February 2024) with a national NGO expert panel elicited stakeholders and ties for authority, influence, and funding, followed by validation. Canvases were used to record the information, and they were digitized afterwards into edge and attribute files. We described network structure and estimated exponential random graph models (ERGMs) for the directed funding network, including overall tie propensity, governance level (EU, national, local), and dyadic influence and authority relations. Results The final network comprises 128 organizations and 836 funding ties (density 5.14%). Funding is predominantly cross-level (71.4%). EU actors show the strongest outward activity (EU-national density 17.8%; EU-local 16.1%), while national-local is lower (6.2%). In ERGMs, influence is the strongest correlate of funding (OR 168.54, p < 0.001), authority is positive but smaller (OR 5.76, p < 0.001), and same-level funding is less likely (OR 0.35, p < 0.001). Model comparisons favored the full specification; structural goodness-of-fit was poor, typical for large, sparse networks, so we interpret effects as dyadic associations. Conclusions This illustrative analysis claims that participatory Net-Map workshops, combined with formal network analysis are helpful in diagnosing coordination patterns in decentralized health systems. The findings draw from a single embedded panel and cross-sectional design that can be extended in future interventions. Still, they are primarily serving as an example of methodological application rather than providing generalizable insights about Romanian cancer prevention governance.