Purpose This paper examines how third-sector organizations and volunteers are integrated into health and social care through the development of Family Centers (FCs) in Brescia, Italy. It investigates the structural, operational, and cultural conditions that shape collaboration between third-sector actors and socio-health professionals, identifying barriers and facilitators that affect service co-delivery. The study also explores the co-delivery strategies used to clarify mandates, strengthen referral and information flows, and sustain multi-actor collaboration within an established service ecosystem. Design/methodology/approach The study used a multi-phase qualitative design combining a targeted literature review with empirical inquiry in the Brescia Family Centers. Data were collected through twelve semi-structured interviews with socio-health professionals and third-sector actors involved in FC planning and delivery (April–July 2024). Interviews were audio-recorded, transcribed verbatim, and coded in NVivo. Findings were developed through abductive analysis and refined by considering negative cases. To validate and deepen interpretation, the interview synthesis informed three participatory workshops that supported collective reflexivity and helped consolidate barriers, facilitators, and co-delivery strategies across the service ecosystem. Findings Findings show that integrating third-sector partners into the FC model depended on resolving structural, operational, and cultural conditions. Key barriers included a weak FC identity due to the lack of a distinct space and dedicated staffing, role overlap with Counseling Centers, and fragmented coordination across actors and case follow-up. Cultural resistance to non-clinical approaches initially limited the uptake of pedagogical and mediation roles. Facilitators included multidisciplinary collaboration, rapid intake and routing through the FC’s orienting functions, calibrated engagement intensity, and culturally responsive practices that broadened support beyond clinical framings. Research limitations/implications This single-case study, focused on early-stage implementation in Brescia, Italy, limits generalizability. Broader, comparative research is needed to assess long-term impacts and applicability in different contexts. Future studies should explore how hybrid governance evolves over time and examine measurable outcomes of third-sector integration in health and social care systems. Practical implications The findings offer actionable insights for managers aiming to improve coordination between public services and third-sector actors. Emphasizing role clarity, structured communication, and flexibility can reduce fragmentation and enhance collaborative service delivery. Social implications Understanding how integrating third-sector organizations supports more inclusive, responsive care. This approach strengthens connections to local communities, facilitates access for vulnerable groups, and promotes shared responsibility in addressing complex social and health needs. Originality/value This study contributes to the growing literature on integrated care by offering empirical insights into the co-production of family-oriented services through third-sector involvement. It proposes actionable strategies to enhance collaboration and sustainability in hybrid governance models, providing guidance for policymakers, practitioners, and researchers engaged in service innovation and community-based care.
Luca et al. (Mon,) studied this question.