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. 2021 Jun 26;21:602. doi: 10.1186/s12913-021-06630-x

Table 2.

Mechanisms present in prior phase of realist synthesis (left) vs. refined theory (right), an explanation of these mechanisms, and which outcome these mechanisms typically produce

Initial mechanisms Refined mechanisms and their type Explanation Most frequent outcome
Task achievement and performance Effectiveness through collaboration: enabling innovation, reduced duplication of effort, sharing of best practices, increased access to resource, reduced gaps in services, increased influence over others The ‘ultimate outcomes’ that usually underlie actual improvements to key metrics of organisational performance n/a
Synergy and collaborative inertia Changes towards collaborative behaviour from competitive behaviour (behaviour) A move from competitive organisational behaviours to collaborative ones Collaborative effectiveness
n/a Risk threshold (cognitive process) How much risk an organisation is willing to take on with a collaborator Collaborative behaviour
Faith Faith (cognitive process) A belief in the collaborative endeavour as a positive force and therefore a motivation to work on its goals Collaborative behaviour
Perception of progress Perception of progress (mindset) Whether actors perceive advancement towards the goals of the collaboration Faith
Conflict Conflict (mindset) The perception by organisational actors that they are in opposition to collaborators in some way Trust
n/a Approach to conflict resolution and accountability (cognitive processes) Processes and attitudes in place that lessen the severity of conflict Conflict
Trust Trust (cognitive process) “A psychological state comprising the intention to accept vulnerability based upon positive expectations of the intentions or behaviour of another” [83]. Risk threshold
Confidence Confidence (cognitive process) A belief that a collaborator will behave collaboratively due to contractual or other obligation Risk threshold
Initial trust Initial trust (cognitive process) Trust that manifests as a result of pre-existing contextual factors Trust
Power n/a (now a contextual factor) Whether one organisation has more influence on proceedings than another Trust
Leadership n/a (now a contextual factor) The set of behaviours and attitudes that key organisational leaders possess Trust
Cultural integration Cultural assimilation (cognitive process) How well actors between organisations are aligning in terms of attitudes and behaviours Trust
Interpersonal communication/ coordination Interpersonal communication & information sharing (behaviour) The behaviour of communicating and sharing information Trust
Perception of task complexity Perception of task complexity/initial faith (cognitive process) How complex actors perceive the collaborative endeavour to be Faith
n/a Clarity and sharedness of vision (cognitive process) How well-defined and to what extent the vision between partners is agreed-upon Trust
n/a Perceived legitimacy of collaboration (cognitive process) How actors perceive the collaboration in terms of its authenticity Initial faith