Bridging governance and practice in cross-sector integrated care: toward a continuum of collaboration

Abstract

Integrated care increasingly relies on cross-sector collaboration to address complex population health needs, yet persistent challenges remain in operationalizing collaboration across health, social care, and community sectors. This mini review synthesizes how collaborative governance frameworks intersect with unified and realist models of integrated care, highlighting a growing shift toward relational and social-process perspectives. While collaborative governance models outline conditions for formal, multi-actor decision making, they offer limited guidance for early, pre-collaborative activities where frontline work predominantly occurs. By examining the overlap between integrated care determinants, cross-sector collaboration constructs, and governance frameworks, this review identifies a critical implementation gap and argues for a continuum-based view of collaboration. It concludes by calling for practice-oriented governance tools to support frontline outreach, relationship initiation, and trust building as foundational processes needed to advance sustainable, community-centered cross-sector integrated care.