Retooling the Workforce for Collaboration: Centering Collective Efficacy in Public Health and Primary Care Leadership Development.

Abstract

Enhanced integration of public health and primary care sectors is necessary to advance population health equity. Integration requires engagement from leaders adept at working collaboratively, yet barriers persist. While leadership development has been a promising means to address interpersonal obstacles, traditional approaches typically focus on teaching discipline-based cognitive skills while underplaying communication, relational, and affective skills that leaders need to excel in increasingly networked and collaborative organizations. Building on previous efforts to foster collaborative leadership in public health, we propose a framework to support the intentional development of collective leadership among public health and primary care professionals. The framework emphasizes collaborative leader behaviors, collective efficacy, and collective performance, and it acknowledges the critical interactions among team members with diverse expertise. It also conceptualizes leadership as a dynamic, shared process among members rather than focusing on a defined person. We offer recommendations for incorporating this framework into intersectoral leadership development programs to strengthen the collective abilities of the workforce and accelerate integration across sectors. (Am J Public Health. Published online ahead of print October 3, 2025:e1-e9. https://doi.org/10.2105/AJPH.2025.308216).