Connecting Professionals and their Centers: Level of Service Integration at Organizational Level is Associated with Professionals’ Individual Experiences with Interprofessional Collaboration

Connecting Professionals and their Centers: Level of Service Integration at Organizational Level is Associated with Professionals’ Individual Experiences with Interprofessional Collaboration | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Connecting Professionals and their Centers: Level of Service Integration at Organizational Level is Associated with Professionals’ Individual Experiences with Interprofessional Collaboration Marian Ooms, Bonne Zijlstra, Ruben Fukkink This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7969185/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Integrating services within early childhood education and care (ECEC) is recommended to address inequalities and to promote inclusive education. Nevertheless, interprofessional collaboration is challenging, particularly in split systems like the Netherlands with little alignment between childcare, school and care. In this study, we analyzed survey data from a national sample of 626 professionals from 46 Dutch centers to investigate whether the level of service integration at organizational level was related to professionals’ attitudes towards interprofessional collaboration (IPC), self-efficacy and perceived team effectiveness regarding IPC. Results showed that a higher level of service integration at the organizational level was positively associated with professionals’ reflection on process and perceived team effectiveness at the individual level. Our findings support the hypothesis that the organizational context is associated with professionals' interprofessional beliefs. Furthermore, senior professionals had a stronger sense of interdependence and belonging, were more positive about involvement in newly developed activities and experienced a greater sense of self-efficacy, compared to their junior colleagues. Interprofessional collaboration early childhood education and care (ECEC) primary education split system Introduction The development of integrated early childhood education and care (ECEC) services is a topical issue in international policies (Eurydice, 2025 ; Institute of Medicine and National Research Council, 2015; Kaga et al., 2010 ; WHO, 2010) and practice (Curran et al., 2014 ; Nores & Fernandez, 2018 ). In child centers that offer these integrated ECEC services, professionals with different disciplinary backgrounds, including childcare, primary education and family support services, collaborate in interprofessional teams to support families with the aim of reducing inequalities and enhancing children’s development (Barnes et al., 2018; EU Council, 2019; Lazzari et al., 2020 ). However, despite the growing awareness of the potential benefits of the integration of ECEC services for children’s development, little is known about differences in level of service integration across organizational contexts, as well as how these differences are associated with individual differences in professionals’ attitudes and self-efficacy regarding IPC among ECEC professionals. In this study, we investigated these differences at the individual level and examine their association with the level of service integration at the organizational level. Understanding these dynamics is crucial, as organizations rely on the quality of interprofessional collaboration (IPC) between the professionals for the attainment of goals (Schor et al., 2020). Furthermore, it provides valuable insight into how organizational development can foster the growth of individual professionals with regard to IPC. On a contextual level, the rationale for collaboration within ECEC is the growing attention for reducing inequalities and inclusive ECEC for young children (Lazzari et al., 2020 ; Sun et al., 2024). Nevertheless, at the national level, a significant disparity exists among European countries in their adaptation of legal and regulatory frameworks to this development. A growing number of countries are integrating ECEC services at the national level. However, in other countries, such as the Netherlands, a clear distinction persists between the laws and regulations for childcare, primary school and other youth support systems for young children (Eurydice, 2019; Eurydice, 2025 ). Notwithstanding the absence of an integrated system at the national level in the Netherlands, some locations have recently started to offer integrated services in a local, bottom-up movement with increasing collaboration of various youth professionals (van Grinten et al., 2019 ). At the organizational level, organizations within childcare and primary education align their work processes in an attempt to integrate services for children and their families (Ališauskienė et al., 2024). Despite the growing commitment and recent developments, research on this alignment within ECEC is limited and service integration in the context of ECEC predominantly builds on the health literature (Verheijen-Tiemstra et al., 2020 ). Furthermore, in countries with a split system, achieving alignment is challenging due to systemic barriers related to national laws and regulations and traditional vocational training. Consequently, the trend towards service integration and IPC is only adopted in some innovative centers. As a result, Dutch ECEC centers exhibit considerable variation in the level of service integration, ranging from innovative and fully integrated centers to traditional centers with separate childcare and education services (van der Grinten et al., 2019 ). Also in the Dutch innovative centers, the level of integration may vary across different themes and subjects (Verheijen-Tiemstra et al., 2020 ). At the individual level, the existence of IPC between professionals within child centers offering integrated services is not self-evident (Karila & Rantavouri, 2014; Wong & Press, 2017 ). Several review studies have identified unclear professional roles, inadequate communication and feelings of distrust as significant barriers for effective IPC (Authors, 2020 ; Authors , 2025a). Another critical factor at the individual level is the disparity in professional status, with teachers generally enjoying a higher status than childcare professionals (Keuning et al., 2022 ; Rantavouri et al., 2019 ; Verheijen-Tiemstra et al., 2020 ). In line with these findings, Verheijen-Tiemstra et al. ( 2023 ) reported that childcare professionals frequently experienced a sense of exclusion within the child center, often attributed to their perceived lower status. Additionally, teachers demonstrated higher levels of self-perceived ability and motivation for IPC than childcare professionals (Verheijen-Tiemstra et al., 2023 ). While these barriers underscore systemic challenges, some small-scale longitudinal studies have shown that teacher beliefs and self-efficacy toward IPC may develop (Authors, 2020 a; Karilla & Rantavouri, 2014; Malmberg-Heimonen et al., 2025 ; Rantavouri, 2018 ). Before professionals can take the responsibility for collaborative practices, they need the trust that collaboration contributes to their own knowledge and is more valuable than working separately (Rantavouri, 2018 ). In line with this, professionals who engage in IPC can develop a more positive attitude towards IPC, reflected by an increase in their sense of interdependence and reflection on the process , which subsequently predicted their perceived team effectiveness and a positive trend in their attitudes toward newly developed activities in the study of Authors ( 2020 a). In addition, the Norwegian study of Malmberg-Heimonen et al. ( 2025 ) revealed that professionals in the intervention group, who implemented an interprofessional model, were more positive in their reflection on the process and newly developed activities compared to the control group. The findings from these studies suggest that a nurturing environment that stimulates IPC has a positive effect on professionals’ attitudes towards interprofessional collaboration. To summarize, the existing literature on IPC within ECEC remains fragmented, often focusing on individual professionals in isolation while neglecting the broader contextual factors that call for an ecological perspective. Furthermore, many studies rely on small samples drawn from innovative but relatively homogeneous settings, thereby limiting the generalizability of their findings. Consequently, it remains unclear how different settings shape professionals' attitudes, beliefs and self-efficacy toward IPC, collectively known as interprofessional identity. A professional community that actively fosters IPC can support the internalization of this interprofessional identity among its members (Canteart et al., 2019; Oosterbaan-Lodder et al., 2025 ; Price et al., 2025 ). Evidence further suggests that interprofessional identity influences interprofessional behavior (Reinders & Krijnen, 2023 ) and team effectiveness (Canteart et al., 2022), pointing to a bidirectional relationship between organizational service integration and professionals’ attitudes toward IPC. Present Study To gain a better understanding of differences in professionals’ attitudes towards IPC in diverse ECEC contexts, this study investigated professionals’ attitudes towards IPC in a heterogenous sample within a national context that does not foster IPC systematically (e.g., a split system). To do so, this study used a contextualized approach to investigate the association between the level of service integration at the organizational level and professionals’ individual experiences with IPC in a Dutch sample. In line with previous research (Canteart et al., 2019; 2022; Oosterbaan-Lodder et al., 2025 ; Price et al., 2025 ), it is assumed that professionals in child centers with higher levels of service integration have developed a more positive interprofessional identity based on attitudes and self-efficacy towards IPC and, as a result, experience more team effectiveness. This study aims to answer the following research questions: Do professionals working in child centers with a higher degree of integration at the organizational level perceive a more positive attitude towards IPC and a higher level of self-efficacy and team effectiveness compared to professionals working in child centers with a lower degree of integration? Is the assumed relation between centers and individual professionals different for professionals in education versus childcare and care, and is it related to other demographic characteristics (i.e., gender, age, years working on location, or educational level)? Method Sample A total of 46 child centers from 11 (out of 12) provinces in the Netherlands participated in this study. Professionals of these child centers, working with children between two and eight years old, were invited to complete an online questionnaire. Altogether, 1,226 professionals were invited, and 629 respondents participated, which corresponds to a response rate of 51%. The majority of the professionals were female (92%) and held an ISCED (2011) level 6 certificate (51%). Furthermore, 31 percent of the professionals were aged between 31 and 40 years old (see Table 1 ). The majority of the professionals worked in primary education (56%), followed by childcare (34%). Eight percent of the professionals worked in both education and childcare. Finally, a small number of professionals were engaged in care (e.g., family support services, welfare, or youth health care) (2%). On average, the professionals worked 7.6 years at the participating child center (SD = 8.23; range: 0.1 years to 52.8 years). Procedure In the spring of 2023, researchers from four universities of applied sciences ( Authors affiliations ) recruited child centers through their regional networks and social media (e.g., LinkedIn). To create a heterogenous sample, child centers were selected with the intention of representing the complete range of levels of service integration (from traditional centers, non-integrated, to fully integrated child centers), based on an intake during the recruitment phase. At the start of the data collection (spring or fall 2023), we conducted face-to-face interviews with the management team of each location (i.e., school principal and childcare manager) to assess the level of service integration. After the interview, each location provided us with a list of professionals working in their child centers with children aged between two and seven in the disciplines of education, childcare and care. In summer or fall 2023, each professional received a link to an online questionnaire (see Measures). We sent four reminders by email over a period of two months. Prior to data collection, the ethics committee of Authors affiliation approved the research plan (FMG-1422). Each participant gave informed consent at the start of the questionnaire. Also, we preregistered our hypotheses by the open science framework (OSF: https://doi.org/10.17605/OSF.IO/7PQ4V ). Measures Below we describe the outcome measures at the individual level (IIC, IPECC-SET 9, IM-PACT) and covariates at the organizational (ICCI) and individual level (e.g., educational level, working experience). Index for Interdisciplinary Collaboration (IIC , Bronstein, 2002). This index measures the attitude of individual professionals towards IPC in the context of ECEC. For this study we used four categories of the IIC: Interdependence (13 items, e.g., ‘My colleagues from other disciplines often refer to me’; α = .77); Reflection on process (10 items, e.g., ‘I discuss with professionals from other disciplines the degree to which each of us should be involved in a particular case’; α = .83); Newly created professional activities (6 items, e.g., ‘Working with colleagues from other disciplines leads to outcomes that we could not achieve alone’; α = .66); Flexibility (5 items, e.g., ‘The professional colleagues from other disciplines with whom I work stick rigidly to their job descriptions’; α = .49). The participants scored each item on a five-point scale: strongly disagree (1), disagree (2), neutral (3), agree (4), or strongly agree (5). In this study, we applied the Dutch version, as translated by Authors ( 2020 a). Interprofessional Education Collaborative Competency Self-Efficacy Tool (IPECC-SET 9 , Kottorp et al., 2019). This instrument is originally designed to evaluate health professions students’ self-efficacy in interprofessional collaborative competency. For this study we slightly adapted this instrument to measure self-efficacy in interprofessional collaborative competency in the context of ECEC (9 items, e.g., ‘Perform effectively on teams and in different team roles in a variety of settings’, ‘Recognize one’s limitations in skills, knowledge and abilities’; α = .90). Professional translators translated the questions back and forth to Dutch. After translation, the questions were adjusted for the Dutch ECEC context. The participants scored each item on a scale from 0 (not confident at all) to 100 (totally confident). IM-PACT (Authors, 2020 a). This instrument measures the perceived team effectiveness in achieving IPC goals in the context of ECEC. We used both the Positive scale (6 items, e.g., ‘We are more able to handle differences in children’s development’; α = .82) and the Negative scale (6 items, e.g., ‘We do not have a joint vision on working with parents’; α = .80). The participants scored each item on a five-point scale: strongly disagree (1), disagree (2), neutral (3), agree (4), or strongly agree (5). The study by Authors ( 2020 a) found support for the internal consistency and the convergent and predictive validity of the IM-PACT scales. Index for Child Center Integration (ICCI, Authors , 2025). This index measures the level of integration between childcare, primary education, and family support services and consists of two subscales: Universal (14 items, e.g., ‘Vision’, ‘Joint Ambition’; α = .94) and Targeted (8 items, e.g., ‘Collaboration with specialized care’, ‘Collaboration with paramedic professionals’; α = .80). The Pearson’s correlation between the two subscales was 0.44. For this study we used the Total score consisting of 22 items (α = .92). Each item was scored during an extensive interview by participants and a researcher together on a three-point scale: separated (1), coordinated (2), or integrated (3). A validation study provided support for the reliability and factor structure of this newly developed measure ( Authors , 2025). In the survey we assessed the individual characteristics of the professionals — including gender, age, educational level, years working on location and discipline — to examine which level one explanatory variables are related to the outcome variable. First, we created dummy variables for gender (male: 1) and discipline (education: 1). Professionals engaged in both education and childcare were assigned to education since they were involved in education, for instance, as staff members or teaching assistants. Secondly, we assessed age and educational level on an ordinal scale. We measured age with the following six categories: 60. Furthermore, we assessed educational level based on Dutch educational levels, which we then converted to ISCED (2011) levels. Finally, we calculated years working on location based on the question ‘Since when do you work in this child center?’ and the date of completing the questionnaire. Analysis All analyses for this study were performed in R (R Core Team, 2021 ). For the preliminary analyses we calculated Pearson correlations between age, educational level, and all outcome variables. Furthermore, we used a t-test to evaluate differences in age, educational level, and outcome scores between professionals from education versus childcare and care. In our sample, professionals are nested within the child centers. Therefore, a multilevel approach is recommended (Roback & Legler, 2021 ). We evaluated for each outcome variable four related multilevel models using the R package lme4 (Bates et al., 2015 ) with maximum likelihood estimation. Model A, the empty baseline model without covariates, was used to evaluate the between- and within-group variance and intraclass correlation. Next, in Model B (RQ 1), we included the mean ICCI score at level 2 (i.e., organizational level) in the model to determine the association between the outcome scores and the ICCI score. Additionally, in Model C (RQ 2), we included the level 1 covariate (i.e., the individual professional level) discipline (i.e., comparing education to childcare and care) and the interaction effect of ICCI*discipline. The final model was Model D (RQ 2) with the additional level 1 characteristics of gender, age, educational level and number of years working at the center. The incremental fit of the Models A vs. B, Model B vs. C, and finally, Model C vs. D was compared with a deviance test. To facilitate the interpretation of the outcomes, we centered all level one covariates, except for the dummy variables. We centered ordinal covariates around the largest score group and continuous covariates around the grand mean. Additionally, we grand mean centered the level 2 covariate ICCI. After running the models, we checked the assumptions of homogeneity of residual variance, linearity and normality of residuals at both levels, which revealed no major violations. Although we initially planned to use the full IIC measure, as indicated in our preregistration, we ultimately opted to analyze individual IIC subscales. This decision was made because the subscale Shared Responsibility was accidentally omitted from the questionnaire and the reliability of the Flexibility subscale was low (α = .49). Results Table 1 shows an overview of the descriptives of the outcome variables and covariates. At the organizational level, participating centers scored on average a medium level of integration with an ICCI score of 1.97 ( SD = 0.47). Table 1 Descriptive Overview for Outcome Variables and Demographic Characteristics Education Childcare and care Total Mean (SD) Mean (SD) Mean (SD) Min; max IIC Interdependence 3.88 (0.39) 3.69 (0.39) 3.79 (0.41) 3.46; 4.15 IIC Newly developed activities 3.59 (0.49) 3.52 (0.48) 3.56 (0.48) 2.92; 4.13 IIC Reflection on process 3.48 (0.50) 3.41 (0.52) 3.45 (0.50) 2.91; 3.84 Self-Efficacy 73.20 (10.12) 70.21 (12.92) 72.21 (11.74) 59.90; 83.26 IM-PACT positive 3.55 (0.58) 3.49 (0.58) 3.53 (0.58) 1.17; 5.00 IM-PACT negative 2.60 (0.65) 2.73 (0.64) 2.66 (0.65) 2.05; 3.10 Age (categories 1-6) 3.67 3.60 3.64 (1.19) 1.00; 6.00 Educational level (ISCED) 5.99 4.51 5.48 (1.22) 3.00; 7.00 Years working on location 8.80 6.35 7.98 (8.48) 0.17; 52.82 A positive significant correlation was found between age and educational level, r (489) = 0.11, p = .01. Furthermore, there was a positive correlation between educational level and Interdependence, r (489) = 0.30, p < .001, Newly developed activities, r (489) = 0.16, p <.001, and Self efficacy, r (489) = 0.20, p < .001. Also, age was related with Interdependence, r (489) = 0.17, p < .001, and Self efficacy, r (489) = 0.22, p < .001. In addition, school professionals scored higher than their colleagues with a care background on educational level, t (233.72) = 13.57, p < .001, IIC Interdependence, t (335.99) =5.19, p < .001, self efficacy, t (275.93) = 2.61, p < .001, and lower on the negative IM-PACT scale, t (344.87) = -2.14, p = .033. Attitude towards IPC Interdependence The multilevel models B and C revealed that higher ICCI scores at the organizational level were associated with higher scores on interdependence at the individual level. Thus, professionals in child centers with higher levels of service integration reported higher levels of interdependency with their colleagues from different disciplinary backgrounds (see Table 3). Model C showed that professionals from education experienced more interdependence compared to professionals from childcare. However, when adding individual characteristics in model D, the association between the ICCI score and an educational background was no longer apparent; only age and educational level were positively associated with interdependence scores in this model. Thus, older and more highly educated professionals experienced higher levels of interdependence in collaborating with their colleagues from different disciplinary backgrounds. Furthermore, the fit improved with each successive model, from Model A to B, χ 2 (1) = 13.25, p <.001; Model B to C, χ 2 (2) = 25.92, p < .001; and Model C to D, χ 2 (4) = 39.54, p < .001. Consequently, Model D was considered the optimal model. Table 3 Multilevel Model Results for IIC Interdependence Model A B C D Fixed part Coeff. (se.) Coeff. (se.) Coeff. (se.) Coeff. (se.) Intercept 3.81 (0.03) *** 3.80 (0.02) *** 3.68 (0.03) *** 3.76 (0.04) *** ICCI 0.19 (0.05) *** 0.16 (0.07) * 0.13 (0.07) Discipline Education vs. Childcare and care 0.19 (0.04) *** 0.06 (0.04) ICCI*Discipline Education 0.02 (0.08) 0.09 (0.08) Male 0.04 (0.06) Age 0.06 (0.01) *** Years working on location 0.00 (0.00) Educational level 0.08 (0.02) *** Random part Intercept 0.01 0.01 0.01 0.01 Residual 0.15 0.14 0.14 0.13 Deviance 476.0 462.7 436.8 397.3 Incremental Model Fit Model A vs. B χ 2 (1) = 13.25*** Model B vs. C χ 2 (2) = 25.92*** Model C vs. D χ 2 (4) = 39.54*** ICC 0.08 0.05 0.06 0.06 Note. * = p ≤ .05; ** = p ≤ .01; *** = p ≤ .001 Newly Developed Professional Activities Only Model B revealed that higher ICCI scores at the organizational level were positively associated with higher scores on newly created professional activities at the individual level. Thus, professionals in child centers with higher levels of service integration experienced more newly created activities with their colleagues from different disciplinary backgrounds (see Table 4). Although the level of service integration was positively associated with newly created professional activities, this association was no longer significant when covariates were added to the models (see Model C and D). Model D with an association between educational level was the optimal model. Thus, more highly educated professionals experienced higher levels of involvement in newly developed professional activities with their colleagues from different disciplinary backgrounds. Table 4 Multilevel Model Results for IIC Newly Developed Professional Activities Model A B C D Fixed part Coeff. (se.) Coeff. (se.) Coeff. (se.) Coeff. (se.) Intercept 3.56 (0.03) *** 3.55 (0.03) *** 3.50 (0.04) *** 3.63 (0.05) *** ICCI 0.20 (0.06) *** 0.16 (0.09) 0.15 (0.09) Discipline Education vs. Childcare and care 0.07 (0.05) -0.06 (0.06) ICCI*Discipline Education 0.04 (0.11) 0.08 (0.10) Male 0.01 (0.08) Age -0.00 (0.02) Years working on location 0.00 (0.00) Educational level 0.08 (0.02) *** Random part Intercept 0.02 0.01 0.02 0.01 Residual 0.22 0.22 0.22 0.21 Deviance 676.2 667.5 665.0 650.7 Incremental Model Fit Model A vs. B χ 2 (1) = 8.71*** Model B vs. C χ 2 (2) = 2.50 Model C vs. D χ 2 (4) = 14.27*** ICC 0.08 0.06 0.06 0.07 Note. * = p ≤ .05; ** = p ≤ .01; *** = p ≤ .001 Reflection on Process Only Model B showed a positive significant association with ICCI score at the organizational level and reflection on process score at the individual level ( p = .012) (see Table 5). Thus, professionals in child centers with higher levels of service integration experience, on average, a more positive attitude towards reflection on the process. This association was no longer significant when other covariates were added to the model (see models C and D). No other significant associations were found. Furthermore, Model B showed a significant better model fit compared to Model A, but the model fit of the subsequent models did not significantly improve. Consequently, Model B with a positive association between IIC reflection on process and ICCI scores, was regarded as the optimal model. Table 5 Multilevel Model Results for IIC Reflection on Process Model A B C D Fixed part Coeff. (se.) Coeff. (se.) Coeff. (se.) Coeff. (se.) Intercept 3.46 (0.03) *** 3.45 (0.03) *** 3.41 (0.04) *** 3.41 (0.05) *** ICCI 0.18 (0.07) * 0.06 (0.09) 0.05 (0.10) Discipline Education vs. Childcare and care 0.05 (0.05) 0.04 (0.06) ICCI*Discipline Education 0.18 (0.11) 0.12 (0.11) Male 0.02 (0.08) Age 0.01 (0.02) Years working on location 0.00 (0.00) Educational level 0.08 (0.02) Random part Intercept 0.02 0.02 0.02 0.02 Residual 0.23 0.23 0.23 0.23 Deviance 706.4 700.1 695.8 695.0 Incremental Model Fit Model A vs. B χ 2 (1) = 6.27* Model B vs. C χ 2 (2) = 4.38 Model C vs. D χ 2 (4) = 0.79 ICC 0.09 0.07 0.07 0.06 Note. * = p ≤ .05; ** = p ≤ .01; *** = p ≤ .001 Self-Efficacy Regarding IPC Only model B of self-efficacy revealed that ICCI scores at the organizational level were positively associated with higher scores on self-efficacy regarding IPC at the individual level (see Table 6). Furthermore, Model C showed that educational professionals experienced more self-efficacy regarding IPC compared to the other professionals (no interaction effect was found). However, after adding individual characteristics in the model (Model D), the association between professionals from education and self-efficacy was no longer apparent; instead, only age and educational level were now positively associated with self-efficacy scores in this model. Thus, older and more highly educated professionals experienced higher levels of self-efficacy in collaborating with their colleagues from different disciplinary backgrounds. Furthermore, the models improved with each successive model, and, hence, Model D with a significant relationship between age, educational level and IIC interdependence was considered the optimal model. Table 6 Multilevel Model Results for Self-Efficacy Regarding IPC Model A B C D Fixed part Coeff. (se.) Coeff. (se.) Coeff. (se.) Coeff. (se.) Intercept 72.32 (0.63) *** 72.09 (0.60) *** 70.15 (0.85) *** 71.21 (1.21) *** ICCI 3.63 (1.35) ** 4.06 (2.07) 3.18 (2.01) Discipline Education 3.07 (1.06) ** 0.26 (1.27) ICCI*Discipline Education -1.21 (2.43) 0.87 (2.36) Male 2.60 (1.81) Age 1.95 (0.44) *** Years working on location 0.04 (0.06) Educational level 1.49 (0.49) ** Random part Intercept 5.37 3.70 4.82 4.51 Residual 120.21 119.63 116.81 108.01 Deviance 3762.0 3755.0 3746.8 3708.5 Incremental Model Fit Model A vs. B χ 2 (1) =6.85** Model B vs. C χ 2 (2) = 8.31* Model C vs. D χ 2 (4) = 38.28*** ICC 0.04 0.03 0.04 0.04 Note. * = p ≤ .05; ** = p ≤ .01; *** = p ≤ .001 IM-PACT: Perceived Team Effectiveness The analysis of the positive IM-PACT subscale revealed a strong positive association between perceived team effectiveness and the ICCI-score (Table 7). For the IM-PACT negative subscale only Model B revealed a significant association (Table 8); this relation was negative for this scale, corresponding with the negative formulation of the items. No further significant associations were found. Furthermore, Model B showed a significant better model fit than A, but model fit did not further improve with Models C or D. Therefore, for both IM-PACT scales, Model B with a significant association between both IM-PACT subscales and the ICCI was considered the optimal model. Table 7 Multilevel Model Results for IM-PACT Positive Model A B C D Fixed part Coeff. (se.) Coeff. (se.) Coeff. (se.) Coeff. (se.) Intercept 3.50 (0.04) *** 3.47 (0.05) *** 3.47 (0.05) *** 3.48 (0.06) *** ICCI 0.32 (0.08) *** 0.23 (0.11) * 0.23 (0.11) * Education vs. Childcare and care 0.04 (0.05) 0.03 (0.07) ICCI*Discipline Education 0.13 (0.12) 0.14 (0.12) Male -0.03 (0.09) Age -0.00 (0.02) Years working on location -0.00 (0.00) Educational level 0.01 (0.02) Random part Intercept 0.04 0.03 0.03 0.03 Residual 0.29 0.29 0.29 0.29 Deviance 823.5 810.0 808.0 807.2 Incremental Model Fit Model A vs. B χ 2 (1) = 13.53*** Model B vs. C χ 2 (2) = 2.00 Model C vs. D χ 2 (4) = 0.77 ICC 0.13 0.09 0.09 0.09 Note. * = p ≤ .05; ** = p ≤ .01; *** = p ≤ .001 Table 8 Multilevel Model Results for IM-PACT Negative Model A B C D Fixed part Coeff. (se.) Coeff. (se.) Coeff. (se.) Coeff. (se.) Intercept 2.66 (0.04) *** 2.68 (0.04) *** 2.69 (0.05) *** 2.73 (0.07) *** ICCI -0.37 (0.08) *** -0.22 (0.12) -0.21 (0.12) Education vs. Childcare and care -0.10 (0.06) -0.05 (0.07) ICCI*Discipline Education -0.22 (0.14) -0.25 (0.14) Male -0.14 (0.11) Age -0.02 (0.03) Years working on location -0.00 (0.00) Educational level -0.02 (0.03) Random part Intercept 0.04 0.02 0.02 0.02 Residual 0.37 0.37 0.37 0.36 Deviance 944.6 927.5 921.6 917.2 Incremental Model Fit Model A vs. B χ 2 (1) = 17.17*** Model B vs. C χ 2 (2) = 5.85 Model C vs. D χ 2 (4) = 4.45 ICC 0.10 0.05 0.05 0.05 Note. * = p ≤ .05; ** = p ≤ .01; *** = p ≤ .001 In summary, our multilevel analyses demonstrated a significant relationship between professionals’ attitudes and the ICCI score at the organizational level. This relation was positive for IIC interdependence, IIC newly developed activities, and IIC reflection on the process, professionals’ self-efficacy, and the positive IM-PACT subscale. Conversely, the negative IM-PACT subscale demonstrated a negative association, as expected. The fit of the models C and D, with demographic variables at the individual level, did not improve for IIC reflection on process and both IM-PACT subscales. Therefore, Model B was considered the optimal model for these outcome variables. With regard to the outcome variables IIC interdependence, newly developed activities, and self-efficacy, Model D was the optimal model. In those models the positive association with the outcome variable and ICCI score was no longer statistically significant after taking into account characteristics of individual professionals. However, a positive significant association emerged between educational level and the three outcome variables, as well as between age and IIC interdependence and self-efficacy. Discussion In a cross-sectional study, we investigated the differences in professionals' attitudes, self-efficacy and perceived team effectiveness towards IPC among a national sample of 46 Dutch ECEC child centers with varying levels of service integration. In the Netherlands, child centers that integrate their services are pioneers who face challenges posed by the nation’s split system with little connection between school, childcare and youth care at systemic level ( Authors , 2025a). Our findings support the hypothesis that professionals working in child centers with higher levels of service integration according to managerial staff experience more team effectiveness in achieving IPC goals. All initial models revealed a positive association between level of service integration at the organizational level and attitude, as well as self-efficacy towards IPC at the individual level. The individual level characteristics disciplinary background, educational level and age proved robust covariates for the individual level dependent variables in our final models, however. Our results highlight thus the importance of an organizational policy aimed at service integration for the professional beliefs of the team but also make clear that seniority and educational level of individual members matter. Specifically, individual characteristics were more predictive with the IIC scales, which ‘assess respondents’ self-reported sense of the quality of collaborative exchanges’ (Bronstein, 2002: 115). The organizational policy proved more important for the perceived progress in the achievement of goals by the team. The association between level of service integration and professionals’ attitude and self-efficacy towards IPC as well as perceived team effectiveness suggests that a nurturing environment at the organizational level can foster youth professionals’ self-efficacy in interprofessional collaboration. This finding is in line with findings of recent studies that demonstrated that a professional learning community (Canteart et al., 2019; Oosterbaan-Lodder et al., 2025 ; Price et al., 2025 ), a coaching trajectory with systematic monitoring over time (Authors, 2020 a), or a targeted intervention (Malmberg-Heimonen et al., 2025 ) can stimulate the development of an interprofessional identity among professionals in an ECEC context. Previous studies reported that attitudes towards IPC are predominantly related to disciplinary background. Specifically, childcare professionals have generally reported less positive attitudes toward IPC in the ECEC context (Keuning et al., 2022 ; Rantavouri et al., 2019 ; Verheijen-Tiemstra et al., 2020 ; 2023 ). In our study, however, the role of disciplinary background was minor, whereas the educational level and age emerged as significant and robust predictors. Elder staff with higher qualifications were more embedded in the team, more involved in the development of new activities and experienced more self-efficacy towards IPC. Leadership from senior managerial staff with higher qualifications (i.e., bachelor of higher) is a driving force in the Dutch context, whereas younger professionals and colleagues with vocational training at intermediate levels in the team feel less skilled in interprofessional collaboration. Although many childcare professionals held a certificate at ISCED level 3 or 4, whereas teachers held a level 6 certificate, teaching assistants, employed in education, also held a certificate at level 3 or 4, similar to childcare staff (Oberhuemer & Schreyer, 2024 ). Educational level transcends, therefore, in our study the boundaries of disciplinary background in relation interdependence, newly developed activities and self-efficacy towards IPC. Finally, a notable finding of this study is the relatively low levels of reflection on process, which was poorly associated with the level of service integration. A collective engagement in reflective practices within the team seems still underdeveloped for all professionals in our sample. A focus on reflection at the group level can be an important predictor of perceived team effectiveness, combined with interdependence (Authors, 2020 a). Furthermore, professionals’ reflection on process as a team can undergo significant enhancement during an intervention (Authors, 2020 a; Malmberg-Heimonen et al., 2025 ). Limitations of this Study Despite the promising results of this study, several limitations should be noted. First, although the sampling strategy targeted professionals in childcare, education and care, only a small proportion of participants were employed in care (e.g., family support services, youth health care, or paramedical care). Our sample reflects the fact that in most centers with integration of services there is structural collaboration between childcare and school, whereas care professionals are not part of the core team. Future research should explore interprofessional collaboration in ECEC in a sample with multiple disciplines. Secondly, team effectiveness was measured through self-reports rather than through objective assessments. Future studies should incorporate objective measures of team effectiveness, possibly involving other stakeholders like children and/or parents. Finally, the cross-sectional design does not allow for causal inferences regarding the level of service integration. Longitudinal or quasi-experimental designs are necessary to capture developmental processes and clarify directionality: does the organizational structure influence professionals, do professionals influence the organizational structure, or both? Conclusion In line with the recent review of Stepanava (2025), our findings point to the importance of leadership and workforce development with reflection at team level now various youth professionals in the Netherlands have become part of a the wider work force with an integrated focus childcare, education and (mental) health. In the context of an ongoing transition from autonomous services to collaborative networking for many Dutch centers, (inter)professional teams can be strengthened in an inclusive approach for all team members (Oberhuemer et al., 2023 ), including senior and younger colleagues. Additional measures may provide school directors and childcare managers with the necessary skills to fulfill the role of a supportive leader (Verheijen-Tiemstra et al., 2023 ) and may stimulate empowerment (Stepanova et al., 2025 ). Declarations Declaration of Interest The authors report no conflicts of interest. Funding This work was supported by Nationaal Regieorgaan Praktijkgericht Onderzoek SIA under Grant number . Author Contribution M.O.: performed data collection, data preparation, analysis, and wrote the first draft of the manuscriptB.Z.: developed an analysis plan and supervised analysisR.F.: responsible for funding and overall research plan, role as supervisorAll authors contributed to the main manuscript and reviewed the manuscript References Authors (2020). ; Authors (2020a); Authors (2025); Authors (2025a): names and references deleted for anonymous peer review . Ališauskienė, S., Hanssen, N. B., & Kairienė, D. (Eds.). (2023). Interprofessional and Family-Professional Collaboration for Inclusive Early Childhood Education and Care . Springer. https://doi.org/10.1007/978-3-031-34023-9 10.1007/978-3-031-34023-9 Barnes, J., Crociani, S., Daniel, S., Feyer, F., Giudici, C., & Zachrisson, H. D. (2020). A comprehensive overview of inter-agency working as a strategy to reduce educational inequalities and discrimination, evidence from Europe and future directions. 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A critical analysis of workforce development research use in the transformation of children’s services. Journal of Social Work , 14 (4), 360–379. https://doi.org/10.1177/1468017313477977 Currie, G., Burgess, N., & Hayton, J. C. (2015). HR Practices and Knowledge Brokering by Hybrid Middle Managers in Hospital Settings: The Influence of Professional Hierarchy. Human Resource Management , 54 , 793–812. 10.1002/hrm.21709 . https://doi-org.proxy.uba.uva.nl/ EU Council recommendations on high quality early childhood education and care systems (2019). https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/? uri = CELEX:32019H0605(01) &rid = 4. Eurydice (2025). Key data on early childhood education and care in Europe – 2025 . Publications Office of the European Union. Retrieved from key data on early childhood education and care in-EC0524395ENN.pdf. Institute of Medicine (IOM) and National Research Council (NRC). (2015). 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European Early Childhood Education Research Journal , 28 (1), 43–57. https://doi.org/10.1080/1350293X.2020.1707361 Malmberg-Heimonen, I., Tøge, A. G., & Akhtar, S. (2025). Improving interprofessional collaboration in schools: A cluster-randomized study evaluating the effectiveness of the LOG model on collaboration practices. Journal of Interprofessional Care , 39 (1), 40–47. https://doi.org/10.1080/13561820.2022.2149717 Nores, M., & Fernandez, C. (2018). Building capacity in health and education systems to deliver interventions that strengthen early child development. Annals of the New York Academy of Sciences , 1419 (1), 57–73. https://doi.org/10.1111/nyas.13682 Oberhuemer, P., Riedel, B., Warnatsch, R., & Bader, S. (2023). Team concepts in ECEC: Potentials and challenges of heterogeneous staff teams. International Journal of Child Care and Education Policy , 17–23. https://doi.org/10.1186/s40723-023-00127-2 Oberhuemer, P., & Schreyer, I. (Eds.). (2024). Early childhood workforce profiles across Europe: 33 Country reports with key contextual data . State Institute for Early Childhood Research and Media Literacy. http://www.seepro.eu/Complete-Publication2024.pdf Oosterbaan-Lodder, S. C. M., Reinders, J. J., Versluis, M. A. C., Scheele, F., & Kusurkar, R. A. (2025). Professional and Interprofessional Identity Formation in Healthcare Students During Placement in an Interprofessional Training Unit - A Multicentre Quantitative Study. Perspectives on Medical Education , 14 (1), 399–410. https://doi.org/10.5334/pme.1649 Price, S., Van Dam, L., Sim, M., Andrews, C., Gilbert, J. H. V., Lackie, K., & Khalili, H. (2025). Becoming Interprofessional: A Longitudinal Study of Professional and Interprofessional Identity Development Across Five Health Professions. Qualitative Health Research , 0 (0). 10.1177/10497323251333960 Rantavouri, L. (2018). The problem-solving process as part of professionals’ boundary work in preschool to school transition. International Journal of Early Years Education , 26 (4), 422–435. Rantavouri, L., Karila, K., & Kupila, P. (2019). Transition practices as an arena for the development of relational expertise. Teacher Development , 23 (2), 249–263. R Core team. (2021). R: A language and environment for statistical computing . R Foundation for Statistical Computing. https://www.R-project.org/ Reinders, J. J., & Krijnen, W. (2023). Interprofessional identity and motivation towards interprofessional collaboration. Medical Education , 57 (11), 1068–1078. https://doi.org/10.1111/medu.15096 Rentzou, K. (2018). The long way towards abandoning ECEC dichotomy in Greece. Early Child Development and Care , 188 (5), 524–541. https://doi.org/10.1080/03004430.2017.1345898 Roback, P., & Legler, J. (2021). Beyond Multiple Linear Regression: Applied Generalized Linear Models and Multilevel Models in R (1st ed.). Chapman and Hall/CRC. https://doi.org/10.1201/9780429066665 Stepanova, E., Hillier-Brown, F., Owen-Boukra, E., Hope, S., Scott, S., Hargreaves, D., Nicholls, D., Viner, R. M., & Summerbell, C. (2025). Commonality of 25 component themes of integrated care for children: Rapid review of 170 models. BMC health services research , 25 (1), 1332. https://doi.org/10.1186/s12913-025-13345-w Van Grinten, M., Kieft, M., Kooij, D., Bomhof, M., & Van den Berg, E. (2019). Samenwerking in beeld 2. [Collaboration in focus 2]. Retrieved from Omslag (oberon.eu). Verheijen-Tiemstra, M. R. E., Ros, A. A., & Vermeulen, M. J. M. (2020). Werelden van verschil: Aard en intensiteit van interprofessionele samenwerking tussen basisonderwijs en kinderopvang [Worlds of difference: Dimensions and levels of intensity in interprofessional collaboration between primary schools and child care services]. Pedagogische Studiën , 97 , 59–75. Verheijen-Tiemstra, R., Ros, A., Vermeulen, M., & Poell, R. F. (2023). Barriers to collaboration between school teachers and child care workers: Implications for HRM and school leadership. International Journal of Educational Management , 38 (1), 96–114. https://doi.org/10.1108/IJEM-04-2023-0169 Willumsen, E. (2008). Interprofessional collaboration; A matter of differentiation and integration? Theoretical reflections based in the context of Norwegian childcare. Journal of Interprofessional Care , 22 (4), 352–363. https://doi.org/10.1080/13561820802136866 World Health Organization (2010). Framework for action on interprofessional education & collaborative practice . WHO. Retrieved from: https://www.who.int/publications/i/item/framework-for-action-on-interprofessional-educationcollaborative-practice Wong, S., & Press, F. (2017). Interprofessional work in early childhood education and care services to support children with additional needs: two approaches. Australian Journal of Learning Difficulties , 22 (1), 49–56. https://doi.org/10.1080/19404158.2017.1322994 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7969185","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":544117872,"identity":"b074c7a7-3f31-4cb9-a52c-c2f394f1f8f9","order_by":0,"name":"Marian 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class=\"CitationRef\"\u003e2010\u003c/span\u003e; WHO, 2010) and practice (Curran et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Nores \u0026amp; Fernandez, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). In child centers that offer these integrated ECEC services, professionals with different disciplinary backgrounds, including childcare, primary education and family support services, collaborate in interprofessional teams to support families with the aim of reducing inequalities and enhancing children’s development (Barnes et al., 2018; EU Council, 2019; Lazzari et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). However, despite the growing awareness of the potential benefits of the integration of ECEC services for children’s development, little is known about differences in level of service integration across organizational contexts, as well as how these differences are associated with individual differences in professionals’ attitudes and self-efficacy regarding IPC among ECEC professionals. In this study, we investigated these differences at the individual level and examine their association with the level of service integration at the organizational level. Understanding these dynamics is crucial, as organizations rely on the quality of interprofessional collaboration (IPC) between the professionals for the attainment of goals (Schor et al., 2020). Furthermore, it provides valuable insight into how organizational development can foster the growth of individual professionals with regard to IPC.\u003c/p\u003e\u003cp\u003eOn a contextual level, the rationale for collaboration within ECEC is the growing attention for reducing inequalities and inclusive ECEC for young children (Lazzari et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Sun et al., 2024). Nevertheless, at the national level, a significant disparity exists among European countries in their adaptation of legal and regulatory frameworks to this development. A growing number of countries are integrating ECEC services at the national level. However, in other countries, such as the Netherlands, a clear distinction persists between the laws and regulations for childcare, primary school and other youth support systems for young children (Eurydice, 2019; Eurydice, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Notwithstanding the absence of an integrated system at the national level in the Netherlands, some locations have recently started to offer integrated services in a local, bottom-up movement with increasing collaboration of various youth professionals (van Grinten et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAt the organizational level, organizations within childcare and primary education align their work processes in an attempt to integrate services for children and their families (Ališauskienė et al., 2024). Despite the growing commitment and recent developments, research on this alignment within ECEC is limited and service integration in the context of ECEC predominantly builds on the health literature (Verheijen-Tiemstra et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Furthermore, in countries with a split system, achieving alignment is challenging due to systemic barriers related to national laws and regulations and traditional vocational training. Consequently, the trend towards service integration and IPC is only adopted in some innovative centers. As a result, Dutch ECEC centers exhibit considerable variation in the level of service integration, ranging from innovative and fully integrated centers to traditional centers with separate childcare and education services (van der Grinten et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Also in the Dutch innovative centers, the level of integration may vary across different themes and subjects (Verheijen-Tiemstra et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAt the individual level, the existence of IPC between professionals within child centers offering integrated services is not self-evident (Karila \u0026amp; Rantavouri, 2014; Wong \u0026amp; Press, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Several review studies have identified unclear professional roles, inadequate communication and feelings of distrust as significant barriers for effective IPC (Authors, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; \u003cem\u003eAuthors\u003c/em\u003e, 2025a). Another critical factor at the individual level is the disparity in professional status, with teachers generally enjoying a higher status than childcare professionals (Keuning et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Rantavouri et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Verheijen-Tiemstra et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In line with these findings, Verheijen-Tiemstra et al. (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) reported that childcare professionals frequently experienced a sense of exclusion within the child center, often attributed to their perceived lower status. Additionally, teachers demonstrated higher levels of self-perceived ability and motivation for IPC than childcare professionals (Verheijen-Tiemstra et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhile these barriers underscore systemic challenges, some small-scale longitudinal studies have shown that teacher beliefs and self-efficacy toward IPC may develop (Authors, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003ea; Karilla \u0026amp; Rantavouri, 2014; Malmberg-Heimonen et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Rantavouri, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Before professionals can take the responsibility for collaborative practices, they need the trust that collaboration contributes to their own knowledge and is more valuable than working separately (Rantavouri, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). In line with this, professionals who engage in IPC can develop a more positive attitude towards IPC, reflected by an increase in their \u003cem\u003esense of interdependence\u003c/em\u003e and \u003cem\u003ereflection on the process\u003c/em\u003e, which subsequently predicted their perceived \u003cem\u003eteam effectiveness\u003c/em\u003e and a positive trend in their attitudes toward \u003cem\u003enewly developed activities\u003c/em\u003e in the study of Authors (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003ea). In addition, the Norwegian study of Malmberg-Heimonen et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) revealed that professionals in the intervention group, who implemented an interprofessional model, were more positive in their \u003cem\u003ereflection on the process\u003c/em\u003e and \u003cem\u003enewly developed activities\u003c/em\u003e compared to the control group. The findings from these studies suggest that a nurturing environment that stimulates IPC has a positive effect on professionals’ attitudes towards interprofessional collaboration.\u003c/p\u003e\u003cp\u003eTo summarize, the existing literature on IPC within ECEC remains fragmented, often focusing on individual professionals in isolation while neglecting the broader contextual factors that call for an ecological perspective. Furthermore, many studies rely on small samples drawn from innovative but relatively homogeneous settings, thereby limiting the generalizability of their findings. Consequently, it remains unclear how different settings shape professionals' attitudes, beliefs and self-efficacy toward IPC, collectively known as interprofessional identity. A professional community that actively fosters IPC can support the internalization of this interprofessional identity among its members (Canteart et al., 2019; Oosterbaan-Lodder et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Price et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Evidence further suggests that interprofessional identity influences interprofessional behavior (Reinders \u0026amp; Krijnen, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) and team effectiveness (Canteart et al., 2022), pointing to a bidirectional relationship between organizational service integration and professionals’ attitudes toward IPC.\u003c/p\u003e\n\u003ch3\u003ePresent Study\u003c/h3\u003e\n\u003cp\u003eTo gain a better understanding of differences in professionals’ attitudes towards IPC in diverse ECEC contexts, this study investigated professionals’ attitudes towards IPC in a heterogenous sample within a national context that does not foster IPC systematically (e.g., a split system). To do so, this study used a contextualized approach to investigate the association between the level of service integration at the organizational level and professionals’ individual experiences with IPC in a Dutch sample. In line with previous research (Canteart et al., 2019; 2022; Oosterbaan-Lodder et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Price et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), it is assumed that professionals in child centers with higher levels of service integration have developed a more positive interprofessional identity based on attitudes and self-efficacy towards IPC and, as a result, experience more team effectiveness. This study aims to answer the following research questions:\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eDo professionals working in child centers with a higher degree of integration at the organizational level perceive a more positive attitude towards IPC and a higher level of self-efficacy and team effectiveness compared to professionals working in child centers with a lower degree of integration?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eIs the assumed relation between centers and individual professionals different for professionals in education versus childcare and care, and is it related to other demographic characteristics (i.e., gender, age, years working on location, or educational level)?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Method","content":"\u003ch2\u003eSample\u003c/h2\u003e\u003cp\u003eA total of 46 child centers from 11 (out of 12) provinces in the Netherlands participated in this study. Professionals of these child centers, working with children between two and eight years old, were invited to complete an online questionnaire. Altogether, 1,226 professionals were invited, and 629 respondents participated, which corresponds to a response rate of 51%. The majority of the professionals were female (92%) and held an ISCED (2011) level 6 certificate (51%). Furthermore, 31 percent of the professionals were aged between 31 and 40 years old (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The majority of the professionals worked in primary education (56%), followed by childcare (34%). Eight percent of the professionals worked in both education and childcare. Finally, a small number of professionals were engaged in care (e.g., family support services, welfare, or youth health care) (2%). On average, the professionals worked 7.6 years at the participating child center (SD = 8.23; range: 0.1 years to 52.8 years).\u003c/p\u003e\u003ch3\u003eProcedure\u003c/h3\u003e\u003cp\u003eIn the spring of 2023, researchers from four universities of applied sciences (\u003cem\u003eAuthors affiliations\u003c/em\u003e) recruited child centers through their regional networks and social media (e.g., LinkedIn). To create a heterogenous sample, child centers were selected with the intention of representing the complete range of levels of service integration (from traditional centers, non-integrated, to fully integrated child centers), based on an intake during the recruitment phase.\u003c/p\u003e\u003cp\u003eAt the start of the data collection (spring or fall 2023), we conducted face-to-face interviews with the management team of each location (i.e., school principal and childcare manager) to assess the level of service integration. After the interview, each location provided us with a list of professionals working in their child centers with children aged between two and seven in the disciplines of education, childcare and care. In summer or fall 2023, each professional received a link to an online questionnaire (see Measures). We sent four reminders by email over a period of two months.\u003c/p\u003e\u003cp\u003ePrior to data collection, the ethics committee of \u003cem\u003eAuthors affiliation\u003c/em\u003e approved the research plan (FMG-1422). Each participant gave informed consent at the start of the questionnaire. Also, we preregistered our hypotheses by the open science framework (OSF: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.17605/OSF.IO/7PQ4V\u003c/span\u003e\u003cspan address=\"10.17605/OSF.IO/7PQ4V\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e).\u003c/p\u003e\u003ch3\u003eMeasures\u003c/h3\u003e\u003cp\u003eBelow we describe the outcome measures at the individual level (IIC, IPECC-SET 9, IM-PACT) and covariates at the organizational (ICCI) and individual level (e.g., educational level, working experience).\u003c/p\u003e\u003cp\u003e\u003cem\u003eIndex for Interdisciplinary Collaboration (IIC\u003c/em\u003e, Bronstein, 2002). This index measures the attitude of individual professionals towards IPC in the context of ECEC. For this study we used four categories of the IIC: \u003cem\u003eInterdependence\u003c/em\u003e (13 items, e.g., ‘My colleagues from other disciplines often refer to me’; α = .77); \u003cem\u003eReflection on process\u003c/em\u003e (10 items, e.g., ‘I discuss with professionals from other disciplines the degree to which each of us should be involved in a particular case’; α = .83); \u003cem\u003eNewly created professional activities\u003c/em\u003e (6 items, e.g., ‘Working with colleagues from other disciplines leads to outcomes that we could not achieve alone’; α = .66); \u003cem\u003eFlexibility\u003c/em\u003e (5 items, e.g., ‘The professional colleagues from other disciplines with whom I work stick rigidly to their job descriptions’; α = .49). The participants scored each item on a five-point scale: strongly disagree (1), disagree (2), neutral (3), agree (4), or strongly agree (5). In this study, we applied the Dutch version, as translated by Authors (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003ea).\u003c/p\u003e\u003cp\u003e\u003cem\u003eInterprofessional Education Collaborative Competency Self-Efficacy Tool (IPECC-SET 9\u003c/em\u003e, Kottorp et al., 2019). This instrument is originally designed to evaluate health professions students’ self-efficacy in interprofessional collaborative competency. For this study we slightly adapted this instrument to measure self-efficacy in interprofessional collaborative competency in the context of ECEC (9 items, e.g., ‘Perform effectively on teams and in different team roles in a variety of settings’, ‘Recognize one’s limitations in skills, knowledge and abilities’; α = .90). Professional translators translated the questions back and forth to Dutch. After translation, the questions were adjusted for the Dutch ECEC context. The participants scored each item on a scale from 0 (not confident at all) to 100 (totally confident).\u003c/p\u003e\u003cp\u003e\u003cem\u003eIM-PACT\u003c/em\u003e (Authors, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003ea). This instrument measures the perceived team effectiveness in achieving IPC goals in the context of ECEC. We used both the \u003cem\u003ePositive scale\u003c/em\u003e (6 items, e.g., ‘We are more able to handle differences in children’s development’; α = .82) and the \u003cem\u003eNegative\u003c/em\u003e scale (6 items, e.g., ‘We do not have a joint vision on working with parents’; α = .80). The participants scored each item on a five-point scale: strongly disagree (1), disagree (2), neutral (3), agree (4), or strongly agree (5). The study by Authors (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003ea) found support for the internal consistency and the convergent and predictive validity of the IM-PACT scales.\u003c/p\u003e\u003cp\u003e\u003cem\u003eIndex for Child Center Integration (ICCI, Authors\u003c/em\u003e, 2025). This index measures the \u003cem\u003elevel of integration between childcare, primary education, and family support services\u003c/em\u003e and consists of two subscales: \u003cem\u003eUniversal\u003c/em\u003e (14 items, e.g., ‘Vision’, ‘Joint Ambition’; α = .94) and \u003cem\u003eTargeted\u003c/em\u003e (8 items, e.g., ‘Collaboration with specialized care’, ‘Collaboration with paramedic professionals’; α = .80). The Pearson’s correlation between the two subscales was 0.44. For this study we used the \u003cem\u003eTotal\u003c/em\u003e score consisting of 22 items (α = .92). Each item was scored during an extensive interview by participants and a researcher together on a three-point scale: separated (1), coordinated (2), or integrated (3). A validation study provided support for the reliability and factor structure of this newly developed measure (\u003cem\u003eAuthors\u003c/em\u003e, 2025).\u003c/p\u003e\u003cp\u003eIn the survey we assessed the individual characteristics of the professionals — including gender, age, educational level, years working on location and discipline — to examine which level one explanatory variables are related to the outcome variable. First, we created dummy variables for gender (male: 1) and discipline (education: 1). Professionals engaged in both education and childcare were assigned to education since they were involved in education, for instance, as staff members or teaching assistants. Secondly, we assessed age and educational level on an ordinal scale. We measured age with the following six categories: \u0026lt;20, 21–30, 31–40, 41–50, 51–60, and \u0026gt; 60. Furthermore, we assessed educational level based on Dutch educational levels, which we then converted to ISCED (2011) levels. Finally, we calculated years working on location based on the question ‘Since when do you work in this child center?’ and the date of completing the questionnaire.\u003c/p\u003e\u003ch3\u003eAnalysis\u003c/h3\u003e\u003cp\u003eAll analyses for this study were performed in R (R Core Team, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). For the preliminary analyses we calculated Pearson correlations between age, educational level, and all outcome variables. Furthermore, we used a t-test to evaluate differences in age, educational level, and outcome scores between professionals from education versus childcare and care.\u003c/p\u003e\u003cp\u003eIn our sample, professionals are nested within the child centers. Therefore, a multilevel approach is recommended (Roback \u0026amp; Legler, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). We evaluated for each outcome variable four related multilevel models using the R package lme4 (Bates et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) with maximum likelihood estimation. Model A, the empty baseline model without covariates, was used to evaluate the between- and within-group variance and intraclass correlation. Next, in Model B (RQ 1), we included the mean ICCI score at level 2 (i.e., organizational level) in the model to determine the association between the outcome scores and the ICCI score. Additionally, in Model C (RQ 2), we included the level 1 covariate (i.e., the individual professional level) discipline (i.e., comparing education to childcare and care) and the interaction effect of ICCI*discipline. The final model was Model D (RQ 2) with the additional level 1 characteristics of gender, age, educational level and number of years working at the center. The incremental fit of the Models A vs. B, Model B vs. C, and finally, Model C vs. D was compared with a deviance test.\u003c/p\u003e\u003cp\u003eTo facilitate the interpretation of the outcomes, we centered all level one covariates, except for the dummy variables. We centered ordinal covariates around the largest score group and continuous covariates around the grand mean. Additionally, we grand mean centered the level 2 covariate ICCI. After running the models, we checked the assumptions of homogeneity of residual variance, linearity and normality of residuals at both levels, which revealed no major violations.\u003c/p\u003e\u003cp\u003eAlthough we initially planned to use the full IIC measure, as indicated in our preregistration, we ultimately opted to analyze individual IIC subscales. This decision was made because the subscale Shared Responsibility was accidentally omitted from the questionnaire and the reliability of the Flexibility subscale was low (α = .49).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable 1 shows an overview of the descriptives of the outcome variables and covariates. At the organizational level, participating centers scored on average a medium level of integration with an ICCI score of 1.97 (\u003cem\u003eSD\u003c/em\u003e = 0.47).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDescriptive Overview for Outcome Variables and Demographic Characteristics\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"699\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cem\u003eEducation\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cem\u003eChildcare and care\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cem\u003eMean (SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cem\u003eMean (SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cem\u003eMean (SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin; max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eIIC Interdependence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3.88 (0.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e3.69 (0.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.79 (0.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.46; 4.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eIIC Newly developed activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3.59 (0.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e3.52 (0.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.56 (0.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2.92; 4.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eIIC Reflection on process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3.48 (0.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e3.41 (0.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.45 (0.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2.91; 3.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eSelf-Efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e73.20 (10.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e70.21 (12.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e72.21 (11.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e59.90; 83.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eIM-PACT positive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3.55 (0.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e3.49 (0.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.53 (0.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.17; 5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eIM-PACT negative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2.60 (0.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e2.73 (0.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2.66 (0.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2.05; 3.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eAge (categories 1-6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e3.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.64 (1.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.00; 6.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eEducational level (ISCED)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e5.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e4.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e5.48 (1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.00; 7.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eYears working on location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e6.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e7.98 (8.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.17; 52.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA positive significant correlation was found between age and educational level, \u003cem\u003er\u003c/em\u003e (489) = 0.11, \u003cem\u003ep\u003c/em\u003e = .01. Furthermore, there was a positive correlation between educational level and Interdependence, \u003cem\u003er\u003c/em\u003e (489) = 0.30, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, Newly developed activities, \u003cem\u003er\u003c/em\u003e (489) = 0.16, \u003cem\u003ep\u003c/em\u003e \u0026lt;.001, and Self efficacy, \u003cem\u003er\u003c/em\u003e (489) = 0.20, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001. Also, age was related with Interdependence, \u003cem\u003er\u003c/em\u003e (489) = 0.17, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, and Self efficacy, \u003cem\u003er\u003c/em\u003e (489) = 0.22, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001. In addition, school professionals scored higher than their colleagues with a care background on educational level, \u003cem\u003et\u003c/em\u003e (233.72) = 13.57, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, IIC Interdependence, \u003cem\u003et\u003c/em\u003e (335.99) =5.19, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, self efficacy, \u003cem\u003et\u003c/em\u003e (275.93) = 2.61, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, and lower on the negative IM-PACT scale, \u003cem\u003et\u003c/em\u003e (344.87) = -2.14, \u003cem\u003ep\u003c/em\u003e = .033.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAttitude towards IPC\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eInterdependence\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe multilevel models B and C revealed that higher ICCI scores at the organizational level were associated with higher scores on interdependence at the individual level. Thus, professionals in child centers with higher levels of service integration reported higher levels of interdependency with their colleagues from different disciplinary backgrounds (see Table 3). Model C showed that professionals from education experienced more interdependence compared to professionals from childcare. However, when adding individual characteristics in model D, the association between the ICCI score and an educational background was no longer apparent; only age and educational level were positively associated with interdependence scores in this model. Thus, older and more highly educated professionals experienced higher levels of interdependence in collaborating with their colleagues from different disciplinary backgrounds. Furthermore, the fit improved with each successive model, from Model A to B, \u0026chi;\u003csup\u003e2\u003c/sup\u003e(1) = 13.25,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e \u0026lt;.001;\u0026nbsp;Model B to C, \u0026chi;\u003csup\u003e2\u003c/sup\u003e(2) = 25.92,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e \u0026lt; .001;\u0026nbsp;and Model C to D, \u0026chi;\u003csup\u003e2\u003c/sup\u003e(4) = 39.54,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e \u0026lt; .001. Consequently,\u0026nbsp;Model D was considered the optimal model.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMultilevel Model Results for IIC Interdependence\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eModel\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFixed part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.81 (0.03) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.80 (0.02) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.68 (0.03) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e3.76 (0.04) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eICCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.19 (0.05) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.16 (0.07) *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.13 (0.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eDiscipline Education vs. Childcare and care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.19 (0.04) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.06 (0.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eICCI*Discipline Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.02 (0.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.09 (0.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.04 (0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.06 (0.01) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eYears working on location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.00 (0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eEducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.08 (0.02) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRandom part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eResidual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eDeviance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e476.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e462.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e436.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e397.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eIncremental Model Fit \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eModel A vs. B\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(1) =\u003csup\u003e\u0026nbsp;\u003c/sup\u003e13.25***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eModel B vs. C\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(2) =\u003csup\u003e\u0026nbsp;\u003c/sup\u003e25.92***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eModel C vs. D\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(4) =\u003csup\u003e\u0026nbsp;\u003c/sup\u003e39.54***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eICC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e * = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .05; ** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .01; *** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .001\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eNewly Developed Professional Activities\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOnly Model B revealed that higher ICCI scores at the organizational level were positively associated with higher scores on newly created professional activities at the individual level. Thus, professionals in child centers with higher levels of service integration experienced more newly created activities with their colleagues from different disciplinary backgrounds (see Table 4). Although the level of service integration was positively associated with newly created professional activities, this association was no longer significant when covariates were added to the models (see Model C and D). Model D with an association between educational level was the optimal model. Thus, more highly educated professionals experienced higher levels of involvement in newly developed professional activities with their colleagues from different disciplinary backgrounds.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMultilevel Model Results for IIC Newly Developed Professional Activities\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFixed part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e3.56 (0.03) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e3.55 (0.03) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e3.50 (0.04) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e3.63 (0.05) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eICCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.20 (0.06) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.16 (0.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.15 (0.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eDiscipline Education vs. Childcare and care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.07 (0.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e-0.06 (0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eICCI*Discipline Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.04 (0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.08 (0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.01 (0.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e-0.00 (0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eYears working on location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.00 (0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eEducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.08 (0.02) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRandom part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eResidual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eDeviance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e676.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e667.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e665.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e650.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eIncremental Model Fit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eModel A vs. B\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(1) =\u003csup\u003e\u0026nbsp;\u003c/sup\u003e8.71***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eModel B vs. C\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(2) =\u003csup\u003e\u0026nbsp;\u003c/sup\u003e2.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eModel C vs. D\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(4) = 14.27***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 169px;\"\u003e\n \u003cp\u003eICC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e * = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .05; ** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .01; *** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .001\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eReflection on Process\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOnly Model B showed a positive significant association with ICCI score at the organizational level and reflection on process score at the individual level (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e= .012) (see Table 5). Thus, professionals in child centers with higher levels of service integration experience, on average, a more positive attitude towards reflection on the process. This association was no longer significant when other covariates were added to the model (see models C and D). No other significant associations were found. Furthermore, Model B showed a significant better model fit compared to Model A, but the model fit of the subsequent models did not significantly improve. Consequently, Model B with a positive association between IIC reflection on process and ICCI scores, was regarded as the optimal model.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMultilevel Model Results for IIC Reflection on Process\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"662\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFixed part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.46 (0.03) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.45 (0.03) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.41 (0.04) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.41 (0.05) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eICCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.18 (0.07) *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.06 (0.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.05 (0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eDiscipline Education vs. Childcare and care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.05 (0.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.04 (0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eICCI*Discipline Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.18 (0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.12 (0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.02 (0.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.01 (0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eYears working on location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.00 (0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eEducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.08 (0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRandom part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eResidual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eDeviance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e706.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e700.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e695.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e695.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eIncremental Model Fit \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eModel A vs. B\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(1) =\u003csup\u003e\u0026nbsp;\u003c/sup\u003e6.27*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eModel B vs. C\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(2) = 4.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eModel C vs. D\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(4) = 0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eICC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e * = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .05; ** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .01; *** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .001\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSelf-Efficacy Regarding IPC\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOnly model B of self-efficacy revealed that ICCI scores at the organizational level were positively associated with higher scores on self-efficacy regarding IPC at the individual level (see Table 6). Furthermore, Model C showed that educational professionals experienced more self-efficacy regarding IPC compared to the other professionals (no interaction effect was found). However, after adding individual characteristics in the model (Model D), the association between professionals from education and self-efficacy was no longer apparent; instead, only age and educational level were now positively associated with self-efficacy scores in this model. Thus, older and more highly educated professionals experienced higher levels of self-efficacy in collaborating with their colleagues from different disciplinary backgrounds. Furthermore, the models improved with each successive model, and, hence, Model D with a significant relationship between age, educational level and IIC interdependence was considered the optimal model.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMultilevel Model Results for Self-Efficacy Regarding IPC\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"662\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFixed part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e72.32 (0.63) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e72.09 (0.60) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e70.15 (0.85) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e71.21 (1.21) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eICCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.63 (1.35) **\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e4.06 (2.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.18 (2.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eDiscipline Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.07 (1.06) **\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.26 (1.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eICCI*Discipline Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e-1.21 (2.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.87 (2.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e2.60 (1.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e1.95 (0.44) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eYears working on location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.04 (0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eEducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e1.49 (0.49) **\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRandom part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e5.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e4.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e4.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eResidual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e120.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e119.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e116.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e108.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eDeviance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3762.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3755.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3746.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3708.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eIncremental Model Fit \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eModel A vs. B\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(1) =6.85**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eModel B vs. C\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(2) = 8.31*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eModel C vs. D\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(4) = 38.28***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eICC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e * = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .05; ** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .01; *** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .001\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eIM-PACT: Perceived Team Effectiveness\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe analysis of the positive IM-PACT subscale revealed a strong positive association between perceived team effectiveness and the ICCI-score (Table 7). For the IM-PACT negative subscale only Model B revealed a significant association (Table 8); this relation was negative for this scale, corresponding with the negative formulation of the items. No further significant associations were found. Furthermore, Model B showed a significant better model fit than A, but model fit did not further improve with Models C or D. Therefore, for both IM-PACT scales, Model B with a significant association between both IM-PACT subscales and the ICCI was considered the optimal model.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMultilevel Model Results for IM-PACT Positive\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"671\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFixed part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3.50 (0.04) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e3.47 (0.05) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3.47 (0.05) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.48 (0.06) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eICCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.32 (0.08) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.23 (0.11) *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.23 (0.11) *\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eEducation vs. Childcare and care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.04 (0.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.03 (0.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eICCI*Discipline Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.13 (0.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.14 (0.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-0.03 (0.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-0.00 (0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eYears working on location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-0.00 (0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eEducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.01 (0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRandom part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eResidual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eDeviance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e823.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e810.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e808.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e807.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eIncremental Model Fit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eModel A vs. B\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(1) =\u003csup\u003e\u0026nbsp;\u003c/sup\u003e13.53***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eModel B vs. C\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(2) =\u003csup\u003e\u0026nbsp;\u003c/sup\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eModel C vs. D\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(4) = 0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eICC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e * = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .05; ** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .01; *** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .001\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 8\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMultilevel Model Results for IM-PACT Negative\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"671\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFixed part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eCoeff. (se.)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2.66 (0.04) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2.68 (0.04) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2.69 (0.05) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2.73 (0.07) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eICCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-0.37 (0.08) ***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.22 (0.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.21 (0.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eEducation vs. Childcare and care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.10 (0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.05 (0.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eICCI*Discipline Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.22 (0.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.25 (0.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.14 (0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.02 (0.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eYears working on location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.00 (0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eEducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e-0.02 (0.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRandom part\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eResidual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eDeviance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e944.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e927.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e921.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e917.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eIncremental Model Fit\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eModel A vs. B\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(1) =\u003csup\u003e\u0026nbsp;\u003c/sup\u003e17.17***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eModel B vs. C\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(2) = 5.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eModel C vs. D\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e(4) = 4.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eICC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e * = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .05; ** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .01; *** = \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; .001\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn summary, our multilevel analyses demonstrated a significant relationship between professionals\u0026rsquo; attitudes and the ICCI score at the organizational level. This relation was positive for IIC interdependence, IIC newly developed activities, and IIC reflection on the process, professionals\u0026rsquo; self-efficacy, and the positive IM-PACT subscale. Conversely, the negative IM-PACT subscale demonstrated a negative association, as expected. The fit of the models C and D, with demographic variables at the individual level, did not improve for IIC reflection on process and both IM-PACT subscales. Therefore, Model B was considered the optimal model for these outcome variables. With regard to the outcome variables IIC interdependence, newly developed activities, and self-efficacy, Model D was the optimal model. In those models the positive association with the outcome variable and ICCI score was no longer statistically significant after taking into account characteristics of individual professionals. However, a positive significant association emerged between educational level and the three outcome variables, as well as between age and IIC interdependence and self-efficacy.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn a cross-sectional study, we investigated the differences in professionals' attitudes, self-efficacy and perceived team effectiveness towards IPC among a national sample of 46 Dutch ECEC child centers with varying levels of service integration. In the Netherlands, child centers that integrate their services are pioneers who face challenges posed by the nation\u0026rsquo;s split system with little connection between school, childcare and youth care at systemic level (\u003cem\u003eAuthors\u003c/em\u003e, 2025a). Our findings support the hypothesis that professionals working in child centers with higher levels of service integration according to managerial staff experience more team effectiveness in achieving IPC goals. All initial models revealed a positive association between level of service integration at the organizational level and attitude, as well as self-efficacy towards IPC at the individual level.\u003c/p\u003e\u003cp\u003eThe individual level characteristics disciplinary background, educational level and age proved robust covariates for the individual level dependent variables in our final models, however. Our results highlight thus the importance of an organizational policy aimed at service integration for the professional beliefs of the team but also make clear that seniority and educational level of individual members matter. Specifically, individual characteristics were more predictive with the IIC scales, which \u0026lsquo;assess respondents\u0026rsquo; self-reported sense of the quality of collaborative exchanges\u0026rsquo; (Bronstein, 2002: 115). The organizational policy proved more important for the perceived progress in the achievement of goals by the team. The association between level of service integration and professionals\u0026rsquo; attitude and self-efficacy towards IPC as well as perceived team effectiveness suggests that a nurturing environment at the organizational level can foster youth professionals\u0026rsquo; self-efficacy in interprofessional collaboration. This finding is in line with findings of recent studies that demonstrated that a professional learning community (Canteart et al., 2019; Oosterbaan-Lodder et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Price et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), a coaching trajectory with systematic monitoring over time (Authors, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003ea), or a targeted intervention (Malmberg-Heimonen et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) can stimulate the development of an interprofessional identity among professionals in an ECEC context.\u003c/p\u003e\u003cp\u003ePrevious studies reported that attitudes towards IPC are predominantly related to disciplinary background. Specifically, childcare professionals have generally reported less positive attitudes toward IPC in the ECEC context (Keuning et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Rantavouri et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Verheijen-Tiemstra et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In our study, however, the role of disciplinary background was minor, whereas the educational level and age emerged as significant and robust predictors. Elder staff with higher qualifications were more embedded in the team, more involved in the development of new activities and experienced more self-efficacy towards IPC. Leadership from senior managerial staff with higher qualifications (i.e., bachelor of higher) is a driving force in the Dutch context, whereas younger professionals and colleagues with vocational training at intermediate levels in the team feel less skilled in interprofessional collaboration. Although many childcare professionals held a certificate at ISCED level 3 or 4, whereas teachers held a level 6 certificate, teaching assistants, employed in education, also held a certificate at level 3 or 4, similar to childcare staff (Oberhuemer \u0026amp; Schreyer, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Educational level transcends, therefore, in our study the boundaries of disciplinary background in relation interdependence, newly developed activities and self-efficacy towards IPC.\u003c/p\u003e\u003cp\u003eFinally, a notable finding of this study is the relatively low levels of reflection on process, which was poorly associated with the level of service integration. A collective engagement in reflective practices within the team seems still underdeveloped for all professionals in our sample. A focus on reflection at the group level can be an important predictor of perceived team effectiveness, combined with interdependence (Authors, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003ea). Furthermore, professionals\u0026rsquo; reflection on process as a team can undergo significant enhancement during an intervention (Authors, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003ea; Malmberg-Heimonen et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eLimitations of this Study\u003c/h2\u003e\u003cp\u003eDespite the promising results of this study, several limitations should be noted. First, although the sampling strategy targeted professionals in childcare, education and care, only a small proportion of participants were employed in care (e.g., family support services, youth health care, or paramedical care). Our sample reflects the fact that in most centers with integration of services there is structural collaboration between childcare and school, whereas care professionals are not part of the core team. Future research should explore interprofessional collaboration in ECEC in a sample with multiple disciplines. Secondly, team effectiveness was measured through self-reports rather than through objective assessments. Future studies should incorporate objective measures of team effectiveness, possibly involving other stakeholders like children and/or parents. Finally, the cross-sectional design does not allow for causal inferences regarding the level of service integration. Longitudinal or quasi-experimental designs are necessary to capture developmental processes and clarify directionality: does the organizational structure influence professionals, do professionals influence the organizational structure, or both?\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003e In line with the recent review of Stepanava (2025), our findings point to the importance of leadership and workforce development with reflection at team level now various youth professionals in the Netherlands have become part of a the wider work force with an integrated focus childcare, education and (mental) health. In the context of an ongoing transition from autonomous services to collaborative networking for many Dutch centers, (inter)professional teams can be strengthened in an inclusive approach for all team members (Oberhuemer et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), including senior and younger colleagues. Additional measures may provide school directors and childcare managers with the necessary skills to fulfill the role of a supportive leader (Verheijen-Tiemstra et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) and may stimulate empowerment (Stepanova et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eDeclaration of Interest\u003c/h2\u003e\u003cp\u003eThe authors report no conflicts of interest.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThis work was supported by Nationaal Regieorgaan Praktijkgericht Onderzoek SIA under \u003cem\u003eGrant number\u003c/em\u003e.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eM.O.: performed data collection, data preparation, analysis, and wrote the first draft of the manuscriptB.Z.: developed an analysis plan and supervised analysisR.F.: responsible for funding and overall research plan, role as supervisorAll authors contributed to the main manuscript and reviewed the manuscript\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAuthors (2020). ; \u003cem\u003eAuthors\u003c/em\u003e (2020a); \u003cem\u003eAuthors\u003c/em\u003e (2025); \u003cem\u003eAuthors\u003c/em\u003e (2025a): \u003cem\u003enames and references deleted for anonymous peer review\u003c/em\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlišauskienė, S., Hanssen, N. 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Interprofessional work in early childhood education and care services to support children with additional needs: two approaches. \u003cem\u003eAustralian Journal of Learning Difficulties\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(1), 49\u0026ndash;56. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/19404158.2017.1322994\u003c/span\u003e\u003cspan address=\"10.1080/19404158.2017.1322994\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Interprofessional collaboration, early childhood education and care (ECEC), primary education, split system","lastPublishedDoi":"10.21203/rs.3.rs-7969185/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7969185/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIntegrating services within early childhood education and care (ECEC) is recommended to address inequalities and to promote inclusive education. Nevertheless, interprofessional collaboration is challenging, particularly in split systems like the Netherlands with little alignment between childcare, school and care. In this study, we analyzed survey data from a national sample of 626 professionals from 46 Dutch centers to investigate whether the level of service integration at organizational level was related to professionals\u0026rsquo; attitudes towards interprofessional collaboration (IPC), self-efficacy and perceived team effectiveness regarding IPC. Results showed that a higher level of service integration at the organizational level was positively associated with professionals\u0026rsquo; reflection on process and perceived team effectiveness at the individual level. Our findings support the hypothesis that the organizational context is associated with professionals' interprofessional beliefs. Furthermore, senior professionals had a stronger sense of interdependence and belonging, were more positive about involvement in newly developed activities and experienced a greater sense of self-efficacy, compared to their junior colleagues.\u003c/p\u003e","manuscriptTitle":"Connecting Professionals and their Centers: Level of Service Integration at Organizational Level is Associated with Professionals’ Individual Experiences with Interprofessional Collaboration","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-13 05:53:59","doi":"10.21203/rs.3.rs-7969185/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c27e7fd1-3c01-4746-8dd5-addb3a33f2dd","owner":[],"postedDate":"November 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-13T05:53:59+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-13 05:53:59","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7969185","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7969185","identity":"rs-7969185","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}