Overcoming translational barriers in nose-to-brain drug delivery for clinical applications

Abstract

<p>Social service nonprofits (SSNs) are often subject to institutional pressures to gain legitimacy and credibility from the government. While previous research has explored nonprofits' strategic responses and the factors that shape organizational behaviors in response to government regulations, little is known about how SSNs strategize to respond in non-Western contexts where civil society is comparatively restricted. Drawing on 21 in-depth interviews with nonprofit managers in Shanghai, China, we examined the strategic responses employed by SSNs to manage and navigate the government-sponsored accreditation system, an evaluation process that rates nonprofits' performance from 1A to 5A. Findings identify three strategic responses: <em>pursuing, compromising,</em> and <em>avoiding</em>, shaped by organizational (evaluation capacity, political connections) and field-level (isomorphic sector development, enforcement barriers) factors. These findings suggest that SSNs balance compliance and autonomy by building internal capacity and establishing political ties to secure legitimacy, while mitigating the costs of state-imposed evaluation. This study offers new insights into nonprofit strategic management in restrictive institutional environments.<br></p>