Does partnership diversity in intersectoral policymaking matter for health promoting intervention packages’ composition? A multiple-case study in the Netherlands

Abstract

Summary Intersectoral policymaking to improve public health includes integrated health promotion (HP) intervention packages that address a variety of health behavior determinants. The involvement of different partners is assumed to be necessary to implement such integrated packages. We examined how partnership diversity was associated with the composition of intervention packages implemented in Dutch municipalities. In a longitudinal multiple-case study (2012–14), we collected questionnaire data among 31 project leaders and 152 intervention implementers in 31 (alliances of) municipalities. Package composition was assessed in terms of intervention strategies, implementation settings and targeted behavioral determinants. Partnership diversity during the adoption and implementation phases was assessed in terms of the actors and sectors, as well as private partners and citizens involved. The association between partnership diversity and package composition was examined using crosstabs. Almost all packages integrated multiple strategies, but mostly education, facilitation and case finding, in multiple, but mostly health and public settings, such as schools. The packages targeted diverse behavioral determinants, although mainly personal and social environmental factors. A variety of partners from multiple sectors was involved, during both adoption and implementation of the packages. However, partners from the health, welfare and education sectors were mostly involved. More partnership diversity, especially during implementation, was associated with more integrated intervention packages. In intersectoral policymaking, investment in diversely composed partnerships seems worthwhile for implementing integrated intervention packages. However, investments in other conditions, like framing health issues and network management, are also needed to make environmental determinants of health behavior the object of HP.

Intersectoral Partnerships Between Local Governments and Health Organisations in High-Income Contexts: A Scoping Review

“… 23 , 45 , 49 Specific communication strategies included holding smaller sub-group meetings which created safer spaces to talk, 47 and encouraging constructive criticism 49 or open debate on issues. 50 Other partnership qualities that facilitated successful cooperation included having a shared vision or message, 23 , 49 enthusiasm, 43 respect, 47 being flexible 16 , 40 , 43 , 47 , 48 or interdisciplinary in approach, 30 , 40 and focusing on improving vertical collaboration. 16 , 35 Such qualities were materialized through collaboratively developed partnership goals, 16 , 26 action plans 23 , 40 , 50 or agendas 45 , 49 , 50 which assisted in negotiating, planning and executing ongoing activities and evaluation.…”

“… 24 , 26 Pooled budgets 25 , 37 , 50 funding of joint positions, and shared human resources were key to driving partnership goals and implementation plans forward, 24 including managerial investments to maintain collaborative work. 30 Sector funding environments creates challenges for intersectoral partnerships, as associated activities may need to be aligned with existing health or government initiatives, creating restrictions on how the partnership functions. 23 From an organisational perspective, aligning partnership goals with the core business of each partner, and identifying areas of overlap may serve as a strategic facilitator.…”

Optimizing the implementation of integrated health promotion packages

“…For the present mixed method study, data were used that were collected as part of a larger longitudinal study (2011)(2012)(2013)(2014). Details about the data collection procedures are reported elsewhere (Grêaux et al, 2020). Data collection took place among the…”

“…In the present study, we aimed to explore the role of the DRS as a possible tool to support EBP in the context of the Gezonde Slagkracht program (Decisive Action for Health program; 2009-2015), which was a program of the Dutch Ministry of Health, Welfare and Sport (Grêaux et al, 2020;ZonMw, 2009). Municipalities or alliances of municipalities (referred to below as projects) could apply for participation in the program.…”

“…The project leader had to take a coordinating role in the establishment of local partnerships involving partners from health and non-health sectors, including private partners and citizens. In most cases, the local partnerships took the adoption decisions about the interventions to be implemented, and subsequently one project partner took the main responsibility for the implementation of a specific intervention (referred to below as the prime implementer), often supported by one or more other partners (referred to below as co-implementers) (Grêaux et al, 2020;ZonMW, 2009).…”