Towards Health in All Policies for Childhood Obesity Prevention

Abstract

The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established.

Local government officials׳ views on intersectoral collaboration within their organization – A qualitative exploration

“…Although quite an extensive range of the literature has explored determinants of ISC [e.g., [5,[11][12][13][14][15][16][17][18][19][20], fewer studies [e.g., [6,[21][22][23][24][25] have documented how ISC is perceived (qualitatively) by officials from different policy sectors (i.e., expertise fields) within local government. Because this type of ISC is critical for making local integrated public health policies [4], the present study aims to answer the following research question: What are the views of public officials on the determinants of intersectoral collaboration (ISC) within local governments during the preparation phase of implementing ISC within their organization?…”

“…The COM-B is part of the Behavior Change Wheel (BCW) [26], which is based on a synthesis of frameworks across a range of areas (e.g., environmental and cultural change, social marketing). Since the transition from intrasectoral to intersectoral collaboration requires the adaptation of working routines and organizational behaviors, and the COM-B system recognizes that behavior change does not occur in a vacuum, but will occur only when COM determinants for ISC are sufficiently present (Figure 1), using the COM-B seemed an appropriate framework for this study [24,26].…”

“…For example, the ability of officials to assess the impact of their own work on PH, their beliefs about their capability to persuade stakeholders to invest in health policies, or the charisma of actors to direct the consensus-building process towards a direction that suits their interests [24,[26][27][28][29].…”

“…Also broader social forces like capitalism or globalization may indirectly shape the policy process. Further, timing, policy free space and fiscal resources are important physical opportunity factors, because decisionmaking moments are often structured, national devolved obligations need to be met and budgets limit how flexible officials can be in choosing their actions [24,[26][27][28][29].…”

“…Automatic motivation can involve work routines like wanting to involve certain colleagues because of personal connection and trust [16]. Reflective motivation can involve choices that are made based on evaluations of past policies, or carefully prepared efforts to push certain policy ideas into formal policies by officials awaiting for a 'window of opportunity' [24,[26][27][28][29][30].…”