Improving health across sectors: Best practices for the implementation of health in all policies approaches

Rachael Cain; Jacey A Greece; Sandro Galea; Erin K Knight; Allison Manco; Amar Parikh; David K Jones

doi:10.1016/j.pmedr.2022.101961

Improving health across sectors: Best practices for the implementation of health in all policies approaches

Prev Med Rep. 2022 Aug 31:29:101961. doi: 10.1016/j.pmedr.2022.101961. eCollection 2022 Oct.

Authors

Rachael Cain¹, Jacey A Greece², Sandro Galea³, Erin K Knight⁴, Allison Manco⁵, Amar Parikh⁵, David K Jones⁶

Affiliations

¹ Boston University School of Public Health, 715 Albany St, Boston, MA, USA.
² Clinical Associate Professor of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
³ Dean of the Boston University School of Public Health, Robert A. Knox Professor, Professor of Family Medicine, Boston University, School of Medicine, Boston, MA, USA.
⁴ Assistant Professor of Health, West Chester University of Pennsylvania, West Chester, PA, USA.
⁵ Boston University School of Public Health, Boston, MA, USA.
⁶ Associate Professor of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA.

Abstract

Health is influenced by a broad range of factors beyond the typical remit of public health. It is therefore increasingly recognized that multiple sectors need to be engaged to improve population health. Health in All Policies (HiAP) is an approach to systematically consider health across policies and programs. This study assessed best practices and gaps in HiAP operationalization to inform practitioners aiming to incorporate HiAP in their work. We used Delaware as a model state to examine operationalization factors in a jurisdiction planning to implement HiAP. Methods included document review, key informant interviews, focus groups, and a questionnaire conducted in Delaware and virtually. Thematic analysis was used to analyze qualitative data to provide information on best practices and gaps in existing HiAP programs and context in Delaware. Descriptive statistics were used to examine collaboration in Delaware and to support or refute qualitative findings. We identified two gaps that can hinder HiAP implementation: 1) HiAP practitioners do not adequately use strategic communications to increase buy-in across sectors; 2) practitioners do not fully recognize the importance of being adaptable throughout HiAP implementation, which hinders sustainability. Qualitative findings from Delaware offer insight to these gaps and opportunities to address them. Refining the essential elements of HiAP to add: 1) strategic communications across sectors and 2) flexibility throughout HiAP implementation may point the way to more successful adoption of HiAP approaches across jurisdictions. This research demonstrated the importance of examining local perspectives on HiAP before implementation based on a jurisdiction's context.

Keywords: Communications; Cross-sector; Flexibility; Health in All Policies.